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Sample records for cancer disappointing results

  1. Disappointment Cycles

    OpenAIRE

    David Dillenberger; Kareen Rozen

    2010-01-01

    We propose a model of history dependent disappointment aversion (HDDA), allowing the attitude of a decision-maker (DM) towards disappointment at each stage of a T-stage lottery to evolve as a function of his history of disappointments and elations in prior stages. We establish an equivalence between the existence of an HDDA representation and two documented cognitive biases. First, the DM overreacts to news: after suffering a disappointment, the DM lowers his threshold for elation and becomes...

  2. What do we talk about when we talk about disappointment? Distinguishing outcome-related disappointment from person-related disappointment

    OpenAIRE

    van Dijk, W.W.; Zeelenberg, M.

    2002-01-01

    Empirical research on the emotion disappointment has focused uniquely on disappointments produced by outcomes that are worse than expectations. Introspection suggests that in many cases persons instead of outcomes cause the disappointment. In the present study we therefore argue that the emotion word ''disappointment'' refers to two different emotional experiences, namely, outcome-related disappointment and person-related disappointment. Results from an empirical study support this distinctio...

  3. Introducing Disappointment Dynamics and Comparing Behaviors in Evolutionary Games: Some Simulation Results

    Directory of Open Access Journals (Sweden)

    Tassos Patokos

    2014-01-01

    Full Text Available The paper presents an evolutionary model, based on the assumption that agents may revise their current strategies if they previously failed to attain the maximum level of potential payoffs. We offer three versions of this reflexive mechanism, each one of which describes a distinct type: spontaneous agents, rigid players, and ‘satisficers’. We use simulations to examine the performance of these types. Agents who change their strategies relatively easily tend to perform better in coordination games, but antagonistic games generally lead to more favorable outcomes if the individuals only change their strategies when disappointment from previous rounds surpasses some predefined threshold.

  4. Neoadjuvant Therapy in Patients with Pancreatic Cancer: A Disappointing Therapeutic Approach?

    International Nuclear Information System (INIS)

    Pancreatic cancer is a devastating disease. It is the fourth leading cause of cancer-related death in Germany. The incidence in 2003/2004 was 16 cases per 100.000 inhabitants. Of all carcinomas, pancreatic cancer has the highest mortality rate, with one- and five-year survival rates of 25% and less than 5%, respectively, regardless of the stage at diagnosis. These low survival rates demonstrate the poor prognosis of this carcinoma. Previous therapeutic approaches including surgical resection combined with adjuvant therapy or palliative chemoradiation have not achieved satisfactory results with respect to overall survival. Therefore, it is necessary to evaluate new therapeutic approaches. Neoadjuvant therapy is an interesting therapeutic option for patients with pancreatic cancer. For selected patients with borderline or unresectable disease, neoadjuvant therapy offers the potential for tumor downstaging, increasing the probability of a margin-negative resection and decreasing the occurrence of lymph node metastasis. Currently, there is no universally accepted approach for treating patients with pancreatic cancer in the neoadjuvant setting. In this review, the most common neoadjuvant strategies will be described, compared and discussed

  5. The Regret/Disappointment Scale

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    Francesco Marcatto

    2008-01-01

    Full Text Available The present article investigates the effectiveness of methods traditionally used to distinguish between the emotions of regret and disappointment and presents a new method --- the Regret and Disappointment Scale (RDS --- for assessing the two emotions in decision making research. The validity of the RDS was tested in three studies. Study 1 used two scenarios, one prototypical of regret and the other of disappointment, to test and compare traditional methods (``How much regret do you feel'' and ``How much disappointment do you feel'' with the RDS. Results showed that only the RDS clearly differentiated between the constructs of regret and disappointment. Study 2 confirmed the validity of the RDS in a real-life scenario, in which both feelings of regret and disappointment could be experienced. Study 2 also demonstrated that the RDS can discriminate between regret and disappointment with results similar to those obtained by using a context-specific scale. Study 3 showed the advantages of the RDS over the traditional methods in gambling situations commonly used in decision making research, and provided evidence for the convergent validity of the RDS.

  6. Chemoprevention of Lung Cancer: Prospects and Disappointments in Human Clinical Trials

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    William N. Rom

    2013-01-01

    Full Text Available Decreasing the risk of lung cancer, or preventing its development in high-risk individuals, would have a huge impact on public health. The most effective means to decrease lung cancer incidence is to eliminate exposure to carcinogens. However, with recent advances in the understanding of pulmonary carcinogenesis and the identification of intermediate biomarkers, the prospects for the field of chemoprevention research have improved dramatically. Here we review the most recent research in lung cancer chemoprevention—focusing on those agents that have been investigated in human clinical trials. These agents fall into three major categories. First, oxidative stress plays an important role in pulmonary carcinogenesis; and therefore, antioxidants (including vitamins, selenium, green tea extracts, and isothiocyanates may be particularly effective in preventing the development of lung cancer. Second, inflammation is increasingly accepted as a crucial factor in carcinogenesis, and many investigators have focused on anti-inflammatory agents, such as glucocorticoids, NSAIDs, statins, and PPARγ agonists. Finally, the PI3K/AKT/mTOR pathway is recognized to play a central role in tobacco-induced carcinogenesis, and inhibitors of this pathway, including myoinositol and metformin, are promising agents for lung cancer prevention. Successful chemoprevention will likely require targeting of multiple pathways to carcinogenesis—both to minimize toxicity and maximize efficacy.

  7. The Organisation of Disappointment

    OpenAIRE

    Clancy, Annette

    2012-01-01

    The aim of this study is to explore the emotion of disappointment in organisations and to develop a new line of theorising inspired by psychodynamic theory. The current literature casts disappointment as a negative emotion undermining morale, depressing expectations and justifying inaction and inertia. This only captures part of the complexity of disappointment and leaves unexplored both its impact on the organisation and its potential creativity. The study presents a theoretical framework de...

  8. Volatility, Investment and Disappointment Aversion

    OpenAIRE

    Joshua Aizenman; Nancy Marion

    1995-01-01

    This study uncovers a statistically significant negative correlation between volatility and private investment over the 1970-93 period in a set of almost fifty developing countries and provides a possible interpretation of this result by using the disappointment- aversion expected utility framework first described by Gul (1991). We consider a number of different volatility measures related to domestic policies or to external factors. As the various volatility measures tend to be positively co...

  9. The impact of disappointment in decision making: Inter-individual differences and electrical neuroimaging

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    Helène eTzieropoulos

    2011-01-01

    Full Text Available Disappointment, the emotion experienced when faced to reward prediction errors, considerably impact decision making. Individuals tend to modify their behavior in an often unpredictable way just to avoid experiencing negative emotions. Despite its importance, disappointment remains much less studied than regret and its impact on upcoming decisions largely unexplored. Here, we adapted the Trust Game to effectively elicit, quantify and isolate disappointment by relying on the formal definition provided by Bell’s in economics. We evaluated the effects of experienced disappointment and elation on future cooperation and trust as well as the rationality and utility of the different behavioral and neural mechanisms used to cope with disappointment. All participants in our game trusted less and particularly expected less from unknown opponents as a result of disappointing outcomes in the previous trial but not necessarily after elation indicating that behavioral consequences of positive and negative reward prediction errors are not the same. A large variance in the tolerance to disappointment was observed across subjects, with some participants needing only a small disappointment to impulsively bias their subsequent decisions. As revealed by high-density EEG recordings the most tolerant individuals - who thought twice before making a decision and earned more money – relied on different neural generators to contend with neutral and unexpected outcomes. This study thus provide some support to the idea that different neural systems underlie reflexive and reflective decisions within the same individuals as predicted by the dual-system theory of social judgment and decision making.

  10. What other's disappointment may do to selfish people: Emotion and social value orientation in a negotiation context

    OpenAIRE

    Kleef, van, G.A.; Lange, de, J.

    2008-01-01

    The authors examined whether individual differences in social value orientation moderate responses to other’s expressions of disappointment in negotiation. The literature suggested competing hypotheses: First, prosocials are more responsive to other’s disappointment because they have a greater concern for other; second, proselfs are more responsive because they see other’s disappointment as a threat to their own outcomes. Results of a computer-mediated negotiation in which a simulated opponen...

  11. Abnormal Cervical Cancer Screening Test Results

    Science.gov (United States)

    ... AQ FREQUENTLY ASKED QUESTIONS FAQ187 GYNECOLOGIC PROBLEMS Abnormal Cervical Cancer Screening Test Results • What is cervical cancer screening? • What causes abnormal cervical cancer screening test ...

  12. Robotic Esophagectomy for Cancer: Early Results and Lessons Learned.

    Science.gov (United States)

    Cerfolio, Robert J; Wei, Benjamin; Hawn, Mary T; Minnich, Douglas J

    2016-01-01

    Minimally invasive esophagectomy with intrathoracic dissection and anastomosis is increasingly performed. Our objectives are to report our operative technique, early results and lessons learned. This is a retrospective review of 85 consecutive patients who were scheduled for minimally invasive Ivor Lewis esophagectomy (laparoscopic or robotic abdominal and robotic chest) for esophageal cancer. Between 4/2011 and 3/2015, 85 (74 men, median age: 63) patients underwent robotic Ivor Lewis esophageal resection. In all, 64 patients (75%) had preoperative chemoradiotherapy, 99% had esophageal cancer, and 99% had an R0 resection. There were no abdominal or thoracic conversions for bleeding. There was 1 abdominal conversion for the inability to completely staple the gastric conduit. The mean operative time was 6 hours, median blood loss was 35ml (no intraoperative transfusions), median number of resected lymph nodes was 22, and median length of stay was 8 days. Conduit complications (anastomotic leak or conduit ischemia) occurred in 6 patients. The 30 and 90-day mortality were 3/85 (3.5%) and 9/85 (10.6%), respectively. Initial poor results led to protocol changes via root cause analysis: longer rehabilitation before surgery, liver biopsy in patients with history of suspected cirrhosis, and refinements to conduit preparation and anastomotic technique. Robotic Ivor Lewis esophagectomy for cancer provides an R0 resection with excellent lymph node resection. Our preferred port placement and operative techniques are described. Disappointingly high thoracic conduit problems and 30 and 90-day mortality led to lessons learned and implementation of change which are shared. PMID:27568155

  13. Results of adjuvant chemo radiation after curative surgery for gastric cancer. A retrospective study

    International Nuclear Information System (INIS)

    Background: Survival rates after curative surgery for gastric cancer are disappointing. Therefore adjuvant therapeutic strategies are required. Aim: To analyze survival and side effects of treatment among gastric cancer patients treated with adjuvant chemoradiotherapy after curative resection of gastric adenocarcinoma. Material and methods: Retrospective review of medical records of 74 patients aged 20 to 74 years, treated with complete resection of gastric adenocarcinoma followed by adjuvant chemo radiation. Survival analysis was based on the records and information from the National Mortality Registry. Results: Five years survival fluctuated from 50% among patients in stage 1B to 25% among those is stage IV. Significant acute toxicity was observed in 23 patients (31%). No patients died due to acute toxicity. Eleven patients (16.4%) developed significant late toxicity, with two possible deaths related to treatment. Conclusions: Postoperative chemoradiotherapy is feasible in our experience. Continuos infusion of 5- fluoruracil is recommended to reduce toxicity

  14. Strategic responses to fuel cell hype and disappointment

    NARCIS (Netherlands)

    Konrad, K.E.; Markard, J.; Ruef, A.; Truffer, B.

    2012-01-01

    This article investigates the interplay of expectation dynamics and innovation processes at the level of organizations and at the innovation system level. We examine how different kinds of organizations contributed and responded to a recent hype and disappointment cycle in the field of stationary fu

  15. [Personalized medicine: expectations, disappointments and hopes].

    Science.gov (United States)

    Baranov, V S

    2011-01-01

    Impressive advances in the studies of human genome, identification of mutant genes of hereditary diseases and candidate genes of many chronic multifactorial diseases (MFD) laid the foundation of molecular medicine. Its characteristic features, such as the focus on individual prophylactic care, give reason to consider it as personalized predictive medicine (PPM). The fundamental concept behind PPM comprises the notion of genetic passport and its methodological basis is genetic testing (GT). Recent progress in PPM has been achieved due to the introduction of comprehensive genomic screening of associations. At the same time, the contribution of known individual genes to the development of MFD appears to be relatively insignificant which does not allow to identify the main causes of MFD. It gave rise to some scepsis as regards the value of genome as a source of information for practical medicine. Possibilities for the improvement of GT and conditions for the introduction of the available data into clinical practice are discussed. The necessity to attract clinicians to the work on PPM is emphasized. The development of unified MFD gene panels for clinical application and software for the evaluation and interpretation of GT results for doctors and patients is an indispensable condition for the use of PPM knowledge in the healthcare practice. The importance of solution of relevant ethical, juridical, and social issues is underscored. PMID:22145369

  16. The disappointment of expectations and the theory of fluctuations

    OpenAIRE

    Meacci, Ferdinando

    2010-01-01

    The role of errors in time (Fanno, 1933) or disappointment of expectations (Hicks, 1933) in the theory of fluctuations was a major object of analysis in the years of high theory (Shackle, 1967) when the paradigm of General Equilibrium Theory was replaced by the new paradigm of the Economics of Uncertainty and Expectations. The scope of this paper is to re-evaluate this object of analysis in the light of the evolution of the theory of fluctuations ever since. The paper is divided in two Parts....

  17. Disappointed "Heirs" as a Socio-Legal Phenomenon

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    Daphna Hacker

    2014-04-01

    Full Text Available This paper focuses on the socio-legal characteristics of succession battles, drawn from a large-scale empirical study of contemporary inheritance and probate procedures and conflicts in Israel. The study shows that litigating disappointed "heirs", i.e. people who challenge the division of the estate because their inheritance hopes have been shattered, are an exception to the rule of undisputed probate and administration of estates. Moreover, the findings point to the will as a risk factor which allows disappointed "heirs" to approach the court, while legal disputes in intestate cases are even scarcer. Based on the findings, the paper also offers a typology of the relational triangles – between the deceased, the alleged heirs, and the disappointed "heirs" - which characterize most of the cases studied. This typology is correlated to the finding that most succession conflicts are not among nuclear family members, but among parties who are remote relatives or with no family relation. Finally, the study documents two dominant outcomes of succession battles: out-of-court compromises that do not respect the prima facie deceased's last wishes; and the irreversible destruction of relationships between siblings. The paper ends with a discussion of the sociological question concerning the possible increase or decrease of the phenomenon of disappointed "heirs", and of the legal implications of the study's findings. Este artículo se centra en las características sociojurídicas de las disputas de sucesión, obtenidas a partir de un estudio empírico a gran escala de los procedimientos contemporáneos de herencias y sucesiones y los conflictos en Israel. El estudio demuestra que los “herederos” decepcionados que litigan, es decir, las personas que cuestionan la división de los bienes porque no se han colmado sus expectativas, son una excepción a la regla de las sucesiones y administración de bienes sin disputas. Es más, los resultados apuntan al

  18. Cervical cancer: evaluation of our results

    International Nuclear Information System (INIS)

    Introduction: Cervical cancer in women occupies 3rd place in incidence and 5th as a cause of cancer death in our country. The evolution is mainly determined by the stage, nodal status and histological type. The treatment of these tumors is surgical, radiant and / or systemic, depending on your choice mainly Stadium. Objective: To analyze the characteristics, evolution, treatment and survival of patients carriers of cervical cancer. Patients and Methods: The medical records were retrospectively analyzed for patients with cervical cancer treated at the Department of Oncology the Clinical Hospital in the period 1994-2004. Curves were constructed survival (sv) of total and free enfemedad sv sv by stage and after relapse by the method of Kaplan-Meier. Results: n = 75 patients, median age 45 years (24-90 years). Histological type: Epidermoid carcinomas 93% 5% 2% adenocarcinomas and adenosquamous. stadium (E) Initial: 31% IE, 38% EII, EIII 25%, 6% EIVA. Treatment was according to the stadium, considering that until 1999 was not standard concurrent chemoradiation. The median sv considering all stages was 124 months. The sv to 5 years for EI was 90% (median 188 sv months), for the ISI 65% (95 months) and the median sv CIRTs was 24 months. Followed for 13 months, 12 patients relapsed and the median after sv relapse was 8 months (95% CI 4-13 months) Conclusions: Although cervical cancer is a preventable disease, remains an important cause of morbidity and mortality. Our results are consistent with those reported in the literature, however far from the optimal, so it is necessary to continue clinical trials in this regard

  19. Cancer immunotherapy: the beginning of the end of cancer?

    OpenAIRE

    Farkona, Sofia; Diamandis, Eleftherios P.; Blasutig, Ivan M

    2016-01-01

    These are exciting times for cancer immunotherapy. After many years of disappointing results, the tide has finally changed and immunotherapy has become a clinically validated treatment for many cancers. Immunotherapeutic strategies include cancer vaccines, oncolytic viruses, adoptive transfer of ex vivo activated T and natural killer cells, and administration of antibodies or recombinant proteins that either costimulate cells or block the so-called immune checkpoint pathways. The recent succe...

  20. Parenting a damaged child: mourning, regression, and disappointment.

    Science.gov (United States)

    Fajardo, B

    1987-01-01

    This paper is an examination of the long-term parenting experiences of parents who have given birth to CNS damaged infants. In particular, the focus is on the mourning, regression, rage, and depression that frequently attend these parents throughout their lives and can become pathological and pathogenic interferences with the provision of good-enough parenting. Several clinical vignettes were presented, each of which illustrated the usefulness of different psychoanalytic clinical theories about normality and pathology of parenting and parent-child interaction. The now-classical contribution of Solnit and Stark (Mourning and the Birth of a Defective Child, 1962) is reviewed along with Benedek's and others' psychoanalytic theories about normal parenting. The thinking of these writers is within the framework of structural/libidinal theory and seems to be useful in describing certain parenting problems that concern the mourning and regressive aspects of parenting. However, it was proposed that some of the adaptive coping and pathology encompassed by Solnit and Stark's explanations is not comfortably illuminated by the structural clinical theory of conflict and drives. Freud's discussion (1917) compares mourning and melancholia, which he differentiated as related but dynamically distinct clinical phenomena. This work is briefly recalled as an earlier point in theory building where structural theory was not sufficient to explain clinical depression and rage that exceeds normal mourning (as in Freud's melancholia). It is felt that an additional theoretical perspective on parenting provided by self psychology can fill in some of the gaps left by structural theory explanations. The self psychology perspective is particularly helpful with understanding the rage, ambivalence, and chronic depression often experienced by parents of damaged children. According to this perspective, the damaged child is a disappointing selfobject for the parent, and the parent's self organization

  1. Treatment of colorectal cancer - distance results

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    L. Vasile

    2012-01-01

    Full Text Available Significant advances about carcinogenesis and natural history of colorectal cancer (CRC,particularly the establishment of filiations polyp-cancer, are important objectives for a new approach to diagnosis of this disease. Decade 1990-2000 was the decade of CRC detection and prevention, but the decade 2000-2010 is the period of application of new diagnostic and therapeutic concepts. The aim of this study was to highlight the epidemiological,clinical,therapeutic, evolution and prognosis aspects of this cancer at five years after treatment. The research was based on examination of the computerized system of C.E.U.H. of Craiova, observation sheets, operation protocols and anatomic-pathological results, from which we identified from January 2003 until December 2005 a number of 134 patients with CRC investigated, treated and followed completely. At study end (01.07.2010 we noted that 51 of 134 resected patients (38.05% were alive. The median survival time to the entire group of 134 caseswas 44.35 + / -29.94 months. Factors that contribute to a favorable prognosis in CRC are female gender, urban environement origin, ounger than 50 years, the absence of disease or complications associated with neoplasia, colic locations, elective surgery, vegetant and papillary forms, G1 and G2 grading and the disease diagnosed in TMN stages I and II.

  2. Hepatic toxicity resulting from cancer treatment

    International Nuclear Information System (INIS)

    Radiation-induced liver disease (RILD), often called radiation hepatitis, is a syndrome characterized by the development of anicteric ascites approximately 2 weeks to 4 months after hepatic irradiation. There has been a renewed interest in hepatic irradiation because of two significant advances in cancer treatment: three dimensional radiation therapy treatment planning and bone marrow transplantation using total body irradiation. RILD resulting from liver radiation can usually be distinguished clinically from that resulting from the preparative regime associated with bone marrow transplantation. However, both syndromes demonstrate the same pathological lesion: veno-occlusive disease. Recent evidence suggests that elevated transforming growth factor β levels may play a role in the development of veno-occlusive disease. Three dimensional treatment planning offers the potential to determine the radiation dose and volume dependence of RILD, permitting the safe delivery of high doses of radiation to parts of the liver. The chief therapy for RILD is diuretics, although some advocate steroids for severe cases. The characteristics of RILD permit the development of a grading system modeled after the NCI Acute Common Toxicity Criteria, which incorporates standard criteria of hepatic dysfunction

  3. Radiation biology: a century of hopes and disappointments

    International Nuclear Information System (INIS)

    In the history of science, radiation biology will rank perhaps as the most popular subject to have attracted researchers from many disciplines of basic as well as applied sciences. Apart from the excitement arising in clinics relating to radiation treatment of cancers the tragedies in Hiroshima and Nagasaki brought numerous scientists together to investigate the harmful biological effects of ionizing radiation. It is then radiation biology picked up a great momentum. It started developing in two different directions what may be called basic radiation biology and radiation biology applied to radiotherapy of cancer. While great strides were being made in basic radiation biology trying to understand the biological effects of radiation and mechanisms thereof, clinical aspect remained confined mainly to the medical fraternity where empiricalism became the rule

  4. Treatment results in males with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pakisch, B. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria); Stoeger, H. [Dept. of Clinical Oncology, Karl Franzens Univ. of Graz (Austria); Poschauko, H. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria); Samonigg, H. [Dept. of Clinical Oncology, Karl Franzens Univ. of Graz (Austria); Bauernhofer, T. [Dept. of Clinical Oncology, Karl Franzens Univ. of Graz (Austria); Pojer, E. [Dept. of Clinical Oncology, Karl Franzens Univ. of Graz (Austria); Leitner, H. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria); Stuecklschweiger, G. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria); Peichl, K.H. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria); Quehenberger, F. [Dept. of Statistics and Documentation, Karl Franzens Univ. of Graz (Austria); Hackl, A. [Dept. of Radiotherapy, Karl Franzens Univ. of Graz (Austria)

    1995-08-01

    Because cancer of the male breast is rare knowledge about its biology and behavior is essentially due to a compilation of pooled experiences. Hence, a continued report of cases appears to be important. Therefore a retrospective review of patients suffering from male breast cancer was carried out. Twenty-four evaluable cases were analyzed. Eight patients (1 patient with bilateral Stage I carcinoma was included) were in Stage I, 7 in Stage II, 2 in Stage IIIa, 4 in Stage IIIb, and 3 in Stage IV. Of 23 patients who were treated with mastectomy, 22 had modified radical mastectomy and postoperative irradiation to the chest wall as well as to the peripheral lymphatic areas in most cases. One patient underwent radical mastectomy. Another patient had an excision biopsy only, followed by irradiation. One of 24 patients received tamoxifen; another received cyclophosphamide, methotrexate, 5-fluorouracil, prednisone (CMF) regimen in an adjuvant setting. Local recurrence developed in one of 23 (4%) patients treated with mastectomy and radiation therapy to the chest wall and peripheral lymphatics. Four (17%) patients developed distant metastases. The 5-year overall survival (Kaplan-Maier) was 90% for the entire group, 100% for patients in Stage I-III disease, and 60% in Stage IV disease (P = < 0.005). As observed in former reports the stage of disease at initial presentation seems to be a parameter that significantly contributes to survival in male breast cancer patients. To what extent improved local control by adequate local therapy, such as surgery and postoperative radiotherapy, may improve overall survival remains to be discussed. (orig.)

  5. Treatment results in males with breast cancer

    International Nuclear Information System (INIS)

    Because cancer of the male breast is rare knowledge about its biology and behavior is essentially due to a compilation of pooled experiences. Hence, a continued report of cases appears to be important. Therefore a retrospective review of patients suffering from male breast cancer was carried out. Twenty-four evaluable cases were analyzed. Eight patients (1 patient with bilateral Stage I carcinoma was included) were in Stage I, 7 in Stage II, 2 in Stage IIIa, 4 in Stage IIIb, and 3 in Stage IV. Of 23 patients who were treated with mastectomy, 22 had modified radical mastectomy and postoperative irradiation to the chest wall as well as to the peripheral lymphatic areas in most cases. One patient underwent radical mastectomy. Another patient had an excision biopsy only, followed by irradiation. One of 24 patients received tamoxifen; another received cyclophosphamide, methotrexate, 5-fluorouracil, prednisone (CMF) regimen in an adjuvant setting. Local recurrence developed in one of 23 (4%) patients treated with mastectomy and radiation therapy to the chest wall and peripheral lymphatics. Four (17%) patients developed distant metastases. The 5-year overall survival (Kaplan-Maier) was 90% for the entire group, 100% for patients in Stage I-III disease, and 60% in Stage IV disease (P = < 0.005). As observed in former reports the stage of disease at initial presentation seems to be a parameter that significantly contributes to survival in male breast cancer patients. To what extent improved local control by adequate local therapy, such as surgery and postoperative radiotherapy, may improve overall survival remains to be discussed. (orig.)

  6. Treatment of Breast Cancer Brain Metastases

    OpenAIRE

    Freedman, Rachel A; Anders, Carey K.

    2011-01-01

    Approximately 10% to 15% of women with metastatic breast cancer will develop brain metastases. Treatment options for these women remain limited, particularly at the time of central nervous system (CNS) relapse following completion of initial CNS-directed therapy. Historically, prior studies have broadly examined systemic treatments for breast cancer brain metastases with mixed, but overall disappointing, results. More recently, studies have increasingly selected patients based on breast cance...

  7. THE ENTRANCE TO THE UPPER LEVEL EXAMINATION. ADMISSION OR DISAPPOINTMENT?

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    María del Rosario Bringas-Benavides

    2014-07-01

    Full Text Available The objective of the research was to determine whether the results of EXANI-II of the school year 2012-2013 are in the Licenciatura en Educación Preescolar (LEPe the Benemérito Instituto Normal del Estado (BINE located in the city of Puebla was an effective selection of the 122 new students with the greatest potential for success and identify areas of opportunity in order to implement academic actions such as remedial courses, consulting and mentoring, etc.. The results showed that the lowest in the Selection Examination in the areas of scores were obtained: Verbal Reasoning, Information and Communication Technology and Mathematics; in the Diagnostic Examination: Module Teaching in the areas of Indirect Writing and English. These results are useful to carry out a preliminary diagnosis that enable an approach to academic performance, but are also the basis for decision-making and action by managers.

  8. Imaging screening of breast cancer: primary results in 5307 cases

    International Nuclear Information System (INIS)

    Objective: To discuss the values of three screening methods for the detection of early breast cancer, and to analyze the features of the screening cancer. Methods: The first screening of breast cancer were performed in 5307 women who aged from 20 to 76 years with median age of 49 years. The three screening methods included physical examination with ultrasound and mammography, physical examination with mammography and mammography only. The rate of recall, biopsy, cancer detection of three methods were analyzed and the mammographic findings were reviewed. Chi-square test or Fisher's exact test were used for the statistics. Results: The recall rates were 4.90% (49/1001), 6.90% (166/2407) and 4. 48% (85/1899) in three methods respectively, the biopsy rates were 1.60% (16/1001), 1.04% (25/2407) and 0.63% (12/1899), the cancer detection rates were 0.50% (5/1001), 0.17% (4/2407) and 0 (0/1899). There were statistical differences among the three groups (χ2=12.99,6.264,8.764, P<0.05). Physical examination with ultrasound and mammography had the highest cancer detection rate, ten breast cancers were detected and 8 were early stage breast cancer. Of seven cancers detected by mammography, only two were found by ultrasound. A cluster of calcifications were found in 2 cases, linear calcifications in 2 cases. One case presented as a asymmetric density, one as a asymmetric density with calcifications, one as multiple nodules with a cluster of calcifications. Two breast cancers presented as asymmetric density were missed on mammography and diagnosed correctly after retrospective review. Conclusion: Physical examination with ultrasound and mammography is the best method for breast cancer screening. The breast cancer can be detected by mammography earlier than other methods. (authors)

  9. Parental Expression of Disappointment: Should It Be a Factor in Hoffman's Model of Parental Discipline?

    Science.gov (United States)

    Patrick, Renee B.; Gibbs, John C.

    2007-01-01

    The authors addressed whether parental expression of disappointment should be included as a distinct factor in M. L. Hoffman's (2000) well-established typology of parenting styles (induction, love withdrawal, power assertion). Hoffman's 3-factor model, along with a more inclusive 4-factor model (induction, love withdrawal, power assertion, and…

  10. Results and analysis of screening for breast cancer

    International Nuclear Information System (INIS)

    Breast cancer is the most frequent cause of death in most countries of the world. Screening of asymptomatic women can detect a large percentage of cancers at an early stage. This is the basis for a possible cure or at least a prolongation of the survival time. The percentage of minimal cancers (smaller than 1 cm without dissemination) may be as high as 48% depending on the screening modality (10% without screening), axillary lymph node involvement can be reduced to 20% (40% without screening), and the percentage of stage II to IV cancers can be reduced to 8-20% (60% without screening). Mortality in the study group over age 50 years was reduced by 30%. Disadvantages of screening are: high cost; biopsies prompted by false positive results; psychological stress for the patients; radiation hazards which have, however, become almost negligible thanks to improved technique (2 cancers in 1 million mammographies and year). (Author)

  11. Is prostate cancer screening responsible for the negative results of prostate cancer treatment trials?

    Science.gov (United States)

    Prasad, Vinay

    2016-08-01

    Clinical guidelines continue to move away from routine prostate specific antigen screening (PSA), once a widespread medical practice. A curious difference exists between early prostate cancer and early breast cancer. While randomized trials of therapy in early breast cancer continue to show overall survival benefit, this is not the case in prostate cancer, where prostatectomy was no better than observation in a recent trial, and where early androgen deprivation is no better than late androgen deprivation. Here, I make the case that prostate cancer screening contributes so greatly to over diagnosis that even treatment trials yield null results due to contamination with non-life threatening disease. PMID:27372859

  12. Cancer Incidence in Egypt: Results of the National Population-Based Cancer Registry Program

    OpenAIRE

    Amal S. Ibrahim; Khaled, Hussein M.; Nabiel NH Mikhail; Hoda Baraka; Hossam Kamel

    2014-01-01

    Background. This paper aims to present cancer incidence rates at national and regional level of Egypt, based upon results of National Cancer Registry Program (NCRP). Methods. NCRP stratified Egypt into 3 geographical strata: lower, middle, and upper. One governorate represented each region. Abstractors collected data from medical records of cancer centers, national tertiary care institutions, Health Insurance Organization, Government-Subsidized Treatment Program, and death records. Data ...

  13. Thyroid cancer development in Chernobyl including new additional results

    International Nuclear Information System (INIS)

    Full text: We have been studying the etiology of thyroid cancer development among the exposed people in Hiroshima. In 1993, we have proposed the hypothesis of oncology model of thyroid cancer development in children following the nuclear power plant accident in Chernobyl, and then related studies has been done in Chernobyl and also in Hiroshima. Following findings are included. Urinary iodine level was lower in Chernobyl than in Hiroshima. Stimulation of ret oncogene in thyroid cancer tissues, and appearance of nuclear abnormalities of thyroid follicular cells were found higher rate among the exposed people. Sensitivity of TSH-receptor in thyroid tissues (TSH-R mRNA expression) was higher while young. Synergistic effect of TSH-R mRNA and ER mRNA expressions were found in both of normal tissues and cancer tissues in thyroid, but it was more apparent in cancer tissues. These findings gave the additional proofs on the hypothesis of thyroid cancer development in Chernobyl. Including these results, we like to present the importance of thyroid for the health of the exposed people in Chernobyl

  14. Treatment results of floor of mouth cancer with definitive radiotherapy

    International Nuclear Information System (INIS)

    The purpose of this study was to report treatment results of floor of mouth cancer with definitive radiotherapy. Sixty-five patients with newly diagnosed floor of mouth cancer received definitive (chemo-) radiotherapy at the department of Radiation Oncology at Aichi Cancer Center. Thirty-five patients were treated with only external irradiation, 28 patients with the combination of external irradiation and brachytherapy, and 2 patients with only brachytherapy. Twenty-nine patients received chemotherapy. Systemic chemotherapy was done for 22 patients with advanced disease (both locally-advanced and neck lymph node metastases), and intra-arterial chemotherapy for 7 patients with locally advanced disease. Five-year overall survival rate (OS) was 59% and 5-year progression free survival rate was 49%. Five-year OS for stage I+II was 69% and that for stage III+IV was 51%. We found 23 recurrences, which were divided into 10 in floor of mouth, 7 in neck lymph nodes, 2 in both, and 4 in distant areas. Late complications were found in 30 patients. Thirteen patients had developed mandibular osteomyelitis, 7 of which required surgical intervention. Soft tissue necrosis was found in 12 patients, and only one received surgery. Double cancers were found in 25 patients. There were 7 oral cancers and 6 esophageal cancers. (author)

  15. Environmental scan of anal cancer screening practices: worldwide survey results

    International Nuclear Information System (INIS)

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening

  16. Environmental scan of anal cancer screening practices: worldwide survey results.

    Science.gov (United States)

    Patel, Jigisha; Salit, Irving E; Berry, Michael J; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-08-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey via email and/or fax. Information was collected on populations screened, services and treatments offered, and personnel. Over 300 invitations were sent; 82 providers from 80 clinics around the world completed the survey. Fourteen clinics have each examined more than 1000 patients. Over a third of clinics do not restrict access to screening; in the rest, eligibility is most commonly based on HIV status and abnormal anal cytology results. Fifty-three percent of clinics require abnormal anal cytology prior to performing high-resolution anoscopy (HRA) in asymptomatic patients. Almost all clinics offer both anal cytology and HRA. Internal high-grade anal intraepithelial neoplasia (AIN) is most often treated with infrared coagulation (61%), whereas external high-grade AIN is most commonly treated with imiquimod (49%). Most procedures are performed by physicians, followed by nurse practitioners. Our study is the first description of global anal cancer screening practices. Our findings may be used to inform practice and health policy in jurisdictions considering anal cancer screening. PMID:24740973

  17. Finasteride concentrations and prostate cancer risk: results from the Prostate Cancer Prevention Trial.

    Directory of Open Access Journals (Sweden)

    Cindy H Chau

    Full Text Available In the Prostate Cancer Prevention Trial (PCPT, finasteride reduced the risk of prostate cancer by 25%, even though high-grade prostate cancer was more common in the finasteride group. However, it remains to be determined whether finasteride concentrations may affect prostate cancer risk. In this study, we examined the association between serum finasteride concentrations and the risk of prostate cancer in the treatment arm of the PCPT and determined factors involved in modifying drug concentrations.Data for this nested case-control study are from the PCPT. Cases were drawn from men with biopsy-proven prostate cancer and matched controls. Finasteride concentrations were measured using a liquid chromatography-mass spectrometry validated assay. The association of serum finasteride concentrations with prostate cancer risk was determined by logistic regression. We also examine whether polymorphisms in the enzyme target and metabolism genes of finasteride are related to drug concentrations using linear regression.Among men with detectable finasteride concentrations, there was no association between finasteride concentrations and prostate cancer risk, low-grade or high-grade, when finasteride concentration was analyzed as a continuous variable or categorized by cutoff points. Since there was no concentration-dependent effect on prostate cancer, any exposure to finasteride intake may reduce prostate cancer risk. Of the twenty-seven SNPs assessed in the enzyme target and metabolism pathway, five SNPs in two genes, CYP3A4 (rs2242480; rs4646437; rs4986910, and CYP3A5 (rs15524; rs776746 were significantly associated with modifying finasteride concentrations. These results suggest that finasteride exposure may reduce prostate cancer risk and finasteride concentrations are affected by genetic variations in genes responsible for altering its metabolism pathway.ClinicalTrials.gov NCT00288106.

  18. Disappointing poverty trends : is the social investment state to blame? An exercise in soul-searching for policy-makers

    OpenAIRE

    Frank Vandenbroucke; Koen Vleminckx

    2011-01-01

    Should we explain the disappointing outcomes of the Open Method of Co-ordination on Inclusion by methodological weaknesses or by substantive contradictions in the “social investment” paradigm? To clarify the underlying concepts, we first revisit the original “Lisbon inspiration”, and subsequently relate it to the idea of the “new welfare state”, as proposed in the literature on new risks in post-industrial societies. We then discuss two explanations for disappointing poverty trends, suggested...

  19. Results of combination treatment for triple-negative breast cancer

    OpenAIRE

    M. A. Sekundova; V.I. Borisov; A. M. Sdvizhkov

    2014-01-01

    The authors give the results of treatment in 128 patients with operable triple-negative breast cancer (BC). All the patients underwent surgical intervention, the volume of which depended on the stage of the disease. The efficiency of adjuvant and neoadjuvant chemotherapy, as well as pre- and postoperative radiotherapy was evaluated. The side effects of different treatment options were analyzed. Five-year relapse-free and overall survival rates were traced in this patient group. It is conclude...

  20. DICOM Structured Reporting and Cancer Clinical Trials Results

    Directory of Open Access Journals (Sweden)

    David A. Clunie

    2007-01-01

    Full Text Available The use of biomarkers derived from radiological images as surrogate end-points in therapeutic cancer clinical trials is well established. DICOM is the ubiquitous standard for the interchange of images for both clinical use as well as research. It also has capabilities for the exchange of image-related information, including categorical and quantitative information derived from images. The use of DICOM Structured Reporting for the encoding and interchange of clinical trial results in a standard manner is reviewed.

  1. DICOM Structured Reporting and Cancer Clinical Trials Results

    OpenAIRE

    David A. Clunie

    2007-01-01

    The use of biomarkers derived from radiological images as surrogate end-points in therapeutic cancer clinical trials is well established. DICOM is the ubiquitous standard for the interchange of images for both clinical use as well as research. It also has capabilities for the exchange of image-related information, including categorical and quantitative information derived from images. The use of DICOM Structured Reporting for the encoding and interchange of clinical trial results in a standar...

  2. Results of lung cancer screening in atomic bomb survivors

    International Nuclear Information System (INIS)

    Risk of lung cancer in A-bomb survivors is reportedly increased. The screening in the title has been conducted since 1988 and this report summarizes its results of the latest 6-year term (2004-2009). The total number of subjects who visited authors' facility for the screening in the period was 39,147 men (average age 70.6 y) and 45,351 women (71.8 y), of the age range of 60-89 y. The screening results of the cancer were examined concerning with sex, age and exposure situation. As well, the relationship between the found cancer incidence and exposure in never, formerly and currently smoking subjects were also examined. Exposure situation was divided in 3 groups of the exposure by entrance in the city/by other reasons, within 2 km close (Close, C) to, and out of 2.1 km afar (Distant, D) from, the city. Statistic analysis was performed by Chi-squire and/or Fisher's exact test. The index of positive finding in the screening of the lung cancer per 1,000 subjects was the highest in C men of ages 70s, 2.88 subjects, which was statistically significant from 0.85 in D men of the same generation. In current smokers, the index 5.40 in C men of ages 70s was significantly higher than 0.90 in D men of the same generation. Overall, positive results tended to be high in survivors of C regardless to sex and smoking, and was significantly high in current smokers of C as above, both implying the particular necessity of promotion to stop smoking in survivors. (T.T.)

  3. Brain metastases from esophageal cancers. Clinical features and treatment results

    International Nuclear Information System (INIS)

    Metastatic brain tumors from esophageal cancer are relatively rare. We analyzed the clinical features and results of treatment in 14 cases of brain metastases from esophageal carcinoma. The average time to diagnosis of brain metastases in the 11 patients with metachronous lesions was 13 months. The average age of patients at the diagnosis of brain metastasis was 65 years. Most patients had T4 or N1 disease at the time of diagnosis of esophageal cancer. Performance status of grade 3 was most frequent at the time of diagnosis of brain metastasis. Treatment for brain metastases was surgery followed by radiation in five cases, radiotherapy alone in seven cases, and conservative treatment in two cases. The median survival time of all patients from the treatment of brain metastases was 2 months, with only one patient alive after more than one year. Improvement in neurological symptoms was demonstrated in 42% of cases. These extremely poor treatment results reflect the fact that most patients at the time of diagnosis of brain metastasis had poor performance status and the presence of extracerebral metastases. Therefore, a short-course, high-dose-per-fraction treatment for brain metastases from esophageal cancer should be selected from the viewpoint of quality of life. (author)

  4. Latest Results for Anti-Angiogenic Drugs in Cancer Treatment

    DEFF Research Database (Denmark)

    Frandsen, Sofie; Kopp, Sascha; Wehland, Markus;

    2016-01-01

    and gastrointestinal cancers. Furthermore, there will be a discussion of unsolved problems, such as lack of biomarkers, drug resistance, and adverse events, for which a solution is necessary in order to improve the benefit of anti-angiogenic drugs in the future. RESULTS: Anti-angiogenic therapy is extensively used...... in the treatment of cancer. There is evidence that drug-induced hypertension serves as a biomarker for a good response to therapy. Currently several possible anti-angiogenic biomarkers are under discussion. Further examples are changes in VEGF or interleukin [IL]-8 polymorphisms, changed plasma levels of VEGF......, or tumor microvessel density. To overcome therapy-associated problems, more research for valid biomarkers is necessary. In addition, a strategy to overcome resistance problems and severe adverse events is desirable. CONCLUSIONS: Clinical trials evaluating targeted therapies with specificity for resistance...

  5. [Adjuvant treatment of colon cancer MOSAIC study's main results].

    Science.gov (United States)

    André, Thierry; Tournigand, Christophe; Achille, Emmanuel; Tubiana-Mathieu, Nicole; Lledo, Gérard; Raoul, Yves; Carola, Elisabeth; Flesch, Michel; Muron, Thierry; Boutan-Laroze, Arnaud; Guérin Meyer, Véronique; Boaziz, Catherine; Maigre, Michel; Ganem, Gérard; Mousseau, Mireille; Mounedji-Boudiaf, Lamia; de Gramont, Aimery

    2006-02-01

    Oxaliplatin in combination with 5-fluorouracil/leucovorin (LV5FU) improves the response rate and survival of patients with metastatic colorectal cancer. The objective of the Mosaic study was to evaluate the efficacy of this association in the adjuvant treatment of stage II and III colon cancer. This international study, including 2,246 patients, compared the efficacy of standard treatment with LV5FU2 alone to that of oxaliplatin-LV5FU (Folfox4 regimen) following R0 resection of the primary tumour. Both treatments were administered every two weeks for six months. At 3-year follow-up, the risk of relapse was decreased by 23% in the Folfox4 group (p = 0.002). The protocol was well tolerated, with an identical overall mortality during treatment (0.5%) in both groups. The main specific complication, peripheral sensory neuropathy was reversible in the great majority of cases. A new analysis at 4-year follow-up (median 48.6 months) confirmed the superior efficacy of the Folfox4 regimen compared to the standard treatment, the reduction in relapse risk being 24% (p = 0.0008). On the strength of these results, oxaliplatin was granted a marketing authorization for the indication adjuvant treatment of stage III colon cancer. Based on the data currently available, physicians should consider adjuvant treatment for stage II patients, making each individual decision for treatment on a case-by-case basis. PMID:16483940

  6. The Results of Postoperative Radiation Therapy in the Rectal Cancer

    International Nuclear Information System (INIS)

    Purpose: Despite apparently complete resection of cancer of the rectum, local recurrence rate was high. Radiation therapy has been used either alone or in combination with chemotherapy as an adjunct to surgery to reduce the risk of recurrence. This study was designed to evaluate the prognostic factors, survival rate and local recurrence rate of the rectal cancer who had received postoperative radiation therapy by retrospective analysis. Method: From 1982 to 1990, 63 patients with cancer of the rectum surgically staged as B2 or C disease received postoperative adjuvant radiation therapy after curative resection of tumor for cure. Postoperative radiation therapy was given to the whole pelvis (mean dose: 5040 cGy in 5-6weeks) and perineum was included in irradiated field in case of abdominoperineal resection. Results: Three-year actuarial survival rate was 73.2% overall, 87.7% in stage B2+3 and 62.9% in stage C2+3. Three-year disease-free survival rate was 69.5% overall, 87.7% in stage B2+3 and 56.8% in stage C2+3. Three-year disease-free survival rate in anterior resection was 77.8% and 44.4% in abdominoperineal resection. The local recurrence rate was 15.9% and distant failure rate was 20.6%. Severe late complication was small bowel obstruction in 6 patients and surgery was required in 4 patients (6.3%). The prognostic factors were stage (p=0.0221) and method of surgery(p=0.0414) (anterior resection vs abdominoperineal resection). Conclusion: This study provides evidence supporting the use of postoperative radiation therapy for reducing the local recurrence rate in patients who have had curative resection of rectal cancer with involvement of perirectal fat or regional nodes or both (stage B2 and C)

  7. The Results of Postoperative Radiation Therapy in the Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Ja [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    1994-02-15

    Purpose: Despite apparently complete resection of cancer of the rectum, local recurrence rate was high. Radiation therapy has been used either alone or in combination with chemotherapy as an adjunct to surgery to reduce the risk of recurrence. This study was designed to evaluate the prognostic factors, survival rate and local recurrence rate of the rectal cancer who had received postoperative radiation therapy by retrospective analysis. Method: From 1982 to 1990, 63 patients with cancer of the rectum surgically staged as B2 or C disease received postoperative adjuvant radiation therapy after curative resection of tumor for cure. Postoperative radiation therapy was given to the whole pelvis (mean dose: 5040 cGy in 5-6weeks) and perineum was included in irradiated field in case of abdominoperineal resection. Results: Three-year actuarial survival rate was 73.2% overall, 87.7% in stage B2+3 and 62.9% in stage C2+3. Three-year disease-free survival rate was 69.5% overall, 87.7% in stage B2+3 and 56.8% in stage C2+3. Three-year disease-free survival rate in anterior resection was 77.8% and 44.4% in abdominoperineal resection. The local recurrence rate was 15.9% and distant failure rate was 20.6%. Severe late complication was small bowel obstruction in 6 patients and surgery was required in 4 patients (6.3%). The prognostic factors were stage (p=0.0221) and method of surgery(p=0.0414) (anterior resection vs abdominoperineal resection). Conclusion: This study provides evidence supporting the use of postoperative radiation therapy for reducing the local recurrence rate in patients who have had curative resection of rectal cancer with involvement of perirectal fat or regional nodes or both (stage B2 and C)

  8. Development and characterization of a novel C-terminal inhibitor of Hsp90 in androgen dependent and independent prostate cancer cells

    OpenAIRE

    Eskew Jeffery D; Sadikot Takrima; Morales Pedro; Duren Alicia; Dunwiddie Irene; Swink Megan; Zhang Xiaoying; Hembruff Stacey; Donnelly Alison; Rajewski Roger A; Blagg Brian SJ; Manjarrez Jacob R; Matts Robert L; Holzbeierlein Jeffrey M; Vielhauer George A

    2011-01-01

    Abstract Background The molecular chaperone, heat shock protein 90 (Hsp90) has been shown to be overexpressed in a number of cancers, including prostate cancer, making it an important target for drug discovery. Unfortunately, results with N-terminal inhibitors from initial clinical trials have been disappointing, as toxicity and resistance resulting from induction of the heat shock response (HSR) has led to both scheduling and administration concerns. Therefore, Hsp90 inhibitors that do not i...

  9. Disappointment and adherence among parents of newborns allocated to the control group

    DEFF Research Database (Denmark)

    Meinich Petersen, Sandra; Zoffmann, Vibeke; Kjærgaard, Jesper;

    2014-01-01

    to the control group of a randomized controlled trial, and how it will affect their future engagement in the trial. METHODS: We included parents of newborns randomized to the control arm in the Danish Calmette study at Rigshospitalet in Copenhagen. The Calmette study is a randomized clinical trial investigating...... among parents of newborns who were randomized to the control group, but also a broad expression of understanding and accepting the idea of randomization. The trial staff might use the model of reactions in understanding the parents' disappointment and in this way support their motives for participation......BACKGROUND: When a child participates in a clinical trial, informed consent has to be given by the parents. Parental motives for participation are complex, but the hope of getting a new and better treatment for the child is important. We wondered how parents react when their child is allocated...

  10. Targeting Chromatin-Mediated Transcriptional Control of Gene Expression in Non-Small Cell Lung Cancer Therapy: Preclinical Rationale and Clinical Results.

    Science.gov (United States)

    Pasini, Alice; Delmonte, Angelo; Tesei, Anna; Calistri, Daniele; Giordano, Emanuele

    2015-10-01

    Targeting chromatin-mediated transcriptional control of gene expression is nowadays considered a promising new strategy, transcending conventional anticancer therapy. As a result, molecules acting as DNA demethylating agents or histone deacetylase inhibitors (HDACi) have entered the clinical arena in the last decade. Given the evidence suggesting that epigenetic regulation is significantly involved in lung cancer development and progression, the potential of epigenetically active compounds to modulate gene expression and reprogram cancer cells to a less aggressive phenotype is, at present, a promising strategy. Accordingly, a large number of compounds that interact with the epigenetic machinery of gene expression regulation are now being developed and tested as potential antitumor agents, either alone or in combination with standard therapy. The preclinical rationale and clinical data concerning the pharmacological modulation of chromatin organization in non-small cell lung cancer (NSCLC) is described in this review. Although preclinical data suggest that a pharmacological treatment targeting the epigenetic machinery has relevant activity over the neoplastic phenotype of NSCLC cells, clinical results are disappointing, leading only to short periods of disease stabilization in NSCLC patients. This evidence calls for a significant rethinking of strategies for an effective epigenetic therapy of NSCLC. The synergistic effect of concurrent epigenetic therapies, use at low doses, the priming of current treatments with previous epigenetic drugs, and the selection of clinical trial populations based on epigenetic biomarkers/signatures appear to be the cornerstones of a mature therapeutic strategy aiming to establish new regimens for reprogramming malignant cells and improving the clinical history of affected patients. PMID:26347133

  11. The Results of Intraoperative Radiotherapy for Stomach Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ji Hoon; Kang, Min Kyu; Kim, Myung Se; Kim, Sung Kyu; Yun, Sang Mo; Kim, Sung Hoon [Dept. of Radiation Oncology, Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2010-11-15

    We retrospectively analyzed the long-term results of radical surgery and intraoperative radiation therapy (IORT) in patients with stomach cancer. From 1988 to 1994, 51 patients were treated with curative surgery and IORT. Postoperative external beam radiotherapy (EBRT) was administered to 30 patients, while adjuvant chemotherapy was administered to 35 patients. A dose of 15 Gy was irradiated with a 9 MeV electron beam as the IORT and a median dose of EBRT was 43.2 Gy (range, 7.2 to 45 Gy). The follow-up period ranged from 1-254 months, with a median follow-up period of 64 months. The median age of all the patients was 58 years (range, 30 to 71 years). The distribution of pathologic stage (American Joint Committee on Cancer [AJCC] 2002 tumor-note-metastasis [TNM]) was as follows: 13 stage I (25.5%), 10 stage II (19.6%), 25 stage III (49.0%), and 3 stage IV (5.9%). Distant metastases occurred in 11 patients (10 in the peritoneum and 1 in bone), including one patient with concurrent local recurrence (anastomosis site). The 5-year locoregional control, disease free survival and overall survival rates were 94.7%, 66.5%, and 51.7%, respectively. For the multivariate analysis, age, TNM stage, and EBRT were significant prognostic factors for overall survival, and only TNM stage for disease free survival. We could have achieved a high loco-regional control rate in patients with locally advanced stomach cancer by adding IORT to radical surgery. However, the benefit of IORT on survival remains to be elucidated.

  12. The PLCO Cancer Screening Trial: Background, Goals, Organization, Operations, Results.

    Science.gov (United States)

    Gohagan, John K; Prorok, Philip C; Greenwald, Peter; Kramer, Barnett S

    2015-01-01

    The randomized PLCO trial was designed to answer four primary questions: does screening for these cancers using often promoted tests reduce cancer-specific mortality? Nearly 155,000 men and women were allocated to screening or usual care arms in a 1:1 ratio under a centralized, secure randomization algorithm at ten competitively selected screening centers nationwide. Screened men received PSA blood tests and digital rectal examinations. Screened women received CA125 blood tests and trans-vaginal ultrasound. Both men and women in the screened arm received anterolateral view chest x-ray and 60 cm flexible sigmoidoscopy. Blood specimens were collected at each screening visit and buccal cell DNA was collected once from the usual care participants. Histology slides were collected for cancer cases. Participants completed a baseline questionnaire covering health and risk factors and a dietary questionnaire. Data collected on standardized machine-readable forms were scanned remotely at screening and laboratory sites utilizing PLCO dedicated, NCI provided and configured computer systems for quality checks, archiving, and analysis. Comprehensive quality assurance was implemented over recruitment, consenting, randomization, screening, data management, records keeping, patient-specific screening results reporting, follow-up, and data analysis. Performance and data quality were monitored on-site and remotely by data edits, site visits, and random record audits. Specially trained and certified professionals performed screening procedures and medical record abstracting. An independent committee of medical specialists reviewed and certified case-specific cause of death. Scientific leadership was provided by NCI Project Officers, PLCO principal investigators, external consultants, and an independent data and safety monitoring board. PMID:26238115

  13. The Results of Intraoperative Radiotherapy for Stomach Cancer

    International Nuclear Information System (INIS)

    We retrospectively analyzed the long-term results of radical surgery and intraoperative radiation therapy (IORT) in patients with stomach cancer. From 1988 to 1994, 51 patients were treated with curative surgery and IORT. Postoperative external beam radiotherapy (EBRT) was administered to 30 patients, while adjuvant chemotherapy was administered to 35 patients. A dose of 15 Gy was irradiated with a 9 MeV electron beam as the IORT and a median dose of EBRT was 43.2 Gy (range, 7.2 to 45 Gy). The follow-up period ranged from 1-254 months, with a median follow-up period of 64 months. The median age of all the patients was 58 years (range, 30 to 71 years). The distribution of pathologic stage (American Joint Committee on Cancer [AJCC] 2002 tumor-note-metastasis [TNM]) was as follows: 13 stage I (25.5%), 10 stage II (19.6%), 25 stage III (49.0%), and 3 stage IV (5.9%). Distant metastases occurred in 11 patients (10 in the peritoneum and 1 in bone), including one patient with concurrent local recurrence (anastomosis site). The 5-year locoregional control, disease free survival and overall survival rates were 94.7%, 66.5%, and 51.7%, respectively. For the multivariate analysis, age, TNM stage, and EBRT were significant prognostic factors for overall survival, and only TNM stage for disease free survival. We could have achieved a high loco-regional control rate in patients with locally advanced stomach cancer by adding IORT to radical surgery. However, the benefit of IORT on survival remains to be elucidated.

  14. Breast cancer: results and side effects of radiotherapy after mastectomy

    International Nuclear Information System (INIS)

    The locoregional control is a crucial step in the achievement of a cancer cure. After mastectomy, the locoregional irradiation clearly reduces the chest wall and nodal relapses, especially with initial lesions more than 5 cm or with nodal involvement and/or large lymphatic or vascular emboli. Two recent randomized trials confirmed the benefit of well-adapted locoregional irradiation. In the Danish trial, including pre-menopausal 'high-risk' women treated by mastectomy and chemotherapy (CMF protocol), the radiotherapy reduced the locoregional relapses from 32 to 9% (P< 0.001) and increased the 10-year survival rates from 45 to 54% (P< 0.001). These results are now also confirmed in a postmenopausal group, with an increased 10-year survival rate of 36 to 45% (P< 0.001). In the Canadian trial, locoregional relapse rate decreased from 25 to 13% and 10-year survival rate increased from 56 to 65%. The meta-analysis published in 1995 by the Early Breast Cancer Trialist Collaborative Group (EBCTCG) showed only a modest benefit due to locoregional irradiation in breast cancer. However, when small trials and older trials started before 1970 are excluded due to imperfect methodologies and for inadequate irradiation techniques, the benefit of the 'modern' radiotherapy appears significant in the 7,840 patients selected in this way. Thus, since the locoregional irradiation can avoid some metastatic evolutions developed only after 'local' or 'nodal' relapse, it must be integrated in a multidisciplinary strategy. Nevertheless, this treatment must be safe and this is possible by the use of new techniques, including the definition of anatomical volumes and provisional dosimetry. The most important point concerns the treatment of the internal mammary nodes, especially when previous chemotherapy including anthracycline was performed. The use of a direct field, with at least 40% of the dose delivered by electrons in an alternating scheme, is recommended to ensure very good protection

  15. Low rectal cancer : aspects of surgical techniques and treatment results

    OpenAIRE

    Anderin, Claes

    2012-01-01

    Rectal cancer is the 7th most common form of cancer in Sweden, both for men and women. About one third of all patients diagnosed with rectal cancer have a low tumour (i.e. 0-5 cm from the anal verge). Abdominoperineal excision (APE) is the most common surgical procedure in low rectal cancer, performed in approximately 80% of patients. While oncological outcomes in rectal cancer have improved in recent decades, the outcome after APE has remained poor and local recurrence rates have been report...

  16. Cosmetic results of conservative treatment for early breast cancer

    International Nuclear Information System (INIS)

    This study was performed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients (90%) and lumpectomy or excisional biopsy for 10 patients (8.3%). Forty six patients (38%) received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the stemal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Cosmetic score was excellent or good in 76% (91/120), fair in 19% (23/120) and poor in 5% (6/ 120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (NO versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0,0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without axillary

  17. Cosmetic results of conservative treatment for early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Kyoung; Shin, Seong Soo; Kim, Seong Deok; Ha, Sung Whan; Noh, Dong Young [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2001-03-01

    This study was performed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients (90%) and lumpectomy or excisional biopsy for 10 patients (8.3%). Forty six patients (38%) received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the stemal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Cosmetic score was excellent or good in 76% (91/120), fair in 19% (23/120) and poor in 5% (6/ 120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (NO versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0,0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without

  18. Photodynamic therapy for locally advanced pancreatic cancer: early clinical results

    Science.gov (United States)

    Sandanayake, N. S.; Huggett, M. T.; Bown, S. G.; Pogue, B. W.; Hasan, T.; Pereira, S. P.

    2010-02-01

    Pancreatic adenocarcinoma ranks as the fourth most common cause of cancer death in the USA. Patients usually present late with advanced disease, limiting attempted curative surgery to 10% of cases. Overall prognosis is poor with one-year survival rates of less than 10% with palliative chemotherapy and/or radiotherapy. Given these dismal results, a minimally invasive treatment capable of local destruction of tumor tissue with low morbidity may have a place in the treatment of this disease. In this paper we review the preclinical photodynamic therapy (PDT) studies which have shown that it is possible to achieve a zone of necrosis in normal pancreas and implanted tumour tissue. Side effects of treatment and evidence of a potential survival advantage are discussed. We describe the only published clinical study of pancreatic interstitial PDT, which was carried out by our group (Bown et al Gut 2002), in 16 patients with unresectable locally advanced pancreatic adenocarcinoma. All patients had evidence of tumor necrosis on follow-up imaging, with a median survival from diagnosis of 12.5 months. Finally, we outline a phase I dose-escalation study of verteporfin single fibre PDT followed by standard gemcitabine chemotherapy which our group is currently undertaking in patients with locally advanced pancreatic cancer. Randomized controlled studies are also planned.

  19. Detection of early bronchial cancer by autofluorescence: results in patients with H&N cancer

    Science.gov (United States)

    Gabrecht, Tanja; Radu, Alexandre; Zellweger, Matthieu; Lovisa, Blaise; Goujon, Didier; Grosjean, Pierre; van den Bergh, Hubert; Monnier, Philippe; Wagnières, Georges

    2007-07-01

    Head and neck (H&N) cancer patients have a high incidence of second primary tumours in the tracheobronchial tree. Diagnostic autofluorescence bronchoscopy (DAFE) has shown promising results in the detection of early neoplastic and pre-neoplastic changes in the bronchi. We have investigated the medical impact of DAFE in a population of H&N cancer patients. The bronchoscopies were performed using a modified commercially available DAFE system. Endoscopic imaging of the tissue autofluorescence (AF) was combined with an online image analysis procedure allowing to discriminate between true and false positive results. White light (WL) bronchoscopy was performed as a control. Twenty-one patients with high lung cancer risk factors underwent WL and AF bronchoscopy with this improved system. Forty-one biopsies were taken on macroscopicall suspicious (WL or AF positive) sites. Seven patients were found to have second primary tumours in the bronchi. The sensitivity for the detection of these early lesions with the DAFE was 1.6 times larger than the sensitivity of WL bronchoscopy only. The positive predictive value (PPV) for AF is 79% (33% for WL alone). The PPV of both methods together is 100%. DAFE proved to be efficient for the detection of second primary lesions in H&N cancer patients and can be used as a simple addition to pre-operative work-up or follow-up in this patient population.

  20. Environmental scan of anal cancer screening practices: worldwide survey results

    OpenAIRE

    Patel, Jigisha; Salit, Irving E.; Berry, Michael J.; de Pokomandy, Alexandra; Nathan, Mayura; Fishman, Fred; Palefsky, Joel; Tinmouth, Jill

    2014-01-01

    Anal squamous cell carcinoma is rare in the general population but certain populations, such as persons with HIV, are at increased risk. High-risk populations can be screened for anal cancer using strategies similar to those used for cervical cancer. However, little is known about the use of such screening practices across jurisdictions. Data were collected using an online survey. Health care professionals currently providing anal cancer screening services were invited to complete the survey ...

  1. Obama and the "Arab Spring": Desire, Hope and the Manufacture of Disappointment. Implications for a Transformative Pedagogy

    Science.gov (United States)

    Roberts, Lorna; Schostak, John

    2012-01-01

    For a period, in the run up to the election (2007-2008) and the months after the election, the name "Obama" signified hope for millions, not just in America but across the world. As the hope turned to disappointment, the financial crisis deepened and the Arab Spring renewed a call for a "humanity" that could transcend the differences of nations…

  2. European cervical cancer screening:experiences and results

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Europe has devoted great efforts to cervical cancer screening over 30 years.The mortality was generally declining although incidence rates of cervical cancer among young women have been increasing in many countries of Europe.The efficiency of screening,however,needs to be addressed by planners for an improved cost-effectiveness in the future.

  3. Clinical results of carbon ion radiotherapy for pancreatic cancer and colorectal cancer

    International Nuclear Information System (INIS)

    Gastrointestinal cancer is still difficult to treat even using the particle therapy. However, because of their excellent dose distribution, cancer surrounded by gastrointestinal tract such as pancreatic cancer and local recurrence of colorectal cancer after surgery becomes to be treated by particle beam with curative intent. The usefulness of particle beam is reported in the patients with locally advanced pancreatic cancer and patents who received preoperative irradiation with resectable pancreatic cancer. In addition, the postoperative recurrence of rectal cancer is reported to achieve more than 90 percent of local control by particle beam. (author)

  4. Finasteride Concentrations and Prostate Cancer Risk: Results from the Prostate Cancer Prevention Trial

    OpenAIRE

    Chau, Cindy H.; Price, Douglas K.; Cathee Till; Goodman, Phyllis J.; Xiaohong Chen; Leach, Robin J; Johnson-Pais, Teresa L.; Hsing, Ann W.; Ashraful Hoque; Tangen, Catherine M.; Lisa Chu; Parnes, Howard L.; Schenk, Jeannette M.; Reichardt, Juergen K. V.; Thompson, Ian M

    2015-01-01

    Objective In the Prostate Cancer Prevention Trial (PCPT), finasteride reduced the risk of prostate cancer by 25%, even though high-grade prostate cancer was more common in the finasteride group. However, it remains to be determined whether finasteride concentrations may affect prostate cancer risk. In this study, we examined the association between serum finasteride concentrations and the risk of prostate cancer in the treatment arm of the PCPT and determined factors involved in modifying dru...

  5. Treatment Results and prognostic Factors in Patients with Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Weon Kuu; Kim, Soo Kon; Kim, Min Chul; Jang, Myoung [Presbyterian Medical Center, Chonju (Korea, Republic of); Moon, Sun Rock [Wonkwang Univ., Medical School, Iksan (Korea, Republic of)

    1995-09-15

    Purpose : To analyse clinical outcome and prognostic factors according to treatment modality, this paper report our experience of retrospective study of patients with esophageal cancer. Materials and Methods : One hundred and ten patients with primary esophageal cancer who were treated in Presbyterian Medical Center from May 1985 to December 1992. We analysed these patients retrospectively with median follow up time of 28 months, one hundred and four patients(95%) were followed up from 15 to 69 months. In methods, twenty-eight patients were treated with median radiation dose irradiated 54.3Gy only. Fifty-six patients were treated with combined chemoradiotherapy. Sixteen cases of these patients were treated with concurrent chemoradiation and the other patients(forty cases) were treated sequential chemoradiotherapy. In concurrent chemoradiotherapy group, patients received 5-FU continuous IV infusion for 4 days. Cisplatin IV bolus, and concurrent esophageal irradiation to 30 Gy. After that patients received ?Fu continuous IV, Cisplatin bolus injection and Mitomycin-C bolus IV, Bleomycin continuous IV, and irradiation to 20 Gy. In sequential chemoradiotherapy group, the chemotherapy consisted of 5-FU 1,000 mg/m2 administered as a continuous 24 hour intravenous infusion during five days and Cisplatin 80-100 mg/m2 bolus injected, or Bleomycin, Vinblastine, Cisplatin, Methotrexate were used of 1 or 2 cycles. After preoperative concurrent chemoradiation, twenty-six patients underwent radical esophagectomy. Results ; ninety-three patients could be examined for response assessment. By treatment modality, response rates were 85.1% for radiation alone group and 86.3% for combined chemoradiation group. But in operation group, after one cycle of concurrent chemoradiation treatment, response rate was 61.9%. The pathologic complete response were 15.4% in operation group. Overall median survival was 11 months and actuarial 5-year survival rate was 8%. The median survival interval

  6. Results of Definitive Chemoradiotherapy for Unresectable Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Noh, O Kyu; Je, Hyoung Uk; Kim, Sung Bae [Ulsan University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2008-12-15

    To investigate the treatment outcome and failure patterns after definitive chemoradiation therapy in locally advanced, unresectable esophageal cancer. Materials and Methods: From February 1994 to December 2002, 168 patients with locally advanced unresectable or medically inoperable esophageal cancer were treated by definitive chemoradiation therapy. External beam radiation therapy (EBRT) (42-46 Gy) was delivered to the region encompassing the primary tumor and involved lymph nodes, while the supraclavicular fossa and celiac area were included in the treatment area as a function of disease location. The administered cone-down radiation dose to the gross tumor went up to 54-66 Gy, while the fraction size of the EBRT was 1.8-2.0 Gy/fraction qd or 1.2 Gy/fraction bid. An optional high dose rate (HDR) intraluminal brachytherapy (BT) boost was also administered (Ir-192, 9-12 Gy/3 -4 fx). Two cycles of concurrent FP chemotherapy (5-FU 1,000 mg/m2/day, days 2-6, 30-34, cisplatin 60 mg/m2/day, days 1, 29) were delivered during radiotherapy with the addition of two more cycles. Results: One hundred sixty patients were analyzable for this review [median follow-up time: 10 months (range 1-149 months)]. The number of patients within AJCC stages I, II, III, and IV was 5 (3.1%), 38 (23.8%), 68 (42.5%), and 49 (30.6%), respectively. A HDR intraluminal BT was performed in 26 patients. The 160 patients had a median EBRT radiation dose of 59.4 Gy (range 44.4-66) and a total radiation dose, including BT, of 60 Gy (range 44.4-72), while 144 patients received a dose higher than 40 Gy. Despite the treatment, the disease recurrence rate was 101/160 (63.1%). Of these, the patterns of recurrence were local in 20 patients (12.5%), persistent disease and local progression in 61 (38.1%), distant metastasis in 15 (9.4%), and concomitant local and distant failure in 5 (3.1%). The overall survival rate was 31.8% at 2 years and 14.2% at 5 years (median 11.1 months). Disease-free survival was 29

  7. Serum Phospholipid Fatty Acids and Prostate Cancer Risk: Results From the Prostate Cancer Prevention Trial

    OpenAIRE

    Brasky, Theodore M.; Till, Cathee; White, Emily; Neuhouser, Marian L; Song, Xiaoling; Goodman, Phyllis; Thompson, Ian M; King, Irena B.; Albanes, Demetrius; Kristal, Alan R.

    2011-01-01

    Inflammation may be involved in prostate cancer development and progression. This study examined the associations between inflammation-related phospholipid fatty acids and the 7-year-period prevalence of prostate cancer in a nested case-control analysis of participants, aged 55–84 years, in the Prostate Cancer Prevention Trial during 1994–2003. Cases (n = 1,658) were frequency matched to controls (n = 1,803) on age, treatment, and prostate cancer family history. Phospholipid fatty acids were ...

  8. Results from phase III clinical trials with radachlorine for photodynamic therapy of pre-cancer and early cancer of cervix

    OpenAIRE

    E. V. Filonenko; L. G. Serova; V. I. Ivanova-Radkevich

    2015-01-01

    The results of clinical study for efficacy of photodynamic therapy (PDT) with radachlorine in patients with pre-cancer and cancer of cervix are represented. The study enrolled 30 patients including 4 patients with cervical erosion, 5 patients with cervical intraepithelial neoplasia II, 13 patients with cervical intraepithelial neoplasia III, 4 patients with carcinoma in situ and 4 patients with cervical cancer stage Ia. Radachlorine was administrated as single 30 minute intravenous injection ...

  9. Results of preoperative chemoradiotherapy in low rectal cancer

    International Nuclear Information System (INIS)

    This study explored the anal sphincter-saving rate and down-staging rate after preoperative chemoradiotherapy for treating lower rectal cancer. We also explored the prognosis of the patients who refused surgery after preoperative chemoradiotherapy. Thirty seven patients with histologically proven lower rectal cancer who underwent preoperative chemoradiotherapy were retrospectively analyzed. In each case, the tumor location was 0 to 5 cm from the anal verge, and curative resection of the cancer with performing a sphincter-saving procedure was not feasible before chemoradiotherapy. In each case, the staging examinations, including biopsy, were done before starting radiotherapy and this was repeated at 1 month after radiation therapy. After chemoradiotherapy, among the 37 included patients, 56.8% and 32.4% were down staged to the T stage and N stage, respectively, when comparing the post radiotherapy stage with pre-radiotherapy stage. Twenty five patients underwent complete resection of cancer at 6 weeks after radiotherapy: eleven, eight and six patients underwent abdominoperineal resection, low anterior resection and local excision, respectively. The sphincter-saving rate among the 24 completely resected cases was 54.2%. Twelve patients refused surgery after radiotherapy. Among 6 patients who refused surgery with biopsy-proven complete remission after chemoradiotherapy, 5 patients were alive without disease at a median follow up period of 31 months, and only 1 patient had local failure. For lower rectal cancer, a high sphincter-saving rate was accomplished with preoperative chemoradiotherapy. The prognosis of the patients who refused surgery with biopsy proven complete remission after chemoradiotherapy was good and these patients need to be kept under close surveillance

  10. Floor of mouth cancer: patient selection and treatment results

    Energy Technology Data Exchange (ETDEWEB)

    Marks, J.E.; Lee, F.; Smith, P.G.; Ogura, J.H.

    1983-04-01

    Retrospective review of 126 primarily treated floor of mouth (FOM) cancers was done to study patient selection and to search for more optimum treatment strategies. Small surface lesions were treated by local excision (LE); small lesions invading FOM without lymph nodes were treated by radiation alone (RA), while larger lesions and those with palpable nodes were treated by preoperative irradiation and surgery (R + S). Ultimate control of the FOM cancer and nodes was achieved for 100% of the LE, 71% of the RA, and 75% of the R + S patients. The majority of primary tumor and nodal recurrences developed by 15 months and 35% of the failures were salvaged by additional treatment. Change in treatment strategies are suggested for surface lesions because of a poor rate of initial tumor control (43%), for patients treated by RA because of a high rate of complications (41%), and for patients without palpable lymph nodes who can be successfully treated by elective neck irradiation.

