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Sample records for carcinoma patients receiving

  1. Circulating endothelial cells and other angiogenesis factors in pancreatic carcinoma patients receiving gemcitabine chemotherapy

    International Nuclear Information System (INIS)

    Pancreatic carcinoma is a significant cause of cancer-related death in developed countries. As the level of circulating endothelial cells (CECs) is known to increase in response to various cancers, we investigated the predictive potential of CEC levels and the association of these levels with the expression of proangiogenic factors in pancreatic carcinoma patients. Pancreatic carcinoma patients receiving gemcitabine chemotherapy were prospectively assigned to this study. CEC levels were measured using the CellTracks system, and the plasma levels of several angiogenesis factors were measured using multiplex immunoassay. Associations between clinical outcomes and the levels of these factors were evaluated. Baseline CEC levels were markedly higher in pancreatic carcinoma patients (n = 37) than in healthy volunteers (n = 53). Moreover, these high CEC levels were associated with decreased overall survival (median, 297 days versus 143 days, P < 0.001) and progression-free survival (median, 150 days versus 64 days, P = 0.008), as well as with high vascular endothelial growth factor, interleukin (IL)-8, and IL-10 expression in the pancreatic carcinoma patients. Several chemokines and proangiogenic factors correlate with the release of CECs, and the number of CECs detected may be a useful prognostic marker in pancreatic carcinoma patients undergoing gemcitabine chemotherapy. UMIN000002323

  2. Severe reversible toxic encephalopathy induced by cisplatin in a patient with cervical carcinoma receiving combined radiochemotherapy

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    Sterzing, F.; Grehn, C.; Dinkel, J.; Krempien, R.; Hartung, G.; Debus, J.; Harms, W. [University of Heidelberg Medical School (Germany). Dept. of Radiation Oncology

    2007-09-15

    Case Report: A 45-year-old patient with cervix carcinoma received combined radiochemotherapy including cisplatin. After a cumulative dose of 240 mg/m{sup 2} the patient suddenly became somnolent and developed a severe tetraparesis and generalized seizures. After ruling out intracranial bleeding, cerebral metastases as well as infectious and metabolic causes of this condition, a severe toxic encephalopathy was diagnosed based on the clinical findings and MRI scans. After symptomatic treatment on the intensive care unit all symptoms were completely reversible. Conclusion: Toxic encephalopathy is a rare but dramatic complication of various cytostatic drugs. With the widespread use of cisplatin this rare disorder should be kept in mind. (orig.)

  3. Yttrium-90 radioembolization in patients with hepatocellular carcinoma who have previously received sorafenib

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    Nitesh eRana

    2013-12-01

    Full Text Available Purpose: Ytrrium-90 radioembolization (RE is a locoregional therapy option for hepatocellular carcinoma (HCC. Sorafenib is a multikinase inhibitor used in HCC that can potentially affect the efficacy of RE by altering tumor vascularity or suppressing post-irradiation angiogenesis. The safety and efficacy of sorafenib followed by RE has not been previously reported. Materials and Methods: Patients with HCC who received RE after sorafenib were included in this retrospective review. Overall survival, toxicity, and maximal radiographic response and necrosis criteria were examined. Results: Ten patients (15 RE administrations fit the inclusion criteria. All were Barcelona Clinic Liver Cancer (BCLC stage C. Median follow- up was 16.5 weeks. Median overall survival and radiographic progression-free survival were 30 weeks and 28 weeks, respectively. Significant differences in overall survival were seen based on Child-Pugh class (p=0.002 and radiographic response (p=0.009. Three patients had partial response, 6 had stable disease, and 1 had progressive disease. Grade 1 or 2 acute fatigue, anorexia, and abdominal pain were common. Three patients had Grade 3 ascites in the setting of disease progression. Two patients had Grade 3 biochemical toxicity. One patient was sufficiently downstaged following RE and sorafenib to receive a partial hepatectomy. Conclusion: Yttrium-90 radioembolization in patients with hepatocellular carcinoma who have received sorafenib demonstrate acceptable toxicity and rates of radiographic response. However, the overall survival is lower than that reported in the literature on RE alone or sorafenib alone. This may be due in part to more patients in this study having advanced disease compared to these other study populations. Larger prospective studies are needed to determine whether the combination of RE and sorafenib is superior to either therapy alone.

  4. Clinical Outcomes of Patients Receiving Integrated PET/CT-Guided Radiotherapy for Head and Neck Carcinoma

    International Nuclear Information System (INIS)

    Purpose: We previously reported the advantages of 18F-fluorodeoxyglucose-positron emission tomography (PET) fused with CT for radiotherapy planning over CT alone in head and neck carcinoma (HNC). The purpose of this study was to evaluate clinical outcomes and the predictive value of PET for patients receiving PET/CT-guided definitive radiotherapy with or without chemotherapy. Methods and Materials: From December 2002 to August 2006, 42 patients received PET/CT imaging as part of staging and radiotherapy planning. Clinical outcomes including locoregional recurrence, distant metastasis, death, and treatment-related toxicities were collected retrospectively and analyzed for disease-free and overall survival and cumulative incidence of recurrence. Results: Median follow-up from initiation of treatment was 32 months. Overall survival and disease-free survival were 82.8% and 71.0%, respectively, at 2 years, and 74.1% and 66.9% at 3 years. Of the 42 patients, seven recurrences were identified (three LR, one DM, three both LR and DM). Mean time to recurrence was 9.4 months. Cumulative risk of recurrence was 18.7%. The maximum standard uptake volume (SUV) of primary tumor, adenopathy, or both on PET did not correlate with recurrence, with mean values of 12.0 for treatment failures vs. 11.7 for all patients. Toxicities identified in those patients receiving intensity modulated radiation therapy were also evaluated. Conclusions: A high level of disease control combined with favorable toxicity profiles was achieved in a cohort of HNC patients receiving PET/CT fusion guided radiotherapy plus/minus chemotherapy. Maximum SUV of primary tumor and/or adenopathy was not predictive of risk of disease recurrence

  5. Associations of ATM Polymorphisms With Survival in Advanced Esophageal Squamous Cell Carcinoma Patients Receiving Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: To investigate whether single nucleotide polymorphisms (SNPs) in the ataxia telangiectasia mutated (ATM) gene are associated with survival in patients with esophageal squamous cell carcinoma (ESCC) receiving radiation therapy or chemoradiation therapy or surgery only. Methods and Materials: Four tagSNPs of ATM were genotyped in 412 individuals with clinical stage III or IV ESCC receiving radiation therapy or chemoradiation therapy, and in 388 individuals with stage I, II, or III ESCC treated with surgery only. Overall survival time of ESCC among different genotypes was estimated by Kaplan-Meier plot, and the significance was examined by log-rank test. The hazard ratios (HRs) and 95% confidence intervals (CIs) for death from ESCC among different genotypes were computed by a Cox proportional regression model. Results: We found 2 SNPs, rs664143 and rs664677, associated with survival time of ESCC patients receiving radiation therapy. Individuals with the rs664143A allele had poorer median survival time compared with the rs664143G allele (14.0 vs 20.0 months), with the HR for death being 1.45 (95% CI 1.12-1.89). Individuals with the rs664677C allele also had worse median survival time than those with the rs664677T allele (14.0 vs 23.5 months), with the HR of 1.57 (95% CI 1.18-2.08). Stratified analysis showed that these associations were present in both stage III and IV cancer and different radiation therapy techniques. Significant associations were also found between the SNPs and locosregional progression or progression-free survival. No association between these SNPs and survival time was detected in ESCC patients treated with surgery only. Conclusion: These results suggest that the ATM polymorphisms might serve as independent biomarkers for predicting prognosis in ESCC patients receiving radiation therapy

  6. Associations of ATM Polymorphisms With Survival in Advanced Esophageal Squamous Cell Carcinoma Patients Receiving Radiation Therapy

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    Du, Zhongli [State Key Laboratory of Molecular Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Department of Etiology and Carcinogenesis (Beijing Key Laboratory for Carcinogenesis and Cancer Prevention), Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Zhang, Wencheng [Department of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Zhou, Yuling; Yu, Dianke; Chen, Xiabin; Chang, Jiang; Qiao, Yan; Zhang, Meng; Huang, Ying; Wu, Chen [State Key Laboratory of Molecular Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Department of Etiology and Carcinogenesis (Beijing Key Laboratory for Carcinogenesis and Cancer Prevention), Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Xiao, Zefen, E-mail: xiaozefen@sina.com [Department of Radiation Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Tan, Wen, E-mail: tanwen@cicams.ac.cn [State Key Laboratory of Molecular Oncology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Department of Etiology and Carcinogenesis (Beijing Key Laboratory for Carcinogenesis and Cancer Prevention), Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); and others

    2015-09-01

    Purpose: To investigate whether single nucleotide polymorphisms (SNPs) in the ataxia telangiectasia mutated (ATM) gene are associated with survival in patients with esophageal squamous cell carcinoma (ESCC) receiving radiation therapy or chemoradiation therapy or surgery only. Methods and Materials: Four tagSNPs of ATM were genotyped in 412 individuals with clinical stage III or IV ESCC receiving radiation therapy or chemoradiation therapy, and in 388 individuals with stage I, II, or III ESCC treated with surgery only. Overall survival time of ESCC among different genotypes was estimated by Kaplan-Meier plot, and the significance was examined by log-rank test. The hazard ratios (HRs) and 95% confidence intervals (CIs) for death from ESCC among different genotypes were computed by a Cox proportional regression model. Results: We found 2 SNPs, rs664143 and rs664677, associated with survival time of ESCC patients receiving radiation therapy. Individuals with the rs664143A allele had poorer median survival time compared with the rs664143G allele (14.0 vs 20.0 months), with the HR for death being 1.45 (95% CI 1.12-1.89). Individuals with the rs664677C allele also had worse median survival time than those with the rs664677T allele (14.0 vs 23.5 months), with the HR of 1.57 (95% CI 1.18-2.08). Stratified analysis showed that these associations were present in both stage III and IV cancer and different radiation therapy techniques. Significant associations were also found between the SNPs and locosregional progression or progression-free survival. No association between these SNPs and survival time was detected in ESCC patients treated with surgery only. Conclusion: These results suggest that the ATM polymorphisms might serve as independent biomarkers for predicting prognosis in ESCC patients receiving radiation therapy.

  7. Should patients with extrapulmonary small-cell carcinoma receive prophylactic cranial irradiation?

    LENUS (Irish Health Repository)

    Naidoo, Jarushka

    2013-09-01

    Extrapulmonary small-cell carcinoma (EPSCC) is a rare disease. Management is based on small-cell lung carcinoma. Prophylactic cranial irradiation (PCI) is not routinely administered in EPSCC. This study investigates the role of PCI in EPSCC, by analyzing the incidence, treatment, and survival of patients with brain metastases in a national cohort. Disease biology and epidemiology are also investigated.

  8. Should all patients with serous and clear cell endometrial carcinoma receive adjuvant chemotherapy?

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    Boren, Todd P; Miller, David S

    2010-11-01

    Uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC) represent two rare subtypes that have an increased risk of recurrence and worse overall survival compared with the more common endometrioid endometrial cancers. Meaningful data in the form of prospective randomized trials is lacking for both advanced and early-stage UPSC and UCCC. Data extrapolated from prospective trials in advanced endometrioid endometrial cancer and retrospective trials on early-stage UPSC suggest that adjuvant platinum and taxane-based chemotherapy may provide a survival benefit for these patients. Future trials specifically examining UPSC and UCCC are needed to elucidate the optimal treatment regimen for these patients. Given the current data, the option of chemotherapy should be considered in treatment-planning discussions for all patients with UPSC and UCCC. PMID:21118038

  9. The predictive and prognostic value of the Glasgow Prognostic Score in metastatic colorectal carcinoma patients receiving bevacizumab.

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    Maillet, Marianne; Dréanic, Johann; Dhooge, Marion; Mir, Olivier; Brezault, Catherine; Goldwasser, François; Chaussade, Stanislas; Coriat, Romain

    2014-11-01

    The Glasgow Prognostic Score (GPS), based on C-reactive protein and albumin levels, has shown its prognostic value in metastatic colorectal carcinoma (mCRC) patients receiving conventional cytotoxic therapy. Bevacizumab, a monoclonal antibody to vascular epidermal growth factor, improves the overall survival in mCRC. The aim of the present study was to assess the prognostic value of GPS in mCRC patients receiving antivascular epidermal growth factor therapy. From August 2005 to August 2012, consecutive patients with mCRC who received chemotherapy plus bevacizumab were eligible for the present analysis. The clinical stage, C-reactive protein, albumin and the Eastern Cooperative Oncology Group performance status were recorded at the time of initiation of bevacizumab. Patients received 5-fluorouracil-based chemotherapy plus bevacizumab in accordance with the digestive oncology multidisciplinary staff proposal and in line with the French recommendations for the treatment of mCRC. Eighty patients were eligible (colon n = 59, rectum n = 21), with a median follow-up of 14 months (range 1-58 months). Chemotherapy given with bevacizumab and 5-fluorouracil was oxaliplatin (n = 41, 51%) or irinotecan (n = 27, 34%). At baseline, 56, 31 and 13% of patients had a GPS of 0 (n = 45), 1 (n = 25) and 2 (n = 10), respectively. The median progression-free survival in these groups was 10.1, 6.5 and 5.6 months (P = 0.16), respectively. The median overall survival was 20.1, 11.4 and 6.5 months, respectively (P = 0.004). Our study confirmed the prognostic value of GPS in mCRC patients receiving chemotherapy plus bevacizumab. Given the poor survival observed in patients with an GPS of 2, studies dedicated to these patients could identify optimal treatment modalities. PMID:24858536

  10. Is there a benefit in receiving concurrent chemoradiotherapy for elderly patients with inoperable thoracic esophageal squamous cell carcinoma?