  11. Floor of mouth cancer: patient selection and treatment results

    International Nuclear Information System (INIS)

    Retrospective review of 126 primarily treated floor of mouth (FOM) cancers was done to study patient selection and to search for more optimum treatment strategies. Small surface lesions were treated by local excision (LE); small lesions invading FOM without lymph nodes were treated by radiation alone (RA), while larger lesions and those with palpable nodes were treated by preoperative irradiation and surgery (R + S). Ultimate control of the FOM cancer and nodes was achieved for 100% of the LE, 71% of the RA, and 75% of the R + S patients. The majority of primary tumor and nodal recurrences developed by 15 months and 35% of the failures were salvaged by additional treatment. Change in treatment strategies are suggested for surface lesions because of a poor rate of initial tumor control (43%), for patients treated by RA because of a high rate of complications (41%), and for patients without palpable lymph nodes who can be successfully treated by elective neck irradiation

  12. Late results of chemotherapy of the advanced ovarian cancer

    International Nuclear Information System (INIS)

    Out of 108 patients with advanced ovarian cancer treated by postoperative combined chemotherapy with cisplatin, 13% survived 5 years, 11% with NED and 1.8% with signs of the disease. 67.6% patients responded to treatment in 33.3% of them it was CR and in 34.3% - PR. There was a close relationship between the type of response and survival, as 2 years survived 63.8% patients with CR, 31.4% with PR and only 5.4% of non-responders. Ten out of 36 patients with CR survived 5 years with NED, but out of 4 patients with PR 2 patients survived without symptoms and 2 with signs of the disease. During further follow-up in 4 out of 12 patients who survived 5 years with NED progression of cancer was diagnosed. (author)

  13. Factors influencing cosmetic results after conservation therapy for breast cancer

    International Nuclear Information System (INIS)

    Purpose: Host, tumor, and treatment-related factors influencing cosmetic outcome are analyzed for patients receiving breast conservation treatment. Methods and Materials: Four-hundred and fifty-eight patients with evaluable records for cosmesis evaluation, a subset of 701 patients treated for invasive breast cancer with conservation technique between 1969 and 1990, were prospectively analyzed. In 243 patients, cosmetic evaluation was not adequately recorded. Cosmesis evaluation was carried out from 3.7 months to 22.3 years, median of 4.4 years. By pathologic stage, tumors were 62% T1N0, 14% T1N1, 15% T2N0, and 9% T2N1. The majority of patients were treated with 4-6 MV photons. Cosmetic evaluation was rated by both patient and physician every 4-6 months. A logistic regression analysis was completed using a stepwise logistic regression. P-values of 0.05 or less were considered significant. Excellent cosmetic scores were used in all statistical analyses unless otherwise specified. Results: At most recent follow-up, 87% of patients and 81% of physicians scored their cosmetic outcome as excellent or good. Eighty-two percent of physician and patient evaluations agreed with excellent-good vs. fair-poor rating categories. Analysis demonstrated a lower proportion of excellent cosmetic scores when related to patient age > 60 years (p = 0.001), postmenopausal status (p = 0.02), black race (p = 0.0034), and T2 tumor size (p = 0.05). Surgical factors of importance were: volume of resection > 100 cm3 (p = 0.0001), scar orientation compliance with the National Surgical Adjuvant Breast Project (NSABP) guidelines (p = 0.0034), and > 20 cm2 skin resected (p = 0.0452). Extent of axillary surgery did not significantly affect breast cosmesis. Radiation factors affecting cosmesis included treatment volume (tangential breast fields only vs. three or more fields) (p = 0.034), whole breast dose in excess of 50 Gy (p = 0.0243), and total dose to tumor site > 65 Gy (p = 0.06), as well as

  14. The results of combination therapy for local cervical cancer

    International Nuclear Information System (INIS)

    Administration of the developed technique os combination treatment based on split course of combination radiotherapy against a background of neoadjuvant chemotherapy to 275 patients with stage II-III cervical cancer allowed to transfer an immobile tumor process to the respectable in 46.0% og cases, which was followed by the uterus and appendages removal, while with traditional course of radiotherapy operability index was only 6.9%

  15. Golestan cohort study of oesophageal cancer: feasibility and first results

    OpenAIRE

    Pourshams, A; Saadatian-Elahi, M; M Nouraie; Malekshah, A F; Rakhshani, N.; Salahi, R; Yoonessi, A; S. Semnani; Islami, F; Sotoudeh, M.; Fahimi, S.; Sadjadi, A R; Nasrollahzadeh, D; Aghcheli, K; Kamangar, F

    2004-01-01

    To investigate the incidence of oesophageal cancer (EC) in the Golestan province of North-East Iran, we invited 1349 rural and urban inhabitants of Golestan province aged 35–80 to undergo extensive lifestyle interviews and to provide biological samples. The interview was repeated on a subset of 130 participants to assess reliability of questionnaire and medical information. Temperature at which tea was consumed was measured on two occasions by 110 subjects. Samples of rice, wheat and sorghum ...

  16. Development of a distress inventory for cancer: preliminary results.

    OpenAIRE

    Thomas B; Mohan V; Thomas I; Pandey M

    2002-01-01

    CONTEXT: Advances in cancer treatment have led to cure and prolongation of patients′ lives; however associated psychosocial problems, including distress, can detrimentally affect patients′ compliance with treatment and ultimately, their outcome. Symptom distress has been well addressed in many studies; however, psychological distress has only been quantified by using depression or anxiety scales/checklists or quality of life scales containing a distress sub scale/component or by...

  17. Diet, Supplement Use, and Prostate Cancer Risk: Results From the Prostate Cancer Prevention Trial

    OpenAIRE

    Kristal, Alan R.; Arnold, Kathryn B.; Neuhouser, Marian L; Goodman, Phyllis; Platz, Elizabeth A.; Albanes, Demetrius; Thompson, Ian M

    2010-01-01

    The authors examined nutritional risk factors for prostate cancer among 9,559 participants in the Prostate Cancer Prevention Trial (United States and Canada, 1994–2003). The presence or absence of cancer was determined by prostate biopsy, which was recommended during the trial because of an elevated prostate-specific antigen level or an abnormal digital rectal examination and was offered to all men at the trial's end. Nutrient intake was assessed using a food frequency questionnaire and a str...

  18. Concurrent Chemoradiotherapy Results in Patients with Anal Cancer

    International Nuclear Information System (INIS)

    Among the 63 patients with histopathologically proven primary squamous cell anal cancer who were managed in Presbyterian Medical Center and Yonsei University Cancer from Jan. 1971 to Dec. 1991, 34 patients, who were managed with surgery alone (abdominoperineal resection) or post-operative radiotherapy and concurrent chemoradiotherapy were analyzed. With mean follow up time of 81.3 months, 30 patients (88%) were followed up from 17 to 243 months. In methods, 10 patients were treated with surgery alone. 9 patients were treated with combined surgery and postoperative radiotherapy (59∼60 Gy in 28∼30 fractions). 15 patients were treated with concurrent chemoradiotherapy. Chemotherapy (Mitomycin C 15 mg/squ, bolus injection day 1;5-FU, 750 mg/squ, 24hr infusion, day 1 to 5) and radiotherapy started the same day. A dose of 30 Gy was given to the tumor and to the pelvis including inguinal nodes, in 15 fractions. After 2 weeks a boost of radiotherapy (20 Gy) to the ano-perineal area and second cycle of chemotherapy completed the treatment. The overall 50 year survival rate was 56.2%. concurrent chemoradiotherapy group was 70% and surgery alone group was 16.7%. According to the cox proportional harzard model, there was significant different between survival with concurrent chemoradiotherapy and surgery alone (p=0.0129), but post-operative radiotherapy was 64.8%, which was not statically significant (p=0.1412). In concurrent chemoradiotherapy group, the anal function preservation rate was 87% and the severe complication rate (grade 3 stenosis and incontinence) was 13.3%. In conclusion, we conclude that the concurrent chemoradiotherapy may be effective treatment modality in patients with anal cancer

  19. Long-term results of ipsilateral radiotherapy for tonsil cancer

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Tae Ryoolk; Wu, Hong Gyun [Dept. of Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2013-06-15

    We evaluated the effectiveness and safety of ipsilateral radiotherapy for the patient with well lateralized tonsil cancer: not cross midline and <1 cm of tumor invasion into the soft palate or base of tongue. From 2003 to 2011, twenty patients with well lateralized tonsil cancer underwent ipsilateral radiotherapy. Nineteen patients had T1-T2 tumors, and one patient had T3 tumor; twelve patients had N0-N2a disease and eight patients had N2b disease. Primary surgery followed by radiotherapy was performed in fourteen patients: four of these patients received chemotherapy. Four patients underwent induction chemotherapy followed by concurrent chemoradiotherapy (CCRT). The remaining two patients received induction chemotherapy followed by radiotherapy and definitive CCRT, respectively. No patient underwent radiotherapy alone. We analyzed the pattern of failure and complications. The median follow-up time was 64 months (range, 11 to 106 months) for surviving patients. One patient had local failure at tumor bed. There was no regional failure in contralateral neck, even in N2b disease. At five-year, local progression-free survival, distant metastasis-free survival, and progression-free survival rates were 95%, 100%, and 95%, respectively. One patient with treatment failure died, and the five-year overall survival rate was 95%. Radiation Therapy Oncology Group grade 2 xerostomia was found in one patient at least 6 months after the completion of radiotherapy. Ipsilateral radiotherapy is a reasonable treatment option for well lateralized tonsil cancer. Low rate of chronic xerostomia can be expected by sparing contralateral major salivary glands.

  20. Concurrent Chemoradiotherapy Results in Patients with Anal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Weon Kuu; Kim, Soo Kon [Presbyterian Medical Center, Chonju (Korea, Republic of); Lee, Chang Geol; Seong, Jin Sil; Kim, Gwi Eon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1994-02-15

    Among the 63 patients with histopathologically proven primary squamous cell anal cancer who were managed in Presbyterian Medical Center and Yonsei University Cancer from Jan. 1971 to Dec. 1991, 34 patients, who were managed with surgery alone (abdominoperineal resection) or post-operative radiotherapy and concurrent chemoradiotherapy were analyzed. With mean follow up time of 81.3 months, 30 patients (88%) were followed up from 17 to 243 months. In methods, 10 patients were treated with surgery alone. 9 patients were treated with combined surgery and postoperative radiotherapy (59{approx}60 Gy in 28{approx}30 fractions). 15 patients were treated with concurrent chemoradiotherapy. Chemotherapy (Mitomycin C 15 mg/squ, bolus injection day 1;5-FU, 750 mg/squ, 24hr infusion, day 1 to 5) and radiotherapy started the same day. A dose of 30 Gy was given to the tumor and to the pelvis including inguinal nodes, in 15 fractions. After 2 weeks a boost of radiotherapy (20 Gy) to the ano-perineal area and second cycle of chemotherapy completed the treatment. The overall 50 year survival rate was 56.2%. concurrent chemoradiotherapy group was 70% and surgery alone group was 16.7%. According to the cox proportional harzard model, there was significant different between survival with concurrent chemoradiotherapy and surgery alone (p=0.0129), but post-operative radiotherapy was 64.8%, which was not statically significant (p=0.1412). In concurrent chemoradiotherapy group, the anal function preservation rate was 87% and the severe complication rate (grade 3 stenosis and incontinence) was 13.3%. In conclusion, we conclude that the concurrent chemoradiotherapy may be effective treatment modality in patients with anal cancer.

  1. [Curative treatment for esophageal cancer: results of a multidisciplinary consensus].

    Science.gov (United States)

    Allemann, Pierre; Mantziari, Styliani; Wagner, Dorothea; Digklia, Antonia; Ozsahin, Esat; De Bari, Berardino; Dorta, Gian; Godat, Sébastien; Montserrat, Fraga; Sempoux, Christine; Brunel, Christophe; Demartines, Nicolas; Schäfer, Markus

    2016-06-15

    The management of patients with resectable cancer of the esophagus or gastroesophageal junction is currently not standardized. A multi- disciplinary regional consensus has been developed and is presented in this article. The standard workup includes an upper endoscopy, ultrasonography and a CT-scan. For locally advanced tumors, surgery should be associated with either preoperative radiochemotherapy orperioperative chemotherapy after discussion in multidisciplinary tumor board. Before the operation, smoking and alcohol cessation is imperative and nutritional status should be optimized. Nowadays, surgery is well standardized and generally performed minimally invasive accesses. After surgery, clinical and oncological follow-up is necessary. PMID:27487620

  2. The result of implementation of multidisciplinary teams in rectal cancer

    DEFF Research Database (Denmark)

    Wille-Jørgensen, Peer; Sparre, Peter; Glenthøj, Anders; Holck, Susanne; Petersen, Lone Nørgaard; Harling, Henrik; Højen, Helle Stub; Bülow, Steffen

    2013-01-01

    Aim:  In 2003 colorectal multidisciplinary teams (MDT) were established in all major Danish hospitals treating colorectal cancer. The aim was to improve the prognosis by a multidisciplinary evaluation and decision about surgical and oncological treatment, based on medical history, clinical...... examination, imaging, histology, and comorbidity.The present study evaluated the effect of the introduction of colorectal MDT on 1.8.2004 in two Danish hospitals. Method:  A retrospective cohort study was conducted comparing the outcome during the last three years before introduction of the MDT with the first...

  3. Results of combination chemo-radiotherapy for nasopharyngeal cancer

    International Nuclear Information System (INIS)

    A new protocol for the treatment of nasopharyngeal cancer was designed and has been employed since 1984 at Hyogo Medical Center for Adults. Thirty-three previously untreated patients who were assigned to this protocol from 1984 to 1991 were analyzed in this study. Eighty-six nasopharyngeal cancer patients who were treated at our institution from 1972 to 1983 were chosen as an historical control group. All patients were followed up for a minimum of 2 years. The essence of the treatment philosophy of our protocol was: combination chemo-radiotherapy using CDDP (but excluding pacients 70 years old or older); boost irradiation of 10-20 Gy for patients with tumors persisting even at 40 Gy or T4 cases; prophylactic neck irradiation. The protocol yielded a better 5-year survival rate (56.6% vs 47.6%, p<0.05) and less frequent locoregional failure rate (18.2% vs 48.8%, p<0.01) than those of patients in the control group. Among the patients with T1-3 and N0-2 disease, the difference between survival rates with and without protocol was statistically significant but not for the patients with T4 and N3 disease, The protocol was well tolerated by most of the patients. (author)

  4. Synchronous Onset of Breast and Pancreatic Cancers: Results of Germline and Somatic Genetic Analysis

    Directory of Open Access Journals (Sweden)

    Michael Castro

    2016-07-01

    Full Text Available Background: Synchronous cancers have occasionally been detected at initial diagnosis among patients with breast and ovarian cancer. However, simultaneous coexistence and diagnosis of breast and pancreas cancer has not previously been reported. Case Report: Paternal transmission of a germline BRCA2 mutation to a patient who was diagnosed at age 40 with locally advanced breast and pancreas cancer is presented. Somatic genomic analysis of both cancers with next-generation DNA sequencing confirmed the germline result and reported a variety of variants of unknown significance alterations, of which two were present in both the breast and pancreas cancers. Discussion: The possibility that genomic alterations could have been responsible for modulating the phenotypic or clinical expression of this rare presentation is considered. The authors call attention to the practice of privatizing the clinicogenetic information gained from genetic testing and call for health policy that will facilitate sharing in order to advance the outcomes of patients diagnosed with hereditary cancers.

  5. Results of preoperative concurrent chemoradiotherapy for locally advanced rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Sang Gyu; Kim, Su Ssan; Bae, Hoon Sik [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2007-03-15

    We performed a retrospective non-randomized clinical study of locally advanced rectal cancer, to evaluate the anal sphincter preservation rates, down staging rates and survival rates of preoperative chemoradiotherapy. From January 2002 to December 2005, patients with pathologically confirmed rectal cancer with clinical stage T2 or higher, or patients with lymph node metastasis were enrolled in this study. A preoperative staging work-up was conducted in 36 patients. All patients were treated with preoperative chemoradiotherapy, and curative resection was performed for 26 patients at Hallym University Sacred Heart Hospital. Radiotherapy treatment planning was conducted with the use of planning CT for all patients. A total dose of 45.0 {approx} 52.2 Gy conventionally fractionated three-dimensional radiotherapy was delivered to the whole pelvis. Chemotherapy was given at the first and fifth week of radiation therapy with continuous infusion i.v. 5-FU (Fluorouracil) and LV (Leucovorine). Surgical resection was performed 2 to 4 weeks after the completion of the chemoradiotherapy regimen. The complete resection rate with negative resection margin was 100% (26/26). However, a pathologically complete response was not seen after curative resection. Surgery was done by LAR (low anterior resection) in 23 patients and APR (abdomino-perineal resection) in 3 patients. The sphincter preservation rate was 88.5% (23/26), down staging of the tumor occurred in 12 patients (46.2%) and down-sizing of the tumor occurred in 19 patients (73%). Local recurrence after surgical resection developed in 1 patient, and distant metastasis developed in 3 patients. The local recurrence free survival rate, distant metastasis free survival rate, and progression free survival rate were 96.7%, 87% and 83.1%, respectively. Treatment related toxicity was minimal except for one grade 3, one grade 4 anemia, one grade 3 leukopenia, and one grade 3 ileus. Preoperative concurrent chemoradiotherapy for locally

  6. Correlates of positive health behaviors in cancer survivors: results from the 2010 LIVESTRONG survey.

    Science.gov (United States)

    Low, Carissa A; Beckjord, Ellen; Bovbjerg, Dana H; Dew, Mary Amanda; Posluszny, Donna M; Schmidt, John E; Lowery, Amy E; Nutt, Stephanie A; Arvey, Sarah R; Rechis, Ruth

    2014-01-01

    Positive health-promoting behaviors, including lifestyle factors (e.g., physical activity) and appropriate health service utilization (e.g., screening for secondary cancers), can minimize the health risks and challenges facing cancer survivors. The goal of this article is to examine factors associated with positive health behaviors in 2,615 posttreatment cancer survivors who completed the 2010 LIVESTRONG survey. Multivariate logistic regression was used to model odds of reporting each of six positive health behaviors "as a result of your experience with cancer": three "healthy lifestyle" behaviors and three "health care utilization" behaviors. In fully adjusted models, factors associated with greater likelihood of engaging in positive lifestyle behaviors (e.g., physical activity, changing diet) included sociodemographic factors, greater knowledge about how to reduce cancer risk; and reporting more psychological benefits due to cancer (ps Factors associated with greater likelihood of attending medical appointments and obtaining recommended cancer screenings included older age, better patient-provider communication, greater knowledge about how to reduce cancer risk, and more psychological benefits of cancer (ps healthy lifestyle behaviors. Clinical interventions targeting these modifiable factors could maximize positive health behavior changes among cancer survivors, affecting risk for cancer recurrence as well as overall health and well-being. PMID:25176347

  7. Non-surgical management of stage I lung cancer

    OpenAIRE

    Gore, Elizabeth M.

    2010-01-01

    Stage I lung cancer has a high cure rate with surgery, although many patients are not surgical candidates due to comorbid conditions. Historically, non-operative treatment has been disappointing. New and promising ablative therapies offer a curative option.

  8. Association of Symptomatic Benign Prostatic Hyperplasia and Prostate Cancer: Results from the Prostate Cancer Prevention Trial

    OpenAIRE

    Schenk, Jeannette M.; Kristal, Alan R.; Arnold, Kathryn B.; Tangen, Catherine M.; Neuhouser, Marian L; Lin, Daniel W; White, Emily; Thompson, Ian M

    2011-01-01

    This study examined the association between symptomatic benign prostatic hyperplasia (BPH) and prostate cancer risk in 5,068 placebo-arm participants enrolled in the Prostate Cancer Prevention Trial (1993–2003). These data include 1,225 men whose cancer was detected during the 7-year trial—556 detected for cause (following abnormal prostate-specific antigen or digital rectal examination) and 669 detected not for cause (without indication), as well as 3,843 men who had biopsy-proven absence of...

  9. Molecular markers and targets for colorectal cancer prevention

    Institute of Scientific and Technical Information of China (English)

    Naveena B JANAKIRAM; Chinthalapally V RAO

    2008-01-01

    Colorectal cancer is the third most prevalent cancer in the world. If detected at an early stage, treatment often might lead to cure. As prevention is better than cure, epidemiological studies reveal that having a healthy diet often protects from pro-moting/developing cancer. An important consideration in evaluating new drugs and devices is determining whether a product can effectively treat a targeted disease. There are quite a number of biomarkers making their way into clinical trials and few are awaiting the preclinical efficacy and safety results to enter into clinical trials. Researchers are facing challenges in modifying trial design and defining the right control population, validating biomarker assays from the bio-logical and analytical perspective and using biomarker data as a guideline for decision making. In spite of following all guidelines, the results are disappointing from many of the large clinical trials. To avoid these disappointments, selection of biomarkers and its target drug needs to be evaluated in appropriate animal models for its toxicities and efficacies. The focus of this review is on the few of the potential molecular targets and their biomarkers in colorectal cancers. Strengths and limitations of biomarkers/surrogate endpoints are also discussed. Various pathways involved in tumor cells and the specific agents to target the altered molecular biomarkerin biomolecular pathwayare elucidated. Importance of emerging new platforms siRNAs and miRNAs technology for colorectal cancer therapeutics is reviewed.

  10. The treatment Results of Radiotherapy for nonsmall Cell Lung Cancer

    International Nuclear Information System (INIS)

    From Nov. 1983 through Jan. 1986, 43 patients with nonsmall cell lung cancer were treated by radiation therapy at Inje Medical College Paik Hospital. 38 patients were available for the analysis of this study. 33 patients received definite irradiation with curative intent, while 5 patients received postoperative irradiation. Chemotherapy was added in 12 patients before, during and after radio-therapy. 28 patients were squamous cell carcinoma and 10 patients were adenocarcinoma. There were 29 men and 9 women (median age, 58 years; range 34 to 74 years). Stage I was 1 patient, Stage 11, 7 patient, and Stage 111, 30 patients. Among 33 patients who received radiotherapy with curative intent, follow up radiological study revealed complete response in 12 patients (36%), partial response, in 9 patients (27%), and minimal response, in 5 patients (15%), while 7 patients (21%) were nonresponders. Median survival for all patients was 6.9 months; squamous cell carcinoma, 7.3 months, adenocarcinoma, 5.9 months. Responders survived median 7 months, while nonresponders survived median 1.9 months. Improved complete response rate and survival were shown in high radiation dose group. As prognostic factors, age, initial performance status, sex, histology and tumor location were evaluated

  11. Golestan cohort study of oesophageal cancer: feasibility and first results.

    Science.gov (United States)

    Pourshams, A; Saadatian-Elahi, M; Nouraie, M; Malekshah, A F; Rakhshani, N; Salahi, R; Yoonessi, A; Semnani, S; Islami, F; Sotoudeh, M; Fahimi, S; Sadjadi, A R; Nasrollahzadeh, D; Aghcheli, K; Kamangar, F; Abnet, C C; Saidi, F; Sewram, V; Strickland, P T; Dawsey, S M; Brennan, P; Boffetta, P; Malekzadeh, R

    2005-01-17

    To investigate the incidence of oesophageal cancer (EC) in the Golestan province of North-East Iran, we invited 1349 rural and urban inhabitants of Golestan province aged 35-80 to undergo extensive lifestyle interviews and to provide biological samples. The interview was repeated on a subset of 130 participants to assess reliability of questionnaire and medical information. Temperature at which tea was consumed was measured on two occasions by 110 subjects. Samples of rice, wheat and sorghum were tested for fumonisin contamination. An active follow-up was carried out after 6 and 12 months. A total of 1057 subjects (610 women and 447 men) participated in this feasibility study (78.4% participation rate). Cigarette smoking, opium and alcohol use were reported by 163 (13.8%), 93 (8.8%) and 39 (3.7%) subjects, respectively. Tobacco smoking was correlated with urinary cotinine (kappa = 0.74). Most questionnaire data had kappa > 0.7 in repeat measurements; tea temperature measurement was reliable (kappa = 0.71). No fumonisins were detected in the samples analysed. During the follow-up six subjects were lost (0.6%), two subjects developed EC (one dead, one alive); in all, 13 subjects died (with cause of death known for 11, 84.6%). Conducting a cohort study in Golestan is feasible with reliable information obtained for suspected risk factors; participants can be followed up for EC incidence and mortality. PMID:15597107

  12. Results of electron beam irradiation for tongue cancer

    International Nuclear Information System (INIS)

    From 1967 through 1988 183 previously untreated patients with squamous-cell carcinoma of the tongue were treated with electron beam irradiation. The patients were restaged as stage I (38 patients), stage II (64), stage III (58), and stage IV (28). For evaluable patients treated with intra-oral cone irradiation (IOC) alone (n=53) or combined with external irradiation (n=120), the two-year local control rate was 85% for T1, 73% for T2, and 58% for T3. According to clinical features, it was 80% for tumorous type, 68% for small ulceration type, and 53% for large ulceration type. In comparing uneven and even fractionated irradiation procedures, there was no significant difference in two-year local control rate (68% for uneven fractionated irradiation vs. 61% for even fractionated irradiation). When restricting to T2 and T3 patients, it was significantly higher for uneven fractionated irradiation (77% and 63%) than even fractionated irradiation (56% and 40%). In comparing T3 patients categorized as having >1000 mm2 (I) with those as having ≤1000 mm2 (II). the two-year local control rate was 48% for category I and 72% for category II. For T3 patients, it was 43% when associated with ulcer, as compared with 74% without it. The actuarial five-year survival rate was 92% for stage I, 72% for stage II, 67% for stage III, and 12% for stage IV. Delayed radiation ulcer and bone exposure were seen in 22 and 7 patients, respectively. In conclusion, IOC is comparable to internal irradiation and is clinically effective for T1 through T3 (in smaller size) tongue cancer. (N.K.)

  13. Incidence of cervical cancer after several negative smear results by age 50: prospective observational study

    DEFF Research Database (Denmark)

    Rebolj, Matejka; van Ballegooijen, Marjolein; Lynge, Elsebeth;

    2009-01-01

    OBJECTIVE: To determine the incidence of cervical cancer after several negative cervical smear tests at different ages. DESIGN: Prospective observational study of incidence of cervical cancer after the third consecutive negative result based on individual level data in a national registry...... of histopathology and cytopathology (PALGA). SETTING: Netherlands, national data. Population 218,847 women aged 45-54 and 445,382 aged 30-44 at the time of the third negative smear test. MAIN OUTCOME MEASURES: 10 year cumulative incidence of interval cervical cancer. RESULTS: 105 women developed cervical cancer...... within 2 595,964 woman years at risk after the third negative result at age 30-44 and 42 within 1,278,532 woman years at risk after age 45-54. During follow-up, both age groups had similar levels of screening. After 10 years of follow-up, the cumulative incidence rate of cervical cancer was similar: 41...

  14. Risk of Breast Cancer in Women with False-Positive Results according to Mammographic Features.

    Science.gov (United States)

    Castells, Xavier; Torá-Rocamora, Isabel; Posso, Margarita; Román, Marta; Vernet-Tomas, Maria; Rodríguez-Arana, Ana; Domingo, Laia; Vidal, Carmen; Baré, Marisa; Ferrer, Joana; Quintana, María Jesús; Sánchez, Mar; Natal, Carmen; Espinàs, Josep A; Saladié, Francina; Sala, María

    2016-08-01

    Purpose To assess the risk of breast cancer in women with false-positive screening results according to radiologic classification of mammographic features. Materials and Methods Review board approval was obtained, with waiver of informed consent. This retrospective cohort study included 521 200 women aged 50-69 years who underwent screening as part of the Spanish Breast Cancer Screening Program between 1994 and 2010 and who were observed until December 2012. Cox proportional hazards regression analysis was used to estimate the age-adjusted hazard ratio (HR) of breast cancer and the 95% confidence interval (CI) in women with false-positive mammograms as compared with women with negative mammograms. Separate models were adjusted for screen-detected and interval cancers and for screen-film and digital mammography. Time without a breast cancer diagnosis was plotted by using Kaplan-Meier curves. Results When compared with women with negative mammograms, the age-adjusted HR of cancer in women with false-positive results was 1.84 (95% CI: 1.73, 1.95; P breast cancer, particularly women who had calcifications at mammography. Women who had more than one examination with false-positive findings and in whom the mammographic features changed over time had a highly increased risk of breast cancer. Previous mammographic features might yield useful information for further risk-prediction models and personalized follow-up screening protocols. (©) RSNA, 2016 Online supplemental material is available for this article. PMID:26878225

  15. Five polymorphisms and breast cancer risk: results from the Breast Cancer Association Consortium

    DEFF Research Database (Denmark)

    Gaudet, Mia M; Milne, Roger L; Cox, Angela;

    2009-01-01

    Previous studies have suggested that minor alleles for ERCC4 rs744154, TNF rs361525, CASP10 rs13010627, PGR rs1042838, and BID rs8190315 may influence breast cancer risk, but the evidence is inconclusive due to their small sample size. These polymorphisms were genotyped in more than 30,000 breast...... cancer cases and 30,000 controls, primarily of European descent, from 30 studies in the Breast Cancer Association Consortium. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) as a measure of association. We found that the minor alleles for these polymorphisms were not related to...... invasive breast cancer risk overall in women of European descent: ECCR4 per-allele OR (95% CI) = 0.99 (0.97-1.02), minor allele frequency = 27.5%; TNF 1.00 (0.95-1.06), 5.0%; CASP10 1.02 (0.98-1.07), 6.5%; PGR 1.02 (0.99-1.06), 15.3%; and BID 0.98 (0.86-1.12), 1.7%. However, we observed significant between...

  16. Hepatitis B vaccinations among Koreans: Results from 2005 Korea National Cancer Screening Survey

    Directory of Open Access Journals (Sweden)

    Kwak Min-Son

    2009-11-01

    Full Text Available Abstract Background Liver cancer is one of most commonly diagnosed cancers among Koreans. Chronic hepatitis B virus (HBV infection is a major risk factor for liver cancer. HBV infection can be prevented by effective screening and vaccination programs. The purpose of this study is to examine the status of HBV infection and the predictors associated with HBV vaccination. Methods The study population was derived from the 2005 Korea National Cancer Screening Survey (KNCSS. The KNCSS is an annual cross-sectional survey that uses a nationally-representative random sampling to investigate cancer screening rates. A total of 1,786 Koreans over 40 years of age participated in this study. Results Of all the participants, 5.9% reported HBV positive (HBsAg+, HBsAb-, 41.8% were HBV negative but protected (HBsAg-, HBsAb+, and 52.3% were unprotected (HBsAg-, HBsAb-. Among unprotected individuals (n = 934, 23.1% reported to have received the vaccination. About half of those who had vaccinations completed the 3-shot vaccine series. In multiple analyses, education, having private cancer insurance, alcohol use, having regular check-up, and doing regular exercise were associated with completed HBV vaccination. Conclusion This study result suggests that we need a liver cancer education program to increase HBV awareness and to increase the liver cancer prevention message among low educated populations.

  17. Colorectal Cancer with Synchronous Liver Metastases: Influence of Surgical Strategy on Treatment Results and Costs

    OpenAIRE

    Kolesnik, O. O.; Burlaka, A. A.; Lukashenko, A. V.; Priymak, V. V.; Volk, M. O.

    2015-01-01

    The objective of the research was to improve immediate and long-term results of treatment in patients with synchronous metastatic colorectal cancers (smCRC) developing surgical treatment program with application of simultaneous and staged methods for resection of primary tumor and liver metastases.   Materials and methods. The study was based upon reviewing treatment results for 125 patients with smCRC (рТ1-4N0-2M1 in colon cancer and рТ1-3N0-2M1 in rectal cancer) who underwent either simulta...

  18. Second primary cancer risk - the impact of applying different definitions of multiple primaries: results from a retrospective population-based cancer registry study

    OpenAIRE

    Aishah, Coyte; Morrison, David S.; McLoone, Philip

    2014-01-01

    Background: There is evidence that cancer survivors are at increased risk of second primary cancers. Changes in the prevalence of risk factors and diagnostic techniques may have affected more recent risks. Methods: We examined the incidence of second primary cancer among adults in the West of Scotland, UK, diagnosed with cancer between 2000 and 2004 (n = 57,393). We used National Cancer Institute Surveillance Epidemiology and End Results and International Agency for Research on Canc...

  19. Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

    DEFF Research Database (Denmark)

    Kristiansen, Bettina Kjær

    2014-01-01

    -up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone......Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow...... follow-up, or because of organizational aspects of the screening program, where communication regarding test results can fail either in content or with delay.This study will evaluate two interventions designed to increase follow-up: 1) A letter with the test result and potential recommendation for follow...

  20. Hyperfractionation in the reirradiation of head and neck cancers. Result of a pilot study

    International Nuclear Information System (INIS)

    Between November 1988 and May 1992, 19 patients were enrolled in a pilot study to evaluate feasibility and results of a hyperfractionated reirradiation in the treatment of head and neck recurrences or second primary tumors developed in previously irradiated volume. Patients were divided in two groups according to the initial treatment before reirradiation: group 1 included 14 patients treated with radical surgery and reirradiated because histological evidence of positive margins and/or extra capsular spread of tumor in lymph node metastases; group 2 included five patients treated with three cycles of CDDP-5FU for unresectable tumors and reirradiated because they experienced a complete or good partial (≥80%) response after chemotherapy. The reirradiation planned dose was 60 Gy in 5 weeks, with two daily fractions of 1.2 Gy spaced by 6-8 h intervals. Reirradiation was delivered exclusively with photon beams in 17 cases and with a combination of photon and electron beams in two cases. Follow-up ranged from 3 to 45 months with a median of 17 months. Of the 19 patients, 13 received the reirradiation scheduled dose of 60 Gy. For the six remaining patients, the reirradiation doses ranged from 45.6 to 57.6 Gy. All patients experienced an acute mucositis which never led to interruption of treatment. Of the 14 patients of group 1, 10 died 3-41 months after reirradiation (mean: 14 months), three were disease-free 16-37 months after reirradiation and one patient was alive with local progressive disease 39 months after the reirradiation. The overall local control within reirradiated volume was 36% before and 43% after salvage surgery. For all group 1 patients, 12- and 24-month overall survival was 64 and 36%, respectively (mean: 21 months). All patients of group 2 presented a local failure within the reirradiated volume. Three of them died 12, 16 and 25 months after reirradiation, while two of them were alive with progressive disease 25 and 30 months after reirradiation

  1. Role of EUS-FNA in Recurrent Lung Cancer: Maximum Results with Minimum (minimally invasive) Effort

    OpenAIRE

    Ioncica, Ana M.; Bektas, Mehmet; Suzuki, Rei; Saftoiu, Adrian; Artifon, Everson L.A.; Bhutani, Manoop S.

    2013-01-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an excellent method for primary lung cancer staging. We describe a 66-year-old male who underwent EUS-FNA for the diagnosis of recurrent lung cancer. Two years after initial radiation therapy followed by complete remission, routine follow-up imaging study revealed a mass in the right hilum. Trans-esophageal EUS revealed a 1.3-cm mass and the result of EUS-FNA was consistent with non-small lung cancer. EUS-FNA can play an importa...

  2. European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project: Results of the treatment of skin cancer.

    Science.gov (United States)

    Bertino, Giulia; Sersa, Gregor; De Terlizzi, Francesca; Occhini, Antonio; Plaschke, Christina Caroline; Groselj, Ales; Langdon, Cristobal; Grau, Juan J; McCaul, James A; Heuveling, Derrek; Cemazar, Maja; Strojan, Primoz; de Bree, Remco; Leemans, C Renè; Wessel, Irene; Gehl, Julie; Benazzo, Marco

    2016-08-01

    Electrochemotherapy is an effective and safe method for local treatment of cutaneous and subcutaneous tumours, where electric pulses cause increased permeability of cell membranes in the tumour mass, enabling dramatically enhanced effectiveness of bleomycin and other hydrophilic drugs. Here, we report results of a European multi-institutional prospective study of the effectiveness of electrochemotherapy in the treatment of skin cancer of the head and neck (HN) area, where standard treatments had either failed or were not deemed suitable or declined by the patient. A total of 105 patients affected by primary or recurrent skin cancer of the HN area were enrolled; of these, 99 were eligible for evaluation of tumour response. By far, the majority (82%) were treated only once, and 18% of patients had a second treatment. The objective response was highest for basal cell carcinoma (97%) and for other histologies was 74%. Small, primary, and treatment-naive carcinomas responded significantly better (p life, estimated by the European Organisation for Research and Treatment of Cancer quality of life questionnaires. At 1-year follow-up, the percentages of overall and disease-free survival were 76% and 89%, respectively. Electrochemotherapy is an effective option for skin cancers of the HN area and can be considered a feasible alternative to standard treatments when such an alternative is appropriate. The precise role for electrochemotherapy in the treatment algorithm for non-melanoma skin cancer of the HN region requires data from future randomised controlled studies. (ISRCTN registry N. 30427). PMID:27267144

  3. Does the cancer patient want to know? Results from a study in an Indian tertiary cancer center

    Directory of Open Access Journals (Sweden)

    Shekhawat Laxmi

    2013-01-01

    Full Text Available Objective: The disclosure of the diagnosis of cancer is a distressing and complex issue. Families and doctors still do not tell patients when they have cancer in the belief that the patient does not want to know and telling him would lead to fear and depression. The aim of this survey was to evaluate the information needs of Indian cancer patients. Materials and Methods: A cross-sectional survey of 300 patients′ views was conducted with the help of an adaptation of Cassileth′s Information Needs questionnaire. Results: A majority of cancer patients exhibited a strong need for information about illness and treatment. Ninety-four percent wanted to know if their illness was cancer. Most patients also wanted to know the chance of cure (92%. Age, education, and type of treatment significantly affect information preferences. Gender did not have an effect on information needs. Conclusion: This study showed that most of the patients wanted to know about their illness, treatment, side-effects, and chances of cure.

  4. Process and results of the development of an ICNP® Catalogue for Cancer Pain

    Directory of Open Access Journals (Sweden)

    Marisaulina Wanderley Abrantes de Carvalho

    2013-10-01

    Full Text Available This was a methodological study conducted to describe the process and results of the development of an International Classification for Nursing Practice (ICNP® Catalogue for Cancer Pain. According to the International Council of Nurses (ICN, this catalogue contains a subset of nursing diagnoses, outcomes, and interventions to document the implementation of the nursing process in cancer patients. This catalogue was developed in several steps according to the guidelines recommended by the ICN. As a result, 68 statements on nursing diagnoses/outcomes were obtained, which were classified according to the theoretical model for nursing care related to cancer pain into physical (28, psychological (29, and sociocultural and spiritual (11 aspects. A total of 116 corresponding nursing interventions were obtained. The proposed ICNP® Catalogue for Cancer Pain aims to provide safe and systematic orientation to nurses who work in this field, thus improving the quality of patient care and facilitating the performance of the nursing process.

  5. Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition

    OpenAIRE

    Rohrmann, Sabine; Overvad, Kim; Bueno-de-Mesquita, H Bas; Jakobsen, Marianne U; Egeberg, Rikke; Tjønneland, Anne; Nailler, Laura; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Françoise; Krogh, Vittorio; Palli, Domenico; Panico, Salvatore; Tumino, Rosario; Ricceri, Fulvio; Bergmann, Manuela M

    2013-01-01

    Background Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or...

  6. Meat consumption and mortality--results from the European Prospective Investigation into Cancer and Nutrition.

    OpenAIRE

    Rohrmann, S; Overvad, K.; Bueno-de-Mesquita, HB; Jakobsen, MU; Egeberg, R; Tjønneland, A.; Nailler, L; Boutron-Ruault, MC; Clavel-Chapelon, F.; Krogh, V.; Palli, D; Panico, S.; Tumino, R; Ricceri, F.; Bergmann, MM

    2013-01-01

    BACKGROUND: Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Included in the analysis were 448,568 men and women without prevalent cancer, stroke, ...

  7. Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition

    OpenAIRE

    Rohrmann, Sabine; Overvad, Kim; Bueno-de-Mesquita, H Bas; Jakobsen, Marianne U; Egeberg, Rikke; Tjonneland, Anne; Nailler, Laura; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Francoise; Krogh, Vittorio; Palli, Domenico; Panico, Salvatore; Tumino, Rosario; Ricceri, Fulvio; Bergmann, Manuela M

    2013-01-01

    Background: Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Included in the analysis were 448,568 men and women without prevalent cancer, stroke, ...

  8. Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition

    OpenAIRE

    Rohrmann, Sabine; Overvad, Kim; Bueno-de-Mesquita, H Bas; Jakobsen, Marianne U; Egeberg, Rikke; Tjønneland, Anne; Nailler, Laura; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Françoise; Krogh, Vittorio; Palli, Domenico; Panico, Salvatore; Tumino, Rosario; Ricceri, Fulvio; Bergmann, Manuela M

    2013-01-01

    BACKGROUND: Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Included in the analysis were 448,568 men and women without prevalent cancer, strok...

  9. Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition.

    OpenAIRE

    Rohrmann, Sabine; Overvad, Kim; Bueno-de-Mesquita, H.; Jakobsen, Marianne; Egeberg, Rikke; Tjønneland, Anne; Nailler, Laura; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Françoise; Krogh, Vittorio; Palli, Domenico; Panico, Salvatore; Tumino, Rosario; Ricceri, Fulvio; Bergmann, Manuela

    2013-01-01

    BACKGROUND: Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Included in the analysis were 448,568 men and women without prevalent cancer, stroke, ...

  10. Meat consumption and mortality : results from the European Prospective Investigation into Cancer and Nutrition

    OpenAIRE

    Rohrmann, Sabine; Overvad, Kim; Bueno-de-Mesquita, H Bas; Jakobsen, Marianne U; Egeberg, Rikke; Tjonneland, Anne; Nailler, Laura; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Francoise; Krogh, Vittorio; Palli, Domenico; Panico, Salvatore; Tumino, Rosario; Ricceri, Fulvio; Bergmann, Manuela M

    2013-01-01

    Background: Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Included in the analysis were 448,568 men and women without prevalent cancer, stroke, ...

  11. Choosing observers for evaluation of aesthetic results in breast cancer conservative treatment

    International Nuclear Information System (INIS)

    Purpose: The subjective evaluation of aesthetic results in conservative breast cancer treatment has largely been used without questioning the observer's skills. The aim of this study was to evaluate interobserver agreement of the aesthetic results of breast cancer conservative treatment in three groups of observers with different levels of experience. Methods and materials: Photographs were taken of 55 women who had undergone conservative unilateral breast cancer treatment and 5 control women with no breast disease. The images were then distributed to 13 observers who were divided into three groups according to their experience in breast cancer treatment: experienced, medium experienced, and inexperienced. They were first asked to distinguish the patients from the controls and for the patients to identify the operated side. Subsequently, they were asked to classify the aesthetic result as excellent, good, fair, or poor. The accuracy in identifying controls, patients, and side of treatment was calculated individually for all observers. The interobserver agreement for the aesthetic result was calculated using observed agreement and multiple κ statistic (κ) in each of the three groups. Results: Inexperienced observers performed significantly worse than experienced observers in identifying controls, patients, and the side of treatment. Agreement of the aesthetic result was significantly greater in the group of experienced observers (κ = 0.59) than in the medium experienced (κ = 0.35) and inexperienced (κ = 0.33) observers. Conclusion: Previous experience in breast cancer conservative treatment should be considered a prerequisite for the evaluation of the aesthetic results

  12. Confrontation with the threat of breast cancer: first results of a prospective study

    International Nuclear Information System (INIS)

    Introduction: The process of adaptation to cancer begins to develop before the suspected of having this disease. Coping strategies can affect on mental illness and treatment adherence. Objective: We will compare the coping strategies used by women according to the likelihood of cancer according to the results of their mammograms. We also seek to detect differences in coping between women who eventually receive a positive diagnosis, and those which do not present pathology. Methods: Patients sent from services were interviewed mammographic screening at Hospital de Clinicas to complete their diagnostic studies, also administered the HADS and POMS questionnaires. interviews were recorded and analyzed according to Ulm Coping Manual. Results: The sample consisted of 377 patients (mean age: 47.93, range: 17-84, SD: 11.22). The mammographic results or were divided into 3 groups according clinical symptoms. Women who had a BIRADS 4 or 5 showed higher Resignation use as coping (p = .001) and less use of Acceptance active (p = 0.003). 10% of women (n = 37) received a positive diagnosis. Resignation was used by 49% of these patients, compared to 30% of healthy (p = 0.041). 51% of women without cancer Acceptance actively used, compared 24% of cancer patients (p = .003). The strategy most used by women without cancer was active acceptance (20%), while the most used cancer patients was the active avoidance (11%). conclusions: Resignation was more used by women who were diagnosed positive, while the Acceptance showed the opposite trend

  13. Long-term oncologic results of salvage radical prostatectomy for locally recurrent prostate cancer after radiotherapy

    International Nuclear Information System (INIS)

    Purpose: Salvage radical prostatectomy (RP) may potentially cure patients who have isolated local prostate cancer recurrence after radiotherapy (RT). We report the long-term cancer control associated with salvage RP in a consecutive cohort of patients and identify the variables associated with disease progression and cancer survival. Methods and Materials: A total of 100 consecutive patients underwent salvage RP with curative intent for biopsy-confirmed, locally recurrent, prostate cancer after RT. Disease progression after salvage RP was defined as a prostate-specific antigen (PSA) level of ≥0.2 ng/mL or by initiation of androgen deprivation therapy. Cancer-specific mortality was defined as active clinical disease progression despite castration. Cox regression analysis was used to evaluate these endpoints. The median follow-up from RT was 10 years (range, 3-27 years) and from salvage RP was 5 years (range, 1-20 years). Results: Overall, the 5-year progression-free probability was 55% (95% confidence interval, 46-64%), and the median progression-free interval was 6.4 years. The preoperative PSA level was the only significant pretreatment predictor of disease progression in the multivariate analysis (p = 0.01). The 5-year progression-free probability for patients with a preoperative PSA level of 10 ng/mL was 86%, 55%, and 37%, respectively. The 10-year and 15-year cancer-specific mortality after salvage RP was 27% and 40%, respectively. The median time from disease progression to cancer-specific death was 10.3 years (95% confidence interval, 7.6-12.9). After multivariate analysis, the preoperative serum PSA level and seminal vesicle or lymph node status correlated independently with disease progression. Conclusions: Greater preoperative PSA levels are associated with disease progression and cancer-specific death. Long-term control of locally recurrent prostate cancer after definitive RT is possible when salvage RP is performed early in the course of recurrent

  14. Cell of origin of lung cancer

    OpenAIRE

    Hanna, Jennifer M.; Onaitis, Mark W.

    2013-01-01

    Lung cancer is the leading cause of cancer deaths worldwide, and current therapies are disappointing. Elucidation of the cell(s) of origin of lung cancer may lead to new therapeutics. In addition, the discovery of putative cancer-initiating cells with stem cell properties in solid tumors has emerged as an important area of cancer research that may explain the resistance of these tumors to currently available therapeutics. Progress in our understanding of normal tissue stem cells, tumor cell o...

  15. Does increased local bone resorption secondary to breast and prostate cancer result in increased cartilage degradation?

    DEFF Research Database (Denmark)

    Leeming, Diana J; Byrjalsen, Inger; Qvist, Per;

    2008-01-01

    BACKGROUND: Breast and prostate cancer patients often develop lesions of locally high bone turnover, when the primary tumor metastasizes to the bone causing an abnormal high bone resorption at this site. The objective of the present study was to determine whether local increased bone turnover in...... breast and prostate cancer patients is associated with an increase in cartilage degradation and to test in vitro whether osteoclasts or cathepsin K alone generate CTXII from human bone. METHODS: The study included 132 breast and prostate cancer patient, where presence of bone metastases was graded...... according to the Soloway score. Total bone resorption (CTXItotal) and cartilage degradation (CTXII) were determined. RESULTS: Breast and prostate cancer patients with bone metastases revealed significant increased levels of CTXItotal at Soloway scores 1 and higher compared to patients without bone...

  16. Treatment for liver metastases from breast cancer: Results and prognostic factors

    Institute of Scientific and Technical Information of China (English)

    Xiao-Ping Li; Zhi-Qiang Meng; Wei-Jian Guo; Jie Li

    2005-01-01

    AIM: Liver metastases from breast cancer (BCLM) are associated with poor prognosis. Cytotoxic chemotherapy can result in regression of tumor lesions and a decrease in symptoms. Available data, in the literature, also suggest a subgroup of patients rraay berefit from surgery, but few talked about transcatheter arterial chemoembolization (TACE).We report the results of TACE and systemic chemotherapy for patients with liver metastases from breast cancer and evaluate the prognostic factors. METHODS: Forty-eight patients with liver metastases, from proved breast primary cancer were treated with TACEor systemic chemotherapy between January 1995 and December 2000. Treatment results were assessed according to WHO criteria, along with analysis of prognostic factors for survival using Cox regression model.RESULTS: The median follow-up was 28 mo (1-72 mo). Response rates were calculated for the TACE group and chemotherapy group, being 35.7% and 7.1%,respectively. The difference was significant. The one-, two- and three-year Survival rates for the TACE group were 63.04%, 30.35%, and 13.01%, and those for the systemic chemotherapy group were 33.88%, 11.29%, and 0%. According to univariate analysis, variables significantly associated with survival were the lymph node status of the primary cancer, the clinical stage of liver metastases, the Child-Pugh grade, loss of weight. Other factors such as age, the intervals between the primary to the metastases, the maximal diameter of the liver metastases, the number of liver metastases, extrahepatic metastasis showed no prognostic significances. These factors mentioned above such as the lymph node status of the primary cancer, the clinical stage of liver metastases, the Child-Pugh grade, loss of weight were also independent factors in multivariate analysis.CONCLUSION: TACE treatment of liver metastases from breast cancer may prolong survival in certain patients. This approach offers new promise for the curative treatment of the patients

  17. Prognosis of screen-detected breast cancers: results of a population based study

    Directory of Open Access Journals (Sweden)

    Rashid Ivan

    2006-01-01

    Full Text Available Abstract Background The reduced mortality rate from breast carcinoma among women offered screening mammography is demonstrated after 15–20 years of follow-up. However, the assessment of 5-year overall and event-free survival could represent an earlier measure of the efficacy of mammography screening program (MSP. Methods All cases of breast cancer diagnosed in the Province of Modena between years 1996 and 2000 in women aged 50 to 69 years, were identified through the Modena Cancer Registry (MCR. Stage of disease and treatment information were obtained from clinical records. All the events occurring up to June 30, 2003 were retrieved by experienced monitors. Five-year overall and event-free survival were the principal end-points of the study. Results During a 5-year period, 587 primary breast cancers were detected by the MSP and 471 primary breast cancers were diagnosed out of the MSP. The screen-detected breast cancers were smaller, more likely node negative, with low histological grade, low proliferative activity and positive receptors status. Furthermore, the breast cancer diagnosed through the MSP more frequently received a conservative surgery. The 5-year survival rate was 94% in the screen-detected group, versus 84% in the other group (p = 0.0001. The rate of 5-year event-free survival was 89% and 75% for the MSP participants and not participants, respectively (p = 0.0001. Conclusions Our data confirm a favourable outcome of screen-detected breast cancers in terms of five-year overall and event-free survival, which reflect the good quality assurance parameters of the MSP. Finally, a cancer registry should be implemented in every area covered by screening programs.

  18. Student-Faculty Interactions about Disappointing Grades: Application of the Goals-Plans-Actions Model and the Theory of Planned Behavior

    Science.gov (United States)

    Henningsen, Mary Lynn Miller; Valde, Kathleen S.; Russell, Gregory A.; Russell, Gregory R.

    2011-01-01

    The goals-plans-actions model and the theory of planned behavior were used to predict what lead to students having a conversation about a disappointing grade with a faculty member. Participants (N = 130) completed two surveys. In the first survey, participants completed measures of primary and secondary goals, planning, decision to engage,…

  19. Cervical cancer screening in immigrant women in Italy: a survey on participation, cytology and histology results.

    Science.gov (United States)

    Campari, Cinzia; Fedato, Chiara; Iossa, Anna; Petrelli, Alessio; Zorzi, Manuel; Anghinoni, Emanuela; Bietta, Carla; Brachini, Angela; Brezzi, Silvia; Cogo, Carla; Giordano, Livia; Giorgi, Daniela; Palazzi, Mauro; Petrella, Marco; Schivardi, Maria R; Visioli, Carmen B; Giorgi Rossi, Paolo

    2016-07-01

    Cervical cancer screening programmes in Italy actively invite all 25-64-year-old resident women for the Pap test every 3 years irrespective of their citizenship. Immigrant women come from countries where screening is absent or poorly implemented and the prevalence of human papillomavirus is often high. These women therefore have significant risk factors for cervical cancer. The Italian Group for Cervical Cancer Screening promoted a survey of all the screening programmes on the participation and the positivity and detection rates in Italian and foreign women in 2009-2011. Aggregated data for participation, cytology results, compliance with colposcopy and histology results were collected, distinguishing between women born in Italy and abroad. All comparisons were age adjusted. Forty-eight programmes out of 120 participated in the immigrant survey, with 3 147 428 invited and 1 427 412 screened Italian women and 516 291 invited and 205 948 screened foreign women. Foreign women had a slightly lower participation rate compared with Italians (39.9 vs. 45.4%), whereas compliance with colposcopy was similar (90%). Foreigners showed a higher risk of pathological findings than Italians: cytology positivity [relative risk (RR)=1.25, 95% confidence interval (CI) 1.24-1.27] and detection rate for cervical intraepithelial neoplasia grade 2 (CIN2) (RR=1.39, 95% CI 1.31-1.47), CIN3 (RR=2.07, 95% CI 1.96-2.18) and cancer (RR=2.68, 95% CI 2.24-3.22). The ratio between cancer and CIN was higher in immigrants (0.06 vs. 0.04, P<0.01). Foreign women had a higher risk of cervical precancer and cancer. Because of their high risk and because opportunistic screening does not cover this often disadvantaged group, achieving high participation in screening programmes for foreigners is critical to further reducing the cervical cancer burden in Italy. PMID:26207563

  20. Bedaquiline for the treatment of multidrug-resistant tuberculosis: great promise or disappointment?

    OpenAIRE

    Field, Stephen K

    2015-01-01

    Acquired drug resistance by Mycobacterium tuberculosis (MTB) may result in treatment failure and death. Bedaquiline was recently approved for the treatment of multidrug-resistant tuberculosis (MDR-TB). This report examines the available data on this novel drug for the treatment of MDR-TB. PubMed searches, last updated 18 February 2015, using the terms bedaquiline, TMC 207 and R207910 identified pertinent English citations. Citation reference lists were reviewed to identify other relevant repo...

  1. Still Bound for Disappointment? Another Look at Faculty and Library Journal Collections

    OpenAIRE

    Jennifer Rutner; James Self

    2013-01-01

    Objective – To examine why faculty members at Columbia University are dissatisfied with the library’s journal collections and to follow up on a previous study that found negative perceptions of journal collections among faculty at Association of Research Libraries (ARL) member institutions in general.Methods – In 2006, Jim Self of the University of Virginia published the results of an analysis of LibQUAL+® survey data for ARL member libraries, focusing on faculty perceptions of journal collec...

  2. Still Bound for Disappointment? Another Look at Faculty and Library Journal Collections

    Directory of Open Access Journals (Sweden)

    Jennifer Rutner

    2013-06-01

    Full Text Available Objective – To examine why faculty members at Columbia University are dissatisfied with the library’s journal collections and to follow up on a previous study that found negative perceptions of journal collections among faculty at Association of Research Libraries (ARL member institutions in general.Methods – In 2006, Jim Self of the University of Virginia published the results of an analysis of LibQUAL+® survey data for ARL member libraries, focusing on faculty perceptions of journal collections as measured by LibQUAL+® item IC-8: “print and/or electronic journal collections I require for my work.” The current analysis includes data from 21 ARL libraries participating in the LibQUAL+® survey from 2006 through 2009. Notebooks for each library were accessed and reviewed for the Information Control and overall satisfaction scores. At Columbia, the results were used to identify departments with negative adequacy gaps for the IC-8 item. Follow-up phone interviews were conducted with 24 faculty members in these departments, focusing on their minimum expectation for journal collections, their desired expectations, and preferences for print or electronic journals.Results – Analysis of the 2009 LibQUAL+® scores shows that faculty across ARL libraries remain dissatisfied with journal collections. None of the libraries achieved a positive adequacy gap, in which the perceived level of service exceeded minimum expectations. There was no significant change in the adequacy gap for the IC-8 item since 2006, and satisfaction relative to expectations remained consistent, showing neither improvement nor decline. While most of the faculty members interviewed at Columbia stated that the journal collections met their minimum expectations, 15 of 24 reported that the library did not meet their desired level of service in this area. Key issues identified in the interviews included insufficient support from library staff and systems regarding journal

  3. Preliminary results of SIB-IMRT in head and neck cancers: Report from a regional cancer center in northern India

    Directory of Open Access Journals (Sweden)

    Chakraborty Santam

    2009-01-01

    Full Text Available Background : Intensity-modulated radiotherapy using simultaneous integrated boost (SIB-IMRT is an attractive method for the treatment of head and neck cancers with sparing of the salivary function. Aims : To assess the feasibility, toxicity, and tumor control using SIB-IMRT in locally advanced head and neck cancers in the Indian setting. Settings and Design : The study was conducted in a regional cancer center in northern India. A review of the treatment result of the first 20 patients is presented. Methods and Materials : SIB-IMRT was planned for 20 patients-14 patients were treated with the SIB-72 schedule delivering a dose of 72 Gy, 66 Gy, and 57 Gy to the PTV GTV , PTV CTV1 , and PTV CTV2 in 33 fractions. Six patients were treated with the SIB-66 schedule delivering 66 Gy, 60 Gy, and 54 Gy to the above-mentioned volumes in 30 fractions. Patients were monitored for toxicity using the CTCAE v 3.0 criteria. Descriptive analysis of toxicity and actuarial estimates of the loco-regional control and survival are presented. Results : Grade III mucositis was seen in 65% patients. None of the patients had Grade III dermatitis. The projected 2-year overall survival was 95%. Conclusion : SIB-IMRT schedules evaluated were found to be safe and effective and are being subjected to further prospective studies.

  4. Cosmetic results in early stage breast cancer patients with high-dose brachytherapy after conservative surgery

    International Nuclear Information System (INIS)

    Purpose: to reveal cosmetic results in patients at early stages of low risk breast cancer treated with partial accelerated radiotherapy using high dose rate brachytherapy. Methods and materials: from March 2001 to July 2003,14 stages l and ll breast cancer patients were treated at the Colombian national cancer institute in Bogota with conservative surgery and radiotherapy upon the tumor bed (partial accelerated radiotherapy), using interstitial implants with iridium 192 (high dose rate brachytherapy) with a dose of 32 Gys, over 4 days, at 8 fractions twice a day. Results: with an average follow up of 17.7 months, good cosmetic results were found among 71.4 % of patients and excellent results among 14.3% of patients, furthermore none of the patients neither local nor regional or distant relapses. Conclusion: among patients who suffer from breast cancer at early stages, it showed is possible to apply partial accelerated radiotherapy upon the tumor bed with high doses over 4 days with good to excellent cosmetic results

  5. Prostate cancer detection at rebiopsy after an initial benign diagnosis: results using sextant extended prostate biopsy

    Directory of Open Access Journals (Sweden)

    Katia Ramos Moreira Leite

    2008-01-01

    Full Text Available INTRODUCTION: Sextant prostate biopsy remains the standard technique for the detection of prostate cancer. It is well known that after a diagnosis of small acinar proliferation (ASAP or high grade prostate intraepithelial neoplasia (HGPIN, the possibility of finding cancer is approximately 40% and 30%, respectively. OBJECTIVE: We aim to analyze follow-up biopsies on patients who initially received a benign diagnosis after exclusion of HGPIN and ASAP. METHODS: From July 2000 to December 2003, 1177 patients were submitted to sextant extended prostate biopsy in our hospital. The mean patient age was 65.5 years old, and the median number of fragments collected at biopsy was 13. HGPIN and ASAP were excluded from our study. We only considered patients who had a diagnosis of benign at the first biopsy and were subjected to rebiopsies up until May 2005 because of a maintained suspicion of cancer. RESULTS: Cancer was initially detected in 524 patients (44.5%, and the diagnosis was benign in 415 (35.3%. Rebiopsy was indicated for 76 of the latter patients (18.3% because of a persistent suspicion of cancer. Eight cases of adenocarcinoma (10.5% were detected, six (75% at the first rebiopsy. Six patients were submitted to radical prostatectomy, and all tumors were considered clinically significant. CONCLUSION: Our data indicate that in extended prostate biopsy, the first biopsy detects more cancer, and the first, second, and third rebiopsies after an initial benign diagnosis succeed in finding cancer in 7.9% (6/55, 5.9% (1/15 and 20% (1/4 of patients, respectively.

  6. Disappointed Love and Suicide: A Randomized Controlled Trial of "Abandonment Psychotherapy" Among Borderline Patients.

    Science.gov (United States)

    Andreoli, A; Burnand, Y; Cochennec, M-F; Ohlendorf, P; Frambati, L; Gaudry-Maire, D; Di Clemente, Th; Hourton, G; Lorillard, S; Canuto, A; Frances, A

    2016-04-01

    To determine whether ambulatory psychotherapy targeted to abandonment experiences and fears can reduce suicidality and improve outcome in borderline patients referred to the emergency room with major depressive disorder and self-destructive behavior severe enough to require medical/surgical treatment and a brief psychiatric hospitalization. A total of 170 subjects were randomized at hospital discharge into three treatment groups: treatment as usual (TAU), abandonment psychotherapy delivered by certified psychotherapists, and abandonment psychotherapy delivered by nurses. Assessments were performed before randomization and at 3-month follow-up. Continued suicidality and other outcome measures were significantly worse in the treatment-as-usual as compared to both abandonment psychotherapy groups, but there were no differences between the two psychotherapy groups. These results suggest the efficacy of manualized psychotherapy that specifically targets the abandonment fears and experiences that are so common as precipitants to suicidal and self-destructive acts in borderline patients. It does not appear that formal psychotherapy training is associated with better outcomes. PMID:26111250

  7. Bedaquiline for the treatment of multidrug-resistant tuberculosis: great promise or disappointment?

    Science.gov (United States)

    Field, Stephen K

    2015-07-01

    Acquired drug resistance by Mycobacterium tuberculosis (MTB) may result in treatment failure and death. Bedaquiline was recently approved for the treatment of multidrug-resistant tuberculosis (MDR-TB). This report examines the available data on this novel drug for the treatment of MDR-TB. PubMed searches, last updated 18 February 2015, using the terms bedaquiline, TMC 207 and R207910 identified pertinent English citations. Citation reference lists were reviewed to identify other relevant reports. Pertinent MDR-TB treatment reports on the US Food and Drug Administration, Centers for Disease Control and Prevention (CDC), World Health Organization (WHO) and Cochrane websites were also evaluated. Bedaquiline is an adenosine triphosphate (ATP) synthase inhibitor specific for MTB and some nontuberculous mycobacteria. The early bactericidal activity (EBA) of bedaquiline is delayed until ATP stores are depleted but subsequently it is similar to the EBA of isoniazid and rifampin. Bedaquiline demonstrated excellent minimum inhibitory concentrations (MICs) against both drug-sensitive and MDR-TB. Adding it to the WHO-recommended MDR-TB regimen reduced the time for sputum culture conversion in pulmonary MDR-TB. Rifampin, other cytochrome oxidase 3A4 inducers or inhibitors alter its metabolism. Adverse effects are common with MDR-TB treatment regimens with or without bedaquiline. Nausea is more common with bedaquiline and it increases the QTcF interval. It is not recommended for children, pregnant or lactating women. More patients died in the bedaquiline-treatment arms despite better microbiological outcomes in two recent trials. The WHO and CDC published interim guidelines that recommend restricting its use to patients with MDR-TB or more complex drug resistance who cannot otherwise be treated with a minimum of three effective drugs. It should never be added to a regimen as a single drug nor should it be added to a failing regimen to prevent the emergence of bedaquiline

  8. Use of dairy products, lactose, and calcium and risk of ovarian cancer - results from a Danish case-control study

    DEFF Research Database (Denmark)

    Faber, Mette Tuxen; Jensen, Allan; Søgaard, Marie;

    2012-01-01

    A number of epidemiological studies have examined the association between use of dairy products and risk of ovarian cancer, but results are conflicting. Using data from a large Danish population-based case-control study we here further examined the association between dairy consumption, lactose......, and calcium and risk of overall ovarian cancer and histological types of ovarian cancer....

  9. Hereditary non-polyposis colorectal cancer: clinical features and survival. Results from the Danish HNPCC register

    DEFF Research Database (Denmark)

    Myrhøj, T; Bisgaard, M L; Bernstein, Inge Thomsen;

    1997-01-01

    were compared with 870 patients with sporadic colorectal cancer. RESULTS: The median age at CRC diagnosis was 41 years in the HNPCC group. HNPCC patients had significantly more carcinomas located to the right colon (68% against 49% in controls), more synchromous tumours (7% versus 1%), more...

  10. Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition

    OpenAIRE

    Rohrmann, Sabine; Overvad, Kim; Bueno-de-Mesquita, H. B.; Jakobsen, Marianne U; Egeberg, Rikke; Tjønneland, Anne; Nailler, Laura; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Françoise; Krogh, Vittorio; Palli, Domenico; Panico, Salvatore; Tumino, Rosario; Ricceri, Fulvio; Bergmann, Manuela M

    2013-01-01

    Background Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods ...

  11. Breast-conserving surgery after neoadjuvant chemotherapy in patients with locally advanced cancer. Preliminary results

    OpenAIRE

    VERGINE, M.; SCIPIONI, P.; GARRITANO, S.; COLANGELO, M.; Di Paolo, A; LIVADOTI, G.; MATURO, A.; Monti, M

    2013-01-01

    Neoadjuvant chemotherapy (NACT) in locally advanced breast tumors may allow an adequate control of the disease impossible with surgery alone. Moreover, NACT increases the chance of breast-conserving surgery. Between 2008 and 2012, we treated with NACT 83 patients with locally advanced breast cancer. We report the preliminary results evaluating the impact of NACT on the type of surgery.

  12. Results of radiotherapy for cancer of head and neck region, 2

    International Nuclear Information System (INIS)

    From 1967 through 1985, 86 patients with cancer of the paranasal sinuses and 6 patients with cancer of the nasal cavity (excluding sarcoma) were treated by irradiation at the Department of Radiology, Kumamoto National Hospital. The mean age was 60.7. The rate of men to women was 1.2 : 1. The results were as follows ; 1) Fifty-nine patients (51 cases of maxillary sinus carcinoma, 4 of ethmoid sinus carcinoma, and 4 of cancer of the nasal cavity) were treated with antrostomy followed by radiotherapy and regional arterial infusion of 5-fluorouracil alone or a combination of 5-fluorouracil and bleomycin. In 11 cases of these, salvage with total maxillectomy was performed and 10 % of which were controlled for more than five years. In 9 cases of these, no case was salvaged with radiotherapy. An overall five-year survival rate was 32 %. 2) The survival rate of the postoperative irradiation (11 cases of maxillary sinus carcinoma, 1 of cancer of the nasal cavity) was 42 % at 2 and 4 years after the operations. 3) Twelve patients with cancer of the paranasal sinuses (11 cases of maxillary sinus carcinoma, 1 of ethmoid sinus carcinoma) survived more than five years. All of them were irradiated curatively with doses more than 40 Gy. In our series, there was no difference in long-term survival between 5-fluorouracil alone and a combination of 5-fluorouracil and bleomycin. (author)

  13. Risk of lung cancer and residential radon: pooled results of two studies in China

    International Nuclear Information System (INIS)

    Objective: To verify the prognosis that miners' exposure to radon is the second leading cause of lung cancer. Methods: The authors collected data from two case-control studies of residential radon representing two large radon studies conducted in China. The studies included 1050 lung cancer cases and 1996 controls. Results: Based on a linear model, the excess odds ratio (EOR) with 95% confidence intervals (CI) at 100 Bq/m3 was 0.133 (0.01, 0.36). For subjects living in the current home for 30 years or more, the EOR was 0.315 (0.07, 0.91). EOR estimates were similar to those in the extrapolations from miner data and consistent with residential radon studies in North American and Europe. Conclusion: Long-term radon exposure at concentrations found in many houses increases lung cancer risk

  14. The Basic Facts of Korean Breast Cancer in 2012: Results from a Nationwide Survey and Breast Cancer Registry Database

    OpenAIRE

    Kim, Zisun; Min, Sun Young; Yoon, Chan Seok; Jung, Kyu-Won; Ko, Beom Seok; Kang, Eunyoung; Nam, Seok Jin; Lee, Seokwon; Hur, Min Hee; ,

    2015-01-01

    The Korean Breast Cancer Society has constructed a nationwide breast cancer database through utilization of an online registration program. We have reported the basic facts about breast cancer in Korea in 2012, and analyzed the changing patterns in the clinical characteristics and management of breast cancer in Korea over the last 10 years. Data on patients newly diagnosed with breast cancer were collected for the year 2012 from 97 hospitals and clinics nationwide using a questionnaire survey...

  15. Interferon-β-armed oncolytic adenovirus induces both apoptosis and necroptosis in cancer cells

    Institute of Scientific and Technical Information of China (English)

    Hongling Huang; Tian Xiao; Lingfeng He; Hongbin Ji; Xin-Yuan Liu

    2012-01-01

    Interferon-β (IFN-β) has been widely used in cancer therapy,but the clinical trial results are generally disappointing.Our previous studies have shown that an oncolytic adenovirus carrying IFN-β (ZD55-IFN-β) exhibits significant anti-tumor activities.However,the underlying mechanisms are not clear.Here we showed that ZD55-IFN-β infection-induced S-phase cell cycle arrest in a p53-dependent manner by activating the ataxia telangiectasia mutated-dependent DNA damage pathway.In addition, ZD55-IFN-β infection could initiate both caspase-dependent apoptosis and necroptosis in cancer cells.More importantly,ZD55-IFN-β showed a synergistic effect on cancer cells when combined with doxorubicin.These results suggest that the combination of ZD55-IFN-β with doxorubicin may represent a promising clinical strategy in cancer therapy.

  16. Assess results of PET/CT in cancer diagnosis, follow up treatment and simulation for radiation therapy

    International Nuclear Information System (INIS)

    PET/CT (Positron Emission Computed Tomography) has been studied and established as routine at the Nuclear Medicine and Oncology Center, Bach Mai hospital. From 8/2009 to 5/2015, 6223 patients have been undergone PET/CT scan. Among them, diagnostic and simulation PET/CT scan for cancer patients accounted to 5833 (93.8%). Researches about value of PET/CT for most common cancers have been done. Results: PET/CT can help the primary tumor diagnosis, metastases detection, staging, simulation for radiation therapy, response to treatment assessment, and relapses after treatment identification. Percentage accordance between PET / CT and histopathology was 96% (esophagus cancer), 94.7% (lung cancer). Average maxSUV value of primary tumor of the esophagus cancer, colorectal cancer, nasopharynx cancer, lung cancer, and NHL respectively 9.50, 9.78, 11.08, 9.17, 10.21. MaxSUV value increased with histological grade and tumor size. After undergone PET / CT, stage of disease changed in 28% esophagus cancer; 22.7% colorectal cancer; stage of disease increased in 23.5% of NHL, 32.0% of lung cancer, and 25.0% of nasopharynx cancer. PET / CT simulation for radiation therapy target volume reduced in 28% of nasopharynx cancer, which helped the radioactive dose concentrate exactly in the target lesions, minimize effect to healthy tissues, improved the effectiveness of treatment and reduced complications. (author)

  17. The impact of radiologists' expertise on screen results decisions in a CT lung cancer screening trial

    International Nuclear Information System (INIS)

    To evaluate the impact of radiological expertise on screen result decisions in a CT lung cancer screening trial. In the NELSON lung cancer screening trial, the baseline CT result was based on the largest lung nodule's volume. The protocol allowed radiologists to manually adjust screen results in cases of high suspicion of benign or malignant nodule nature. Participants whose baseline CT result was based on a solid or part-solid nodule were included in this study. Adjustments by radiologists at baseline were evaluated. Histology was the reference for diagnosis or to confirm benignity and stability on subsequent CT examinations. A total of 3,318 participants (2,796 male, median age 58.0 years) were included. In 195 participants (5.9 %) the initial baseline screen result was adjusted by the radiologist. Adjustment was downwards from positive or indeterminate to negative in two and 119 participants, respectively, and from positive to indeterminate in 65 participants. None of these nodules turned out to be malignant. In 9/195 participants (4.6 %) the screen result was adjusted upwards from negative to indeterminate or indeterminate to positive; two nodules were malignant. In one in 20 cases of baseline lung cancer screening, nodules were reclassified by the radiologist, leading to a reduction of false-positive screen results. (orig.)

  18. 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

  19. URODYNAMIC FINDINGS IN ASSESSMENT OF THE RESULTS OF PARTIAL CYSTECTOMY FOR BLADDER CANCER

    OpenAIRE

    F. Sh. Engalychev; N.G. Galkina

    2014-01-01

    Objectives. We determined the role of urodynamic results on the estimation of treatment efficiency of patients with bladder cancer.Subjects and methods. The study consequently included 160 patients receiving TUR and open resection in 2005−2009. Quality of life was assessed using the IPSS, QoL and International Inventory of Erectile Function (IIEF). Uroflowmetry, bladder diary were carried out to determine lower urinary tract symptoms befor treatment, 3 and 12 mo later.Results. In 3 months aft...

  20. Results of whole brain radiotherapy in patients with brain metastases from breast cancer: a retrospective study

    International Nuclear Information System (INIS)

    Purpose: To analyze the factors that affect survival in patients with brain metastases (BM) from breast cancer who were treated with whole brain radiotherapy (WBRT). Methods and Materials: We identified 116 women with breast cancer who were treated with WBRT alone between February 1984 and September 2000. All patients had treatment and follow-up data available in their medical charts, which we extracted for this retrospective study. We evaluated a number of potential predictors of survival after WBRT: age, primary tumor stage, control of primary tumor, presence of other systemic metastases, site of systemic metastases, Karnofsky performance status, Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis class, total dose of WBRT, and number of BM. Eighteen patients received a total dose >3000 cGy and 7 received a partial brain boost. Results: For the entire cohort, the median survival from the start of WBRT was 4.2 months. The 1-year survival rate was 17%, and the 2-year survival rate was 2%. Using univariate analysis, only Karnofsky performance status (p=0. 0084), recursive partitioning analysis class (p=0. 0147), and total WBRT dose (p=0.0001) were predictive of longer survival. In multivariate analysis, Karnofsky performance status was the only significant predictor. Conclusion: Overall survival in breast cancer patients with BM treated with WBRT is poor. We recommend breast cancer patients with BM be enrolled in prospective trials to improve results

  1. Post-operative condition of breast cancer patients from standpoint of psycho-oncology: Preliminary results

    Directory of Open Access Journals (Sweden)

    Kovač Aleksandra

    2014-01-01

    Full Text Available Introduction. Information on being diagnosed to have cancer is always shocking for the patient, and it always causes a lot of psychosocial problems during its treatment. In these moments, patients need understanding, support and someone who can help them to apprehend all available options and choices clearly. The purpose of this study is to show the psychological states of patients with breast cancer after breast surgery, the importance of the psychological support, and first experiences in psycho-oncological management of breast cancer patients. Material and Methods. The study sample included 46 women, their average age being 52.32 (± 8.98, who had answered questions in a questionnaire in the period after surgery. Results. The patients experienced fears and worries associated with almost every part of cancer treatment likely to happen in the near future. The fear of chemotherapy and radiotherapy (67%, the horror of losing hair (59% and the fear of relapse or disease progression (57% were evident. Moreover, the patients dreaded the forthcoming pathological results and the decisions to be made by the Oncology Commission (57%, with accompanying insomnia caused by disturbing thoughts in 39% of the patients. Conclusion. These findings suggest that psychological support is important in this early period after breast surgery due to the vulnerability of the patients, and because it can diminish the risk of potential escalation of distress.