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    Peng Zhang

    Full Text Available BACKGROUND AND PURPOSE: The benefit of concurrent chemoradiotherapy (CCRT in elderly patients with inoperable esophageal squamous cell carcinoma (SCC is controversial. This study aimed to assess the efficiency and safety of CCRT in elderly thoracic esophageal cancer patients. METHODS AND MATERIALS: Between January 2002 and December 2011, 128 patients aged 65 years or older treated with CCRT or radiotherapy (RT alone for inoperable thoracic esophageal SCC were analyzed retrospectively (RT alone, n = 55; CCRT, n = 73. RESULTS: No treatment-related deaths occurred and no patients experienced any acute grade 4 non-hematologic toxicities. Patients treated with CCRT developed more severe acute toxicities than patients who received RT alone. The 3-year overall survival (OS rate was 36.1% for CCRT compared with 28.5% following RT alone (p = 0.008. Multivariate analysis identified T stage and treatment modality as independent prognostic factors for survival. Further analysis revealed that survival was significantly better in the CCRT group than in the RT alone group for patients ≤ 72 years. Nevertheless, the CCRT group had a similar OS to the RT group for patients > 72 years. CONCLUSION: Our results suggest that elderly patients with inoperable thoracic esophageal SCC could benefit from CCRT, without major toxicities. However, for patients older than 72 years, CCRT is not superior to RT alone in terms of survival benefit.

  11. Plasma uric acid and tumor volume are highly predictive of outcome in nasopharyngeal carcinoma patients receiving intensity modulated radiotherapy

    International Nuclear Information System (INIS)

    The combined predictive value of plasma uric acid and primary tumor volume in nasopharyngeal carcinoma (NPC) patients receiving intensity modulated radiation therapy (IMRT) has not yet been determined. In this retrospective study, plasma uric acid level was measured after treatment in 130 histologically-proven NPC patients treated with IMRT. Tumor volume was calculated from treatment planning CT scans. Overall (OS), progression-free (PFS) and distant metastasis-free (DMFS) survival were compared using Kaplan-Meier analysis and the log rank test, and Cox multivariate and univariate regression models were created. Patients with a small tumor volume (<27 mL) had a significantly better DMFS, PFS and OS than patients with a large tumor volume. Patients with a high post-treatment plasma uric acid level (>301 μmol/L) had a better DMFS, PFS and OS than patients with a low post-treatment plasma uric acid level. Patients with a small tumor volume and high post-treatment plasma uric acid level had a favorable prognosis compared to patients with a large tumor volume and low post-treatment plasma uric acid level (7-year overall OS, 100% vs. 48.7%, P <0.001 and PFS, 100% vs. 69.5%, P <0.001). Post-treatment plasma uric acid level and pre-treatment tumor volume have predictive value for outcome in NPC patients receiving IMRT. NPC patients with a large tumor volume and low post-treatment plasma uric acid level may benefit from additional aggressive treatment after IMRT

  12. Epigastric Distress Caused by Esophageal Candidiasis in 2 Patients Who Received Sorafenib Plus Radiotherapy for Hepatocellular Carcinoma: Case Report.

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    Chen, Kuo-Hsin; Weng, Meng-Tzu; Chou, Yueh-Hung; Lu, Yueh-Feng; Hsieh, Chen-Hsi

    2016-03-01

    Sorafenib followed by fractionated radiotherapy (RT) has been shown to decrease the phagocytic and candidacidal activities of antifungal agents due to radiosensitization. Moreover, sorafenib has been shown to suppress the immune system, thereby increasing the risk for candida colonization and infection. In this study, we present the 2 hepatocellular carcinoma (HCC) patients suffered from epigastric distress caused by esophageal candidiasis who received sorafenib plus RT.Two patients who had received sorafenib and RT for HCC with bone metastasis presented with hiccups, gastric ulcer, epigastric distress, anorexia, heart burn, and fatigue. Empiric antiemetic agents, antacids, and pain killers were ineffective at relieving symptoms. Panendoscopy revealed diffuse white lesions in the esophagus. Candida esophagitis was suspected. Results of periodic acid-Schiff staining were diagnostic of candidiasis. Oral fluconazole (150 mg) twice daily and proton-pump inhibitors were prescribed. At 2-weak follow-up, esophagitis had resolved and both patients were free of gastrointestinal symptoms.Physicians should be aware that sorafenib combined with RT may induce an immunosuppressive state in patients with HCC, thereby increasing their risk of developing esophagitis due to candida species. PMID:26986168

  13. Recommendation for a contouring method and atlas of organs at risk in nasopharyngeal carcinoma patients receiving intensity-modulated radiotherapy

    International Nuclear Information System (INIS)

    Background and purpose: To recommend contouring methods and atlas of organs at risk (OARs) for nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiotherapy, in order to help reach a consensus on interpretations of OARs delineation. Methods and materials: Two to four contouring methods for the middle ear, inner ear, temporal lobe, parotid gland and spinal cord were identified via systematic literature review; their volumes and dosimetric parameters were compared in 41 patients. Areas under the receiver operating characteristic curves for temporal lobe contouring were compared in 21 patients with unilateral temporal lobe necrosis (TLN). Results: Various contouring methods for the temporal lobe, middle ear, inner ear, parotid gland and spinal cord lead to different volumes and dosimetric parameters (P < 0.05). For TLN, D1 of PRV was the most relevant dosimetric parameter and 64 Gy was the critical point. We suggest contouring for the temporal lobe, middle ear, inner ear, parotid gland and spinal cord. A CT–MRI fusion atlas comprising 33 OARs was developed. Conclusions: Different dosimetric parameters may hinder the dosimetric research. The present recommendation and atlas, may help reach a consensus on subjective interpretation of OARs delineation to reduce inter-institutional differences in NPC patients

  14. Rectal Motion in Patients Receiving Preoperative Radiotherapy for Carcinoma of the Rectum

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    Purpose: To assess the movement of rectum, mesorectum, and rectal primary during a course of preoperative chemoradiotherapy. Methods and Materials: Seventeen patients with Stage II or III rectal cancer had a planning CT scan with rectal contrast before commencement of preoperative chemoradiation. The scan was repeated during Weeks 1, 3, and 5 of chemoradiation. The rectal primary (gross tumor volume), rectum, mesorectum, and bladder were contoured on all four scans. An in-house biomechanical model-based deformable image registration technique, Morfeus, was used to measure the three-dimensional spatial change in these structures after bony alignment. The required planning target volume margin for this spatial change, after bone alignment, was also calculated. Results: Rectal contrast was found to introduce a systematic error in the position of all organs compared with the noncontrast state. The largest change in structures during radiotherapy was in the anterior and posterior directions for the mesorectum and rectum and in the superior and inferior directions for the gross tumor volume. The planning target volume margins required for internal movement for the mesorectum based on the three scans acquired during treatment are 4 mm right, 5 mm left, 7 mm anterior, and 6 mm posterior. For the rectum, values were 8 mm right, 8 mm left, 8 mm anterior, and 9 mm posterior. The greatest movement of the rectum occurred in the upper third. Conclusions: Contrast is no longer used in CT simulation. Assuming bony alignment, a nonuniform margin of 8 mm anteriorly, 9 mm posteriorly, and 8 mm left and right is recommended.

  15. Survival prognostic factors for patients with synchronous brain oligometastatic non-small-cell lung carcinoma receiving local therapy

    OpenAIRE

    Bai H; Xu J; Yang H; Jin B; Lou Y; Wu D.; Han B.

    2016-01-01

    Hao Bai,1,* Jianlin Xu,1,* Haitang Yang,2,* Bo Jin,1 Yuqing Lou,1 Dan Wu,3 Baohui Han1 1Department of Pulmonary, 2Department of Pathology, 3Central Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China *These authors contributed equally to this work Introduction: Clinical evidence for patients with synchronous brain oligometastatic non-small-cell lung carcinoma is limited. We aimed to summarize the clinical data of these patient...

  16. Survival prognostic factors for patients with synchronous brain oligometastatic non-small-cell lung carcinoma receiving local therapy

    OpenAIRE

    Han, Baohui

    2016-01-01

    Hao Bai,1,* Jianlin Xu,1,* Haitang Yang,2,* Bo Jin,1 Yuqing Lou,1 Dan Wu,3 Baohui Han1 1Department of Pulmonary, 2Department of Pathology, 3Central Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China *These authors contributed equally to this work Introduction: Clinical evidence for patients with synchronous brain oligometastatic non-small-cell lung carcinoma is limited. We aimed to summarize the clinical data of these...

  17. Evaluation of Health Related Quality of Life in Patient with Oral Cavity Squamous Cell Carcinoma Receiving Chemotherapy

    OpenAIRE

    Mistry CB; Rana DS; Batra V

    2015-01-01

    Objective: To evaluate impact of chemotherapy on Health Related Quality of Life (HRQOL) in patients of oral cavity squamous cell carcinoma (OCSCC) by analysis of two different treatments named Concurrent Chemo - Radiation (CTRT) and Neo-Adjuvant Chemotherapy (NACT). Study Design and Instrument: Prospective longitudinal study by evaluation HRQOL by general quality of life (QLQC30) and head & neck specific (QLQ-H&N35) questionnaires of the European Organization for Res...

  18. Risk Assessment of Hepatocellular Carcinoma Using Transient Elastography Vs. Liver Biopsy in Chronic Hepatitis B Patients Receiving Antiviral Therapy.

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    Seo, Yeon Seok; Kim, Mi Na; Kim, Seung Up; Kim, Sang Gyune; Um, Soon Ho; Han, Kwang-Hyub; Kim, Young Seok

    2016-03-01

    Liver stiffness (LS) assessed using transient elastography (TE) can assess the risk of developing hepatocellular carcinoma (HCC). We evaluated whether TE, when compared with histological data as a reference standard, can predict the risk of HCC development in chronic hepatitis B (CHB) patients starting antiviral therapy.Observational cohort database of 381 patients with CHB who underwent liver biopsy (LB) and TE were reviewed. All patients underwent surveillance for HCC development using ultrasonography and alpha-fetoprotein.During the median follow-up period of 48.1 (interquartile range 30.3-69.3) months, HCC developed in 34 (8.9%) patients. In patients with HCC development, age, proportion of diabetes mellitus, histological fibrosis stage, and LS value were significantly higher than those in patients without (all P 13 kPa; log-rank test, P 0.05).TE predicted HCC development independently in patients with CHB starting antiviral therapy. However, further investigation is needed to determine whether the current surveillance strategy can be optimized based on the LS value at the time of starting antiviral therapy. PMID:27015173

  19. The CpG island methylator phenotype may confer a survival benefit in patients with stage II or III colorectal carcinomas receiving fluoropyrimidine-based adjuvant chemotherapy

    International Nuclear Information System (INIS)

    Colorectal carcinoma (CRC) with CpG island methylator phenotype (CIMP) is recognized as a distinct subgroup of CRC, and CIMP status affects prognosis and response to chemotherapy. Identification of CIMP status in CRC is important for proper patient management. In Eastern countries, however, the clinicopathologic and molecular characteristics and prognosis of CRCs with CIMP are still unclear. A total of 245 patients who underwent their first surgical resection for sporadic CRC were enrolled and CIMP status of the CRCs was determined using the quantitative MethyLight assay. The clinicopathologic and molecular characteristics were reviewed and compared according to CIMP status. In addition, the three-year recurrence-free survival (RFS) of 124 patients with stage II or stage III CRC was analyzed in order to assess the effectiveness of fluoropyrimidine-based adjuvant chemotherapy with respect to CIMP status. CIMP-high CRCs were identified in 34 cases (13.9%), and were significantly associated with proximal tumor location, poorly differentiated carcinoma, mucinous histology, and high frequencies of BRAF mutation, MGMT methylation, and MSI-high compared to CIMP-low/negative carcinomas. For patients with stage II or III CIMP-low/negative CRCs, no significant difference was found in RFS between those undergoing surgery alone and those receiving surgery with fluoropyrimidine-based adjuvant chemotherapy. However, for patients with CIMP-high CRCs, patients undergoing surgery with fluoropyrimidine-based adjuvant chemotherapy (n = 17; three-year RFS: 100%) showed significantly better RFS than patients treated with surgery alone (n = 7; three-year RFS: 71.4%) (P = 0.022). Our results suggest that selected patients with CIMP-high CRC may benefit from fluoropyrimidine-based adjuvant chemotherapy with longer RFS. Further large scale-studies are required to confirm our results

  20. The CpG island methylator phenotype may confer a survival benefit in patients with stage II or III colorectal carcinomas receiving fluoropyrimidine-based adjuvant chemotherapy

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    Park Cheol

    2011-08-01

    Full Text Available Abstract Background Colorectal carcinoma (CRC with CpG island methylator phenotype (CIMP is recognized as a distinct subgroup of CRC, and CIMP status affects prognosis and response to chemotherapy. Identification of CIMP status in CRC is important for proper patient management. In Eastern countries, however, the clinicopathologic and molecular characteristics and prognosis of CRCs with CIMP are still unclear. Methods A total of 245 patients who underwent their first surgical resection for sporadic CRC were enrolled and CIMP status of the CRCs was determined using the quantitative MethyLight assay. The clinicopathologic and molecular characteristics were reviewed and compared according to CIMP status. In addition, the three-year recurrence-free survival (RFS of 124 patients with stage II or stage III CRC was analyzed in order to assess the effectiveness of fluoropyrimidine-based adjuvant chemotherapy with respect to CIMP status. Results CIMP-high CRCs were identified in 34 cases (13.9%, and were significantly associated with proximal tumor location, poorly differentiated carcinoma, mucinous histology, and high frequencies of BRAF mutation, MGMT methylation, and MSI-high compared to CIMP-low/negative carcinomas. For patients with stage II or III CIMP-low/negative CRCs, no significant difference was found in RFS between those undergoing surgery alone and those receiving surgery with fluoropyrimidine-based adjuvant chemotherapy. However, for patients with CIMP-high CRCs, patients undergoing surgery with fluoropyrimidine-based adjuvant chemotherapy (n = 17; three-year RFS: 100% showed significantly better RFS than patients treated with surgery alone (n = 7; three-year RFS: 71.4% (P = 0.022. Conclusions Our results suggest that selected patients with CIMP-high CRC may benefit from fluoropyrimidine-based adjuvant chemotherapy with longer RFS. Further large scale-studies are required to confirm our results.

  1. Patient- and therapy-related factors associated with the incidence of xerostomia in nasopharyngeal carcinoma patients receiving parotid-sparing helical tomotherapy

    OpenAIRE

    Tsair-Fwu Lee; Ming-Hsiang Liou; Hui-Min Ting; Liyun Chang; Hsiao-Yi Lee; Stephen Wan Leung; Chih-Jen Huang; Pei-Ju Chao

    2015-01-01

    We investigated the incidence of moderate to severe patient-reported xerostomia among nasopharyngeal carcinoma (NPC) patients treated with helical tomotherapy (HT) and identified patient- and therapy-related factors associated with acute and chronic xerostomia toxicity. The least absolute shrinkage and selection operator (LASSO) normal tissue complication probability (NTCP) models were developed using quality-of-life questionnaire datasets from 67 patients with NPC. For acute toxicity, the do...

  2. Laparoendoscopic Single-Site (LESS) Retroperitoneal Radical Nephrectomy in a Patient with Renal Cell Carcinoma Receiving Hemodialysis.

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    Nomura, Takeo; Sato, Fuminori; Takahashi, Mika; Sumino, Yasuhiro; Mimata, Hiromitsu

    2011-01-01

    We present here the patient undergoing laparoendoscopic single-site (LESS) retroperitoneal radical nephrectomy while receiving hemodialysis. An 81-year-old man under hemodialysis for 6 years was incidentally discovered to have two left renal masses with acquired cystic disease of the kidney (ACDK). A 4-cm flank incision for GelPort was made. Three trocars were inserted into the retroperitoneum through GelPort. After division of the renal vessels and ureter, the kidney was placed into the extraction bag and was retrieved through flank incision without any extra skin incision. There were no intraoperative and postoperative complications. This procedure offers an effective, minimally invasive therapeutic alternative to the standard laparoscopic technique in high-risk end-stage renal disease patients. PMID:21687538

  3. Comparison of quality of life in patients with nasopharyngeal carcinoma receiving conventional external beam radiation therapy versus intensity modulated radiation therapy

    International Nuclear Information System (INIS)

    Objective: To compare the acute and late adverse events and quality of life (QOL) in patients with nasopharyngeal carcinomas receiving conventional external beam radiation therapy (RT) versus intensity modulated radiation therapy (IMRT). Methods: Ninety-one patients with newly diagnosed nasopharyngeal carcinoma treated in our institution between August 2008 and September 2010 were systemically reviewed, including 35 cases administered with conventional RT (RT group) and 56 cases with IMRT (IMRT group). Conjoint faciocervical fields plus tangential lower neck-supraclavicular field initially, and then shrinking preauricular portals plus electron beams to the neck were adopted in RT groups, with a total dose of 70 Gy/35 fractions.Nine coplanar fields were conducted in IMRT group with a total dose of 69.96 Gy/33 fractions. Acute and late adverse reactions were observed and compared between RT and IMRT groups, including acute reactions as xerostomia, odynophagia, dermatitis/mucositis and late events as dysphagia, trismus, hypothyroidism, optic/acoustic impairments, skin injury, hypodermal fibrosis, spinal myelitis and brain injury. Results: Compared with RT group, IMRT group showed less acute reactions in xerostomia, odynophagia, dysphagia and dermatitis and mucositis (χ2=85.73, 56.03, 26.58, 69.28, 55.99, P<0.05), and less late reactions in xerostomia, dysphagia, trismus, taste loss and skin injury (χ2=37.95, 7.48, 9.49, 9.49, 11.87, P<0.05), whereas the degree of acoustic/optic impairments and brain injury showed no difference in both groups. Conclusions: As compared to conventional RT, IMRT could decrease acute and some late side events, and improve the quality of life in patients with nasopharyngeal carcinoma. (authors)

  4. Fatigue in patients with advanced renal cell carcinoma receiving sunitinib on an intermittent versus continuous dosing schedule in a randomized phase II trial

    International Nuclear Information System (INIS)

    A phase II trial in advanced renal cell carcinoma (RCC) found no benefit in efficacy or safety between patients receiving oral sunitinib 50 mg/day for 4 weeks followed by 2-week off-treatment (Schedule 4/2) and those receiving 37.5 mg continuous daily sunitinib. We hypothesized that fatigue would have a more variable “on-off” effect with the 4/2 schedule. A total of 292 patients completed two fatigue-related items on Days 1 and 29 of each treatment cycle. Mean absolute slopes were compared across treatments. A planned analysis of item “I feel fatigued” demonstrated that the mean absolute slope was greater in Schedule 4/2 compared to continuous dosing (0.042 vs. 0.032, P = 0.003), and analysis based on the change from Day 1 to Day 29 (0.52 vs. 0.21, P = 0.002) and, separately, Day 29 to the next Day 1 (−0.38 vs. −0.05, P < 0.001) showed the changes to be significantly larger in Schedule 4/2 than continuous dosing. “I have a lack of energy” showed a similar pattern graphically, however, the planned analysis was not statistically significant based on the absolute slopes but was when Day 1 to Day 29 and Day 29 to Day 1 changes were analyzed separately. The 4/2 arm was associated with a greater degree of variability in fatigue reflecting a possible “on-off” effect whereby patients receiving the 4/2 schedule reported less fatigue at the beginning of each cycle compared to Day 29. The findings can inform care for individuals with advanced RCC receiving intermittent dosing of sunitinib

  5. Evaluation of Various Nuclear Cytological Changes in Normal Buccal Mucosa and Peritumoural Area in Patients with Oral Squamous Cell Carcinoma Receiving Concomitant Chemoradiotherapy

    Science.gov (United States)

    Minhas, Sadia; Kashif, Muhammad; Nagi, A. H.

    2016-01-01

    Objectives. To evaluate the role of serial cytological assay in calculating the nuclear response of contralateral normal buccal mucosa and peritumoural area of squamous cell carcinoma of oral cavity in patients receiving fractionated radiotherapy (RT) and chemotherapy. Materials and Methods. This prospective, nonrandomized study was comprised of 76 histologically confirmed cases of oral squamous cell carcinoma on cyclical chemoradiation treatment. Chemoradiosensitivity was evaluated using serial scrape smears taken before and after immediate exposure to CCRT, at 17th day of CCRT (mid of treatment), and at the end of treatment. The nuclear changes, such as multinucleation, micronucleation, karyorrhexis, karyolysis, nuclear budding, prominent nucleoli, and binucleation occurring in both irradiated cancer cells and contralateral normal buccal mucosa, had a statistically significant dose related increase with concomitant chemoradiotherapy (p < 0.05). Conclusion. We recommend regular use of serial cytological assay during CCRT as it may prove to be a valuable tool for assessment of chemoradiosensitivity and persistence of tumour/dysplastic cells after radiotherapy. PMID:27148467

  6. Imatinib induces hypothyroidism in patients receiving levothyroxinc

    NARCIS (Netherlands)

    de Groot, JWB; Zonnenberg, BA; Plukker, JTM; van Der Graaf, WTA; Links, TP

    2005-01-01

    Interactions of imatinib with other drugs have been scarcely reported. We report a previously unknown effect of imatinib on levothyroxine therapy. Eleven patients (1 with gastrointestinal stromal tumor and 10 with medullary thyroid carcinoma) received imatinib. Eight had undergone thyroidectomy and

  7. SU-E-J-265: Feasibility Study of Texture Analysis for Prognosis of Local Tumor Recurrence Within 5-Years for Pharyngeal-Laryngeal Carcinoma Patients Received Radiotherapy Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Huang, W; Tu, S [Chang Gung University, Kwei-shan, Tao-Yuan, Taiwan (China)

    2015-06-15

    Purpose: Pharyngeal and laryngeal carcinomas (PLC) are among the top leading cancers in Asian populations. Typically the tumor may recur and progress in a short period of time if radiotherapy fails to deliver a successful treatment. Here we used image texture features extracted from images of computed tomography (CT) planning and conducted a retrospective study to evaluate whether texture analysis is a feasible approach to predict local tumor recurrence for PLC patients received radiotherapy treatment. Methods: CT planning images of 100 patients with PLC treated by radiotherapy at our facility between 2001 and 2010 are collected. These patients were received two separate CT scans, before and mid-course of the treatment delivery. Before the radiotherapy, a CT scanning was used for the first treatment planning. A total of 30 fractions were used in the treatment and patients were scanned with a second CT around the end of the fifteenth delivery for an adaptive treatment planning. Only patients who were treated with intensity modulated radiation therapy and RapidArc were selected. Treatment planning software of Eclipse was used. The changes of texture parameters between two CT acquisitions were computed to determine whether they were correlated to the local tumor recurrence. The following texture parameters were used in the preliminary assessment: mean, variance, standard deviation, skewness, kurtosis, energy, entropy, inverse difference moment, cluster shade, inertia, cluster prominence, gray-level co-occurrence matrix, and gray-level run-length matrix. The study was reviewed and approved by the committee of our institutional review board. Results: Our calculations suggested the following texture parameters were correlated with the local tumor recurrence: skewness, kurtosis, entropy, and inertia (p<0.0.05). Conclusion: The preliminary results were positive. However some works remain crucial to be completed, including addition of texture parameters for different image

  8. SU-E-J-265: Feasibility Study of Texture Analysis for Prognosis of Local Tumor Recurrence Within 5-Years for Pharyngeal-Laryngeal Carcinoma Patients Received Radiotherapy Treatment

    International Nuclear Information System (INIS)

    Purpose: Pharyngeal and laryngeal carcinomas (PLC) are among the top leading cancers in Asian populations. Typically the tumor may recur and progress in a short period of time if radiotherapy fails to deliver a successful treatment. Here we used image texture features extracted from images of computed tomography (CT) planning and conducted a retrospective study to evaluate whether texture analysis is a feasible approach to predict local tumor recurrence for PLC patients received radiotherapy treatment. Methods: CT planning images of 100 patients with PLC treated by radiotherapy at our facility between 2001 and 2010 are collected. These patients were received two separate CT scans, before and mid-course of the treatment delivery. Before the radiotherapy, a CT scanning was used for the first treatment planning. A total of 30 fractions were used in the treatment and patients were scanned with a second CT around the end of the fifteenth delivery for an adaptive treatment planning. Only patients who were treated with intensity modulated radiation therapy and RapidArc were selected. Treatment planning software of Eclipse was used. The changes of texture parameters between two CT acquisitions were computed to determine whether they were correlated to the local tumor recurrence. The following texture parameters were used in the preliminary assessment: mean, variance, standard deviation, skewness, kurtosis, energy, entropy, inverse difference moment, cluster shade, inertia, cluster prominence, gray-level co-occurrence matrix, and gray-level run-length matrix. The study was reviewed and approved by the committee of our institutional review board. Results: Our calculations suggested the following texture parameters were correlated with the local tumor recurrence: skewness, kurtosis, entropy, and inertia (p<0.0.05). Conclusion: The preliminary results were positive. However some works remain crucial to be completed, including addition of texture parameters for different image

  9. Dosimetric benefits of placing dose constraints on the brachial plexus in patients with nasopharyngeal carcinoma receiving intensity-modulated radiation therapy. A comparative study

    International Nuclear Information System (INIS)

    This study aimed to evaluate whether placing dose constraints on the brachial plexus (BP) could provide dosimetric benefits in patients with nasopharyngeal carcinoma (NPC) undergoing intensity-modulated radiation therapy (IMRT). Planning CT images for 30 patients with NPC treated with definitive IMRT were retrospectively reviewed. Target volumes, the BP and other critical structures were delineated; two separate IMRT plans were designed for each patient: one set no restrictions for the BP; the other considered the BP as a critical structure for which a maximum dose limit of ≤66 Gy was set. No significant differences between the two plans were observed in the conformity index, homogeneity index, maximum dose to the planning target volumes (PTVs), minimum dose to the PTVs, percentages of the volume of the PTVnx and PTVnd receiving more than 110% of the prescribed dose, or percentages of the volume of the PTVs receiving 95% and > 93% of the prescribed dose. Dose constraints significantly reduced the maximum dose, mean dose, V45, V50, V54, V60, V66 and V70 to the BP. Dose constraints significantly reduced the maximum dose to the BP, V45, V60 and V66 in both N0–1 and N2–3 disease; however, the magnitude of the dosimetric gain for each parameter between N0–1 and N2–3 disease was not significantly different, except for the V60 and V66. In conclusion, placing dose constraints on the BP can significantly decrease the irradiated volume and dose, without compromising adequate dose delivery to the target volume. (author)

  10. Concurrent Chemoradiotherapy With 5-Fluorouracil and Mitomycin C for Invasive Anal Carcinoma in Human Immunodeficiency Virus-Positive Patients Receiving Highly Active Antiretroviral Therapy

    International Nuclear Information System (INIS)

    Purpose: To report the clinical outcomes of chemoradiotherapy (CRT) for anal carcinoma in human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy. Patients and Methods: Between 1997 and 2008, 21 HIV-positive patients who were receiving highly active antiretroviral therapy were treated with CRT (50.4 Gy at 1.8 Gy/fraction plus a 5.4-10.8-Gy external boost; 5-fluorouracil, 1,000 mg/m2, Days 1-4 and 29-32; and mitomycin C, 10 mg/m2, Days 1 and 29). A retrospective analysis was performed with respect to the tumor response, local control, cancer-specific and overall survival, and toxicity. The immunologic parameters, including pre- and post-treatment CD4 count, viral load, and acquired immunodeficiency syndrome-specific morbidity was recorded during follow-up (median, 53 months; range, 10-99). Results: CRT could be completed in all 21 patients with a reduction in the chemotherapy dose and/or interruption of radiotherapy in 5 and 5 cases, respectively. Acute Grade 3 toxicity occurred in 8 (38%) of the 21 patients. A complete response was achieved in 17 patients (81%), and tumor persistence or early progression was noted in 4 (19%). Six patients (29%) died, 5 of cancer progression and 1 of treatment-related toxicity. The 5-year local control, cancer-specific, and overall survival rate was 59%, 75%, and 67%, respectively. The median CD4 count significantly decreased from 347.5 cells/μL before CRT to 125 cells/μL 3-7 weeks after CRT completion (p <.001). In 6 (32%) of 19 patients, an increase of the HIV viral load was noted. Both parameters returned to the pretreatment values with additional follow-up. Conclusion: Our data have confirmed that in the highly active antiretroviral therapy era, HIV-related anal cancer can be treated with standard CRT without dose reductions. Close surveillance of the immunologic parameters is necessary.

  11. Eyelid Carcinoma in Patients with Systemic Lymphoma

    Directory of Open Access Journals (Sweden)

    Debraj Shome

    2010-01-01

    Full Text Available Purpose: To describe a series of patients with Non-Hodgkin′s lymphoma (NHL and concomitant eyelid carcinoma. Methods: In this non-comparative interventional case series, we retrospectively reviewed the medical records of 5 patients with NHL who developed eyelid carcinoma. Results: The patients included one female and four male subjects. Systemic lymphoma had been diagnosed 1 to 72 months prior to development of the eyelid carcinoma. The lesions were basal cell carcinoma in three, and squamous cell carcinoma in two cases. The lymphoma was advanced (stage III or IV in all patients. Four patients underwent surgical excision of the carcinoma and one patient was awaiting surgical treatment after completing systemic chemotherapy. Three subjects had high-grade carcinomas. Two patients had perineural invasion; one received adjuvant radiotherapy postoperatively but the other did not due to receiving systemic chemotherapy for recurrent NHL. Conclusions: Systemic lymphoma may be associated with aggressive eyelid carcinomas. Perineural invasion is frequently encountered in this situation and should be treated with adjuvant radiation therapy to decrease the likelihood of local recurrence.