  2. Treatment results of radiotherapy for early tongue cancer of young age

    International Nuclear Information System (INIS)

    Treatment results of early tongue cancer of young age are still controversial. Low dose rate (LDR) interstitial brachytherapy with or without external radiotherapy was mainly used for early tongue cancer in our institute. Patients with 70 early tongue cancer less than 40 years old were treated with radiotherapy alone. The 5-year local control and cause-specific survival (CSS) rates were 78% and 80%, respectively. There were no significant differences between those of the middle age group (40-64 years old) and of the old age group (65 years old or more). Univariate analysis was performed using young patients. Significant factors of poor prognosis were tumor thickness (more than 11 mm) for local control, tumor thickness and sex (male) for nodal control and tumor thickness, T stage (T2) and sex for CSS. The tumor type was not a significant factor in the 5-year control rate. However, higher local recurrence rate was shown in the indurative type within first three years and late recurrences were often observed in the superficial or exophytic type. Treatment results of radiotherapy for early tongue cancer of the young age were not worse than of the older age. However, it seems important to select the treatment method according to prognostic factors. (author)

  3. Results of radioiodine therapy in patients with pulmonary metastases of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Factors affecting the effect of 131I treatment and survival after pulmonary metastases in patients with differentiated thyroid cancer, were studied. Between 1984-1999, pulmonary metastases was observed in 51 out of 153 patients with differentiated thyroid cancer at our institution. Of these 41 patients had papillary and 10 follicular thyroid cancer. There were 37 females and 14 males with mean age (±S.D.) of 50.5±19.0 years. These 51 patients were subjected to 131I therapy. The effect of 131I treatment and the prognostic values of the following variables were examined: sex, age at the time of 131I treatment, histologic type of cancer, size of pulmonary metastases on CT, total-body scintigraphy with 201Tl and 131I, serum thyroglobulin levels and presence of metastases in distant sites other than lung. The effect of 131I treatment was evaluated by means of changes in the number and size of metastatic shadows on chest CT and by serum thyroglobulin levels. The minimum duration of follow-up was 12 months. Therapeutic 131I dose scans revealed detectable uptake in 25 of 51 patients. Therapeutic 131I dose uptake was achieved more frequently in patients under 40 years of age and in those with follicular cancers. Of the 51 patients, 13 were evaluated to be treated successfully. Those under 40 years of age, with 131I up-take in the lung and presence of other metastases showed a good response to treatment than others. Follicular cancer showed a more significant association with coarse type of lung metastases (>5 mm in diameter on chest CT) and good 131I uptake than papillary cancer. Of all the variables studied, the best prognosis for survival was demonstrated by increased 131I uptake in pulmonary metastases. These results indicate that age, 131I uptake and presence of other metastases are important factors in predicting the effect of 131I treatment for pulmonary metastases of differentiated thyroid cancer. (author)

  4. Conservative surgery and radiotherapy in the treatment of breast cancer. Preliminary results of 148 patients

    International Nuclear Information System (INIS)

    The combination of tumoral resection and radiotherapy with preservation of the breast is called conservative treatment of breast cancer. The literature considers this treatment a good option if used by an experient team and with appropriate equipment. This paper shows the results of 148 cases of breast cancer treated by this conservative approach at Centro de Oncologia Campinas. Follow-up varied from 3 to 87 months (mean 28) considered by the histological diagnosis. Overall actuarial survival of 5 years was 77% disease-free survival 55%. Twelve patients (8%) presented local relapse and 13 (9%) had distant metastases as the first therapeutic failure. Cosmetic results were considered good and fair in 89% of patients. These results are similar to others published in the literature (Author)

  5. Meta-analysis of aspirin use and risk of lung cancer shows notable results.

    Science.gov (United States)

    Hochmuth, Friederike; Jochem, Maximilian; Schlattmann, Peter

    2016-07-01

    Aspirin is a promising agent for chemoprevention of lung cancer. We assessed the association of aspirin use and the development of lung cancer, with a focus on heterogeneity between studies. Databases were searched for relevant studies until September 2014. Studies evaluating the relationship of aspirin use and incidence of lung cancer were considered. Relative risks (RR) were extracted and a pooled estimate was calculated. Heterogeneity was assessed by the I measure, random-effects models, and finite-mixture models. Sources of heterogeneity were investigated using a meta-regression. A decreased risk of lung cancer was found including 20 studies [RR=0.87, 95% confidence interval (CI): 0.79-0.95] on the basis of a random-effects model. Strong heterogeneity was observed (τ=0.0258, I=74.4%). As a result, two subpopulations of studies were identified on the basis of a mixture model. The first subpopulation (42%) has an average RR of 0.64. The remaining subpopulation (58%) shows an RR of 1.04. Different results were found for case-control (RR=0.74, 95% CI: 0.60-0.90) and cohort studies (RR=0.99, 95% CI: 0.93-1.06) in a stratified analysis. In a subgroup analysis, use of aspirin was associated with a decreased risk of non-small-cell lung cancer in case-control studies (RR=0.74; 95% CI: 0.58-0.94). At first glance, our meta-analysis shows an average protective effect. A second glance indicates that there is strong heterogeneity. This leads to a subpopulation with considerable benefit and another subpopulation with no benefit. For further investigations, it is important to identify populations that benefit from aspirin use. PMID:26067033

  6. Results of LINAC radiotherapy of patients with cancer in Nuclear Medicine and Oncology Center, Bach Mai Hospital

    International Nuclear Information System (INIS)

    Purpose of the study is to review some characteristics of LINAC radiotherapy and to evaluate rate of objective response in some common cancer diseases. Patients and method: Cross study with patients were confirmed diagnostic by histopathology who have indication radiation of treatment from July 2007 to March 2015, completely treatment protocol, were followed up regularly, fully medical record. Results: 6290 patients, most of patients were male (61.1%), 40-50 years old (51.8%). Common cancer diseases included lung cancer (25.0%) , malignant brain tumor (13.6%), oesophageal cancer (12.1%), nasopharyngeal cancer (9.0%). PET/CT simulation was applied in 1036 patients (16.5%), the highest rate disease was nasopharyngeal cancer (26.4%), oesophageal cancer (24.8%). 464 cases were treated by IMRT technic (7.4%). In IMRT technic, the highest rate disease was hypopharyngeal cancer (23.5%), cervical cancer (19.4%), nasopharyngeal cancer (16.2%). Five common diseases, compare to CT Sim, PET/CT sim made change GTV from 33.3% to 64.7%, detected new lesions (19.4-36.2%). Compare to 3D-CRT, IMRT technic ensured dose of organ at risk lower, the tumor dose was the same in 2 technic. The nasopharyngeal cancer had highest responsive rate (95.8%), complete response was 88.4%, following is rectal cancer( 94% and 59.3%), pharyngeal cancer (85.8% and 46.6%) esophageal cancer (84.9% and 18.4%) and lung cancer (80.1% and 15.4%), respectively. Conclusions: LINAC radiotherapy, especially PET/CT Sim, IMRT technic were of much benefit to many patients with cancer. (author)

  7. Radiolabeled antibody imaging in the management of colorectal cancer. Results of a multicenter clinical study

    International Nuclear Information System (INIS)

    Presurgical colorectal cancer patients (n = 116) received single intravenous infusions of 1 mg of CYT-103 (OncoScint CR103), an immunoconjugate of monoclonal antibody B72.3, radiolabeled with 111In. Following gamma camera imaging, 103 patients underwent an operative procedure: 92 had primary or recurrent colorectal carcinoma, 1 patient evaluated for recurrence of colorectal cancer had a second primary malignancy (small cell lung), and 10 patients had no demonstrable evidence of malignancy. 111In-CYT-103 immunoscintigraphic findings were consistent with the pathologic diagnoses for 70% of patients with colorectal cancer and 90% of disease-free patients. Antibody imaging contributed to surgical decision making through the detection of occult disease (12% of patients) and the confirmation of localized, potentially resectable disease without regional or metastatic spread. Seven patients (6%) experienced adverse effects, primarily fevers and itching, and 33% of patients developed antibodies to murine immunoglobulin after administration of 111In-CYT-103. The results of this study suggest that 111In-CYT-103 is a useful diagnostic tool for the presurgical evaluation of colorectal cancer patients

  8. Yttrium-90 radioembolization for the treatment of unresectable liver cancer: Results of a single center

    Directory of Open Access Journals (Sweden)

    Özhan Özgür

    2014-03-01

    Full Text Available Objective: To determine the effects of yttrium-90 (Y-90 resin microsphere radioembolization therapy on patients with unresectable liver cancer who do not benefit from chemotherapy. Methods: Fifty-five patients underwent radioembolization therapy included in the study whose had unresectable primary or metastatic liver cancer originating from the gastrointestinal tract. Three were excluded from the study after pre-evaluation angiography. Thirteen (23.6% of the remaining 52 patients had hepatocellular carcinoma and 39 (76.4% had metastatic liver cancer. Fifty-two patients underwent Y-90 radioembolization treatment. Each patient's response to the administered treatment was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST and the overall probability of survival was displayed graphically by the Kaplan-Meier method. Results: After Y-90 therapy, 47 patients were follow-up. While 57% of the patients responded to treatment as clinical benefit, the disease progressed in 43%. The median hepatic progression-free survival time of the patients was 3.4 months (95% confidence interval (ci:1.4-5.3 and the overall survival time was 11.3 months (95%, CI:8.7-14.03. Conclusion: This study emphasizes that Y-90 resin microsphere radioembolization treatment is effective in patients with unresectable liver cancer.

  9. Diabetes, metformin and incidence of and death from invasive cancer in postmenopausal women: Results from the women's health initiative.

    Science.gov (United States)

    Gong, Zhihong; Aragaki, Aaron K; Chlebowski, Rowan T; Manson, JoAnn E; Rohan, Thomas E; Chen, Chu; Vitolins, Mara Z; Tinker, Lesley F; LeBlanc, Erin S; Kuller, Lewis H; Hou, Lifang; LaMonte, Michael J; Luo, Juhua; Wactawski-Wende, Jean

    2016-04-15

    Findings from studies of metformin use with risk of cancer incidence and outcome provide mixed results; with few studies examined associations by recency of diabetes diagnosis or duration of medication use. Thus, in the Women's Health Initiative, we examined these associations and further explored whether associations differ by recency of diabetes and duration of metformin use. Cox regression models were used to estimate hazard ratios (HR) and their 95% confidence intervals. Diabetes was associated with higher risk of total invasive cancer (HR, 1.13; p cancers (HR, 1.2-1.4, and up to over twofold). Diabetes was also associated with higher risk of death from cancer (HR, 1.46; p cancer incidence by diabetes therapy (p = 0.66). However, there was a lower risk of death from cancer for metformin users, compared to users of other medications, relative to women without diabetes, overall (HRs, 1.08 vs. 1.45; p = 0.007) and for breast cancer (HRs, 0.50 vs. 1.29; p = 0.05). Results also suggested that lower cancer risk associated with metformin may be evident only for a longer duration of use in certain cancer sites or subgroup populations. We provide further evidence that postmenopausal women with diabetes are at higher risk of invasive cancer and cancer death. Metformin users, particularly long-term users, may be at lower risk of developing certain cancers and dying from cancer, compared to users of other anti-diabetes medications. Future studies are needed to determine the long-term effect of metformin in cancer risk and survival from cancer. PMID:26616262

  10. Clinical–Pathologic Stage Discrepancy in Bladder Cancer Patients Treated With Radical Cystectomy: Results From the National Cancer Data Base

    Energy Technology Data Exchange (ETDEWEB)

    Gray, Phillip J. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Lin, Chun Chieh; Jemal, Ahmedin [Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia (United States); Shipley, William U. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Fedewa, Stacey A. [Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia (United States); Kibel, Adam S. [Division of Urology, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Rosenberg, Jonathan E. [Genitourinary Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Kamat, Ashish M. [Division of Surgery, Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Virgo, Katherine S. [Department of Health Policy and Management, Emory University, Atlanta, Georgia (United States); Blute, Michael L. [Department of Urology, Massachusetts General Hospital, Boston, Massachusetts (United States); Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Efstathiou, Jason A., E-mail: jefstathiou@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2014-04-01

    Purpose: To examine the accuracy of clinical staging and its effects on outcome in bladder cancer (BC) patients treated with radical cystectomy (RC), using a large national database. Methods and Materials: A total of 16,953 patients with BC without distant metastases treated with RC from 1998 to 2009 were analyzed. Factors associated with clinical–pathologic stage discrepancy were assessed by multivariate generalized estimating equation models. Survival analysis was conducted for patients treated between 1998 and 2004 (n=7270) using the Kaplan-Meier method and Cox proportional hazards models. Results: At RC 41.9% of patients were upstaged, whereas 5.9% were downstaged. Upstaging was more common in females, the elderly, and in patients who underwent a more extensive lymphadenectomy. Downstaging was less common in patients treated at community centers, in the elderly, and in Hispanics. Receipt of preoperative chemotherapy was highly associated with downstaging. Five-year overall survival rates for patients with clinical stages 0, I, II, III, and IV were 67.2%, 62.9%, 50.4%, 36.9%, and 27.2%, respectively, whereas those for the same pathologic stages were 70.8%, 75.8%, 63.7%, 41.5%, and 24.7%, respectively. On multivariate analysis, upstaging was associated with increased 5-year mortality (hazard ratio [HR] 1.80, P<.001), but downstaging was not associated with survival (HR 0.88, P=.160). In contrast, more extensive lymphadenectomy was associated with decreased 5-year mortality (HR 0.76 for ≥10 lymph nodes examined, P<.001), as was treatment at an National Cancer Institute–designated cancer center (HR 0.90, P=.042). Conclusions: Clinical–pathologic stage discrepancy in BC patients is remarkably common across the United States. These findings should be considered when selecting patients for preoperative or nonoperative management strategies and when comparing the outcomes of bladder sparing approaches to RC.

  11. Clinical–Pathologic Stage Discrepancy in Bladder Cancer Patients Treated With Radical Cystectomy: Results From the National Cancer Data Base

    International Nuclear Information System (INIS)

    Purpose: To examine the accuracy of clinical staging and its effects on outcome in bladder cancer (BC) patients treated with radical cystectomy (RC), using a large national database. Methods and Materials: A total of 16,953 patients with BC without distant metastases treated with RC from 1998 to 2009 were analyzed. Factors associated with clinical–pathologic stage discrepancy were assessed by multivariate generalized estimating equation models. Survival analysis was conducted for patients treated between 1998 and 2004 (n=7270) using the Kaplan-Meier method and Cox proportional hazards models. Results: At RC 41.9% of patients were upstaged, whereas 5.9% were downstaged. Upstaging was more common in females, the elderly, and in patients who underwent a more extensive lymphadenectomy. Downstaging was less common in patients treated at community centers, in the elderly, and in Hispanics. Receipt of preoperative chemotherapy was highly associated with downstaging. Five-year overall survival rates for patients with clinical stages 0, I, II, III, and IV were 67.2%, 62.9%, 50.4%, 36.9%, and 27.2%, respectively, whereas those for the same pathologic stages were 70.8%, 75.8%, 63.7%, 41.5%, and 24.7%, respectively. On multivariate analysis, upstaging was associated with increased 5-year mortality (hazard ratio [HR] 1.80, P<.001), but downstaging was not associated with survival (HR 0.88, P=.160). In contrast, more extensive lymphadenectomy was associated with decreased 5-year mortality (HR 0.76 for ≥10 lymph nodes examined, P<.001), as was treatment at an National Cancer Institute–designated cancer center (HR 0.90, P=.042). Conclusions: Clinical–pathologic stage discrepancy in BC patients is remarkably common across the United States. These findings should be considered when selecting patients for preoperative or nonoperative management strategies and when comparing the outcomes of bladder sparing approaches to RC

  12. Modelling lung cancer due to radon and smoking in WISMUT miners: Preliminary results

    International Nuclear Information System (INIS)

    A mechanistic two-stage carcinogenesis model has been applied to model lung-cancer mortality in the largest uranium-miner cohort available. Models with and without smoking action both fit the data well. As smoking information is largely missing from the cohort data, a method has been devised to project this information from a case-control study onto the cohort. Model calculations using 256 projections show that the method works well. Preliminary results show that if an explicit smoking action is absent in the model, this is compensated by the values of the baseline parameters. This indicates that in earlier studies performed without smoking information, the results obtained for the radiation parameters are still valid. More importantly, the inclusion of smoking-related parameters shows that these mainly influence the later stages of lung-cancer development. (authors)

  13. A multicentre randomised controlled trial of reciprocal lung cancer peer review and supported quality improvement: results from the improving lung cancer outcomes project

    OpenAIRE

    Russell, G K; Jimenez, S; Martin, L; Stanley, R; Peake, M D; Woolhouse, I

    2014-01-01

    Background: Results from the National Lung Cancer Audit demonstrate unexplained variation in outcomes. Peer review with supported quality improvement has been shown to reduce variation in other areas of health care but has not been formally tested in cancer multidisciplinary teams. The aim of the current study is to assess the impact of reciprocal peer-to-peer review visits with supported quality improvement and collaborative working on lung cancer process and outcome measures. Methods: Engli...

  14. Hopes, Hypes and Disappointments: On the role of expectations for sustainability transitions : A case study on hydrogen and fuel cell technology for transport

    OpenAIRE

    Budde, B

    2015-01-01

    The aim of this thesis is to better understand the role of (changing) expectations for innovation and transition processes. It aims to gain insights in the processes leading to periods of hypes, followed by disappointment and the effects of such expectation dynamics on transitions. Empirically this thesis focusses on fuel cell technology. Already during the 1990s fuel cell technology became one of the most promising technologies to power the car of the future. Early optimistic expectations ho...

  15. Bisphosphonates in the adjuvant treatment of cancer: experimental evidence and first clinical results

    OpenAIRE

    I.J. Diel; Mundy, G R; ,

    2000-01-01

    Several animal models, as well as a number of cell culture experiments, indicate a prophylactic effect of bisphosphonates in respect of subsequent bone metastasis. Moreover, in preliminary clinical trials involving patients with advanced breast cancer and local or remote metastases, biophosphonates produced a reduction in new skeletal metastases. This overview summarizes and discusses the results of the latest investigations. It opens with a section on the pathophysiology of bone metastasis, ...

  16. Results of low threshold to biopsy following high-intensity focused ultrasound for localized prostate cancer

    OpenAIRE

    Richard L Haddad; Tania A Hossack; Woo, Henry H.

    2012-01-01

    Context: There are different treatment options for localized prostate cancer. The success of high-intensity focused ultrasound (HIFU) is based largely on biochemical prostate specific antigen (PSA) results. Aims: To evaluate the impact of using a low PSA threshold to perform prostate biopsies after HIFU in order to more accurately gauge treatment success. Settings and Design: Eleven patients underwent HIFU at Sydney Adventist Hospital in Sydney, 10 as primary and 1 as salvage therapy ...

  17. Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition

    OpenAIRE

    Rohrmann, Sabine; Overvad, Kim; Bueno-de-Mesquita, H Bas; Jakobsen, Marianne Uhre; Egeberg, Rikke; Tjønneland, Anne; Nailler, Laura; Boutron-Ruault, Marie Christine; Clavel-Chapelon, Françoise; Krogh, Vittorio; Palli, Domenico; Panico, Salvatore; Tumino, Rosario; Ricceri, Fulvio; Bergmann, Manuela M

    2013-01-01

    Background: Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Included in the analysis were 448,568 men and women without prevalent canc...

  18. Preliminary Treatment Results of Intensity-Modulated Radiotherapy for Prostate Cancer

    OpenAIRE

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

    2006-01-01

    Background: To review the initial treatment results of intensity-modulated radiotherapy(IMRT) for prostate cancer.Methods: Ninety-two patients treated with IMRT before July 2003 were included inthis study. The median follow-up was 32 months. The indications for IMRTincluded primary, adjuvant, and salvage treatment. Combined treatment withandrogen suppression therapy was variable. The primary study endpointswere chronic adverse events which were subjectively reported. Only patientswith an aden...

  19. Comparative results of end colostomy for low rectal cancer using alloplastic material

    Directory of Open Access Journals (Sweden)

    I. G. Gataullin

    2012-01-01

    Full Text Available The results of research on the causes affecting in the development of para-colostomy complications after abdomino-perineal extirpation of the rectum for cancer patients, who were treated by us from 2005 to 2012 found that the development of complications para-colostomy affects in the age of patient, comorbidity, severity of anemia, and obesity. Allocation of risk and patient groups at increased risk for complications allows differentiated approach to their prevention.

  20. An attempt to improve the results of treatment for breast cancer complicated by lysis

    Directory of Open Access Journals (Sweden)

    G. A. Khakimov

    2014-01-01

    Full Text Available Lysis in locally advanced breast cancer (BC is not a sign of tumor process dissemination. The correct elaboration of management tactics for such patients may achieve rather good early and late results. The doxorubicin + xeloda regimen for BC complicated by lysis has some advantage over the FAC regimen, without additionally increasing the rate of adverse reactions and worsening the quality of life.

  1. An attempt to improve the results of treatment for breast cancer complicated by lysis

    OpenAIRE

    G. A. Khakimov; A. K. Madalimov; Sh. G. Khakimova; Kh. I. Dzhumaniyozov

    2014-01-01

    Lysis in locally advanced breast cancer (BC) is not a sign of tumor process dissemination. The correct elaboration of management tactics for such patients may achieve rather good early and late results. The doxorubicin + xeloda regimen for BC complicated by lysis has some advantage over the FAC regimen, without additionally increasing the rate of adverse reactions and worsening the quality of life.

  2. Results of mass endoscopic examination for gastric cancer in Kamigoto Hospital, Nagasaki Prefecture

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To examine how the introduction of endoscopy to gastric cancer screening affected survival prognosis in a regional population.METHODS: The subjects comprised 4261 residents of Kamigoto, Nagasaki Prefecture, who underwent gastric X-ray examination for gastric cancer screening from 1991 to 1995, and all 7178 residents who underwent endoscopic examination for the same purpose from 1996to 2003. The analysis evaluated trends in age-adjusted gastric cancer mortality rates and standard mortality ratios (SMRs) among the Kamigoto residents.RESULTS: According to demographic statistics, the 1995 and 2000 age-adjusted gastric cancer mortality rates in Nagasaki Prefecture (per 100000 population) were 42.6 and 37.3 for males and 18.6 and 16.0 for females, while the corresponding rates in Kamigoto before and after the introduction of endoscopic screening were respectively 51.9 and 28.0, and 26.6 and 6.9. The data obtained in this study were divided into those for two periods,1990-1996 and 1997-2006, and SMRs were calculated separately for males and females. For the first period,the SMR was 1.04 (95% CI 0.50-1.58) for males and 1.54(95% CI 0.71-2.38) for females, while for the second period the SMR was 0.71 (95% CI 0.33-1.10) for males and 0.62 (95% CI 0.19-1.05) for females.CONCLUSION: Following the introduction of endoscopic examination, gastric cancer death rates decreased in Kamigoto.

  3. Correlation of the results of radiotherapy of pancreatic cancer with different clinical factors

    International Nuclear Information System (INIS)

    Altogether 124 patients with pancreatic cancer radiation treated at doses of 50-80 Gy. With the period of medical history from 1 to 6 months in 82.1 % of the patients, 6-12 months in 74.4 % and over 12 months in 61.9 % of the patients the mean survival time after radiotherapy was respectively 20.1, 15.5 and 14.3 months, i.e. radiotherapeutic results got worse with the increase of the period of disease. Better survival results were obtained for pancreatic head cancer (14.7 months), worse results in its total involvement (10.4 months). Optimum time between operation and irradiation depending on the degree of jaundice was 0.5-1.5 months. With concomitant pancreatitis irradiation was combined with i.v. administration of contrykal that helped to alleviate the pain syndrome. Irradiation of pancreatic cancer complicated by diabetes mellitus facilitates the course of diabetes during follow-up

  4. Long-term Results of Breast-conserving Surgery and Radiation Therapy in Early Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hee; Byun, Sang Jun [Dongsan Medical Center, Daegu (Korea, Republic of)

    2009-09-15

    To evaluate the long-term results after breast-conserving surgery and radiation therapy in early breast cancer in terms of failure, survival, and cosmesis. One hundred fifty-four patients with stage I and II breast cancer were treated with conservative surgery plus radiotherapy between January 1992 and December 2002 at the Keimyung University Dongsan Medical Center. According to TNM stage, 93 patients were stage I, 50 were IIa, and 11 were IIb. The affected breasts were irradiated with 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks with a boost irradiation dose of 10{approx}16 Gy to the excision site. Chemotherapy was administered in 75 patients and hormonal therapy in 92 patients with tamoxifen. Follow-up periods were 13{approx}179 months, with a median of 92.5 months. The 5- and 10-year overall survival rates were 97.3% and 94.5%, respectively. The 5- and 10-year disease-free survival (5YDFS and 10YDFS, respectively) rates were 92.5% and 88.9%, respectively; the ultimate 5YDFS and 10YDFS rates after salvage treatment were 93.9% and 90.2%, respectively. Based on multivariate analysis, only the interval between surgery and radiation therapy ({<=}6 weeks vs. >6 weeks, p=0.017) was a statistically significant prognostic factor for DFS. The major type of treatment failure was distant failure (78.5%) and the most common distant metastatic site was the lungs. The cosmetic results were good-to-excellent in 96 patients (80.7%). Conservative surgery and radiation for early stage invasive breast cancer yielded excellent survival and cosmetic results. Radiation therapy should be started as soon as possible after breast-conserving surgery in patients with early breast cancer, ideally within 6 weeks.

  5. Long-term Results of Breast-conserving Surgery and Radiation Therapy in Early Breast Cancer

    International Nuclear Information System (INIS)

    To evaluate the long-term results after breast-conserving surgery and radiation therapy in early breast cancer in terms of failure, survival, and cosmesis. One hundred fifty-four patients with stage I and II breast cancer were treated with conservative surgery plus radiotherapy between January 1992 and December 2002 at the Keimyung University Dongsan Medical Center. According to TNM stage, 93 patients were stage I, 50 were IIa, and 11 were IIb. The affected breasts were irradiated with 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks with a boost irradiation dose of 10∼16 Gy to the excision site. Chemotherapy was administered in 75 patients and hormonal therapy in 92 patients with tamoxifen. Follow-up periods were 13∼179 months, with a median of 92.5 months. The 5- and 10-year overall survival rates were 97.3% and 94.5%, respectively. The 5- and 10-year disease-free survival (5YDFS and 10YDFS, respectively) rates were 92.5% and 88.9%, respectively; the ultimate 5YDFS and 10YDFS rates after salvage treatment were 93.9% and 90.2%, respectively. Based on multivariate analysis, only the interval between surgery and radiation therapy (≤6 weeks vs. >6 weeks, p=0.017) was a statistically significant prognostic factor for DFS. The major type of treatment failure was distant failure (78.5%) and the most common distant metastatic site was the lungs. The cosmetic results were good-to-excellent in 96 patients (80.7%). Conservative surgery and radiation for early stage invasive breast cancer yielded excellent survival and cosmetic results. Radiation therapy should be started as soon as possible after breast-conserving surgery in patients with early breast cancer, ideally within 6 weeks

  6. Cancer: beyond speciation.

    Science.gov (United States)

    Vincent, Mark D

    2011-01-01

    A good account of the nature of cancer should provide not only a description of its consistent features, but also how they arise, how they are maintained, why conventional chemotherapy succeeds, and fails, and where to look for better targets. Cancer was once regarded as enigmatic and inexplicable; more recently, the "mutation theory," based on random alterations in a relatively small set of proto-oncogenes and tumor suppressor genes, has enjoyed widespread acceptance. The "mutation theory," however, is noticeable for its failure to explain the basis of differential chemosensitivity, for providing a paucity of targets, especially druggable ones, and for justifying the development of targeted therapies with, in general, disappointingly abbreviated clinical benefit. Furthermore, this theory has mistakenly predicted a widespread commonality of consistent genetic abnormalities across the range of cancers, whereas the opposite, that is, roiling macrogenomic instability, is generally the rule. In contrast, concerning what actually is consistent, that is, the suite of metabolic derangements common to virtually all, especially aggressive, cancers, the "Mutation Theory" has nothing to say. Other hypotheses merit serious consideration "aneuploidy theories" posit whole-genome instability and imbalance as causally responsible for the propagation of the tumor. Another approach, that is, "derepression atavism," suggests cancer results from the release of an ancient survival program, characterized by the emergence of remarkably primitive features such as unicellularity, fermentation, and immortality; existential goals are served by heuristic genomic instability coupled with host-to-tumor biomass interconversion, mediated by the Warburg effect, a major component of the program. Carcinogenesis is here seen as a process of de-speciation; however, genomic nonrestabilization raises issues as to where on the tree of life cancers belong, as a genuinely alternative modus vivendi

  7. The results of screening examinations of breast cancer conducted from 2004 to 2005 in Sierpc poviat

    International Nuclear Information System (INIS)

    Background: Breast cancer is one of the most common malignant neoplasms among women in Poland. 11733 new cases were registered in 2003. Well organized screening examinations are the most effective method of fighting against breast cancer. Aim of study: The main objective of this work was a preliminary analysis of a prophylactic examination programme for breast cancer in Sierpc district performed by the Independent Unit of Public Health Care Centres in Sierpc during the period of 2004 to 2005. Material and methods: The research was performed based on retrospective analysis of files obtained from the Department of Radiology of the Independent Unit of Public Health Care Centres in Sierpc. Prophylactic examination for detection of breast cancer includes physical examination of the breast as well as mammography. Results: The research includes 1291 women, most of them at age 50-55 years (57.1 years on average). City residents represent the biggest group of women. Nearly half of women had their first menstruation at the age of 14 to 15 years. The last menstruation occurred at age between 46 and 50 years old most frequently. The average number of labours was 2.3 and 2.5 during the analyzed period. The first labour occurred most frequently in women at the age of 21 to 25 years old. Most of the women never took previously and still do not take hormonal medicines. 80% of women have done breast self examination but over half of them (60.8%) did it occasionally. Breast examination done by a gynaecologist was performed in 22% of women during the last year. Breast cancer did not occur among family members in most of the analyzed women. Breast pain was the most frequent complaint. Over half of women (64.6%) previously underwent mammography. The biggest group among them (31.1%) includes women who had mammography between 2003 and 2004. Adipose glandular breast texture was detected in near half of women (43.5%). The result of mammography was normal in most analyzed women (87.1%). A

  8. Neoadjuvant radiochemotherapy for locally advanced gastric cancer: Long-term results of a phase I trial

    International Nuclear Information System (INIS)

    Purpose: To assess the long-term results of radiation therapy (RT) when added preoperatively to systemic chemotherapy in patients with locally advanced gastric cancer. Methods and Materials: Patients presenting with T3-4 or N+ gastric cancer received two cycles of cisplatin 100 mg/m2 d1, 5FU 800 mg/m2 d1-4, and Leucovorin 60 mg twice daily d1-4; one cycle before and one concomitantly with hyperfractionated RT (median dose, 38.4; range, 31.2-45.6 Gy). All patients underwent a total or subtotal gastrectomy with D2 lymph node resection. Results: Nineteen patients were accrued and 18 completed the neoadjuvant therapeutic program. All patients were subsequently operated and no fatality occurred. At a mean follow-up of 8 years for the surviving patients, no severe late toxicity was observed. The 5-year locoregional control, disease-free, and overall survival were of 85%, 41%, and 35%, respectively. The peritoneum was the most frequent site of relapse. Among long terms survivors, no severe (Radiation Therapy Oncology Group Grade 3-4) late complication was reported. Conclusions: The present neoadjuvant treatment does not seem to increase the operative risk, nor the late side effects. The encouraging locoregional control rate suggests that the neoadjuvant approach should be considered for future trials in locally advanced gastric cancer. Also, the frequency of peritoneal recurrence stresses the need for a more efficient systemic or intraperitoneal treatment

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

    Institute of Scientific and Technical Information of China (English)

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

    1998-01-01

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

  10. Simultaneous chemoradiotherapy with Taxol/Carboplatin in advanced head and neck cancer. Preliminary results

    International Nuclear Information System (INIS)

    Background: The purpose of simultaneous chemoradiotherapy is to increase local-regional control and to decrease the incidence of distant metastases. Regimens containing cisplatin/5-FU chemotherapy are widely accepted as standard treatment in advanced head and neck cancer. Most studies reported promising response and survival data, but also severe mucosal toxicity. In recent years the newly developed drug Taxol demonstrated interesting activity in head and neck cancer as a single agent and as well in combination drug regimens. In the present outpatient phase-II trial we investigated the combination of Taxol/carboplatin with 40 Gy radiotherapy in a neoadjuvant setting of operable Stage-III/IV squamous cell carcinoma of the oral cavity and oropharynx. Patients and Methods: Twelve patients were enrolled in this ongoing trial with a projected number of 30 patients and received 5 cycles of weekly Taxol (40 mg/m2) and carboplatin (AUC 1.5) with conventional radiotherapy (40 Gy). Within 3 to 4 weeks after chemoradiotherapy resection of the primary tumor and the regional neck nodes was performed. Results: So far 12 patients were evaluable for toxicity and response. Complete response was noted in 8/12 patients (Cr 66%). In 6/10 patients (60%) complete pathologic response was documented in the resection specimens. Conclusion: Our preliminary results demonstrated excellent clinical and pathological response rates of concurrent Taxol/carboplatin and radiotherapy as preoperative treatment modality in advanced oral and oropharyngeal cancer. (orig.)

  11. Biosemiotic Entropy of the Genome: Mutations and Epigenetic Imbalances Resulting in Cancer

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    Samuel S. Shepard

    2013-01-01

    Full Text Available Biosemiotic entropy involves the deterioration of biological sign systems. The genome is a coded sign system that is connected to phenotypic outputs through the interpretive functions of the tRNA/ribosome machinery. This symbolic sign system (semiosis at the core of all biology has been termed “biosemiosis”. Layers of biosemiosis and cellular information management are analogous in varying degrees to the semiotics of computer programming, spoken, and written human languages. Biosemiotic entropy — an error or deviation from a healthy state — results from errors in copying functional information (mutations and errors in the appropriate context or quantity of gene expression (epigenetic imbalance. The concept of biosemiotic entropy is a deeply imbedded assumption in the study of cancer biology. Cells have a homeostatic, preprogrammed, ideal or healthy state that is rooted in genomics, strictly orchestrated by epigenetic regulation, and maintained by DNA repair mechanisms. Cancer is an eminent illustration of biosemiotic entropy, in which the corrosion of genetic information via substitutions, deletions, insertions, fusions, and aberrant regulation results in malignant phenotypes. However, little attention has been given to explicitly outlining the paradigm of biosemiotic entropy in the context of cancer. Herein we distill semiotic theory (from the familiar and well understood spheres of human language and computer code to draw analogies useful for understanding the operation of biological semiosis at the genetic level. We propose that the myriad checkpoints, error correcting mechanisms, and immunities are all systems whose primary role is to defend against the constant pressure of biosemiotic entropy, which malignancy must shut down in order to achieve advanced stages. In lieu of the narrower tumor suppressor/oncogene model, characterization of oncogenesis into the biosemiotic framework of sign, index, or object entropy may allow for more

  12. The Reality in the Surveillance of Breast Cancer Survivors—Results of a Patient Survey

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    Stemmler Hans-Joachim

    2008-01-01

    Full Text Available Background: International guidelines for the surveillance of breast cancer patients recommend a minimized clinical follow-up including routine history and physical examination and regularly scheduled mammograms. However, the abandonment of scheduled follow-up examinations in breast cancer survivors remains a contradiction to established follow-up guidelines for other solid tumours.Patients and Methods: We report the patients’ view on the basis of a survey performed in two separate geographical areas in Germany. The questionnaires were sent out to 2.658 patients with a history of breast cancer.Results: A total of 801 patients (30.1% responded to the questionnaire. The results of the survey can be summarized in two major categories: First, necessity for surveillance was affi rmed by a majority (>95%, and 47.8% of the organized patients answered that there was a need for more intensive diagnostic effort during follow-up. The main expectation from an intensified follow-up was the increased feeling of security as expressed by >80% of the women. Second, the present survey indicates that most of the regularly scheduled follow-up visits were expanded using extensive laboratory and imaging procedures exceeding the quantity of examinations recommended in the present follow-up guidelines.Conclusion: Despite the fact that only one third of the patients responded to the questionnaire, the survey indicates that a majority of physicians who treated these patients still do not accept the present follow-up guidelines. To some extent this may be explained by the observation that patients and possibly also their doctors trust that intensified follow-up increases diagnostic security and survival. Since considerable changes in the treatment options of breast cancer have been made during the last decades a new trial of investigations in follow-up is warranted.

  13. Use of information sources by cancer patients: results of a systematic review of the research literature

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    Kalyani Ankem

    2006-01-01

    Full Text Available Objectives. Existing findings on cancer patients' use of information sources were synthesized to 1 rank the most and least used information sources and the most helpful information sources and to 2 find the impact of patient demographics and situations on use of information sources. Method. . To synthesize results found across studies, a systematic review was conducted. Medline and CINAHL were searched to retrieve literature on cancer patients' information source use. The retrieved articles were carefully selected according to predetermined criteria, and several articles were eliminated in a systematic approach. Analysis. The twelve articles that met the criteria were systematically analysed by extracting data from articles and summarizing data for the purpose of synthesis to determine the meaning of findings on most used information sources, least used information sources, most helpful information sources, effect of patient characteristics on preference for an information source, and effect of patient situations on preference for an information source. Results. In descending order of use, health care professionals, medical pamphlets, and family and friends were most used information sources. Internet and support groups were least used. In descending order of helpfulness, books, health care professionals and medical pamphlets were found to be most helpful information sources. Younger patients used health care professionals and certain forms of written information sources more than older patients. Conclusion. . The systematic review shows that many areas of cancer patients' information source use have been either neglected or barely analysed. An in-depth understanding of cancer patients' use of information sources and the characteristics in information sources they consider to be helpful is important for developing successful interventions to better inform patients.

  14. The Results of Primary Radiotherapy following Breast-Conserving Surgery for Early Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Kyong Hwan; Kim, Mi Sook; Yoo, Seong Yul [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1995-06-15

    Purpose : Primary radiation therapy following breast-conserving surgery has been an accepted alternative to mastectomy during the past 2 decades. In this country, however, the practice of conservative therapy for early invasive breast cancer has not been generalized yet. The purpose of this report was to evaluate the results and complications of breast conservation therapy in Korean Cancer Center Hospital(KCCH) Materials and Methods : From January 1987 to December 1989, 45 patients with early breast cancer treated with conservative treatment in KCCH were studied retrospectively. Median follow up was 54 months(range, 4 to 82 months). All patients received partial mastectomy (biopsy, tumorectomy, or quadrantectomy) and radiation therapy. Twenty eight patients received axillary dissection. The breast was treated with two opoosing tangential fields (total 50 Gy or 50.4 Gy in 5 weeks with daily target dose of 2 Gy or 1.8 Gy). Thirty patients received chemotherapy before and after radiotherapy. Eleven patients received hormonal therapy. Results : Five-year survival rate, 5-year disease free survival rate and 5-year local control rate were 87.2%, 86.5% and 97.6%, respectively. Administration of systemic Therapy (chemotherapy or hormonal therapy) correlated with good prognosis but statistically not significant (0.05 < p < 0.01). The sever late complication rate was 8.9%. Conclusion : Primary radiation therapy following breast-conserving surgery for early breast cancer is an alternative treatment comparing to radical treatment. Long term follow-up and more patients collection is needed to evaluate the prognostic factor and cosmetic outcome.

  15. The Results of Primary Radiotherapy following Breast-Conserving Surgery for Early Breast Cancer

    International Nuclear Information System (INIS)

    Purpose : Primary radiation therapy following breast-conserving surgery has been an accepted alternative to mastectomy during the past 2 decades. In this country, however, the practice of conservative therapy for early invasive breast cancer has not been generalized yet. The purpose of this report was to evaluate the results and complications of breast conservation therapy in Korean Cancer Center Hospital(KCCH) Materials and Methods : From January 1987 to December 1989, 45 patients with early breast cancer treated with conservative treatment in KCCH were studied retrospectively. Median follow up was 54 months(range, 4 to 82 months). All patients received partial mastectomy (biopsy, tumorectomy, or quadrantectomy) and radiation therapy. Twenty eight patients received axillary dissection. The breast was treated with two opoosing tangential fields (total 50 Gy or 50.4 Gy in 5 weeks with daily target dose of 2 Gy or 1.8 Gy). Thirty patients received chemotherapy before and after radiotherapy. Eleven patients received hormonal therapy. Results : Five-year survival rate, 5-year disease free survival rate and 5-year local control rate were 87.2%, 86.5% and 97.6%, respectively. Administration of systemic Therapy (chemotherapy or hormonal therapy) correlated with good prognosis but statistically not significant (0.05 < p < 0.01). The sever late complication rate was 8.9%. Conclusion : Primary radiation therapy following breast-conserving surgery for early breast cancer is an alternative treatment comparing to radical treatment. Long term follow-up and more patients collection is needed to evaluate the prognostic factor and cosmetic outcome

  16. Clinical results for stage III{center_dot}IV cancer of the tongue

    Energy Technology Data Exchange (ETDEWEB)

    Mitani, Hiroki; Kamata, Shin-etsu; Nigauri, Tomohiko; Yonekawa, Hiroyuki [Japanese Foundation for Cancer Research, Tokyo (Japan). Hospital

    2003-04-01

    Our department has been treating patients with tongue cancer since 1946. Until the early 1980s, treatment for primary lesions consisted mainly of a small dose of radium irradiation, regardless of the clinical stage. The approximate 5-year survival rate for progressive tongue cancer with a staging of greater than T 3 was as low as 20.3% (N=137) between 1946 and 1970. Irradiation methods have since improved, and the resection-reconstruction method using a deltopectral skin flap had been introduced. In addition, a trend has emerged towards performing surgical treatment and reconstructions using a greater pectoral muscle skin flap. As a result, the approximate 5-year survival rate for T 3+T 4 tongue cancer improved to 37.0% (N=40) for the period between 1971 and 1980. In 1982, a reconstruction technique using a free skin flap with the goal of reconciling the preservation of function and an improvement in the clinical results was established. Treatment protocols have changed drastically since then, making it possible to perform an extended resection while maintaining the swallowing function. As a result, the approximate 5-year survival rate for T 3+T 4 tongue cancer has improved to 51.6% (N=126). This paper describes the clinical outcome for stage III and IV progressive tongue cancerstreated mainly by surgery over the past twenty years. The subjects included 192 cases of stage III or IV squamous cell carcinoma of the tongue; all of the subjects underwent radical operations between January 1981 and December 1999. The approximate 5-year survival rate (disease-specific survival rate) for stage III cancers was 65.3% (71.8%) (N=123), while that for stage IV cancers was 38.2% (40.0%) (N=69). The 5-year primary lesion control rate according to T classification was as follows: T 1, 100%, T 2, 83.8%, T 3, 81.7%; and T 4, 77.4%. The 5-year neck control rate was 77.1%. Our department, in principle, usually administers external irradiation at a dosage of 40 Gy. We histologically

  17. [Preliminary results of lymphatic chemotherapy in the treatment of rectal cancer].

    Science.gov (United States)

    Narvuzov, S N; Zkbarov, E T; Abduzhabborov, S B; Khakimov, A M; Bobokulov, Kh B; Sidikov, U R

    2004-03-01

    Preliminary results of treatment of 28 patients with cancer recti, in whom lymphatic chemotherapy was applied and operative intervention as well, were studied. The results of treatment in control group, consisting of 28 patients, to whom neoadjuvant systemic chemotherapy was conducted, are adduced. Comparative analysis performed have shown that general toxic signs occurred three times lesser in patients of the main group, than in a control one; the postoperative complications was two times lesser. In one-year follow-up in the main group the recurrences and metastases were absent, in a control group the tumor recurrence had occurred in 3 (10%) of patients. PMID:15154248

  18. RESULTS OF A GOAL-ORIENTED PROSTATE CANCER SCREENING PROGRAM IN THE PENZA REGION

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    F. Sh. Engalychev

    2014-07-01

    Full Text Available Prostate cancer (PC has been recently the most common male cancer disease. At the same time, its incidence is ever increasing. In this connection, PS screening is highly pressing.Objective: to study and assess the first results of a regional goal-oriented PC screening program in the Penza Region.Subjects and methods. The regional goal-oriented “Male Health” program for PC screening was launched in the Penza Region in February 2008. The serum level of prostate-specific antigen (PSA was detected in all 45-to-70-year men who had visited the region’s polyclinics and hospitals for any disease. Digital rectal and transrectal ultrasound studies were additionally performed in patients having the symptoms of lower urinary tract dysfunction. When the PSA level was > 4 ng/ml, multifocal biopsy was made through transperineal and transrectal accesses under ultrasound guidance, by using 12-24 points.Results. In February 2008 to June 2010, blood was tested for PSA in 55 of 103 patients. In 5910 (10.7% of them, its level (> 4 ng/ml was above the allowable limit. Multifocal prostate puncture biopsy was performed in 1695 patients with elevated PSA levels for further examination to rule out PC. The latter was established by the results of biopsy in 737 patients. The percentage of biopsy results positive for cancer was 38.9%. That of PC detected among all the men examined for serum PSA level was 1.3%.Conclusion. To elaborate programs for the early diagnosis and screening of PC is one of the priorities of the development of oncourology, which can considerably improve the results of treatment for this disease.

  19. Results of radiotherapy for cancer of head and neck region, 3. Pharyngeal cancer, carcinoma of the oral tongue and oral cavity

    Energy Technology Data Exchange (ETDEWEB)

    Fujimura, Noriharu; Shinzato, Jintetsu; Watanabe, Keikichi; Habu, Kenjiro; Hirayama, Haruyuki

    1988-04-01

    A total of 122 patients with pharyngeal cancer (55 cases), carcinoma of the oral tongue (28 cases) and carcinoma of the oral cavity (39 cases) were treated by external irradiation at the Department of Radiology, Kumamoto National Hospital. In the retrospective study, therapeutic results in pharyngeal cancer (39 cases), in carcinoma of the oral tongue (20 cases) and in carcinoma of the oral cavity (30 cases) were analyzed. 1) Thirty-nine cases of pharyngeal cancer consitituted 9 cases of epipharyngeal cancer, 17 of mesopharyngeal cancer and 13 of hypopharyngeal cancer. The five-year survival rate was 35 % for epipharyngeal cancer, 13 % for mesopharyngeal cancer and 10 % for hypopharyngeal cancer. 2) Twenty cases of carcinoma of the oral tongue were treated by external irradiation and intraoral electron therapy. The five-year survival rate was 28 %. Three cases survived more than five years ; 2 were preoperative irradiation and 1 undergoing a curative irradiation was salvaged with surgery. 3) Thirty cases of carcinoma of the oral cavity consitituted 10 cases of carcinoma of the floor of the mouth, 9 of carcinoma of the cheek mucosa, 7 of carcinoma of the gum, 2 of carcinoma of the hard palate and 2 of carcinoma of the lip. An overall survival rate was 27 %. Five cases survived more than five years ; 3 were carcinoma of the gum and 2 were carcinoma of the cheek mucosa.

  20. Results of complex treatment of locally disseminated breast cancer making use of neutron-photon therapy

    International Nuclear Information System (INIS)

    The objective of the study was to evaluate the efficiency of preoperative neutron therapy in the combined treatment of patients with locally advanced forms of breast cancer T3-4N1-2MO according to the results of the 3-year period of observation. Fifty-one women with primary locally advanced breast cancer were under study. Twenty-four patients received neoadjuvant chemotherapy (1 - 2 courses) according to the scheme CMF, the preoperative course of neutron therapy at a single dose of 2.4 Gy, at a total dose of 7.2 Gy (isoeffect is 40 Gy), radical mastectomy, remote gamma-therapy at a total dose of 40 Gy, adjuvant chemotherapy of 4 - 5 courses. The control group included 27 patients who received the combined treatment by similar schedule except neutron therapy. Combined treatment of locally advanced breast cancer including preoperative neutron therapy the frequency of local relapses of the tumor and increases the replace-free survival without influence of the indices of non-metastatic and total survival rate. Increase of efficiency of treating the given category of patients is possible in intensive systemic antitumor action

  1. Risk of lung cancer and residental radon in China: pooled results of two studies

    International Nuclear Information System (INIS)

    Studies of radon-exposed underground miners predict that residential radon is the second leading cause of lung cancer mortality; however, case-control studies of residential radon have not provided unambiguous evidence of an association. Owing to small expected risks from residential radon and uncertainties in dosimetry, large studies or pooling of multiple studies are needed to fully evaluate effects. We pooled data from 2 case-control studies of residential radon representing 2 large radon studies conducted in China. The studies included 1,050 lung cancer cases and 1,996 controls. In the pooled data, odds ratios (OR) increased significantly with greater radon concentration. Based on a linear model, the OR with 95% confidence intervals (CI) at 100 Becquerel/cubic-meter (Bq/m3) was 1.13 (1.01, 1.36). For subjects resident in the current home for 30 years or more, the OR at 100 Bq/m3 was 1.32 (1.07, 1.91). Results across studies were consistent with homogeneity. Estimates of ORs were similar to extrapolations from miner data and consistent with published residential radon studies in North American and Europe, suggesting long-term radon exposure at concentrations found in many homes increases lung cancer risk. (orig.)

  2. Bladder cancer among workers in the textile industry: results of a Spanish case-control study.

    Science.gov (United States)

    Gonzales, C A; Riboli, E; Lopez-Abente, G

    1988-01-01

    This paper presents results from a case-control study carried out in the county of Mataro, Spain. The study was designed to investigate the possible causes of an unusually high mortality rate from bladder cancer in Mataro county as compared to Spain as a whole, and this report focuses on occupational exposures. The study is based on 57 cases who were hospitalized for or died from bladder cancer between 1978 and 1981. Two controls per case were matched for sex, age, residence, and date of either hospitalization or death. Information was collected on smoking, coffee drinking, and occupation. Occupational histories were then evaluated and coded blind by a group of occupational health physicians. Analyses were carried out by means of conditional logistic regression. Among a group of common occupational sectors, an increased risk for past employment in the textile industry (OR = 2.2; p = .038) was found. Further analyses indicated that the risk is particularly elevated (OR = 4.41; 95% confidence limits; 1.15-16.84) for subjects who worked in dyeing or printing and who were most probably exposed to azo-dyes. Exposure in the textile industry may be responsible for 16% of the bladder cancers in the Mataro area. A list of dyes commonly used in the Mataro textile industries was compiled and cross-checked with lists of substances tested or evaluated for carcinogenesis. PMID:3232687

  3. State of the art of neoadjuvant chemotherapy in breast cancer: rationale, results and recent developments

    Directory of Open Access Journals (Sweden)

    Solomayer, Erich-Franz

    2005-09-01

    Full Text Available Aims, results, advantages and possible disadvantages of preoperative chemotherapy (pCHT for breast cancer are discussed in this review. Established chemotherapeutic regimens are described with respect to new drugs that are added to combinations now and in the future. Illustrating the potential of new components, trastuzumab and cytotoxic chemotherapy, were combined in neoadjuvant trials for the first time. This approach yielded impressing and unprecedented high pathological response rates. An overview regarding current neoadjuvant cytostatic and immunotherapy trials is given. Established prognostic factors like axillary lymph-nodal status are altered during pCHT, which causes the need for new prognostic markers. The consequences of these changes for clinical decision making are demonstrated. It seems possible that the advances of gene array and protein expression profile technologies will lead to improved prognostic and predictive statements. Tumor tissue can be analyzed before during and after treatment in this regard recent studies investigating the response to specific, chemotherapeutics in correlation to molecular markers are reviewed. These approaches might enable us to identify chemoresistance of specific tumors. Furthermore pCHT allows testing of chemosensitivity in vivo in an early stage, which might lead to a more individualized cancer therapy. We discuss radiotherapy after neoadjuvant therapy and the risk of local relapse after breast conserving surgery, which was made feasible by pCHT. It is shown how the evaluation of efficacy of new cancer drugs, using the neoadjuvant situation, can be done more rapidly than in the metastatic and adjuvant setting.

  4. Prevalence and Treatment Management of Oropharyngeal Candidiasis in Cancer Patients: Results of the French Candidoscope Study

    International Nuclear Information System (INIS)

    Purpose: The aim of this pharmaco-epidemiological study was to evaluate the prevalence of oropharyngeal candidiasis (OPC) in cancer patients treated with chemotherapy and/or radiotherapy. Methods and Materials: Signs and symptoms of OPC were noted for all patients. Antifungal therapeutic management was recorded in OPC patients. Patients receiving local antifungal treatments were monitored until the end of treatment. Results: Enrolled in the study were 2,042 patients with solid tumor and/or lymphoma treated with chemotherapy and/or another systemic cancer treatment and/or radiotherapy. The overall prevalence of OPC was 9.6% (95% confidence interval, 8.4%-11.0%] in this population. It was most frequent in patients treated with combined chemoradiotherapy (22.0%) or with more than two cytotoxic agents (16.9%). Local antifungal treatments were prescribed in 75.0% of OPC patients as recommended by guidelines. The compliance to treatment was higher in patients receiving once-daily miconazole mucoadhesive buccal tablet (MBT; 88.2%) than in those treated with several daily mouthwashes of amphotericin B (40%) or nystatin (18.8%). Conclusion: OPC prevalence in treated cancer patients was high. Local treatments were usually prescribed as per guidelines. Compliance to local treatments was better with once-daily drugs.

  5. Painful neuropathy in a diabetic patient resulting from lung cancer and not diabetes: A case report

    Science.gov (United States)

    YAO, HE-BIN; CHEN, YA-NING; SHANG, JIAN; HAN, QIAO-JUN

    2015-01-01

    The current study reports the case of a 61-year-old man with diabetes who was suffering from generalized pain over the whole body and gradually progressive numbness. The patient was initially diagnosed with diabetic peripheral neuropathy and received treatment, however, the symptoms persisted. In October 2010, the patient was admitted to the Chinese People's Liberation Army Navy General Hospital (Beijing, China) for the treatment of diabetes, however, a full-body sharp pain was also described, which was relieved upon massaging the area. Causes, other than diabetes, were investigated for these symptoms. Chest computed tomography and positron emission tomography-computed tomography scans revealed a mass shadow in the right lower lobe of the lung, with multiple lymphatic metastases. Lung cancer was diagnosed with a tumor-node-metastasis stage of T1N3Mx. Following treatment of the cancer with chemotherapy and radiotherapy, the patient's symptoms were significantly improved. The present study reports a rare case of a paraneoplastic neurological syndrome (PNS) that presented as painful neuropathy resulting from lung cancer, which mimicked diabetic peripheral neuropathy. PMID:26788221

  6. Geographic disparities in late stage breast cancer incidence: results from eight states in the United States

    OpenAIRE

    Tatalovich, Zaria; Zhu, Li; Rolin, Alicia; Lewis, Denise R.; Harlan, Linda C.; Winn, Deborah M.

    2015-01-01

    Background Late stage of cancer at diagnosis is an important predictor of cancer mortality. In many areas worldwide, cancer registry systems, available data and mapping technologies can provide information about late stage cancer by geographical regions, offering valuable opportunities to identify areas where further investigation and interventions are needed. The current study examined geographical variation in late stage breast cancer incidence across eight states in the United States with ...

  7. Cancer research results of the consortial radiation team of the NSBRI

    Science.gov (United States)

    Dicello, J. F.; Chang, P. Y.; Huso, D. L.; Kennedy, A. R.

    During the last eight years through a cooperative agreement with NASA, the National Space Biomedical Research Institute (NSBRI) has been investigating biological risks for personnel in Space, biologic mechanisms and environmental factors responsible for those risks, and countermeasures that could reduce the consequences. The NSBRI uses a programmatic approach where each major risk is investigated by a team through a consortium of individual peer-reviewed research grants. In its initial structuring, NSBRI recognized radiation as one of the major risks in Space, and the Radiation Team has been investigating radiation-induced excess cancer incidences, damage to the central nervous system, and other non-malignant diseases. This presentation reports cancer results and underlying mechanisms. The team is completing the first comprehensive measurement of cancers induced by protons or energetic heavy ions (HZEs) in rodent models (J. Dicello). The results for breast cancer suggest that the biological effectiveness of particles such as iron ions may be less than that frequently assumed. The Team has further demonstrated that exposures to such particles at levels comparable to those in space might be mitigated through pharmaceutical intervention even after exposures have occurred (D. Huso). Dr. Huso's group was able to identify through genetic marking with quantitative immunohistochemistry and microarray analysis that resistant, poorly differentiated breast cancers appear to arise from epithelial cells with a unique gene expression profile. In a parallel NIH grant, Dr. D. Huso developed a new transgenic mouse model for NSBRI studies that better parallels specific genetic pathways associated with hematopoietic malignancies. Dr. A. Kennedy's group at the University of Pennsylvania has shown that non-toxic nutritional supplements can decrease the cytotoxicity levels of oxidative stress and yields of malignantly transformed cells induced by the types of radiation encountered

  8. Modulation of P-Glycoprotein Mediated Multidrug Resistance (Mdr in Cancer Using Chemosensitizers.

    Directory of Open Access Journals (Sweden)

    Velingkar V.S

    2010-03-01

    Full Text Available Multidrug resistance (MDR is one of the main obstacles in the chemotherapy of cancer. MDR is associated with the over expression of P-glycoprotein (P-gp, resulting in increased efflux of chemotherapy from cancer cells. Inhibiting P-gp as a method to reverse MDR in cancer patients has been studied extensively, but the results have generally been disappointing. First-generation agents were limited by unacceptable toxicity, whereas second-generation agents had bettertolerability but were confounded by unpredictable pharmacokinetic interactions and interactions with other transporter proteins. Third-generation inhibitors have high potency and specificity for P-gp. Furthermore, pharmacokinetic studies to date have shown no appreciable impact on drug metabolism and no clinically significant drug interactions with common chemotherapy agents. Third-generation P-gp inhibitors have shown promise in clinical trials. The continued development of these agents may establish the true therapeutic potential of P-gp-mediated MDR reversal.

  9. Clinical results of intensity modulated radiotherapy for breast cancer after breast-conserving surgery

    International Nuclear Information System (INIS)

    Objective: To analyze the efficacy and cosmetic results of intensity modulate radiation therapy (IMRT) for breast cancer after breast-conserving surgery. Methods: From 2003 to 2006, 117 patients with breast cancer, after breast-conserving surgery followed by 4 - 6 cycles of chemotherapy, received intensity modulated radiotherapy (IMRT) or three-dimensional conformal radiotherapy (3DCRT). The radiation dose was 50 Gy in 25 fractions to the whole breast and 10 Gy boost to the tumor bed. Patients with positive hormone receptors then received endocrine treatment. Results: The follow-up rate was 94.0% until September 2009. 114 and 91 patients were followed up to 3 and 5 years, respectively. The 3-and 5-year overall survival rates were 99.1% and 96%. The 5-year disease free survival and local recurrence rates were 88% and 3.6%. Cosmetic results were satisfied. Severe radiation toxicities, such as radiation pneumonitis, pulmonary fibrosis and heart injury were not found. Conclusions: Patients treated with IMRT after breast-conserving surgery have a satisfied prognosis as well as cosmetic results. (authors)

  10. Dietary patterns associated with colon and rectal cancer: Results from the Dietary Patterns and Cancer (DIETSCAN) Project

    NARCIS (Netherlands)

    Dixon, L.B.; Balder, H.F.; Virtanen, M.J.; Rashidkhani, B.; Männistö, S.; Krogh, V.; Brandt, P.A. van den; Hartman, A.M.; Pietinen, P.; Tan, F.; Virtamo, J.; Wolk, A.; Goldbohm, R.A.

    2004-01-01

    Background: An analysis of dietary patterns or combinations of foods may provide insight regarding the influence of diet on the risk of colon and rectal cancer. Objective: A primary aim of the Dietary Patterns and Cancer (DIETSCAN) Project was to develop and apply a common methodologic approach to s

  11. Results of a sentinel lymph node biopsy for primary breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoshinaga, Yasuteru; Hiratsuka, Masafumi; Baba, Miki; Beppu, Richiko; Maekawa, Takafumi; Kawahara, Katsunobu; Shirakusa; Takayuki; Fujimitsu, Ritsuko [Fukuoka Univ. (Japan). School of Medicine

    2003-03-01

    Although the role of an axillary lymph node dissection for the primary breast cancer is considered to be a prognostic indicator, regarding the determination of the treatment strategy after surgery, and the best modality for regional control, this procedure is harmful rather than ineffective in cases with a histologically negative node. The sentinel lymph node (SLN) biopsy is a procedure used to assess the degree of nodal involvement before and/or during surgery. From June, 1999 to January, 2002, we performed an SLN biopsy for 47 primary breast cancer patients (T1-2N0-1M0) using either a dye or combined (dye and gamma probe guided) method with a back up conventional axillary node dissection at the Second Department of Surgery, Fukuoka University School of Medicine. The dye method was performed on 39 patients, and it resulted in the accurate identification of the SLN in 74.4% of patients, compared with 94.7% in latter series of 19 patients. In addition, the dye method demonstrated a sensitivity of 66.6%, a specificity of 100% and an accuracy of 96.6%. Eight patients received the combined method, and the SLN was identified in 100% of these patients. This combined method showed a sensitivity of 80%, a specificity of 100% and an accuracy of 87.5%. On the other hand an intraoperative examination using frozen sections resulted in a sensitivity of 50%, a specificity of 100% and an accuracy in the diagnosis of 83.3%. These data suggest that an SLN biopsy for early breast cancer (T1N0) can be performed to eliminate any unnecessary axillary node dissection in cases with negative SLN. However, the successful results of this method depend on the cooperation of the multidisciplinary team (surgeons, pathologists and nuclear radiologists) and the informed consent of all patients. (author)

  12. Subareolar breast cancer: long-term results with conservative surgery and radiation therapy

    International Nuclear Information System (INIS)

    Purpose: It has been suggested that patients presenting with breast cancers within 2 cm of the nipple areolar complex represent a relative contraindication to conservative management due to either a compromised cosmetic result associated with sacrifice of the nipple areolar complex, reluctance to include the entire nipple areolar complex in the conedown field, or increased risk of multicentricity. We have reviewed our experience of conservatively treated patients with specific reference to the subset of patients presenting with tumors within 2 cm of the nipple areolar complex. Methods and Materials: Between January 1970 and December 1989, 1014 patients with early stage breast cancer were treated at Yale-New Haven Hospital by excisional biopsy with or without axillary lymph node dissection. Of the 1014 charts reviewed, a total of 98 patients fulfilled the criteria of having a central/subareolar breast cancer. Reexcision was performed on only 16 patients. Following conservative surgery, patients were treated with radiation therapy to the intact breast to a total median dose of 48 Gy with conedown to a total of 64 Gy. Adjuvant systemic therapy and regional nodal irradiation were administered as clinically indicated. Results: As of December 1993, the median follow-up for the 98 patients in this study was 9.03 years. The majority of patients had presented with either a palpable mass or a mammographically detected lesion. Three patients presented with Paget's disease, five with nipple discharge, and seven with nipple inversion. Ten of the 98 patients had the nipple areolar complex sacrificed at the time of surgery, while the remaining 88 patients had the entire nipple areolar complex included in the conedown field. Four of these 88 patients had the nipple partially blocked during the electron conedown. There were no significant complications associated with including the entire nipple areolar complex within the conedown field to a median dose of 64 Gy. Six of the 98

  13. LOW-DOSE RATE BRACHYTHERAPY FOR PROSTATE CANCER: DIFFERENT INDICATIONS – DIFFERENT RESULTS

    Directory of Open Access Journals (Sweden)

    V. A. Biryukov

    2014-07-01

    Full Text Available In Russia, there is presently a growing interest in low-dose intratissue radiotherapy (brachytherapy for locally advanced prostate cancer (PC. Since its inception, current brachytherapy has undergone a number of significant changes in terms of improved visualization and better treatment planning and monitoring, which is sure to have affected the higher quality of their performance and better long-term results. The main purpose of the given paper is to generalize the data of foreign investigators who have the greatest experience with brachytherapy for its further use in the treatment of patients with locally advanced PC under the conditions of Russian clinics.

  14. RESULTS OF 192IR CONTACT RADIATION THERAPY FOR CERVIX UTERI CANCER

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    O. A. Kravets

    2014-09-01

    Full Text Available The paper presents the results of treatment for locally advanced cervix uteri cancer, by applying a 192Ir radioactive source for contact radiation. Three- and five-year overall and relapse-free survival rates have been obtained for stages: 82.5 and 82.5%; 78.4 and 78.4% for Stage IIb; 57 and 52.3%; 41.6 and 41.6 for IIIb; 53.3 and 47.3%; 42.4 and 37.7% for IVb, respectively.

  15. Results of surgical treatment of cervical cancer patients of childbearing age

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    V. S. Navruzova

    2015-09-01

    Full Text Available The world marked increase in the incidence of cervical cancer in young women, especially from 29 to 45 years old. Analysis showed that in patients with preserved ovarian function, not only the effectiveness of the treatment, but also the quality of life. It is associated with the acceleration, earlier puberty and the onset of sexual activity. In recent years more and more widely used radical surgery with preservation of the ovaries and the abduction of the radiation castration and preservation of reproductive function. In the National Cancer Research Centre of the Ministry of Health of the Republic of Uzbekistan analyzed the results of surgical treatment of 204 patients with cervical cancer younger. Age of patients from 23 to 45 years, that is, in the most hard-working, reproductive period. In our study patients met principally with exophytic – 82 (40.2 % and 68 (33.3 % еndophytic growth cervical tumors. Histological in 197 (96.6 % patients with squamous cervical cancer patients with 7 (3.4%. Adenocarcinoma of cervical cancer. Handard examination of the patient are further adapted to determine the level of sex hormones (estradiol, progesterone, determination of the tumor marter CA-125 levels of calcium and phosphate in the blood. 112 patients from the main group and the combined complex therapy surgical treatment with organ-component (conservation and ovarian transposition. The first group included 112 (55.1 % patients, who as part of combination therapy was performed and complex surgical treatment of ovarian transposition. The second group included 92 (44.9% patients who as part of combination therapy and complex surgery performed without ovarian transposition. Each group was divided into 3 subgroup included patients with stage process T1b–2aN0M0. Which performs the combined radiotherapy. The second subgroups included patients with stage process that runs systemic chemotherapy, surgery, combined radiotherapy. The third group included

  16. Thermochemoradiotherapy for advanced or recurrent head and neck cancer. Analysis of clinical results and background variables

    Energy Technology Data Exchange (ETDEWEB)

    Hoshina, Hideyuki; Takagi, Ritsuo; Nagashima, Katsuhiro; Fujita, Hajime; Miyamoto, Takeshi; Sohma, Yoh; Fukuda, Jun-ichi; Imai, Nobuyuki; Nagata, Masaki [Niigata Univ. (Japan). Faculty of Dentistry

    2001-03-01

    Eighteen patients with 25 unresectable advanced or recurrent head and neck cancers (squamous cell carcinomas) received thermochemotherapy in combination with radiotherapy. The total radiation dose ranged from 50 to 82 Gy (mean, 65.6 Gy). Patients received thermochemotherapy twice a week, for a total number of 8.8 sessions, on average. The temperature in the tumor, as a result of the hyperthermia, was over 42 deg C in 185 (84.5%) of the 219 treatments. Three kinds of heating systems were used: a 13.56-MHz radiofrequency system, a 2450-MHz microwave system, and a radiofrequency interstitial system. The total amount of administered CDDP ranged from 40 to 300 mg (mean, 110 mg), combined with PEP and/or 5FU. Background factors (tumor factors and treatment factors) were investigated in detail, and the clinical results (tumor response and the 5-year cumulative focal control rate) were evaluated. The relationship between these two results was then analyzed using univariate and multivariate statistics. The clinical results of patients with a WHO histological classification of grade 3 were poor compared with patients with a classification of grade 1 or 2. The difference between these two results was significant when analyzed using univariate statistics, but not significant when analyzed using multivariate statistics. The clinical results of patients with primary lesions surrounded by bony tissues were slightly poor compared with those of patients whose lesions were surrounded by soft tissues, but the difference between these two results was not significant. Successful treatment of refractory recurrent tumors, large tumor masses, and diffuse invasive carcinomas was not affected by the treatment factors (heating systems, heating sessions, radiation dose, and CDDP dose and drug combination). These results suggest that refractory recurrence, proximity to bony tissues, tumor size, and histological malignancy might not be prognostic variables for thermochemoradiotherapy strategy

  17. Long-term results of breast cancer irradiation treatment with low-dose-rate external irradiation

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to assess beam therapy with low-dose-rate (LDR) external irradiation in a group of patients with breast cancer. Methods and Materials: This trial compared, from 1986 to 1989, patients with advanced breast cancer treated either by conventional fractionation or low-dose-rate (LDR) external radiotherapy (dose-rate 15 mGy/min, 5 sessions of 9 Gy delivered on 5 consecutive days). Results: A total of 21 patients were included in the fractionated therapy arm. At follow-up 15 years after treatment, 7 local recurrences had occurred, 3 patients had died of cancer, 18 patients were alive, 10 were without evidence of disease, and 6 had evidence of disease. A total of 22 patients had been included in the LDR arm of the study. Of these, 11 had received a dose of 45 Gy; thereafter, in view of severe local reactions, the dose was reduced to 35 Gy. There was no local recurrence in patients who had received 45 Gy, although there were 2 local recurrences among the 11 patients after 35 Gy. The sequelae were severe in patients who received 45 Gy but were comparable to those observed in patients treated by fractionated radiotherapy who received 35 Gy. The higher efficacy of tumor control in patients treated by LDR irradiation as well as the lower tolerance of normal tissue are probably related to the lack of repopulation. Conclusion: Although the patient numbers in this study are limited, based on our study results we conclude that the data for LDR irradiation are encouraging and that further investigation is warranted

  18. Results of radial therapy epidermoid of lungs cancer with dynamic fractionating dozes

    International Nuclear Information System (INIS)

    Under supervision there were 53 patients epidermoid of lung cancer by which radial therapy under the radical program (Muravskaja G. V. and co author 1998)was carried out . The purpose of work was studying results of radial treatment epidermoid lungs cancer under the radical program and some factors of the prognosis. The diagnosis of epidermoid lungs cancer patients has been confirmed by morphologic. All patients were under supervision more than 1 year.27 from the above stated patients (the first group) 26 patients (the second group)-less than one year lived more than 1 year (51.0%). The two year survival rate of patients of the first group has made 15.1% .Three year survival rate - 11.3% . Results correspond to the literary data(Bauman M.2001)distinction on age was not. At the analysis of distribution of patients on a degree of prevalence of a tumour it is established , that in the first group it was observed: T2NO-4;T2N1-4;T2-3N2,T3NO-1-19,accordingly, in the second group: T2 N0-3,T2N1-2;T2-3N2,T3N1-14;T2-3 N3-7. In both groups prevailed 111 degree of disease:in the first -70,9%,in the second 80.8%. But in group of patients living less than one year, in 26,9% was observed metastatic spreading tumours in the lymphatic nodes, corresponding to category N3. In the second group also much more often are atelectasis, not allowed radiographical to limit a shadow of a tumour from a shadow atelectasis (58.0±9.7% and 30.0±8.8%,p<0.05).Frequency full resorption tumours was observed in the first group in 37.0±9.3%, in the second 3.9±3.8%, almost in 10 times it is less. The received data specify direct correlation between the loco-regional control and lymphogenous distribution epidermoid lungs cancer, presence of atelectasis.In the latter case deterioration of results is probably caused by impossibility at radiological research to define border a tumour and atelectasis that is important at planning volume of irradiation.I n this connection other method of visualization are

  19. Cancer and common mental disorders in the community: Results of the Israel-World Mental Health Survey

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    Ora Nakash

    2012-09-01

    Full Text Available Background and Objectives: To study common mental disorders (CMD and other mental health-related variables among community residents with active cancer, cancer survivors and cancer-free respondents. Methods: Data were extracted from the Israeli component of the 28-country World Mental Health Survey. The sample included 165 respondents who reported ever having cancer and 2,282 cancer-free respondents, all aged 39 years and older. The WHO/Composite International Diagnostic Interview (CIDI was used to determine the prevalence rate of CMD. Emotional distress (ED was ascertained with the GHQ-12. Also, respondents were asked about sleep disturbances and mental health service utilization. Results: Respondents with active cancer were more likely to endorse CMD in the past year than cancer-free respondents, 22.1% SE = 6.1 and 7.2% SE = 2.5, respectively (adjusted odds ratio = 2.6, 95% CI 1.2-5.6; to have higher ED scores, M = 27.1 SE = 1.3 and M = 19.8 SE = 0.3, respectively (Wald F = 16.7, p < 0.001; and higher prevalence rates of sleep disturbances, 64.7% SE = 6.5% and 31.5% SE = 4.6%, respectively (adjusted odds ratio = 2.1, 95% CI 1.1-3.9. Cancer survivors did not significantly differ from cancer-free respondents on the study variables. Despite the emotional toll, there were no differences in mental health service utilization among the three cancer groups. Conclusions: Respondents with active cancer residing in the community show enhanced psychopathology. Study findings highlight a double need: to adequately assess mental health problems in persons with cancer and to bridge the treatment gap.