  12. OVARIAN METASTASIS IN PATIENT WITH ENDOMETRIAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    ZHOU Feng-zhi; CHEN Yi-nan; ZHANG Guo-nan

    2005-01-01

    Objective: To study the clinical pathological characteristics of ovarian metastasis of endometrial carcinoma and the factors affecting prognosis. Methods: Retrospective analysis was made to the clinical pathological outcome of endometrial carcinoma patients receiving surgical treatment in our hospital from January 1990 to December 2002. Results:Among the 191 cases of endometrial carcinoma patients, 17 cases (8.9%) had ovarian metastasis and young patients were more likely to have ovarian metastasis. The multiple factor analysis showed that the independent risk factors of ovarian metastasis in endometrial carcinoma included the depth of myometrial invasion, lymph node metastasis and pathological types. Conclusion: Ovarian metastasis in patients with endometrial carcinoma is associated with poor prognosis, the depth of myometrial invasion, lymph node metastasis and histologic types are independent risk factors affecting the prognosis. For young patients at early stage of the disease, it should be prudent as to whether to retain the ovary.

  13. Coagulation function in patients with pancreatic carcinoma

    Institute of Scientific and Technical Information of China (English)

    WANG Hang-yan; XIU Dian-rong; LI Zhi-fei; WANG Gang

    2009-01-01

    Background The coagulation function in patients with pancreatic carcinoma is abnormal and the reason is not very clear. In this study, we retrospectively analyzed the coagulation function in patients with pancreatic carcinoma.Methods From June 2004 to December 2007, 132 patients received diagnosis and treatment in our hospital. The coagulative parameters including the prothrombin time, activated partial thromboplastin time, and fibrinogen levels were collected and studied retrospectively.Results The average fibrinogen levels in patients with pancreatic carcinoma, (476.21±142.05) mg/dl, were significantly higher than in patients with cholangiolithiasis, (403.28±126.41) mg/dl (P 0.05).Conclusions The level of fibrinogen in patients with pancreatic carcinoma was elevated. The elevated fibrinogen level may be associated with invasiveness and lymphatic metastasis. Using vitamin K in perioperation management did not reduce intraoperative blood loss.

  14. The predictive value of serum squamous cell carcinoma antigen in patients with cervical cancer who receive neoadjuvant chemotherapy followed by radical surgery: a single-institute study.

    Directory of Open Access Journals (Sweden)

    Xiong Li

    Full Text Available Neoadjuvant chemotherapy (NACT could affect the levels of squamous cell carcinoma antigen (SCC-Ag. This study evaluates the predictive value of pre- and posttreatment SCC-Ag levels in patients with cervical cancer who were treated with NACT followed by radical surgery.A total of 286 patients with Stage IB1-IIIB squamous cell carcinoma of the uterine cervix who were treated with NACT followed by radical hysterectomy were analyzed retrospectively. The relationship between SCC-Ag levels, the clinicopathologic parameters, the response to NACT and the three-year survival rate was investigated.The levels of SCC-Ag were elevated (>3.5 ng/mL in 43.8% of patients before NACT, and 13.0% of patients after NACT. Pre- and posttreatment levels of SCC-Ag correlated with the response to NACT (P = 0.010, and P3.5 ng/mL (P3.5 ng/mL indicated a poor response to NACT and a higher risk of lymph node metastases. Elevated posttreatment levels of SCC-Ag were correlated with poor DFS and OS.

  15. Quality of Life and Survival Outcome for Patients With Nasopharyngeal Carcinoma Receiving Three-Dimensional Conformal Radiotherapy vs. Intensity-Modulated Radiotherapy-A Longitudinal Study

    International Nuclear Information System (INIS)

    Purpose: To investigate the changes of quality of life (QoL) and survival outcomes for patients with nasopharyngeal carcinoma (NPC) treated by three-dimensional conformal radiotherapy (3D-CRT) vs. intensity-modulated radiotherapy (IMRT). Methods and Materials: Two hundred and three newly diagnosed NPC patients, who were curatively treated by 3D-CRT (n = 93) or IMRT (n = 110) between March 2002 and July 2004, were analyzed. The distributions of clinical stage according to American Joint Committee on Cancer 1997 were I: 15 (7.4%), II: 78 (38.4%), III: 74 (36.5%), and IV: 36 (17.7%). QoL was longitudinally assessed by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC QLQ-H and N35 questionnaires at the five time points: before RT, during RT (36 Gy), and 3 months, 12 months, and 24 months after RT. Results: The 3-year locoregional control, metastasis-free survival, and overall survival rates were 84.8%, 76.7%, and 81.7% for the 3D-CRT group, respectively, compared with 84.2%, 82.6%, and 85.4% for the IMRT group (p value > 0.05). A general trend of maximal deterioration in most QoL scales was observed during RT, followed by a gradual recovery thereafter. There was no significant difference in most scales between the two groups at each time point. The exception was that patients treated by IMRT had a both statistically and clinically significant improvement in global QoL, fatigue, taste/smell, dry mouth, and feeling ill at the time point of 3 months after RT. Conclusions: The potential advantage of IMRT over 3D-CRT in treating NPC patients might occur in QoL outcome during the recovery phase of acute toxicity

  16. Eyelid Carcinoma in Patients with Systemic Lymphoma

    OpenAIRE

    Debraj Shome; Diana Bell; Bita Esmaeli

    2010-01-01

    Purpose: To describe a series of patients with Non-Hodgkin′s lymphoma (NHL) and concomitant eyelid carcinoma. Methods: In this non-comparative interventional case series, we retrospectively reviewed the medical records of 5 patients with NHL who developed eyelid carcinoma. Results: The patients included one female and four male subjects. Systemic lymphoma had been diagnosed 1 to 72 months prior to development of the eyelid carcinoma. The lesions were basal cell carcinoma in three, and...

  17. Long-Term Prognostic Effects of Plasma Epstein-Barr Virus DNA by Minor Groove Binder-Probe Real-Time Quantitative PCR on Nasopharyngeal Carcinoma Patients Receiving Concurrent Chemoradiotherapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate the long-term prognostic impact of plasma Epstein-Barr virus (EBV) DNA concentration measured by real-time quantitative polymerase chain reaction (RTQ-PCR) in nasopharyngeal carcinoma (NPC) patients receiving concurrent chemoradiotherapy (CCRT). Methods and Materials: Epstein-Barr virus DNA was retrospectively measured from stock plasma of 152 biopsy-proven NPC patients with Stage II-IV (M0) disease with a RTQ-PCR using the minor groove binder-probe. All patients received CCRT with a median follow-up of 78 months. We divided patients into three subgroups: (1) low pretreatment EBV DNA (<1,500 copies/mL) and undetectable posttreatment EBV DNA (pre-L/post-U) (2) high pretreatment EBV DNA (≥1,500 copies/mL) and undetectable posttreatment EBV DNA (pre-H/post-U), and (3) low or high pretreatment EBV DNA and detectable posttreatment EBV DNA (pre-L or H/post-D) for prognostic analyses. Results: Epstein-Barr virus DNA (median concentration, 573 copies/mL; interquartile range, 197-3,074) was detected in the pretreatment plasma of 94.1% (143/152) of patients. After treatment, plasma EBV DNA decreased or remained 0 for all patients and was detectable in 31 patients (20.4%) with a median concentration 0 copy/mL (interquartile range, 0-0). The 5-year overall survival rates of the pre-L/post-U, pre-H/post-U, and pre-L or H/post-D subgroups were 87.2%, 71.0%, and 38.7%, respectively (p < 0.0001). The relapse-free survival showed similar results with corresponding rates of 85.6%, 75.9%, and 26.9%, respectively (p < 0.0001). Multivariate Cox analysis confirmed the superior effects of plasma EBV DNA compared to other clinical parameters in prognosis prediction. Conclusion: Plasma EBV DNA is the most valuable prognostic factor for NPC. More chemotherapy should be considered for patients with persistently detectable EBV DNA after CCRT

  18. Usefulness of Interim FDG-PET After Induction Chemotherapy in Patients With Locally Advanced Squamous Cell Carcinoma of the Head and Neck Receiving Sequential Induction Chemotherapy Followed by Concurrent Chemoradiotherapy

    International Nuclear Information System (INIS)

    Purpose: Induction chemotherapy (ICT) has been used to select patients for organ preservation and determine subsequent treatments in patients with locally advanced squamous cell carcinoma of the head and neck (LASCCHN). Still, the clinical outcomes of LASCCHN patients who showed response to ICT are heterogeneous. We evaluated the efficacy of interim 18-fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) after ICT in this specific subgroup of LASCCHN patients who achieved partial response (PR) after ICT to predict clinical outcomes after concurrent chemoradiotherapy (CCRT). Methods and Materials: Twenty-one patients with LASCCHN who showed PR to ICT by Response Evaluation Criteria In Solid Tumors before definitive CCRT were chosen in this retrospective analysis. FDG-PET was performed before and 2-4 weeks after ICT to assess the extent of disease at baseline and the metabolic response to ICT, respectively. We examined the correlation of the metabolic response by the percentage decrease of maximum standardized uptake value (SUVmax) on the primary tumor or lymph node after ICT or a specific threshold of SUVmax on interim FDG-PET with clinical outcomes including complete response (CR) rate to CCRT, progression-free survival (PFS), and overall survival (OS). Results: A SUVmax of 4.8 on interim FDG-PET could predict clinical CR after CCRT (100% vs. 20%, p = 0.001), PFS (median, not reached vs. 8.5 mo, p < 0.001), and OS (median, not reached vs. 12.0 months, p = 0.001) with a median follow-up of 20.3 months in surviving patients. A 65% decrease in SUVmax after ICT from baseline also could predict clinical CR after CCRT (100% vs. 33.3%, p = 0.003), PFS (median, not reached vs. 8.9 months, p < 0.001) and OS (median, not reached vs. 24.4 months, p = 0.001) of the patients. Conclusion: These data suggest that interim FDG-PET after ICT might be a useful determinant to predict clinical outcomes in patients with LASCCHN receiving sequential ICT followed by CCRT.

  19. HPV Carcinomas in Immunocompromised Patients

    Directory of Open Access Journals (Sweden)

    Nicole M. Reusser

    2015-01-01

    Full Text Available Human papillomavirus (HPV infection is the most common sexually transmitted disease worldwide and can result in pre-malignancies or overt malignancies of the skin and mucosal surfaces. HPV-related illnesses are an important personal and public health problem causing physical, mental, sexual and financial detriments. Moreover, this set of malignancies severely affects the immunosuppressed population, particularly HIV-positive patients and organ-transplant recipients. There is growing incidence of HPV-associated anogenital malignancies as well as a decrease in the average age of affected patients, likely related to the rising number of high-risk individuals. Squamous cell carcinoma is the most common type of HPV-related malignancy. Current treatment options for HPV infection and subsequent disease manifestations include imiquimod, retinoids, intralesional bleomycin, and cidofovir; however, primary prevention with HPV vaccination remains the most effective strategy. This review will discuss anogenital lesions in immunocompromised patients, cutaneous warts at nongenital sites, the association of HPV with skin cancer in immunocompromised patients, warts and carcinomas in organ-transplant patients, HIV-positive patients with HPV infections, and the management of cutaneous disease in the immunocompromised patient.

  20. Interstitial brachytherapy for eyelid carcinoma. Outcome analysis in 60 patients

    International Nuclear Information System (INIS)

    Eyelid cancer is a therapeutic challenge due to the cosmetic and functional implications of this anatomical region and the objectives of therapy are tumor control, functional and cosmetic outcome. The present study was performed to analyze local control, toxicity, functional and cosmetic results in patients with eyelid carcinoma treated by interstitial brachytherapy. In this study 60 patients with eyelid carcinoma were treated by interstitial brachytherapy using iridium (192Ir) wires with a linear activity of 1.2-1.7 mCi/cm. The prescription dose was 51-70 Gy (mean 65 Gy, median 66 Gy). Of the 60 patients 51 (85.0 %) had received no prior treatment, 4 (6.7 %) had received previous surgery with positive or close margins and 5 (8.3 %) had suffered local recurrence after surgery. Of the tumors 52 (86.7 %) were basal cell carcinoma, 7 (11.7 %) squamous cell carcinoma and 1 (1.7 %) Merkel cell carcinoma. Clinical stage of the 51 previously untreated tumors was 38 T1N0, 12 T2N0 and 1 T3N0. Mean follow-up was 92 months (range 6-253 months). Local control was maintained in 96.7 % of patients. Late effects higher than grade 2 were observed in 3.0 % of cases. Functional and cosmetic outcomes were optimal in 68.4 % of patients. Interstitial brachytherapy for carcinoma of the eyelid can achieve local control, cosmetic and functional results comparable to those of surgery. (orig.)

  1. Percentage of Surgical Patients Receiving Recommended Care

    Science.gov (United States)

    ... view charts and maps. State Percentage of Surgical Patients Receiving Recommended Care by ... U.S. Department of Health & Human Services — 200 Independence Avenue, S.W. — Washington, D.C. 20201

  2. Radiotherapy for 71 patients with tonsillar carcinoma

    International Nuclear Information System (INIS)

    Objective: To evaluate the therapeutic outcome and determine the prognosticators of tonsillar carcinoma treated by different approaches. Methods: A retrospective study was done on 71 tonsillar carcinoma patients treated from August 1971 to October 1995 by three different ways of radiotherapy. All were pathologically proved. Fifteen patients received external bean therapy plus intracavitary brachytherapy (EBRT + BRT), 39 patients were treated by EBRT only (EBRT) and the other 17 patients underwent FBRT plus chemotherapy (EBTR + CHEMO). Results: The local control rates of EBRT + BRT, EBRT and EBRT + chemo were 82.1%, 68.4% and 64.2%. There was significant difference between EBRT + BRT and the other two groups (x2=4.65, P=0.030; x2=5.65, P=0.018). The 3-, 5- and 10- year survival rates of EBRT + BRT, EBRT and EBRT + CHEMO were 76.3%, 53.2%, 31.2%; 74.0%, 45.2%, 33.5% and 75.2%, 47.1%, 25.3%. All these survival rates showed no statistical significance. (P > 0.05). Conclusion: Brachytherapy, when used to increase the dose effect, may enhance the local effect without any change in the overall survival

  3. Prognostic Significance of VEGF Expression in Patients with Bulky Cervical Carcinoma Receiv-ing Neoadjuvant Chemotherapy%血管内皮生长因子在宫颈癌中的表达及其与新辅助化疗疗效的关系

    Institute of Scientific and Technical Information of China (English)

    黄翀

    2015-01-01

    [Objective] To explore the prognostic significance of vascular endothelial growth factor (VEGF) ex‐pression in patients with bulky cervical carcinoma receiving neoadjuvant chemotherapy (NACT) .[Methods] The ex‐pression of VEGF was analyzed by immunohistochemistry using paraffin‐embedded pre‐treatment cervical biopsy tis‐sues .There were a total of 29 patients on NACT for bulky IB to IIA cervical squamous cell carcinoma .[Results]Fif‐teen (51 .7% ) of them were scored as VEGF‐positive .Compared with pre‐NACT ,the positive expression of VEGF decreased after NACT ( P<0 .05) .After NACT ,the outcomes were complete remission (CR ,n=5) ,partial re‐mission (PR ,n=18) ,stable disease (SD ,n =9) and nonresponder (NR ,n =0) .The response rate and disease control rate was 69 .0% and 100% respectively .[Conclusion] The expression of VEGF in bulky cervical carcinoma may be used as a predictive index of responding to NACT .%【目的】探讨血管内皮生长因子(VEGF)在宫颈癌中的表达及其与新辅助化疗(NACT )疗效的关系。【方法】采用免疫组化检测29例ⅠB~Ⅱ A 期宫颈癌组织 NACT 化疗前后VEGF的表达,并分析其与NACT的关系。【结果】29例ⅠB~ⅡA期宫颈癌患者NACT 化疗前VEGF阳性表达率51.7%(15/29),显著高于NACT化疗后6.9%(2/29)( P<0.05)。NACT化疗后,完全缓解2例,部分缓解18例,稳定9例,无进展病例,有效率为69.0%,疾病控制率为100.0%。【结论】宫颈癌组织中VEGF的表达可作为NACT疗效的参考指标。

  4. Anxiety, depression in patients receiving chemotherapy for solid tumors

    International Nuclear Information System (INIS)

    To determine the frequency of anxiety and depression in patients undergoing chemotherapy for solid tumors using Hospital Anxiety Depression Scale (HADS). Study Design: Cross sectional descriptive study. Place and Duration of Study: Out-patient department of Armed Forces Institute of Mental Health, Rawalpindi from June 2011 to December 2011. Methodology: Consecutive non probability sampling technique was used to select patients of age (25-70 years), male or female, who had received atleast 03 cycles of chemotherapy for solid tumors. Those with history of prior psychiatric illness, current use of psychotropic medication or psychoactive substance use, and any major bereavement in past one year were excluded from the study. After taking informed consent, relevant socio- demographic data was collected and HADS was administered. HADS-A cut off score of 7 was taken as significant anxiety while a HADS-D cut off score of 7 was taken as significant depression. Results: The total number of participants was 209. The mean age of patients was 42.9 years, with 55.5% males and 44.5% females. Overall 33/209 (15.8%) patients had anxiety while 56/209 (26.8%) were found to have depression. There was a higher frequency of anxiety and depression in younger patients (less than age 40 years), females, patients who were single or divorced, and patients receiving chemotherapy for pancreatic carcinoma. Conclusion: Patients undergoing chemotherapy suffer from considerable levels of anxiety and depression, thus highlighting the need for specialized interventions. (author)

  5. Sorafenib-Induced Interstitial Pneumonitis in a Patient with Hepatocellular Carcinoma: A Case Report

    OpenAIRE

    Myung, Hyung-Joon; Jeong, Sook-Hyang; Kim, Jin-Wook; Kim, Hee-Sup; Jang, Je-Hyuck; Yoon, Ho Il; Kim, Jae-Sung

    2010-01-01

    Sorafenib is an oral multikinase inhibitor that has shown a survival benefit in patients with advanced hepatocellular carcinoma, and is considered to be generally safe. We treated a patient with interstitial lung disease that was associated with sorafenib therapy for the treatment of advanced hepatocellular carcinoma. A 74-year-old man with hepatitis-C-virus-related hepatocellular carcinoma was treated with sorafenib. After 8 days of sorafenib administration, he received radiation therapy for...

  6. Sunitinib benefits patients with renal cell carcinoma

    Science.gov (United States)

    Findings from clinical trial patients with metastatic renal cell carcinoma, a common kidney cancer, show they did not have accelerated tumor growth after treatment with sunitinib, in contrast to some study results in animals.

  7. Cognitive and neuropsychiatric impairment in cerebral radionecrosis patients after radiotherapy of nasopharyngeal carcinoma

    OpenAIRE

    Wu, Xiaohong; Gu, Mofa; Zhou, Guijuan; Xu, Xue; Wu, Mengmeng; Huang, Haiwei

    2014-01-01

    Background We sought to characterize the cognitive function and neuropsychiatric symptoms in cerebral radionecrosis (CRN) patients who have received conformal radiation for nasopharyngeal carcinoma. Methods A total of 40 patients treated with radiotherapy (RT) that developed CRN (RT + CRN), 40 patients treated with radiotherapy that did not have CRN (RT-No-CRN), and 36 newly diagnosed untreated nasopharyngeal carcinoma patients (No-RT) were recruited. The cognitive function and neuropsychiatr...

  8. Metastasis-induced acute pancreatitis in a patient with small cell carcinoma of the lung.

    OpenAIRE

    Kim, K. H.; Kim, C D; Lee, S. J.; Lee, G.; Jeen, Y T; Lee, H.S.; Chun, H J; Song, C. W.; Um, S. H.; Lee, S. W.; Choi, J. H.; Ryu, H. S.; Hyun, J. H.

    1999-01-01

    Acute pancreatitis in cancer patients can be secondary to the malignant process itself or a complication of antineoplastic agent administration. However, acute pancreatitis caused by metastatic carcinoma of the pancreas is an uncommon condition with a poor prognosis. We report a case of a 63-year-old man with small cell carcinoma of the lung, who developed acute pancreatitis lately. Thirteen months earlier, he developed small cell carcinoma of the lung and received 6 cycles of chemotherapy. A...

  9. Arterial embolization in patients with renal carcinoma

    DEFF Research Database (Denmark)

    Christensen, S W; Berg, J; Brynitz, S;

    1989-01-01

    The literature concerning embolization of the renal artery in patients with renal cell carcinoma is reviewed. Based on this review it is concluded that the method is useful in this patient group as it will facilitate the surgical procedure if nephrectomy is performed afterwards. Used as a...

  10. Cancer and treatment related pains in patients with cervical carcinoma

    Directory of Open Access Journals (Sweden)

    Das Saikat

    2005-01-01

    Full Text Available Pain in carcinoma cervix is a multidimensional experience with sensory, affective and cognitive-evaluative components. Many patients do not receive adequate pain management because of a lack of proper assessment, misconceptions regarding the pharmacologic and non pharmacologic methods of pain management and failure to distinguish between different types of pain. In our audit pelvic and nodal recurrence were the commonest cause of pain presenting as as pelvic pain, [42%], lumbosacral plexopathy [40%] and abdominal pain [34%] [n = 30]. Pain on defaecation caused by rectal obstruction, and suprapubic pain due to pyometra can be relieved by colostomy and drainage. Very little literature is available on the pain syndromes associated with carcinoma cervix. The present article is a review of cancer and treatment related pains in carcinoma cervix.

  11. Clinical Analysis of 45 Patients with Thymic Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Ruitai Fan; Jingmin Wang; Hongzhi Zhang; Yanna Guo; Hao Gu

    2009-01-01

    OBJECTIVE To retrospectively evaluate the prognostic factors for advanced thymic carcinoma.METHODS The data from 45 patients with advanced thymic carcinoma were retrospectively analyzed according to Masaoka stage criteria. There were 29 Stage Ⅲ patients and 16 Stage Ⅳ patients (13 Stage IVA patients and 3 Stage IVB patients).According to the World Heath Organization Histological Criteria (2004), 25 cases were identified as low-grade and 20 cases were identified as high-grade. All diagnoses were confirmed by biopsy. Five patients underwent gross total resection, 21patients underwent subtotal resection and 19 patients underwent biopsy alone. Forty-two patients received radiotherapy with a median dose of 60 Gy, and 37 patients underwent conventional radiotherapy, including local irradiation and expanded irradiation.Local irradiation volume covered the primary tumor bed and approximately 1-2 cm2 surrounding the tumor (according to preoperative imaging). Expanded irradiation volume covered the full mediastinal and pericardium areas (with or without prophylactic irradiation in the supraclavicular area). Five cases received stereotactic radiotherapy. Thirty-one patients were also treated with chemotherapeutics, including Cisplatin, VP-16,Endoxan, 5-FU and taxol.RESULTS The median follow-up period was 59 months. The overall 3-year survival rate was 57.8%, and the median survival was 45 months. Univariate statistical analysis showed that the histological subtype and Masaoka stage were prognostic factors.The 3-year survival rate was 61.9% in patients treated with gross total resection and 55.0% in those who underwent biopsy only. The 3-year survival rate was 59.5% in patients treated with conventional radiotherapy and 80% in those treated with stereotactic radiotherapy. The 3-year survival rate was 64.5% in patients treated with simultaneous chemotherapy and 42.9%in patients treated without simultaneous chemotherapy (P >0.05). Chemotherapy in combination with radiation

  12. Carcinoma verrugoso en paciente joven Verrucous carcinoma in young patient

    Directory of Open Access Journals (Sweden)

    LN Rosa

    2003-06-01

    observed2. Metastasis is a rare event in verrucous carcinomas 6, 8, 9. The treatment of choice is surgical excision, optionally combined with radiotherapy. The authors report a clinical case of a 13-year-old patient with a lesion compromising the whole lower Iip vermilion. The initial treatment proposed was radiotherapy combined with chemotherapy, due to the patient's age and the localization and extent of the lesion. After a total dose of 70Gy, full regression of the lesion took place. Thus, treatment of verrucous carcinoma by combining radiotherapy with chemotherapy proved satisfactory in this case.

  13. A Phase II Study of Docetaxel, Cisplatin and 5- Fluorouracil (TPF) In Patients with Locally Advanced Head and Neck Carcinomas

    OpenAIRE

    Ansari, M.; Omidvari, S; Mosalaei, A.; Ahmadloo, N; Mosleh-Shirazi, M. A.; Mohammadianpanah, M.

    2011-01-01

    Background The combination of cisplatin and 5-fluorouracil (PF) is currently considered a standard and effective regimen for the treatment of advanced head and neck carcinomas. The aim of this study was to evaluate the efficacy and safety of docetaxel, cisplatin and 5-fluorouracil (TPF) in patients with unresectable head and neck carcinomas. Methods Forty-six patients with previously untreated non-metastatic stage IV head and neck carcinomas were enrolled. All patients received three cycles o...

  14. Every second cancer patient receives radiotherapy

    International Nuclear Information System (INIS)

    Radiotherapy to treat cancer was given for the first time exactly one hundred years ago. Today, radiotherapy and surgery are the two main modes of treating cancer. One in two cancer patients receives radiotherapy at some point during the course of treatment for the disease. Radiotherapy is applied most commonly in cases where surgery is not possible. Moreover, these two modes of treatment are often used together to supplement each other. About half of new cancer cases detected today can be ordered. The estimate given by the EU for cancers cured is 45 per cent, which is divided between the various treatment modes as follows: surgery 22 %, radiotherapy 12 %, surgery plus radiotherapy 6 %, and drug therapy 6 %. In addition to curative treatment, radiotherapy plays a crucial role in palliative treatment, i.e. treatment that alleviates symptoms. The sensitivity of malignant tumours to radiotherapy varies over a wide range; the same is true for healthy tissues. Radiotherapy can only be used to cure a tumour that is more sensitive to radiation than the surrounding healthy tissue. The tumour must also be sufficiently small in size and limited to a relatively small area. (orig.)

  15. UPPER ESOPHAGEAL STRICTURE POST CHEMOIRRADIATION IN PATIENTS WITH CARCINOMA HYPOPHARYNX

    Directory of Open Access Journals (Sweden)

    Nikhila Radhakrisha

    2014-11-01

    Full Text Available BACKGROUND: Concurrent chemo irradiation is the standard treatment for patients with head & neck cancer (HNC. Dysphagia is a common late toxicity of treatment. 7-21% of these patients have treatment induced stricture of the upper esophagus causing dysphagia, with a high incidence of the same in cases of carcinoma hypopharynx. The objective of the present study was to identify the incidence of treatment related stricture of the upper esophagus in patients with hypopharyngeal cancer in our institution. METHODS: A retrospective analysis on patients treated for carcinoma hypopharynx, in the department of Radiotherapy at our Institute, between 2008-12 was conducted. All patients who had received chemo irradiation were included Patients who had developed upper esophageal stricture post treatment diagnosed by upper GI endoscopy and required periodic dilatation were analyzed using Fisher’s exact test. RESULTS: 377 patients of H&N cancers were evaluated, out of which 15.38 % (58/377 had a hypopharyngeal primary. 51 patients were evaluable for the current analysis (15 females, 36 males; mean age 57yrs; out of which 10 patients developed treatment related stricture in the proximal esophagus (20% (4 females, 6 males. Post cricoid primary had a higher incidence of stricture (7/10 (p=0.0012** two-tailed, followed by primary of the pyriform sinus (3/10. Posterior pharyngeal wall malignancies did not have treatment induced strictures. The mean interval between completion of treatment and endoscopic diagnosis of stricture was 4 months. 5 out of 10 patients underwent periodic dilatations up to an average of 13mm. CONCLUSIONS: Upper esophageal stricture is an important late effect of chemo irradiation in patients with carcinoma hypopharynx. Post cricoid cancers have a higher incidence of treatment induced strictures.

  16. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Junor, E.J.; Paul, J.; Reed, N.S. (Beatson Oncology Centre, Glasgow (United Kingdom))

    1992-04-01

    Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dyspnagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. (Author).

  17. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy

    International Nuclear Information System (INIS)

    Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dyspnagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. (Author)

  18. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy.