  20. Cosmetic results following lumpectomy axillary dissection and radiotherapy for smaal breast cancers

    International Nuclear Information System (INIS)

    Between 1970 and April 1982, 592 women, with T/sub 1/, small T/sub 2/, N/sub 0/, N/sub 1/, M/sub 0/ breast cancer were managed by lumpectomy, axillary dissection and radiotherapy at the Institut Gustave Roussy (IGR). The overall cosmetic result and the degree of assymetry, fibrosis and telangiectasia of the treated breast were assessed by the radiation oncologist at each follow-up visit. The changes in these cosmetic parameters with time are shown. At 5 years the overall cosmetic result was excellent in 58%, good in 38% and fair or poor in 8%. A multivariate analysis was performed of the factors associated with a cosmetic defect. The most significant factors were tumour size, the presence of defect after surgery and the daily applied dose per fraction to the breast. Surgical and radiotherapy technique (especially alternate day fractionation) can significantly affect the cosmetic result obtained

  1. Intraoperative photodynamic therapy of bladder cancer with alasens (results of multicenter trial

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    E. V. Filonenko

    2014-01-01

    Full Text Available The results of multicenter prospective trial for efficacy of combined modality treatment: transurethral resection (TUR + photodynamic therapy (PDT with alasens for bladder cancer are represented in the article. Trials were organized by Research Institute of Organic Intermediates and Dyes and conducted according to clinical protocol approved by Ministry of Health of Russia, at the sites of leading Russian cancer clinical centers. The trial included 45 subjects with verified diagnosis of non-muscle-invasive bladder cancer. Patients underwent TUR of bladder with simultaneous PDT as anti-relapse treatment. Alasens was administered to patients as intravesicular instillation of 3% solution in volume of 50 ml with 1.5–2h exposure (prior to TUR. TUR was performed after instillation. PDT session was conducted immediately after the completion of TUR on a single occasion by means of combined local irradiation on tumor bed with diffuse irradiation on whole urinary bladder mucosa (light dose of local irradiation – 100 J/cm2, diffuse irradiation – 20 J/cm2. Good tolerance of the treatment was noticed, there were no complications. Among 45 patients included in the trial, 35 (78% completed 12 month protocol follow-up without relapse. The recurrence of bladder tumor was registered in 10 (22% cases 6–12 months after TUR+PDT including 3 patients with recurrence 6 months after treatment, 3–9 months and 4–12 months. These patients underwent repeated TUR, whereafter their follow-up in the settings of the clinical trial was disposed. Thus, PDT with alasens after TUR allowed to decrease the recurrence rate of non-muscle-invasive bladder cancer for 1st year after treatment to 22% versus 40–80% for TUR as monotherapy according to literature data. The obtained results were comparable by efficiency with TUR combined with methods of adjuvant treatment for bladder tumors (the recurrence rates for 1-year follow-up after TUR+chemotherapy – 36–44%, after TUR

  2. Results of radiotherapy of primary lung cancer with reference to metastases in regional lymph nodes

    International Nuclear Information System (INIS)

    The results of radiotherapy in the treatment of primary lung cancer is presented with reference to metastases in regional lymph nodes. The study involved 382 patients with histologically proven lung cancer of all cell types who, between 1945 and 1955, initially underwent definitive radiotherapy with TDFs of more than 70. The evaluable patients comprised 66 for N0, 177 for N1 and 139 for N2. Cumulative five-year survival rates for N0, N1 and N2 were 23.9%, 6.1% and 5.6%, respectively. Although surgical treatment before radiotherapy did not significantly improve a cumulative five-year survival rate for each N category, it kept patients alive longer for the median survival time (month). In 89 patients with involved mediastinal lymph nodes that specific sites were identified at the time of the surgical treatment (pN2), prolonged survival was obtained by radiotherapy if lymphatic spread was absent in the sites of No.1, No.2, No.3, No.5 and No.6. If present, however, none of patients were alive at the post-treatment time of three years. As to 155 patients with stage III disease comprising T3 and/or N2, both cumulative five-year survival rate and median survival time showed better results in the group of N2 disease than those in T3. (author)

  3. Clinical results of a concomitant boost radiotherapy technique for muscle-invasive bladder cancer

    International Nuclear Information System (INIS)

    Purpose: to update the results of external radiotherapy with a focal concomitant boost technique on local control and bladder function in patients with muscle-invasive bladder cancer. Patients and methods: the authors retrospectively evaluated 92 elderly or disabled patients with localized T2-4 N0-1 M0 transitional cell carcinoma of the bladder and a median age of 79 years, not suitable for radical surgery and treated between 1994 and 2005. Treatment consisted of a dose of 40 Gy/2 Gy to the small pelvis with a daily concomitant boost of 0.75 Gy to the tumor. Total dose was 55 Gy in 4 weeks. Results: complete remission rate after evaluation by means of cystoscopy at 3 months was 78%. 3-year local control rate amounted to 56%, and 3-year overall survival to 36%. The posttreatment bladder capacity was comparable with the pretreatment capacity and was ≥ 200 ml in 81% of the cases. Mean bladder capacity did not deteriorate at longer follow-up. Conclusion: the local control rate after external beam radiotherapy in elderly patients with a focal concomitant boost for localized muscle-invasive bladder cancer was 56% at 3 years. Functional bladder outcome was good. (orig.)

  4. Clinical results of a concomitant boost radiotherapy technique for muscle-invasive bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Piet, A.H.M.; Hulshof, M.C.C.M.; Pieters, B.R.; Koning, C.C.E. [Dept. of Radiation Oncology, Academic Medical Center, Univ. of Amsterdam (Netherlands); Pos, F.J. [Dept. of Radiation Oncology, The Netherlands Cancer Inst., Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Reijke, T.M. de [Dept. of Urology, Academic Medical Center, Univ. of Amsterdam (Netherlands)

    2008-06-15

    Purpose: to update the results of external radiotherapy with a focal concomitant boost technique on local control and bladder function in patients with muscle-invasive bladder cancer. Patients and methods: the authors retrospectively evaluated 92 elderly or disabled patients with localized T2-4 N0-1 M0 transitional cell carcinoma of the bladder and a median age of 79 years, not suitable for radical surgery and treated between 1994 and 2005. Treatment consisted of a dose of 40 Gy/2 Gy to the small pelvis with a daily concomitant boost of 0.75 Gy to the tumor. Total dose was 55 Gy in 4 weeks. Results: complete remission rate after evaluation by means of cystoscopy at 3 months was 78%. 3-year local control rate amounted to 56%, and 3-year overall survival to 36%. The posttreatment bladder capacity was comparable with the pretreatment capacity and was {>=} 200 ml in 81% of the cases. Mean bladder capacity did not deteriorate at longer follow-up. Conclusion: the local control rate after external beam radiotherapy in elderly patients with a focal concomitant boost for localized muscle-invasive bladder cancer was 56% at 3 years. Functional bladder outcome was good. (orig.)

  5. Sociodemographic Characteristics, Distance to the Clinic, and Breast Cancer Screening Results

    OpenAIRE

    Kim, Seijeoung; Chukwudozie, Beverly; Calhoun, Elizabeth

    2013-01-01

    Timely detection and follow-up of abnormal cellular changes can aid in early diagnosis of breast cancer, thus leading to better treatment outcomes. However, despite substantial breast cancer screening initiatives, the proportion of female breast cancer cases diagnosed at late stages remains high. Distance to screening clinics may affect access to care, particularly for women living in impoverished areas with limited means of reliable transportation. Utilizing breast cancer screening data coll...

  6. Hepatitis B vaccinations among Koreans: Results from 2005 Korea National Cancer Screening Survey

    OpenAIRE

    Kwak Min-Son; Park Eun-Cheol; Choi Kui; Juon Hee-Soon; Lee Sunmin

    2009-01-01

    Abstract Background Liver cancer is one of most commonly diagnosed cancers among Koreans. Chronic hepatitis B virus (HBV) infection is a major risk factor for liver cancer. HBV infection can be prevented by effective screening and vaccination programs. The purpose of this study is to examine the status of HBV infection and the predictors associated with HBV vaccination. Methods The study population was derived from the 2005 Korea National Cancer Screening Survey (KNCSS). The KNCSS is an annua...

  7. 1-stearoylglycerol is associated with risk of prostate cancer: results from serum metabolomic profiling

    OpenAIRE

    Mondul, Alison M.; Moore, Steven C.; Weinstein, Stephanie J.; Männistö, Satu; Sampson, Joshua N.; Albanes, Demetrius

    2014-01-01

    Although prostate cancer is the most commonly diagnosed cancer among men in developed populations, recent recommendations against routine prostate-specific antigen screening have cast doubt on its utility for early detection. We compared the metabolomic profiles of prospectively collected fasting serum from 74 prostate cancer cases and 74 controls selected from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study cohort of male smokers. Circulating 1-stearoylglycerol (1-SG, or 1-monost...

  8. Adherence to the World Cancer Research Fund/American Institute for Cancer Research lifestyle recommendations in colorectal cancer survivors : Results of the PROFILES registry

    NARCIS (Netherlands)

    Winkels, Renate M; van Lee, Linde; Beijer, Sandra; Bours, Martijn J; van Duijnhoven, Fränzel J B; Geelen, Anouk; Hoedjes, Meeke; Mols, F.; de Vries, Jeanne; Weijenberg, Matty P; Kampman, Ellen

    2016-01-01

    We examined adherence to the eight The World Cancer Research Foundation/American Institute for Cancer Research (WCRF/AICR) recommendations on diet, physical activity, and body weight among colorectal cancer survivors, and whether adherence was associated with intention to eat healthy and with the ne

  9. Alcohol and ovarian cancer risk: Results from the Netherlands Cohort Study

    NARCIS (Netherlands)

    Schouten, L.J.; Zeegers, M.P.A.; Goldbohm, R.A.; Brandt, P.A. van den

    2004-01-01

    Objective: To study alcohol consumption in relation to ovarian cancer risk in a prospective cohort study. Methods: The Netherlands Cohort Study on diet and cancer was initiated in 1986. A self-administered questionnaire on dietary habits and other risk factors for cancer was completed by 62,573 post

  10. Tangential Radiotherapy Without Axillary Surgery in Early-Stage Breast Cancer: Results of a Prospective Trial

    International Nuclear Information System (INIS)

    Purpose: To determine the risk of regional-nodal recurrence in patients with early-stage, invasive breast cancer, with clinically negative axillary nodes, who were treated with breast-conserving surgery, 'high tangential' breast radiotherapy, and hormonal therapy, without axillary surgery or the use of a separate nodal radiation field. Methods and Materials: Between September 1998 and November 2003, 74 patients who were ≥55 years of age with Stage I-II clinically node-negative, hormone-receptor-positive breast cancer underwent tumor excision to negative margins without axillary surgery as a part of a multi-institutional prospective study. Postoperatively, all underwent high-tangential, whole-breast radiotherapy with a boost to the tumor bed, followed by 5 years of hormonal therapy. Results: For the 74 patients enrolled, the median age was 74.5 years, and the median pathologic tumor size was 1.2 cm. Lymphatic vessel invasion was present in 5 patients (7%). At a median follow-up of 52 months, no regional-nodal failures or ipsilateral breast recurrences had been identified (95% confidence interval, 0-4%). Eight patients died, one of metastatic disease and seven of other causes. Conclusion: In this select group of mainly older patients with early-stage hormone-responsive breast cancer and clinically negative axillary nodes, treatment with high-tangential breast radiotherapy and hormonal therapy, without axillary surgery, yielded a low regional recurrence rate. Such patients might be spared more extensive axillary treatment (axillary surgery, including sentinel node biopsy, or a separate nodal radiation field), with its associated time, expense, and morbidity

  11. Intensity modulated radiation therapy and chemotherapy for locally advanced pancreatic cancer: Results of feasibility study

    Institute of Scientific and Technical Information of China (English)

    Yong-Rui Bai; Guo-Hua Wu; Wei-Jian Guo; Xu-Dong Wu; Yuan Yao; Yin Chen; Ren-Hua Zhou; Dong-Qin Lu

    2003-01-01

    AIM: To explore whether intensity modulated radiation therapy (IMRT) in combination with chemotherapy could increase radiation dose to gross tumor volume without severe acute radiation related toxicity by decreasing the dose to the surrounding normal tissue in patients with locally advanced pancreatic cancer.METHODS: Twenty-one patients with locally advanced pancreatic cancer were evaluated in this clinical trial,Patients would receive the dose of IMRT from 21Gy to 30Gy in 7 to 10 fractions within two weeks after conventional radiotherapy of 30Gy in 15 fractions over 3 weeks. The total escalation tumor dose would be 51, 54,57, 60Gy, respectively. 5-fluororacil (5-FU) or gemcitabine was given concurrently with radiotherapy during the treatment course.RESULTS: Sixteen patients who had completed the radiotherapy plan with doses of 51Gy (3 cases), 54Gy (3 cases), 57Gy (3 cases) and 60Gy (7 cases) were included for evaluation. The median levels of CA19-9 prior to and after radiotherapy were 716 U/ml and 255 U/ml respectively (P<0.001) in 13 patients who demonstrated high levels of CA19-9 before radiotherapy. Fourteen patients who suffered from pain could reduce at least 1/3-1/2 amount of analgesic intake and 5 among these patients got complete relief of pain. Ten patients improved in Kamofsky performance status (KPS). The median follow-up period was 8 months and one-year survival rate was 35 %. No patient suffered more than grade Ⅲ acute toxicities induced by radiotherapy.CONCLUSION: Sixty Gy in 25 fractions over 5 weeks with late course IMRT technique combined with concurrent 5-FU chemotherapy can provide a definitely palliative benefit with tolerable acute radiation related toxicity for patients with advanced pancreatic cancer.

  12. Repetitive transarterial chemoembolization (TACE) of liver metastases from gastric cancer: Local control and survival results

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J., E-mail: T.Vogl@em.uni-frankfurt.de [Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt (Germany); Gruber-Rouh, Tatjana; Eichler, Katrin [Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt (Germany); Nour-Eldin, Nour-Eldin A. [Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt (Germany); Department of Radiology, Faculty of Medicine, Cairo University, Cairo (Egypt); Trojan, Jörg [Department of Internal Medicine I, Johann Wolfgang Goethe-University Frankfurt (Germany); Zangos, Stephan [Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt (Germany); Naguib, Nagy N.N. [Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University Frankfurt (Germany); Radiology Department, Faculty of Medicine, Alexandria University, Alexandria (Egypt)

    2013-02-15

    Objective: To evaluate the local tumor control and survival data after transarterial chemoembolization with different drug combinations in the palliative treatment of patients with liver metastases of gastric cancer. Materials and methods: The study was retrospectively performed. 56 patients (mean age, 52.4) with unresectable liver metastases of gastric cancer who did not respond to systemic chemotherapy were repeatedly treated with TACE in 4-week intervals. In total, 310 chemoembolization procedures were performed (mean, 5.5 sessions per patient). The local chemotherapy protocol consisted of mitomycin alone (30.4%), mitomycin and gemcitabine (33.9%), or mitomycin, gemcitabine and cisplatin (35.7%). Embolization was performed with lipiodol and starch microspheres. Local tumor response was evaluated by MRI according to RECIST. Survival data from first chemoembolization were calculated according to the Kaplan–Meier method. Results: The local tumor control was: complete response in 1.8% (n = 1), partial response in 1.8% (n = 1), stable disease in 51.8% (n = 29) and progressive disease in 44.6% (n = 25) of patients. The 1-, 2-, and 3-year survival rate from the start of chemoembolization were 58%, 38%, and 23% respectively. The median and mean survival times were 13 and 27.1 months. A Statistically significant difference between patients treated with different chemotherapy protocols was noted (ρ = 0.045) with the best survival time in the mitomycin, gemcitabine and cisplatin group. Conclusion: Transarterial chemoembolization is a minimally invasive therapy option for palliative treatment of liver metastases in patients with gastric cancer.

  13. Repetitive transarterial chemoembolization (TACE) of liver metastases from gastric cancer: Local control and survival results

    International Nuclear Information System (INIS)

    Objective: To evaluate the local tumor control and survival data after transarterial chemoembolization with different drug combinations in the palliative treatment of patients with liver metastases of gastric cancer. Materials and methods: The study was retrospectively performed. 56 patients (mean age, 52.4) with unresectable liver metastases of gastric cancer who did not respond to systemic chemotherapy were repeatedly treated with TACE in 4-week intervals. In total, 310 chemoembolization procedures were performed (mean, 5.5 sessions per patient). The local chemotherapy protocol consisted of mitomycin alone (30.4%), mitomycin and gemcitabine (33.9%), or mitomycin, gemcitabine and cisplatin (35.7%). Embolization was performed with lipiodol and starch microspheres. Local tumor response was evaluated by MRI according to RECIST. Survival data from first chemoembolization were calculated according to the Kaplan–Meier method. Results: The local tumor control was: complete response in 1.8% (n = 1), partial response in 1.8% (n = 1), stable disease in 51.8% (n = 29) and progressive disease in 44.6% (n = 25) of patients. The 1-, 2-, and 3-year survival rate from the start of chemoembolization were 58%, 38%, and 23% respectively. The median and mean survival times were 13 and 27.1 months. A Statistically significant difference between patients treated with different chemotherapy protocols was noted (ρ = 0.045) with the best survival time in the mitomycin, gemcitabine and cisplatin group. Conclusion: Transarterial chemoembolization is a minimally invasive therapy option for palliative treatment of liver metastases in patients with gastric cancer

  14. Clinical short-term results of radiofrequency ablation in liver cancers

    Institute of Scientific and Technical Information of China (English)

    Hong-Chi Jiang; Lian-Xin Liu; Da-Xun Piao; Jun Xu; Min Zheng; An-Long Zhu; Shu-Yi Qi; Wei-Hui Zhang; Lin-Feng Wu

    2002-01-01

    AIM: To study local therapeutic efficacy, side effects, andcomplications of radiofrequency ablation (RFA), whichis emerging as a new method for the treatment ofpatients with hepatocellular carcinoma (HCC) withcirrhosis or chronic hepatitis and metastatic liver cancer.METHODS: Thirty-six patients with primary andsecondary liver cancers (21 with primaryhepatocellular carcinoma, 12 with colorectal cancerliver metastases and 3 with other malignant livermetastases), which were considered not suitable forcurative resection, were include in this study. Theywere treated either with RFA (RITA2000, MountainView, California, USA) percutaneously (n=20)orintraoperatively (n=16).The procedures wereperformed using the ultrasound guidance. The qualityof RFA were based on monitoring of equipments andsubject feeling of the practitioners. Patients treatedwith RFA was followed according to clinical findings,radiographic images, and tumor markers.RESULTS: Thirty-six patients underwent RFA for 48nodules. RFA was used to treat an average 1.3 lesionsper patient, and the median size of treated lesions was2.5 cm (range, 0.5-9 cm). The average hospital staywas 5.6 days overall (2.8 days for percutaneous casesand 7.9 days for open operations). Seven patientsunderwent a second RFA procedure (sequentialablations). Sixteen HCC patients with a high level ofalpha fetoprotein (AFP) and 9 colorectal cancer livermetastases patients with a high level of serumcarcinoembryonic antigen (CEA) have a great reductionbenefited from RFA. Four (11.1 %) patients hadcomplications: one skin burn; one postoperativehemorrhage; one cholecystitis and one hepatic abscessassociated with percutaneous ablations of a largelesion. There were 4 deaths: 3 patients died from localand system diseases (1 at 7 month, 1 at 9 month, and 1at 12 month), 1 patients died from cardiovascular shock,but no RFA-related death. At a median follow-up of 10months (range, 1-24 months), 6 patients (16.7 %) hadrecurrences at an RFA site, and 20

  15. Treatment results of different radiotherapy for 763 patients with advanced cervical cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical value of different radiotherapy protocols in the treatment of advanced cervical cancer. Methods: From 1976 to 2006, 763 patients with stage III cervical cancer (722 with squamous cell carcinoma and 41 with adenocarcinoma) were treated by radiotherapy in our hospital. 113 patients were treated by two-field whole pelvic irradiation in conventional fractionation plus brachytherapy (CF group), 44 by four-field whole pelvic irradiation in accelerated hyperfractionation plus brachytherapy (AHF group), and 606 by concomitant four-field unconventional fractionation radiotherapy and brachytherapy( FRT group). Sixty-one patients were treated by radiotherapy and chemotherapy. Among 350 patients who had complete data, the shore-term efficacy and toxicities were compared. Results: For patients in CF, AHF and FRT groups, the 3-year overall survival rates (OS) were 65.7%, 66.8% and 44.3%, respectively (P=0.000), and the 5-year OS were 65.7%, 66.8% and 36.3%, respectively (P=0.000). The 10-year OS were 43.3% and 31.9% in CF and FRT groups(P=0.200). For squamous cell carcinoma,the OS was higher of patients with chemotherapy than those without. In 350 patients who had complete data, the local control rates of CF, AHF and FRT groups were 83.0%, 93.2% and 86.1%, respectively (χ2=2.70, P =0.259); AHF group had the lowest side effect rate, especially skin reaction (9.1%, χ2=20.25, P= 0.002); CF group had the lowest acute bone marrow suppression rate (χ2=25.95, P=0.000); for squamous cell carcinoma, the OS was higher in patients with chemotherapy than those without; the acute bone marrow and intestinal toxicities were more in patients with chemotherapy than those without. Conclusions: CF and AHF groups have similar 5-year OS of patients with advanced cervical cancer. AHF group has less toxicities, shorter treatment course and a trend of better local control. Concurrent chemoradiation could improve survival and local control of the patients with

  16. URODYNAMIC FINDINGS IN ASSESSMENT OF THE RESULTS OF PARTIAL CYSTECTOMY FOR BLADDER CANCER

    Directory of Open Access Journals (Sweden)

    F. Sh. Engalychev

    2014-08-01

    Full Text Available Objectives. We determined the role of urodynamic results on the estimation of treatment efficiency of patients with bladder cancer.Subjects and methods. The study consequently included 160 patients receiving TUR and open resection in 2005−2009. Quality of life was assessed using the IPSS, QoL and International Inventory of Erectile Function (IIEF. Uroflowmetry, bladder diary were carried out to determine lower urinary tract symptoms befor treatment, 3 and 12 mo later.Results. In 3 months after operation statistically authentic changes of semiotics were noted. But in a year all indicators were in norm or approached to it.Conclusions. Urodinamic methods of research can be recommended to application as criterion of efficiency of operative intervention and for definition of rehabilitation times in the postoperative period in a complex with other methods.

  17. Oncologists' and Cancer Patients' Views on Whole-Exome Sequencing and Incidental Findings: Results from The CanSeq Study

    Science.gov (United States)

    Gray, Stacy W.; Park, Elyse R.; Najita, Julie; Martins, Yolanda; Traeger, Lara; Bair, Elizabeth; Gagne, Joshua; Garber, Judy; Jänne, Pasi A.; Lindeman, Neal; Lowenstein, Carol; Oliver, Nelly; Sholl, Lynette; Van Allen, Eliezer M.; Wagle, Nikhil; Wood, Sam; Garraway, Levi; Joffe, Steven

    2016-01-01

    Purpose While targeted sequencing improves outcomes for many cancer patients, how somatic and germline whole-exome sequencing (WES) will integrate into care remains uncertain. Methods We conducted surveys and interviews, within a study of WES integration at an academic center, to determine oncologists' attitudes about WES and to identify lung and colorectal cancer patients' preferences for learning WES findings. Results 167 patients (85% white, 58% female, mean age 60) and 27 oncologists (22% female) participated. Although oncologists had extensive experience ordering somatic tests (median 100/year), they had little experience ordering germline tests. Oncologists intended to disclose most WES results to patients but anticipated numerous challenges in using WES. Patients had moderately low levels of genetic knowledge (mean 4 correct of 7). Most patients chose to learn results that could help select a clinical trial, pharmacogenetic and positive prognostic results, and results suggesting inherited predisposition to cancer and treatable non-cancer conditions (all ≥95%). Fewer chose to receive negative prognostic results (84%) and results suggesting predisposition to untreatable non-cancer conditions (85%). Conclusion The majority of patients want most cancer-related and incidental WES results. Patients' low levels of genetic knowledge and oncologists' inexperience with large-scale sequencing presage challenges to implementing paired WES in practice. PMID:26866579

  18. Toxicity and first treatment results after of neoadjuvant thermal radiochemotherapy in operable oesophageal cancer

    International Nuclear Information System (INIS)

    Full text: To demonstrate the toxicity and preliminary treatment results of neo-adjuvant regional hyperthermia combined with concurrent radiochemotherapy in oesophageal cancer. Background: In 2002 a phase I study was completed with neo-adjuvant regional hyperthermia combined with chemotherapy (cisplatin and etoposide) in patients with operable oesophageal cancer. It was concluded that hyperthermia was feasible. However, the toxicity of the concurrent chemotherapy was very high, resulting in only 31 % of patients receiving the planned three hyperthermia sessions and 27 % receiving not more than one hyperthermia session. Based on these results we planned to continue hyperthermia in a phase II study aiming at a decrease of (chemotherapy induced) toxicity and an improvement of response rate compared to previous radiochemotherapy studies. In August 2003 a phase II study was started combining five times regional hyperthermia with concurrent radiochemotherapy over a 4,5 weeks period consisting of weekly carboplatin (AUC = 2) and paclitaxel (50 mg/m2) plus 41,4 Gy radiotherapy in 1.8 Gy daily fractions. Chemotherapy was infused during hyperthermia. An oesophagus resection was planned at 4-6 weeks after the end of radiotherapy. 28 patients have entered the study so far, 94 % with a T3 tumor and 59 % with N1 disease on echo-endosonography. Median follow-up is 9 months and 23 patients are evaluable for histological response. Toxicity was much less compared to the previous cisplatin/etoposide study; all five hyperthermia sessions were given in 88 % of patients (and 96 % had at least four sessions). No haematological toxicity was seen and nausea ≤ grade 2 in only 24 %. Dysphagia and weight loss during treatment were absent in 68 % and 81 % of patients respectively. A histological confirmed complete remission rate (CR) was found in 17 % and only residual microscopic tumor foci (Pmic) in an extra 33 %. Partial remission (PR) was accomplished in 33 %. Mean T90 in patients with a

  19. Treatment results of neck dissection with the preservation of cervical nerves for hypopharyngeal cancer

    International Nuclear Information System (INIS)

    Treatment results of neck dissection with the preservation of cervical nerves for hypopharyngeal cancer were analyzed retrospectively by comparing neck dissection with the preservation of cervical nerves and that with the resection of cervical nerves. Pharyngolaryngectomy or pharyngolaryngoesophagectomy with bilateral neck dissection was performed in 76 hypopharyngeal cancer cases between January 1992 and November 2001. Neck dissection with the resection of cervical nerves was performed on 42 sides of the neck in 21 cases (the cervical nerve-resected group). In 55 cases we attempted to employ neck dissection with the preservation of cervical nerves, but in 9 cases the cervical nerves were resected because of their nodal adhesion or involvement Neck dissection with the preservation of cervical nerves was performed on 92 sides of the neck in 46 cases (the cervical nerve-preserved group). There were significant differences between background factors of two groups about age, sex, induction chemotherapy, preservation of accessory nerve, and pN classification. The 5-year cumulative control rates of cervical lymph nodes were 81.3% for the cervical nerve-resected group and 79.7% for the cervical nerve-preserved group. There was no significant difference between the two groups. It was suggested that neck dissection with the preservation of cervical nerves for cases whose cervical nerves were able to be preserved from metastatic lymph nodes under induction chemotherapy and post-operative irradiation was as effective to control cervical lymph nodes as neck dissection with the resection of cervical nerves. (author)

  20. Brachytherapy with Iodine-125 seeds in initial prostate cancer treatment: preliminary results and complications

    International Nuclear Information System (INIS)

    Low-dose rate brachytherapy as monotherapy is a treatment option for early stage prostate cancer. It consists of the permanent implantation of Iodine-125 seeds in the gland of patients with PSA≤ 10ng/ml, Gleason ≤ 6 and clinical stage from T1 until T2b. The 68 patients enrolled in this study were treated by the technique developed at the Northwest Pacific Hospital, Seattle, USA. Sixty four patients treated with low-dose rate brachytherapy were followed for 4-48 months (median = 32 months). The treatment results were based on the periodic evaluation of the total PSA values and it was found that, after this time, 55% of patients had total PSA equal or below 1ng/ml. Post-implant morbidities were evaluated, showing that 89% presented negligible or low grade side effects. Low-dose rate brachytherapy is an appealing option for the treatment of early stage prostate cancer because of its successful local control and low morbidity. (author)

  1. Active exercises utilizing a facilitating device in the treatment of lymphedema resulting from breast cancer therapy

    Directory of Open Access Journals (Sweden)

    de Fátima Guerreiro Godoy, Maria

    2010-01-01

    Full Text Available The aim of this study was to evaluate the reduction in volume of arm lymphedema secondary to breast cancer therapy utilizing an exercise facilitating device. Twenty-one women with arm lymphedema resulting from the surgical and radiotherapeutic treatment of breast cancer were randomly selected. Evaluation was made by water-displacement volumetry before and after each session. The patients were submitted to a series of active exercises using a facilitating device for four 12-minute sessions with intervals of 3 minutes between sessions in the sitting position with alignment of the spinal column. The lymphedematous arm was maintained under compression using a cotton-polyester sleeve. The active exercising device used was a mobile flexion bar fixed on a metal base at a height of 30 cm from the tabletop and at a distance of 10 cm from the patient’s body. The paired t-test was utilized for statistical analysis with an alpha error of 5% (p-value ≤0.05 being considered significant. The initial mean volume of the arms was 2,089.9 and the final volume was 2,023.0 mL with a mean loss of 66.9 mL (p-value <0.001. In conclusion, active exercises utilizing facilitating devices can contribute to a reduction in size of lymphedematous limbs.

  2. Concurrent chemoradiation for stage III non small cell lung cancer: present results and future prospects

    International Nuclear Information System (INIS)

    The prognosis of stage III non small cell lung cancer is reportedly poor, particularly in patients with mediastinal lymph node involvement. These patients may be either good surgical candidates, marginally resectable, or inoperable for technical or medical reasons, but, in any case, surgery and/or radiotherapy are curative in only a minority of them. The high incidence of early distant failures underscores the need for early and effective systemic therapy in association with local treatment, since occult metastatic disease is present in most patients at the time of diagnosis. Recent phase III trials have demonstrated significant benefit to induction chemotherapy prior to irradiation or surgery in reducing the distant metastasis rate. However, poor local control remains a major issue in these locally advanced tumors. In patients with inoperable disease, the concomitant use of chemotherapy along with radiotherapy substantially improves local control. For operable patients, induction chemotherapy with concomitant moderate-dose radiotherapy improves local control as well, and may facilitate surgical resection in marginally operable cases. Currently, a number of phase II clinical trials report encouraging results with concomitant chemoradiotherapy used either prior to surgery or with curative intent in locally advanced non small cell lung cancer. (authors). 27 refs

  3. 18F - fluorodeoxyglucose (FDG) and broncho-pulmonary cancer. Preliminary results

    International Nuclear Information System (INIS)

    The metabolic imaging allowed by emission positron tomography (EPT) represents a new approach in the cancer diagnosis. The augmentation of glycoprotein metabolism in malignant lesions can be evidenced by FDG. The broncho-pulmonary cancer (BPC) poses clinical problems of tissue characterization which are not solved optimally by radiological imaging, so that the new technique presents a major interest. The authors report the first data obtained in France with a positron chamber in 12 patients studied since June 1996, namely 10 cases of pulmonary nodules and two of mediastinal ganglionic extension of BPC. Cross sections from skull to pelvis were achieved 45 minutes after the IV injection of 37 MBq of FDG per 10 kg of weight. The anatomical-pathological examination was systematic and the agreement with EPT was good in 10 cases of 12 (9 positive trues and 1 negative true), in addition, new sites were evidenced, 3 times of 12. They were overlooked by the radiological technique and thus, susceptible of modifying the treatment. These preliminary results are coherent with those reported in the international literature. They incited starting a prospective large-scale study of measuring the diagnosis performances of FDG in EPT in determining the malignity of solitary nodules and mediastinal extension of primary tumors

  4. Routine assessment of psychosocial problems after cancer genetic counseling: results from a randomized controlled trial.

    Science.gov (United States)

    Eijzenga, W; Bleiker, E M A; Ausems, M G E M; Sidharta, G N; Van der Kolk, L E; Velthuizen, M E; Hahn, D E E; Aaronson, N K

    2015-05-01

    Approximately 70% of counselees undergoing cancer genetic counseling and testing (CGCT) experience some degree of CGCT-related psychosocial problems. We evaluated the efficacy of an intervention designed to increase detection and management of problems 4 weeks after completion of CGCT. In this randomized, controlled trial, 118 participants completed a CGCT-related problem questionnaire prior to an - audiotaped - telephone session with their counselor 1 month after DNA-test disclosure. For those randomized to the intervention group (n = 63), a summary of the questionnaire results was provided to the counselor prior to the telephone session. Primary outcomes were discussion of the problems, counselors' awareness of problems, and problem management. Secondary outcomes included self-reported distress, cancer worries, CGCT-related problems, and satisfaction. Counselors who received a summary of the questionnaire were more aware of counselees' problems in only one psychosocial domain (practical issues). No significant differences in the number of problems discussed, in problem management, or on any of the secondary outcomes were observed. The prevalence of problems was generally low. The telephone session, combined with feedback on psychosocial problems, has minimal impact. The low prevalence of psychosocial problems 1 month post-CGCT recommends against its use as a routine extension of the CGCT procedure. PMID:25130962

  5. Residual deficits in quality of life one year after intensity-modulated radiotherapy for patients with locally advanced head and neck cancer. Results of a prospective study

    International Nuclear Information System (INIS)

    Patients with locally advanced head and neck cancer (LAHNC) undergo life-changing treatments that can seriously affect quality of life (QoL). This prospective study examined the key QoL domains during the first year after intensity-modulated radiotherapy (IMRT) and identified predictors of these changes in order to improve patient outcomes. A consecutive series of patients with LAHNC completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core module (QLQ-C30) and the HNC-specific QLQ-HN35 before (t0) and at the end (t1) of definitive or adjuvant IMRT, then at 6-8 weeks (t2), 6 months (t3), and 1 year (t4) after IMRT. Patients (n = 111) completing questionnaires at all five time points were included (baseline response rate: 99 %; dropout rate between t0 and t4: 5 %). QoL deteriorated in all domains during IMRT and improved slowly during the first year thereafter. Many domains recovered to baseline values after 1 year but problems with smelling and tasting, dry mouth, and sticky saliva remained issues at this time. Increases in problems with sticky saliva were greater after 1 year in patients with definitive versus adjuvant IMRT (F = 3.5, P = 0.05). QoL in patients with LAHNC receiving IMRT takes approximately 1 year to return to baseline; some domains remain compromised after 1 year. Although IMRT aims to maintain function and QoL, patients experience long-term dry mouth and sticky saliva, particularly following definitive IMRT. Patients should be counseled at the start of therapy to reduce disappointment with the pace of recovery. (orig.)

  6. Advanced head and neck cancer: Long-term results of chemo-radiotherapy, complications and induction of second malignancies

    OpenAIRE

    Munker, Reinhold; Purmale, L.; Aydemir, Ü.; Reitmeier, M.; Pohlmann, H.; Schorer, H.; Hartenstein, R.

    2001-01-01

    Background: Chemo-radiotherapy is superior to radiotherapy alone in the treatment of advanced, inoperable head and neck cancer. The long-term treatment results, the induction of second malignant tumors, and other long-term toxicities are not well defined. Patients and Methods: 100 consecutive patients with advanced head and neck cancer who were treated at our center were studied. Treatment results, survival, the occurrence of late complications, and second malignant tumors (SMT) were investig...

  7. The Results and Prognostic Factors of Postoperative Radiation Therapy in the Early Stages of Endometrial Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Ja [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    2008-09-15

    To evaluate the results and prognostic factors for postoperative adjuvant radiation therapy in patients at stages I and II of endometrial cancer. Materials and Methods: Between January 1991 and December 2006, 35 patients with FIGO stages I and II disease, who received adjuvant radiation therapy following surgery for endometrial cancer at Ewha Womans University Hospital, were enrolled in this study. A total of 17 patients received postoperative pelvic external beam radiation therapy; whereas, 12 patients received vaginal brachytherapy alone, and 6 patients received both pelvic radiation therapy and vaginal brachytherapy. Results: The median follow-up period for all patients was 54 months. The 5-yr overall survival and disease-free survival rates for all patients were 91.4% and 81.7%, respectively. The 5-yr overall survival rates for low-risk, intermediate-risk, and high-risk groups were 100%, 100% and 55.6%, respectively. In addition, the 5-yr disease-free survival rates were 100%, 70.0%, and 45.7%, respectively. Although no locoregional relapses were identified, distant metastases were observed in 5 patients (14%). The most common site of distant metastases was the lung, followed by bone, liver, adrenal gland, and peritoneum. A univariate analysis revealed a significant correlation between distant metastases and risk-group (p=0.018), pathology type (p=0.001), and grade (p=0.019). A multivariate analysis also revealed that distant metastases were correlated with pathology type (p=0.009). Papillary, serous and clear cell carcinoma cases demonstrated a poor patient survival rate compared to cases of endometrioid adenocarcinoma or adenosquamous carcinoma. The most common complication of pelvic external beam radiation therapy was enteritis (30%), followed by proctitis, leucopenia, and lymphedema. All these complications were of RTOG grades 1 and 2; no grades 3 and 4 were observed. Conclusion: For the low-risk and intermediate-risk groups (stages 1 and 2) endometrial

  8. The results of radiotherapy for T1 glottic cancers; influence of radiation beam energy

    International Nuclear Information System (INIS)

    Purpose; To report our results of radiotherapy for T1 glottic cancers and to analyze the influence of various parameters. Materials and Methods; Reviewed were the outcome of 57 patients with T1 glottic cancers who received definitive radiotherapy between 1985 and 1993. Of 57 patients, 46 had T1a lesions and 11 T1b. Of 57 lesions, 29 were well differentiated carcinoma, 12 moderately, one poorly and 15 unknown. Seven patients were treated with cobalt-60 unit, 26 with 3-MV linear accelerator, 7 with 6-MV and 17 with 10-MV. Of 17 patients treated with 10-MV, 4 also received part of their treatment with a cobalt-60 unit. Right and left lateral parallel opposed fields was used with all patients. The average field size was 30cm2, with typical field sizes ranging from 5x5 cm to 6x6 cm. Doses reported in this study refer to the central absorbed dose calculated at the central axis. The total radiation doses was 6000 cGy for 49 patients (86%) and the mean total radiation doses was 6100 cGy (range, 5600-7000 cGy). A daily fraction dose was 200 cGy for all patients. All courses of radiotherapy were delivered by using once-a-day fractionation 5 days per week without interruption. Chemotherapy was concurrently used with radiotherapy for 32 patients. Median follow-up was 53 months (range, 3-102 months). The local control and survival curves were adjusted and expressed by Kaplan-Meier method and comparison of the curves were calculated using the log-rank test. Results; Of 54 patients, 13 (24%) had local recurrence. Various parameters including substage; histologic grade; treatment machine; use of chemotherapy were analyzed. The only factor that influenced local control was treatment machine. The local control rate at five years was 93% for cases treated with cobalt-60 unit or a 3-MV linear accelerator and 53% for cases treated with a 6- or 10-MV linear accelerator. The local control rate for cases treated with cobalt-60 unit or a 3-MV linear accelerator was significantly better (p

  9. Treatment results of radioiodine therapy in patients with pulmonary metastases of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Purpose: Radioiodine treatment is a popular treatment approach for patients with pulmonary metastases of differentiated thyroid cancer. In this study, we evaluated the survival of patients with pulmonary metastases of differentiated thyroid cancer receiving periodic 131I therapy and influence factors of prognosis. Methods: Ninety six patients with pulmonary metastases from well-differentiated thyroid carcinoma received initial 131I therapy in our department from 1976 to December 2001 were reviewed retrospectively. Follow-up data were recorded up to December 2003. Most of them underwent total or near total thyroidectomy before 1311 treatment. Sixty eight patients were PTC and 28 were FC. We had 49 males and 47 females with a mean age of 48.6 years. Thyroid hormone medications were withheld for two weeks for triiodothyronine (T3) and five weeks for thyroxine (T4). For postoperative ablation of thyroid bed remnants, activity in the range of 2.75-5.5 GBq (75-150 mCi) is administered. For treatment of pulmonary metastases, activity of 5.55-7.4 GBq (150-200 mCi) is given every six months. The range of accumulative dose of 131I was 100-1650 mCi. Survival was estimated by using the Kaplan-Meier method. Results: The overall 5-year and 10-year survivals for all patients were 95% and 85%, respectively. The post-lung-metastasis 5-year and 10-year survivals were 81% and 56%, respectively. Twenty-one of 59 (61.5%) of patients had a response after 131I treatment, with a complete response of 24.0% and a partial response of 37.5%, Papillary carcinoma, age less than 45 at diagnosis, treatment response (CR+PR), without other distant metastases, the radioiodine uptake in the lesions are favorite important facts affected prognosis. Conclusions: The results suggest that differentiated thyroid cancer patients with pulmonary metastases are indolent clinical course. 131I is an effective treatment for these patients with pulmonary metastases. (authors)

  10. The role of laboratory animals in studying bone cancer resulting from skeletally deposited radionuclides

    International Nuclear Information System (INIS)

    There is a continuing need to determine and understand the long-term health risks of internally deposited radionuclides in persons exposed medically or occupationally, or from radionuclides in the environment. A full understanding of these health risks, particularly for exposures involving low doses and dose rates, requires in-depth knowledge of both the dosimetry of a given exposure and the resulting long-term biological effects. Human data on 224Ra and 226,228Ra and their decay products are our primary sources of knowledge on the health risks of chronic alpha irradiation of the skeleton and serve as essential segments of our radiation protection practices for internally deposited radionuclides. However, we cannot obtain all of the needed information from these studies. This paper examines the role of laboratory animal studies in complementing and extending the knowledge of radiation-induced bone cancer obtained from studies of humans exposed to 224Ra or 226,228Ra

  11. Multiple miscarriages are associated with the risk of ovarian cancer: results from the European Prospective Investigation into Cancer and Nutrition.

    Directory of Open Access Journals (Sweden)

    Marieke G M Braem

    Full Text Available While the risk of ovarian cancer clearly reduces with each full-term pregnancy, the effect of incomplete pregnancies is unclear. We investigated whether incomplete pregnancies (miscarriages and induced abortions are associated with risk of epithelial ovarian cancer. This observational study was carried out in female participants of the European Prospective Investigation into Cancer and Nutrition (EPIC. A total of 274,442 women were followed from 1992 until 2010. The baseline questionnaire elicited information on miscarriages and induced abortions, reproductive history, and lifestyle-related factors. During a median follow-up of 11.5 years, 1,035 women were diagnosed with incident epithelial ovarian cancer. Despite the lack of an overall association (ever vs. never, risk of ovarian cancer was higher among women with multiple incomplete pregnancies (HR(≥4vs.0: 1.74, 95% CI: 1.20-2.70; number of cases in this category: n = 23. This association was particularly evident for multiple miscarriages (HR(≥4vs.0: 1.99, 95% CI: 1.06-3.73; number of cases in this category: n = 10, with no significant association for multiple induced abortions (HR(≥4vs.0: 1.46, 95% CI: 0.68-3.14; number of cases in this category: n = 7. Our findings suggest that multiple miscarriages are associated with an increased risk of epithelial ovarian cancer, possibly through a shared cluster of etiological factors or a common underlying pathology. These findings should be interpreted with caution as this is the first study to show this association and given the small number of cases in the highest exposure categories.

  12. Results of Breast Conserving Surgery and Subsequent Postoperative Radiotherapy for Cases of Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chie, Eui Kyu; Kim, Kyu Bo; Choi, Jin Hwa [Seoul National University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2008-09-15

    We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by postoperative radiotherapy. Materials and Methods: A total of 424 breast cancer patients treated with breast conserving surgery and postoperative radiotherapy between February 1992 and January 2001 were retrospectively analyzed. A quadrantectomy and axillary lymph node dissection was performed in 396 patients. A total of 302 patients had T1 disease, and 122 patients had T2 disease. Lymph node involvement was confirmed in 107 patients. Whole breast irradiation was administered at up to 50.4 Gy in 28 fractions, followed by a 10 Gy boost in 5 fractions to the tumor bed. In addition, 57 patients underwent regional lymph node irradiation. Moreover, chemotherapy was administered in 231 patients. A regimen consisting of cyclophosphamide, methotrexate, and 5-fluorouracil was most frequently used with 170 patients. The median follow-up time was 64 months. Results: The 5-year local control rate was 95.6%. During the follow-up period, local tumor recurrence was observed in 15 patients. The 5-year overall and disease-free survival rates were 93.1% and 88.7%, respectively. The 5-year overall survival rates, by stage, were 94.8% for stage I, 95.0% for stage IIA, 91.1% for stage IIB, 75.9% for stage IIIA, and 57.1% for stage IIIC. As for disease-free survival, the corresponding figures, by stage (in the same order), were 93.1%, 89.4%, 82.8%, 62.0%, and 28.6%, respectively. The advanced N stage (p=0.0483) was found to be a significant prognostic factor in predicting poor overall survival, while the N stage (p=0.0284) and age at diagnosis (p=0.0001) were associated with disease-free survival. Conclusion: This study has shown that breast conserving surgery and postoperative radiotherapy for early breast cancer results was excellent for local control and survival.

  13. Sexual Function After Stereotactic Body Radiotherapy for Prostate Cancer: Results of a Prospective Clinical Trial

    International Nuclear Information System (INIS)

    Purpose: To study the sexual quality of life for prostate cancer patients after stereotactic body radiotherapy (SBRT). Methods and Materials: Using the Expanded Prostate Cancer Index Composite (EPIC)-validated quality-of-life questionnaire, the sexual function of 32 consecutive patients who received prostate SBRT in a prospective Phase II clinical trial were analyzed at baseline, and at median times of 4, 12, 20, and 50 months after treatment. SBRT consisted of 36.25 Gy in five fractions of 7.25 Gy using the Cyberknife. No androgen deprivation therapy was given. The use of erectile dysfunction (ED) medications was monitored. A comprehensive literature review for radiotherapy-alone modalities based on patient self-reported questionnaires served as historical comparison. Results: Median age at treatment was 67.5 years, and median follow-up was 35.5 months (minimum 12 months). The mean EPIC sexual domain summary score, sexual function score, and sexual bother score decreased by 45%, 49%, and 25% respectively at 50 months follow-up. These differences reached clinical relevance by 20 months after treatment. Baseline ED rate was 38% and increased to 71% after treatment (p = 0.024). Use of ED medications was 3% at baseline and progressed to 25%. For patients aged <70 years at follow-up, 60% maintained satisfactory erectile function after treatment compared with only 12% aged ≥70 years (p = 0.008). Penile bulb dose was not associated with ED. Conclusions: The rates of ED after treatment appear comparable to those reported for other modalities of radiotherapy. Given the modest size of this study and the uncertainties in the physiology of radiotherapy-related ED, these results merit further investigations.

  14. Recent results concerning radiation-induced cancer in the Japanese atomic bomb survivors

    International Nuclear Information System (INIS)

    The most recent data of the prospective study among Hiroshima and Nagasaki atomic bomb survivors support the following conclusions: (a) the dose-response relationship is consistent with a straight line through the origin, including the lowest dose group (approx. 3 rad); (b) sensitivity to cancer induction varies considerably by irradiated tissues. (c) most cancers show a radiation effect still increasing 40 years after exposure; (d) a small leukemia excess among those irradiated is still present in Hiroshima; (e) the thyroid cancer excess is declining at present; (g) smoking adds to lung cancer incidence; (g) certain benign tumors show a radiation-related effect; (h) children under 10 years old at time of bombing are presently showing the highest relative cancer risk compared to other survivors at equal attained age. If this effect persists, age-specific cancer risk coefficients are necessary

  15. The development of a telemedical cancer center within the Veterans Affairs Health Care System: a report of preliminary clinical results.

    Science.gov (United States)

    Billingsley, Kevin G; Schwartz, David L; Lentz, Susan; Vallières, Eric; Montgomery, R Bruce; Schubach, William; Penson, David; Yueh, Bevan; Chansky, Howard; Zink, Claudia; Parayno, Darla; Starkebaum, Gordon

    2002-01-01

    In order to optimize the delivery of multidisciplinary cancer care to veterans, our institution has developed a regional cancer center with a telemedical outreach program. The objectives of this report are to describe the organization and function of the telemedical cancer center and to report our early clinical results. The Veterans Affairs Health Care System is organized into a series of integrated service networks that serve veterans within different areas throughout the United States. Within Veterans Integrated Service Network 20 (Washington, Alaska, Idaho, Oregon) we have developed a regional cancer center with telemedicine links to four outlying facilities within the service area. The telemedical outreach effort functions through the use of a multidisciplinary telemedicine tumor board. The tumor board serves patients in outlying facilities by providing comprehensive, multidisciplinary consultation for the complete range of malignancies. For individuals who do require referral to the cancer center, the tumor board serves to coordinate the logistical and clinical details of the referral process. This program has been in existence for 1 year. During that time 85 patients have been evaluated in the telemedicine tumor board. Sixty-two percent of the patients were treated at their closest facility; 38% were referred to the cancer center for treatment and/or additional diagnostic studies. The patients' diagnoses included the entire clinical spectrum of malignant disease. Preliminary clinical results demonstrate the program is feasible and it improves access to multidisciplinary cancer care. Potential benefits include improved referral coordination and minimization of patient travel and treatment delays. PMID:12020412

  16. The results of the treatment of various morphological types of ENT skin cancer by photodynamic therapy

    OpenAIRE

    Volgin V.N.; Stranadko E.F.; Kagoyants R.V.

    2014-01-01

    This article discusses one of the urgent problems of modern oncology — the question of treatment of skin cancer (SC). The experience of the new promising method of photodynamic therapy (PDT) in the treatment of patients with primary and recurrent skin cancer. Aim: to evaluate the effectiveness of photodynamic therapy (PDT) in the treatment of patients with primary and recurrent skin cancer (SC). Materials. The Main Military Clinical Hospital SC treatment of upper respiratory tract with PDT pe...

  17. Treatment results of radiation therapy for muscle-invasive bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Langsenlehner, Tanja; Doeller, Carmen; Stranzl-Lawatsch, Heidi; Kapp, Karin S. [Univ. Clinic of Therapeutic Radiology and Oncology, Medical Univ. of Graz (Austria); Quehenberger, Franz [Inst. for Medical Informatics, Statistics and Documentation, Medical Univ. of Graz (Austria); Langsenlehner, Uwe [Internal Outpatient Dept., Steiermaerkische GKK, Graz (Austria); Pummer, Karl [Dept. of Urology, Medical Univ. of Graz (Austria)

    2010-04-15

    Purpose: To assess local control and survival rates in patients with muscle-invasive bladder cancer treated with external-beam radiotherapy and to investigate prognostic factors. Patients and methods: Between 1997 and 2007, 75 patients (male, n = 58; female, n = 17, median age, 74.2 years) with localized transitional cell carcinoma of the bladder (T2, n = 34; T3, n = 32; T4, n = 9) not suitable for radical surgery due to advanced age, comorbidity or inoperability underwent external-beam radiotherapy without simultaneous chemotherapy at the University Clinic of Therapeutic Radiology and Oncology, Medical University of Graz, Austria. A conformal four-field technique was used in all patients to treat the tumor and regional lymph nodes with single daily fractions of 1.8-2 Gy to a total dose of 50-50.4 Gy, followed by a cone-down to encompass the empty bladder which was boosted to 70-70.4 Gy. All patients had undergone transurethral tumor resection prior to radiotherapy which was macroscopically incomplete in 62 patients. Results: Complete response was achieved in 65% of patients. Actuarial 3-year local control and metastases-free survival rates were 52.5% and 63.7%, 3-year local recurrence-free survival rate in complete responders was 71%. In univariate analysis, hydronephrosis, lymph vessel invasion, and macroscopic residual tumor were significantly predictive of disease progression. Hydronephrosis and lymph vessel invasion were also associated with a higher risk of local recurrence. The actuarial 3-year progression-free and overall survival rates were 40.1% and 56.9%, respectively. Conclusion: Radiotherapy is an effective treatment option in terms of local control and survival even in elderly patients with locally advanced bladder cancer not suitable for cystectomy. (orig.)

  18. Risk stratification of patients with locally aggressive differentiated thyroid cancer. Results of the MSDS trial

    Energy Technology Data Exchange (ETDEWEB)

    Riemann, B.; Kraemer, J.A.; Schober, O. [Dept. of Nuclear Medicine, Univ. Hospital, Muenster (Germany); Schmid, K.W. [Inst. of Pathology and Neuropathology, Univ. Hospital of Essen, Univ. of Duisburg-Essen (Germany); Dralle, H. [Dept. of General Surgery, Univ. Halle-Wittenberg (Germany); Dietlein, M.; Schicha, H. [Dept. of Nuclear Medicine, Univ. Cologne (Germany); Sauerland, C. [Dept. of Medical Informatics and Biomathematics, Univ. Muenster (Germany); Frankewitsch, T. [IT-Center - Research and Education, Univ. Muenster (Germany)

    2010-07-01

    The Multicentre Study Differentiated Thyroid Cancer (MSDS) collective represents a well defined group of patients with locally aggressive thyroid carcinomas (pT4; AJCC/UICC 1997). The aim of the present study was to compare the survival of patients with minimum and extensive extrathyroidal growth according to the new AJCC/UICC TNM staging system 2009. Patients, methods: The follow-up data of 347 patients were analysed. Patients were reclassified according to the current AJCC/UICC 2009 classification. The event-free and overall survival was evaluated using Kaplan-Meier analysis. In addition, postoperative complications and status of disease were documented. Results: 327 patients were assigned to stage pT3 and 20 patients to stage pT4a, respectively. Median follow-up was 6.1 years (range 0.04-9.8 years). 92.5% of patients reached complete remission. There were 7.8% recurrences in the thyroid bed, in locoregional lymph nodes and/or in distant sites. The overall survival was >98% both in pT3 and pT4a patients (p = n. s.). In contrast, the event-free survival was significantly less favourable in pT4a patients (p < 0.001). Using multivariate analysis the following parameters were significant predictors of event-free survival: histological tumour type, degree of extrathyroidal extension and nodal metastasis (p < 0.05). Conclusions: The MSDS patients with locally aggressive differentiated thyroid cancer showed an excellent overall survival during a median follow-up of 6.1 years. According to the current AJCC/UICC 2009 classification, pT3 patients with minimal extrathyroidal extension revealed a significantly better event-free survival than pT4a patients with extensive extrathyroidal growth. (orig.)

  19. Long-term results of accelerated radiation treatment for advanced head and neck cancer

    International Nuclear Information System (INIS)

    Background and purpose: This report presents long-term follow-up data from a prospective but unrandomized trial of a continuous 3.5-week course of accelerated radiation treatment (ART) used as primary treatment for patients with loco-regionally advanced head and neck cancer. Materials and methods: Ninety-three patients in three centres in New Zealand and Australia were treated with ART (59.40 Gy in 33 fractions over 24-25 days). Their disease originated from three anatomical regions (oral cavity, 35 patients; pharynx, 31 patients; larynx, 27 patients). Seventy-nine of these patients had stage III or IV cancers. Results: Follow-up ranged from 68 to 203 months (median 139 months). Loco-regional (LR) failure occurred in 52 patients leading to a 10-year actuarial expectation of LR control of 38%. The actuarial expectation of LR control at 10 years was highly dependent on stage and for stage III, IVA and IVB patients it was 57±8.1%, 32±1.7% and 7±0.5%, respectively. Multivariate analysis could not confirm an independent impact of primary site or histological differentiation on LR failure. Two patients died of acute toxicity of treatment and six patients developed grade 3/4 late complications affecting soft tissues only, yielding an actuarial expectation of complications of this severity at 5 years of 9%. No cases of osteoradionecrosis or myelitis were observed. Conclusion: This ART, which has proved easy to use at a number of large and small centres, has produced encouraging long-term LR control at a cost of limited soft tissue morbidity. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  20. Data from a national lung cancer registry contributes to improve outcome and quality of surgery: Danish results

    DEFF Research Database (Denmark)

    Jakobsen, Erik; Palshof, Torben; Østerlind, Kell;

    2008-01-01

    improve the quality of the clinical management of lung cancer. The results of this effort are reported with special focus on surgery. METHODS: Through systematic nationwide registration a total of 24,153 patients have been included in the period 2000-2007. Indicators describing staging, surgical...... baseline data and quality parameters has been a contributory factor to significantly improve the quality of lung cancer surgery....

  1. Adjuvant Chemotherapy for Patients with Stage III Colon Cancer: Results from a CDC-NPCR Patterns of Care Study

    OpenAIRE

    Cress, Rosemary D; Sabatino, Susan A.; Wu, Xiao-Cheng; Schymura, Maria J; Rycroft, Randi; Stuckart, Erik; Fulton, John; Shen, Tiefu

    2009-01-01

    Objective: To evaluate adjuvant chemotherapy use for Stage III colon cancer. Methods: This analysis included 973 patients with surgically treated stage III colon cancer. Socioeconomic information from the 2000 census was linked to patients’ residential census tracts. Vital status through 12/31/02 was obtained from medical records and linkage to state vital statistics files and the National Death Index. Results: Adjuvant chemotherapy was received by 67%. Treatment varied by state of residence,...

  2. Periodontal diseases and risk of oral cancer in Southern India: Results from the HeNCe Life study.

    Science.gov (United States)

    Laprise, Claudie; Shahul, Hameed Puthiyannal; Madathil, Sreenath Arekunnath; Thekkepurakkal, Akhil Soman; Castonguay, Geneviève; Varghese, Ipe; Shiraz, Shameena; Allison, Paul; Schlecht, Nicolas F; Rousseau, Marie-Claude; Franco, Eduardo L; Nicolau, Belinda

    2016-10-01

    Some studies suggest that periodontal diseases increase the risk of oral cancer, but contradictory results also exist. Inadequate control of confounders, including life course exposures, may have influenced prior findings. We estimate the extent to which high levels of periodontal diseases, measured by gingival inflammation and recession, are associated with oral cancer risk using a comprehensive subset of potential confounders and applying a stringent adjustment approach. In a hospital-based case-control study, incident oral cancer cases (N = 350) were recruited from two major referral hospitals in Kerala, South India, from 2008 to 2012. Controls (N = 371), frequency-matched by age and sex, were recruited from clinics at the same hospitals. Structured interviews collected information on several domains of exposure via a detailed life course questionnaire. Periodontal diseases, as measured by gingival inflammation and gingival recession, were evaluated visually by qualified dentists following a detailed protocol. The relationship between periodontal diseases and oral cancer risk was assessed by unconditional logistic regression using a stringent empirical selection of potential confounders corresponding to a 1% change-in-estimates. Generalized gingival recession was significantly associated with oral cancer risk (Odds Ratio = 1.83, 95% Confidence Interval: 1.10-3.04). No significant association was observed between gingival inflammation and oral cancer. Our findings support the hypothesis that high levels of periodontal diseases increase the risk of oral cancer. PMID:27215979

  3. Socioeconomic status and stomach cancer incidence in men: Results from the Netherlands Cohort Study

    NARCIS (Netherlands)

    Loon, A.J.M. van; Goldbohm, R.A.; Brandt, P.A. van den

    1998-01-01

    Study objective - To study the association between socioeconomic status (SES) and stomach cancer incidence (cardia and non-cardia) and the role of lifestyle factors in explaining this association. Design - Prospective cohort study on diet and cancer that started in 1986. Data were collected by means

  4. Hereditary non-polyposis colorectal cancer: clinical features and survival. Results from the Danish HNPCC register

    DEFF Research Database (Denmark)

    Myrhøj, T; Bisgaard, M L; Bernstein, Inge Thomsen; Svendsen, L B; Søndergaard, J O; Bülow, Steffen

    1997-01-01

    BACKGROUND: Hereditary non-polyposis colorectal cancer (HNPCC) is a dominantly inherited syndrome characterized by the development of colorectal cancer (CRC) and other carcinomas. Our aim was to evaluate tumour parameters and survival in HNPCC. METHODS: One hundred and eight Danish HNPCC patients...

  5. Eliminating Disparities in Cancer Screening and Follow-up of Abnormal Results: What Will It Take?

    OpenAIRE

    Fiscella, Kevin; Humiston, Sharon; Hendren, Samantha; Winters, Paul; Jean-Pierre, Pascal; Idris, Amna; Ford, Patricia

    2011-01-01

    Health and health care disparities related to cancer are a major public health problem in the United States. Providing care that is truly patient-centered could address disparities in cancer screening and follow-up through better alignment between patient needs and health care resources available to address those needs. Key health care reforms offer promise for doing so.

  6. Sequence variant classification and reporting: recommendations for improving the interpretation of cancer susceptibility genetic test results.

    NARCIS (Netherlands)

    Plon, S.E.; Eccles, D.M.; Easton, D.; Foulkes, W.D.; Genuardi, M.; Greenblatt, M.S.; Hogervorst, F.B.; Hoogerbrugge, N.; Spurdle, A.B.; Tavtigian, S.V.

    2008-01-01

    Genetic testing of cancer susceptibility genes is now widely applied in clinical practice to predict risk of developing cancer. In general, sequence-based testing of germline DNA is used to determine whether an individual carries a change that is clearly likely to disrupt normal gene function. Genet

  7. Alcohol consumption, cigarette smoking, and endometrial cancer risk: Results from the Netherlands Cohort Study

    NARCIS (Netherlands)

    Loerbroks, A.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2007-01-01

    Objective: To examine the association between alcohol consumption, cigarette smoking, and endometrial cancer. Methods: In 1986, the Netherlands Cohort Study was initiated. A self-administered questionnaire on dietary habits and other cancer risk factors was completed by 62,573 women. Follow-up for c

  8. Physical activity and risk of ovarian cancer: Results from the Netherlands Cohort Study (The Netherlands)

    NARCIS (Netherlands)

    Biesma, R.G.; Schouten, L.J.; Dirx, M.J.M.; Goldbohm, R.A.; Brandt, P.A. van den

    2006-01-01

    Objective: To investigate the association between nonoccupational physical activity and the risk of ovarian cancer among post-menopausal women. Methods: The Netherlands Cohort Study on Diet and Cancer consists of 62,573 women aged 55-69 years at baseline. Information regarding baseline nonoccupation

  9. THE FIRST RESULTS OF TARGETED THERAPY FOR KIDNEY CANCER IN MOSCOW

    Directory of Open Access Journals (Sweden)

    V. I. Shirokorad

    2014-07-01

    Full Text Available The paper provides the first interim analysis of a database including information on 427 metastatic kidney cancer patients receiving targeted therapy in the cancer facilities of the Moscow Healthcare Department. It shows a comparative analysis of the periods of first-line targeted therapy with different drugs until progression is established.

  10. THE FIRST RESULTS OF TARGETED THERAPY FOR KIDNEY CANCER IN MOSCOW

    Directory of Open Access Journals (Sweden)

    V. I. Shirokorad

    2013-01-01

    Full Text Available The paper provides the first interim analysis of a database including information on 427 metastatic kidney cancer patients receiving targeted therapy in the cancer facilities of the Moscow Healthcare Department. It shows a comparative analysis of the periods of first-line targeted therapy with different drugs until progression is established.

  11. Rare neuroendocrine tumours : Results of the surveillance of rare cancers in Europe project

    NARCIS (Netherlands)

    van der Zwan, Jan Maarten; Trama, Annalisa; Otter, Renee; Larranaga, Nerea; Tavilla, Andrea; Marcos-Gragera, Rafael; Dei Tos, Angelo Paolo; Baudin, Eric; Poston, Graeme; Links, Thera

    2013-01-01

    Because of the low incidence, and limited opportunities for large patient volume experiences, there are very few relevant studies of neuroendocrine tumours (NETs). A large population-based database (including cancer patients diagnosed from 1978 to 2002 and registered in 76 population-based cancer re

  12. Inhibition of the JAK2/STAT3 pathway in ovarian cancer results in the loss of cancer stem cell-like characteristics and a reduced tumor burden

    International Nuclear Information System (INIS)

    Current treatment of ovarian cancer patients with chemotherapy leaves behind a residual tumor which results in recurrent ovarian cancer within a short time frame. We have previously demonstrated that a single short-term treatment of ovarian cancer cells with chemotherapy in vitro resulted in a cancer stem cell (CSC)-like enriched residual population which generated significantly greater tumor burden compared to the tumor burden generated by control untreated cells. In this report we looked at the mechanisms of the enrichment of CSC-like residual cells in response to paclitaxel treatment. The mechanism of survival of paclitaxel-treated residual cells at a growth inhibitory concentration of 50% (GI50) was determined on isolated tumor cells from the ascites of recurrent ovarian cancer patients and HEY ovarian cancer cell line by in vitro assays and in a mouse xenograft model. Treatment of isolated tumor cells from the ascites of ovarian cancer patients and HEY ovarian cancer cell line with paclitaxel resulted in a CSC-like residual population which coincided with the activation of Janus activated kinase 2 (JAK2) and signal transducer and activation of transcription 3 (STAT3) pathway in paclitaxel surviving cells. Both paclitaxel-induced JAK2/STAT3 activation and CSC-like characteristics were inhibited by a low dose JAK2-specific small molecule inhibitor CYT387 (1 μM) in vitro. Subsequent, in vivo transplantation of paclitaxel and CYT387-treated HEY cells in mice resulted in a significantly reduced tumor burden compared to that seen with paclitaxel only-treated transplanted cells. In vitro analysis of tumor xenografts at protein and mRNA levels demonstrated a loss of CSC-like markers and CA125 expression in paclitaxel and CYT387-treated cell-derived xenografts, compared to paclitaxel only-treated cell-derived xenografts. These results were consistent with significantly reduced activation of JAK2 and STAT3 in paclitaxel and CYT387-treated cell-derived xenografts

  13. Phase 1 Trials in Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Esther Yu

    2014-07-01

    Full Text Available Despite many clinical trials over the last two decades since the approval of gemcitabine, the survival of patients with pancreatic cancer has improved by a few only months. This disappointing reality underlines an urgent need to develop more effective drugs or better combinations. A variety of phase I trials were presented at the annual meeting of ASCO 2014 focusing on locally advanced and metastatic pancreatic cancer. We summarize four abstracts (abstracts #4116, #4123, #4026, #4138.

  14. Divergent targets of glycolysis and oxidative phosphorylation result in additive effects of metformin and starvation in colon and breast cancer.

    Science.gov (United States)

    Marini, Cecilia; Bianchi, Giovanna; Buschiazzo, Ambra; Ravera, Silvia; Martella, Roberto; Bottoni, Gianluca; Petretto, Andrea; Emionite, Laura; Monteverde, Elena; Capitanio, Selene; Inglese, Elvira; Fabbi, Marina; Bongioanni, Francesca; Garaboldi, Lucia; Bruzzi, Paolo; Orengo, Anna Maria; Raffaghello, Lizzia; Sambuceti, Gianmario

    2016-01-01

    Emerging evidence demonstrates that targeting energy metabolism is a promising strategy to fight cancer. Here we show that combining metformin and short-term starvation markedly impairs metabolism and growth of colon and breast cancer. The impairment in glycolytic flux caused by starvation is enhanced by metformin through its interference with hexokinase II activity, as documented by measurement of 18F-fluorodeoxyglycose uptake. Oxidative phosphorylation is additively compromised by combined treatment: metformin virtually abolishes Complex I function; starvation determines an uncoupled status of OXPHOS and amplifies the activity of respiratory Complexes II and IV thus combining a massive ATP depletion with a significant increase in reactive oxygen species. More importantly, the combined treatment profoundly impairs cancer glucose metabolism and virtually abolishes lesion growth in experimental models of breast and colon carcinoma. Our results strongly suggest that energy metabolism is a promising target to reduce cancer progression. PMID:26794854

  15. Cervical cancer: the Indian perspective. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer.

    Science.gov (United States)

    Vallikad, E

    2006-11-01

    Cancer of the uterine cervix is the commonest gynaecologic cancer in India, with most women presenting with disease extending beyond the cervix. The majority of women belong to the lower socioeconomic status, are rural, aged between 35 and 64 years and highly noncompliant for complete treatment and follow-up. Opportunistic screening with cytology, colposcopy and test for Human Papilloma Virus and appropriate treatment are available on payment at urban private medical centres but are not available at urban and rural government health centres that are accessed by women of the lower socioeconomic status. The Government's investment in health is 0.9% of the GDP. Thus cytology screening as a government health measure is not feasible. The 'social vaccine' of health empowerment along with visual inspection and appropriate referral by the rural and urban health personnel (Department of Health and Family Welfare); with an additional input of health awareness and motivation by Anganwadi Workers (Department of Women and Child Development), elected women representatives in the Panchayats (Department of Rural Development and Panchayati Raj) and non-governmental development agencies could be a collaborative effort towards "downstaging" cervical cancer. This could lay the foundation for the introduction of cytology screening when resources are available. PMID:17161161

  16. Omega-3 Fatty Acid Consumption and Prostate Cancer: A Review of Exposure Measures and Results of Epidemiological Studies.

    Science.gov (United States)

    Dinwiddie, Michael T; Terry, Paul D; Whelan, Jay; Patzer, Rachel E

    2016-07-01

    Animal studies have shown that dietary omega-3 polyunsaturated fatty acids (n-3) may play a role in the development of prostate cancer, but the results of epidemiologic studies have been equivocal. Associations in humans may vary depending on study design, measurement methodology of fatty acid intake, intake ranges, and stage of cancer development. To address this, we identified 36 published studies through PubMed (Medline) from 1993 through 2013 on long-chain n-3s and prostate cancer. Exposure measurements included dietary assessment and biomarker levels. Associations for total, early, and late stage prostate cancer were examined by subgroup of study design and exposure measure type and by using forest plots to illustrate the relative strength of associations within each subgroup. We also tested for potential threshold effects by considering studies that included measurement cut-points that met intake levels recommended by the American Heart Association. We found no consistent evidence supporting a role of n-3s in either the causation or prevention of prostate cancer at any stage or grade. Results did not vary appreciably by study design, exposure measurement, intake level, or stage of cancer development. PMID:26595854

  17. Colorectal cancer screening practices of primary care providers: results of a national survey in Malaysia.

    Science.gov (United States)

    Norwati, Daud; Harmy, Mohamed Yusoff; Norhayati, Mohd Noor; Amry, Abdul Rahim

    2014-01-01

    The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics. PMID:24761922

  18. Similar fecal immunochemical test results in screening and referral colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Sietze T van Turenhout; Leo GM van Rossum; Frank A Oort; Robert JF Laheij; Anne F van Rijn; Jochim S Terhaar sive Droste; Paul Fockens

    2012-01-01

    AIM:To improve the interpretation of fecal immunochemical test (FIT) results in colorectal cancer (CRC)cases from screening and referral cohorts.METHODS:In this comparative observational study,two prospective cohorts of CRC cases were compared.The first cohort was obtained from 10 322 average risk subjects invited for CRC screening with FIT,of which,only subjects with a positive FIT were referred for colonoscopy.The second cohort was obtained from 3637subjects scheduled for elective colonoscopy with a positive FIT result.The same FIT and positivity threshold (OC sensor; ≥ 50 ng/mL) was used in both cohorts.Colonoscopy was performed in all referral subjects and in FIT positive screening subjects.All CRC cases were selected from both cohorts.Outcome measurements were mean FIT results and FIT scores per tissue tumor stage (T stage).RESULTS:One hundred and eighteen patients with CRC were included in the present study:28 cases obtained from the screening cohort (64% male; mean age 65 years,SD 6.5) and 90 cases obtained from the referral cohort (58% male; mean age 69 years,SD 9.8).The mean FIT results found were higher in the referral cohort (829 ± 302 ng/mL vs 613 ± 368 ng/mL,P =0.02).Tissue tumor stage (T stage) distribution was different between both populations [screening population:13 (46%) T1,eight (29%) T2,six (21%) T3,one (4%)T4 carcinoma; referral population:12 (13%) T1,22(24%) T2,52 (58%) T3,four (4%) T4 carcinoma],and higher T stage was significantly associated with higher FIT results (P < 0.001).Per tumor stage,no significant difference in mean F1T results was observed (screening vs referral:T1 498 ± 382 ng/mL vs 725 ± 374 ng/mL,P =0.22; T2 787 ± 303 ng/mL vs 794 ± 341 ng/mL,P=0.79; T3 563 ± 368 ng/mL vs 870 ± 258 ng/mL,P =0.13; T4 not available).Alter correction for T stage in logistic regression analysis,no significant differences in mean FIT results were observed between both types of cohorts (P =0.10).CONCLUSION

  19. Persistent quality of life impairments in differentiated thyroid cancer patients: results from a monitoring programme

    International Nuclear Information System (INIS)

    Health-related quality of life (HRQOL) in differentiated thyroid cancer (DTC) research has so far received little attention and available results are conflicting. We studied the HRQOL of radioiodine-naive DTC patients in comparison with the general population (GP), investigated the course of HRQOL up to 30 months after radioiodine remnant ablation (RAA) and sought to identify patient characteristics associated with HRQOL. We analysed data from routine HRQOL monitoring at a nuclear medicine department. Between 2005 and 2013, a total of 439 thyroid cancer patients (all histologies) completed the EORTC Quality of Life Questionnaire Core-30 (QLQ-C30) at least once during their treatment at the department. We compared patients' baseline HRQOL scores before RAA with scores from age-matched and sex-matched controls from the Austrian GP. We then determined the course of HRQOL over the 30 months after RAA and assessed the impact of the following clinical variables on HRQOL: method of thyroid-stimulating hormone (TSH) stimulation, histology (papillary vs. follicular) and disease stage. A total of 284 patients (mean age 48.3 years, SD 15.0 years; 71.6 % women; 80.7 % papillary type) with a baseline HRQOL assessment before RAA were available. We found clinically meaningful differences in the detriment in patients on almost all domains. These were largest for fatigue (23 points) and role functioning (25 points). Data from 241 patients (mean age 48.6 years, SD 15.9 years; 68.9 % women; 76.3 % papillary type) were included in the longitudinal analysis. Investigating the course of HRQOL, a significant improvement over time was found for role and emotional functioning, fatigue, pain, and dyspnoea. A range of HRQOL scores were improved in patients with exogenous TSH stimulation, but some scores both in patients with exogenous TSH stimulation and in those followed for 30 months, especially fatigue and role functioning, did not reach levels in the GP sample. Our results show that

  20. Persistent quality of life impairments in differentiated thyroid cancer patients: results from a monitoring programme

    Energy Technology Data Exchange (ETDEWEB)

    Gamper, Eva-Maria [Medical University Innsbruck, Department for Nuclear Medicine, Innsbruck (Austria); Medical University Innsbruck, Department for Psychiatry and Psychotherapy, Innsbruck (Austria); Wintner, Lisa M.; Holzner, Bernhard [Medical University Innsbruck, Department for Psychiatry and Psychotherapy, Innsbruck (Austria); Rodrigues, Margarida; Buxbaum, Sabine; Nilica, Bernhard; Virgolini, Irene [Medical University Innsbruck, Department for Nuclear Medicine, Innsbruck (Austria); Singer, Susanne [University of Mainz, Institute of Medical Biostatistics, Epidemiology, and Informatics, Mainz (Germany); Giesinger, Johannes M. [Netherlands Cancer Institute, Amsterdam (Netherlands)

    2015-07-15

    Health-related quality of life (HRQOL) in differentiated thyroid cancer (DTC) research has so far received little attention and available results are conflicting. We studied the HRQOL of radioiodine-naive DTC patients in comparison with the general population (GP), investigated the course of HRQOL up to 30 months after radioiodine remnant ablation (RAA) and sought to identify patient characteristics associated with HRQOL. We analysed data from routine HRQOL monitoring at a nuclear medicine department. Between 2005 and 2013, a total of 439 thyroid cancer patients (all histologies) completed the EORTC Quality of Life Questionnaire Core-30 (QLQ-C30) at least once during their treatment at the department. We compared patients' baseline HRQOL scores before RAA with scores from age-matched and sex-matched controls from the Austrian GP. We then determined the course of HRQOL over the 30 months after RAA and assessed the impact of the following clinical variables on HRQOL: method of thyroid-stimulating hormone (TSH) stimulation, histology (papillary vs. follicular) and disease stage. A total of 284 patients (mean age 48.3 years, SD 15.0 years; 71.6 % women; 80.7 % papillary type) with a baseline HRQOL assessment before RAA were available. We found clinically meaningful differences in the detriment in patients on almost all domains. These were largest for fatigue (23 points) and role functioning (25 points). Data from 241 patients (mean age 48.6 years, SD 15.9 years; 68.9 % women; 76.3 % papillary type) were included in the longitudinal analysis. Investigating the course of HRQOL, a significant improvement over time was found for role and emotional functioning, fatigue, pain, and dyspnoea. A range of HRQOL scores were improved in patients with exogenous TSH stimulation, but some scores both in patients with exogenous TSH stimulation and in those followed for 30 months, especially fatigue and role functioning, did not reach levels in the GP sample. Our results show that

  1. A Possible Association between Melanoma and Prostate Cancer. Results from a Case-Control-Study

    Directory of Open Access Journals (Sweden)

    Alina Goldenberg

    2015-04-01

    Full Text Available Melanoma and prostate cancer are the fifth and first most common cancers in men within the United States, respectively. The association between the two cancers lies in the mutual androgen-dependence. However, the relationship between prostate cancer history and melanoma development remains to be further elucidated. We aim to determine the odds of history of prostate cancer among men with melanoma as compared to time-frame, clinic, and provider-matched controls without melanoma within a single academic surgical center. We present a case-control study comparing men treated for melanoma and non-melanoma cancer by a single provider between 2010 and 2014 within an academic dermatologic surgical center. Overall, there were nine cases of prostate cancer among the melanoma group and two cases amongst the controls—a statistically significant difference in both uni- and multivariable analyses (p = 0.057 [95% CI 1, 23.5], p = 0.042 [95% CI 1.1, 129], respectively. Body mass index, alcohol use, and skin type II were significant risk factors for melanoma (p = 0.011 [95% CI 1, 1.3], 0.005 [95% CI 1.4, 7], 0.025 [95% CI 1.1, 3.3], respectively. There were more immunosuppressed controls (p = 0.002; however, the melanoma patients had a significantly longer duration of immunosuppression (11.6 vs. 1.9 years, p < 0.001 [95% CI 0.03, 0.5]. Melanoma screenings for men should include questions on prostate cancer history. Prostate cancer patients may benefit from more frequent and comprehensive melanoma screening.