    Science.gov (United States)

    Junor, E J; Paul, J; Reed, N S

    1992-04-01

    Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dysphagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. PMID:1582515

  19. Carcinoma in situ of contralateral testis in patients with testicular germ cell cancer: study of 27 cases in 500 patients

    DEFF Research Database (Denmark)

    von der Maase, H; Rørth, M; Walbom-Jørgensen, S; Sørensen, B L; Christophersen, I S; Hald, T; Jacobsen, G K; Berthelsen, J G; Skakkebaek, N E

    1986-01-01

    Carcinoma in situ in the contralateral testis was diagnosed in 27 of 500 patients (5.4%) with unilateral testicular germ cell cancer. Eight of the 27 patients received intensive chemotherapy for spread of their initial testicular cancer. Follow up biopsy studies did not detect changes of carcinoma...... in situ in any of these patients, and none developed a contralateral testicular tumour (observation time 12-88 months). Of the remaining 19 patients with carcinoma in situ, seven developed contralateral testicular cancer. The estimated risk of developing invasive growth was 40% within three years and...... 50% within five years. None of the 473 patients without carcinoma in situ detected by screening biopsy developed contralateral testicular cancer (observation time 12-96 months). No serious complications arose from the biopsy procedures. All patients with unilateral testicular germ cell cancer should...

  20. Gingival squamous cell carcinoma: imaging analysis of seven patients

    International Nuclear Information System (INIS)

    The authors studied seven patients with gingival carcinoma attended at the Head and Neck Surgery and Otorrhinolaryngology Service and the Diagnostic Imaging Service of 'Complexo Hospitalar Heliopolis', Sao Paulo, SP, Brazil, between 1985 and 1996. Squamous cell type carcinomas were identified in all cases. All patients were male (100%) aged 48-72 years. Computed tomography was performed in six patients (85.6%). Four patients (57.1%) had not received any treatment before imaging examination whereas three patients (42.8%) had already been submitted to surgery or radiotherapy. The authors analyzed the primary site of the tumor and its extension to the mandible (5/7 cases; 71.4%), the floor of the mouth (3/7 cases; 42.8%), the floor of the maxillary sinus (1/7 cases; 14.2%) and the retromolar trigonum (1/7 cases; 14.2%). Metastatic lymph nodes were observed in five patients (71.4%). Diagnosis was confirmed by biopsy and histopathological examination in all cases. Comparison with surgical findings was possible in five cases (71.4%). (author)

  1. Clinicopathologic characteristics of esophagectomy for esophageal carcinoma in elderly patients

    Institute of Scientific and Technical Information of China (English)

    Jian-Yang Ma; Zhu Wu; Yun Wang; Yong-Fan Zhao; Lun-Xu Liu; Ying-Li Kou; Qing-Hua Zhou

    2006-01-01

    AIM: To evaluate the risk of esophagectomy for carcinoma of the esophagus in the elderly (70 years or more)compared with younger patients (<70 years) and to determine whether the short-term outcomes of esophagectomy in the elderly have improved in recent years.METHODS: Preoperative risks, postoperative morbidity and mortality in 60 elderly patients (≥70 years) with esophagectomy for carcinoma of the esophagus were compared with the findings in 1 782 younger patients (<70 years) with esophagectomy between January 1990and December 2004. Changes in perioperative outcome and short-time survival in elderly patients between 1990to 1997 and 1998 to 2004 were separately analyzed.RESULTS: Preoperatively, there were significantly more patients with hypertension, pulmonary dysfunction, cardiac disease, and diabetes mellitus in the elderly patients as compared with the younger patients. No significant difference was found regarding the operation time, blood loss, organs in reconstruction and anastomotic site between the two groups, but elderly patients were more often to receive blood transfusion than younger patients.Significantly more transhiatal and fewer transthoracic esophagectomies were performed in the elderly patients as compared with the younger patients. Resection was considered curative in 71.66% (43/60) elderly and 64.92% (1 157/1 782) younger patients, which was not statistically significant (P>0.05). There were no significant differences in the prevalence of surgical complications between the two groups. Postoperative cardiopulmonary medical complications were encountered more frequently in elderly patients. The hospital mortality rate was 3.3% (2/60) for elderly patients and 1.1% (19/1782) for younger patients without a significant difference. When the study period was divided into a former (1990 to 1997) and a recent (1997 to 2004) period,operation time, blood loss, and percentage ot patients receiving blood transfusion of the elderly patients

  2. Sentinel lymph node biopsy in patients with breast ductal carcinoma in situ: Chinese experiences

    OpenAIRE

    SUN, Xiao; Li, Hao; LIU, YAN-BING; ZHOU, ZHENG-BO; Chen, Peng; Zhao, Tong; WANG, CHUN-JIAN; Zhang, Zhao-Peng; Qiu, Peng-Fei; Wang, Yong-Sheng

    2015-01-01

    The axillary treatment of patients with ductal carcinoma in situ (DCIS) remains controversial. The aim of the present study was to evaluate the roles of sentinel lymph node biopsy (SLNB) in patients with breast DCIS. A database containing the data from 262 patients diagnosed with breast DCIS and 100 patients diagnosed with DCIS with microinvasion (DCISM) who received SLNB between January 2002 and July 2014 was retrospectively analyzed. Of the 262 patients with DCIS, 9 presented with SLN metas...

  3. Carcinoma of the vulva and vagina in patients irradiated for carcinoma of the cervix

    International Nuclear Information System (INIS)

    Six patients with carcinoma of the vulva and 3 with carcinoma of the vagina following radiation therapy for cancer of the cervix were analyzed. The interval between irradiation and diagnosis of the second tumor varied from 5 to 23 years. Despite the lack of having detailed information on irradiation factors in all patients, circumstantial evidence from this study suggests that radiation therapy may have contributed to the development of carcinoma of the vulva and vagina in some of the patients. Close follow-up patients treated for squamous carcinoma of the genital tract must emphasize inspection for new lesions. The incidences previously reported in the literature are also reviewed for comparison. (author)

  4. Carcinoma of the vulva and vagina in patients irradiated for carcinoma of the cervix

    Energy Technology Data Exchange (ETDEWEB)

    Tsukiyama, Iwao; Kakehi, Masae; Ono, Ryosuke; Watai, Kiichi; Yanagawa, Shigeo; Kasamatsu, Tatsuhiro

    1984-08-01

    Six patients with carcinoma of the vulva and 3 with carcinoma of the vagina following radiation therapy for cancer of the cervix were analyzed. The interval between irradiation and diagnosis of the second tumor varied from 5 to 23 years. Despite the lack of having detailed information on irradiation factors in all patients, circumstantial evidence from this study suggests that radiation therapy may have contributed to the development of carcinoma of the vulva and vagina in some of the patients. Close follow-up patients treated for squamous carcinoma of the genital tract must emphasize inspection for new lesions. The incidences previously reported in the literature are also reviewed for comparison. (author).

  5. Prognostic Factors in Patients with Pancreatic Carcinoma

    Institute of Scientific and Technical Information of China (English)

    HANYue; SUICheng-guang1; RUANZhi-ping

    2004-01-01

    To evaluate the major prognostic factors in patients with pancreatic carcinoma.Methods : 113 cases of a particular disease were retrospectively analysed and 9 factors for prognosis were studied by muitivaritate analysis with Cox proportional hazards survival model. Survival rate was calculated by Kaplan-Meier estimation. Results:In this group,survival time was 0.1 to 82 months,and the median survival time was 3 months.Overall survival rates at month 6,12,18,36 were 35.6%, 20.3%, 15.9% and 6.2%, respectively.Multivariate analyses revealed significant prognostic factors as follows:jaundice, metastasis, therapy method and synthetic therapy. Conchusion: The prognosis of pancreatic carcinoma is determined by various factors. Jaundice and metastasis are independent predictors of poor survival.Radical operation and synthetic therapy will improve the prognosis.

  6. Anogenital squamous cell carcinoma in neglected patient.

    Science.gov (United States)

    Svecova, D; Havrankova, M; Weismanova, E; Babal, P

    2012-01-01

    Skin squamous cell carcinomas (SCCs) are arguably the second most common carcinoma of the skin and are responsible for the majority of non-melanoma skin cancer deaths. Gynecologist treated a Caucasian 56-years old female patient for genital wart with podophyllotoxin cream. She did not achieve complete response and therefore she has interrupted the therapy and the collaboration with the gynecologist. At the time of evaluation the lesion had a size of man's palm in anogenital region and showed characteristic features of neoplasm. The regional lymph nodes have produced infiltrated painful bubo. PCR analysis for HPV proved negative. Histopathology revealed well-differentiated squamous cell keratinizing carcinoma from the tumor as well as from the regional lymph node packet. Staging computed tomography scans proved negative and pelvis scans disclosed regional lymphadenopathy underlying the tumor. Palliative radiation therapy (by linear accelerator) was administered for the oversized tumor to the total TD 50.0Gy. The patient died 6 months after diagnostic assessment from cardio-respiratory failure. Staging computed tomography before her death did not disclose distinct metastases in her inner organs. Well-differentiated squamous cell keratinizing carcinoma could be growing endophytically affecting the underlying adipose tissue and musculature, with spreading into the regional lymph nodes. The rate of metastases into inner organs seems to vary according to the aggressiveness and metastatic behavior of each SCC. The case report calls for attention to the importance of collaboration among various specialists assisting in the diagnosis and management of skin neoplasm (Fig. 5, Ref. 12). Full Text in PDF www.elis.sk. PMID:22502759

  7. The clinicalapplication of interleukin-2therapy in patients withmetastatic renal cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    Li-Wen Zhou

    2015-01-01

    Objective: To analyze the clinical application of interleukin-2 therapy in patients with metastatic renal cell carcinoma.Methods:From January 2010 to July 2014 of 108 patients with metastatic renal cell carcinoma patients in our hospital as research subjects were randomly divided into the experimental group and the control group. The experimental group received IL-2 combined with Nexavar therapy, and the control group only received Nexavar treatment, clinical efficacy and incidence of adverse reactions between the two groups of patients were compared.Results:Compared with the control group, clinical efficacy in the experimental group was significantly higher, the difference was statistically significant. The incidence of adverse events was higher in patients than that in the experimental group, the difference was statistically significant, but IL-2 had no new adverse reactions and side effects.Conclusions:Interleukin-2 combined with Nexavar treatment of metastatic renal cell carcinoma can improve the clinical efficacy of metastatic renal cell carcinoma in patients, and ease the patient's condition from worsening and promote the quality of life. However, adverse reactions caused by drugs were inevitable; we should pay attention to treatment and prevention of adverse reactions in order to improve the quality of life of patients with metastatic renal cell carcinoma.

  8. Inhalative versus oral prophylaxis of pneumonitis in patients receiving thoracic irradiation

    International Nuclear Information System (INIS)

    Fifty-seven patients receiving thoracic irradiation for bronchial carcinoma were assigned to 2 therapeutic groups; half of the patients were given 10 mg of oral prednisolone per day, while the other half received daily inhalative beclomethasone. All patients were evaluated for radiographic signs of pneumonitis. Thirty-two patients received additional investigations for pulmonary diffusion capacity of carbonmonoxide. The overall incidence of pneumonitis was 17.6% (10/57 patients). Neither total radiation dose nor mode of fractionation did significantly contribute to the incidence of pneumonitis. Those patients showing a pulmonary diffusion capacity for carbonmonoxide of less than 60% prior to radiotherapy had a significantly higher risk of developing pneumonitis (4/7) than patients with a higher diffusion capacity (3/25, p=0.026). In the follow-up period we did not see significant changes in diffusion capacity neither with patients who developed pneumonitis nor with those patients showing no evidence of pulmonary injury. Comparing the chest X-rays there were less radiographic changes consistent with pneumonitis in the inhalative beclomethasone (2/28) than in the oral prednisolone group (8/29, p=0.045). In order to reduce the incidence of pneumonitis in patients receiving thoracic irradiation we support a continuous application of steroids in the course of and following radiotherapy. The inhalative use of beclomethasone has proved to be superior to oral prednisolone due to better local efficacy and decreased unwanted side effects. (orig./MG)

  9. Vocal changes in patients undergoing radiation therapy for glottic carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Miller, S.; Harrison, L.B.; Solomon, B.; Sessions, R.B. (Memorial Sloan-Kettering Cancer Center, New York, NY (USA))

    1990-06-01

    A prospective evaluation of vocal changes in patients receiving radiation therapy for T1 and T2 (AJC) glottic carcinoma was undertaken in January 1987. Vocal analysis was performed prior to radiotherapy and at specific intervals throughout the radiation treatment program. The voicing ratio was extrapolated from a sustained vowel phonation using the Visipitch interfaced with the IBM-PC. Preliminary observations suggested three distinct patterns of vocal behavior: 1. reduced voicing ratio with precipitous improvement within the course of treatment, 2. high initial voicing ratio with reduction secondary to radiation induced edema, with rapid improvement in the voicing component after the edema subsided, and 3. fluctuating voicing ratio during and following treatment. Enrollment of new patients and a 2-year follow-up of current patients was undertaken.