  2. Enhancing Cancer Screening in Primary Care: Rationale, Design, Analysis Plan, and Recruitment Results

    OpenAIRE

    Murray, David M.; Katz, Mira L.; Post, Doug M.; Pennell, Michael L.; Young, Gregory S.; Tatum, Cathy M.; Paskett, Electra D.

    2013-01-01

    Colorectal cancer (CRC) is the third leading type of cancer and the third leading cause of cancer death in the United States. National policy-making organizations recognize and support a variety of CRC screening strategies among average-risk adults aged 50 and older based on strong evidence showing that screening decreases mortality from CRC and can also reduce the incidence of the disease. The goal of this study was to test a multi-level stepped intervention to increase CRC screening rates. ...

  3. Oral contraceptives and breast cancer: results from an expanded case-control study.

    OpenAIRE

    Stanford, J. L.; Brinton, L. A.; Hoover, R.N.

    1989-01-01

    The relationship between oral contraceptives and breast cancer was evaluated among 2,022 cases and 2,183 controls participating in a multicentre breast cancer screening programme. Ever use of oral contraceptives was not related to breast cancer risk (RR = 1.0, 95% CI 0.9-1.2), and no overall patterns of increasing or decreasing risks were observed according to the duration of use, or time since first or most recent use. Although we had no women with extended periods of oral contraceptive use ...

  4. Predictors of the immediate results of thrombectomy in kidney cancer patients with venous tumor thrombosis

    Directory of Open Access Journals (Sweden)

    M. I. Davydov

    2014-01-01

    Full Text Available Objective: to identify the predictors of perioperative complications and deaths in surgically treated patients with kidney cancer complicated by venous tumor thrombosis.Subjects and methods. The investigation included data on 463 kidney cancer patients with venous tumor thrombosis. The patients, median age was 57 years. The male / female ratio was 2.5:1. Perirenal, subhepatic, retrohepatic, and supradiaphragmatic tumor thrombi were diagnosed in 161 (34.8 %, 135 (29.2 %, 82 (17.7 %, and 85 (18.3 % patients, respectively. Regional and distant metastases occurred in 90 (19.4 % and 145 (31.3 % cases, respectively. All the patients underwent thrombectomy, retroperitoneal lymphadenectomy; a tumor-affected kidney was removed in 452 (97.6 % patients.Results. Median surgery duration was 259 (30–580 min; median blood loss was 3500 (100–27 000 ml. The incidence of intraoperative complications was 24.6 % (114 / 463; mortality was 0.9 % (4 / 463. The independent risk factors of intraoperative complications were cranial margin of a tumor thrombus (odds ratio (OR 1.9; 95 % CI 1.4–2.6; p < 0.0001 and circular resection of the inferior vena cava (OR 5.8; 95 % CI 1.2–27.8; p < 0.0001. The incidence of postoperative complications was 25.7 % (118 / 459;mortality was 6.0 % (28 / 459. Resurgery was required in 31 (6.8 % cases. Regression analysis identified the risk factors of postoperative complications (highly located cranial thrombus margin (OR 2.6; 95 % CI 1.1–6.4; p = 0.037 and lactate acidosis (OR27.1; 95 % CI 1.2–613.1; p = 0.038, postoperative death (hepatic vein thrombosis (OR 15.6; 95 % CI 4.5–54.3; p < 0.0001,lactate acidosis (OR 23.1; 95 % CI 3.4–158.4; p = 0.001 thrombus removal from the heart (OR 5.0; 95 % CI 2.1–12.2; p < 0.0001,perioperative death (cranial thrombus margin (OR 1.9; 95 % CI 1.2–3.2; р = 0.007, contralateral renal vein thrombosis (O R 4.4;95 % CI 1.2–15.8; p = 0.025, lactate acidosis (OR 28.4; 95 % CI 4

  5. Automated detection of discourse segment and experimental types from the text of cancer pathway results sections

    Science.gov (United States)

    Burns, Gully A.P.C.; Dasigi, Pradeep; de Waard, Anita; Hovy, Eduard H.

    2016-01-01

    Automated machine-reading biocuration systems typically use sentence-by-sentence information extraction to construct meaning representations for use by curators. This does not directly reflect the typical discourse structure used by scientists to construct an argument from the experimental data available within a article, and is therefore less likely to correspond to representations typically used in biomedical informatics systems (let alone to the mental models that scientists have). In this study, we develop Natural Language Processing methods to locate, extract, and classify the individual passages of text from articles’ Results sections that refer to experimental data. In our domain of interest (molecular biology studies of cancer signal transduction pathways), individual articles may contain as many as 30 small-scale individual experiments describing a variety of findings, upon which authors base their overall research conclusions. Our system automatically classifies discourse segments in these texts into seven categories (fact, hypothesis, problem, goal, method, result, implication) with an F-score of 0.68. These segments describe the essential building blocks of scientific discourse to (i) provide context for each experiment, (ii) report experimental details and (iii) explain the data’s meaning in context. We evaluate our system on text passages from articles that were curated in molecular biology databases (the Pathway Logic Datum repository, the Molecular Interaction MINT and INTACT databases) linking individual experiments in articles to the type of assay used (coprecipitation, phosphorylation, translocation etc.). We use supervised machine learning techniques on text passages containing unambiguous references to experiments to obtain baseline F1 scores of 0.59 for MINT, 0.71 for INTACT and 0.63 for Pathway Logic. Although preliminary, these results support the notion that targeting information extraction methods to experimental results could provide

  6. Automated detection of discourse segment and experimental types from the text of cancer pathway results sections.

    Science.gov (United States)

    Burns, Gully A P C; Dasigi, Pradeep; de Waard, Anita; Hovy, Eduard H

    2016-01-01

    Automated machine-reading biocuration systems typically use sentence-by-sentence information extraction to construct meaning representations for use by curators. This does not directly reflect the typical discourse structure used by scientists to construct an argument from the experimental data available within a article, and is therefore less likely to correspond to representations typically used in biomedical informatics systems (let alone to the mental models that scientists have). In this study, we develop Natural Language Processing methods to locate, extract, and classify the individual passages of text from articles' Results sections that refer to experimental data. In our domain of interest (molecular biology studies of cancer signal transduction pathways), individual articles may contain as many as 30 small-scale individual experiments describing a variety of findings, upon which authors base their overall research conclusions. Our system automatically classifies discourse segments in these texts into seven categories (fact, hypothesis, problem, goal, method, result, implication) with an F-score of 0.68. These segments describe the essential building blocks of scientific discourse to (i) provide context for each experiment, (ii) report experimental details and (iii) explain the data's meaning in context. We evaluate our system on text passages from articles that were curated in molecular biology databases (the Pathway Logic Datum repository, the Molecular Interaction MINT and INTACT databases) linking individual experiments in articles to the type of assay used (coprecipitation, phosphorylation, translocation etc.). We use supervised machine learning techniques on text passages containing unambiguous references to experiments to obtain baseline F1 scores of 0.59 for MINT, 0.71 for INTACT and 0.63 for Pathway Logic. Although preliminary, these results support the notion that targeting information extraction methods to experimental results could provide

  7. Identification of a functional genetic variant at 16q12.1 for breast cancer risk: results from the Asia Breast Cancer Consortium.

    Directory of Open Access Journals (Sweden)

    Jirong Long

    2010-06-01

    Full Text Available Genetic factors play an important role in the etiology of breast cancer. We carried out a multi-stage genome-wide association (GWA study in over 28,000 cases and controls recruited from 12 studies conducted in Asian and European American women to identify genetic susceptibility loci for breast cancer. After analyzing 684,457 SNPs in 2,073 cases and 2,084 controls in Chinese women, we evaluated 53 SNPs for fast-track replication in an independent set of 4,425 cases and 1,915 controls of Chinese origin. Four replicated SNPs were further investigated in an independent set of 6,173 cases and 6,340 controls from seven other studies conducted in Asian women. SNP rs4784227 was consistently associated with breast cancer risk across all studies with adjusted odds ratios (95% confidence intervals of 1.25 (1.20-1.31 per allele (P = 3.2 x 10(-25 in the pooled analysis of samples from all Asian samples. This SNP was also associated with breast cancer risk among European Americans (per allele OR = 1.19, 95% CI = 1.09-1.31, P = 1.3 x 10(-4, 2,797 cases and 2,662 controls. SNP rs4784227 is located at 16q12.1, a region identified previously for breast cancer risk among Europeans. The association of this SNP with breast cancer risk remained highly statistically significant in Asians after adjusting for previously-reported SNPs in this region. In vitro experiments using both luciferase reporter and electrophoretic mobility shift assays demonstrated functional significance of this SNP. These results provide strong evidence implicating rs4784227 as a functional causal variant for breast cancer in the locus 16q12.1 and demonstrate the utility of conducting genetic association studies in populations with different genetic architectures.

  8. Brain Cancer Stem Cells Display Preferential Sensitivity to Akt Inhibition

    OpenAIRE

    Eyler, Christine E.; Foo, Wen-Chi; LaFiura, Katherine M.; McLendon, Roger E.; Hjelmeland, Anita B.; Rich, Jeremy N.

    2008-01-01

    Malignant brain tumors are among the most lethal cancers, and conventional therapies are largely limited to palliation. Novel therapies targeted against specific molecular pathways may offer improved efficacy and reduced toxicity compared to conventional therapies, but initial clinical trials of molecular targeted agents in brain cancer therapy have been frequently disappointing. In brain tumors and other cancers, subpopulations of tumor cells have recently been characterized by their ability...

  9. ONCOLOGICAL RESULTS OF RADICAL SURGICAL TREATMENT IN PATIENTS WITH LOCALLY ADVANCED PROSTATE CANCER

    OpenAIRE

    O. B. Loran; E. I. Veliyev; S. V. Kotov

    2014-01-01

    The authors consider and prove the efficiency of radical prostatectomy used in the treatment of patients with locally advanced prostate cancer as monotherapy and as a component of multimodality therapy.

  10. Imediate and long term therapeutic results from association of chemotherapy and radiotherapy in head neck cancer

    International Nuclear Information System (INIS)

    A analysis of 922 cases of head and neck cancer observed from March of 1977 to March of 1987 is presented. The actual position of the combined treatment of radiotherapy and chemotherapy is reported. (author)

  11. A case of jawbone necrosis resulting from radiation treatment of multiple bone metastases from breast cancer

    International Nuclear Information System (INIS)

    Radiotherapy for malignant tumors is sometimes associated with side effects that can appear early in the course of treatment. Radiation necrosis of the jawbone sometimes occurs after exposure to a radiation dose of 60 Gy or more for treatment of malignant tumors of the head and neck, and this can have a marked influence on subsequent dental care. The effect is often more marked in the lower than in the upper jaw, and becomes typically evident at the time of tooth extraction. As well as cancers of the head and neck, patients with breast cancer can also be affected by radiation necrosis of the jawbone. It is well known that the rate of bone metastases from breast cancer is much high especially appearing the mandibular in the head and neck lesions. Here we report an overview of jawbone necrosis in the light of our experience of one such case following radiation treatment of multiple bone metastases from breast cancer. (author)

  12. Reduced Circumferential Resection Margin Involvement in Rectal Cancer Surgery: Results of the Dutch Surgical Colorectal Audit

    NARCIS (Netherlands)

    Gietelink, L.; Wouters, M.W.; Tanis, P.J.; Deken, M.M.; Berge, M.G. Ten; Tollenaar, R.A.; Krieken, J.H.J.M. van; Noo, M.E. de

    2015-01-01

    BACKGROUND: The circumferential resection margin (CRM) is a significant prognostic factor for local recurrence, distant metastasis, and survival after rectal cancer surgery. Therefore, availability of this parameter is essential. Although the Dutch total mesorectal excision trial raised awareness ab

  13. Long-term results of concurrent radiotherapy and UFT in patients with locally advanced pancreatic cancer

    DEFF Research Database (Denmark)

    Bjerregaard, Jon K; Mortensen, Michael B; Jensen, Helle A;

    2009-01-01

    BACKGROUND: Definition and treatment options for locally advanced non-resectable pancreatic cancer (LAPC) vary. Treatment options range from palliative chemotherapy to chemoradiotherapy (CRT). Several studies have shown that a number of patients become resectable after complementary treatment prior...

  14. Cancer Incidence - Surveillance, Epidemiology, and End Results (SEER) Registries Limited-Use

    Data.gov (United States)

    U.S. Department of Health & Human Services — SEER Limited-Use cancer incidence data with associated population data. Geographic areas available are county and SEER registry. The Surveillance, Epidemiology, and...

  15. Results of treatment of differentiated thyroid cancers using Iodine-131 at Sri Lanka's first private institution

    International Nuclear Information System (INIS)

    Full text: This department was started in order to meet the urgent demand of iodine-131 treatment in differentiated thyroid cancer (DTC), as the waiting list in government hospitals was unduly long. Data obtained revealed that 52% of the patients had iodine-131 therapy within 4 months, 31% in 4 to 8 months and 17% over 8 months time. Institute received license to order, stock and administer iodine-131 from the AEA-Sri Lanka as its facilities were according to IAEA standards. Facility included three 'single bedded en-suit toilet rooms' with storage capacity for iodine-131 capsules. 115 cases (male: female ratio 1:4) of DTC were treated during the past one and half year and each received 100 GBq of radioactivity. 89 (77.3%) comprised papillary carcinoma, 25 (21.7%) follicular carcinoma and 1 case of mixed carcinoma. 52% of males and 60.8% of females were in the 26-45 years age group. Sixty cases of papillary carcinoma were sub-typed and grouped to observe the distribution of metastases and response to iodine-131. They were follicular variant (FV) in 28 (46%), micropaillary (MP) in 10 (20%), encapsulated (EP) in 8 (13.3%), tall cell (TC) in 3 (5%) and diffuse sclerosis (DS) in 9 (15%). TSH and Tg values were measured before therapy and four months afterwards. Activity readings were measured 30 min after ingestion and 4 days later and discharged when the values were less than 20 μSv / hour. Six of the nine (66%) DS cancer patients had metastasis in lymph nodes and lungs when referred for iodine-131 treatment. In 8 of these patients, Tg levels were raised. 36% (8/9) of the FC patients also had raised Tg levels indicating metastases and 4/5 were found to have bony metastases. In post iodine-131 therapy whole body scans, 3.3% had metastases in the lungs in PC and 20% of FC in skeleton. With a single dose of iodine-131 over 90% had drop in Tg levels to less than I ng/ml except in DS (23% drop) and TC (33% drop). The study shows that sub-typing of PC was useful and TC and

  16. Parenteral nutrition support for patients with pancreatic cancer. Results of a phase II study

    Directory of Open Access Journals (Sweden)

    Riess Hanno

    2010-03-01

    Full Text Available Abstract Background Cachexia is a common problem in patients (pts suffering from upper gastrointestinal cancer. In addition, most of these patients suffer from malabsorption and stenosis of the gastrointestinal tract due to their illness. Various methods of supplementary nutrition (enteral, parenteral are practised. In patients with advanced pancreatic cancer (APC, phase angle, determined by bio-electrical impedance analysis (BIA, seems to be a survival predictor. The positive influence of BIA determinate predictors by additional nutrition is currently under discussion. Methods To examine the impact of additional parenteral nutrition (APN we assessed outpatients suffering from APC and progressive cachexia. The assessment based on the BIA method. Assessment parameters were phase angle, ECM/BCM index (ratio of extracellular mass to body cell mass, and BMI (body mass index. Patients suffering from progressive weight loss in spite of additional enteral nutritional support were eligible for the study. Results Median treatment duration in 32 pts was 18 [8-35] weeks. Response evaluation showed a benefit in 27 pts (84% in at least one parameter. 14 pts (43.7% improved or stabilised in all three parameters. The median ECM/BCM index was 1.7 [1.11-3.14] at start of APN and improved down to 1.5 [1.12-3.36] during therapy. The median BMI increased from 19.7 [14.4-25.9] to 20.5 [15.4-25.0]. The median phase angle improved by 10% from 3.6 [2.3-5.1] to 3.9 [2.2-5.1]. Conclusions We demonstrated the positive impact of APN on the assessed parameters, first of all the phase angle, and we observed at least a temporary benefit or stabilisation of the nutritional status in the majority of the investigated patients. Based on these findings we are currently investigating the impact of APN on survival in a larger patient cohort. Trial registration ClinicalTrials.gov Identifier: NCT00919659

  17. 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

  18. [Immunogenetic prognosis and long-term results of surgery for gastric cancer].

    Science.gov (United States)

    Korotkova, I Iu; Egorov, D N; Solov'eva, I G; Cherenkova, M M; Vardosanidze, K V; Abramov, V V; Konenkov, V I

    2005-01-01

    A link between HLA allelic variants and long-term results of surgery for gastric tumors was established on the basis of a 10-years follow-up of 112 cancer patients (stage I-II--37.9, III-IV--62.1%; radical surgery--44.6%). HLA class I was studied in a lymphocytotoxic test; HLA class II--gene DRBI specificity using polymerase chain reaction of peripheral blood cell DNA. The control group included healthy subjects living in the city of Novosibirsk (n = 341). High frequency of antigens HLA-B41, -DR1, -DR7 (p HLA-A2, -B12, -B13 and -B18 presence (p HLA-A1, -B8, -B15, -DR3 and -DR5 carriers at early stages. Tumor development at later stages (III-IV) was associated with HLA-A2, -B12, -B17, -B35, -B41 and -DR7. A link was registered between lethality rate, on the one hand, and HLA-A3, -B22, and, in particular, DR4, on the other, while remission of more than 7-years--with HLA-A11, -B13, -B21 and -DR5. HLA-B22/DR3 phenotype involved worse prognosis in radically-treated patients whereas that of HLA-B8/DR3--a better one. PMID:17037033

  19. Photodynamic therapy of locally advanced pancreatic cancer (VERTPAC study): final clinical results

    Science.gov (United States)

    Huggett, M. T.; Jermyn, M.; Gillams, A.; Mosse, S.; Kent, E.; Bown, S. G.; Hasan, T.; Pogue, B. W.; Pereira, S. P.

    2013-03-01

    We undertook a phase I dose-escalation study of verteporfin photodynamic therapy (PDT) in 15 patients with locally advanced pancreatic cancer. Needle placement and laser delivery were technically successful in all patients. Thirteen patients were treated with a single laser fibre. Three treatments were carried out each at 5, 10 and 20 J/cm2; and 5 treatments (4 patients) at 40 J/cm2. A further 2 patients were treated with 2 or 3 laser fibres at 40 J/cm2. Tumour necrosis was measured on CT (computed tomography) by two radiologists 5 days after treatment. There was a clear dosedependent increase in necrosis with a median area of 20 x 16 mm (range 18 x 16 to 35 x 30 mm) at 40 J/cm2. In the 2 patients treated with multiple fibres, necrosis was 40 x 36 mm and 30 x 28 mm, respectively. There were no early complications in patients treated with a single fibre. Both patients treated with multiple fibres had evidence on CT of inflammatory change occurring anterior to the pancreas but without clinical deterioration. These results suggest that single fibre verteporfin PDT is safe in a clinical setting up to 40J/cm2 and produces a dose-dependent area of pancreatic necrosis.

  20. Proteomic Study of HPV-Positive Head and Neck Cancers: Preliminary Results

    Directory of Open Access Journals (Sweden)

    Géraldine Descamps

    2014-01-01

    Full Text Available Human papillomavirus (HPV was recently recognized as a new risk factor for head and neck squamous cell carcinoma. For oropharyngeal cancers, an HPV+ status is associated with better prognosis in a subgroup of nonsmokers and nondrinkers. However, HPV infection is also involved in the biology of head and neck carcinoma (HNC in patients with a history of tobacco use and/or alcohol consumption. Thus, the involvement of HPV infection in HN carcinogenesis remains unclear, and further studies are needed to identify and analyze HPV-specific pathways that are involved in this process. Using a quantitative proteomics-based approach, we compared the protein expression profiles of two HPV+ HNC cell lines and one HPV− HNC cell line. We identified 155 proteins that are differentially expressed (P<0.01 in these three lines. Among the identified proteins, prostate stem cell antigen (PSCA was upregulated and eukaryotic elongation factor 1 alpha (EEF1α was downregulated in the HPV+ cell lines. Immunofluorescence and western blotting analyses confirmed these results. Moreover, PSCA and EEF1α were differentially expressed in two clinical series of 50 HPV+ and 50 HPV− oral cavity carcinomas. Thus, our study reveals for the first time that PSCA and EEF1α are associated with the HPV-status, suggesting that these proteins could be involved in HPV-associated carcinogenesis.

  1. Prostate Cancer Detection at Rebiopsy After an Initial Benign Diagnosis: Results Using Sextant Extended Prostate Biopsy

    OpenAIRE

    Katia Ramos Moreira Leite; Luiz Heraldo Camara-Lopes; José Cury; Marcos F. Dall'Oglio; Adriana Sañudo; Miguel Srougi

    2008-01-01

    INTRODUCTION: Sextant prostate biopsy remains the standard technique for the detection of prostate cancer. It is well known that after a diagnosis of small acinar proliferation (ASAP) or high grade prostate intraepithelial neoplasia (HGPIN), the possibility of finding cancer is approximately 40% and 30%, respectively. OBJECTIVE: We aim to analyze follow-up biopsies on patients who initially received a benign diagnosis after exclusion of HGPIN and ASAP. METHODS: From July 2000 to December 2003...

  2. Development of a Communication Protocol for Telephone Disclosure of Genetic Test Results for Cancer Predisposition

    OpenAIRE

    Patrick-Miller, Linda J.; Egleston, Brian L.; Fetzer, Dominique; Forman, Andrea; Bealin, Lisa; Rybak, Christina; Peterson, Candace; Corbman, Melanie; Albarracin, Julio; Stevens, Evelyn; Daly, Mary B.; Bradbury, Angela R.

    2014-01-01

    Background Dissemination of genetic testing for disease susceptibility, one application of “personalized medicine”, holds the potential to empower patients and providers through informed risk reduction and prevention recommendations. Genetic testing has become a standard practice in cancer prevention for high-risk populations. Heightened consumer awareness of “cancer genes” and genes for other diseases (eg, cardiovascular and Alzheimer’s disease), as well as the burgeoning availability of inc...

  3. Results of combination treatment using docetaxel in an adjuvant chemotherapy regimen for resectable breast cancer

    OpenAIRE

    L. V. Bolotina; T. I. Deshkina

    2014-01-01

    Breast cancer (BC) dominates in the structure of cancer morbidity and mortality in women worldwide. Despite the advances made in the treatment of this pathology, there is still a variety of unsolved problems, including those associated with disease progression after radical sur- gical interventions. One of the urgent current tasks is to estimate the adequate volume of adjuvant treatment with regard to the biological features of a tumor. Our investigation comparatively analyzed the efficiency ...

  4. Clinical evaluation of seven tumour markers in lung cancer diagnosis: can any combination improve the results?

    OpenAIRE

    Plebani, M; Basso, D.; Navaglia, F; Paoli, M.; Tommasini, A; Cipriani, A

    1995-01-01

    In this study we compared the diagnostic utility of: (1) neuron-specific enolase (NSE); (2) squamous cell carcinoma antigen (SCC); (3) carcinoembryonic antigen (CEA); and (4) cytokeratin markers (CYFRA 21-1, TPA, TPM, TPS) in patients with small-cell lung cancer (SCLC) (21 cases) and non-small-cell lung cancer (94 cases). For comparison we also studied 66 patients with benign lung diseases and nine with pleural mesothelioma. NSE levels in SCLC patients were significantly higher than those in ...

  5. Analysis of 5-year treatment results for patients with vulva cancer

    International Nuclear Information System (INIS)

    34 patients was examined.Surgical treatment applied as an advanced vulvectomy by Bohman method. Patients with vulva cancer were treated combinationally started with surgical intervention with following postoperational external beam gamma-therapy for a vulva region using ''Rokus-M'' device: classic fractioning operative local dose 2 Gy, total local dose 40 Gy. Patients with vulva cancer were treated post operationally in next mode total local dose 30 Gy with radiomodification of cisplatin 100 mg one time per week

  6. Legal termination of a pregnancy resulting from transplanted cryopreserved ovarian tissue due to cancer recurrence

    DEFF Research Database (Denmark)

    Ernst, EH; Offersen, Birgitte Vrou; Andersen, Claus Yding;

    2013-01-01

    To report on a woman who conceived naturally and had a normal intrauterine pregnancy following transplantation of frozen/thawed ovarian tissue but decided to have an early abortion due to recurrence of breast cancer.......To report on a woman who conceived naturally and had a normal intrauterine pregnancy following transplantation of frozen/thawed ovarian tissue but decided to have an early abortion due to recurrence of breast cancer....

  7. Results of Endoscopic Treatment for Early Gastric Cancer by Nd-YAG Laser

    OpenAIRE

    Tani, M; Takeshita, K; Honda, T.; Saito, N; Endo, M.(Graduate School of Science, Osaka University, Osaka, Japan)

    1997-01-01

    We have introduced two endoscopic treatments for early gastric cancer: endoscopic mucosal resection using a cap-fitted panendoscope (EMRC), and endoscopic laser therapy using a Nd-YAG laser. Thirty-two patients (34 lesions) with gastric cancer were treated by Nd-YAG laser; including 23 initial-therapy cases (25 lesions) and 9 second-therapy cases representing failures of endoscopic mucosal resection or endoscopic ethanol injection. Endoscopic laser therapy was performed safely without complic...

  8. Post-operative condition of breast cancer patients from standpoint of psycho-oncology: Preliminary results

    OpenAIRE

    Kovač Aleksandra; Popović-Petrović Svetlana; Nedeljković Miroslav; Kojić Marijana; Tomić Sanja

    2014-01-01

    Introduction. Information on being diagnosed to have cancer is always shocking for the patient, and it always causes a lot of psychosocial problems during its treatment. In these moments, patients need understanding, support and someone who can help them to apprehend all available options and choices clearly. The purpose of this study is to show the psychological states of patients with breast cancer after breast surgery, the importance of the psychological...

  9. Cost of Starting Colorectal Cancer Screening Programs: Results From Five Federally Funded Demonstration Programs

    OpenAIRE

    Janet Royalty, MS; James Gardner, MSPH; A. Blythe Ryerson, MPH; Marion Nadel, PhD; Florence K. L. Tangka, PhD; Sujha Subramanian, PhD; Bela Bapat, MS; Laura C. Seeff, MD; Amy DeGroff, MPH

    2008-01-01

    Introduction In 2005, the Centers for Disease Control and Prevention (CDC) started a 3-year colorectal cancer screening demonstration project and funded five programs to explore the feasibility of a colorectal cancer program for the underserved U.S. population. CDC is evaluating the five programs to estimate implementation cost, identify best practices, and determine the most cost-effective approach. The objectives are to calculate start-up costs and estimate funding requirements for widespre...

  10. Radiotherapy combined with cetuximab for locally advanced head and neck cancer: Results and toxicity

    International Nuclear Information System (INIS)

    Purpose. - To describe the clinical results and tolerance of the combined treatment with radiotherapy and cetuximab for locally advanced head and neck cancer. Patients and methods. - From August 2006 and October 2010, 36 patients with advanced squamous cell head and neck carcinoma were treated with radiotherapy (70 Gy/35 fractions) and cetuximab (400 mg/m2 one week before radiotherapy, following by 250 mg/m2 once weekly, until week 7 of radiotherapy). Tolerance was evaluated every week. All patients were examined every 3 months the first 3 years after therapy, and then every year. Results. - The median follow-up was 14 months. The majority of patients were male (31 out of 36). Mean age was 59 years. The tumours sites were: oral cavity (n 8); oropharynx (n = 15); hypopharynx (n = 5); larynx (n = 8). Ninety percent of tumors were T3 or T4, and 45% were N2 or N3. Complete response was seen in 74% of patients, partial response in 17% and no response in 9% of patients. The overall survival was 44.4%. Relapse occurred in six patients. Anaphylactic reaction during the first infusion of cetuximab was observed in one patient. One patient developed severe aplasia after 48 Gy and 5 weeks of cetuximab, and died of sepsis. Eighty percent of patients presented acne, 16 patients developed a mucositis grade 2-3 and 23 patients a grade 2 skin reaction. Conclusion. - The concomitant use of cetuximab and radiotherapy in locally advanced head and neck carcinoma is well tolerated in this group of patients. The results seem comparable to those in the literature. (authors)

  11. Testicular cancer: seminoma. Stage I. Adjuvant radiotherapy. Results at 3 years

    International Nuclear Information System (INIS)

    Full text: Purpose: To evaluate the results achieved with adjuvant radiotherapy. Materials and methods: We analyzed 40 medical records of patients diagnosed with stage I of testicular cancer, all of them received adjuvant radiotherapy between April 1992 and May 2004. The histological type was classical seminoma (95%) and spermatocytes (5%). Diagnosis and staging were performed with testicular ultrasound, determination of tumor markers, computed tomography of abdomen - pelvis and chest radiographs. Radiotherapy: Patients were treated with 60Co unit and a linear accelerator of 6 MV photons. Volumes: Group I: lumboaortic lymph node region and ipsilateral pelvis. Group II: lumboaortic only. Daily dose: 1.8 Gy, total dose: 30.6 Gy. Patient in supine position, 2 parallel fields and opposed, DFP: 80 cm, calculated from midplane. They were followed for 3 years with chest X-ray, CAT scan of abdomen and pelvis at 12 months and then a full clinical control 1 time per year. Results: We defined the rate of ipsilateral pelvic node recurrence (group I: 0% vs. Group II: 6.25%), progression at distance (group I: 8.3% vs. Group II: 0%) and global survival (GS) (group I: 100% vs. group II: 100%) at 3 years of follow up. Conclusions: Our result is similar to that published in the international literature. Given the small number of patients, no evidence of changes in GS with the addition of radiotherapy to ipsilateral pelvic node. Radiation therapy to lumboaortic lymph nodes is the usual treatment, being necessary to optimize the modality of radiotherapy (RC3D - IRMT) to reduce toxicity in a long term. (authors)

  12. Results of Preoperative Concurrent Chemoradiotherapy for the Treatment of Rectal Cancer

    International Nuclear Information System (INIS)

    The purpose of this study is to evaluate anal sphincter preservation rates, survival rates, and prognostic factors in patients with rectal cancer treated with preoperative chemoradiotherapy. Materials and Methods: One hundred fifty patients with pathologic confirmed rectal cancer and treated by preoperative chemoradiotherapy between January 1999 and June 2007. Of the 150 patients, the 82 who completed the scheduled chemoradiotherapy, received definitive surgery at our hospital, and did not have distant metastasis upon initial diagnosis were enrolled in this study. The radiation dose delivered to the whole pelvis ranged from 41.4 to 46.0 Gy (median 44.0 Gy) using daily fractions of 1.8-2.0 Gy at 5 days per week and a boost dose to the primary tumor and high risk area up to a total of 43.2-54 Gy (median 50.4 Gy). Sixty patients (80.5%) received 5-fluorouracil, leucovorin, and cisplatin, while 16 patients (19.5%) were administered 5-fluorouracil and leucovorin every 4 weeks concurrently during radiotherapy. Surgery was performed for 3 to 45 weeks (median 7 weeks) after completion of chemoradiotherapy. Results: The sphincter preservation rates for all patients were 73.2% (60/82). Of the 48 patients whose tumor was located at less than 5 cm away from the anal verge, 31 (64.6%) underwent sphincter-saving surgery. Moreover, of the 34 patients whose tumor was located at greater than or equal to 5 cm away from the anal verge, 29 (85.3%) were able to preserve their anal sphincter. A pathologic complete response was achieved in 14.6% (12/82) of all patients. The downstaging rates were 42.7% (35/82) for the T stage, 75.5% (37/49) for the N stage, and 67.1% (55/82) for the overall stages. The median follow-up period was 38 months (range 11 -107 months). The overall 5-year survival, disease-free survival, and locoregional control rates were 67.4%, 58.9% and 84.4%, respectively. The 5-year overall survival rates based on the pathologic stage were 100% for stage 0 (n=12), 59

  13. Occupational risk factors for bladder cancer: results from a case-control study in Montreal, Quebec, Canada.

    Science.gov (United States)

    Siemiatycki, J; Dewar, R; Nadon, L; Gérin, M

    1994-12-15

    A population-based case-control study of the associations between various cancers and occupational exposures was carried out in Montreal, Quebec, Canada. Between 1979 and 1986, 484 persons with pathologically confirmed cases of bladder cancer and 1,879 controls with cancers at other sites were interviewed, as was a series of 533 population controls. The job histories of these subjects were evaluated by a team of chemist/hygienists for evidence of exposure to a list of 294 workplace chemicals, and information on relevant non-occupational confounders was obtained. On the basis of results of preliminary analyses and literature review, 19 occupations, 11 industries, and 23 substances were selected for in-depth multivariate analysis. Logistic regression analyses were carried out to estimate the odds ratio between each of these occupational circumstances and bladder cancer. There was weak evidence that the following substances may be risk factors for bladder cancer: natural gas combustion products, aromatic amines, cadmium compounds, photographic products, acrylic fibers, polyethylene, titanium dioxide, and chlorine. Among the substances evaluated which showed no evidence of an association were benzo(a)pyrene, leather dust, and formaldehyde. Several occupations and industries were associated with bladder cancer, including motor vehicle drivers and textile dyers. PMID:7998589

  14. Prognostic Significance of Immunoreactive Neutrophil Elastase in Human Breast Cancer: Long-Term Follow-Up Results in 313 Patients

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    Miwa Akizuki

    2007-03-01

    Full Text Available OBJECTIVE: We have measured the concentration of immunoreactive neutrophil elastase (ir-NE in the tumor extracts of 313 primary human breast cancers. Sufficient time has elapsed, and we are now ready to analyze its prognostic value in human breast cancer. METHODS: ir-NE concentration in tumor extracts was determined with an enzyme-linked immunosorbent assay that enables a rapid measurement of both free-form ir-NE and the α1-protease inhibitor-complexed form of ir-NE. We analyzed the prognostic value of this enzyme in human breast cancer in univariate and multivariate analyses. RESULTS: Patients with breast cancer tissue containing a high concentration of ir-NE had poor survival compared to those with a low concentration of ir-NE at the cutoff point of 9.0 µg/100 mg protein (P = .0012, which had been previously determined in another group of 49 patients. Multivariate stepwise analysis selected lymph node status (P= .0004; relative risk = 1.46 and ir-NE concentration (P= .0013; relative risk = 1.43 as independent prognostic factors for recurrence. CONCLUSIONS: Tumor ir-NE concentration is an independent prognostic factor in patients with breast cancer who undergo curative surgery. This enzyme may play an active role in tumor progression that leads to metastasis in human breast cancer.

  15. Does an asymmetric lobe in digital rectal examination include any risk for prostate cancer? results of 1495 biopsies

    Science.gov (United States)

    Yilmaz, Ömer; Kurul, Özgür; Ates, Ferhat; Soydan, Hasan; Aktas, Zeki

    2016-01-01

    ABSTRACT Introduction: Despite the well-known findings related to malignity in DRE such as nodule and induration, asymmetry of prostatic lobes, seen relatively, were investigated in a few studies as a predictor of prostate cancer so that there is no universally expected conclusion about asymmetry. We aimed to compare cancer detection rate of normal, asymmetric or suspicious findings in DRE by using biopsy results. Materials and Methods: Data of 1495 patients underwent prostate biopsy between 2006-2014 were searched retrospectively. Biopsy indications were abnormal DRE and or elevated PSA level(>4ng/mL). DRE findings were recorded as Group 1: Benign DRE, Group 2: Asymmetry and Group 3: Nodule/induration. Age, prostatic volume, biopsy results and PSA levels were recorded. Results: Mean age, prostate volume and PSA level were 66.72, 55.98 cc and 18.61ng/ mL respectively. Overall cancer detection rate was 38.66 % (575 of 1495). PSA levels were similar in group 1 and 2 but significantly higher in group 3. Prostatic volume was similar in group 1 and 2 and significantly lower in Group 3. Malignity detection rate of group 1,2 and 3 were 28.93%, 34.89% and 55.99% respectively. Group 1 and 2 were similar (p=0.105) but 3 had more chance for cancer detection. Conclusion: Nodule is the most important finding in DRE for cancer detection. Only an asymmetric prostate itself does not mean malignity. PMID:27564280

  16. Clinical results from first use of prostate stent as fiducial for radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Purpose. A clinical feasibility study using a removable prostate stent as fiducial for image-guided radiotherapy (IGRT) of localized prostate cancer (PC). Material and methods. The study included patients with local or locally advanced PC. The clinical target volume (CTV) was outlined on magnetic resonance (MR) images co-registered to planning computer tomography (CT) images. Daily online IGRT was delivered using the stent as fiducial. Risk of migration was estimated using multiple MR. Acute urinary toxicity was scored using the international prostate symptom score (IPSS). Late gastro-intestinal (GI) and genito-urinary (GU) toxicity was scored using the Radio Therapy Oncology Group (RTOG) score, biochemical failure (BF) was defined as an elevation of prostate specific antigen (PSA) above nadir plus 2 ng/ml after radiotherapy. Results. One hundred men were enrolled in the study. Ninety completed radiotherapy with the stent as fiducial. No migration of the stent was seen, but three cases of dislocation of the stent to the bladder were observed. Acute urinary toxicity based on IPSS was comparable to toxicity in patients who had gold markers (GM) as fiducials. Removal of the stent was associated with a high frequency of urinary retention. Late GI and GU toxicity and BF were comparable to those of other studies, but longer observation time is needed. Conclusions. This study reports the first clinical results of using a prostate stent as fiducial. No migration of the stent observed. Dislocation of the stent to the urinary bladder was observed in three cases, requiring removal of the stent and insertion of a new fiducial. Acute toxicity during radiotherapy evaluated from IPSS was comparable to toxicity in patients with GM. Removal of the stent was associated with a high frequency of post procedural urinary retention. Late toxicity and BF were comparable to those of other studies, though longer observation time is needed

  17. Clinical results from first use of prostate stent as fiducial for radiotherapy of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Carl, Jesper; Nielsen, Jane (Dept. of Medical Physics, Dept. of Oncology, Aalborg Hospital, Aarhus Univ. Hospital, Aalborg (Denmark)), e-mail: jhc@rn.dk; Holmberg, Mats (Dept. of Oncology, Aalborg Hospital, Aarhus Univ. Hospital, Aalborg (Denmark)); Larsen, Erik Hoejkjaer; Fabrin, Knud (Dept. of Urology, Aalborg Hospital, Aarhus Univ. Hospital, Aalborg (Denmark)); Fisker, Rune V. (Dept. of Radiology, Aalborg Hospital, Aarhus Univ. Hospital, Aalborg (Denmark))

    2011-05-15

    Purpose. A clinical feasibility study using a removable prostate stent as fiducial for image-guided radiotherapy (IGRT) of localized prostate cancer (PC). Material and methods. The study included patients with local or locally advanced PC. The clinical target volume (CTV) was outlined on magnetic resonance (MR) images co-registered to planning computer tomography (CT) images. Daily online IGRT was delivered using the stent as fiducial. Risk of migration was estimated using multiple MR. Acute urinary toxicity was scored using the international prostate symptom score (IPSS). Late gastro-intestinal (GI) and genito-urinary (GU) toxicity was scored using the Radio Therapy Oncology Group (RTOG) score, biochemical failure (BF) was defined as an elevation of prostate specific antigen (PSA) above nadir plus 2 ng/ml after radiotherapy. Results. One hundred men were enrolled in the study. Ninety completed radiotherapy with the stent as fiducial. No migration of the stent was seen, but three cases of dislocation of the stent to the bladder were observed. Acute urinary toxicity based on IPSS was comparable to toxicity in patients who had gold markers (GM) as fiducials. Removal of the stent was associated with a high frequency of urinary retention. Late GI and GU toxicity and BF were comparable to those of other studies, but longer observation time is needed. Conclusions. This study reports the first clinical results of using a prostate stent as fiducial. No migration of the stent observed. Dislocation of the stent to the urinary bladder was observed in three cases, requiring removal of the stent and insertion of a new fiducial. Acute toxicity during radiotherapy evaluated from IPSS was comparable to toxicity in patients with GM. Removal of the stent was associated with a high frequency of post procedural urinary retention. Late toxicity and BF were comparable to those of other studies, though longer observation time is needed

  18. Single-Fraction Intraoperative Radiotherapy for Breast Cancer: Early Cosmetic Results

    International Nuclear Information System (INIS)

    Purpose: To evaluate the cosmetic outcome of patients treated with wide local excision and intraoperative radiotherapy for early-stage breast cancer. Methods and Materials: A total of 50 women were treated on a pilot study to evaluate the feasibility of intraoperative radiotherapy at wide local excision. The eligibility criteria included age >60, tumor size ≤2.0 cm, clinically negative lymph nodes, and biopsy-established diagnosis. After wide local excision, a custom breast applicator was placed in the excision cavity, and a dose of 20 Gy was prescribed to a depth of 1 cm. After 18 patients were treated, the dose was constrained laterally to 18 Gy. The cosmetic outcome was evaluated by photographs at baseline and at 6 and 12 months postoperatively. Four examiners graded the photographs for symmetry, edema, discoloration, contour, and scarring. The grades were evaluated in relationship to the volume of irradiated tissue, tumor location, and dose at the lateral aspects of the cavity. Results: The median volume of tissue receiving 100% of the prescription dose was 47 cm3 (range, 20-97 cm3). Patients with ≤47 cm3 of treated tissue had better cosmetic outcomes than did the women who had >47 cm3 of treated tissue. Women who had received 18 Gy at the lateral aspects of their cavities had better cosmetic outcomes than did women who had received 20 Gy at the lateral aspects. When comparing the 6- and 12-month results, the scores remained stable for 63%, improved for 17%, and worsened for 20%. Conclusion: Intraoperative radiotherapy appears feasible for selected patients. A favorable cosmetic outcome appears to be related to a smaller treatment volume. The cosmetic outcome is acceptable, although additional follow-up is necessary

  19. Cancer incidence in type 2 diabetes patients - first results from a feasibility study of the D2C cohort

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    Hense Hans-Werner

    2011-07-01

    Full Text Available Abstract Background A large prospective study in patients with type 2 diabetes (T2D, the German D2C cohort, is presently being enumerated to investigate risk factors of incident cancer in diabetic patients. Study setting A disease management program was offered, on a voluntary basis, to all T2D patients who were members of a statutory health insurance fund in Germany. This first feasibility report uses data from 26.742 T2D patients, who were 40 to 79 years old, resided in the Muenster District, and who were enrolled between June 2003 and July 2008. Cancer cases were identified through the regional Cancer Registry. Methods Invasive cancer cases were identified using probabilistic record linkage procedures and pseudonymised personal identifiers. Censoring date was December 31, 2008. We included only first cancers, leaving 12.650 male and 14.092 female T2D with a total of 88.778 person-years (py. We computed standardised incidence ratios (SIR for external comparisons and we employed Cox regression models and hazard ratios (HR within the cohort. Results We identified 759 first cancers among male T2D patients (18.7 per 1,000 py and 605 among females (12.7 per 1,000 py. The risk of any incident cancer in T2D was raised (SIR = 1.14; 95% confidence interval [1.10 - 1.21], in particular for cancer of the liver (SIR = 1.94 [1.15 - 2.94] and pancreas (SIR = 1.45 [1.07-1.92]. SIRs decreased markedly with time after T2D diagnosis. In Cox models, adjusting for diabetes duration, body mass index and sex, insulin therapy was related to higher cancer risk (HR = 1.25 [1.17 - 1.33]. No effect was seen for metformin. Discussion Our study demonstrates feasibility of record linkage between DMP and cancer registries. These first cohort results confirm previous reports. It is envisaged to enhance this cohort by inclusion of further regions of the state, expansion of the follow-up times, and collection of a more detailed medication history.

  20. 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

  1. Does increased local bone resorption secondary to breast and prostate cancer result in increased cartilage degradation?

    International Nuclear Information System (INIS)

    Breast and prostate cancer patients often develop lesions of locally high bone turnover, when the primary tumor metastasizes to the bone causing an abnormal high bone resorption at this site. The objective of the present study was to determine whether local increased bone turnover in breast and prostate cancer patients is associated with an increase in cartilage degradation and to test in vitro whether osteoclasts or cathepsin K alone generate CTXII from human bone. The study included 132 breast and prostate cancer patient, where presence of bone metastases was graded according to the Soloway score. Total bone resorption (CTXItotal) and cartilage degradation (CTXII) were determined. Breast and prostate cancer patients with bone metastases revealed significant increased levels of CTXItotal at Soloway scores 1 and higher compared to patients without bone metastases (p < 0.001). CTXII was statistically elevated at score 3 and 4 (p < 0.01). CTXII/CTXItotal significantly decreased at score 3 and 4 (p < 0.001). Levels of CTXItotal, CTXII and CTXII/CTXItotal changed +900%, +130%, and -90%, respectively at Soloway score 4 compared to score 0. The in vitro experiments revealed that osteoclasts released CTXI fragments but not CTXII from bone specimens. The same was observed for cathepsin K. Data suggest that an uncoupling between bone resorption and cartilage degradation occurs in breast and lung cancer patient

  2. Results of surgical treatment of regional cervical cancer cytotoxic drugs with when combined radiation therapy

    International Nuclear Information System (INIS)

    In the department of clinical radio oncology brachytherapy unit of the National Cancer Institute con-ducted combined radiotherapy 103 patients with cervical cancer stage IIB-IIIB cancer. Depending on the method of combined radiotherapy patients divided into 2 major (33 and 34 patients) and control (36 patients) group. In the study group patients underwent conformal radiotherapy and brachytherapy sources of high activity dose radiation (HDR). In the study group I patients during radiotherapy combined tegafur used orally in radiomodifying dose of 800 mg per day and cisplatin intravenously 50 mg 1 time per week to a total dose of 200-300 mg. In the control group patients underwent conventional external beam radiotherapy and brachytherapy sources intermediate dose radiation (MDR). Use chemoradiomodification facilities and modern radiotherapy in patients with cervical cancer helps to speed up the pace and increase the degree of regression of cervical cancer compared to the standard method of combined radiotherapy does not increase the frequency and manifestations of general and local toxicity of treatment

  3. Breast Retraction Assessment: an objective evaluation of cosmetic results of patients treated conservatively for breast cancer

    International Nuclear Information System (INIS)

    Breast Retraction Assessment (BRA) is an objective evaluation of the amount of cosmetic retraction of the treated breast in comparison to the untreated breast in patients who receive conservative treatment for breast cancer. A clear acrylic sheet supported vertically and marked as a grid at 1 cm intervals is employed to perform the measurements. Average BRA value in 29 control patients without breast cancer was 1.2 cm. Average BRA value in 27 patients treated conservatively for clinical Stage I or II unilateral breast cancer was 3.7 cm. BRA values in breast cancer patients ranged from 0.0 to 8.5 cm. Patients who received a local radiation boost to the primary tumor bed site had statistically significantly less retraction than those who did not receive a boost. Patients who had an extensive primary tumor resection had statistically significantly more retraction than those who underwent a more limited resection. In comparison to qualitative forms of cosmetic analysis, BRA is an objective test that can quantitatively evaluate factors which may be related to cosmetic retraction in patients treated conservatively for breast cancer

  4. Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size

    Energy Technology Data Exchange (ETDEWEB)

    Fallenberg, E.M.; Renz, D.M. [Charite - Universitaetsmedizin Berlin, Clinic of Radiology, Berlin (Germany); Dromain, C. [Institut Gustave Roussy, Department of Radiology, Villejuif cedex (France); Diekmann, F. [St. Joseph-Stift Bremen, Department of Medical Imaging, Bremen (Germany); Engelken, F.; Krohn, M.; Singh, J.M.; Bick, U. [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Ingold-Heppner, B. [Charite - Universitaetsmedizin Berlin, Institute of Pathology, Berlin (Germany); Winzer, K.J. [Charite - Universitaetsmedizin Berlin, Breast Center, Department of Gynecology, Berlin (Germany)

    2014-01-15

    To compare mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in the detection and size estimation of histologically proven breast cancers using postoperative histology as the gold standard. After ethical approval, 80 women with newly diagnosed breast cancer underwent MG, CESM, and MRI examinations. CESM was reviewed by an independent experienced radiologist, and the maximum dimension of suspicious lesions was measured. For MG and MRI, routine clinical reports of breast specialists, with judgment based on the BI-RADS lexicon, were used. Results of each imaging technique were correlated to define the index cancer. Fifty-nine cases could be compared to postoperative histology for size estimation. Breast cancer was visible in 66/80 MG, 80/80 CESM, and 77/79 MRI examinations. Average lesion largest dimension was 27.31 mm (SD 22.18) in MG, 31.62 mm (SD 24.41) in CESM, and 27.72 mm (SD 21.51) in MRI versus 32.51 mm (SD 29.03) in postoperative histology. No significant difference was found between lesion size measurement on MRI and CESM compared with histopathology. Our initial results show a better sensitivity of CESM and MRI in breast cancer detection than MG and a good correlation with postoperative histology in size assessment. (orig.)

  5. Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size

    International Nuclear Information System (INIS)

    To compare mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in the detection and size estimation of histologically proven breast cancers using postoperative histology as the gold standard. After ethical approval, 80 women with newly diagnosed breast cancer underwent MG, CESM, and MRI examinations. CESM was reviewed by an independent experienced radiologist, and the maximum dimension of suspicious lesions was measured. For MG and MRI, routine clinical reports of breast specialists, with judgment based on the BI-RADS lexicon, were used. Results of each imaging technique were correlated to define the index cancer. Fifty-nine cases could be compared to postoperative histology for size estimation. Breast cancer was visible in 66/80 MG, 80/80 CESM, and 77/79 MRI examinations. Average lesion largest dimension was 27.31 mm (SD 22.18) in MG, 31.62 mm (SD 24.41) in CESM, and 27.72 mm (SD 21.51) in MRI versus 32.51 mm (SD 29.03) in postoperative histology. No significant difference was found between lesion size measurement on MRI and CESM compared with histopathology. Our initial results show a better sensitivity of CESM and MRI in breast cancer detection than MG and a good correlation with postoperative histology in size assessment. (orig.)

  6. Assessing risk of breast cancer in an ethnically South-East Asia population (results of a multiple ethnic groups study

    Directory of Open Access Journals (Sweden)

    Gao Fei

    2012-11-01

    Full Text Available Abstract Background Gail and others developed a model (GAIL using age-at-menarche, age-at-birth of first live child, number of previous benign breast biopsy examinations, and number of first-degree-relatives with breast cancer as well as baseline age-specific breast cancer risks for predicting the 5-year risk of invasive breast cancer for Caucasian women. However, the validity of the model for projecting risk in South-East Asian women is uncertain. We evaluated GAIL and attempted to improve its performance for Singapore women of Chinese, Malay and Indian origins. Methods Data from the Singapore Breast Screening Programme (SBSP are used. Motivated by lower breast cancer incidence in many Asian countries, we utilised race-specific invasive breast cancer and other cause mortality rates for Singapore women to produce GAIL-SBSP. By using risk factor information from a nested case-control study within SBSP, alternative models incorporating fewer then additional risk factors were determined. Their accuracy was assessed by comparing the expected cases (E with the observed (O by the ratio (E/O and 95% confidence interval (CI and the respective concordance statistics estimated. Results From 28,883 women, GAIL-SBSP predicted 241.83 cases during the 5-year follow-up while 241 were reported (E/O=1.00, CI=0.88 to 1.14. Except for women who had two or more first-degree-relatives with breast cancer, satisfactory prediction was present in almost all risk categories. This agreement was reflected in Chinese and Malay, but not in Indian women. We also found that a simplified model (S-GAIL-SBSP including only age-at-menarche, age-at-birth of first live child and number of first-degree-relatives performed similarly with associated concordance statistics of 0.5997. Taking account of body mass index and parity did not improve the calibration of S-GAIL-SBSP. Conclusions GAIL can be refined by using national race-specific invasive breast cancer rates and mortality rates

  7. Usefulness of low iodine diet in managing patients with differentiated thyroid cancer - initial results

    International Nuclear Information System (INIS)

    Low iodine diet (LID) is recommended in patients with differentiated thyroid cancer before radioiodine administration. Patients with increased thyroglobulin (Tg) level, but negative 131I whole body scan present diagnostic and therapeutic dilemma. This study was designed to evaluate the benefit of a two-week LID in patients with elevated serum Tg levels and negative 131I whole body scans. For the impact assessment of two-week LID on radioiodine tissue avidity, radioiodine scans before and after LID were compared. Sixteen patients with serum Tg > 2 μg/L, negative Tg-antibodies, and negative radioiodine scans underwent two-week LID before the 131I administration. Fourteen patients underwent diagnostic scanning and two patients received radioiodine therapy. Iodine concentration in the morning urine specimens were measured in each patient, a day before and 15th day after starting LID. Following self-managed LID, patients were able to significantly reduce their iodine body content by 50% (range 28–65%, p<0,001). 13 patients (82%) accomplished mild iodine deficiency (50-99 μg/L) and one patient (6%) achieved targeted moderate iodine deficient state (<50 μg/L). All diagnostic post-LID scans were negative. Both post-therapy 131I scans showed radioiodine accumulation outside of normal 131I distribution (neck region and diffuse hepatic uptake). This study demonstrated that two-week LID is effective way to decrease total body iodine content, although without a visible effect on post-LID diagnostic 131I scans. A more stringent dietary protocol and longer iodine restriction period are probably needed to achieve targeted moderate iodine deficiency in patients preparing for 131I administration. This might result in higher radioiodine avidity of thyroid remnant/metastases

  8. Food groups and the risk of colorectal cancer: results from a Jordanian case-control study.

    Science.gov (United States)

    Abu Mweis, Suhad S; Tayyem, Reema F; Shehadah, Ihab; Bawadi, Hiba A; Agraib, Lana M; Bani-Hani, Kamal E; Al-Jaberi, Tareq; Al-Nusairr, Majed

    2015-07-01

    The role of diet in colorectal cancer (CRC) in Jordan has not been studied previously. This study aimed at examining the association between food groups (including grains, fruits, vegetables, milk, and meat and legumes) and CRC risk in Jordan. We compared intakes of the different food groups among CRC patients (n=167) and matched controls (n=240) by age, sex, occupation, and marital status. A validated food frequency questionnaire was used to collect dietary data. Logistic regression was used to evaluate the association of quartiles of intakes of the different food groups with CRC risk. In addition, the association of selected food items with CRC risk was examined. Odds ratios (ORs) for the fourth versus the first quartile of intake were 2.92 [95% confidence interval (CI): 1.40-6.08] for grains, 1.66 (95% CI: 0.81-3.40) for vegetables, 0.55 (95% CI: 0.26-1.16) for fruits, 0.96 (95% CI: 0.46-1.97) for milk, and 1.43 (95% CI: 0.68-2.98) for meat and legumes. In a comparison of the highest with the lowest weekly frequency of consumption, there was a direct association between the risk of CRC and the frequency of consumption of chicken (OR=2.52, 95% CI: 1.33-4.77). An increase in risk was observed with increased consumption of white bread (OR=3.13, 95% CI: 1.18-9.25), whereas consumption of whole bread was associated with a decreased risk for CRC (OR=0.32, 95% CI: 0.12-0.84). Our results support a role of diet in CRC. Direct associations were found for grains, white bread, and chicken, whereas an inverse relation was reported for whole bread. PMID:25415835

  9. Online Adaptive Radiotherapy for Muscle-Invasive Bladder Cancer: Results of a Pilot Study

    International Nuclear Information System (INIS)

    Purpose: To determine the advantages and disadvantages of daily online adaptive image-guided radiotherapy (RT) compared with conventional RT for muscle-invasive bladder cancer. Methods and Materials: Twenty-seven patients with T2-T4 transitional cell carcinoma of the bladder were treated with daily online adaptive image-guided RT using cone-beam computed tomography (CBCT). From day 1 daily soft tissue-based isocenter positioning was performed using CBCT images acquired before treatment. Using a composite of the initial planning CT and the first five daily CBCT scans, small, medium, and large adaptive plans were created. Each of these adaptive plans used a 0.5-cm clinical target volume (CTV) to planning target volume expansion. For Fractions 8-32, treatment involved daily soft tissue-based isocenter positioning and selection of suitable adaptive plan of the day. Treating radiation therapists completed a credentialing program, and one radiation oncologist performed all the contouring. Comparisons were made between adaptive and conventional treatment on the basis of CTV coverage and normal tissue sparing. Results: All 27 patients completed treatment per protocol. Bladder volume decreased with time or fraction number (p 45 Gy was 29% (95% confidence interval, 24-35%) less with adaptive RT compared with conventional RT. The mean volume of normal tissue receiving >5 Gy was 15% (95% confidence interval, 11-18%) less with adaptive RT compared with conventional RT. Conclusions: Online adaptive radiotherapy is feasible in an academic radiotherapy center. The volume of normal tissue irradiated can be significantly smaller without reducing CTV coverage.

  10. Radiofrequency ablation of pulmonary metastasis from colorectal cancer - follow up radiological appearances and results

    International Nuclear Information System (INIS)

    Full text: Tumour ablation with radiofrequency (RF) energy is a relatively new procedure for the treatment of focal malignant disease. Several published trials show the benefit of this procedure in the treatment of malignant liver lesions, however, there are few trials on the benefits of treating pulmonary metastases in this way. The first 14 patients having RF ablation of pulmonary metastases from colorectal cancer (CRC) have been followed. 11 had their RF ablation performed at St George Public Hospital under CT fluoroscopy, 3 under fluoroscopy at St George Private Hospital. Complications from the procedure are described, as well as follow up appearances and results. The only significant complications described so far are five pneumothoraces, three requiring treatment with one needing extended hospital admission. Intraprocedural parenchymal haemorrhage, and changes of consolidation in surrounding lung not causing significant clinical symptoms were also found. One case of post procedure pneumonia occurred. Minor haemoptysis also occurred. Successfully ablated lesions show and increase in size in the one week and one month CT scans, but then progressively fall in size. Some show cavitation, which resolves. No significant detrimental impact on quality of life has so far been found, but medium and long-term effects are yet to be studied. RF ablation of pulmonary metastases from CRC, while still at its early stages, shows promise as a possible second line treatment (with other adjuvant therapy) for the management of focal malignant disease in the lung. CT fluoroscopy/fluoroscopy is a viable method for electrode placement and is performed this way at our institution. Copyright (2002) Blackwell Science Pty Ltd

  11. Impact of age-related comorbidity on results of colorectal cancer surgery

    Institute of Scientific and Technical Information of China (English)

    Corrado Pedrazzani; Guido Cerullo; Giovanni De Marco; Daniele Marrelli; Alessandro Neri; Alfonso De Stefano; Enrico Pinto; Franco Roviello

    2009-01-01

    AIM: To analyze the correlation between preexisting comorbidity and other clinicopathological features, short-term surgical outcome and long-term survival in elderly patients with colorectal cancer (CRC). METHODS: According to age, 403 patients operated on for CRC in our department were divided into group A (< 70 years old) and group B (≥ 70 years old) and analyzed statistically.RESULTS: Rectal localization prevailed in group A (31.6% vs 19.7%, P = 0.027), whereas the percentage of R0 resect ions was 77% in the two groups.Comorbidity rate was 46.2% and 69.1% for group A and B, respectively ( P < 0.001), with a huge difference as regards cardiovascular diseases. Overall, postoperative morbidity was 16.9% and 20.8% in group A and B,respectively ( P = 0.367), whereas mortality was limited to group B (4.5%, P = 0.001). In both groups, patients who suffered from postoperative complications had a higher overall comorbidity rate, with preexisting cardiovascular diseases prevailing in group B ( P = 0.003).Overall 5-year survival rate was significantly better for group A (75.2% vs 55%, P = 0.006), whereas no significant difference was observed considering diseasespecific survival (76.3% vs 76.9%, P = 0.674).CONCLUSION: In spite of an increase in postoperative mortality and a lower overall long-term survival for patients aged ≥ 70 years old, it should be considered that, even in the elderly group, a significant number of patients is alive 5 years after CRC resection.

  12. Pulmonary toxicity after radiotherapy in primary breast cancer patients: results from a randomized chemotherapy study

    International Nuclear Information System (INIS)

    Purpose: Pulmonary toxicity was prospectively evaluated within a randomized trial for breast cancer patients at high risk for relapse, who postoperatively received as adjuvant therapy either 9 cycles of tailored chemotherapy (20 patients) (cyclophosphamide, epirubicin, 5-fluorouracil [FEC]) or standard FEC x 3 followed by high-dose chemotherapy (cyclophosphamide, thiotepa, carboplatin [CTCb]) supported by peripheral blood stem cell transplantation (14 patients). After high-dose chemotherapy or tailored FEC, all patients received locoregional radiotherapy (50 Gy/5 weeks), plus tamoxifen for 5 years. Methods and Materials: Lung function tests (FVC, FEV1, and DLCO) were performed before chemotherapy and 9 months after radiotherapy. Computed tomography of the lungs was performed before radiotherapy and 6 weeks, 3 months, and 9 months after radiotherapy. Results: Clinical signs of suspected pneumonitis were noted in 29% of patients, but only 1 patient needed symptomatic therapy. Radiologic changes were detected in 68% of patients, and they were most frequent at 3 months after radiotherapy. FVC decreased in both groups (tailored FEC: mean difference, -6.5%, p=0.0005; CTCb: -2.0%, p=0.21; tailored FEC vs. CTCb: -4.5%, p=0.05). DLCO decreased significantly in both groups (tailored FEC: mean difference, -11.2%, p<0.0001; CTCb: -5.6%, p=0.02; tailored FEC vs. CTCb: -5.6%, p=0.07). FEV1 decreased by 7.3% in patients treated with tailored FEC (p<0.0001) and by 2.5% in patients treated with CTCb (p=0.03) (tailored FEC vs. CTCb: 3.7%, p=0.08). Conclusions: Changes in pulmonary function were thus detected in both groups, although to a greater extent in the tailored FEC group. The clinical significance of these findings should be balanced carefully against the improved, statistically significant relapse-free survival achieved with the tailored FEC regimen compared to high-dose CTCb + peripheral blood stem cell transplantation (PSCT)

  13. Vaginal Radical Trachelectomy for early stage cervical cancer. Results of the Danish National Single Center Strategy

    DEFF Research Database (Denmark)

    Hauerberg, L; Høgdall, C; Loft, A;

    2015-01-01

    OBJECTIVE: To present and evaluate an unselected national single center strategy with fertility preserving trachelectomy in cervical cancer. In 2003 nationwide single-center referral of women for trachelectomies was agreed upon between all Danish departments performing cervical cancer surgery with...... the purpose of increasing volume, to increase surgical safety and facilitate follow-up. METHODS: Prospective data were recorded in the Danish Gynecological Cancer Database of all Vaginal Radical Trachelectomies (VRT) performed in Denmark between 2002 and 2013. Oncologic, fertility and obstetrical...... total of 77 pregnancies. Of the 72 women 40 were referred to fertility treatment. First and second trimester miscarriage rates were 21.6% and 2.7%, respectively. A total of 53 children were born of which 41 were delivered after gestational week 34. CONCLUSION: This unselected national single center...

  14. 18fluoro-2 deoxyglucose and PET: literature review and our results in extra pulmonary cancers

    International Nuclear Information System (INIS)

    Although lung cancer (subject of several articles published in this journal) is to date the first clinical indication for FDG scanning in oncology, the clinical utility of this position emitting radiopharmaceutical has been assessed in various other cancers, among which several were recently granted a french marketing authorization. For one year and a half, the authors have performed 561 FDG scans, including 405 examinations in non-lung cancer patients, using a dual-head gamma camera in coincidence detection mode (CDET). They compare their experience with the data of literature concerning feasibility of FDG scan on a 'conventional' gamma camera and also with the published values of accuracy in several clinical settings. (author)

  15. Results of a survey of the treatment policy for early stage tongue and oral floor cancer

    International Nuclear Information System (INIS)

    To realize the treatment policy for early stage oral cancer, a survey of 102 institutes in Japan was performed by questionnaire. A majority of the otolaryngologists preferred surgery for the treatment of T1N0 and T2N0 cases of oral cancer. The preferred method of treatment for the T1N0 cases was simple tumor resection and that for the T2N0 cases was extended tumor resection with plastic surgery, elective neck dissection and combined radio-and/or chemotherapy. A majority of the radiologists preferred brachytherapy for T1N0 and non-invasive T2N0 cases. For invasive cases of T2N0 oral cancer, radiologists preferred either surgical treatment or the combination of brachytherapy and external irradiation. (author)

  16. Molecular profiles of screen detected vs. symptomatic breast cancer and their impact on survival: results from a clinical series

    International Nuclear Information System (INIS)

    Stage shift is widely considered a major determinant of the survival benefit conferred by breast cancer screening. However, factors and mechanisms underlying such a prognostic advantage need further clarification. We sought to compare the molecular characteristics of screen detected vs. symptomatic breast cancers and assess whether differences in tumour biology might translate into survival benefit. In a clinical series of 448 women with operable breast cancer, the Kaplan-Meier method and the log-rank test were used to estimate the likelihood of cancer recurrence and death. The Cox proportional hazard model was used for the multivariate analyses including mode of detection, age at diagnosis, tumour size, and lymph node status. These same models were applied to subgroups defined by molecular subtypes. Screen detected breast cancers tended to show more favourable clinicopathological features and survival outcomes compared to symptomatic cancers. The luminal A subtype was more common in women with mammography detected tumours than in symptomatic patients (68.5 vs. 59.0%, p=0.04). Data analysis across categories of molecular subtypes revealed significantly longer disease free and overall survival for screen detected cancers with a luminal A subtype only (p=0.01 and 0.02, respectively). For women with a luminal A subtype, the independent prognostic role of mode of detection on recurrence was confirmed in Cox proportional hazard models (p=0.03). An independent role of modality of detection on survival was also suggested (p=0.05). Molecular subtypes did not substantially explain the differences in survival outcomes between screened and symptomatic patients. However, our results suggest that molecular profiles might play a role in interpreting such differences at least partially. Further studies are warranted to reinterpret the efficacy of screening programmes in the light of tumour biology

  17. Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

    International Nuclear Information System (INIS)

    To assess the diagnostic value of integrated PET/MRI for whole-body staging of cervical cancer patients, as well as to investigate a potential association between PET/MRI derived functional parameters and prognostic factors of cervical cancer. The present study was approved by the local institutional review board. Twenty-seven patients with histopathologically confirmed cervical cancer were prospectively enrolled in our study. All patients underwent a whole-body PET/MRI examination after written informed consent was obtained. Two radiologists separately evaluated the PET/MRI data sets regarding the determination of local tumor extent of primary cervical cancer lesions, as well as detection of nodal and distant metastases. Furthermore, SUV and ADC values of primary tumor lesions were analyzed and correlated with dedicated prognostic factors of cervical cancer. Results based on histopathology and cross-sectional imaging follow-up served as the reference standard. PET/MRI enabled the detection of all 27 primary tumor lesions of the uterine cervix and allowed for the correct determination of the T-stage in 23 (85 %) out of the 27 patients. Furthermore, the calculated sensitivity, specificity and diagnostic accuracy for the detection of nodal positive patients (n = 11) were 91 %, 94 % and 93 %, respectively. PET/MRI correctly identified regional metastatic disease (N1-stage) in 8/10 (80 %) patients and non-regional lymph node metastases in 5/5 (100 %) patients. In addition, quantitative analysis of PET and MRI derived functional parameters (SUV; ADC values) revealed a significant correlation with pathological grade and tumor size (p < 0.05). The present study demonstrates the high potential of integrated PET/MRI for the assessment of primary tumor and the detection of lymph node metastases in patients with cervical cancer. Providing additional prognostic information, PET/MRI may serve as a valuable diagnostic tool for cervical cancer patients in a pretreatment setting

  18. Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Grueneisen, Johannes; Kinner, Sonja; Forsting, Michael; Lauenstein, Thomas; Umutlu, Lale [University Hospital Essen, University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Schaarschmidt, Benedikt Michael [University Hospital Dusseldorf, University of Dusseldorf, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Heubner, Martin; Aktas, Bahriye [University Hospital Essen, University of Duisburg-Essen, Department of Obstetrics and Gynecology, Essen (Germany); Ruhlmann, Verena [University Hospital Essen, University of Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany)

    2015-11-15

    To assess the diagnostic value of integrated PET/MRI for whole-body staging of cervical cancer patients, as well as to investigate a potential association between PET/MRI derived functional parameters and prognostic factors of cervical cancer. The present study was approved by the local institutional review board. Twenty-seven patients with histopathologically confirmed cervical cancer were prospectively enrolled in our study. All patients underwent a whole-body PET/MRI examination after written informed consent was obtained. Two radiologists separately evaluated the PET/MRI data sets regarding the determination of local tumor extent of primary cervical cancer lesions, as well as detection of nodal and distant metastases. Furthermore, SUV and ADC values of primary tumor lesions were analyzed and correlated with dedicated prognostic factors of cervical cancer. Results based on histopathology and cross-sectional imaging follow-up served as the reference standard. PET/MRI enabled the detection of all 27 primary tumor lesions of the uterine cervix and allowed for the correct determination of the T-stage in 23 (85 %) out of the 27 patients. Furthermore, the calculated sensitivity, specificity and diagnostic accuracy for the detection of nodal positive patients (n = 11) were 91 %, 94 % and 93 %, respectively. PET/MRI correctly identified regional metastatic disease (N1-stage) in 8/10 (80 %) patients and non-regional lymph node metastases in 5/5 (100 %) patients. In addition, quantitative analysis of PET and MRI derived functional parameters (SUV; ADC values) revealed a significant correlation with pathological grade and tumor size (p < 0.05). The present study demonstrates the high potential of integrated PET/MRI for the assessment of primary tumor and the detection of lymph node metastases in patients with cervical cancer. Providing additional prognostic information, PET/MRI may serve as a valuable diagnostic tool for cervical cancer patients in a pretreatment setting

  19. Result of radiation therapy of sino-nasal cancers using partial attenuation filter

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hee; Kim, Ok Bae; Choi, Tae Jin [Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2007-06-15

    This study was to evaluate the survival and pattern of failure after radiation therapy of sino-nasal cancer using partial attenuation filer and wedged beams and to help radiotherapy planning of sino-nasal cancer. Between February 1992 and March 2003, 17 patients with sino-nasal cancers underwent radiation therapy using partial attenuation filter at Dongsan Medical Center, Keimyung university. There were 9 male and 8 female patients. Patients' age ranged from 40 to 75 years (median 59 years). There were 10 patients of maxillary sinus cancer, 7 patients of nasal cancer. The histologic type was squamous cell carcinoma in 11, adenoid cystic carcinoma in 4 and olfactory neuroblastoma in 2. The distribution of clinical stage by the AJCC system was 3 for stage II, 7 for III and 6 for IV. The five patients were treated with radiation alone and 12 patients were treated with surgery and postoperative radiation therapy. The range of total radiation dose delivered to the primary tumor was from 44 to 76 Gy (median 60 Gy). The follow-up period ranged from 3 to 173 months with median of 78 months. The overall 2 year survival rate and disease free survival rate was 76.4%. The 5 year and 10 year survival rate were 76.4% and 45.6% and the 5 year and 10 year disease free survival rate was 70.6%. The 5 year disease free survival rate by treatment modality was 91.6% for postoperative radiation group and 20% for radiation alone group, statistical significance was found by treatment modality ({rho} = 0.006). There were no differences in survival by pathology and stage. There were local failure in 5 patients (29%) but no distant failure and no severe complication required surgical intervention. Radiation therapy of sino-nasal cancer using partial attenuation filter was safe and effective. Combined modality with conservative surgery and radiation therapy was more advisable to achieve loco-regional control in sino-nasal cancer. Also we considered high precision radiation therapy with

  20. Cancers and genetic defects resulting from the use of various energy sources

    International Nuclear Information System (INIS)

    A review of recent literature on carcinogenic effects of chemical products derived from the combustion of organic fuels suggests that the numbers of fatal cancers and genetic defects induced by utilization of fossil fuels may be much greater than the numbers induced by utilization of nuclear power to produce the same amount of energy. Despite the uncertainties involved in these estimates, the maximum risk of fatal cancers due to carcinogenic by-products associated with the production of electricity by any of these methods appears to be remarkably low compared with the risk of other fatal hazards in Canada and the U.S.A. (author)

  1. Asbestosis as a precursor of asbestos related lung cancer: results of a prospective mortality study.

    OpenAIRE

    Hughes, J. M.; Weill, H

    1991-01-01

    A prospective mortality study of 839 men employed in the manufacture of asbestos cement products in 1969 examined lung cancer risk in relation to lung fibrosis seen on chest x ray film, controlling for age, smoking, and exposure to asbestos. Twenty or more years after hire, no excess of lung cancer was found among workers without radiographically detectable lung fibrosis, even among long term workers (greater than or equal to 21.5 years); nor was there a trend in risk by level of cumulative e...

  2. Colorectal cancer associated with abdominal aortic aneurysm: results of EVAR followed by colectomy.

    Science.gov (United States)

    Illuminati, Giulio; Ceccanei, Gianluca; Pacilè, Maria A; Pizzardi, Giulia; Palumbo, Piergaspare; Vietri, Francesco

    2013-01-01

    The association of colorectal cancer and abdominal aortic aneurysm (AAA) is infrequent but poses special problems of priority of treatment under elective circumstances. The purpose of this study was to retrospectively evaluate the outcome of 16 consecutive patients undergoing endovascular aneurysm repair (EVAR) followed by colectomy. Operative mortality was nil. Operative morbidity included two transient rise of serum creatinine level and one extraperitoneal anastomotic leakage which evolved favourably with conservative treatment. EVAR allowed a very short delay of treatment of colorectal cancer after aneurysm repair, minimizing operative complications. PMID:23151840

  3. Serum beta-carotene and subsequent risk of cancer: results from the BUPA Study.

    OpenAIRE

    Wald, N J; Thompson, S G; Densem, J W; Boreham, J.; Bailey, A

    1988-01-01

    In the BUPA Study, a prospective study of 22,000 men attending a screening centre in London, serum samples were collected and stored. The concentration of beta-carotene was measured in the stored serum samples from 271 men who were subsequently notified as having cancer and from 533 unaffected controls, matched for age, smoking history and duration of storage of the serum samples. The mean beta-carotene level of the cancer subjects was significantly lower than that of their matched controls (...

  4. Regulation of Gene Expression and Inhibition of Experimental Prostate Cancer Bone Metastasis by Dietary Genistein

    OpenAIRE

    Yiwei Li; Mingxin Che; Sunita Bhagat; Kerrie-Lynn Ellis; Omer Kucuk; Doerge, Daniel R.; Judith Abrams; Cher, Michael L.; Sarkar, Fazlul H

    2004-01-01

    Prostate cancer frequently metastasizes to the bone, and the treatment outcome for metastatic prostate cancer has been disappointing so far. Dietary genistein, derived primarily from soy product, has been proposed to be partly responsible for the low rate of prostate cancer in Asians. Our previous studies have shown that genistein elicits pleiotropic effects on prostate cancer cells, but there are no studies documenting comprehensive gene expression profiles and antitumor effects of dietary g...

  5. Regulation of Gene Expression and Inhibition of Experimental Prostate Cancer Bone Metastasis by Dietary Genistein1

    OpenAIRE

    Li, Yiwei; Che, Mingxin; Bhagat, Sunita; Ellis, Kerrie-Lynn; KUCUK, Omer; Doerge, Daniel R.; Abrams, Judith; Cher, Michael L.; Sarkar, Fazlul H

    2004-01-01

    Prostate cancer frequently metastasizes to the bone, and the treatment outcome for metastatic prostate cancer has been disappointing so far. Dietary genistein, derived primarily from soy product, has been proposed to be partly responsible for the low rate of prostate cancer in Asians. Our previous studies have shown that genistein elicits pleiotropic effects on prostate cancer cells, but there are no studies documenting comprehensive gene expression profiles and antitumor effects of dietary g...

  6. Chemoradiotherapy as preoperative treatment in locally advanced unresectable pancreatic cancer patients: results of a feasibility study

    International Nuclear Information System (INIS)

    Purpose: The combination of radiotherapy and fluorouracil (5-FU) in patients with locally unresectable pancreatic carcinoma has led to a significant increase in survival in comparison with radiotherapy alone. Doxifluridine (5-DFUR) is an orally active fluoropyrimidine, and its cytotoxic metabolite (5-FU) may concentrate in areas of high tumor vascularisation. This trial was carried out with the aims of improving locoregional control and making lesions resectable in patients with unresectable pancreatic cancer. Methods: 5-DFUR was given at a dose of 500 mg/m2 b.i.d. by way of mouth for 4 days every other week for a total of four courses, with leucovorin 25 mg b.i.d. orally being given 2 hours before each 5-DFUR administration. External beam RT was administered at a dose of 1000 cGy per week for 3 weeks, followed by a 2-week break and then by 1000 cGy per week for a further 2 weeks (a total dose of 5000 cGy). The patients were restaged 4 weeks after the end of treatment and explored for resection in cases of partial response (PR). Results: A total of 32 patients were treated between 1992 and 1997. Ab initio un resectability was shown by laparotomy (16 cases) or computed tomography (16 cases), and was due to vascular invasion in 27 patients, massive regional nodal metastases in nine, and both in four. The median age was 63 years (range 36-71); performance status (PS) (ECOG): 0-1 28 and PS 2 = 4. All the patients had measurable disease and were evaluable for response. There were seven PR (22%), 10 SD (31%), and 15 PD (47%). All of the responders underwent surgical exploration, and radical resection was possible in 5. Three of these patients are still disease-free with a follow-up of 18, 27, and 65 months; the other two cases relapsed 11 and 14 months after surgery. The median survival time was 9 months for the entire group, and 1-year survival rate was 31%. The treatment was never stopped because of toxicity. There were no CTC-NCI grade 3 or 4 toxic events; grade 1

  7. Thyroid exposure in Ukrainian and White Russian children following the Chernobyl disaster and the resultant risk of acquiring thyroid cancer

    International Nuclear Information System (INIS)

    After a presentation of the main strong and weak points of various studies on the risk of acquiring thyroid cancer after the Chernobyl disaster this study summarises the results of a recent ecological study. 175,800 measurements of 131I activity in the human thyroid gland performed in the contaminated regions of the Ukraine and White Russia during the first weeks after the Chernobyl disaster served as a starting point for this study on thyroid exposure in Ukrainian and White Russian children following the Chernobyl disaster and the resultant risk of acquiring thyroid cancer. More than 10 measurements were performed in each of altogether 1,114 locations. Age and sex-specific doses were calculated for each of these locations within the 1968-85 birth cohort. 95% of all dose values were within the range of 0.017 to 0.69 Gy. Since 1990 the incidence of thyroid cancer within the study area has increased at a markedly higher rate than one would expect on the basis of the cohort members' growing age. In the period from 1990 to 2001 1,091 cases of surgery for thyroid cancer were reported. The additional absolute risk per 104 PY Gy was calculated as 2.5 (95% CI: 2.3;2.9). The additional relative risk per dose was calculated as 10 (95% CI: 8;12) Gy-1. These results are consistent with risk values found for thyroid cancer after external exposure during childhood. Assuming that the calculated risk values also apply for the intervention level of 0.05 Gy at which iodine tablets are distributed in the event of a major release of radioiodide this means that within the period of 4 to 15 years following the exposure 3 additional cases of thyroid cancer are expected to occur within a collective of 20,000 children and adolescents. This is equivalent to a 50% increase in the spontaneous incidence of the disease

  8. Results of Preoperative Concurrent Chemoradiotherapy for the Treatment of Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Mee Sun; Nam, Taek Keun; Kim, Hyeong Rok; Nah, Byung Sik; Chung, Woong Ki; Kim, Young Jin; Ahn, Sung Ja; Song, Ju Young; Jeong, Jae Uk [Chonnam National University College of Medicine, Gwangju (Korea, Republic of)

    2008-12-15

    The purpose of this study is to evaluate anal sphincter preservation rates, survival rates, and prognostic factors in patients with rectal cancer treated with preoperative chemoradiotherapy. Materials and Methods: One hundred fifty patients with pathologic confirmed rectal cancer and treated by preoperative chemoradiotherapy between January 1999 and June 2007. Of the 150 patients, the 82 who completed the scheduled chemoradiotherapy, received definitive surgery at our hospital, and did not have distant metastasis upon initial diagnosis were enrolled in this study. The radiation dose delivered to the whole pelvis ranged from 41.4 to 46.0 Gy (median 44.0 Gy) using daily fractions of 1.8-2.0 Gy at 5 days per week and a boost dose to the primary tumor and high risk area up to a total of 43.2-54 Gy (median 50.4 Gy). Sixty patients (80.5%) received 5-fluorouracil, leucovorin, and cisplatin, while 16 patients (19.5%) were administered 5-fluorouracil and leucovorin every 4 weeks concurrently during radiotherapy. Surgery was performed for 3 to 45 weeks (median 7 weeks) after completion of chemoradiotherapy. Results: The sphincter preservation rates for all patients were 73.2% (60/82). Of the 48 patients whose tumor was located at less than 5 cm away from the anal verge, 31 (64.6%) underwent sphincter-saving surgery. Moreover, of the 34 patients whose tumor was located at greater than or equal to 5 cm away from the anal verge, 29 (85.3%) were able to preserve their anal sphincter. A pathologic complete response was achieved in 14.6% (12/82) of all patients. The downstaging rates were 42.7% (35/82) for the T stage, 75.5% (37/49) for the N stage, and 67.1% (55/82) for the overall stages. The median follow-up period was 38 months (range 11 -107 months). The overall 5-year survival, disease-free survival, and locoregional control rates were 67.4%, 58.9% and 84.4%, respectively. The 5-year overall survival rates based on the pathologic stage were 100% for stage 0 (n=12), 59

  9. Stereotactic Radiotherapy of Primary Lung Cancer and Other Targets: Results of Consultant Meeting of the International Atomic Energy Agency

    International Nuclear Information System (INIS)

    To evaluate the current status of stereotactic body radiotherapy (SBRT) and identify both advantages and disadvantages of its use in developing countries, a meeting composed of consultants of the International Atomic Energy Agency was held in Vienna in November 2006. Owing to continuous developments in the field, the meeting was extended by subsequent discussions and correspondence (2007-2010), which led to the summary presented here. The advantages and disadvantages of SBRT expected to be encountered in developing countries were identified. The definitions, typical treatment courses, and clinical results were presented. Thereafter, minimal methodology/technology requirements for SBRT were evaluated. Finally, characteristics of SBRT for developing countries were recommended. Patients for SBRT should be carefully selected, because single high-dose radiotherapy may cause serious complications in some serial organs at risk. Clinical experiences have been reported in some populations of lung cancer, lung oligometastases, liver cancer, pancreas cancer, and kidney cancer. Despite the disadvantages expected to be experienced in developing countries, SBRT using fewer fractions may be useful in selected patients with various extracranial cancers with favorable outcome and low toxicity.

  10. Survey of breast cancer screening by mammography. Results of a questionnaire sent to local self-governing bodies

    International Nuclear Information System (INIS)

    In order to grasp the current status of breast cancer screening in Japan, a questionnaire was distributed to all local self-governing bodies (LSGB). The results indicated that breast cancer screening with mammography was performed by 97.9% of LSGB. Breast cancer screening was started for women aged less than 40 years at 11.9% of the LSGB, and from 40 years of age at 86.8%. Breast cancer screening for women aged 30-39 years was performed at 51.2% of the LSGB. The proportions of studies involving palpation, mammography, and ultrasonography (US) were 34.0%, 24.5%, and 41.6%, respectively. The coverage of screening invitations between April 2006 and March 2007 was grasped at 94.7% of LSGB. At 23.2%, the coverage was less than 10%, and at 33.8% was 10-19.9%. At 7.1%, the coverage was 50% or more. The national average for coverage was 10%, and was especially low in large cities. The recall rate for LSBG between April 2006 and March 2007 was 85.2%. At 22.4% of the LSBG, recall rates were less than 5%, and at 15.6% the recall rates were 50% or more. Screening mammography for women aged 30-39 years needs to be examined in the future. When recall rates exceed 20%, it is necessary to re-examine the accuracy management of breast cancer screening. (author)

  11. Self-reported Cognitive Failure in Breast Cancer Survivors: Preliminary Results from a Danish Nationwide Cohort Study

    DEFF Research Database (Denmark)

    Amidi, Ali; Mehlsen, Mimi Yung; Zachariae, Robert;

    2012-01-01

    Purpose: Self-reported cognitive impairment after chemotherapy has instigated the colloquial use of the term “chemo-brain”. There is, however, uncertainty related to the cognitive impairments observed following cancer treatment, both in terms of the potential causes and long term status. The aim of...... when the effect of age was accounted for. Our results therefore indicate that any initial cognitive complaints may have diminished seven to ten years after treatment, and that younger breast cancer patients are slightly more susceptible to report cognitive failures....... the current study was to investigate: a) the long-term prevalence of self-reported cognitive failures in a large population based sample of breast cancer survivors, and, b) whether such reports differ between survivors treated with or without chemotherapy. Methods: Data originated from a large Danish...

  12. Cranial nerve palsies in metastatic prostate cancer--results of base of skull radiotherapy

    International Nuclear Information System (INIS)

    We studied the rate of response to palliative external beam radiation therapy (20 Gy/5 or 30 Gy/10 fractions) to the base of skull in 32 prostate cancer patients with cranial nerve dysfunction. Sixteen patients (50%; 95% CI, 34-66%) had a useful response to therapy. The median survival post-therapy was 3 months

  13. Cost-effectiveness of oral cancer screening: results from a cluster randomized controlled trial in India

    Directory of Open Access Journals (Sweden)

    Sujha Subramanian

    2009-03-01

    Full Text Available OBJECTIVE: To evaluate oral cancer screening by visual inspection. METHODS: A cluster randomized controlled trial was initiated in Trivandrum district, Kerala, India. Of 13 population clusters, seven were randomly allocated to three rounds of screening between 1996 and 2004, while standard care was provided in six (control arm. An activity-based approach was employed to calculate costs associated with various components of the screening trial. Information on the resources used and on clinical events in each trial arm was derived from trial databases. Total costs for each cluster were estimated in 2004 United States dollars (US$. The incremental cost per life-year saved was calculated for all eligible individuals and for high-risk individuals (i.e. tobacco or alcohol users. FINDINGS: The proportion of oral cancers detected at an early stage (i.e. stage I or II was higher in the intervention arm than the control arm (42% versus 24%, respectively. The incremental cost per life-year saved was US$ 835 for all individuals eligible for screening and US$ 156 for high-risk individuals. Oral cancer screening by visual inspection was performed for under US$ 6 per person. CONCLUSION: The most cost-effective approach to oral cancer screening by visual inspection is to offer it to the high-risk population. Targeted screening of this group will ensure that screening can be offered at a reasonable cost in a limited-resource setting.

  14. Results of low threshold to biopsy following high-intensity focused ultrasound for localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Richard L Haddad

    2012-01-01

    Conclusions: A low threshold to re-biopsy post-HIFU reveals a high local failure rate of 82%. Oncological efficacy is questioned, and using high threshold to biopsy may therefore be overestimating the effectiveness of HIFU as a primary treatment for localized prostate cancer.

  15. Cancer patients’ experiences with and perceived outcomes of yoga: results from focus groups

    NARCIS (Netherlands)

    Uden-Kraan, van C.F.; Chinapaw, M.J.M.; Drossaert, C.H.C.; Verdonck- de Leeuw, I.M.; Buffart, L.M.

    2013-01-01

    Purpose Yoga is a “mind–body” exercise, a combination of physical poses with breathing and meditation, and may have beneficial effects on physical and psychosocial symptoms. We aimed to explore cancer patients’ motives for practicing yoga, experiences of practicing yoga, and perceived physical and

  16. Risk of breast cancer after false-positive test results in screening mammography

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My Catarina; Risør, Louise Madeleine; Thorsted, Brian Larsen;

    2012-01-01

    Screening for disease in healthy people inevitably leads to some false-positive tests in disease-free individuals. Normally, women with false-positive screening tests for breast cancer are referred back to routine screening. However, the long-term outcome for women with false-positive tests is un...

  17. Treatment results of preoperative radiotherapy for advanced head and neck cancers

    International Nuclear Information System (INIS)

    One hundred and nine patients with advanced head and neck cancers (oral cavity: 50, oropharynx: 11, hypopharynx: 18, larynx: 30) received preoperative radiotherapy from 1987 through 1997 in our institute. The median age was 66 years (20-83). Almost all patients had advanced disease (stage II: 17, III: 34, IV: 58). The median dose of preoperative radiotherapy was 40 Gy (20-50). Seventy patients received chemotherapy. The median follow-up time was 30 months. The 5-year overall and disease-free survival rates of all patients were 66% and 56%, respectively. The 5-year locoregional and distant failure rates were 36% and 10%, respectively. The locoregional failure rate of oral cavity cancer (54%) was worse than those of other sites (13-28%) (p=0.0015). The locoregional failure rates of oral cavity cancers according to clinical stage were 59% (II), 57% (III) and 48% (IV), respectively. Incidentally those of other sites were 0% (II), 16% (III) and 30% (IV), respectively. Thirty-eight patients had major complication after surgery. The locoregional failure rates of preoperative radiotherapy following surgery for oral cavity cancers of all stages and other sites of stage IV were high. Preoperative radiotherapy should be stopped and postoperative radiotherapy for these patients should be considered. (author)

  18. Cancer Screening Knowledge Changes: Results from a Randomized Control Trial of Women with Developmental Disabilities

    Science.gov (United States)

    Parish, Susan L.; Rose, Roderick A.; Luken, Karen; Swaine, Jamie G.; O'Hare, Lindsey

    2012-01-01

    Background: Women with developmental disabilities are much less likely than nondisabled women to receive cervical and breast cancer screening according to clinical guidelines. One barrier to receipt of screenings is a lack of knowledge about preventive screenings. Method: To address this barrier, we used a randomized control trial (n = 175 women)…

  19. Results of the Randomized Danish Lung Cancer Screening Trial with Focus on High-Risk Profiling

    DEFF Research Database (Denmark)

    M. W. Wille, Mathilde; Dirksen, Asger; Ashraf, Haseem; Saghir, Zaigham; Bach, Karen Skjøldstrup; Brodersen, John; Clementsen, Paul F; Hansen, Hanne; Larsen, Klaus R; Mortensen, Jann; Rasmussen, Jakob F; Seersholm, Niels; Skov, Birgit G; Thomsen, Laura; Tønnesen, Philip; Pedersen, Jesper H.

    2016-01-01

    , respectively; P = 0.025), this difference was statistically significant, indicating an absolute stage shift. Older participants, those with chronic obstructive pulmonary disease, and those with more than 35 pack-years of smoking had a significantly increased risk of death due to lung cancer, with...

  20. Implementing a One-on-One Peer Support Program for Cancer Survivors Using a Motivational Interviewing Approach: Results and Lessons Learned

    OpenAIRE

    Allicock, Marlyn; Carr, Carol; Johnson, La-Shell; Smith, Rosie; Lawrence, Mary; Kaye, Leanne; Gellin, Mindy; Manning, Michelle

    2014-01-01

    Peer Connect matches cancer survivors and caregivers (guides) with those currently experiencing cancer-related issues seeking support (partners). Motivational interviewing (MI)-based communication skills are taught to provide patient-centered support. There is little guidance about MI-based applications with cancer survivors who may have multiple coping needs. This paper addresses the results and lessons learned from implementing Peer Connect. Thirteen cancer survivors and two caregivers rece...

  1. Genetic Variation on 9p22 Is Associated with Abnormal Ovarian Ultrasound Results in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

    OpenAIRE

    Wentzensen, Nicolas; Black, Amanda; Jacobs, Kevin; Yang, Hannah P.; Berg, Christine D.; Caporaso, Neil; Peters, Ulrike; Ragard, Lawrence; Buys, Saundra S.; Chanock, Stephen; Hartge, Patricia

    2011-01-01

    Background A recent ovarian cancer genome-wide association study (GWAS) identified a locus on 9p22 associated with reduced ovarian cancer risk. The single nucleotide polymorphism (SNP) markers localize to the BNC2 gene, which has been associated with ovarian development. Methods We analyzed the association of 9p22 SNPs with transvaginal ultrasound (TVU) screening results and CA-125 blood levels from participants without ovarian cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Scre...

  2. Communication Between Breast Cancer Patients Who Received Inconclusive Genetic Test Results and Their Daughters and Sisters Years After Testing.

    Science.gov (United States)

    Baars, Jessica E; Ausems, Margreet G E M; van Riel, Els; Kars, Marijke C; Bleiker, Eveline M A

    2016-06-01

    Inconclusive genetic test results including screening recommendations for the breast cancer patients and their first-degree relatives are the most common outcomes of BRCA 1/2 testing. Patients themselves should communicate these results to their relatives. Our aim was to explore communication of breast cancer genetic counseling results with daughters and sisters over a long period of time. Breast cancer patients, who had received an inconclusive DNA test result 7-14 years earlier, completed a self-report questionnaire. Additionally, in-depth interviews were conducted and analysed thematically. Of the 93 respondents, 85 (91 %) considered themselves responsible for communicating genetic test results to relatives. In-depth interviews (n = 14) showed, that counselees wanted 'to hand over' their responsibilities to communicate the test results and screening recommendations to their sisters. Although most patients had informed their daughters and sisters about the genetic test results, usually little is spoken about genetic test results and screening recommendations once the duty of informing is completed. We recommend that, similar to the procedure for BRCA1/2-mutation carriers, a separate letter for first-degree relatives of patients with an inconclusive test result should be provided. In this way information about risks and screening recommendations can be verified by family members years after genetic testing has been completed. PMID:26446011

  3. Breast and Colorectal Cancer Screening and Sources of Cancer Information Among Older Women in the United States: Results From the 2003 Health Information National Trends Survey

    Directory of Open Access Journals (Sweden)

    Steven S. Coughlin, PhD

    2007-07-01

    Full Text Available IntroductionThe number of people in the United States aged 65 years and older is increasing. Older people have a higher risk of dying from cancer; however, recent information about breast and colorectal cancer screening rates among women aged 65 years and older and about sources of health information consulted by these women is limited.MethodsWe examined data from the Health Information National Trends Survey for women aged 65 years and older who had no personal history of breast or colorectal cancer. Women whose self-reported race and ethnicity was non-Hispanic white, non-Hispanic black, or Hispanic were included in the analysis. The overall response rate for the 2003 survey was 34.5%.ResultsWomen aged 75 years and older had lower rates of recent mammography (mammogram in previous 2 years than did women aged 65 to 74 years. In both age groups, rates were especially low for Hispanic women and women with a household income of less than $15,000 per year. Rates of recent colorectal cancer screening (fecal occult blood test in previous year or endoscopy in previous 5 years were markedly lower for non-Hispanic black women aged 75 years and older than for other women in this age group, and for Hispanic women aged 65 to 74 years than for non-Hispanic women in this age group. Screening rates were lowest for women with an annual household income of less than $15,000, no family history of cancer, no usual health care provider, or 1 or no provider visits in the previous year.Differences were found in the groups’ preferred channel for receiving health information. Women who had had a mammogram in the previous 2 years were more likely to pay attention to health information on the radio or in newspapers and magazines than were women who had not received a recent mammogram. Women who had had a recent colorectal cancer screening test were more likely to pay attention to health information in magazines or on the Internet than were those who had not

  4. Radiation therapy and chemotherapy after breast conserving surgery for invasive breast cancer: an intermediate result

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seok Ho; Lee, Kyu Chan; Choi, Jin Ho; Lee, Young Don; Park, Heoung Kyu; Kim, Hyun Young; Park, Se Hoon [Gachon Medical School, Incheon (Korea, Republic of)

    2007-03-15

    Breast conserving surgery (BCS) followed by chemotherapy (CT{sub x}.) and radiation therapy (RT) is widely performed for the treatment of early breast cancer. This retrospective study was undertaken to evaluate our interim results in terms of failure patterns, survival and relative risk factors. From January 1999 through December 2003, 129 patients diagnosed with invasive breast cancer and treated with BCS followed by RT were subject to retrospective review. The median age of the patients was 45 years (age distribution, 27 {approx} 76 years). The proportions of patients according to their tumor, nodes, and metastases (TNM) stage were 65 (50.4%) in stage I, 41 (31.7%) in stage IIa, 13 (10.1%) in stage IIb, 9 (7.0%) in stage III, and 1 patient (0.8%) in stage IIIc. For 32 patients (24.8%), axillary node metastasis was found after dissection, BCS consisted of quadrantectomy in 115 patients (89.1%) and lumpectomy in 14 patients (10.6%). Axillary node dissection at axillary level I and II was performed for 120 patients (93%). For 7 patients (5.4%), only sentinel node dissection was performed with BCS. For 2 patients (1.6%) axillary dissection of any type was not performed. Postoperative RT was given with 6 MV X-rays. A tumor dose of 50.4 Gy was delivered to the entire breast area using a tangential field with a wedge compensator. An additional dose of 9 {approx} 16 Gy was given to the primary tumor bed areas with electron beams. In 30 patients (23.3%), RT was delivered to the supraclavicular node. Most patients had adjuvant CT{sub x}. with 4 {approx} 6 cycles of CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens. The median follow-up period was 50 months (range: 17 {approx} 93 months). The actuarial 5 year survival rate (5Y-OSR) was 96.9%, and the 5 year disease free survival rate (5Y-DFSR) was 93.7%. Local recurrences were noted in 2 patients (true: 2, regional node: 1) as the first sign of recurrence at a mean time of 29.3 months after surgery. Five

  5. 3D freehand ultrasound for medical assistance in diagnosis and treatment of breast cancer: preliminary results

    Science.gov (United States)

    Torres, Fabian; Fanti, Zian; Arambula Cosío, F.

    2013-11-01

    Image-guided interventions allow the physician to have a better planning and visualization of a procedure. 3D freehand ultrasound is a non-invasive and low-cost imaging tool that can be used to assist medical procedures. This tool can be used in the diagnosis and treatment of breast cancer. There are common medical practices that involve large needles to obtain an accurate diagnosis and treatment of breast cancer. In this study we propose the use of 3D freehand ultrasound for planning and guiding such procedures as core needle biopsy and radiofrequency ablation. The proposed system will help the physician to identify the lesion area, using image-processing techniques in the 3D freehand ultrasound images, and guide the needle to this area using the information of position and orientation of the surgical tools. We think that this system can upgrade the accuracy and efficiency of these procedures.

  6. Clinical, MRI, and histological results after photodynamic therapy of oral cancer

    Science.gov (United States)

    Herzog, Michael; Fellbaum, Ch.; Wagner-Manslau, C.; Horch, Hans-Henning

    1992-06-01

    Twenty-one carcinomas of the oral cavity in 18 patients were treated by photodynamic therapy (PDT). Patients were sensitized with Photosan III (2 mg/kg body weight), a modified HPD. Forty-eight hours after application of Photosan III, the tumor and surrounding tissues were irradiated with red laser light (200 mW/cm2, 120 J/cm2). MRI controls were carried out 24 hours after irradiation. Three to five days after irradiation, tumors were removed by conventional surgery. All specimens underwent histological examination. Histologically, hemorrhagic necroses of the irradiated tumors was found in all cases. The depth of necrosis varied from 2 to 8 mm. By MRI controls it was possible to detect edemas as change of signal resonance. PDT is a reliable therapy to reduce oral cancer selectively. Cancer destruction is limited by penetration depth of the laser light.

  7. Enzalutamide monotherapy: Phase II study results in patients with hormone-naive prostate cancer

    DEFF Research Database (Denmark)

    Tombal, Bertrand; Borre, Michael; Rathenborg, Per Zier;

    2013-01-01

    studies that exclusively enrolled patients with CRPC receiving androgen deprivation therapy (ie, testosterone (T) levels #50 ng/dL), this phase II study assessed the efficacy and safety of ENZA monotherapy in patients who had never received hormone therapy; presenting with non-castrate T levels ($230 ng....../dL). Methods: This was a 25-wk, open-label, single-arm study of patients with hormone-naïve, histologically confirmed prostate cancer (all stages) requiring hormonal treatment, an ECOG PS score of 0,and a life expectancy .1 y. All patients received ENZA 160 mg/d without concomitment castration. Primary endpoint......Background: Enzalutamide (ENZA) is an oral androgen receptor inhibitor that has been approved in the US and shown to increase overall survival by 4.8 months over a placebo (HR,0.63) in patients with metastatic castration resistant prostate cancer (CRPC) previously treated with docetaxel (Scher et...

  8. Case-control study on radon exposure and lung cancer in an Italian region. Preliminary results

    International Nuclear Information System (INIS)

    The present estimates of the lung cancer risk for the general population due to radon exposure in dwellings are generally obtained by extrapolating the risk estimates derived from epidemiologic studies on miner cohorts. However, due to uncertainties related to this extrapolation, numerous case-control studies in Europe and North America were planned to estimate directly the risk in dwellings. Most of these studies are still underway and, thanks to their similar design and compatible protocols, it will be possible to perform a pooled analysis in order to improve statistical power. One of these projects is being conducted in the Lazio region of Italy, which is one of the Italian regions with the highest levels of radon indoors. A total of 408 cases and 424 controls older than 34 years, who lived for 25 years or longer in the Lazio Region, were recruited in a hospital of Rome. Detailed information regarding smoking, and occupational exposure of the subjects were collected by interviews in hospital. Residential histories (periods and addresses) during the 35 years preceding the enrolment were ascertained for all study members from the local Register and from a short questionnaire to the subjects or to the next-of-kin, resulting in 2068 dwellings to be monitored within the Lazio region. The distribution of the number of dwellings among cases and controls was the following: 25.7% of the cases and 27.3% of the controls had lived all the preceding 35 years in a single dwelling, whereas only a minority (7.9%) changed five addresses or more. The mean number of dwellings was very similar among cases (2.47) and controls (2.50). In each dwelling, radon dosemeters were placed in both the main bedroom and living room for two consecutive six-month periods. In the second six-month period, two thermoluminescent dosemeters were also collocated in each monitored room to measure gamma radiation emitted by the building materials, in order to evaluate more comprehensively the exposure of

  9. Meeting the Information Needs of Lower Income Cancer Survivors: Results of a Randomized Control Trial Evaluating the American Cancer Society’s “I Can Cope”

    OpenAIRE

    Martin, Michelle Y.; Evans, Mary B; KRATT, POLLY; Pollack, Lori A.; Smith, Judith Lee; Oster, Robert; Dignan, Mark; Prayor-Patterson, Heather; Watson, Christopher; HOUSTON, PETER; ANDREWS, SHIQUINA; LIWO, AMANDIY; TSENG, TUNG SUNG; HULLETT, SANDRAL; OLIVER, JOANN

    2014-01-01

    The American Cancer Society is a leader in the development of cancer survivorship resources. One resource of the American Cancer Society is the I Can Cope program, an educational program for cancer survivors and their families. Evaluations of this program indicate that cancer patients highly rate its objectives. Yet, there are gaps in the understanding of the full impact of the program on diverse cancer survivors. In this study, the authors used a randomized trial to evaluate the program. Par...

  10. Impact of intermediate mammography assessment on the likelihood of false-positive results in breast cancer screening programmes

    International Nuclear Information System (INIS)

    Breast cancer screening is offered to 100% of the target population in Spain and intermediate mammograms (IMs) are sometimes indicated. This study was aimed at analysing the frequency of IMs, the factors determining their recommendation, and their impact on the risk of false-positive results and the detection rate. Data from 3,471,307 mammograms from Spanish breast cancer screening programmes were included. 3.36% of the mammograms were IMs. The factors associated with the use of IMs were age, initial screening, previous invasive tests, a familial history of breast cancer and use of hormone replacement therapy. In screening episodes with an IM, the probability of a false-positive result was 13.74% (95% CI: 13.43-14.05), almost double that in episodes without IMs (6.02%, 95% CI 5.99-6.05). In young women with previous invasive procedures, a familial history of breast cancer or hormone replacement therapy use who were undergoing their initial screen, this probability was lower when IMs were performed. IMs always increased the detection rate. The factors prompting IMs should be characterised so that radiologists can systematise their recommendations according to the presence of the factors maximising the benefits and minimising the adverse effects of this procedure. (orig.)

  11. Performance of gadofosveset-enhanced MRI for staging rectal cancer nodes: can the initial promising results be reproduced?

    Energy Technology Data Exchange (ETDEWEB)

    Heijnen, Luc A.; Martens, Milou H. [Maastricht University Medical Center, Department of Radiology, P.O. Box 5800, Maastricht (Netherlands); Maastricht University Medical Center, Department of Surgery, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Lambregts, Doenja M.J.; Maas, Monique; Bakers, Frans C.H. [Maastricht University Medical Center, Department of Radiology, P.O. Box 5800, Maastricht (Netherlands); Cappendijk, Vincent C. [Jeroen Bosch Ziekenhuis, Department of Radiology, ' s Hertogenbosch (Netherlands); Oliveira, Pedro [Instituto Portugues de Oncologia do Porto Francisco Gentil, Department of Radiology, Porto (Portugal); Lammering, Guido [Maastro Clinic, Radiation Oncology, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Riedl, Robert G. [Maastricht University Medical Center, Department of Pathology, Maastricht (Netherlands); Beets, Geerard L. [Maastricht University Medical Center, Department of Surgery, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Beets-Tan, Regina G.H. [Maastricht University Medical Center, Department of Radiology, P.O. Box 5800, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht (Netherlands)

    2014-02-15

    A previous study showed promising results for gadofosveset-trisodium as a lymph node magnetic resonance imaging (MRI) contrast agent in rectal cancer. The aim of this study was to prospectively confirm the diagnostic performance of gadofosveset MRI for nodal (re)staging in rectal cancer in a second patient cohort. Seventy-one rectal cancer patients were prospectively included, of whom 13 (group I) underwent a primary staging gadofosveset MRI (1.5-T) followed by surgery (± preoperative 5 x 5 Gy) and 58 (group II) underwent both primary staging and restaging gadofosveset MRI after a long course of chemoradiotherapy followed by surgery. Nodal status was scored as (y)cN0 or (y)cN+ by two independent readers (R1, R2) with different experience levels. Results were correlated with histology on a node-by-node basis. Sensitivity, specificity and area under the receiver operating characteristics curve (AUC) were 94 %, 79 % and 0.89 for the more experienced R1 and 50 %, 83 % and 0.74 for the non-experienced R2. R2's performance improved considerably after a learning curve, to an AUC of 0.83. Misinterpretations mainly occurred in nodes located in the superior mesorectum, nodes located in between vessels and nodes containing micrometastases. This prospective study confirms the good diagnostic performance of gadofosveset MRI for nodal (re)staging in rectal cancer. (orig.)

  12. Cryotherapy for primary treatment of prostate cancer: intermediate term results of a prospective study from a single institution.

    Science.gov (United States)

    Rodríguez, S Alvarez; Arias Fúnez, F; Bueno Bravo, C; Rodríguez-Patrón Rodríguez, R; Sanz Mayayo, E; Palacios, V Hevia; Burgos Revilla, F J

    2014-01-01

    Purpose. Published data about cryotherapy for prostate cancer (PC) treatment are based on case series with a lack of clinical trials and the inexistence of a validated definition of biochemical failure. A prospective study with standardized followup protocol was conducted in our institution. Material and Methods. Prospective study of a series of cases including 108 patients diagnosed with localized PC at clinical stage T1c-T2c treated by primary cryoablation and median followup of 61 months. Criteria of biochemical recurrence were unified according to the American Society for Therapeutic Radiology and Oncology (ASTRO). End points were biochemical progression-free survival (BPFS), cancer-specific survival, and overall survival. Rate of complications was reported. Results. The BPFS for low-, medium-, and high-risk patients was 96.4%, 91.2%, and 62.2%, respectively. Cancer-specific survival was 98.1%. Overall survival reached 94.4%. Complications included incontinence in 5.6%, urinary tract obstruction in 1.9%, urethral sloughing in 5.6%, haematuria in 1.9%, perineal pain in 11.1%, and prostatorectal fistula in 0.9%. Erectile disfunction was found in 98.1%. Conclusions. Cryotherapy is an effective and minimally invasive treatment for primary PC in well-selected cases, with low surgical risk and good results in terms of BPFS, cancer-specific survival, and overall survival. PMID:24693437

  13. Impact of intermediate mammography assessment on the likelihood of false-positive results in breast cancer screening programmes

    Energy Technology Data Exchange (ETDEWEB)

    Ascunce, Nieves [Public Health Institute, CIBERESP, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Instituto de Salud Publica, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Ederra, Maria; Delfrade, Josu; Erdozain, Nieves [Public Health Institute, CIBERESP, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Baroja, Araceli [Fundacion Rioja Salud, Logrono (Spain); Zubizarreta, Raquel [Public Health and Planning Directorate, Health Office, Galician Breast Cancer Screening Programme, Galicia (Spain); Salas, Dolores [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia (Spain); Castells, Xavier [Mar Teaching Hospital, CIBERESP, Department of Clinical Epidemiology, Barcelona (Spain)

    2012-02-15

    Breast cancer screening is offered to 100% of the target population in Spain and intermediate mammograms (IMs) are sometimes indicated. This study was aimed at analysing the frequency of IMs, the factors determining their recommendation, and their impact on the risk of false-positive results and the detection rate. Data from 3,471,307 mammograms from Spanish breast cancer screening programmes were included. 3.36% of the mammograms were IMs. The factors associated with the use of IMs were age, initial screening, previous invasive tests, a familial history of breast cancer and use of hormone replacement therapy. In screening episodes with an IM, the probability of a false-positive result was 13.74% (95% CI: 13.43-14.05), almost double that in episodes without IMs (6.02%, 95% CI 5.99-6.05). In young women with previous invasive procedures, a familial history of breast cancer or hormone replacement therapy use who were undergoing their initial screen, this probability was lower when IMs were performed. IMs always increased the detection rate. The factors prompting IMs should be characterised so that radiologists can systematise their recommendations according to the presence of the factors maximising the benefits and minimising the adverse effects of this procedure. (orig.)

  14. THE RESEARCH RESULTS OF TENDER PROCUREMENTS OF THE DRUGS FOR CANCER PATIENTS IN UKRAINE

    OpenAIRE

    Panfilova, G. L.; Tsurikova, O. V.

    2014-01-01

    Introduction. Since 2002, the pharmaceutical care of the cancer patients in Ukraine is carried out centrally by public funds in the framework of the target program "Oncology." In a chronic shortage of funds in the national health care system, as well as taking into account the perspectives of the introduction of the social model of obligatory medical insurance (OMI), enhanced the importance of research on the development of rational mechanisms for the use of public funds, which are sent to dr...

  15. Treatment with subcutaneous and transdermal fentanyl: results from a population pharmacokinetic study in cancer patients

    OpenAIRE

    Oosten, Astrid W.; Abrantes, João A.; Jönsson, Siv; Bruijn, Peter; Kuip, Evelien J. M.; Falcao, Amilcar; van der Rijt, Carin C. D.; Mathijssen, Ron H. J.

    2016-01-01

    Purpose Transdermal fentanyl is effective for the treatment of moderate to severe cancer-related pain but is unsuitable for fast titration. In this setting, continuous subcutaneous fentanyl may be used. As data on the pharmacokinetics of continuous subcutaneous fentanyl are lacking, we studied the pharmacokinetics of subcutaneous and transdermal fentanyl. Furthermore, we evaluated rotations from the subcutaneous to the transdermal route. Methods Fifty-two patients treated with subcutaneous an...

  16. Dual-energy perfusion-CT in recurrent pancreatic cancer. Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, F.; Skornitzke, S.; Kauczor, H.U.; Stiller, W.; Klauss, M. [Heidelberg Univ. (Germany). Clinic of Diagnostic and Interventional Radiology; Hackert, T. [Heidelberg Univ. (Germany). Clinic of Surgery; Grenacher, L. [Diagnostik Muenchen (Germany). Diagnostic Imaging Center

    2016-06-15

    To evaluate the diagnostic performance of dual energy (DE) perfusion-CT for the differentiation between postoperative soft-tissue formation and tumor recurrence in patients after potentially curative pancreatic cancer resection. 24 patients with postoperative soft-tissue formation in the conventional regular follow-up CT acquisition after pancreatic cancer resection with curative intent were included prospectively. They were examined with a 64-row dual-source CT using a dynamic sequence of 34 DE acquisitions every 1.5 s (80 ml of iodinated contrast material, 370 mg/ml, flow rate 5 ml/s). Weighted average (linearly blended M0.5) 120 kVp-equivalent dual-energy perfusion image data sets were evaluated with a body-perfusion CT tool for estimating blood flow, permeability, and blood volume. Diagnosis was confirmed by histological study (n=4) and by regular follow-up. Final diagnosis was local recurrence of pancreatic cancer in 15 patients and unspecific postoperative tissue formation in 9 patients. The blood-flow values for recurrence tissue trended to be lower compared to postoperative tissue formation with 16.6 ml/100 ml/min and 24.7 ml/100 ml/min, respectively for weighted average 120 kVp-equivalent image data, which was not significant (n.s.) (p=0.06, significance level 0.05). Permeability- and blood-volume values were only slightly lower in recurrence tissue (n.s.). DE perfusion-CT is feasible in patients after pancreatic cancer resection and a promising functional imaging technique. As only a trend for lower perfusion values in local recurrence compared to unspecific postoperative alterations was found, the perfusion differences are not yet sufficient to differentiate between malignancy and unspecific postoperative alterations for this new technique. Further studies and technical improvements are needed to generate reliable data for this clinically highly relevant differentiation.

  17. Dual-energy perfusion-CT in recurrent pancreatic cancer. Preliminary results

    International Nuclear Information System (INIS)

    To evaluate the diagnostic performance of dual energy (DE) perfusion-CT for the differentiation between postoperative soft-tissue formation and tumor recurrence in patients after potentially curative pancreatic cancer resection. 24 patients with postoperative soft-tissue formation in the conventional regular follow-up CT acquisition after pancreatic cancer resection with curative intent were included prospectively. They were examined with a 64-row dual-source CT using a dynamic sequence of 34 DE acquisitions every 1.5 s (80 ml of iodinated contrast material, 370 mg/ml, flow rate 5 ml/s). Weighted average (linearly blended M0.5) 120 kVp-equivalent dual-energy perfusion image data sets were evaluated with a body-perfusion CT tool for estimating blood flow, permeability, and blood volume. Diagnosis was confirmed by histological study (n=4) and by regular follow-up. Final diagnosis was local recurrence of pancreatic cancer in 15 patients and unspecific postoperative tissue formation in 9 patients. The blood-flow values for recurrence tissue trended to be lower compared to postoperative tissue formation with 16.6 ml/100 ml/min and 24.7 ml/100 ml/min, respectively for weighted average 120 kVp-equivalent image data, which was not significant (n.s.) (p=0.06, significance level 0.05). Permeability- and blood-volume values were only slightly lower in recurrence tissue (n.s.). DE perfusion-CT is feasible in patients after pancreatic cancer resection and a promising functional imaging technique. As only a trend for lower perfusion values in local recurrence compared to unspecific postoperative alterations was found, the perfusion differences are not yet sufficient to differentiate between malignancy and unspecific postoperative alterations for this new technique. Further studies and technical improvements are needed to generate reliable data for this clinically highly relevant differentiation.

  18. Neoadjuvant chemotherapy in advanced ovarian cancer: latest results and place in therapy

    OpenAIRE

    Sato, Seiya; Itamochi, Hiroaki

    2014-01-01

    Approximately 70% of women with epithelial ovarian cancer (EOC) are diagnosed with advanced stage disease, which is associated with high morbidity and mortality. The standard approach to treating patients with advanced EOC remains primary debulking surgery (PDS) followed by chemotherapy. EOC is one of the most sensitive of all solid tumors to cytotoxic drugs, with over 80% of women showing a response to standard chemotherapy combined with taxane and platinum. Furthermore, residual disease is ...

  19. Willingness to pay to avoid metastatic breast cancer treatment side effects: results from a conjoint analysis

    OpenAIRE

    Lalla, Deepa; Carlton, Rashad; Santos, Eduardo; Bramley, Thomas; D’Souza, Anna

    2014-01-01

    Purpose Metastatic breast cancer (MBC) patients are treated with a variety of regimens with differing side effects that can reduce the patients’ quality of life. This study assessed the willingness to pay (WTP) to avoid side effects related to MBC treatment using conjoint analysis. Methods An online, self-administered conjoint analysis survey of US adult female MBC patients was conducted to elicit preferences for MBC treatment side effects. Attributes included in the analysis were hair loss, ...

  20. Antioxidant intake and risk of endometrial cancer: Results from the Nurses' Health Study

    OpenAIRE

    Cui, Xiaohui; Rosner, Bernard; Willett, Walter C.; Hankinson, Susan E

    2011-01-01

    To investigate the associations between antioxidant intake and risk of endometrial cancer, the authors analyzed data from the prospective Nurses’ Health Study. From 1980 to 2006, 669 invasive adenocarcinoma cases were identified over 1.3 million person-years of follow-up. Information on dietary intake was collected in 1980 and updated every 2–4 years. Cox proportional hazard models were used to calculate the multivariate relative risks (RRs), controlling for total energy and potential risk fa...

  1. Surgical Margins and Short-Term Results of Laparoscopic Total Mesorectal Excision for Low Rectal Cancer

    OpenAIRE

    Yang, Qingqiang; Xiu, Peng; Qi, Xiaolong; Yi, Guoping; Xu, Liang

    2013-01-01

    Background and Objectives: The confines of the narrow bony pelvis make laparoscopic surgery more challenging in the treatment of low rectal cancer. Macroscopic evaluation of the completeness of the mesorectum provides detailed information about the quality of surgery. This study was performed to observe the short-term outcomes and evaluate the macroscopic quality of specimens acquired from laparoscopic total mesorectal excision versus open total mesorectal excision in patients with low rectal...

  2. [Lung cancer and cigarette smoking in women. (Results of a case control study)].

    Science.gov (United States)

    Vutuc, C

    1982-08-01

    Smoking habits of 297 female lung cancer patients (Kreyberg I: 202, Kreyberg II: 95) and 580 controls were analyzed. In addition tar exposures (TE) were calculated. Calculation of TE includes amount of consumptions, duration and the tar yields of all cigarette brands ever smoked. These are significant more smokers among patients (63%) and patients with a K I tumor (80%) compared to the controls (21%); K II: 29%. All patients and patients with a K I tumor had a significant longer smoking career (39.3 years; 39.6 years) and a higher tar exposure (TE = 1767; TE - 1810) compared to the controls (31.9 years, TE = 1146). K II: 37.4 years, TE = 1508. Lung cancer risks (adj. for TE) and population attributable risks (PAR) were: all age groups R = 7.3*, PAR = 54%; less than 40 years R = 1.1, PAR = 3%; 41-50 years R = 4.2*, PAR = 42% ; 51-60 years R = 7.6*, PAR = 62%; 61-70 years R = 7.8*, PAR = 54%; greater than 71 years R = 8.0*, PAR = 55%. Lung cancer risks (adj. for age) in relation to tar exposure and attributable risks (AR) were: TE less than 500: all cases R = 1.5, AT = 34% (KIR = 2.9, K II R = 0.8); TE 501-1000: all cases R = 4.2*, AR = 76% (KIR = 9.9*, K II R - 1.1): TE 1001-2000: all cases R = 12.1*, AR = 92% (KIR = 27.2*, K II R = 2.6**); TE 2001-3000: all cases R = 11.1*, AR = 91% (KIR = 25.2*, K II R = 2.0); TE greater than 3001: all cases R = 13.0*, AR = 92% (KIR = 29.3*, K II R = 3.3). These is a significant increase of risk of cigarette smokers beyond a TE of 501, which could be identified as a sort of critical exposure. There is a pronounced dose response relationship between cigarette smoking in relation to TE and lung cancer risk as concerning K I tumors but not KII tumors. Lung cancer risks in relation to age began smoking: less than 19 years R = 7.8*; 19 years and above R = 6.5*. *P less than 1%, **P less than 5%. PMID:7148206

  3. Irrefutable evidence for the use of docetaxel in newly diagnosed metastatic prostate cancer: results from the STAMPEDE and CHAARTED trials.

    Science.gov (United States)

    van Soest, Robert J; de Wit, Ronald

    2015-01-01

    Androgen deprivation therapy (ADT) has been used in the treatment of metastatic prostate cancer since the first description of its hormonal dependence in 1941. In 2004, docetaxel chemotherapy became the mainstay of treatment in metastatic castration-resistant prostate cancer (mCRPC), following robust, albeit modest, survival benefit in two randomized phase 3 trials. The recently published CHAARTED trial was the first to show that combining ADT with docetaxel in men with hormone-naïve (hormone-sensitive) metastatic prostate cancer (mHSPC) yielded a remarkable overall survival benefit of 13.6 months as compared with ADT alone. In the current issue of The Lancet, James et al. report results of the STAMPEDE trial in men with high-risk locally advanced or metastatic prostate cancer initiating long-term hormone therapy. The combination of six cycles of docetaxel with ADT in men commencing long-term ADT demonstrated a similar OS benefit compared with standard of care (SOC) by a median of 10 months. Based on the consistency of the data and the firmness of the benefit provided, docetaxel in addition to ADT should be considered SOC for men with newly diagnosed mHSPC. PMID:26695172

  4. Characterization of a Test for Invasive Breast Cancer Using X-ray Diffraction of Hair - Results of a Clinical Trial

    Directory of Open Access Journals (Sweden)

    Gary L. Corino

    2009-11-01

    Full Text Available Objective: To assess the performance of a test for breast cancer utilizing synchrotron x-ray diffraction analysis of scalp hair from women undergoing diagnostic radiology assessment. Design and Setting: A double-blinded clinical trial of women who attended diagnostic radiology clinics in Australia. Patients: 1796 women referred for diagnostic radiology, with no previous history of cancer. Main Outcome Measures: Sensitivity, specificity and accuracy of the hair test analysis compared to the gold standard of imaging followed by biopsy where indicated. Results: The hair-based assay had an overall accuracy of >77% and a negative predictive value of 99%. For all women, the sensitivity of both mammography and x-ray diffraction alone was 64%, but when used together the sensitivity rose to 86%. The sensitivity of the hair test for women under the age of 70 was 74%. Conclusion: In this large population trial the association between the presence of breast cancer and an altered hair fibre X-ray diffraction pattern previously reported has been confirmed. It appears that mammography and X-ray diffraction of hair detect different populations of breast cancers, and are synergistic when used together.

  5. Regional variations in mortality rates of pancreatic cancer in China:Results from 1990-1992 national mortality survey

    Institute of Scientific and Technical Information of China (English)

    Ke-Xin Chen; Peizhong Peter Wang; Si-Wei Zhang; Lian-Di Li; Feng-Zhu Lu; Xi-Shan Hao

    2003-01-01

    AIM: To examine the regional variations in mortality rates of pancreatic cancer in China.METHODS: Aggregated mortality data of pancreatic cancer were extracted from the 1990-1992 national death of all causes and its mortality survey in China. Age specific and standardized mortality rates were calculated at both national and provincial levels with selected characteristics including sex and residence status.RESULTS: Mortality of pancreatic cancer ranked the ninth and accounted for 1.38 percent of the total malignancy deaths. The crude and age standardized mortality rates of pancreatic cancer in China in the period of 1990-1992 were 1.48/100 000 and 1.30/100 000, respectively. Substantial regional variations in mortality rates across China were observed with adjusted mortality rates ranging from 0.43/100 000 to 3.70/100 000 with an extremal value of 8.7.Urban residents had significant higher pancreatic mortality than rural residents.CONCLUSION: The findings of this study show different mortality rates of this disease and highlight the importance of further investigation on factors, which might contribute to the observed epidemiological patterns.

  6. Diabetes, metformin and incidence of and death from invasive cancer in postmenopausal women: Results from the women’s health initiative

    Science.gov (United States)

    Gong, Zhihong; Aragaki, Aaron K.; Chlebowski, Rowan T.; Manson, JoAnn E.; Rohan, Thomas E.; Chen, Chu; Vitolins, Mara Z.; Tinker, Lesley F.; LeBlanc, Erin S.; Kuller, Lewis H.; Hou, Lifang; LaMonte, Michael J.; Luo, Juhua; Wactawski-Wende, Jean

    2016-01-01

    Findings from studies of metformin use with risk of cancer incidence and outcome provide mixed results; with few studies examined associations by recency of diabetes diagnosis or duration of medication use. Thus, in the Women’s Health Initiative, we examined these associations and further explored whether associations differ by recency of diabetes and duration of metformin use. Cox regression models were used to estimate hazard ratios (HR) and their 95% confidence intervals. Diabetes was associated with higher risk of total invasive cancer (HR, 1.13; p < 0.001) and of several site-specific cancers (HR, 1.2–1.4, and up to over twofold). Diabetes was also associated with higher risk of death from cancer (HR, 1.46; p < 0.001). There was no overall difference in cancer incidence by diabetes therapy (p = 0.66). However, there was a lower risk of death from cancer for metformin users, compared to users of other medications, relative to women without diabetes, overall (HRs, 1.08 vs. 1.45; p = 0.007) and for breast cancer (HRs, 0.50 vs. 1.29; p = 0.05). Results also suggested that lower cancer risk associated with metformin may be evident only for a longer duration of use in certain cancer sites or subgroup populations. We provide further evidence that postmenopausal women with diabetes are at higher risk of invasive cancer and cancer death. Metformin users, particularly long-term users, may be at lower risk of developing certain cancers and dying from cancer, compared to users of other anti-diabetes medications. Future studies are needed to determine the long-term effect of metformin in cancer risk and survival from cancer. PMID:26616262

  7. Imaging of tumor viability in lung cancer. Initial results using 23Na-MRI

    International Nuclear Information System (INIS)

    23Na-MRI has been proposed as a potential imaging biomarker for the assessment of tumor viability and the evaluation of therapy response but has not yet been evaluated in patients with lung cancer. We aimed to assess the feasibility of 23Na-MRI in patients with lung cancer. Three patients with stage IV adenocarcinoma of the lung were examined on a clinical 3 Tesla MRI system (Magnetom TimTrio, Siemens Healthcare, Erlangen, Germany). Feasibility of 23Na-MRI images was proven by comparison and fusion of 23Na-MRI with 1H-MR, CT and FDG-PET-CT images. 23Na signal intensities (SI) of tumor and cerebrospinal fluid (CSF) of the spinal canal were measured and the SI ratio in tumor and CSF was calculated. One chemonaive patient was examined before and after the initiation of combination therapy (Carboplatin, Gemcitabin, Cetuximab). All 23Na-MRI examinations were successfully completed and were of diagnostic quality. Fusion of 23Na-MRI images with 1H-MRI, CT and FDG-PET-CT was feasible in all patients and showed differences in solid and necrotic tumor areas. The mean tumor SI and the tumor/CSF SI ratio were 13.3 ± 1.8 x 103 and 0.83 ± 0.14, respectively. In necrotic tumors, as suggested by central non-FDG-avid areas, the mean tumor SI and the tumor/CSF ratio were 19.4 x 103 and 1.10, respectively. 23Na-MRI is feasible in patients with lung cancer and could provide valuable functional molecular information regarding tumor viability, and potentially treatment response. (orig.)

  8. Imaging of tumor viability in lung cancer. Initial results using {sup 23}Na-MRI

    Energy Technology Data Exchange (ETDEWEB)

    Henzler, T.; Apfaltrer, P.; Haneder, S.; Schoenberg, S.O.; Fink, C. [University Medical Center Mannheim Heidelberg Univ., Mannheim (Germany). Inst. of Clinical Radiology and Nuclear Medicine; Konstandin, S.; Schad, L. [University Medical Center Mannheim Heidelberg Univ., Mannheim (Germany). Computer Assisted Clinical Medicine; Schmid-Bindert, G.; Manegold, C. [University Medical Center Mannheim Heidelberg Univ., Mannheim (Germany). Interdisciplinary Thoracic Oncology; Wenz, F. [University Medical Center Mannheim Heidelberg Univ., Mannheim (Germany). Dept. of Radiation Oncology

    2012-04-15

    {sup 23}Na-MRI has been proposed as a potential imaging biomarker for the assessment of tumor viability and the evaluation of therapy response but has not yet been evaluated in patients with lung cancer. We aimed to assess the feasibility of {sup 23}Na-MRI in patients with lung cancer. Three patients with stage IV adenocarcinoma of the lung were examined on a clinical 3 Tesla MRI system (Magnetom TimTrio, Siemens Healthcare, Erlangen, Germany). Feasibility of {sup 23}Na-MRI images was proven by comparison and fusion of {sup 23}Na-MRI with {sup 1}H-MR, CT and FDG-PET-CT images. {sup 23}Na signal intensities (SI) of tumor and cerebrospinal fluid (CSF) of the spinal canal were measured and the SI ratio in tumor and CSF was calculated. One chemonaive patient was examined before and after the initiation of combination therapy (Carboplatin, Gemcitabin, Cetuximab). All {sup 23}Na-MRI examinations were successfully completed and were of diagnostic quality. Fusion of {sup 23}Na-MRI images with {sup 1}H-MRI, CT and FDG-PET-CT was feasible in all patients and showed differences in solid and necrotic tumor areas. The mean tumor SI and the tumor/CSF SI ratio were 13.3 {+-} 1.8 x 103 and 0.83 {+-} 0.14, respectively. In necrotic tumors, as suggested by central non-FDG-avid areas, the mean tumor SI and the tumor/CSF ratio were 19.4 x 103 and 1.10, respectively. {sup 23}Na-MRI is feasible in patients with lung cancer and could provide valuable functional molecular information regarding tumor viability, and potentially treatment response. (orig.)

  9. Overweight, obesity, and breast cancer screening: results from the 2012 Swiss Health Survey

    OpenAIRE

    Eichholzer, Monika; Richard, Aline; Rohrmann, Sabine; Schmid, Seraina; Güth, Uwe

    2016-01-01

    Obesity is associated with poor breast cancer (BC) prognosis. Larger tumor size and more advanced disease stage at diagnosis could partly explain this outcome and nonadherence of obese women to BC screening may play a role. We examined the relationship between BMI (kg/m) and the use of mammography in Switzerland as well as separately in the German-speaking part with mainly opportunistic screening and in the French-speaking part with organized programs. We analyzed the data of 50-69-year-old w...

  10. Results of radioiodine treatment in 158 children from Belarus with thyroid cancer after the Chernobyl accident

    International Nuclear Information System (INIS)

    In 134 out of 158 children more than one course of radioiodine treatment has been performed in Germany up to now.In 101 out of 134 children (75%) complete remissions of thyroid cancer could be achieved up to now.In the remaining 25% of the cases,we were able to recognise partial remissions defined as decrease in tumour volume,tumour marker serum level or intensity of radioiodine uptake for at least 50%.In no single case has progression of disease been observed

  11. Epoetin alfa in platinum-treated ovarian cancer patients: results of a multinational, multicentre, randomised trial

    OpenAIRE

    Wilkinson, P. M.; Antonopoulos, M; Lahousen, M; Lind, M.; Kosmidis, P

    2006-01-01

    This multicentre, open-label, controlled clinical trial assessed the effects of epoetin alfa treatment on haematologic and quality of life (QOL) parameters in 182 anaemic (Hb⩽12 g dl−1) ovarian cancer patients receiving platinum chemotherapy. Patients were randomised 2 : 1 to receive epoetin alfa 10 000–20 000 IU three times weekly plus best standard treatment (BST) or BST only. Main study end points were changes from baseline in haemoglobin (Hb) level, transfusion requirements, and QOL. For ...

  12. The ways of improvement of combination therapy results in patients with local cervical cancer

    International Nuclear Information System (INIS)

    A new solutions of a scientific task of modern oncogynecology, improvement of the efficacy of treatment for local cervical cancer on the account of expansion of the indications to operative treatment is presented on the clinical material (275 patients with stage II-III CC). The use of the developed technique of multimodality therapy based on the split course of combination radiation therapy against a background of neoadjuvant chemotherapy allowed to convert in 49.6% of cases of immobile tumor process to an operable stage followed by uterus and adnexae removal while at the traditional combination radiotherapy the resectability index was 6.9%.

  13. Results of the European research project 'Improving the effectiveness of cancer treatment with 3D Brachytherapy'

    International Nuclear Information System (INIS)

    The project iMERA + T2.J06 'Improving the effectiveness of cancer treatment using 3D brachytherapy' was solved in the period 2008-2011 in collaboration of metrology institutes from 10 European Union countries, including participation of the Czech Republic. Its main objective was to create a means to ensure metrological quantity absorbed dose in water from brachyterapeutical (BT) sources enabling more accurate assessment of therapeutic benefit than using existing dosimetry protocols that are based on the quantity kerma in the air. This project is discussed.

  14. Radar-based breast cancer detection using a hemispherical antenna array—experimental results

    OpenAIRE

    Klemm, M; Craddock, IJ; Leendertz, JA; Preece, AW; BENJAMIN, R.

    2009-01-01

    In this contribution, an ultrawideband (UWB) microwave system for breast cancer detection is presented. The system is based on a novel hemispherical real-aperture antenna array, which is employed in a multi-static radar-based detection system. The array consists of 16 UWB aperture-coupled stacked-patch antennas located on a section of a hemisphere. The radar system is designed to be used with realistic three-dimensional (3D) breast phantoms, which have been developed, as well as with real bre...

  15. Therapeutic results in ovarian cancer after replacement of conventional radiotherapy by Co-60 irradiation

    International Nuclear Information System (INIS)

    The use of Co-60 screen and pendular irradiation instead of conventional radiotherapy has brought about an improvement in the 5-year survival rate in patients with more advanced stages of ovarian cancer. Although the general side effects of Co-60 irradiation are considered to be more unpleasant than those of X-ray and radium therapy, severe, reversible or irreversible damage to the urogenital tract and intestinal organs was diminished by accurate planning of Co-60 therapy, so that these complications occurred less frequently than with conventional radiotherapy. (author)

  16. Promising results after endoscopic vacuum treatment of anastomotic leakage following resection of rectal cancer with ileostomy

    DEFF Research Database (Denmark)

    Nerup, Nikolaj; Johansen, John Lykkegaard; Alkhefagie, Ghalib Ali Abod;

    2013-01-01

    , conservative irrigation regimes are reported to perdure for months and some even years and to be associated with a poor stoma closure rate. In the present paper, we evaluated endoscopic vacuum treatment of the perianastomotic abscess. MATERIAL AND METHODS: Patients who had LAR due to rectal cancer with total......-18) sessions. The median length of hospital stay was 25 (7-39) days. Mortality was zero, and the stoma closure rate was 12/13 (97%). CONCLUSION: Our data support the positive findings previously reported by other studies. Endoscopic vacuum treatment seems to be a safe approach for selected patients in the...

  17. Increased gene dosage of Ink4a/Arf results in cancer resistance and normal aging

    OpenAIRE

    Matheu, Ander; Pantoja, Cristina; Efeyan, Alejo; Criado, Luis M.; Martín-Caballero, Juan; Flores, Juana M.; Klatt, Peter; Serrano, Manuel

    2004-01-01

    Mammalian genes frequently present allelic variants that differ in their expression levels and that, in the case of tumor suppressor genes, can be of relevance for cancer susceptibility and aging. We report here the characterization of a novel mouse model with increased activity for the Ink4a and Arf tumor suppressors. We have generated a “super Ink4a/Arf” mouse strain carrying a transgenic copy of the entire Ink4a/Arf locus. Cells derived from super Ink4a/Arf mice have increased resistance t...

  18. Genetic polymorphism in the manganese superoxide dismutase gene, antioxidant intake, and breast cancer risk: results from the Shanghai Breast Cancer Study

    International Nuclear Information System (INIS)

    It has been suggested that oxidative stress and mitochondrial DNA damage play important roles in breast cancer carcinogenesis. Manganese superoxide dismutase (MnSOD) is a major enzyme that is responsible for the detoxification of reactive oxygen species in the mitochondria. A T → C substitution in the MnSOD gene results in a Val → Ala change at the -9 position of the mitochondrial targeting sequence (Val-9Ala), which alters the protein secondary structure and thus affects transport of MnSOD into the mitochondria. We evaluated this genetic polymorphism in association with breast cancer risk using data from the Shanghai Breast Cancer Study, a population-based case–control study conducted in urban Shanghai from 1996 to 1998. The MnSOD Val-9Ala polymorphism was examined in 1125 breast cancer cases and 1197 age-frequency-matched control individual. Breast cancer risk was slightly elevated in women with Ala/Ala genotype (odds ratio [OR] 1.3, 95% confidence interval [CI] 0.7–2.3), particularly among premenopausal women (OR 1.8, 95% CI 0.9–3.7), as compared with those with Val/Val genotype. The increased risk with the Ala/Ala genotype was stronger among premenopausal women with a higher body mass index (OR 2.5, 95% CI 0.9–7.0) and more years of menstruation (OR 2.6, 95% CI 0.8–8.0). The risk among premenopausal women was further increased twofold to threefold among those with a low intake of fruits, vegetables, vitamin supplements, selenium, or antioxidant vitamins, including carotenes and vitamins A, C, and E. However, the frequency of the Ala allele was low (14%) in the study population, and most of the ORs provided above were not statistically significant. The present study provides some evidence that genetic polymorphism in the MnSOD gene may be associated with increased risk of breast cancer among Chinese women with high levels of oxidative stress or low intake of antioxidants. Studies with a larger sample size are needed to confirm the findings

  19. Neoadjuvant therapy for esophageal cancer

    Institute of Scientific and Technical Information of China (English)

    Rachit; D; Shah; Anthony; D; Cassano; James; P; Neifeld

    2014-01-01

    Esophageal cancer is increasing in incidence more than any other visceral malignancy in North America. Adenocarcinoma has become the most common cell type. Surgery remains the primary treatment modality for locoregional disease. Overall survival with surgery alone has been dismal, with metastatic disease the primary mode of treatment failure after an R0 surgical resection. Cure rates with chemotherapy or radiation therapy alone have been disappointing as well. For these reasons, over the last decade multi-modality treatment has gained increasing acceptance as the standard of care. This review examines the present data and role of neoadjuvant treatment using chemotherapy and radiation therapy followed by surgery for the treatment of esophageal cancer.

  20. Cancer

    Science.gov (United States)

    ... Blood tests (which look for chemicals such as tumor markers) Bone marrow biopsy (for lymphoma or leukemia) Chest ... the case with skin cancers , as well as cancers of the lung, breast, and colon. If the tumor has spread ...

  1. Cancer

    Science.gov (United States)

    Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms ... be benign or malignant. Benign tumors aren't cancer while malignant ones are. Cells from malignant tumors ...

  2. Preliminary results on the role of PET/CT in initial staging, restaging, and management of lung cancer

    International Nuclear Information System (INIS)

    Aim: To determine true-positive and true-negative rates of PET/CT studies in the staging of lung cancer as compared with conventional imaging (CT and bone scan and occasionally MRI) and the impact of PET/CT on the treatment strategy in patients with lung cancer. Materials and method: Twenty patients (21 studies) with known or suspected lung cancer (14 patients with non-small-cell lung cancer (NSCLC), three patients with small-cell lung cancer (SCLC), three patients with solitary pulmonary nodule underwent initial staging (seven studies) or restaging (14 studies) with combined FDG PET and CT scans on a PET/CT tomograph. PET/CT images were evaluated separately by two nuclear medicine physicians and two radiologists specialized on PET, CT, and MRI. Histology results and a more than 6 months follow-up served as the reference standards. Results: Accurate diagnosis was achieved on 16 studies. Site-by-site analysis gave the following results: 16 true-positive sites (seven on histology, nine on >6 months follow-up), six true-negative sites (two on histology, four on >6 months follow-up). On PET/CT, six patients were correctly down-staged, three patients were correctly upstaged and seven patients were diagnosed correctly as being on the same stage (2/7 with increase of extent of disease, 5/7 with the same extent of disease). One patient was falsely upstaged and three patients were falsely down-staged. On the basis of PET/CT results, change of management was induced in six patients, while in 14 patients there was no change induced. In five cases PET/CT was partially accurate: on site-by-site analysis, four sites proved true positive (on histology), one site false positive (on histology), and four sites false negative (one on histology, three on >6 months follow-up). Conclusion: In our early experience, PET/CT contributed significantly to correct staging and management of patients with lung cancer

  3. Preliminary results on the role of PET/CT in initial staging, restaging, and management of lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Malamitsi, J. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece): Department of Medical Physics, Medical School, University of Athens (Greece)]. E-mail: j.malamitsi@yahoo.gr; Valotassiou, B. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece); Iliadis, K. [Thoracic Surgical Department, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece); Kosmidis, P. [2nd Medical Oncology Department, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece); Laspas, F. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece); Vasilaki, M. [Oncologist, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece); Pipini, E. [Thoracic Medicine Clinic, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece); Petounis, A. [1st Internal Medicine and Oncology Department, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece); Gogou, L. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece); Pagou, M. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece); Dalianis, K. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece); Efthimiadou, R. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece); Andreou, J. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens, Hygeia, Athens (Greece)

    2006-12-20

    Aim: To determine true-positive and true-negative rates of PET/CT studies in the staging of lung cancer as compared with conventional imaging (CT and bone scan and occasionally MRI) and the impact of PET/CT on the treatment strategy in patients with lung cancer. Materials and method: Twenty patients (21 studies) with known or suspected lung cancer (14 patients with non-small-cell lung cancer (NSCLC), three patients with small-cell lung cancer (SCLC), three patients with solitary pulmonary nodule underwent initial staging (seven studies) or restaging (14 studies) with combined FDG PET and CT scans on a PET/CT tomograph. PET/CT images were evaluated separately by two nuclear medicine physicians and two radiologists specialized on PET, CT, and MRI. Histology results and a more than 6 months follow-up served as the reference standards. Results: Accurate diagnosis was achieved on 16 studies. Site-by-site analysis gave the following results: 16 true-positive sites (seven on histology, nine on >6 months follow-up), six true-negative sites (two on histology, four on >6 months follow-up). On PET/CT, six patients were correctly down-staged, three patients were correctly upstaged and seven patients were diagnosed correctly as being on the same stage (2/7 with increase of extent of disease, 5/7 with the same extent of disease). One patient was falsely upstaged and three patients were falsely down-staged. On the basis of PET/CT results, change of management was induced in six patients, while in 14 patients there was no change induced. In five cases PET/CT was partially accurate: on site-by-site analysis, four sites proved true positive (on histology), one site false positive (on histology), and four sites false negative (one on histology, three on >6 months follow-up). Conclusion: In our early experience, PET/CT contributed significantly to correct staging and management of patients with lung cancer.

  4. Preliminary results on the role of PET/CT in initial staging, restaging, and management of lung cancer

    Science.gov (United States)

    Malamitsi, J.; Valotassiou, B.; Iliadis, K.; Kosmidis, P.; Laspas, F.; Vasilaki, M.; Pipini, E.; Petounis, A.; Gogou, L.; Pagou, M.; Dalianis, K.; Efthimiadou, R.; Andreou, J.

    2006-12-01

    AimTo determine true-positive and true-negative rates of PET/CT studies in the staging of lung cancer as compared with conventional imaging (CT and bone scan and occasionally MRI) and the impact of PET/CT on the treatment strategy in patients with lung cancer. Materials and methodTwenty patients (21 studies) with known or suspected lung cancer (14 patients with non-small-cell lung cancer (NSCLC), three patients with small-cell lung cancer (SCLC), three patients with solitary pulmonary nodule underwent initial staging (seven studies) or restaging (14 studies) with combined FDG PET and CT scans on a PET/CT tomograph. PET/CT images were evaluated separately by two nuclear medicine physicians and two radiologists specialized on PET, CT, and MRI. Histology results and a more than 6 months follow-up served as the reference standards. ResultsAccurate diagnosis was achieved on 16 studies. Site-by-site analysis gave the following results: 16 true-positive sites (seven on histology, nine on >6 months follow-up), six true-negative sites (two on histology, four on >6 months follow-up). On PET/CT, six patients were correctly down-staged, three patients were correctly upstaged and seven patients were diagnosed correctly as being on the same stage (2/7 with increase of extent of disease, 5/7 with the same extent of disease). One patient was falsely upstaged and three patients were falsely down-staged. On the basis of PET/CT results, change of management was induced in six patients, while in 14 patients there was no change induced. In five cases PET/CT was partially accurate: on site-by-site analysis, four sites proved true positive (on histology), one site false positive (on histology), and four sites false negative (one on histology, three on >6 months follow-up). ConclusionIn our early experience, PET/CT contributed significantly to correct staging and management of patients with lung cancer.