  10. Vocal changes in patients undergoing radiation therapy for glottic carcinoma

    International Nuclear Information System (INIS)

    A prospective evaluation of vocal changes in patients receiving radiation therapy for T1 and T2 (AJC) glottic carcinoma was undertaken in January 1987. Vocal analysis was performed prior to radiotherapy and at specific intervals throughout the radiation treatment program. The voicing ratio was extrapolated from a sustained vowel phonation using the Visipitch interfaced with the IBM-PC. Preliminary observations suggested three distinct patterns of vocal behavior: 1. reduced voicing ratio with precipitous improvement within the course of treatment, 2. high initial voicing ratio with reduction secondary to radiation induced edema, with rapid improvement in the voicing component after the edema subsided, and 3. fluctuating voicing ratio during and following treatment. Enrollment of new patients and a 2-year follow-up of current patients was undertaken

  11. Sexual function in hypertensive patients receiving treatment

    Directory of Open Access Journals (Sweden)

    Thorsten Reffelmann

    2006-12-01

    Full Text Available Thorsten Reffelmann, Robert A KlonerUniversity of Southern California, The Heart Institute, Good Samaritan Hospital, Division of Cardiovascular Medicine, Keck School of Medicine, Los Angeles, CA, USAAbstract: In many forms of erectile dysfunction (ED, cardiovascular risk factors, in particular arterial hypertension, seem to be extremely common. While causes for ED are related to a broad spectrum of diseases, a generalized vascular process seems to be the underlying mechanism in many patients, which in a large portion of clinical cases involves endothelial dysfunction, ie, inadequate vasodilation in response to endothelium-dependent stimuli, both in the systemic vasculature and the penile arteries. Due to this close association of cardiovascular disease and ED, patients with ED should be evaluated as to whether they may suffer from cardiovascular risk factors including hypertension, cardiovascular disease or silent myocardial ischemia. On the other hand, cardiovascular patients, seeking treatment of ED, must be evaluated in order to decide whether treatment of ED or sexual activity can be recommended without significantly increased cardiac risk. The guideline from the first and second Princeton Consensus Conference may be applied in this context. While consequent treatment of cardiovascular risk factors should be accomplished in these patients, many antihypertensive drugs may worsen sexual function as a drug specific side-effect. Importantly, effective treatment for arterial hypertension should not be discontinued as hypertension itself may contribute to altered sexual functioning; to the contrary, alternative antihypertensive regimes should be administered with individually tailored drug regimes with minimal side-effects on sexual function. When phosphodiesterase-5 inhibitors, such as sildenafil, tadalafil and vardenafil, are prescribed to hypertensive patients on antihypertensive drugs, these combinations of antihypertensive drugs and

  12. Wernicke’s Encephalopathy in a Patient with Nasopharyngeal Carcinoma: Magnetic Resonance Imaging Findings

    OpenAIRE

    Law, Huong Ling; Tan, Suzet; Sedi, Rosleena

    2011-01-01

    We report a case of Wernicke’s encephalopathy in a patient with nasopharyngeal carcinoma with a 3-month history of poor oral intake related to nausea and vomiting due to chemotherapy. The patient later developed deep coma while receiving in-patient therapy. Magnetic resonance imaging of the brain revealed typical findings of Wernicke’s encephalopathy. The patient was treated with thiamine injections, which resulted in subsequent partial recovery of neurological function. This paper stresses t...

  13. Sarcopenia Predicts Early Dose-Limiting Toxicities and Pharmacokinetics of Sorafenib in Patients with Hepatocellular Carcinoma

    OpenAIRE

    Mir, Olivier; Coriat, Romain; Blanchet, Benoit; Durand, Jean-Philippe; Boudou-Rouquette, Pascaline; Michels, Judith; Ropert, Stanislas; Vidal, Michel; Pol, Stanislas; Chaussade, Stanislas; Goldwasser, François

    2012-01-01

    Background Sorafenib induces frequent dose limiting toxicities (DLT) in patients with advanced hepatocellular carcinoma (HCC). Sarcopenia has been associated with poor performance status and shortened survival in cancer patients. Patients and Methods The characteristics of Child Pugh A cirrhotic patients with HCC receiving sorafenib in our institution were retrospectively analyzed. Sorafenib plasma concentrations were determined at each visit. Toxicities were recorded during the first month o...

  14. Radiation therapy for patients with obstructive jaundice caused by carcinoma of the extrahepatic biliary system

    International Nuclear Information System (INIS)

    From February 1980 through September 1990, 92 patients with obstructive jaundice resulting from biliary tract cancer were registered at Shikoku Cancer Center Hospital or Ehime University Hospital. Radiation therapy (RT) was used to treat 38 of these patients (30 with carcinoma of the extrahepatic bile duct, excluding ampulla of Vater, and eight patients with carcinoma of the gallbladder). Of 38 patients, 11 underwent intraoperative radiation therapy (IORT), and 27 were treated by external radiation therapy (ERT) alone. In contrast, 54 patients (39 with carcinoma of the extrahepatic bile duct and eight with carcinoma of the gallbladder) were not treated by RT. All jaundiced patients received external and/or internal biliary drainage of some kind. Among patients undergoing biliary drainage with a catheter, 21 patients who underwent RT (four with IORT) survived significantly longer than 19 patients who did not (generalized Wilcoxon test: p<0.05). There were no significant differences in survival between 7 patients with recanalization and 11 patients with no recanalization. Concerning the survival of laparotomized patients, excluding those with complete resection or perioperative death, eight patients treated with postoperative ERT survived longer than 12 patients who did not have postoperative ERT (not significant). Eleven patients underwent IORT. A patient with unresectable carcinoma of the hilar bile duct survived 2 years and 3 months after a combination treatment of ERT and IOTR. In four of eight autopsied patients, radiation effects of Grade II were observed (Oboshi and Shimosato's evaluation system for the histological effects of radiation therapy). Our experience suggests that RT is effective in patients with obstructive jaundice caused by carcinoma of the biliary system. (author)

  15. Radiation therapy for patients with obstructive jaundice caused by carcinoma of the extrahepatic biliary system

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, Masashi; Nakagawa, Hirofumi (National Shikoku Cancer Center Hospital, Ehime (Japan)); Kataoka, Masaaki (and others)

    1992-04-01

    From February 1980 through September 1990, 92 patients with obstructive jaundice resulting from biliary tract cancer were registered at Shikoku Cancer Center Hospital or Ehime University Hospital. Radiation therapy (RT) was used to treat 38 of these patients (30 with carcinoma of the extrahepatic bile duct, excluding ampulla of Vater, and eight patients with carcinoma of the gallbladder). Of 38 patients, 11 underwent intraoperative radiation therapy (IORT), and 27 were treated by external radiation therapy (ERT) alone. In contrast, 54 patients (39 with carcinoma of the extrahepatic bile duct and eight with carcinoma of the gallbladder) were not treated by RT. All jaundiced patients received external and/or internal biliary drainage of some kind. Among patients undergoing biliary drainage with a catheter, 21 patients who underwent RT (four with IORT) survived significantly longer than 19 patients who did not (generalized Wilcoxon test: p<0.05). There were no significant differences in survival between 7 patients with recanalization and 11 patients with no recanalization. Concerning the survival of laparotomized patients, excluding those with complete resection or perioperative death, eight patients treated with postoperative ERT survived longer than 12 patients who did not have postoperative ERT (not significant). Eleven patients underwent IORT. A patient with unresectable carcinoma of the hilar bile duct survived 2 years and 3 months after a combination treatment of ERT and IOTR. In four of eight autopsied patients, radiation effects of Grade II were observed (Oboshi and Shimosato's evaluation system for the histological effects of radiation therapy). Our experience suggests that RT is effective in patients with obstructive jaundice caused by carcinoma of the biliary system. (author).

  16. Care of the patient receiving radiation therapy

    International Nuclear Information System (INIS)

    External radiation therapy, or teletherapy, is the use of ionizing radiation to destroy cancer cells. Clinical use of ionizing radiation as treatment for cancer began with the discovery of x-rays in 1895, the identification of natural radioactivity (radium) in 1896, and the first reported cure of cancer, a basal cell epithelioma, induced by radiation in 1899. Initially, radiation was administered as a single large dose and produced severe, life-threatening side effects. The basis for the use of ionizing radiation in daily increments for a period of weeks was provided by Regaud in 1922; ten years later, Coutard clinically developed the method of dose fractionation, which remains in use today. Although the use of ionizing radiation as a treatment is over eighty years old, only in recent years have advancements in its clinical application been based on research related to the biologic effect of radiation on human cells. To effectively care for the patient prior to, during, and at the completion of external radiation therapy, the nurse must know the physical and biologic basis of external radiation therapy and its clinical application

  17. A Patient with Refractory Psoriasis Who Developed Sebaceous Carcinoma on the Neck during Cyclosporine Therapy and Showed Rapid Progression

    Science.gov (United States)

    Shima, Tomoko; Yamamoto, Yuki; Okuhira, Hisako; Mikita, Naoya; Furukawa, Fukumi

    2016-01-01

    We report a patient who developed sebaceous carcinoma on the neck during therapy with immunosuppressive agents (cyclosporine, corticosteroid, methotrexate) for refractory psoriasis vulgaris, which showed rapid enlargement, leading to a fatal outcome. Multiple-organ metastases were detected. Weekly carboplatin + paclitaxel therapy resulted in the disappearance of tumor cells, but the patient died of febrile neutropenia. The development of sebaceous carcinoma is rare among psoriasis patients receiving immunosuppressive agents including cyclosporine. PMID:27462222

  18. Concomitant lung metastasis in patients with advanced hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Tian Yang; Jun-Hua Lu; Chuan Lin; Song Shi; Ting-Hao Chen; Rong-Hua Zhao; Yi Wang; Meng-Chao Wu

    2012-01-01

    AIM:To investigate the clinical features and prognostic factors of advanced hepatocellular carcinoma (HCC) patients presenting with lung metastasis at initial diagnosis.METHODS:Between 2001 and 2010,we recruited 76consecutive HCC patients initially presenting with lung metastasis,without co-existing metastasis from other sites.These patients were divided into three groups:untreated group (n =22),single treatment group (n =19),and combined treatment group (n =35).RESULTS:Metastasis of bilateral lung lobes was common and noted in 35 patients (46.1%),and most of patients (59/76,77.6%) presented with multiple lung metastatic nodules.Nineteen patients (25.0%)received single-method treatment,including hepatectomy in 4,transcatheter arterial chemoembolization in 6,radiotherapy in 5,and oral sorafenib in 4.Thirty-five patients (46.1%) received combined treatment modalities.The overall median survival of the all patients was 8.7 ± 0.6 mo; 4.1 ± 0.3,6.3 ± 2.5 and 18.6 ± 3.9 mo,respectively in the untreated group,single treatment group and combined treatment group,respectively,with a significant difference (log-rank test,P < 0.001).Multivariate analysis revealed that Child-Pugh score,the absence or presence of portal vein tumor thrombus,and treatment modality were three independent prognostic factors affecting survival of patients with advanced HCC and concomitant lung metastasis.CONCLUSION:Combined treatment modalities tend to result in a better survival as compared with the conservative treatment or single treatment modality for HCC patients initially presenting with lung metastasis.

  19. Interstitial brachytherapy for eyelid carcinoma. Outcome analysis in 60 patients

    Energy Technology Data Exchange (ETDEWEB)

    Krengli, M.; Deantonio, L. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); University of ' ' Piemonte Orientale' ' , Department of Translational Medicine, Novara (Italy); Masini, L.; Filomeno, A.; Gambaro, G. [University Hospital ' ' Maggiore della Carita' ' , Division of Radiotherapy, Novara (Italy); Comoli, A.M. [University Hospital Maggiore della Carita, Ophthalmology, Novara (Italy); Negri, E. [University Hospital Maggiore della Carita, Medical Physics, Novara (Italy)

    2014-03-15

    Eyelid cancer is a therapeutic challenge due to the cosmetic and functional implications of this anatomical region and the objectives of therapy are tumor control, functional and cosmetic outcome. The present study was performed to analyze local control, toxicity, functional and cosmetic results in patients with eyelid carcinoma treated by interstitial brachytherapy. In this study 60 patients with eyelid carcinoma were treated by interstitial brachytherapy using iridium ({sup 192}Ir) wires with a linear activity of 1.2-1.7 mCi/cm. The prescription dose was 51-70 Gy (mean 65 Gy, median 66 Gy). Of the 60 patients 51 (85.0 %) had received no prior treatment, 4 (6.7 %) had received previous surgery with positive or close margins and 5 (8.3 %) had suffered local recurrence after surgery. Of the tumors 52 (86.7 %) were basal cell carcinoma, 7 (11.7 %) squamous cell carcinoma and 1 (1.7 %) Merkel cell carcinoma. Clinical stage of the 51 previously untreated tumors was 38 T1N0, 12 T2N0 and 1 T3N0. Mean follow-up was 92 months (range 6-253 months). Local control was maintained in 96.7 % of patients. Late effects higher than grade 2 were observed in 3.0 % of cases. Functional and cosmetic outcomes were optimal in 68.4 % of patients. Interstitial brachytherapy for carcinoma of the eyelid can achieve local control, cosmetic and functional results comparable to those of surgery. (orig.) [German] Das Karzinom des Augenlids stellt aufgrund der funktionellen und kosmetischen Beeintraechtigungen dieser anatomischen Region eine therapeutische Herausforderung dar. Ziele der Therapie sind sowohl die Tumorkontrolle als auch ein gutes funktionelles und kosmetisches Ergebnis. Lokale Kontrolle, Toxizitaet sowie funktionelle und kosmetische Ergebnisse bei Patienten mit Karzinom des Augenlids, die mit interstitieller Brachytherapie behandelt wurden, sollten analysiert werden. Sechzig Patienten mit Karzinom des Augenlids wurden mit interstitieller Brachytherapie mit Iridium-192-Draehten

  20. Medical evaluations of ionizing radiation effects during I131 therapy in patients after thyroid carcinoma surgery

    International Nuclear Information System (INIS)

    This study shows the para-clinical studies on a 39 years old patient who was operated on of a thyroid carcinoma and who, under the beirwaltes medical record (in use in our country), received in the post surgical stage, a Iodine-131 dose of about 2960 MBq (80 mCi) for ablation, having been noted subsequently her pregnancy condition. (author). 6 refs

  1. Anxiety and depression in patients receiving radiotherapy. Prospective study

    International Nuclear Information System (INIS)

    The objective of this study was to detect the prevalence of anxiety and depressive disorders using the Hospital Anxiety and Depression Scale (HADS) prospectively in patients receiving Radiotherapy (RT) during and after treatment. 140 consecutive cancer patients referred for radiotherapy and their care givers were included. All patients were administered the Hospital Anxiety and Depression Scale (HADS) conducted at intake, just before starting RT, after finishing the course of RT, and at 3-4 months follow-up. Anxiety and depression are detected frequently in patients receiving RT both prior to treatment and later during follow-up

  2. Quality of life in patients receiving home parenteral nutrition

    OpenAIRE

    Jeppesen, P; Langholz, E; Mortensen, P.

    1999-01-01

    BACKGROUND/AIMS—Quality of life is an important determinant of the effectiveness of health technologies, but it has rarely been assessed in patients receiving home parenteral nutrition (HPN).
PATIENTS/METHODS—The non-disease specific sickness impact profile (SIP) and the disease specific inflammatory bowel disease questionnaire (IBDQ) were used on a cohort of 49 patients receiving HPN, and the results compared with those for 36 non-HPN patients with either anatomical (2.0 MJ/day (~488 kcal/da...