  5. Quality-of-life results used to endorse changes in standard of care for recurrent platinum-sensitive ovarian cancer.

    Science.gov (United States)

    Chase, Dana M; Wenzel, Lari B; Monk, Bradley J

    2012-06-01

    Most women with ovarian cancer will suffer a recurrence. Unfortunately, although initial treatment can lead to undetectable disease, recurrent disease is often more challenging to control. As curative intent is less common after relapse, patients and doctors argue for improving quality-of-life (QoL) outcomes when therapies are selected. The article reviewed here discusses the QoL results of a trial in platinum-sensitive recurrent ovarian cancer where over 900 patients were randomized to the standard treatment (carboplatin and paclitaxel) versus carboplatin and pegylated liposomal doxorubicin. In the paper under evaluation, the standard of care is challenged based on a favorable clinical outcome in addition to QoL results in the experimental arm. PMID:22812551

  6. Results of radiation therapy for uterine cervical cancer using high dose rate remote after loading system

    International Nuclear Information System (INIS)

    In Japan, radiotherapy with high dose rate remote after loading system (HDR-RALS) for intracavitary brachytherapy is the standard treatment for more than 30 years. This report showed the usefulness of HDR-RALS for uterine cervical cancer. From 1980 through 1999, 442 patients with uterine cervical cancers (stage I: 66, stage II: 161, stage III: 165, stage IV: 50) were treated. Radiotherapy was performed both external teletherapy and HDR-RALS. Overall survival rate at 5 years was 60.2%. The 5-year actuarial incidence of all complications was 16.4%. The 5-year actuarial incidence of all complications in cases treated with the sum doses of whole pelvic irradiation (without central shield) and RALS up to 49 Gy, 50 to 59 Gy or larger doses were 7.5%, 11.0% and 25.2%, respectively. Radiation therapy using HDR-RALS was very effective. While the dose of whole pelvic irradiation was increased, the actuarial incidence of all complications was increased. (author)

  7. Recombinant leukocyte A interferon in advanced breast cancer. Results of a phase II efficacy trial.

    Science.gov (United States)

    Sherwin, S A; Mayer, D; Ochs, J J; Abrams, P G; Knost, J A; Foon, K A; Fein, S; Oldham, R K

    1983-05-01

    Nineteen patients with advanced refractory metastatic breast cancer no longer responsive to chemotherapy were treated in the first phase II efficacy trial of recombinant leukocyte A interferon (IFL-rA), a highly purified single molecular species of alpha interferon prepared by recombinant DNA methods. Patients received a previously determined maximum tolerated dose for this agent (50 X 10(6) U/m2 body surface area) by intramuscular injection three times weekly for up to 3 months. The symptoms of toxicity observed in this trial resemble those previously reported for alpha interferons and include fever, chills, fatigue, anorexia, and leukopenia. All patients required dose reductions, most often for reasons of severe fatigue. Of the 17 patients evaluable for tumor response, one patient had stable disease and 16 had evidence of tumor progression. We conclude that IFL-rA is not an active agent in the treatment of advanced, refractory breast cancer when used at a maximum tolerated dose on this treatment schedule. PMID:6342490

  8. Premenopausal Circulating Androgens and Risk of Endometrial Cancer: results of a Prospective Study.

    Science.gov (United States)

    Clendenen, Tess V; Hertzmark, Kathryn; Koenig, Karen L; Lundin, Eva; Rinaldi, Sabina; Johnson, Theron; Krogh, Vittorio; Hallmans, Göran; Idahl, Annika; Lukanova, Annekatrin; Zeleniuch-Jacquotte, Anne

    2016-06-01

    Endometrial cancer risk is increased by estrogens unopposed by progesterone. In premenopausal women, androgen excess is often associated with progesterone insufficiency, suggesting that premenopausal androgen concentrations may be associated with risk. In a case-control study nested within three cohorts, we assessed the relationship between premenopausal androgens and risk of endometrial cancer (161 cases and 303 controls matched on age and date of blood donation). Testosterone, DHEAS, androstenedione, and SHBG were measured in serum or plasma. Free testosterone was calculated from testosterone and SHBG. We observed trends of increasing risk across tertiles of testosterone (ORT3-T1 = 1.59, 95 % CI = 0.96, 2.64, p = 0.08) and free testosterone (ORT3-T1 = 1.76, 95 % CI = 1.01, 3.07, p = 0.047), which were not statistically significant after adjustment for body mass index (BMI). There was no association for DHEAS, androstenedione, or SHBG. There were significant interactions by age at diagnosis (androgens are correlated, our observation of an association of premenopausal androgens with risk among women aged ≥55 years at diagnosis could be due to the effect on the endometrium of postmenopausal androgen-derived estrogens in the absence of progesterone, which is no longer secreted. PMID:26925952

  9. Epoetin alfa in platinum-treated ovarian cancer patients: results of a multinational, multicentre, randomised trial

    Science.gov (United States)

    Wilkinson, P M; Antonopoulos, M; Lahousen, M; Lind, M; Kosmidis, P

    2006-01-01

    This multicentre, open-label, controlled clinical trial assessed the effects of epoetin alfa treatment on haematologic and quality of life (QOL) parameters in 182 anaemic (Hb⩽12 g dl−1) ovarian cancer patients receiving platinum chemotherapy. Patients were randomised 2 : 1 to receive epoetin alfa 10 000–20 000 IU three times weekly plus best standard treatment (BST) or BST only. Main study end points were changes from baseline in haemoglobin (Hb) level, transfusion requirements, and QOL. For the epoetin alfa group, mean Hb increased by 1.8 g dl−1 by weeks 4–6 and was significantly increased from baseline through study end (P<0.001). The mean change in Hb from baseline was significantly (P<0.001) greater for epoetin alfa than BST patients at all postbaseline evaluations. Significantly fewer epoetin alfa than BST patients required transfusion(s) after the first 4 weeks of treatment (7.9 vs 30.5%; P<0.001). Also, significant (P⩽0.04) differences favouring the epoetin alfa group over the BST group were found for all three median CLAS scores (Energy Level, Ability to Do Daily Activities, Overall QOL) and the median average CLAS score during chemotherapy. These findings support use of epoetin alfa to increase Hb levels, reduce transfusion use, and improve QOL in anaemic ovarian cancer patients receiving platinum chemotherapy. PMID:16570051

  10. Results of therapy of cancer of the movable part of the tongue with clinically intact regional lymph nodes

    International Nuclear Information System (INIS)

    A study was made of the frequency of metastatic spreading to the regional neck lymph nodes and long-term results of therapy of patients with cancer of the movable part of the tongue with clinically intact regional lymph nodes of the neck. The 5-year survival rates were 79, 50, 49 and 67% and 61% for the whole group. The main cause of death in 40% of the patients was a primary tumor recurrences

  11. Brachytherapy versus prostatectomy in localized prostate cancer: Results of a French multicenter prospective medico-economic study

    International Nuclear Information System (INIS)

    Purpose: To prospectively compare health-related quality of life (HRQOL), patient-reported treatment-related symptoms, and costs of iodine-125 permanent implant interstitial brachytherapy (IB) with those of radical prostatectomy (RP) during the first 2 years after these treatments for localized prostate cancer. Methods and Materials: A total of 435 men with localized low-risk prostate cancer, from 11 French hospitals, treated with IB (308) or RP (127), were offered to complete the European Organization for Research and Treatment of Cancer core Quality of Life Questionnaire QLQ-C30 version 3 (EORTC QLQ-C30) and the prostate cancer specific EORTC QLQ-PR25 module before and at the end of treatment, 2, 6, 12, 18, and 24 months after treatment. Repeated measures analysis of variance and analysis of covariance were conducted on HRQOL changes. Comparative cost analysis covered initial treatment, hospital follow-up, outpatient and production loss costs. Results: Just after treatment, the decrease of global HRQOL was less pronounced in the IB than in the RP group, with a 13.5 points difference (p < 0.0001). A difference slightly in favor of RP was observed 6 months after treatment (-7.5 points, p = 0.0164) and was maintained at 24 months (-8.2 points, p = 0.0379). Impotence and urinary incontinence were more pronounced after RP, whereas urinary frequency, urgency, and urination pain were more frequent after IB. Mean societal costs did not differ between IB ( Euro 8,019 at T24) and RP ( Euro 8,715 at T24, p = 0.0843) regardless of the period. Conclusions: This study suggests a similar cost profile in France for IB and RP but with different HRQOL and side effect profiles. Those findings may be used to tailor localized prostate cancer treatments to suit individual patients' needs

  12. Assessment of rehabilitation needs in colorectal cancer treatment: Results from a mixed audit and qualitative study in Denmark.

    Science.gov (United States)

    Wiedenbein, Liza; Kristiansen, Maria; Adamsen, Lis; Hjort, Dorte; Hendriksen, Carsten

    2016-06-01

    Background Systematic assessments of cancer patients' rehabilitation needs are a prerequisite for devising appropriate survivorship programs. Little is known about the fit between needs assessment outlined in national rehabilitation policies and clinical practice. This study aimed to explore clinical practices related to identification and documentation of rehabilitation needs among patients with colorectal cancer at Danish hospitals. Material and methods A retrospective clinical audit was conducted utilizing data from patient files randomly selected at surgical and oncology hospital departments treating colorectal cancer patients. Forty patients were included, 10 from each department. Semi-structured interviews were carried out among clinical nurse specialists. Audit data was analyzed using descriptive statistics, qualitative data using thematic analysis. Results Documentation of physical, psychological and social rehabilitation needs initially and at end of treatment was evident in 10% (n = 2) of surgical patient trajectories and 35% (n = 7) of oncology trajectories. Physical rehabilitation needs were documented among 90% (n = 36) of all patients. Referral to municipal rehabilitation services was documented among 5% (n = 2) of all patients. Assessments at surgical departments were shaped by the inherent continuous assessment of rehabilitation needs within standardized fast-track colorectal cancer surgery. In contrast, the implementation of locally developed assessment tools inspired by the distress thermometer (DT) in oncology departments was challenged by a lack of competencies and funding, impeding integration of data into patient files. Conclusion Consensus must be reached on how to ensure more systematic, comprehensive assessments of rehabilitation needs throughout clinical cancer care. Fast-track surgery ensures systematic documentation of physical needs, but the lack of inclusion of data collected by the DT in oncological departments

  13. Treatment results for hypopharyngeal cancer by different treatment strategies and its secondary primary- an experience in Taiwan

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate treatment results in our hypopharyngeal cancer patients. A total of three hundred and ninety five hypopharyngeal cancer patients received radical treatment at our hospital; 96% were male. The majority were habitual smokers (88%), alcohol drinkers (73%) and/or betel quid chewers (51%). All patients received a CT scan or MRI for tumor staging before treatment. The stage distribution was stage I: 2 (0.5%); stage II: 22 (5.6%); stage III: 57 (14.4%) and stage IV: 314 (79.5%). Radical surgery was used first in 81 patients (20.5%), and the remaining patients (79.5%) received organ preservation-intended treatment (OPIT). In the OPIT group, 46 patients received radiotherapy alone, 156 patients received chemotherapy followed by radiotherapy (CT/RT) and 112 patients received concomitant chemo-radiotherapy (CCRT). The five-year overall survival rates for stages I/II, III and IV were 49.5%, 47.4% and 18.6%, respectively. There was no significant difference in overall and disease-specific survival rates between patients who received radical surgery first and those who received OPIT. In the OPIT group, CCRT tended to preserve the larynx better (p = 0.088), with three-year larynx preservation rates of 44.8% for CCRT and 27.2% for CT/RT. Thirty-seven patients developed a second malignancy, with an annual incidence of 4.6%. There was no survival difference between OPIT and radical surgery in hypopharyngeal cancer patients at our hospital. CCRT may offer better laryngeal preservation than RT alone or CT/RT. However, prospective studies are still needed to confirm this finding. Additionally, second primary cancers are another important issue for hypopharyngeal cancer management

  14. Response to an Abnormal Ovarian Cancer Screening Test Result: Test of the Social Cognitive Processing and Cognitive Social Health Information Processing Models

    OpenAIRE

    Andrykowski, Michael A.; Pavlik, Edward J.

    2010-01-01

    All cancer screening tests produce a proportion of abnormal results requiring follow-up. Consequently, the cancer screening setting is a natural laboratory for examining psychological and behavioral response to a threatening health-related event. This study tested hypotheses derived from the Social Cognitive Processing and Cognitive-Social Health Information Processing models in trying to understand response to an abnormal ovarian cancer (OC) screening test result. Women (n=278) receiving an ...

  15. Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis

    Directory of Open Access Journals (Sweden)

    Al Asiri M

    2016-05-01

    Full Text Available Mushabbab Al Asiri,1,* Mutahir A Tunio,1,* Reham Abdulmoniem,2,*1Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia; 2Radiation Oncology, National Cancer Institute, Cairo, Egypt *These authors contributed equally to this work Background: A meta-analysis was conducted to assess the impact of radiation-induced ovarian ablation (RT-OA on amenorrhea cessation rates, progression-free survival, and overall survival in pre/perimenopausal women with breast cancer. Materials and methods: The Medline, CANCERLIT, and Cochrane Library databases and search engines were searched to identify randomized controlled studies comparing RT-OA with control for early or metastatic breast cancer. Further, radiotherapy doses, techniques, and associated side effects were evaluated. Results: Six controlled trials with a total patient population of 3,317 were identified. Pooled results from these trials showed significant amenorrhea rates (P<0.00001 and increase in progression-free survival in patients treated with RT-OA (P<0.00001. However, there was no difference in overall survival (P=0.37. The majority of patients were treated with larger field sizes with parallel-opposed anteroposterior and posteroanterior pelvic fields. RT-OA was generally well tolerated. Radiotherapy doses of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions were associated with excellent amenorrhea rates. The resultant funnel plot showed no publication bias (Egger test P=0.16. Conclusion: RT-OA is cost-effective and can safely be used in pre/perimenopausal women with metastatic breast cancer, or if luteinizing hormone-releasing hormone analogs are contraindicated, or in patients in whom fertility preservation is not an issue. Radiation dose of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions showed more efficacies

  16. Survival Effect of Neoadjuvant Radiotherapy Before Esophagectomy for Patients With Esophageal Cancer: A Surveillance, Epidemiology, and End-Results Study

    International Nuclear Information System (INIS)

    Purpose: The role of neoadjuvant radiotherapy (NeoRT) before definitive surgery for esophageal cancer remains controversial. This study used a large population-based database to assess the effect of NeoRT on survival for patients treated with definitive surgery. Methods and Materials: The overall survival (OS) and cause-specific survival for patients with Stage T2-T4, any N, M0 (cT2-T4M0) esophageal cancer who had undergone definitive surgery between 1998 and 2004 were analyzed by querying the Surveillance, Epidemiology, and End-Results database. Kaplan-Meier survival curves were generated and univariate comparisons were made using the log-rank test. Cox proportional hazards survival regression multivariate analysis was performed with NeoRT, T stage (T2 vs. T3-T4), pathologic nodal status (pN0 vs. pN1), number of nodes dissected (>10 vs. ≤10), histologic type (adenocarcinoma vs. squamous cell carcinoma), age (10 nodes dissected, and Stage T2 disease were all independently correlated with increased OS. Conclusion: These results support the use of NeoRT for patients with esophageal cancer. Prospective studies are needed to confirm these results

  17. Targeting breast cancer stem cells by dendritic cell vaccination in humanized mice with breast tumor: preliminary results

    Science.gov (United States)

    Pham, Phuc Van; Le, Hanh Thi; Vu, Binh Thanh; Pham, Viet Quoc; Le, Phong Minh; Phan, Nhan Lu-Chinh; Trinh, Ngu Van; Nguyen, Huyen Thi-Lam; Nguyen, Sinh Truong; Nguyen, Toan Linh; Phan, Ngoc Kim

    2016-01-01

    Background Breast cancer (BC) is one of the leading cancers in women. Recent progress has enabled BC to be cured with high efficiency. However, late detection or metastatic disease often renders the disease untreatable. Additionally, relapse is the main cause of death in BC patients. Breast cancer stem cells (BCSCs) are considered to cause the development of BC and are thought to be responsible for metastasis and relapse. This study aimed to target BCSCs using dendritic cells (DCs) to treat tumor-bearing humanized mice models. Materials and methods NOD/SCID mice were used to produce the humanized mice by transplantation of human hematopoietic stem cells. Human BCSCs were injected into the mammary fat pad to produce BC humanized mice. Both hematopoietic stem cells and DCs were isolated from the human umbilical cord blood, and immature DCs were produced from cultured mononuclear cells. DCs were matured by BCSC-derived antigen incubation for 48 hours. Mature DCs were vaccinated to BC humanized mice with a dose of 106 cells/mice, and the survival percentage was monitored in both treated and untreated groups. Results The results showed that DC vaccination could target BCSCs and reduce the tumor size and prolong survival. Conclusion These results suggested that targeting BCSCs with DCs is a promising therapy for BC. PMID:27499638

  18. Intraoperative radiotherapy given as a boost for early breast cancer: Long-term clinical and cosmetic results

    International Nuclear Information System (INIS)

    Purpose: The standard radiotherapy (RT) of breast cancer consists of 50 Gy external beam RT (EBRT) to the whole breast followed by an electron boost of 10-16 Gy to the tumor bed, but this has several cosmetic disadvantages. Intraoperative radiotherapy (IORT) could be an alternative to overcome these. Methods and Materials: We evaluated 50 women with early breast cancer operated on in a dedicated IORT facility. Median dose of 10 Gy was delivered using 9-MeV electron beams. All patients received postoperative EBRT (50 Gy in 2 Gy fractions). Late toxicity and cosmetic results were assessed independently by two physicians according to the Common Terminology Criteria for Adverse Event v3.0 grading system and the European Organization for Research and Treatment of Cancer questionnaires. Results: After a median follow-up of 9.1 years (range, 5-15 years), two local recurrences were observed within the primary tumor bed. At the time of analysis, 45 patients are alive with (n = 1) or without disease. Among the 42 disease-free remaining patients, 6 experienced Grade 2 late subcutaneous fibrosis within the boost area. Overall, the scores indicated a very good quality of life and cosmesis was good to excellent in the evaluated patients. Conclusion: Our results confirm that IORT given as a boost after breast-conserving surgery is a reliable alternative to conventional postoperative fractionated boost radiation

  19. Review of Adjuvant Radiochemotherapy for Resected Pancreatic Cancer and Results From Mayo Clinic for the 5th JUCTS Symposium

    International Nuclear Information System (INIS)

    Purpose: To present an overview of Phase III trials in adjuvant therapy for pancreatic cancer and review outcomes at the Mayo Clinic after adjuvant radiochemotherapy (RT/CT) for resected pancreatic cancer. Methods and Materials: A literature review and a retrospective review of 472 patients who underwent an R0 resection for T1-3N0-1M0 invasive carcinoma of the pancreas from 1975 to 2005 at the Mayo Clinic, Rochester, MN. Patients with metastatic or unresectable disease at the time of surgery, positive surgical margins, or indolent tumors and those treated with intraoperative radiotherapy were excluded from the analysis. Median radiotherapy dose was 50.4Gy in 28 fractions, with 98% of patients receiving concurrent 5-fluorouracil- based chemotherapy. Results: Median follow-up was 2.7 years. Median overall survival (OS) was 1.8 years. Median OS after adjuvant RT/CT was 2.1 vs. 1.6 years for surgery alone (p = 0.001). The 2-y OS was 50% vs. 39%, and 5-y was 28% vs. 17% for patients receiving RT/CT vs. surgery alone. Univariate and multivariate analysis revealed that adverse prognostic factors were positive lymph nodes (risk ratio [RR] 1.3, p < 0.001) and high histologic grade (RR 1.2, p < 0.001). T3 tumor status was found significant on univariate analysis only (RR 1.1, p = 0.07). Conclusions: Results from recent clinical trials support the use of adjuvant chemotherapy in resected pancreatic cancer. The role of radiochemotherapy in adjuvant treatment of pancreatic cancer remains a topic of debate. Results from the Mayo Clinic suggest improved outcomes after the administration of adjuvant radiochemotherapy after a complete resection of invasive pancreatic malignancies.

  20. Toxicity and cosmetic result of partial breast high-dose-rate interstitial brachytherapy for conservatively operated early breast cancer

    International Nuclear Information System (INIS)

    Objective: Objective To study the method, side effects and cosmetic outcome of high- dose-rate (HDR) accelerated partial breast interstitial irradiation (APBI) alone in early stage breast cancer' after conservative surgery. Methods: From February 2002 to June 2003,47 breast cancer lesions from 46 patients suffering from stage I/II breast cancer were treated with HDR 192Ir APBI after conservative surgery. All patients were over 40 year-old, with T1-2N0-1 (≤3 lymph nodes positive), surgical margin > 1-2 mm, but those having lobular or inflammatory breast cancer were excluded. HDR brachytherapy with 34 Gy, 10 fractions/5 days was used after surgery, toxic reaction and cosmetic outcome were observed in one month, 6 and 12 months respectively. Results: Follow up of 1846 months, 34 months was carried out for the whole group. During the treatment, acute reactions including: erythema, edema, tenderness and infection, all under I-II grade, none of III-IV grade were observed in 21 patients(46%); late toxicity reactions: skin fibrosis, breast tenderness, fat necrosis, and telangiectasia, totally 20 patients (43%) were observed: 2 patients in III grade but one patient received 6 cycle chemotherapy. The result of cosmetic outcome evaluation was excellent or good, at 6 months 95% and 12 months 98%, respectively, but there was no recurfence. Conclusions: Excellent and favorable cosmetic results are noted after APBI by interstitial alone. Acute and late reactions are few. Long term observation is necessary for the rate of' local control. (authors)

  1. Thyroid exposure in Belorussian and Ukrainian children after the Chernobyl accident and resulting risk of thyroid cancer. Final report

    International Nuclear Information System (INIS)

    Main objectives of the BfS Project StSch4240 Thyroid Exposure of Belarusian and Ukrainian Children due to the Chernobyl Accident and Resulting Thyroid Cancer Risk were: - to establish improved estimates of average thyroid dose for both genders and for each birth-year cohort of the period 1968-1985 in Ukrainian and Belarusian settlements, in which more than 10 measurements of the 131I activity in the human thyroid have been performed in May/June 1986 - to explore, whether this dosimetric database can be extended to neighboring settlements - to establish improved estimates of average thyroid dose for both genders and for each birth-year cohort of the period 1968-1985 in Ukrainian and Belarusian oblasts (regions) and larger cities - to document the thyroid cancer incidence for the period 1986-2001 in Ukraine and Belarus and describe morphological characteristics of the cancer cases - to assess the contribution of the baseline incidence to the total thyroid cancer incidence in the two countries and identify regional and temporal dependencies - to perform analyses of excess risks in settlements with more than 10 measurements of the 131I activity in the human thyroid. The project has been accompanied by the BFS project StSch 4299 Range of applicability of epidemiological studies with aggregate data for risk factor determination. The purpose of that project is to explore by simulation calculations to which degree there is an ecologic bias in the risk studies performed in the frame of the present project. The results of project StSch 4299 indicate that the ecologic bias of excess absolute risk estimates is small because: - radiation is the dominating cause of thyroid cancer among those who were children or adolescents in the highly contaminated areas at the time of the accident - there is no indication that the dose-response for thyroid cancer after exposures during childhood is non-linear in the dose range of 0.05-1.0 Gy - the variability of average doses in the age

  2. Recent results in the treatment of early and late testicular cancer

    Energy Technology Data Exchange (ETDEWEB)

    Seeber, S.; Schuette, J.; Niederle, N.; Schmidt, C.G.

    1983-04-01

    This report summarizes our long-term experience with sequential combination chemotherapy in early and late testicular cancer and presents data from a total of 390 patients treated at the West German Tumor Center Essen between 1973 and 1981. In stage II A (positive retroperitoneal nodes, radically resected) the projected 5-year survival rate is 97%, in stage II B (residual disease after lymphadenectomy), and in stage II C (massive abdominal involvement) the long-term survival was 70% and 30%, respectively. In disseminated disease survival was closely related to the initial tumour burden (> 80% after 5 years for minimal pulmonal disease and < 30% in patients with pulmonal plus massive retroperitoneal involvement). Adriamycin/cisplatinum and belban/bleomycin were equally effective in the total analysis; however, the first combination appeared to be superior in choriocarcinoma, the latter in embryonal carcinoma. An analysis of primary therapeutic failures revealed a low incidence of cross-resistance for the two sequential combinations.

  3. Predictive Modelling of Toxicity Resulting from Radiotherapy Treatments of Head and Neck Cancer

    CERN Document Server

    Dean, Jamie A; Harrington, Kevin J; Nutting, Christopher M; Gulliford, Sarah L

    2014-01-01

    In radiotherapy for head and neck cancer, the radiation dose delivered to the pharyngeal mucosa (mucosal lining of the throat) is thought to be a major contributing factor to dysphagia (swallowing dysfunction), the most commonly reported severe toxicity. There is a variation in the severity of dysphagia experienced by patients. Understanding the role of the dose distribution in dysphagia would allow improvements in the radiotherapy technique to be explored. The 3D dose distributions delivered to the pharyngeal mucosa of 249 patients treated as part of clinical trials were reconstructed. Pydicom was used to extract DICOM (digital imaging and communications in medicine) data (the standard file formats for medical imaging and radiotherapy data). NumPy and SciPy were used to manipulate the data to generate 3D maps of the dose distribution delivered to the pharyngeal mucosa and calculate metrics describing the dose distribution. Multivariate predictive modelling of severe dysphagia, including descriptions of the d...

  4. Tumor induction following intraoperative radiotherapy: Late results of the National Cancer Institute canine trials

    Energy Technology Data Exchange (ETDEWEB)

    Barnes, M.; Duray, P.; DeLuca, A.; Anderson, W.; Sindelar, W.; Kinsella, T. (Fox Chase Cancer Center, Philadelphia, PA (USA))

    1990-09-01

    Intraoperative radiotherapy has been employed in human cancer research for over a decade. Since 1979, trials to assess the acute and late toxicity of IORT have been carried out at the National Cancer Institute in an adult dog model in an attempt to establish dose tolerance guidelines for a variety of organs. Of the 170 animals entered on 12 studies with a minimum follow-up of 2 years, 148 dogs received IORT; 22 control animals received only surgery. Animals were sacrificed at designated intervals following IORT, usually at 1, 6, 12, 24, and 60 month intervals. 102 of 148 irradiated dogs were sacrificed less than 24 months; 46 dogs were followed greater than or equal to 24 months after IORT. To date, 34 of the 46 animals have been sacrificed; the 12 remaining animals are to be followed to 5 years. These 12 animals have minimum follow-up of 30 months. In the irradiated group followed for greater than or equal to 24 months, 10 tumors have arisen in 9 animals. One animal developed an incidental spontaneous breast carcinoma outside the IORT port, discovered only at scheduled post-mortem exam. The remaining nine tumors arose within IORT ports. Two tumors were benign neural tumors--a neuroma and a neurofibroma. One animal had a collision tumor comprised of grade I chondrosarcoma adjacent to grade III osteosarcoma arising in lumbar vertebrae. Two other grade III osteosarcomas, one grade III fibrosarcoma, and one grade III malignant fibrous histiocytoma arose in retroperitoneal/paravertebral sites. An embryonal rhabdomyosarcoma (sarcoma botryoides) arose within the irradiated urinary bladder of one animal. No sham irradiated controls nor IORT animals sacrificed less than 24 months have developed any spontaneous or radiation-induced tumors. The time range of diagnoses of tumors was 24-58 months. The IORT dose range associated with tumor development was 20-35 Gy.

  5. Cadmium exposure and incidence of diabetes mellitus--results from the Malmo Diet and Cancer study.

    Directory of Open Access Journals (Sweden)

    Yan Borné

    Full Text Available Cadmium is a pollutant with multiple adverse health effects: renal dysfunction, osteoporosis and fractures, cancer, and probably cardiovascular disease. Some studies have reported associations between cadmium and impaired fasting glucose and diabetes. However, this relationship is controversial and there is a lack of longitudinal studies.To examine prospectively whether cadmium in blood is associated with incidence of diabetes mellitus.The study population consists of 4585 subjects without history of diabetes (aged 46 to 67 years, 60% women, who participated in the Malmö Diet and Cancer study during 1991-1994. Blood cadmium levels were estimated from hematocrit and cadmium concentrations in erythrocytes. Incident cases of diabetes were identified from national and local diabetes registers.Cadmium concentrations in blood were not associated with blood glucose and insulin levels at the baseline examination. However, cadmium was positively associated with HbA1c in former smokers and current smokers. During a mean follow-up of 15.2 ± 4.2 years, 622 (299 men and 323 women were diagnosed with new-onset of diabetes. The incidence of diabetes was not significantly associated with blood cadmium level at baseline, neither in men or women. The hazard ratio (4th vs 1st quartile was 1.11 (95% confidence interval 0.82-1.49, when adjusted for potential confounders.Elevated blood cadmium levels are not associated with increased incidence of diabetes. The positive association between HbA1c and blood cadmium levels has a likely explanation in mechanisms related to erythrocyte turnover and smoking.

  6. Promising results with image guided intensity modulated radiotherapy for muscle invasive bladder cancer

    International Nuclear Information System (INIS)

    To describe the feasibility of image guided intensity modulated radiotherapy (IG-IMRT) using daily soft tissue matching in the treatment of bladder cancer. Twenty-eight patients with muscle-invasive carcinoma of the bladder were recruited to a protocol of definitive radiation using IMRT with accelerated hypofractionation with simultaneous integrated boost (SIB). Isotropic margins of .5 and 1 cm were used to generate the high risk and intermediate risk planning target volumes respectively. Cone beam CT (CBCT) was acquired daily and a soft tissue match was performed. Cystoscopy was scheduled 6 weeks post treatment. The median age was 83 years (range 58-92). Twenty patients had stage II or III disease, and eight were stage IV. Gross disease received 66 Gy in 30 fractions in 11 patients (ten with concurrent chemotherapy) or 55 Gy in 20 fractions for those of poorer performance status or with palliative intent. All patients completed radiation treatment as planned. Three patients ceased chemotherapy early due to toxicity. Six patients (21 %) had acute Grade ≥ 2 genitourinary (GU) toxicity and six (21 %) had acute Grade ≥ 2 gastrointestinal (GI) toxicity. Five patients (18 %) developed Grade ≥2 late GU toxicity and no ≥2 late GI toxicity was observed. Nineteen patients underwent cystoscopy following radiation, with complete response (CR) in 16 cases (86 %), including all patients treated with chemoradiotherapy. Eight patients relapsed, four of which were local relapses. Of the patients with local recurrence, one underwent salvage cystectomy. For patients treated with definitive intent, freedom from locoregional recurrence (FFLR) and overall survival (OS) was 90 %/100 % for chemoradiotherapy versus 86 %/69 % for radiotherapy alone. IG- IMRT using daily soft tissue matching is a feasible in the treatment of bladder cancer, enabling the delivery of accelerated synchronous integrated boost with good early local control outcomes and low toxicity

  7. Stereotactic radiotherapy for stage I lung cancer: current results and new developments

    International Nuclear Information System (INIS)

    In early stage non-small cell lung cancer (N.S.C.L.C.), recent data from both prospective clinical trials and single institutions indicate that local control rates in excess of 88% can be achieved using stereotactic radiotherapy (S.R.T.). Treatment-related toxicity is uncommon when 'risk-adapted' fractionation schemes are applied, with lower dose per fraction used for larger tumors and when the planning target volume is in the proximity of critical structures. Both the superior outcome and convenience of fewer visits have led to a preference for S.R.T. over conventional radiotherapy in countries such as Japan and the Netherlands. Reports on outcomes of S.R.T. in patients unfit to undergo surgery may underestimate late toxicity as such patients have significant non-cancer related mortality. The evolution of technology has allowed for further improvements in the accuracy and speed of S.R.T. delivery. Recent advances such as on-board imaging and intensity-modulated arc delivery techniques have improved treatment accuracy and tolerability, as well as the confidence of clinicians in applying S.R.T. outside the setting of specialized tertiary institutions. Studies comparing primary surgery with S.R.T. are underway, but the available data are compelling enough to allow S.R.T. to be considered an established treatment option in patients who are aged 75 years and older, and in whom the estimated risks of postoperative mortality rates are high. The clinical development of S.R.T. will be greatly facilitated by improvements in diagnostic procedures for peripheral pulmonary nodules. However, treatment without pathological confirmation may be justified in medically inoperable patients if the risk of malignancy is sufficiently high as to warrant an invasive diagnostic procedure. (authors)

  8. Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis

    Science.gov (United States)

    Asiri, Mushabbab Al; Tunio, Mutahir A; Abdulmoniem, Reham

    2016-01-01

    Background A meta-analysis was conducted to assess the impact of radiation-induced ovarian ablation (RT-OA) on amenorrhea cessation rates, progression-free survival, and overall survival in pre/perimenopausal women with breast cancer. Materials and methods The Medline, CANCERLIT, and Cochrane Library databases and search engines were searched to identify randomized controlled studies comparing RT-OA with control for early or metastatic breast cancer. Further, radiotherapy doses, techniques, and associated side effects were evaluated. Results Six controlled trials with a total patient population of 3,317 were identified. Pooled results from these trials showed significant amenorrhea rates (Pwomen with metastatic breast cancer, or if luteinizing hormone-releasing hormone analogs are contraindicated, or in patients in whom fertility preservation is not an issue. Radiation dose of 1,500 cGy in five fractions, 1,500 cGy in four fractions, 1,600 cGy in four fractions, and 2,000 cGy in ten fractions showed more efficacies. However, further studies incorporating three-dimensional conformal radiotherapy and intensity-modulated radiotherapy are warranted. PMID:27307764

  9. Utilization of breast cancer screening methods in a developing nation: results from a nationally representative sample of Malaysian households.

    Science.gov (United States)

    Dunn, Richard A; Tan, Andrew K G

    2011-01-01

    As is the case in many developing nations, previous studies of breast cancer screening behavior in Malaysia have used relatively small samples that are not nationally representative, thereby limiting the generalizability of results. Therefore, this study uses nationally representative data from the Malaysia Non-Communicable Disease Surveillance-1 to investigate the role of socio-economic status on breast cancer screening behavior in Malaysia, particularly differences in screening behaviour between ethnic groups. The decisions of 816 women above age 40 in Malaysia to screen for breast cancer using mammography, clinical breast exams (CBE), and breast self-exams (BSE) are modeled using logistic regression. Results indicate that after adjusting for differences in age, education, household income, marital status, and residential location, Malay women are less likely than Chinese and Indian women to utilize mammography, but more likely to perform BSE. Education level and urban residence are positively associated with utilization of each method, but these relationships vary across ethnicity. Higher education levels are strongly related to using each screening method among Chinese women, but have no statistically significant relationship to screening among Malays. PMID:21615819

  10. Low-dose-rate brachytherapy for patients with transurethral resection before implantation in prostate cancer: long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Prada, Pedro J.; Anchuelo, Javier; Blanco, Ana Garcia; Paya, Gema; Cardenal, Juan; Acuña, Enrique; Ferri, Maria [Department of Radiation Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria (Spain); Vazquez, Andres; Pacheco, Maite; Sanchez, Jesica [Department of Radiation Physics, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria (Spain)

    2016-01-15

    Objectives: We analyzed the long-term oncologic outcome for patients with prostate cancer and transurethral resection who were treated using low-dose-rate (LDR) prostate brachytherapy. Methods and Materials: From January 2001 to December 2005, 57 consecutive patients were treated with clinically localized prostate cancer. No patients received external beam radiation. All of them underwent LDR prostate brachytherapy. Biochemical failure was defined according to the 'Phoenix consensus'. Patients were stratified as low and intermediate risk based on The Memorial Sloan Kettering group definition. Results: The median follow-up time for these 57 patients was 104 months. The overall survival according to Kaplan-Meier estimates was 88% (±6%) at 5 years and 77% (±6%) at 12 years. The 5 and 10 years for failure in tumour-free survival (TFS) was 96% and respectively (±2%), whereas for biochemical control was 94% and respectively (±3%) at 5 and 10 years, 98% (±1%) of patients being free of local recurrence. A patient reported incontinence after treatment (1.7%). The chronic genitourinary complains grade I were 7% and grade II, 10%. At six months 94% of patients reported no change in bowel function. Conclusions: The excellent long-term results and low morbidity presented, as well as the many advantages of prostate brachytherapy over other treatments, demonstrates that brachytherapy is an effective treatment for patients with transurethral resection and clinical organ-confined prostate cancer. (author)

  11. Treatment results of Intensity Modulated Radiation Therapy and Image Guided Radiation Therapy for head and neck cancers

    International Nuclear Information System (INIS)

    Purpose is to evaluate treatment results of Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT) for head and neck cancers. Methods and Materials: descriptive cross sectional study on 45 head and neck cancer patients treated by IMRT-IGRT with curative intent at Department of Radiation Oncology, 108 Central Military Hospital from 12/2013 to 3/2015. Results: 100% IMRT plan underwent quality assurance with gamma index ≥ 95%. Mean conformity index of IMRT plans was 1.21 ± 0.13. Patient setup errors in supero-inferior (SI), antero-posterior (AP) and medio-lateral (ML) were ≤ 3 mm. Overall treatment complete response, partial response and stable disease rates were 75.6% and 15.6 % and 8.8%, respectively. There were 42.2 % patients with no xerostomia; 57.8% grade 1 and no grade 2 - 4 xerostomia. Conclusions: Head and neck cancers treatment with IMRT-IGRT showed good tumor response with safety, high accuracy and acceptable side effects. (author)

  12. [Electrochemotherapy: mechanism of action and clinical results in the locoregional treatment of patients with skin cancers and superficial metastases].

    Science.gov (United States)

    Campana, Luca Giovanni; Marconato, Roberto; Sieni, Elisabetta; Valpione, Sara; Corti, Luigi; Mocellin, Simone; Rossi, Carlo Riccardo

    2016-08-01

    Electrochemotherapy (ECT) has emerged among European centers as an innovative locoregional treatment for patients with unresectable skin cancers or superficial metastases from any histotype. The combined administration of a cytotoxic agent (bleomycin or cisplatin) with properly tuned electric pulses results in locally-enhanced drug delivery (reversible electroporation) into malignant cells and sustained tumor response. Reversible electroporation represents the basis of ECT and allows the potentiation of two low permeant cytotoxic agents such as bleomycin (~8000 fold) and cisplatin (~80 fold). The procedure was standardized in 2006 - thanks to a European project - and shortly after introduced in the clinical practice. In recent years, experience with ECT has accumulated mainly in melanoma and breast cancer patients with cutaneous metastases, in whom complete response rates of 20-50% and 40-75% have been reported, respectively, depending on tumor size. Currently, this therapy is being investigated in deep-seated (i.e. bone, soft tissue) metastases and visceral malignancies (i.e. locally advanced pancreatic cancer), with encouraging results. PMID:27571558

  13. Concurrent cisplatin and radiotherapy for inoperable bladder cancer: long term results and prognostic predictors of local control and survival

    International Nuclear Information System (INIS)

    Therapeutic strategies for muscle invasive bladder cancer are currently evolving. A recent European randomized study has shown that neo-adjuvant chemotherapy does not improve the chance of cure or of conservative treatment. Concurrent chemotherapy and radiotherapy would provide better results but these is a need to identify by prognostic factors patients who may benefit from such a conservative strategy. Concurrent cisplatin and radiation therapy is a potentially locally curative treatment for 43 % of patients with muscle-invasive bladder cancer not candidates for radical surgery. Clinical T-stage and hydronephrosis have a significant and independent prognostic value on local control but appears not discriminant enough to select patients for conservative treatment. (authors)

  14. Results of the 03-05 patterns of care study nationwide survey for small-cell lung cancer

    International Nuclear Information System (INIS)

    The Japanese Patterns of Care Study (PCS) conducted a third nationwide survey of care process for patients with limited-disease small cell lung cancer (PCS 03-05). The PCS investigated changes in the care process including continuous technical evolution in radiotherapy as compared with preceding surveys (PCS 95-97, PCS 99-01) and assessed their influence on early outcome. PCS 99-01 showed that evidence based practice pattern had well penetrated into clinical practice. PCS 03-05 demonstrated several changes in patterns of radiotherapy. Decrease in the use of twice-daily radiotherapy did not influence early outcome. Results support the general consideration that technical evolution in radiotherapy has essential role in the era of intensive chemoradiation for small cell lung cancer. (author)

  15. Improvement in treatment results for hypopharyngeal cancer through the advance of treatment methods. The usefulness of team practice

    International Nuclear Information System (INIS)

    Treatment results were analyzed in 392 hypopharyngeal cancer patients who were radically treated at Kurume University Hospital between 1960 and 2003. In the analysis, they were divided into three chronological groups: the first consisting of 37 patients treated between 1960 and 1970, the second of 122 patients treated between 1971 and 1988, and the third of 233 patients treated between 1989 and 2003. The cause-specific 5-year survival rate for the second group was 38%. In contrast, the survival rate for the third group rose to 67%. The first choice of treatment for early hypopharyngeal cancer in the first and second groups was partial pharyngectomy. However, that of the third group was CO2 laser resection or radiotherapy followed by laser resection. The cause-specific 5-year survival rate with laser surgery was 86%. Over the years, the method of reconstruction after total resection for advanced hypopharyngeal cancer has changed. At present free jejunum reconstructive surgery after total pharyngo-laryngo-esophagectomy is considered to be a safe and most stable method, because it enables resection of the primary lesion with sufficient margin as required. Failure of reconstruction by jejunum graft was detected in only three of 137 patients (2%) who received total pharyngo-laryngo-esophagectomy. In patients who received free jejunum reconstructive surgery, the rate of cause of death tied to primary or metastatic lymph node decreased by resecting the primary lesion with sufficient margin as required, bilateral neck dissection, bilateral Rouviere and paratracheal neck dissection, and post-operative radiation. The findings indicate that treatment results for hypopharyngeal cancer improved dramatically by team practice involving a head and neck surgeon, surgeon, plastic surgeon and radiation oncologist. (author)

  16. Inhibition of the mammalian target of rapamycin (mTOR in advanced pancreatic cancer: results of two phase II studies

    Directory of Open Access Journals (Sweden)

    Zhang Yujian

    2010-07-01

    Full Text Available Abstract Background The phosphoinositide 3-kinase (PI3K/Akt pathway is constitutively activated in pancreatic cancer and the mammalian target of rapamycin (mTOR kinase is an important mediator for its signaling. Our recent in vitro studies suggest that prolonged exposure of pancreatic cancer cells to mTOR inhibitors can promote insulin receptor substrate-PI3K interactions and paradoxically increase Akt phosphorylation and cyclin D1 expression in pancreatic cancer cells (negative feedback loop. The addition of erlotinib to rapamycin can down-regulate rapamycin-stimulated Akt and results in synergistic antitumor activity with erlotinib in preclinical tumor models. Methods Two studies prospectively enrolled adult patients with advanced pancreatic cancer, Eastern Cooperative Oncology Group performance status 0-1, adequate hematologic, hepatic and renal parameters and measurable disease. In Study A, temsirolimus was administered intravenously at 25 mg weekly. In Study B, everolimus was administered orally at 30 mg weekly and erlotinib was administered at 150 mg daily. The primary endpoint in both studies was overall survival at 6 months. Secondary endpoints included time to progression, progression-free survival, overall survival, response rate, safety and toxicity. Pretreatment tumor biopsies were analyzed by immunofluorescence and laser scanning cytometry for the expression of pmTOR/mTOR, pAkt/Akt, pErk/Erk, pS6, p4EBP-1 and PTEN. Results Five patients enrolled in Study A; Two patients died within a month (rapid disease progression and hemorrhagic stroke, respectively. One patient developed dehydration and another developed asthenia. Sixteen patients enrolled in Study B.: 12 males, all ECOG PS = 1. Median cycles = 1 (range 1-2. Grade 4 toxicity: hyponatremia (n = 1, Grade 3: diarrhea (n = 1, cholangitis (n = 3, hyperglycemia (n = 1, fatigue (n = 1. Grade 2: pneumonia (n = 2, dehydration (n = 2, nausea (n = 2, neutropenia (n = 1, mucositis (n = 2

  17. Preliminary results of the study about predictors of rectal side effects in radical radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Objective: To analyze quantitatively and qualitatively the rectal side effect of radical radiotherapy applied to prostate cancer in patients treated at the National Cancer Institute (INCA) with three-dimensional external radiotherapy which the purposes is to determine predictions of this. Materials and Methods: From July 2008 to July 2010 98 patients were recruited, 63 of whom were followed up for 6 months. The gastrointestinal secondary effects occurred in different times of monitoring patients with RTOG / EORTC classifications (Radiation Therapy Oncology Group / European Organization for Research and Treatment of Cancer) and SOMA / LENT, is also used a questionnaire specifically constructed and validated by the cooperative Italian group . The results were correlated with clinical parameters (PSA, Gleason score, clinical T, risk class, hypertension and diabetes) and dosimetry (treatment volume, rectal volume, Total Dose, Dose Maximum rectum, mean dose to the rectum) to assess the correlation between them and the appearance of gastrointestinal secondary effects. Results: 27% and 28% patients experienced grade 1 and 2 RTOG rectal secondary effect at 1 and 3 months and 6 months the SOMA / LENT classification determined by 25%. Qualitatively altered intestinal transit is the most affected in these patients, it is having also found some relationship between the probability of occurrence of abnormal intestinal transit, and the tracking time passed. Conclusions: The rectal secondary effects is one of the major side effects both acute an chronic of the prostate radiotherapy, identify the determinants effects of the INCA patient population implies a substantial improvement in the quality of prostate cancer patients. Patients treated with radical radiotherapy for prostate cancer often have long survivals and consequently may suffer chronic effects of radiation therapy. We have verified the existence of secondary effects in the intestine but the results are very preliminary

  18. The effect of lung cancer patients' weight, blood glucose concentration and lesion size of lung cancer on 18F-FDG PET/CT lesions SUV results

    International Nuclear Information System (INIS)

    Objective: To study the effects of lung cancer patients' weight,blood glucose concentration and lesion size of lung cancer on 18F-FDG PET/CT lesions SUV results. Methods: Fifty cases of lung cancer patients without a history of diabetes mellitus were enrolled in this study. Among them, 21 patients with mediastinal metastases were detected. According to clinical routine 18F-FDG PET/CT scanning,automatic extraction of lung cancer SUV, weight and size correction SUV were obtained using the GE Advantage Workstation image processing workstation. Liver reference background SUV was obtained using semiautomatic extraction method of extraction. Lung cancer primary tumors and metastatic lesions diagnosis reference standards were accordant with the liver reference background SUV or SUV shape correction ×1.5+2 × standard deviation. Results: Fifty cases of lung cancer in patients with blood sugar concentration and liver reference background SUV had positive correlation with lung cancer, SUV of primary lung cancer was negatively correlated with blood sugar, but it showed a positive correlation between blood sugar and lung metastases. According to the reference criteria for the diagnosis of 50 primary lung cancer cases and 21 metastatic lung cancer cases before and after the clinical diagnosis, the glucose concentration,lesion size correction accuracies were 90.00%, 71.43% and 100%, 95.24% respectively. Conclusions: Patients' body weight,blood glucose concentration and lesion size significantly affect the accuracy of clinical diagnosis of lung cancer. After correction accuracy, it remarkably improved the clinical diagnosis of lung cancer. The results suggest that when using 18F-FDG PET/CT for lung cancer diagnosis, the effects of body weight, blood glucose concentration and lesion size should be concerned. (authors)

  19. Residual deficits in quality of life one year after intensity-modulated radiotherapy for patients with locally advanced head and neck cancer. Results of a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Tribius, Silke; Raguse, Marieclaire; Voigt, Christian; Petersen, Cordula; Kruell, Andreas [University Medical Center Hamburg-Eppendorf, Department of Radiation Oncology, Hamburg (Germany); Muenscher, Adrian [University Medical Center Hamburg-Eppendorf, Department of Otorhinolaryngology and Head and Neck Surgery, Hamburg (Germany); Groebe, Alexander [University Medical Center Hamburg-Eppendorf, Department of Maxillofacial Surgery, Hamburg (Germany); Bergelt, Corinna [University Medical Center Hamburg-Eppendorf, Department of Medical Psychology, Hamburg (Germany); Singer, Susanne [University Medical Center Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Mainz (Germany)

    2015-03-08

    Patients with locally advanced head and neck cancer (LAHNC) undergo life-changing treatments that can seriously affect quality of life (QoL). This prospective study examined the key QoL domains during the first year after intensity-modulated radiotherapy (IMRT) and identified predictors of these changes in order to improve patient outcomes. A consecutive series of patients with LAHNC completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core module (QLQ-C30) and the HNC-specific QLQ-HN35 before (t0) and at the end (t1) of definitive or adjuvant IMRT, then at 6-8 weeks (t2), 6 months (t3), and 1 year (t4) after IMRT. Patients (n = 111) completing questionnaires at all five time points were included (baseline response rate: 99 %; dropout rate between t0 and t4: 5 %). QoL deteriorated in all domains during IMRT and improved slowly during the first year thereafter. Many domains recovered to baseline values after 1 year but problems with smelling and tasting, dry mouth, and sticky saliva remained issues at this time. Increases in problems with sticky saliva were greater after 1 year in patients with definitive versus adjuvant IMRT (F = 3.5, P = 0.05). QoL in patients with LAHNC receiving IMRT takes approximately 1 year to return to baseline; some domains remain compromised after 1 year. Although IMRT aims to maintain function and QoL, patients experience long-term dry mouth and sticky saliva, particularly following definitive IMRT. Patients should be counseled at the start of therapy to reduce disappointment with the pace of recovery. (orig.) [German] Die Therapie von Patienten mit lokal fortgeschrittenen Kopf-Hals-Tumoren (LFKHT) geht mit einschneidenden Veraenderungen einher und beeinflusst die Lebensqualitaet (LQ) erheblich. Diese prospektive Studie untersucht die LQ waehrend des ersten Jahres nach intensitaetsmodulierter Strahlentherapie (IMRT) und hat Praediktoren dieser Veraenderungen herausgearbeitet, um

  20. Usefulness and reliability of available epidemiological study results in assessments of radiation-related risks of cancer. Pt. 4

    International Nuclear Information System (INIS)

    Carcinomas occurring in the thyroid gland as a result of radiation generally affect the papillary and, to a slightly lesser extent, follicular parts of this organ, while the available body of evidence hardly gives any indications of anaplastic and medullary neoplasms. Radiation has, however, mostly been associated with multicentric tumours. Among the survivors of the nuclear assaults on Hiroshima and Nagasaki, there are no known cases of anaplastic carcinomas of the thyroid. The papillary carcinoma, which is the prevailing type of neoplasm after radiation exposure, has less malignant potential than the follicular one and is encountered in all age groups. Malignant carcinomas of the thyroid are predominantly found in the middle and high age groups. It was calculated that high Gy doses and dose efficiencies are associated in children with a risk coefficient of 2.5 in 104 person-years. This rate is only half as high for adults. Studies performed on relevant cohorts point to latency periods of at least five years. Individuals exposed to radiation are believed to be at a forty-year or even life-long risk of developing cancer. The cancer risk can best be described on the basis of a linear dose-effect relationship. The mortality rate calculated for cancer of the thyroid amounts to approx. 10% of the morbidity rate. The carcinogenic potential of iodine-131 in the thyroid is only one-third as great as that associated with external radiation of high dose efficiency. (orig./MG)

  1. Estimating the risks of cancer mortality and genetic defects resulting from exposures to low levels of ionizing radiation

    International Nuclear Information System (INIS)

    Estimators for calculating the risk of cancer and genetic disorders induced by exposure to ionizing radiation have been recommended by the US National Academy of Sciences Committee on the Biological Effects of Ionizing Radiations, the UN Scientific Committee on the Effects of Atomic Radiation, and the International Committee on Radiological Protection. These groups have also considered the risks of somatic effects other than cancer. The US National Council on Radiation Protection and Measurements has discussed risk estimate procedures for radiation-induced health effects. The recommendations of these national and international advisory committees are summarized and compared in this report. Based on this review, two procedures for risk estimation are presented for use in radiological assessments performed by the US Department of Energy under the National Environmental Policy Act of 1969 (NEPA). In the first procedure, age- and sex-averaged risk estimators calculated with US average demographic statistics would be used with estimates of radiation dose to calculate the projected risk of cancer and genetic disorders that would result from the operation being reviewed under NEPA. If more site-specific risk estimators are needed, and the demographic information is available, a second procedure is described that would involve direct calculation of the risk estimators using recommended risk-rate factors. The computer program REPCAL has been written to perform this calculation and is described in this report. 25 references, 16 tables

  2. Estimating the risks of cancer mortality and genetic defects resulting from exposures to low levels of ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Buhl, T.E.; Hansen, W.R.

    1984-05-01

    Estimators for calculating the risk of cancer and genetic disorders induced by exposure to ionizing radiation have been recommended by the US National Academy of Sciences Committee on the Biological Effects of Ionizing Radiations, the UN Scientific Committee on the Effects of Atomic Radiation, and the International Committee on Radiological Protection. These groups have also considered the risks of somatic effects other than cancer. The US National Council on Radiation Protection and Measurements has discussed risk estimate procedures for radiation-induced health effects. The recommendations of these national and international advisory committees are summarized and compared in this report. Based on this review, two procedures for risk estimation are presented for use in radiological assessments performed by the US Department of Energy under the National Environmental Policy Act of 1969 (NEPA). In the first procedure, age- and sex-averaged risk estimators calculated with US average demographic statistics would be used with estimates of radiation dose to calculate the projected risk of cancer and genetic disorders that would result from the operation being reviewed under NEPA. If more site-specific risk estimators are needed, and the demographic information is available, a second procedure is described that would involve direct calculation of the risk estimators using recommended risk-rate factors. The computer program REPCAL has been written to perform this calculation and is described in this report. 25 references, 16 tables.

  3. Quality of life in colon cancer patients with skin side effects: preliminary results from a monocentric cross sectional study

    Directory of Open Access Journals (Sweden)

    Meriggi Fausto

    2010-04-01

    Full Text Available Abstract Background Epidermal growth factor receptor inhibitors are widely prescribed anticancer drugs. Patients treated commonly develop dermatologic adverse drugs reactions, but rarely they are involved in systematic evaluation of their quality of life. This monocentric cross sectional study is carried out to assess quality of life in colon cancer patients experienced skin side effects due to anti epidermal growth factor receptor inhibitors therapy. Methods Consecutive patients with skin side effects to therapy treated at Fondazione Poliambulanza were enrolled in this study. Quality of life was evaluated with the Italian validated version of Skindex-29 questionnaire, exploring three dimensions: symptoms, emotional, and physical functioning. Skindex-29 was administered one time between the eighth and the twelfth week of the treatment. Results Forty-five consecutive patients, mainly with metastatic colon cancer (29 female, 16 male, with an average age of 59.31 years (ranging from 34-78 were included in the study and analyzed. Patients showed a great impact of skin side effects on symptoms (mean 43, followed by emotional (mean 30, and functioning (mean 26 scales. In general women, the 55-65 age class, and patients with partial remission reported the worst quality of life. Conclusions Epidermal growth factor receptor inhibitors' skin side effects have an important impact on quality of life in advanced colon cancer patients; symptoms scale is the most effect respect to emotional and functioning scales.

  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. Invitation to cervical cancer screening does increase participation in Germany: Results from the MARZY study.

    Science.gov (United States)

    Radde, Kathrin; Gottschalk, Andrea; Bussas, Ulrike; Schülein, Stefanie; Schriefer, Dirk; Seifert, Ulrike; Neumann, Anne; Kaiser, Melanie; Blettner, Maria; Klug, Stefanie J

    2016-09-01

    The effect of different invitation models on participation in cervical cancer screening (CCS) was investigated in a randomized population-based cohort study in Germany. Participants were randomly selected via population registries and randomized into intervention Arm A (invitation letter) and Arm B (invitation letter and information brochure) or control Arm C (no invitation). The intervention and control arms were compared with regard to 3-year participation and the two invitation models were compared between intervention arms. Of the 7,758 eligible women aged 30-65 years, living in the city of Mainz and in the rural region of Mainz-Bingen, 5,265 were included in the analysis. Differences in proportions of women attending CCS were investigated and logistic regression was performed to analyze various factors influencing participation. In the intervention group, 91.8% participated in CCS compared to 85.3% in the control group (p education, migrant women and older women. No difference in participation was found between the intervention Arm A and Arm B. An accompanying information brochure did not motivate more women to undergo CCS. However, a written invitation statistically significantly increased participation in CCS in Germany. PMID:27083776

  6. Quality Assessment of Colonoscopy Reporting: Results from a Statewide Cancer Screening Program

    Directory of Open Access Journals (Sweden)

    Jun Li

    2010-01-01

    Full Text Available This paper aimed to assess quality of colonoscopy reports and determine if physicians in practice were already documenting recommended quality indicators, prior to the publication of a standardized Colonoscopy Reporting and Data System (CO-RADS in 2007. We examined 110 colonoscopy reports from 2005-2006 through Maryland Colorectal Cancer Screening Program. We evaluated 25 key data elements recommended by CO-RADS, including procedure indications, risk/comorbidity assessments, procedure technical descriptions, colonoscopy findings, specimen retrieval/pathology. Among 110 reports, 73% documented the bowel preparation quality and 82% documented specific cecal landmarks. For the 177 individual polyps identified, information on size and morphology was documented for 87% and 53%, respectively. Colonoscopy reporting varied considerately in the pre-CO-RADS period. The absence of key data elements may impact the ability to make recommendations for recall intervals. This paper provides baseline data to assess if CO-RADS has an impact on reporting and how best to improve the quality of reporting.

  7. Proteomic changes resulting from gene copy number variations in cancer cells.

    Directory of Open Access Journals (Sweden)

    Tamar Geiger

    2010-09-01

    Full Text Available Along the transformation process, cells accumulate DNA aberrations, including mutations, translocations, amplifications, and deletions. Despite numerous studies, the overall effects of amplifications and deletions on the end point of gene expression--the level of proteins--is generally unknown. Here we use large-scale and high-resolution proteomics combined with gene copy number analysis to investigate in a global manner to what extent these genomic changes have a proteomic output and therefore the ability to affect cellular transformation. We accurately measure expression levels of 6,735 proteins and directly compare them to the gene copy number. We find that the average effect of these alterations on the protein expression is only a few percent. Nevertheless, by using a novel algorithm, we find the combined impact that many of these regional chromosomal aberrations have at the protein level. We show that proteins encoded by amplified oncogenes are often overexpressed, while adjacent amplified genes, which presumably do not promote growth and survival, are attenuated. Furthermore, regulation of biological processes and molecular complexes is independent of general copy number changes. By connecting the primary genome alteration to their proteomic consequences, this approach helps to interpret the data from large-scale cancer genomics efforts.

  8. Long-term results and complications of preoperative radiation in the treatment of rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Reed, W.P.; Garb, J.L.; Park, W.C.; Stark, A.J.; Chabot, J.R.; Friedmann, P.

    1988-02-01

    A retrospective study of 149 patients with rectal cancer diagnosed between 1972 and 1979 was undertaken to compare survival, disease-free survival, recurrence sites, and long-term complications of 40 patients who received 4000 to 4500 rads of preoperative adjuvant radiotherapy (radiation group) with those of 109 patients treated by resection alone (control group). After a mean follow-up of 84 months and 99 months, respectively, survival of the irradiated patients was significantly better than that of controls (68% versus 52%, p less than 0.05). Disease-free survival of those patients rendered free of disease by treatment was also superior for the irradiated group (84% versus 57%, p less than 0.005). Local recurrence without signs of distant metastases developed only one-third as often in irradiated patients (6% versus 18%). Distant metastases, alone or in combination with local recurrence, were also less common after radiation (12% versus 27%). Second primary tumors developed in 15% and 10% of the respective groups, a difference that was not statistically significant. When we consider the survival benefit of preoperative radiation therapy, long-term complications were relatively mild. Delayed healing of the perineum was noted in two irradiated patients. Persistent diarrhea was severe enough to warrant treatment in only one case, and one patient required a colostomy for intestinal obstruction from pelvic fibrosis.

  9. Long-term results and complications of preoperative radiation in the treatment of rectal cancer

    International Nuclear Information System (INIS)

    A retrospective study of 149 patients with rectal cancer diagnosed between 1972 and 1979 was undertaken to compare survival, disease-free survival, recurrence sites, and long-term complications of 40 patients who received 4000 to 4500 rads of preoperative adjuvant radiotherapy (radiation group) with those of 109 patients treated by resection alone (control group). After a mean follow-up of 84 months and 99 months, respectively, survival of the irradiated patients was significantly better than that of controls (68% versus 52%, p less than 0.05). Disease-free survival of those patients rendered free of disease by treatment was also superior for the irradiated group (84% versus 57%, p less than 0.005). Local recurrence without signs of distant metastases developed only one-third as often in irradiated patients (6% versus 18%). Distant metastases, alone or in combination with local recurrence, were also less common after radiation (12% versus 27%). Second primary tumors developed in 15% and 10% of the respective groups, a difference that was not statistically significant. When we consider the survival benefit of preoperative radiation therapy, long-term complications were relatively mild. Delayed healing of the perineum was noted in two irradiated patients. Persistent diarrhea was severe enough to warrant treatment in only one case, and one patient required a colostomy for intestinal obstruction from pelvic fibrosis

  10. Strontium-89 in Hormonal Resistant Prostate Cancer Patients: Results of a Pharmacokinetic Study

    International Nuclear Information System (INIS)

    Strontium is a radionuclide that precipitates in bone mineral and imitates calcium bio-distribution.In the last years there is a growing interest in using 89Sr therapy as an analgesic treatment for Hormonal Resistant Prostate Cancer Patients (HRPCP )with bony metastases. It is of great importance to study the behavior of the intravenously injected strontium in those patients More accurate information about the excretion and retention of the radio-strontium in the body will contribute to a better evaluation of the amount of radioactive material sufficient for the treatment,thus leading to a reduction in the radiation dose received by the patient. 89Sr is considered a pure beta emitter and pharmacokinetic studies were based on monitoring of bremsstrahlung or by injection of relatively high doses of 85Sr, which emits gamma rays at the energy of 514 keV with a yield of 99%. 89Sr emits gamma rays at an energy of 909 keV with a very low yield of less than 1%.The commercial product that is being used for injection is Metastron,manufactured by Amersham.It contains 89Sr Chloride and an impurity of 85 Sr. We introduced a simple technique to study the pharmacokinetics of radio-strontium in patients by the detection of both 89Sr and 85Sr ,that coexist in the original preparate,using gamma ray spectrometry. The evaluation of the clearance of strontium from the body is based on measuring blood and urine samples

  11. Measurement of serum ferritin by radioimmunoassay: results in normal individuals and patients with breast cancer

    International Nuclear Information System (INIS)

    Ferritins are iron-containing proteins found in normal tissues; they increase in concentration in many tumors and the blood of tumor-bearing individuals. We utilized a double-antibody radioimmunoassay for measurement of serum ferritin and defined the upper limit of normal as 146 ng/ml for women (mean 34 ng/ml) and 193 ng/ml for men (mean 93 ng/ml). Serum ferritin levels exceeded these limits in preoperative sera of 41 percent of women with mammary carcinoma (mean 199 ng/ml) and in 67 percent of women with locally recurrent or metastatic mammary carcinoma (mean 671 ng/ml). Individuals with hepatic inflammatory states are known to have high serum ferritin, and ferritin was increased in 43 percent of patients with hepatitis or cirrhosis (mean 364 ng/ml) and in 13 percent of patients with ulcerative colitis or gastroduodenal ulcers (mean 106 ng/ml). Measurement of serum ferritin may be useful in evaluation of patients with breast cancer and in monitoring their response to therapy. (auth)

  12. Reproductive risk factors in relation to molecular subtypes of breast cancer: Results from the nurses' health studies.

    Science.gov (United States)

    Sisti, Julia S; Collins, Laura C; Beck, Andrew H; Tamimi, Rulla M; Rosner, Bernard A; Eliassen, A Heather

    2016-05-15

    Several intrinsic breast cancer subtypes, possibly representing unique etiologic processes, have been identified by gene expression profiles. Evidence suggests that associations with reproductive risk factors may vary by breast cancer subtype. In the Nurses' Health Studies, we prospectively examined associations of reproductive factors with breast cancer subtypes defined using immunohistochemical staining of tissue microarrays. Multivariate-adjusted Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Over follow-up, we identified 2,063 luminal A, 1,008 luminal B, 209 HER2-enriched, 378 basal-like and 110 unclassified tumors. Many factors appeared associated with luminal A tumors, including ages at menarche (p(heterogeneity) = 0.65) and menopause (p(heterogeneity) = 0.05), and current HT use (p(heterogeneity) = 0.33). Increasing parity was not associated with any subtype (p(heterogeneity) = 0.76), though age at first birth was associated with luminal A tumors only (per 1-year increase HR = 1.03 95%CI (1.02-1.05), p(heterogeneity)  = 0.04). Though heterogeneity was not observed, duration of lactation was inversely associated with risk of basal-like tumors only (7+ months vs. never HR = 0.65 95%CI (0.49-0.87), ptrend = 0.02), p(heterogeneity) = 0.27). Years between menarche and first birth was strongly positively associated with luminal A and non-luminal subtypes (e.g. 22-year interval vs. nulliparous HR = 1.80, 95%CI (1.08-3.00) for basal-like tumors; p(heterogeneity) = 0.003), and evidence of effect modification by breastfeeding was observed. In summary, many reproductive risk factors for breast cancer appeared most strongly associated with the luminal A subtype. Our results support previous reports that lactation is protective against basal-like tumors, representing a potential modifiable risk factor for this aggressive subtype. PMID:26684063

  13. Effects of music therapy on pain among female breast cancer patients after radical mastectomy: results from a randomized controlled trial.

    Science.gov (United States)

    Li, Xiao-Mei; Yan, Hong; Zhou, Kai-Na; Dang, Shao-Nong; Wang, Duo-Lao; Zhang, Yin-Ping

    2011-07-01

    Music therapy has been used in multiple health care settings to reduce patient pain, anxiety, and stress. However, few available studies have investigated its effect on pain among breast cancer patients after radical mastectomy. The aim of this study was to explore the effects of music therapy on pain reduction in patients with breast cancer after radical mastectomy. This randomized controlled trial was conducted at the Surgical Department of Oncology Center, First Affiliated Hospital of Xi'an Jiaotong University from March to November 2009. A total of 120 breast cancer patients who received Personal Controlled Analgesia (PCA) following surgery (mastectomy) were randomly allocated to two groups, an intervention group and a control group (60 patients in each group). The intervention group accepted music therapy from the first day after radical mastectomy to the third admission to hospital for chemotherapy in addition to the routine nursing care, while the control group received only routine nursing care. Pain scores were measured at baseline and three post-tests using the General Questionnaire and Chinese version of Short-Form of McGill Pain Questionnaire. The primary endpoint was the change in the Pain Rating Index (PRI-total) score from baseline. Music therapy was found to reduce the PRI-total score in the intervention group significantly compared with the control group with a mean difference (95% CI) of -2.38 (-2.80, -1.95), -2.41 (-2.85, -1.96), and -1.87 (-2.33, -1.42) for the 1st, 2nd, and 3rd post-tests, respectively. Similar results were found for Visual Analogue Scale (VAS) and Present Pain Intensity (PPI) scores. The findings of the study provide some evidence that music therapy has both short- and long-term positive effects on alleviating pain in breast cancer patients following radical mastectomy. PMID:21537935

  14. Immunoscintigraphic diagnosis of ovarian cancer with Tc-99m labeled MAb ior-c5: First clinical results

    International Nuclear Information System (INIS)

    Purpose: The aim of the present study was to assess the value of radioimmunoscintigraphy using Tc-99m labeled monoclonal antibody ior-c5 labeled with Tc-99m in the detection primary, metastatic and recurrent ovarian cancer. Twenty-two patients, aged between 20 and 67 years were included. There were nine new patients with palpable ovarian mass without any previous treatment nor any past history of ovarian cancer (Group-I). In Group -II there were 13 patients with past history of ovarian tumour. Each patient received 1.85-2.22 GBq Tc-99m -ior-c5 injected intravenously. Radiochemical purity of Tc-99m -ior-c5 was 97±2%. Planar and SPECT images were obtained at 4 hours and 18-24 hours. Final diagnosis was made in all patients on the basis of histopathology. The results of scintigraphic studies were correlated with those of histopathological examinations. Histopathology in all nine patients of Group-I were found to be negative for ovarian cancer. However radioimmunoscintigraphy falsely diagnosed 2 cases from this group as positive. These two cases were an ovarian fibroma and a mature cystic teratoma. Ten out of the 13 patients in Group II (77%) had histologically active malignant disease; immunoscintigraphic images correctly identified all positive lesions (9 locoregional, 3 distant). Tumour-to-background ratio was found to be 2.07±0.41. The sensitivity, specificity and accuracy of immunoscintigraphy with Tc-99m ior-c5 were 100%, 83.3% and 90.9%, respectively. The kappa coefficient of agreement (k) was 0.82±0.12. There were no adverse reactions. It was concluded that radioimmunoscintigraphy with Tc-99m -ior-c5 could be useful in the diagnosis and follow-up of patients with ovarian cancer. However, its clinical role should be more precisely determined in a larger patient population. (author)

  15. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort.

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    Esther Roura

    Full Text Available In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC. However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of developing cervical intraepithelial neoplasia grade 3 (CIN3/carcinoma in situ (CIS and invasive cervical cancer (ICC.We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC Study. At enrollment, participants completed a questionnaire and provided serum. After a 9-year median follow-up, 261 ICC and 804 CIN3/CIS cases were reported. In a nested case-control study, the sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11,16,18,31,33,35,45,52,58, and antibodies against Chlamydia trachomatis and Human herpesvirus 2. Multivariate analyses were performed to estimate hazard ratios (HR, odds ratios (OR and corresponding 95% confidence intervals (CI. The cohort analysis showed that number of full-term pregnancies was positively associated with CIN3/CIS risk (p-trend = 0.03. Duration of oral contraceptives use was associated with a significantly increased risk of both CIN3/CIS and ICC (HR = 1.6 and HR = 1.8 respectively for ≥ 15 years versus never use. Ever use of menopausal hormone therapy was associated with a reduced risk of ICC (HR = 0.5, 95%CI: 0.4-0.8. A non-significant reduced risk of ICC with ever use of intrauterine devices (IUD was found in the nested case-control analysis (OR = 0.6. Analyses restricted to all cases and HPV seropositive controls yielded similar results, revealing a significant inverse association with IUD for combined CIN3/CIS and ICC (OR = 0.7.Even though HPV is the necessary cause of CC, our results suggest that several hormonal factors are risk factors for cervical carcinogenesis. Adherence to current cervical cancer screening

  16. The Influence of Hormonal Factors on the Risk of Developing Cervical Cancer and Pre-Cancer: Results from the EPIC Cohort

    Science.gov (United States)

    Roura, Esther; Travier, Noémie; Waterboer, Tim; de Sanjosé, Silvia; Bosch, F. Xavier; Pawlita, Michael; Pala, Valeria; Weiderpass, Elisabete; Margall, Núria; Dillner, Joakim; Gram, Inger T.; Tjønneland, Anne; Munk, Christian; Palli, Domenico; Khaw, Kay-Tee; Overvad, Kim; Clavel-Chapelon, Françoise; Mesrine, Sylvie; Fournier, Agnès; Fortner, Renée T.; Ose, Jennifer; Steffen, Annika; Trichopoulou, Antonia; Lagiou, Pagona; Orfanos, Philippos; Masala, Giovanna; Tumino, Rosario; Sacerdote, Carlotta; Polidoro, Silvia; Mattiello, Amalia; Lund, Eiliv; Peeters, Petra H.; Bueno-de-Mesquita, H. B(as).; Quirós, J. Ramón; Sánchez, María-José; Navarro, Carmen; Barricarte, Aurelio; Larrañaga, Nerea; Ekström, Johanna; Lindquist, David; Idahl, Annika; Travis, Ruth C.; Merritt, Melissa A.; Gunter, Marc J.; Rinaldi, Sabina; Tommasino, Massimo; Franceschi, Silvia; Riboli, Elio; Castellsagué, Xavier

    2016-01-01

    Background In addition to HPV, high parity and hormonal contraceptives have been associated with cervical cancer (CC). However, most of the evidence comes from retrospective case-control studies. The aim of this study is to prospectively evaluate associations between hormonal factors and risk of developing cervical intraepithelial neoplasia grade 3 (CIN3)/carcinoma in situ (CIS) and invasive cervical cancer (ICC). Methods and Findings We followed a cohort of 308,036 women recruited in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. At enrollment, participants completed a questionnaire and provided serum. After a 9-year median follow-up, 261 ICC and 804 CIN3/CIS cases were reported. In a nested case-control study, the sera from 609 cases and 1,218 matched controls were tested for L1 antibodies against HPV types 11,16,18,31,33,35,45,52,58, and antibodies against Chlamydia trachomatis and Human herpesvirus 2. Multivariate analyses were performed to estimate hazard ratios (HR), odds ratios (OR) and corresponding 95% confidence intervals (CI). The cohort analysis showed that number of full-term pregnancies was positively associated with CIN3/CIS risk (p-trend = 0.03). Duration of oral contraceptives use was associated with a significantly increased risk of both CIN3/CIS and ICC (HR = 1.6 and HR = 1.8 respectively for ≥15 years versus never use). Ever use of menopausal hormone therapy was associated with a reduced risk of ICC (HR = 0.5, 95%CI: 0.4–0.8). A non-significant reduced risk of ICC with ever use of intrauterine devices (IUD) was found in the nested case-control analysis (OR = 0.6). Analyses restricted to all cases and HPV seropositive controls yielded similar results, revealing a significant inverse association with IUD for combined CIN3/CIS and ICC (OR = 0.7). Conclusions Even though HPV is the necessary cause of CC, our results suggest that several hormonal factors are risk factors for cervical carcinogenesis. Adherence to

  17. The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

    Energy Technology Data Exchange (ETDEWEB)

    Roman, M., E-mail: Marta.Roman@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Department of Women and Children’s Health, Oslo University Hospital, Oslo (Norway); Skaane, P., E-mail: PERSK@ous-hf.no [Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Oslo (Norway); Hofvind, S., E-mail: Solveig.Hofvind@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Oslo and Akershus University College of Applied Sciences, Faculty of Health Science, Oslo (Norway)

    2014-09-15

    Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

  18. The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

    International Nuclear Information System (INIS)

    Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

  19. Inhibition of the mammalian target of rapamycin (mTOR) in advanced pancreatic cancer: results of two phase II studies

    International Nuclear Information System (INIS)

    The phosphoinositide 3-kinase (PI3K)/Akt pathway is constitutively activated in pancreatic cancer and the mammalian target of rapamycin (mTOR) kinase is an important mediator for its signaling. Our recent in vitro studies suggest that prolonged exposure of pancreatic cancer cells to mTOR inhibitors can promote insulin receptor substrate-PI3K interactions and paradoxically increase Akt phosphorylation and cyclin D1 expression in pancreatic cancer cells (negative feedback loop). The addition of erlotinib to rapamycin can down-regulate rapamycin-stimulated Akt and results in synergistic antitumor activity with erlotinib in preclinical tumor models. Two studies prospectively enrolled adult patients with advanced pancreatic cancer, Eastern Cooperative Oncology Group performance status 0-1, adequate hematologic, hepatic and renal parameters and measurable disease. In Study A, temsirolimus was administered intravenously at 25 mg weekly. In Study B, everolimus was administered orally at 30 mg weekly and erlotinib was administered at 150 mg daily. The primary endpoint in both studies was overall survival at 6 months. Secondary endpoints included time to progression, progression-free survival, overall survival, response rate, safety and toxicity. Pretreatment tumor biopsies were analyzed by immunofluorescence and laser scanning cytometry for the expression of pmTOR/mTOR, pAkt/Akt, pErk/Erk, pS6, p4EBP-1 and PTEN. Five patients enrolled in Study A; Two patients died within a month (rapid disease progression and hemorrhagic stroke, respectively). One patient developed dehydration and another developed asthenia. Sixteen patients enrolled in Study B.: 12 males, all ECOG PS = 1. Median cycles = 1 (range 1-2). Grade 4 toxicity: hyponatremia (n = 1), Grade 3: diarrhea (n = 1), cholangitis (n = 3), hyperglycemia (n = 1), fatigue (n = 1). Grade 2: pneumonia (n = 2), dehydration (n = 2), nausea (n = 2), neutropenia (n = 1), mucositis (n = 2) & rash (n = 2). Four patients were

  20. Immunogenicity and safety of a NeuGcGM3 based cancer vaccine: Results from a controlled study in metastatic breast cancer patients.

    Science.gov (United States)

    Mulens, Vladimir; de la Torre, Ana; Marinello, Patricia; Rodríguez, Ronald; Cardoso, Jorge; Díaz, René; O'Farrill, Miguel; Macias, Amparo; Viada, Carmen; Saurez, Giselle; Carr, Adriana; Crombet, Tania; Mazorra, Zaima; Perez, Rolando; Fernandez, Luis Enrique

    2010-09-14

    Increased levels of NeuGc-containing gangliosides have been described in human breast cancer. A controlled Phase II clinical trial was conducted in patients with metastatic breast cancer to evaluate immunogenicity, safety and to identify evidences of biological activity of a cancer vaccine composed by NeuGcGM3 in a proteoliposome of Neisseria meningitidis together with Montanide ISA 51 as adjuvant. After first line chemotherapy, 79 women were randomized 1:1 to receive the vaccine candidate or best supportive care. All patients achieved at least stable disease to the first line therapy for the metastatic condition. Treatment consisted on 5 vaccine doses every 2 weeks and then, monthly re-immunization to complete 15 doses. Vaccination with the NeuGcGM3 based vaccine was safe and the most frequent adverse events consisted on injection site reactions, fever, arthralgia and chills. The vaccine was immunogenic and a sustained increase of both IgG and IgM antibody titters against NGcGM3 was observed after the second vaccination month. Antibodies were able to recognize the NeuGcGM3(+) murine tumor cell line L1210 and the myeloma cell line P3X63. Humoral response was specific since vaccination did not result in Neu-Acetyl GM3 or GM2-antibody response. Hyperimmune sera from vaccinated patients were able to prevent the NeuGcGM3 mediated CD4 down-modulation on T lymphocytes. In the intent to treat analysis, there was a trend toward a survival advantage for the vaccine group and this effect was significant for women bearing non-visceral metastasis. Two phase III clinical studies with this vaccine candidate are ongoing. PMID:20855939

  1. Adjuvant chemoradiotherapy after d2-lymphadenectomy for gastric cancer: the role of n-ratio in patient selection. results of a single cancer center

    International Nuclear Information System (INIS)

    Adjuvant chemoradiotherapy is part of a multimodality treatment approach in order to improve survival outcomes after surgery for gastric cancer. The aims of this study are to describe the results of gastrectomy and adjuvant chemoradiotherapy in patients treated in a single institution, and to identify prognostic factors that could determine which individuals would benefit from this treatment. This retrospective study included patients with pathologically confirmed gastric adenocarcinoma who underwent surgical treatment with curative intent in a single cancer center in Brazil, between 1998 and 2008. Among 327 patients treated in this period, 142 were selected. Exclusion criteria were distant metastatic disease (M1), T1N0 tumors, different multimodality treatments and tumors of the gastric stump. Another 10 individuals were lost to follow-up and there were 3 postoperative deaths. The role of several clinical and pathological variables as prognostic factors was determined. D2-lymphadenectomy was performed in 90.8% of the patients, who had 5-year overall and disease-free survival of 58.9% and 55.7%. The interaction of N-category and N-ratio, extended resection and perineural invasion were independent prognostic factors for overall and disease-free survival. Adjuvant chemoradiotherapy was not associated with a significant improvement in survival. Patients with node-positive disease had improved survival with adjuvant chemoradiotherapy, especially when we grouped patients with N1 and N2 tumors and a higher N-ratio. These individuals had worse disease-free (30.3% vs. 48.9%) and overall survival (30.9% vs. 71.4%). N-category and N-ratio interaction, perineural invasion and extended resections were prognostic factors for survival in gastric cancer patients treated with D2-lymphadenectomy, but adjuvant chemoradiotherapy was not. There may be some benefit with this treatment in patients with node-positive disease and higher N-ratio

  2. Second primary cancer following Hodgkin's disease: Updated results of an Italian multicentric study

    International Nuclear Information System (INIS)

    The risk of second primary cancer (SPC) was evaluated in 947 patients treated for Hodgkin's disease (HD) during the period January 1969 to December 1979. The median follow-up of this series was 10.5 years (range, 9 to 19). Treatment categories included radiotherapy (RT) alone (115 patients, 12%), chemotherapy (CHT) alone (161 patients, 17%), combined RT plus CHT (381 patients, 40%), and salvage treatment for resistant or relapsing HD (290 patients, 30.6%). Fifty-six SPCs were observed, occurring between 1 and 17 years from initial treatment. Among these, secondary acute nonlymphoid leukemia (s-ANLL) was the most frequent SPC (23 cases). Secondary non-Hodgkin's lymphoma (s-NHL) occurred in 5 patients, whereas a secondary solid tumor (s-ST) was observed in 28 patients. The calculated actuarial risk (+/- SE) of developing SPC was 5.0% (+/- 0.9%) and 23.1% (+/- 5.8%) at 10 and 19 years, respectively. Concerning treatment modalities and s-ANLL risk, no cases were observed in the radiotherapy group, whereas CHT plus RT and salvage groups showed the highest actuarial risk. This was, in fact, at 10 and 19 years, 3.1% (+/- 0.9%) and 8.1% (+/- 4.0%) in the former group, and 1.8% (+/- 1.0%) and 16% (+/- 9.0%) in the latter. A statistically significant difference was observed when the CHT plus RT group was compared with CHT and RT groups (P = .04). Concerning the relationships with chemotherapeutic regimens, 12 s-ANLL cases occurred in the mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) plus RT group, and only one case in the group receiving doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) plus RT. A statistically significant difference of s-ANLL actuarial risk was found comparing patients receiving MOPP plus RT to all other treatment groups (P = .04)

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

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the clinical efficacy in our daily practice, outside clinical trials, of cetuximab plus radiotherapy in a majority of treatment-naive patients with locoregionally advanced head and neck squamous cell carcinomas. A retrospective study was performed to evaluate outcomes in patients who were treated definitively with cetuximab and radiotherapy (ExRT). Patients with stage III or IV, nonmetastatic, measurable squamous cell carcinoma of the head and neck (SCCHN) were eligible. There were 18 males and two females. The median age was 61 years (range from 49 to 87 years old). Concurrent radiotherapy and cetuximab was used, in first line, in 17 patients with locally advanced disease; two patients with recurrent SCCHN, who were intolerant of Cisplatin-based regimens, were treated with radiotherapy combined with weekly cetuximab; and 1 patient received cetuximab and radiotherapy postoperatively. The median time of response was 10 months (range from 2 to 24 months). A partial response was observed in 11 cases; a complete response in nine cases. The occurrence of grade 2–3 skin toxicity was observed in 11 cases. Skin toxicity was clearly correlated with a better response and the duration of the response to the treatment. The use of cetuximab in combination with radiotherapy does not increase the side effects of radiotherapy. At the end of the follow-up, 17 patients died. Cetuximab, with its highly targeted mechanism of action and synergistic activity with current treatment modalities, is a valuable treatment option in head and neck patients. The effect of the epidermal growth factor receptor antagonist occurs without any change in the pattern and the severity of toxicity usually associated with head and neck radiation. Cetuximab seems not to provide the most benefit for patients with oropharyngeal cancers but will in patients with T4 tumors. However, the median duration of local control was less as described in the clinical trials

  4. Retrospective study of results of interstitial radiotherapy for cancer of the tongue

    International Nuclear Information System (INIS)

    This retrospective study was carried out to clarify whether interstitial radiotherapy is effective in the management of carcinoma of the tongue. The subjects were 65 previously untreated patients with invasive squamous cell carcinoma of the anterior two-thirds of the tongue who received mainly interstitial radiotherapy using 137Cs needles with or without external irradiation between 1977 and 1993. The local control rate was 80% for T1, 73% for T2, 57% for T3 and 73% overall. Thirteen of 16 patients for whom local control failed achieved good control by salvage surgery. The local control rates were slightly lower with combined radiotherapy (64%) than with the interstitial radiotherapy alone (78%), but there was no significant difference between external radiation (≤30 Gy) and external radiation (>30 Gy). Cervical lymph node metastases developed in 26% of patients with T1-3 N0. Neck control was achieved in 20 (74%) of 27 patients in whom pathologically positive nodes were found. Twenty-two patients developed soft tissue or/and mandibular complications for a total of 28 cases. Soft tissue complications were more likely to occur in patients who received interstitial radiotherapy alone. On the other hand, mandibular complications were likely to occur in patients who received external irradiation. The cumulative 5-year survival rate was 92% for T1, 72% for T2 and 33% for T3. The 5-year survival rate of patients with subsequent cervical node metastases was 41%, whereas in patients without subsequent cervical node metastases it was 89% (P<0.001). Interstitial radiotherapy with or without external irradiation has useful implications in the local control of newly diagnosed cases of tongue cancer. If local recurrence develops, it is possible to control the primary lesion and prolong survival by salvage surgery. The most effective treatment modality for neck control and survival could not be determined from this study. (author)

  5. Effect of radiologist experience on the risk of false-positive results in breast cancer screening programs

    International Nuclear Information System (INIS)

    To evaluate the effect of radiologist experience on the risk of false-positive results in population-based breast cancer screening programmes. We evaluated 1,440,384 single-read screening mammograms, corresponding to 471,112 women aged 45-69 years participating in four Spanish programmes between 1990 and 2006. The mammograms were interpreted by 72 radiologists. The overall percentage of false-positive results was 5.85% and that for false-positives resulting in an invasive procedure was 0.38%. Both the risk of false-positives overall and of false-positives leading to an invasive procedure significantly decreased (p 14,999 mammograms with respect to the reference category (<500). The risk of both categories of false-positives was also significantly reduced (p < 0.001) as radiologists' years of experience increased: OR 0.96 and OR 0.84, respectively, for 1 year's experience and OR 0.72 and OR 0.73, respectively, for more than 4 years' experience with regard to the category of <1 year's experience. Radiologist experience is a determining factor in the risk of a false-positive result in breast cancer screening. (orig.)

  6. Evaluation of the efficiency of biofield diagnostic system in breast cancer detection using clinical study results and classifiers.

    Science.gov (United States)

    Subbhuraam, Vinitha Sree; Ng, E Y K; Kaw, G; Acharya U, Rajendra; Chong, B K

    2012-02-01

    The division of breast cancer cells results in regions of electrical depolarisation within the breast. These regions extend to the skin surface from where diagnostic information can be obtained through measurements of the skin surface electropotentials using sensors. This technique is used by the Biofield Diagnostic System (BDS) to detect the presence of malignancy. This paper evaluates the efficiency of BDS in breast cancer detection and also evaluates the use of classifiers for improving the accuracy of BDS. 182 women scheduled for either mammography or ultrasound or both tests participated in the BDS clinical study conducted at Tan Tock Seng hospital, Singapore. Using the BDS index obtained from the BDS examination and the level of suspicion score obtained from mammography/ultrasound results, the final BDS result was deciphered. BDS demonstrated high values for sensitivity (96.23%), specificity (93.80%), and accuracy (94.51%). Also, we have studied the performance of five supervised learning based classifiers (back propagation network, probabilistic neural network, linear discriminant analysis, support vector machines, and a fuzzy classifier), by feeding selected features from the collected dataset. The clinical study results show that BDS can help physicians to differentiate benign and malignant breast lesions, and thereby, aid in making better biopsy recommendations. PMID:20703753

  7. Breast Cancers Detected at Screening MR Imaging and Mammography in Patients at High Risk: Method of Detection Reflects Tumor Histopathologic Results.

    Science.gov (United States)

    Sung, Janice S; Stamler, Sarah; Brooks, Jennifer; Kaplan, Jennifer; Huang, Tammy; Dershaw, D David; Lee, Carol H; Morris, Elizabeth A; Comstock, Christopher E

    2016-09-01

    Purpose To compare the clinical, imaging, and histopathologic features of breast cancers detected at screening magnetic resonance (MR) imaging, screening mammography, and those detected between screening examinations (interval cancers) in women at high risk. Materials and Methods This retrospective institutional review board-approved, HIPAA-compliant review of 7519 women at high risk for breast cancer who underwent screening with MR imaging and mammography between January 2005 and December 2010 was performed to determine the number of screening-detected and interval cancers diagnosed. The need for informed consent was waived. Medical records were reviewed for age, risk factors (family or personal history of breast cancer, BRCA mutation status, history of high-risk lesion or mantle radiation), tumor histopathologic results, and time between diagnosis of interval cancer and most recent screening examination. The χ(2) test and logistic regression methods were used to compare the features of screening MR imaging, screening mammography, and interval cancers. The Wilcoxon signed-rank test was used to calculate P values. Results A total of 18 064 screening MR imaging examinations and 26 866 screening mammographic examinations were performed. Two hundred twenty-two cancers were diagnosed in 219 women, 167 (75%) at MR imaging, 43 (19%) at mammography, and 12 (5%) interval cancers. Median age at diagnosis was 52 years. No risk factors were associated with screening MR imaging, screening mammography, or interval cancer (P > .06). Cancers found at screening MR imaging were more likely to be invasive cancer (118 of 167 [71%]; P mammography, 38 (88%) manifested as calcifications and 28 (65%) were ductal carcinoma in situ. Interval cancers were associated with nodal involvement (P = .005) and the triple-negative subtype (P = .03). Conclusion In women at high risk for breast cancer who underwent screening with mammography and MR imaging, invasive cancers were more likely to be

  8. Radiation therapy improves survival in rectal small cell cancer - Analysis of Surveillance Epidemiology and End Results (SEER) data

    International Nuclear Information System (INIS)

    Small cell carcinoma of the rectum is a rare neoplasm with scant literature to guide treatment. We used the Surveillance Epidemiology and End Results (SEER) database to investigate the role of radiation therapy in the treatment of this cancer. The SEER database (National Cancer Institute) was queried for locoregional cases of small cell rectal cancer. Years of diagnosis were limited to 1988–2010 (most recent available) to reduce variability in staging criteria or longitudinal changes in surgery and radiation techniques. Two month conditional survival was applied to minimize bias by excluding patients who did not survive long enough to receive cancer-directed therapy. Patient demographics between the RT and No-RT groups were compared using Pearson Chi-Square tests. Overall survival was compared between patients who received radiotherapy (RT, n = 43) and those who did not (No-RT, n = 28) using the Kaplan-Meier method. Multivariate Cox proportional hazards model was used to evaluate important covariates. Median survival was significantly longer for patients who received radiation compared to those who were not treated with radiation; 26 mo vs. 8 mo, respectively (log-rank P = 0.009). We also noted a higher 1-year overall survival rate for those who received radiation (71.1% vs. 37.8%). Unadjusted hazard ratio for death (HR) was 0.495 with the use of radiation (95% CI 0.286-0.858). Among surgery, radiotherapy, sex and age at diagnosis, radiation therapy was the only significant factor for overall survival with a multivariate HR for death of 0.393 (95% CI 0.206-0.750, P = 0.005). Using SEER data, we have identified a significant survival advantage with the use of radiation therapy in the setting of rectal small cell carcinoma. Limitations of the SEER data apply to this study, particularly the lack of information on chemotherapy usage. Our findings strongly support the use of radiation therapy for patients with locoregional small cell rectal cancer

  9. Psychiatric disorders and associated factors in cancer: results of an interview study with patients in inpatient, rehabilitation and outpatient treatment.

    Science.gov (United States)

    Härter, M; Reuter, K; Aschenbrenner, A; Schretzmann, B; Marschner, N; Hasenburg, A; Weis, J

    2001-07-01

    An association between mental disorders, especially affective and anxiety disorders, and cancer has been reported in many studies. The present study investigated current (4-weeks-, 12-months-, and lifetime-prevalence rates of comorbid mental disorders in cancer patients. Through a cross-sectional design, 517 patients (75% female patients) from two acute inpatient care clinics, two rehabilitation clinics and nine specialised practices for oncology were examined with standardised scales for psychological burden and quality of life. Somatic parameters were assessed through standardised medical records. In the second-stage-examination, a sample of 200 patients was interviewed with standardised clinical interview (CIDI) in order to obtain DSM-IV diagnoses of mental disorders. Differences in the type of mental disorders were examined for gender, treatment setting, severity of cancer and physical impairment. Prevalence rates of mental disorders were 23.5% for the 4-weeks, 40% for the 12-months, and 56.5% for the lifetime periods. The current and 12-months rates of affective and anxiety disorders were approximately 25-33% higher than prevalence rates found in recent epidemiological studies of the general population. These higher rates were, however, mainly due to the preponderance of female patients with a higher risk for mental disorders compared with males. The most prevalent current disorders were affective (9.5%), and anxiety disorders (13%). Female gender was associated with an approximately 2-fold risk of mental disorders during the patient's lifespan. Current diagnosis of affective disorders in women was highly related to the cancer. Physical impairment was also associated with the frequency of current psychiatric disorders, especially affective and anxiety disorders. The frequency of mental disorders in cancer patients does not differ from results of recent international epidemiological studies of the normal population. The slightly higher rates of anxiety

  10. Meeting the information needs of lower income cancer survivors: results of a randomized control trial evaluating the american cancer society's "I can cope".

    Science.gov (United States)

    Martin, Michelle Y; Evans, Mary B; Kratt, Polly; Pollack, Lori A; Smith, Judith Lee; Oster, Robert; Dignan, Mark; Prayor-Patterson, Heather; Watson, Christopher; Houston, Peter; Andrews, Shiquina; Liwo, Amandiy; Tseng, Tung Sung; Hullett, Sandral; Oliver, Joann; Pisu, Maria

    2014-04-01

    The American Cancer Society is a leader in the development of cancer survivorship resources. One resource of the American Cancer Society is the I Can Cope program, an educational program for cancer survivors and their families. Evaluations of this program indicate that cancer patients highly rate its objectives. Yet, there are gaps in the understanding of the full impact of the program on diverse cancer survivors. In this study, the authors used a randomized trial to evaluate the program. Participants included 140 low-income survivors (79% Black; 38% breast cancer) from community hospitals who were randomized to 4 sessions of I Can Cope (learning about cancer; understanding cancer treatments; relieving cancer pain; and keeping well in mind and body) or 4 sessions of a wellness intervention (humor, meditation, relaxation, and music therapy). The authors' primary outcome was "met information needs." After controlling for covariates, their analysis indicated that I Can Cope was no more effective than the wellness intervention in addressing survivor information needs relative to the learning objectives. Participants provided high overall ratings for both interventions. Self-efficacy for obtaining advice about cancer, age, education, and income were associated with information needs. Educational programs tailored to levels of self-efficacy and patient demographics may be needed. PMID:24433231

  11. A randomised controlled trial of forward-planned radiotherapy (IMRT) for early breast cancer: Baseline characteristics and dosimetry results

    International Nuclear Information System (INIS)

    Background and purpose: This large trial was designed to investigate whether correction of dose inhomogeneities using intensity-modulated radiotherapy (IMRT) reduces late toxicity and improves quality of life in patients with early breast cancer. This paper reports baseline characteristics of trial participants and dosimetry results. Materials and methods: Standard tangential plans of 1145 trials were analysed. Patients with inhomogeneous plans, defined by ICRU recommendations, were randomised to forward-planned IMRT or standard radiotherapy. Results: Twenty-nine percentage of patients had adequate dosimetry with standard 2D radiotherapy. In the randomised patients, the decreases in mean volumes receiving greater than 107% (Vol > 107) and less than 95% (Vol 3 (95% CI 26.4-41.6; P 3 (95% CI 34.4-61.9; P 107 > 2 cm3 on standard radiotherapy plans. Conclusion: This large trial, in which patients with all breast sizes were eligible, confirmed that breast dosimetry can be significantly improved with a simple method of forward-planned IMRT and has little impact on radiotherapy resources. It is shown that patients with larger breasts are more likely to have dose inhomogeneities and breast separation gives some indication of this likelihood. Photographic assessment of patients at 2 years after radiotherapy, as the next part of this randomised controlled trial, will show whether these results for IMRT translate into improved cosmetic outcome in patients with early breast cancer. This would provide impetus for the widespread adoption of 3D planning and IMRT.

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

    International Nuclear Information System (INIS)

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

  13. 70 Gy Versus 80 Gy in Localized Prostate Cancer: 5-Year Results of GETUG 06 Randomized Trial

    International Nuclear Information System (INIS)

    Purpose: To perform a randomized trial comparing 70 and 80 Gy radiotherapy for prostate cancer. Patients and Methods: A total of 306 patients with localized prostate cancer were randomized. No androgen deprivation was allowed. The primary endpoint was biochemical relapse according to the modified 1997-American Society for Therapeutic Radiology and Oncology and Phoenix definitions. Toxicity was graded using the Radiation Therapy Oncology Group 1991 criteria and the late effects on normal tissues-subjective, objective, management, analytic scales (LENT-SOMA) scales. The patients' quality of life was scored using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30-item cancer-specific and 25-item prostate-specific modules. Results: The median follow-up was 61 months. According to the 1997-American Society for Therapeutic Radiology and Oncology definition, the 5-year biochemical relapse rate was 39% and 28% in the 70- and 80-Gy arms, respectively (p = .036). Using the Phoenix definition, the 5-year biochemical relapse rate was 32% and 23.5%, respectively (p = .09). The subgroup analysis showed a better biochemical outcome for the higher dose group with an initial prostate-specific antigen level >15 ng/mL. At the last follow-up date, 26 patients had died, 10 of their disease and none of toxicity, with no differences between the two arms. According to the Radiation Therapy Oncology Group scale, the Grade 2 or greater rectal toxicity rate was 14% and 19.5% for the 70- and 80-Gy arms (p = .22), respectively. The Grade 2 or greater urinary toxicity was 10% at 70 Gy and 17.5% at 80 Gy (p = .046). Similar results were observed using the LENT-SOMA scale. Bladder toxicity was more frequent at 80 Gy than at 70 Gy (p = .039). The quality-of-life questionnaire results before and 5 years after treatment were available for 103 patients with no differences found between the 70- and 80-Gy arms. Conclusion: High-dose radiotherapy provided a

  14. Prospective Evaluation of Dual-Energy Imaging in Patients Undergoing Image Guided Radiation Therapy for Lung Cancer: Initial Clinical Results

    Energy Technology Data Exchange (ETDEWEB)

    Sherertz, Tracy; Hoggarth, Mark; Luce, Jason; Block, Alec M.; Nagda, Suneel; Harkenrider, Matthew M.; Emami, Bahman; Roeske, John C., E-mail: jroeske@lumc.edu

    2014-07-01

    Purpose: A prospective feasibility study was conducted to investigate the utility of dual-energy (DE) imaging compared to conventional x-ray imaging for patients undergoing kV-based image guided radiation therapy (IGRT) for lung cancer. Methods and Materials: An institutional review board-approved feasibility study enrolled patients with lung cancer undergoing IGRT and was initiated in September 2011. During daily setup, 2 sequential respiration-gated x-ray images were obtained using an on-board imager. Imaging was composed of 1 standard x-ray image at 120 kVp (1 mAs) and a second image obtained at 60 kVp (4 mAs). Weighted logarithmic subtraction of the 2 images was performed offline to create a soft tissue-selective DE image. Conventional and DE images were evaluated by measuring relative contrast and contrast-to-noise ratios (CNR) and also by comparing spatial localization, using both approaches. Imaging dose was assessed using a calibrated ion chamber. Results: To date, 10 patients with stage IA to IIIA lung cancer were enrolled and 57 DE images were analyzed. DE subtraction resulted in complete suppression of overlying bone in all 57 DE images, with an average improvement in relative contrast of 4.7 ± 3.3 over that of 120 kVp x-ray images (P<.0002). The improvement in relative contrast with DE imaging was seen for both smaller (gross tumor volume [GTV] ≤5 cc) and larger tumors (GTV >5 cc), with average relative contrast improvement ratios of 3.4 ± 4.1 and 5.4 ± 3.6, respectively. Moreover, the GTV was reliably localized in 95% of the DE images versus 74% of the single energy (SE images, (P=.004). Mean skin dose per DE image set was 0.44 ± 0.03 mGy versus 0.43 ± 0.03 mGy, using conventional kV imaging parameters. Conclusions: Initial results of this feasibility study suggest that DE thoracic imaging may enhance tumor localization in lung cancer patients receiving kV-based IGRT without increasing imaging dose.

  15. Dose escalation without split-course chemoradiation for anal cancer: results of a phase II RTOG study

    International Nuclear Information System (INIS)

    PURPOSE: An attempt at radiotherapy (RT) dose escalation (from 45 Gy to 59.6 Gy) in a Radiation Therapy Oncology Group (RTOG) chemoradiation protocol for advanced anal cancers had resulted in an unexpectedly high 1-year colostomy rate (23%) and local failure (The Cancer Journal from Scientific American 2 (4):205-211, 1996). This was felt to be probably secondary to the split course chemoradiation (CR) that was mandated in the protocol. A second phase of this dose escalation study was therefore undertaken without a mandatory split and with an identical RT dose (59.6 Gy) and chemotherapy. MATERIALS AND METHODS: Twenty patients with anal cancers ≥2 cms were treated with a concurrent combination of 59.6 Gy to the pelvis and perineum (1.8 Gy daily, 5 times per week in 33 fractions over 6 (1(2)) weeks) and two cycles of 5 fluorouracil infusion (1000 mg/m2 over 24 hours for 4 days) and mitomycin C (10 mg/m2 bolus). A 10 day rest period was allowed only for severe skin reactions. A comparative analysis was made with the 47 patients in the earlier phase of this study who were treated with the identical chemoradiation course but with a mandatory 2-week break at the 36.00 Gy level. RESULTS: Predominant Grade 3 and 4 toxicities in 18 evaluable patients with dermatitis ((14(18)) or 78%), hematologic ((14(18)) or 78%), infection ((3(18)) or 17%) and gastrointestinal ((5(18)) or 28%). There were no fatalities. Nine patients (50%) completed the planned course without a break; 9 others (50%) had their treatments interrupted for a median of 11 days (range 7-19 days) at a median dose of 41.4 Gy (range 32.4 to 48.6 Gy). This compared to (40(47)) patients (85%) who had a 12 day treatment interruption at 36 Gy total dose in a planned break group. One patient had an abdomino-perineal resection (APR) for persistent disease and another for an anal fissure for (2(18)) or 11% 1-year colostomy rate. This was again favorably comparable to 23% 1-year colostomy rate for the earlier group of

  16. False-positive results in mammographic screening for breast cancer in Europe

    DEFF Research Database (Denmark)

    Hofvind, Solveig; Ponti, Antonio; Patnick, Julietta;

    2012-01-01

    To estimate the cumulative risk of a false-positive screening result in European mammographic screening programmes, and examine the rates and procedures of further assessment.......To estimate the cumulative risk of a false-positive screening result in European mammographic screening programmes, and examine the rates and procedures of further assessment....

  17. Associations Between Funding Source and Results of Cost Effectiveness Analyses of Drugs Used in Breast Cancer

    OpenAIRE

    Lane, Jordan D.

    2015-01-01

    Background: Cost effectiveness studies are increasingly included in the regulatory decisions of many countries and in formulary decisions in the United States. Pharmaceutical company sponsorship of economic analyses of oncology drugs previously has been associated with reduced likelihood of reporting unfavorable results. Demonstrating persistence of this relationship may help enable better interpretation of study results and development of strategies to address potential bias. Methods: ...

  18. Screening for early lung cancer with low-dose spiral computed tomography: results of annual follow-up examinations in asymptomatic smokers

    International Nuclear Information System (INIS)

    The aim of this study was analysis of incidence results in a prospective one-arm feasibility study of lung cancer screening with low-radiation-dose spiral computed tomography in heavy smokers. Eight hundred seventeen smokers (≥40 years, ≥20 pack years of smoking history) underwent baseline low-dose CT. Biopsy was recommended in nodules >10 mm with CT morphology suggesting malignancy. In all other lesions follow-up with low-dose CT was recommended. Annual repeat CT was offered to all study participants. Six hundred sixty-eight (81.8%) of the 817 subjects underwent annual repeat CT with a total of 1735 follow-up years. Follow-up of non-calcified nodules present at baseline CT demonstrated growth in 11 of 792 subjects. Biopsy was performed in 8 of 11 growing nodules 7 of which represented lung cancer. Of 174 new nodules, 3 represented lung cancer. The 10 screen-detected lung cancers were all non-small cell cancer (6 stage IA, 1 stage IB, 1 stage IIIA, 2 stage IV). Five symptom-diagnosed cancers (2 small cell lung cancer: 1 limited disease, 1 extensive disease, 3 central/endobronchial non-small cell lung cancer, 2 stage IIIA, 1 stage IIIB) were diagnosed because of symptoms in the 12-month interval between two annual CT scans. Incidence of lung cancer was lower than prevalence, screen-detected cancers were smaller, and stage I was found in 70% (7 of 10) of screen-detected tumors. Only 27% (4 of 15) of invasive procedures was performed for benign lesions; however, 33% (5 of 15) of all cancers diagnosed in the population were symptom-diagnosed cancers (3 central NSCLC, all stage III, 2 SCLC) demonstrating the limitations of CT screening. (orig.)

  19. Duration of short-course androgen suppression therapy and the risk of death as a result of prostate cancer.

    LENUS (Irish Health Repository)

    D'Amico, Anthony V

    2011-12-10

    We evaluated whether the duration of androgen suppression therapy (AST) had an impact on the risk of prostate cancer-specific mortality (PCSM) in men with unfavorable-risk prostate cancer (PC) within established Gleason score (GS) categories.

  20. Absorbed body dose simulation in Thyroid cancer therapy using MCNP4Cand ITScodes and comparison to experimental results

    International Nuclear Information System (INIS)

    Two standard particle transport codes of MCNP4C and integrated tiger series were used to estimate the total body dose in a thyroid cancer therapy study, with I-131 as the radionuclide source. Human body was modeled by water and soft tissue ellipsoids. Phantoms' dimensions were selected according to Brow nell recommendation. Absorbed fractions were calculated by both codes for different phantoms and for gammas with 0.364 MeV energy, which has the highest fraction in I-131 emitting gammas. Results were compared to the data published by Brow nell et.al.. Figure 1 shows the results of MCNP4C and Integrated Tiger Series with results published by Brow nell et. al.

  1. Application of different types of mandible resection in combined treatment of oral cancer patient (pt.): results and complications

    International Nuclear Information System (INIS)

    Surgery is the main part of combined treatment of advanced oral cancer. Three types of mandible resection were applied in our center. Rim mandibulectomy leads to satisfactory cosmetic and functional results, in case of segmental mandibulectomy different methods of mandible restoration are applied. Middle mandibulotomy creates the optimum access to the operation field in patients with a large primary tumor of mobile tongue and a tumor thai is posteriorly located. Aims of the study: analyse of material to estimate the results and complications in cases of application of different types of mandible resection. Conclusions: Segmental mandibulectomy should be performed if erosion of alveolar ridge is detected. Rim manidibulectomy and segmental mandibylectomy with reconstructive surgery lead to good cosmetic and functional results. Usage of mini plates in reconstruction of mandibular arch decrease the number of postoperative complications even in patients after radiation therapy. Previous radiotherapy significantly increase the risk of the postoperative osteomyelitis of mandible

  2. The effects of radiation therapy on quality of life in women with breast cancer: Results of a randomized trial

    International Nuclear Information System (INIS)

    Purpose/Objective: The effects of radiation therapy on quality of life of women with breast cancer are not well known. The purpose of this study was to evaluate the effect of breast irradiation on quality of life including cosmetic outcome in the context of a randomized controlled trial. Methods: Between 1984 and 1989 a randomized trial was conducted in Ontario in which women with node-negative breast cancer who had undergone lumpectomy and axillary section were randomized either to postoperative radiation (4000 cGy in 16 fractions to the whole breast, followed by a boost of 1250 cGy in five fractions to the primary site) or no further treatment (J Natl Cancer Inst 1996; 88:1659). A modified version of the breast cancer chemotherapy questionnaire (J Clin Oncol 1988; 6:1798) containing 17 items was administered to women at baseline, one month and two months postrandomization. Each item was scored on a Likert scale from ''1'' All of the Time to ''7'' None of the Time. Patient assessments of breast pain and cosmetic outcome were also evaluated every three months for the first two years of the study. Results: Of 837 patients, 416 were randomly allocated to radiation therapy and 421 to no further treatment. The groups were comparable in terms of baseline characteristics. Factor analysis identified three different domains of the quality of life instrument: emotional/social, fatigue, and physical/inconvenience. There was a significant difference in the physical/inconvenience and fatigue domain scores between the radiation and control groups over time. The differences in scores between groups at two months post randomization were 0.97, p = 0.0001; 0.33, p=0.0001; and 0.03, p=0.62 for the physical/inconvenience, fatigue and emotional/social domains respectively. The percentage of patients who were troubled by breast pain differed between radiation and control groups up to one year (33.3% vs 19.9%, p = 0.001 at 6 months). Beyond one year, no difference was detected. The

  3. Clinical picture and treatment of complications of lower part of large intestine resulting from radiotherapy for intra-pelvic cancer

    International Nuclear Information System (INIS)

    The authors described clinical pictures and those treatments of 40 patients with complications of the lower part of the large intestine resulting from radiotherapy for cancer of the uterus, ovarium or the penis. As the radiotherapy, 60Co-telecobalt (6,000-16,000R) and 60Co-needle (1,000-8,568 mch) intracavitary irradiation were used alone or in combination. Findings in the complications of the lower part of the large intestine were classified into Grade I (13 cases), II (14), III (14), and IV (4) according to Sherman. The prodromal symptoms of the complications appeared in 2-6 months following the irradiation in more than a half of the patients, and it appeared within a year in most of the patients. Most of the patients complained about melena, anemia, proctagra, tenesmus and diarrhea. In the cases of Grade III, the symptoms of ileus such as constipation, abdominal distention, and abdominal pain appeared. Internal treatment was given principally, and preternal anus was made when frequent blood transfusion was required. Fourteen cases of those in Grade I and II recovered within 1-3 years. The cases which received proctostomy, including those who had bleeding, stricture and fistulation, had favorable prognosis. This result suggested that the radiotherapy for intra-pelvic cancer should be controlled to prevent further development of the complications in the rectum beyond Grade I. (Serizawa, K.)

  4. Migrant breast cancer patients and their participation in genetic counseling: results from a registry-based study

    OpenAIRE

    Baars, J. E.; van Dulmen, A M; Velthuizen, M. E.; Theunissen, E. B. M.; Vrouenraets, B.C.; Kimmings, A.N.; Dalen, T. van; van Ooijen, B; Witkamp, A.J.; van der Aa, M. A.; Ausems, M.G.E.M.

    2016-01-01

    Certain ethnic groups seem to have less access to cancer genetic counseling. Our study was to investigate the participation in cancer genetic counseling among migrant breast cancer patients of Turkish and Moroccan origin. Hospital medical records of Turkish and Moroccan and of a comparative group of non-Turkish/Moroccan newly diagnosed breast cancer patients were studied. All women were diagnosed between 2007 and 2012. Eligibility for genetic counseling was assessed with a checklist. A total ...

  5. Migrant breast cancer patients and their participation in genetic counseling : results from a registry-based study

    OpenAIRE

    Baars, J. E.; van Dulmen, A M; Velthuizen, M. E.; Theunissen, E. B. M.; Vrouenraets, B.C.; Kimmings, A.N.; Dalen, T. van; van Ooijen, B; Witkamp, A.J.; van der Aa, M. A.; Ausems, M.G.E.M.

    2016-01-01

    Certain ethnic groups seem to have less access to cancer genetic counseling. Our study was to investigate the participation in cancer genetic counseling among migrant breast cancer patients of Turkish and Moroccan origin. Hospital medical records of Turkish and Moroccan and of a comparative group of non-Turkish/Moroccan newly diagnosed breast cancer patients were studied. All women were diagnosed between 2007 and 2012. Eligibility for genetic counseling was assessed with a checklist. A total ...

  6. Breast cancer literacy among higher secondary students: results from a cross-sectional study in Western Nepal

    OpenAIRE

    Bhandari, Parash Mani; Thapa, Kiran; Dhakal, Sarmila; Bhochhibhoya, Shristi; Deuja, Rashmi; Acharya, Pawan; Mishra, Shiva Raj

    2016-01-01

    Background Being the most common cancer among women worldwide, it is vital to be well-aware of breast cancer risk factors, symptoms and curability. However, few studies have reported breast cancer literacy in students using a validated instrument. Methods A cross-sectional study was conducted among students of grades 11 and 12 from eleven higher secondary schools, one selected randomly from each ilaka of Parbat district. Questionnaire with modified Comprehensive Breast Cancer Knowledge Test w...

  7. Patient–provider discussions about lung cancer screening: Results from the 2012/2013 Kansas Adult Tobacco Survey

    OpenAIRE

    Rogers, Austin R.; Trevor Christensen; Welsh, Ericka M; Babalola Faseru

    2015-01-01

    Objective: Prior to the 2013 US Preventive Services Task Force (USPSTF) guidelines for lung cancer screening, the American Cancer Society released interim guidance recommending physicians discuss lung cancer screening with high risk patients. We included a question on patient–provider discussions about lung cancer screening on a statewide population-based survey to establish baseline prevalence for surveillance and to identify subpopulation disparities. Methods: We analyzed the 2012/2013 K...

  8. Mindfulness-Based Stress Reduction for lung cancer patients and their partners: Results of a mixed methods pilot study

    OpenAIRE

    van den Hurk, Desiree G. M.; Schellekens, Melanie P. J.; Molema, Johan; Speckens, Anne E M; van der Drift, Miep A.

    2015-01-01

    Background: Lung cancer patients and partners show high rates of impaired quality of life and heightened distress levels. Mindfulness-Based Stress Reduction has proven to be effective in reducing psychological distress in cancer patients. However, studies barely included lung cancer patients. Aim: We examined whether Mindfulness-Based Stress Reduction might be a feasible and effective intervention for patients with lung cancer and partners. Design: Mindfulness-Based Stress Reduction is a trai...

  9. Mutational myriad of tumor suppressor p53 in Filipino breast cancer: results and perspectives in molecular pathology and epidemiology

    International Nuclear Information System (INIS)

    The p53 tumor suppressor is by far the most widely mutated gene in human cancers. p53 encodes a 53-kDa phosphoprotein, transcription-activator whose targets include genes and gene products that orchestrate genomic stability, cellular response to DNA damage, cell cycle progression apoptosis and aging (senescence). Analysis of the p53 gene profile has previously resulted in identifying several cancer-causative factors in the human setting, as well as, in creating a unique molecular profile of a tumor useful in the design of tailored-therapies for individual cancer patients. Our results in screening for p53 abnormalities in 140 Filipino patients with primary breast lesions confined from 1997-1998 in 5 major hospitals in Manila reveal that p53 plays an important role in the development and progression of breast cancer in at least 48% of all cases. Two methods of p53 analysis are employed, enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction-temporal temperature gradient electrophoresis (PCR-TTGE). Inter-comparisons of method exhibit 63.3% concordance in 21 fresh breast carcinoma samples, with ELISA demonstrating 14% false-positives and 10% false-negatives. Only mutations in exon 7 (p=0.063) in the tumor samples how significant correlation with abnormal cellular elevation of p53. PCR-TTGE screening in a large series of 140 patients show that most genetic lesions are localized in exons 5 (41% of the total cases) and 6 (27% of the total cases). No mutations are, however, detected in the transactivation (exons 2-4) and oligomerization (exons 10-11) domains. Invasive carcinomas (stages II and III) are characterized with more frequent and diverse genetic alterations compared with benign tumors, most significantly at exon 5B (p=0.066) and at independently multiple sites (p=0.066). Earlier-onset cases (age of diagnosis < 50 yrs), known to be more clinico-pathologically aggressive, are diagnosed harboring more frequent p53 mutations centered at exon 7 (p=0

  10. Treatment policy of head and neck cancer and the results. Upper pharynx cancer (stage IV) case in Keio University hospital and Shizuoka Red Cross hospital

    International Nuclear Information System (INIS)

    Concerning 54 cases of upper pharynx cancer (stage IV) which received the first treatment during 1980-1996, the change of treatment method and the results were examined. Five years survival rate was 53.6% and ten years survival rate was 39.7%. The ratio of cases which were treated with neo-adjuvant chemotherapy (NAC) was 70% or more in earlier period (1980-1985), but decreased to 50% in the middle period (1986-1991) and 8% in the latter period (1992-1996). On the contrary, the ratio of cases which were treated mainly with irradiation increased. The survival rate was good with the treatment group in latter period. The conventional irradiation was done mainly in the earlier period and the middle period, the fractionated irradiation became to be done mainly in the latter period. A survival rate of the group irradiated fractionally was better than that of the group irradiated conventionally. NAC was done for 24 cases, and the response rate was 75.0%, but the improvement of survival rate wasn't clear. From an above-mentioned results, the fractionated irradiation together with dosage of CBDCA was selected firstly as treatment policy for upper pharynx cancer (stage IV). The irradiation was enforced twice a day with 1.2 Gy in an interval of six hours, and CBDCA 20 mg/m2 was administered intravenously in about 1 hour before the second irradiation. The total radiation dose to a limited part was aimed to be 72 Gy. The fifth week was resting interval in order to avoid a side effect as mucous membrane flame. (K.H.)

  11. Clinical impact of retinoids in redifferentiation therapy of advanced thyroid cancer: final results of a pilot study

    International Nuclear Information System (INIS)

    Differentiated thyroid cancer is a malignant tumour that has a fairly good prognosis, with patients surviving for many years. Multimodal therapy with surgery, radioiodine therapy and TSH suppressive medication is of proven efficacy. However, loss of differentiation is observed in up to one-third of patients with differentiated thyroid cancer, paralleled by an increase in tumour grading and loss of thyroid-specific functions (thyrotropin receptor, iodine accumulation). Such tumours may no longer be amenable to standard treatment protocols, including TSH suppression and radioiodide therapy. Retinoic acids have been shown to exert re-differentiating effects on thyrocytes in various experimental studies and case reports, and it was on this basis that this pilot study was initiated. Patients with advanced thyroid cancer and without the therapeutic options of operation or radioiodide therapy were treated with 13-cis-retinoic acid at a dosage of 1.5 mg/kg body weight daily over 5 weeks. Parameters for assessment of the therapeutic effect were serum thyroglobulin (TG) levels, radioiodine uptake, and tumour size prior to and after retinoid treatment. Fifty patients were evaluated for response, classified as reduction in tumour size and TG levels, stable disease or disease progression. Thirteen patients showed a clear increase in radioiodine uptake, and eight a mild increase. TG levels were unchanged or decreased in 20 patients. Tumour size was assessable in 37 patients; tumour regression was observed in six, and there was no change in 22. In total, a response was seen in 19 patients (38%). Response to retinoid therapy did not always correlate with increased radioiodine uptake, so other direct antiproliferative effects have to be assumed. The encouraging results of the study and the low rate of side-effects with good tolerability of retinoids warrant further studies with altered inclusion criteria and employment of other redifferentiating drugs or combinations of agents

  12. TMPRSS2-ERG gene fusion in Turkish patients with localized prostate cancer: results of radical prostatectomy specimens

    Science.gov (United States)

    Yılmaz, Ömer; Berber, Ufuk; Okçelik, Sezgin; Soydan, Hasan; Ateş, Ferhat; Karademir, Kenan

    2016-01-01

    Objective Our aim was to evaluate and determine the frequency of Transmembrane protease, serine 2 (TMPRSS2)-ERG fusion in Turkish patients with clinically localized prostate cancer by using immunohistochemistry and reveal its relationship with clinicopathologic variables. Material and methods Radical prostatectomy specimens of 99 patients, who underwent radical retropubic prostatectomy for localized cancer, between January 2002 and December 2011 were analyzed in the study. To detect ERG fusions, monoclonal ERG antibodyclone ID: EPR3864 (Epitomics, San Diego, CA, USA) and monoclonal anti-ERG antibody (9FY) (BiocareMedical, LLC, USA) were used. The immunistochemical expression of ERG protein was assessed as positive or negative regardless of stain intensity. Patients’ age, total and primary Gleason scores, PSA levels, prostate volumes, tumor volumes, tumor stages and perineural invasion status were analysed retrospectively. Total fusion rate and correlation between the variables and fusion were evaluated. Results Mean age, prostate volume, tumor volume, PSA value of 99 patients were 62.02 years (±5.93), 50.02 cc (±20.67), 3.19 cc (±4.16), and 9.34 ng/mL (±3.37) respectively. TMPRSS2-ERG fusion was seen in 46 (46.5%) of 99 patients. When the variables analysed with independent samples t test to predict fusion (+) status, none of them was found to be statistically significant. When evaluated by logistic regression analysis for (+) or (−) status, only tumor stage was found to be statistically significantly correlated with fusion (p=0.049). Conclusion The incidence of TMPRSS-ERG fusion in patients with localised prostate cancer in our study with Turkish population was found as 46.5%. Only tumor stage correlated with TMPRSS2-ERG fusion.

  13. Oxidative stress triggered by naturally occurring flavone apigenin results in senescence and chemotherapeutic effect in human colorectal cancer cells

    Directory of Open Access Journals (Sweden)

    Kacoli Banerjee

    2015-08-01

    Full Text Available Recent studies involving phytochemical polyphenolic compounds have suggested flavones often exert pro-oxidative effect in vitro against wide array of cancer cell lines. The aim of this study was to evaluate the in-vitro pro-oxidative activity of apigenin, a plant based flavone against colorectal cancer cell lines and investigate cumulative effect on long term exposure. In the present study, treatment of colorectal cell lines HT-29 and HCT-15 with apigenin resulted in anti-proliferative and apoptotic effects characterized by biochemical and morphological changes, including loss of mitochondrial membrane potential which aided in reversing the impaired apoptotic machinery leading to negative implications in cancer pathogenesis. Apigenin induces rapid free radical species production and the level of oxidative damage was assessed by qualitative and quantitative estimation of biochemical markers of oxidative stress. Increased level of mitochondrial superoxide suggested dose dependent mitochondrial oxidative damage which was generated by disruption in anti-apoptotic and pro-apoptotic protein balance. Continuous and persistent oxidative stress induced by apigenin at growth suppressive doses over extended treatment time period was observed to induce senescence which is a natural cellular mechanism to attenuate tumor formation. Senescence phenotype inducted by apigenin was attributed to changes in key molecules involved in p16-Rb and p53 independent p21 signaling pathways. Phosphorylation of retinoblastoma was inhibited and significant up-regulation of p21 led to simultaneous suppression of cyclins D1 and E which indicated the onset of senescence. Pro-oxidative stress induced premature senescence mediated by apigenin makes this treatment regimen a potential chemopreventive strategy and an in vitro model for aging research.

  14. Long-Term Results of Radiochemotherapy for Solitary Lymph Node Metastasis After Curative Resection of Esophageal Cancer

    International Nuclear Information System (INIS)

    Purpose: To evaluate the long-term efficacy and toxicity of definitive radiochemotherapy for solitary lymph node metastasis after curative surgery of esophageal cancer. Methods and Materials: We performed a retrospective review of 35 patients who underwent definitive radiochemotherapy at Tohoku University Hospital between 2000 and 2009 for solitary lymph node metastasis after curative esophagectomy with lymph node dissection for esophageal cancer. Radiotherapy doses ranged from 60 to 66 Gy (median, 60 Gy). Concurrent chemotherapy was platinum based in all patients. The endpoints of the present study were overall survival, cause-specific survival, progression-free survival, irradiated-field control, overall tumor response, and prognostic factors. Results: The median observation period for survivors was 70.0 months. The 5-year overall survival was 39.2% (median survival, 39.0 months). The 5-year cause-specific survival, progression-free survival, and irradiated-field control were 43.3%, 31.0% and 59.9%, respectively. Metastatic lesion, size of the metastatic lymph node, and performance status before radiochemotherapy were significantly correlated with prognosis. Complete response and partial response were observed in 22.9% and 57.1% of the patients, respectively. There was no Grade 3 or higher adverse effect based on theCommon Terminology Criteria for Adverse Events (CTCAE v3.0) in the late phase. Conclusions: Based on our study findings, approximately 40% of patients with solitary lymph node metastasis after curative resection for esophageal cancer have a chance of long-term survival with definitive radiochemotherapy.

  15. Post-GWAS gene–environment interplay in breast cancer: results from the Breast and Prostate Cancer Cohort Consortium and a meta-analysis on 79 000 women

    OpenAIRE

    Barrdahl, Myrto; Canzian, Federico; Joshi, Amit D.; Ruth C Travis; Chang-Claude, Jenny; Auer, Paul L.; Gapstur, Susan M.; Gaudet, Mia; Diver, W Ryan; Brian E Henderson; Haiman, Christopher A.; Fredrick R Schumacher; Le Marchand, Loïc; Berg, Christine D; Chanock, Stephen J.

    2014-01-01

    We studied the interplay between 39 breast cancer (BC) risk SNPs and established BC risk (body mass index, height, age at menarche, parity, age at menopause, smoking, alcohol and family history of BC) and prognostic factors (TNM stage, tumor grade, tumor size, age at diagnosis, estrogen receptor status and progesterone receptor status) as joint determinants of BC risk. We used a nested case–control design within the National Cancer Institute's Breast and Prostate Cancer Cohort Consortium (BPC...

  16. Electrons for intraoperative radiotherapy in selected breast-cancer patients: late results of the Montpellier phase II trial

    International Nuclear Information System (INIS)

    The Montpellier cancer institute phase II trial started in 2004 and evaluated the feasibility of intraoperative radiotherapy (IORT) technique given as a sole radiation treatment for patients with an excellent prognostic and very low recurrence risk. Forty-two patients were included between 2004 and 2007. Inclusion criteria were patients ≥ 65 years old, T0-T1, N0, ductal invasive unifocal carcinoma, free-margin > 2 mm. IORT was delivered using dedicated linear accelerator. One fraction of 21 Gy was prescribed and specified at the 90% isodose using electrons. In vivo dosimetry was performed for all patients. Primary end-point was the quality index. Secondary endpoints were quality of life, local recurrences, cosmetic results, specific and overall survival. At inclusion, median age was 72 years (range, 66–80). Median tumor diameter was 10 mm. All patients received the total prescribed dose. No acute grade 3 toxicities were observed. Late cosmetic results were good at 5 years despite the poor agreement of accuracy assessment between patients and physicians. Four patients (9.5%) experienced a local failure and underwent salvage mastectomy. The 5 year-disease free survival is 92.7% (range 79.1−97.6). All patients are still alive with a median follow-up of 72 months (range 66–74). Our results confirm with a long-term follow-up that exclusive partial breast IORT is feasible for early-breast cancer in selected patients. IORT provides good late cosmetics results and should be considered as a safe and very comfortable “one-step” treatment procedure. Nevertheless, patient assessments are essential for long-term quality results

  17. Clinical outcome and cosmetic results of conservative surgery plus radiation therapy in early stage breast cancer patients

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical outcome and cosmetic results in early stage breast cancer patients treated with conservative surgery plus radiation therapy. Methods: From May 1995 to December 2002, 109 such patients were so treated. The post-operative radiotherapy consisted of whole-breast 6 MV linear accelerator irradiation with two tangential half-fields to a total dose of 45-52 Gy (mean 48.6 Gy), followed by a boost irradiation to the tumor bed. Among them, 79 patients received 10-12 Gy (DB) boost by interstitial implantation brachytherapy (192Ir HDR, Nucletron), with single plane implantation for T1 and double plane implantation for T2 tumor. Thirty patients received 15 Gy boost by electron beam. Adjuvant/concurrent chemotherapy (CMF or CEF) and hormonotherapy were also used according to the patients' clinical characteristics. The cosmetic results were scored by both the doctor and the patients. Results: The overall actuarial 5-year survival was 93.8%, with local recurrence of 6.5%. No radiation-induced ulcer was observed in the breast except for acute inflammation at skin pinholes in 5 patients treated by interstitial implant brachytherapy. Among the 75 patients who had had breast examination, cosmetic result scored as good by patient and doctor were 81% and 87%, respectively. The good rate assessed by doctor in brachytherapy boost group and electron beam boost group were 81.2% (39/48) and 85.2% (23/27), There was no significant difference between these two boost techniques (P>0.05). Conclusions: Tumor bed boost irradiation by either brachytherapy or electron beam technique can provide satisfactory local control in early breast cancer treated with conservative surgery plus radiotherapy without increasing the side effects. There is no significant difference in cosmetic result between these two boost techniques. (authors)

  18. Molecular targeted treatment and radiation therapy for rectal cancer

    International Nuclear Information System (INIS)

    Background: EGFR (epidermal growth factor receptor) and VEGF (vascular endothelial growth factor) inhibitors confer clinical benefit in metastatic colorectal cancer when combined with chemotherapy. An emerging strategy to improve outcomes in rectal cancer is to integrate biologically active, targeted agents as triple therapy into chemoradiation protocols. Material and methods: cetuximab and bevacizumab have now been incorporated into phase I-II studies of preoperative chemoradiation therapy (CRT) for rectal cancer. The rationale of these combinations, early efficacy and toxicity data, and possible molecular predictors for tumor response are reviewed. Computerized bibliographic searches of Pubmed were supplemented with hand searches of reference lists and abstracts of ASCO and ASTRO meetings. Results: the combination of cetuximab and CRT can be safely applied without dose compromises of the respective treatment components. Disappointingly low rates of pathologic complete remission have been noted in several phase II studies. The K-ras mutation status and the gene copy number of EGFR may predict tumor response. The toxicity pattern (radiation-induced enteritis, perforations) and surgical complications (wound healing, fistula, bleeding) observed in at least some of the clinical studies with bevacizumab and CRT warrant further investigations. Conclusion: longer follow-up (and, finally, randomized trials) is needed to draw any firm conclusions with respect to local and distant failure rates, and toxicity associated with these novel treatment approaches. (orig.)

  19. Molecular targeted treatment and radiation therapy for rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Marquardt, Friederike; Roedel, Franz; Capalbo, Gianni; Weiss, Christian; Roedel, Claus [Dept. of Radiation Therapy, Univ. of Frankfurt/Main (Germany)

    2009-06-15

    Background: EGFR (epidermal growth factor receptor) and VEGF (vascular endothelial growth factor) inhibitors confer clinical benefit in metastatic colorectal cancer when combined with chemotherapy. An emerging strategy to improve outcomes in rectal cancer is to integrate biologically active, targeted agents as triple therapy into chemoradiation protocols. Material and methods: cetuximab and bevacizumab have now been incorporated into phase I-II studies of preoperative chemoradiation therapy (CRT) for rectal cancer. The rationale of these combinations, early efficacy and toxicity data, and possible molecular predictors for tumor response are reviewed. Computerized bibliographic searches of Pubmed were supplemented with hand searches of reference lists and abstracts of ASCO and ASTRO meetings. Results: the combination of cetuximab and CRT can be safely applied without dose compromises of the respective treatment components. Disappointingly low rates of pathologic complete remission have been noted in several phase II studies. The K-ras mutation status and the gene copy number of EGFR may predict tumor response. The toxicity pattern (radiation-induced enteritis, perforations) and surgical complications (wound healing, fistula, bleeding) observed in at least some of the clinical studies with bevacizumab and CRT warrant further investigations. Conclusion: longer follow-up (and, finally, randomized trials) is needed to draw any firm conclusions with respect to local and distant failure rates, and toxicity associated with these novel treatment approaches. (orig.)

  20. Radiotherapy and hyperthermia for treatment of primary locally advanced cervix cancer: results in 378 patients.

    NARCIS (Netherlands)

    Franckena, M.; Lutgens, L.C.; Koper, P.C.; Kleynen, C.E.; Steen-Banasik, E.M. van der; Jobsen, J.J.; Leer, J.W.H.; Creutzberg, C.L.; Dielwart, M.F.; Norden, Y. Van; Canters, R.A.; Rhoon, G.C. van; Zee, J. van der

    2009-01-01

    PURPOSE: To report response rate, pelvic tumor control, survival, and late toxicity after treatment with combined radiotherapy and hyperthermia (RHT) for patients with locally advanced cervical carcinoma (LACC) and compare the results with other published series. METHODS AND MATERIALS: From 1996 to

  1. Validation of natural language processing to extract breast cancer pathology procedures and results

    Directory of Open Access Journals (Sweden)

    Arika E Wieneke

    2015-01-01

    Full Text Available Background: Pathology reports typically require manual review to abstract research data. We developed a natural language processing (NLP system to automatically interpret free-text breast pathology reports with limited assistance from manual abstraction. Methods: We used an iterative approach of machine learning algorithms and constructed groups of related findings to identify breast-related procedures and results from free-text pathology reports. We evaluated the NLP system using an all-or-nothing approach to determine which reports could be processed entirely using NLP and which reports needed manual review beyond NLP. We divided 3234 reports for development (2910, 90%, and evaluation (324, 10% purposes using manually reviewed pathology data as our gold standard. Results: NLP correctly coded 12.7% of the evaluation set, flagged 49.1% of reports for manual review, incorrectly coded 30.8%, and correctly omitted 7.4% from the evaluation set due to irrelevancy (i.e. not breast-related. Common procedures and results were identified correctly (e.g. invasive ductal with 95.5% precision and 94.0% sensitivity, but entire reports were flagged for manual review because of rare findings and substantial variation in pathology report text. Conclusions: The NLP system we developed did not perform sufficiently for abstracting entire breast pathology reports. The all-or-nothing approach resulted in too broad of a scope of work and limited our flexibility to identify breast pathology procedures and results. Our NLP system was also limited by the lack of the gold standard data on rare findings and wide variation in pathology text. Focusing on individual, common elements and improving pathology text report standardization may improve performance.

  2. Surface hyperthermia guided by infrared image and re-irradiation of local relapses of breast cancer; Hyperthermie superficielle guidee par image infrarouge et la re-irradiation des recidives locales du cancer du sein

    Energy Technology Data Exchange (ETDEWEB)

    Notter, M.; Yanes, B.; Germond, J.F. [Hopital Neuchatelois, La Chaux de Fonds (Switzerland)

    2010-10-15

    As the taking into care of local relapses of cancer breast after a conventional treatment remains a challenge, the authors report the exploration of the use of a re-irradiation combined with hyperthermia. As disappointing results obtained with surface hyperthermia are attributed to some technical problems, they use a high resolution infrared image to get a better temperature distribution and to be able to adapt heat application to the dynamic changes of the tumour and of normal tissues, and to improve the hyperthermia quality. Preliminary results obtained on five patients are discussed and seem promising. It provides a better therapeutic efficiency, and gives access to information related to the tumour response, to inflammatory processes, to the vascularisation of healthy tissues, and to radio-induced reactions. Short communication

  3. Five-year Results of Whole Breast Intensity Modulated Radiation Therapy for the Treatment of Early Stage Breast Cancer: The Fox Chase Cancer Center Experience

    International Nuclear Information System (INIS)

    Purpose: To report the 5-year outcomes using whole-breast intensity-modulated radiation therapy (IMRT) for the treatment of early-stage-breast cancer at the Fox Chase Cancer Center. Methods and Materials: A total of 946 women with early-stage breast cancer (stage 0, I, or II) were treated with IMRT after surgery with or without systemic therapy from 2003-2010. Whole-breast radiation was delivered via an IMRT technique with a median whole-breast radiation dose of 46 Gy and median tumor bed boost of 14 Gy. Endpoints included local-regional recurrence, cosmesis, and late complications. Results: With a median follow-up of 31 months (range, 1-97 months), there were 12 ipsilateral breast tumor recurrences (IBTR) and one locoregional recurrence. The 5-year actuarial IBTR and locoregional recurrence rates were 2.0% and 2.4%. Physician-reported cosmestic outcomes were available for 645 patients: 63% were considered “excellent”, 33% “good”, and 900 cc, or boost volumes >34 cc were significantly associated with a “fair/poor” cosmetic outcome. Fibrosis, edema, erythema, and telangectasia were also associated with “fair/poor” physician-reported cosmesis; erythema and telangectasia remained significant on multivariate analysis. Patient-reported cosmesis was available for 548 patients, and 33%, 50%, and 17% of patients reported “excellent”, “good”, and “fair/poor” cosmesis, respectively. The use of a boost and increased boost volume: breast volume ratio were significantly associated with “fair/poor” outcomes. No parameter for patient-reported cosmesis was significant on multivariate analysis. The chances of experiencing a treatment related effect was significantly associated with a boost dose ≥16 Gy, receipt of chemotherapy and endocrine therapy, large breast size, and electron boost energy. Conclusions: Whole-breast IMRT is associated with very low rates of local recurrence at 5 years, 83%-98% “good/excellent” cosmetic outcomes, and minimal

  4. Five-year Results of Whole Breast Intensity Modulated Radiation Therapy for the Treatment of Early Stage Breast Cancer: The Fox Chase Cancer Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Lanea M.M., E-mail: Lanea.Keller@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Sopka, Dennis M. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Li Tianyu [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA (United States); Klayton, Tracy; Li Jinsheng; Anderson, Penny R. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Bleicher, Richard J.; Sigurdson, Elin R. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Freedman, Gary M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)

    2012-11-15

    Purpose: To report the 5-year outcomes using whole-breast intensity-modulated radiation therapy (IMRT) for the treatment of early-stage-breast cancer at the Fox Chase Cancer Center. Methods and Materials: A total of 946 women with early-stage breast cancer (stage 0, I, or II) were treated with IMRT after surgery with or without systemic therapy from 2003-2010. Whole-breast radiation was delivered via an IMRT technique with a median whole-breast radiation dose of 46 Gy and median tumor bed boost of 14 Gy. Endpoints included local-regional recurrence, cosmesis, and late complications. Results: With a median follow-up of 31 months (range, 1-97 months), there were 12 ipsilateral breast tumor recurrences (IBTR) and one locoregional recurrence. The 5-year actuarial IBTR and locoregional recurrence rates were 2.0% and 2.4%. Physician-reported cosmestic outcomes were available for 645 patients: 63% were considered 'excellent', 33% 'good', and <1.5% 'fair/poor'. For physician-reported cosmesis, boost doses {>=}16 Gy, breast size >900 cc, or boost volumes >34 cc were significantly associated with a 'fair/poor' cosmetic outcome. Fibrosis, edema, erythema, and telangectasia were also associated with 'fair/poor' physician-reported cosmesis; erythema and telangectasia remained significant on multivariate analysis. Patient-reported cosmesis was available for 548 patients, and 33%, 50%, and 17% of patients reported 'excellent', 'good', and 'fair/poor' cosmesis, respectively. The use of a boost and increased boost volume: breast volume ratio were significantly associated with 'fair/poor' outcomes. No parameter for patient-reported cosmesis was significant on multivariate analysis. The chances of experiencing a treatment related effect was significantly associated with a boost dose {>=}16 Gy, receipt of chemotherapy and endocrine therapy, large breast size, and electron boost energy

  5. Erythema nodosum as a result of estrogen patch therapy for prostate cancer: a case report

    OpenAIRE

    Coyle, C.; Mangar, S.; Abel, P.; Langley, R. E.

    2015-01-01

    INTRODUCTION: Erythema nodosum is often associated with a distressing symptomatology, including painful subcutaneous nodules, polyarthropathy, and significant fatigue. Whilst it is a well-documented side-effect of estrogen therapy in females, we describe what we believe to be the first report in the literature of erythema nodosum as a result of estrogen therapy in a male. CASE PRESENTATION: A 64-year-old Afro-Caribbean man with locally advanced carcinoma of the prostate agreed to participate ...

  6. Indications, techniques and results of postoperative brachytherapy in cancer of the oral cavity

    International Nuclear Information System (INIS)

    Purpose/objective: We tried to reduce the number of local recurrences after surgery and external beam irradiation (EBI) in carcinoma of the oral cavity, when margins were positive or close. Material and methods: From 1980 to 1992, we treated 97 cases of carcinomas of the oral cavity by postoperative brachytherapy. Surgery was combined with EBI+brachytherapy in 51 cases and with brachytherapy alone in 46 cases. We treated 29 T1, 34 T2, 30 T3T4 and four Tx (73% were N0 at first examination and 23% had positive nodes). The type of surgery is analysed. Brachytherapy was performed in one or two planes along the surgical scar. If the mandibular rim was resected, especially when the tongue or the remaining floor were sutured to the internal face of the inferior lip or to the buccal mucosa, the bridge technique was used. To decrease the dose to the inferior part of the mandible, the bridge was modified thanks to experimental dosimetry. Results: At 5 years, the local control (LC) is 89%, the locoregional control (LRC) 82%, the specific survival (SS) 74% and the overall survival (OS) 67%. Complications: We noted 19% of grade 1 (minor), 12% of grade 2 (moderate) and 6% of grade 3 (major) complications. Conclusion: Compared with the results of the literature, we think that postoperative brachytherapy can improve classical radiosurgical results in selected cases with a risk of local recurrence

  7. Effect of radiologist experience on the risk of false-positive results in breast cancer screening programs

    Energy Technology Data Exchange (ETDEWEB)

    Zubizarreta Alberdi, Raquel [Galician Breast Cancer Screening Programme, Public Health and Planning Directorate, Health Office, Galicia (Spain); Edificio Administrativo da Conselleria de Sanidade, Servicio de Programas Poboacionais de Cribado, Direccion Xeral de Saude Publica e Planificacion, Santiago de Compostela, Galicia (Spain); Llanes, Ana B.F.; Ortega, Raquel Almazan [Galician Breast Cancer Screening Programme, Public Health and Planning Directorate, Health Office, Galicia (Spain); Exposito, Ruben Roman; Collado, Jose M.V.; Oliveres, Xavier Castells [Department of Epidemiology and Evaluation, Institut Municipal d' Investigacio Medica-Parc de Salut Mar. CIBERESP, Barcelona (Spain); Queiro Verdes, Teresa [Galician Agency for Health Technology Assessment, Public Health and Planning Directorate, Health Office, Galicia (Spain); Natal Ramos, Carmen [Principality of Asturias Breast Cancer Screening Programme, Principality of Asturias (Spain); Sanz, Maria Ederra [Public Health Institute, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Salas Trejo, Dolores [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia Breast Cancer Screening Programme, Valencia (Spain)

    2011-10-15

    To evaluate the effect of radiologist experience on the risk of false-positive results in population-based breast cancer screening programmes. We evaluated 1,440,384 single-read screening mammograms, corresponding to 471,112 women aged 45-69 years participating in four Spanish programmes between 1990 and 2006. The mammograms were interpreted by 72 radiologists. The overall percentage of false-positive results was 5.85% and that for false-positives resulting in an invasive procedure was 0.38%. Both the risk of false-positives overall and of false-positives leading to an invasive procedure significantly decreased (p < 0.001) with greater reading volume in the previous year: OR 0.77 and OR 0.78, respectively, for a reading volume 500-1,999 mammograms and OR 0.59 and OR 0.60 for a reading volume of >14,999 mammograms with respect to the reference category (<500). The risk of both categories of false-positives was also significantly reduced (p < 0.001) as radiologists' years of experience increased: OR 0.96 and OR 0.84, respectively, for 1 year's experience and OR 0.72 and OR 0.73, respectively, for more than 4 years' experience with regard to the category of <1 year's experience. Radiologist experience is a determining factor in the risk of a false-positive result in breast cancer screening. (orig.)

  8. Biological Characteristics and Medical Treatment of Breast Cancer in Young Women-A Featured Population: Results from the Nora Study

    International Nuclear Information System (INIS)

    Background. The present paper described the biological characteristics and clinical behavior of young women in the cohort NORA study Patients and Methods. From 2000-2002, patients (N>3500) were enrolled at 77 Italian hospitals. Women aged =50 years (N=1013) were stratified into age groups (=35, 36-40, 41-45, and 46-50 years). The relationship between age and patient characteristics, cancer presentation, and treatment was analyzed. Results. Younger women more frequently had tumors with ER/PgR-negative(x2=7.07; P=.008), HER2 amplification (x2=5.76; P=.01), and high (≤10%) Ki67 labelling index (x2=9.53; P=.002). Positive nodal status, large tumors, and elevated Ki67 all associated with the choice for chemotherapy followed by endocrine therapy in hormone receptor-positive patients (P40 versus =40, P<.0001, resp.). At multivariate analysis, after adjustment for significant clinical and pathological factors, age remains a significant prognostic variable (HR=0.93, P=.0021). Conclusion. This cohort study suggests that age per se is an important prognostic factor. The restricted role of early diagnosis and the aggressive behavior of cancer in this population make necessary the application of targeted medical strategies crucial. human epidermal growth factor receptor

  9. Higher quality of molecular testing, an unfulfilled priority: Results from external quality assessment for KRAS mutation testing in colorectal cancer.

    Science.gov (United States)

    Tembuyser, Lien; Ligtenberg, Marjolijn J L; Normanno, Nicola; Delen, Sofie; van Krieken, J Han; Dequeker, Elisabeth M C

    2014-05-01

    Precision medicine is now a key element in clinical oncology. RAS mutational status is a crucial predictor of responsiveness to anti-epidermal growth factor receptor agents in metastatic colorectal cancer. In an effort to guarantee high-quality testing services in molecular pathology, the European Society of Pathology has been organizing an annual KRAS external quality assessment program since 2009. In 2012, 10 formalin-fixed, paraffin-embedded samples, of which 8 from invasive metastatic colorectal cancer tissue and 2 artificial samples of cell line material, were sent to more than 100 laboratories from 26 countries with a request for routine KRAS testing. Both genotyping and clinical reports were assessed independently. Twenty-seven percent of the participants genotyped at least 1 of 10 samples incorrectly. In total, less than 5% of the distributed specimens were genotyped incorrectly. Genotyping errors consisted of false negatives, false positives, and incorrectly genotyped mutations. Twenty percent of the laboratories reported a technical error for one or more samples. A review of the written reports showed that several essential elements were missing, most notably a clinical interpretation of the test result, the method sensitivity, and the use of a reference sequence. External quality assessment serves as a valuable educational tool in assessing and improving molecular testing quality and is an important asset for monitoring quality assurance upon incorporation of new biomarkers in diagnostic services. PMID:24631467

  10. Accuracy of hydro-multidetector row CT in the local T staging of oesophageal cancer compared to postoperative histopathological results

    International Nuclear Information System (INIS)

    To evaluate the accuracy of multidetector computed tomography with water filling (Hydro-MDCT) in the T-staging of patients with oesophageal cancer. There were 131 consecutive patients who were preoperatively and prospectively examined in the prone position on arterial phase contrast-enhanced MDCT, after ingestion of 1,000-1,500 ml tap water and effervescent granules. Two readers staged the local tumour growth (T-staging) independently. They assessed tumour location, size, presence of stenosis, and morphology of the outer border of the oesophageal wall and perioesophageal fat planes on CT. CT findings were compared with histopathological results from resected specimens. Data were analyzed using the SPSS statistical package. Both readers obtained a high sensitivity of 95% and a high positive predictive value of 96%. Accurate local staging was achieved in 76.3% and 68.7% for readers 1 and 2, respectively. Inter-reader agreement was excellent (weighted κ value of 0.93 and un-weighted κ of 0.89). Using the hydro-technique and applying specific assessment criteria, MDCT appears to be an accurate, non-invasive diagnostic tool for local tumour staging of oesophageal cancer. (orig.)

  11. Does a central review platform improve the quality of radiotherapy for rectal cancer? Results of a national quality assurance project

    International Nuclear Information System (INIS)

    Background and purpose: Quality assurance (QA) for radiation treatment has become a priority since poorly delivered radiotherapy can negatively influence patient outcome. Within a national project we evaluated the feasibility of a central review platform and its role in improving uniformity of clinical target volume (CTV) delineation in daily practice. Material and methods: All Belgian radiotherapy departments were invited to participate and were asked to upload CTVs for rectal cancer treatment onto a secured server. These were centrally reviewed and feedback was given per e-mail. For each five consecutive patients per centre, the overlap parameter dice coefficient (DC) and the volumetric parameters volumetric ratio (RV) and commonly contoured volume (VCC) were calculated. Results: Twenty departments submitted 1224 eligible cases of which 909 were modified (74.3%). There was a significant increase in RV and VCC between the first ten patients per centre and the others. This was not seen for DC. Statistical analysis did not show a further significant improvement in delineation over the entire review period. Conclusion: Central review was feasible and increased the uniformity in CTV delineation in the first ten rectal