  3. Thrombocytosis:A paraneoplastic syndrome in patients with hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Shinn-Jang Hwang; Chun-Chung Lee; Full-Young Chang; Shou-Dong Lee; Jiing-Chyuan Luo; Chung-Pin Li; Cheng-Wei Chu; Jaw-Ching Wu; Chiung-Ru Lai; Jen-Huei Chiang; Gar-Yang Chau; Wing-Yiu Lui

    2004-01-01

    AIM: Hepatocellular carcinoma (HCC) patients manifest a variety of paraneoplastic syndromes. Thrombocytosis was reported in children with hepatoblastoma. The aims of this study were to evaluate the prevalence and dinical significance of thrombocytosis in HCC patients and its relationships with serum thrombopoietin (TPO).METHODS: We retrospectively reviewed clinical, biochemical and image data of 1 154 HCC patients. In addition, we measured platelet count and serum TPO in HCC patients with and without thrombocytosis, in patients with cirrhosis,chronic hepatitis and healthy subjects in a cross-sectional study.RESULTS: Thirty-one (2.7%) of 1 154 HCC patients had thrombocytosis (platelet count ≥400 K/mm3). HCC patients with thrombocytosis were significantly younger, had a higher serum α-fetoprotein, higher rate of main portal vein thrombosis, larger tumor volume, shorter survival, and were less likely to receive therapy than HCC patients without thrombocytosis. Multivariate logistic regression analyses showed that tumor volumes ≥30% and serum α-fetoprotein ≥ 140 000 ng/mL could significantly predict thrombocytosis.HCC patients with thrombocytosis had a significantly higher mean serum TPO than those without, as well as patients with cirrhosis, chronic hepatitis and healthy subjects.Platelet count and serum TPO dropped significantly after tumor resection in HCC patients with thrombocytosis and re-elevated after tumor recurred. Furthermore, the expression of TPO mRNA was found to be more in tumor tissues than in non-tumor tissues of liver in an HCC patient with thrombocytosis.CONCLUSION: Thrombocytosis is a paraneoplastic syndrome of HCC patients due to the overproduction of TPO by HCC.It is frequently associated with a large tumor volume and high serum α-fetoprotein.

  4. Is phenytoin contraindicated in patients receiving cranial irradiation?

    International Nuclear Information System (INIS)

    Three recent publications have reported the development of erythema multiforme and Stevens-Johnson syndrome in patients receiving cranial irradiation and sodium phenytoin. Some authors have recommended that patients receiving whole brain radiation therapy and who have had seizures should not be prescribed phenytoin but an alternative anticonvulsant. This article reviews the current literature pertaining to the development of this potentially lethal complication in patients receiving whole brain radiation and phenytoin, with reference to the single recorded case of Stevens-Johnson syndrome in a patient receiving cranial irradiation and phenytoin in Auckland, New Zealand. While the clinical picture in the 16 patients reported in the literature and the current case report differed from the classical form of erythema multiforme, a similar pattern of presentation and outcome appeared in all patients reviewed, suggesting that the combination of phenytoin, cranial irradiation and the gradual reduction of concomitant steroids seem to lead to the development of erythema multiforme and/or Stevens-Johnson syndrome. The data presented, although sparse, suggest that phenytoin should not be prescribed in patients receiving cranial irradiation. 21 refs., 2 tabs., 3 figs

  5. Enhanced mucosal reactions in AIDS patients receiving oropharyngeal irradiation

    International Nuclear Information System (INIS)

    The oropharynx and hypopharynx are common sites of involvement in AIDS patients with mucocutaneous Kaposi's sarcoma. The radiotherapist is often asked to intervene with these patients due to problems with pain, difficulty in swallowing, or impending airway obstruction. We have noted an unexpected decrease in normal tissue tolerance of the oropharyngeal mucosa to irradiation in AIDS patients treated in our department. Data on 12 patients with AIDS and Kaposi's sarcoma receiving oropharyngeal irradiation are presented here. Doses ranged from 1000 cGy to 1800 cGy delivered in 150-300 cGy fractions. Seven of eight patients receiving doses of 1200 cGy or more developed some degree of mucositis, four of these developed mucositis severe enough to require termination of treatment. All patients in this study received some form of systemic therapy during the course of their disease, but no influence on mucosal response to irradiation was noted. Four patients received total body skin electron treatments, but no effect on degree of mucositis was seen. Presence or absence of oral candidiasis was not an obvious factor in the radiation response of the oral mucosa in these patients. T4 counts were done on 9 of the 12 patients. Although the timing of the T4 counts was quite variable, no correlation with immune status and degree of mucositis was found. The degree of mucositis seen in these patients occurred at doses much lower than expected based on normal tissue tolerances seen in other patient populations receiving head and neck irradiations. We believe that the ability of the oral mucosa to repair radiation damage is somehow altered in patients with AIDS

  6. Enhanced mucosal reactions in AIDS patients receiving oropharyngeal irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Watkins, E.B.; Findlay, P.; Gelmann, E.; Lane, H.C.; Zabell, A.

    1987-09-01

    The oropharynx and hypopharynx are common sites of involvement in AIDS patients with mucocutaneous Kaposi's sarcoma. The radiotherapist is often asked to intervene with these patients due to problems with pain, difficulty in swallowing, or impending airway obstruction. We have noted an unexpected decrease in normal tissue tolerance of the oropharyngeal mucosa to irradiation in AIDS patients treated in our department. Data on 12 patients with AIDS and Kaposi's sarcoma receiving oropharyngeal irradiation are presented here. Doses ranged from 1000 cGy to 1800 cGy delivered in 150-300 cGy fractions. Seven of eight patients receiving doses of 1200 cGy or more developed some degree of mucositis, four of these developed mucositis severe enough to require termination of treatment. All patients in this study received some form of systemic therapy during the course of their disease, but no influence on mucosal response to irradiation was noted. Four patients received total body skin electron treatments, but no effect on degree of mucositis was seen. Presence or absence of oral candidiasis was not an obvious factor in the radiation response of the oral mucosa in these patients. T4 counts were done on 9 of the 12 patients. Although the timing of the T4 counts was quite variable, no correlation with immune status and degree of mucositis was found. The degree of mucositis seen in these patients occurred at doses much lower than expected based on normal tissue tolerances seen in other patient populations receiving head and neck irradiations. We believe that the ability of the oral mucosa to repair radiation damage is somehow altered in patients with AIDS.

  7. Radiation-induced secondary cancer in patients with uterine carcinoma

    International Nuclear Information System (INIS)

    In an effort to identify radiation-induced secondary cancer (RSC), data from 19,384 patients, which were treated for uterine carcinoma at seven institutions in Japan between 1960 and 1978, were statistically analyzed using a computer system. Treatment modalities included surgery alone (n = 6,655), radiation therapy and surgery (n = 4,310), and radiation therapy alone (n = 8,419). According to the criteria of Sakai et al., RSC was identified in 43 (0.3 %) of 12,729 patients receiving irradiation, including rectal cancer (14), leukemia (8), uterine corpus cancer (6), urinary bladder cancer (4), osteosarcoma or uterine sarcoma (3), sigmoid colon cancer or malignant fibrous histiocytoma (2), and ovarian cancer (one). When the risk of RSC for the rectum, the urinary bladder, and leukemia was analyzed using a person-years method, there was no statistically significant difference between the irradiated and non-irradiated patients. Therefore, three institutions were selected for further analysis with 2,686 patients (13,588 person-years), taking the effort and accuracy for follow-up of patients into account. The analysis showed statistically significant increase in RSC for the rectum and leukemia. It can thus be concluded that the accuracy for follow-up of patients is the most important factor in evaluating the incidence of RSC. (Namekawa, K.)

  8. Stress Encountered by Significant Others of Cancer Patients Receiving Chemotherapy.

    Science.gov (United States)

    Hart, Kay

    1987-01-01

    Attempts to identify and describe perceived stress and coping responses of family and nonfamily significant others of cancer patients receiving chemotherapy. Significant others were asked to identify stressful events related to treatment factors, relationship factors, and perception of the patient's condition. Coping responses were categorized in…

  9. Merkel Cell Carcinoma in Immunosuppressed Patients

    International Nuclear Information System (INIS)

    Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous malignancy. The infectivity of Merkel cell polyomavirus (MCPyV), an apparent agent in MCC development, may be exacerbated with impaired immune responses. This paper reviews relevant data regarding the role of immunosuppression in the development of MCC and describes modes of immunodeficient states. Because of the inherently low incidence rate of MCC, several case studies and series are also briefly mentioned to provide a more comprehensive summary of MCC in the setting of immunosuppression. We describe immunosuppressed patients who have experienced excessive UV radiation, organ transplantation, human immunodeficiency virus infection/AIDS, autoimmune diseases, and lymphoproliferative disorders. Iatrogenic forms of immunosuppression are also highlighted. Studies that quantify risks consistently report that individuals with a history of solid organ transplantation, autoimmune diseases, AIDS, and/or lymphoproliferative diseases have a significantly elevated risk of developing MCC. Overall, immunocompromised patients also appear to have an early onset and more aggressive course of MCC, with poorer outcomes. Recommendations for multidisciplinary approaches are proposed to effectively prevent and manage MCC in these patients

  10. Merkel Cell Carcinoma in Immunosuppressed Patients

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Janice E. [Mayo Clinic College of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (United States); Brewer, Jerry D., E-mail: brewer.jerry@mayo.edu [Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (United States)

    2014-06-27

    Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous malignancy. The infectivity of Merkel cell polyomavirus (MCPyV), an apparent agent in MCC development, may be exacerbated with impaired immune responses. This paper reviews relevant data regarding the role of immunosuppression in the development of MCC and describes modes of immunodeficient states. Because of the inherently low incidence rate of MCC, several case studies and series are also briefly mentioned to provide a more comprehensive summary of MCC in the setting of immunosuppression. We describe immunosuppressed patients who have experienced excessive UV radiation, organ transplantation, human immunodeficiency virus infection/AIDS, autoimmune diseases, and lymphoproliferative disorders. Iatrogenic forms of immunosuppression are also highlighted. Studies that quantify risks consistently report that individuals with a history of solid organ transplantation, autoimmune diseases, AIDS, and/or lymphoproliferative diseases have a significantly elevated risk of developing MCC. Overall, immunocompromised patients also appear to have an early onset and more aggressive course of MCC, with poorer outcomes. Recommendations for multidisciplinary approaches are proposed to effectively prevent and manage MCC in these patients.

  11. Assessment of psychological responses in patients about to receive radiotherapy

    International Nuclear Information System (INIS)

    Radiotherapy is considered to be associated with psychological distress. We assessed the mental status, anxiety, and the factors associated with these in cancer patients about to receive radiotherapy. Hospitalized patients about to receive radiotherapy participated. Psychological status was assessed by a psychiatrist, based on interview about the type of anxiety related to cancer or radiotherapy as well as self-rating questionnaires. Eligible data were collected from 94 patients. The incidence of mental disorders was 20%. The total mood disturbance scores were significantly higher in patients with poor performance status. The most common type of anxiety regarding radiotherapy was acute adverse effect, and the predictors were palliative treatment and living alone. Mental disorders, mood disturbance, and anxiety in patients cannot be neglected in radiation oncology practice. Especially careful attention should be paid to patients with these predictive factors. (author)

  12. Abnormal contingent negative variation in HIV patients receiving antiretroviral therapy

    OpenAIRE

    Chao, Linda L.; Cardenas, Valerie A.; Meyerhoff, Dieter J.; Rothlind, Johannes C.; Flenniken, Derek L.; Lindgren, Joselyn A.; Weiner, Michael W.

    2003-01-01

    The contingent negative variation, an event-related potential related to neural activity in the frontal lobe and basal ganglia, neuropsychological tests and structural MRI were used to examine CNS function and structure in HIV-positive patients receiving antiretroviral therapy. Relative to controls, HIV patients had smaller thalamic volume and reduced late contingent negative variation amplitude that correlated with caudal atrophy. Behaviorally, viremic patients were more impaired than virall...

  13. Speech recognition for 40 patients receiving multichannel cochlear implants.

    Science.gov (United States)

    Dowell, R C; Mecklenburg, D J; Clark, G M

    1986-10-01

    We collected data on 40 patients who received the Nucleus multichannel cochlear implant. Results were reviewed to determine if the coding strategy is effective in transmitting the intended speech features and to assess patient benefit in terms of communication skills. All patients demonstrated significant improvement over preoperative results with a hearing aid for both lipreading enhancement and speech recognition without lipreading. Of the patients, 50% demonstrated ability to understand connected discourse with auditory input only. For the 23 patients who were tested 12 months postoperatively, there was substantial improvement in open-set speech recognition. PMID:3755975

  14. The role of thyrotropin suppression in patients with differentiated thyroid carcinoma.

    LENUS (Irish Health Repository)

    Deasy, J

    2010-07-01

    Thyroid carcinoma is the commonest endocrine malignancy. The majority of these are differentiated thyroid carcinomas, which have a good overall prognosis. Treatment includes surgical excision, radio-iodine ablation and long-term thyrotropin suppression. The degree and length of suppression required, as well as the potential side-effect remain controversial. Therefore, the aim of this study was to establish the degree of thyrotropin suppression achieved in a cohort of patients with differentiated thyroid carcinoma. A retrospective review was performed of a prospectively maintained database. All patients with a diagnosis of differentiated thyroid carcinoma between January 1998 and January 2008 were identified. Demographic data, pathological stage and the treatment that the patient received was documented. TSH and free T4 levels were identified at specific time points post-operatively. Eighty-eight patients with differentiated thyroid carcinoma were identified. Seventy patients (79.5%) were female. The mean age was 55, with a range of 18 to 79 years. The majority of patients underwent a total thyroidectomy (n=79; 89.7%) and of those 29 (32.9%) had an associated modified neck dissection. Accurate follow-up was available on forty-nine patients. TSH and free T4 were measured at 3 and 6 months, as well as at 1 and 2 years post-operatively. Adequate TSH suppression was taken at a level < 0.1 mU\\/L. The majority of patients (69.5%) had achieved adequate TSH suppression at 2 years. However, 65% of these same patients had a high free T4 at 2 years indicating a degree of hyperthyroidism. This study has demonstrated that TSH suppression is being adequately achieved in the majority of patients with differentiated thyroid carcinoma. However, this must be carefully weighed against the potential detrimental side-effects of long-term sub-clinical hyperthyroidism.

  15. Osteoporosis prophylaxis in patients receiving chronic glucocorticoid therapy

    International Nuclear Information System (INIS)

    Glucocorticoid-induced osteoporosis (GIOP) is the most common form of secondary osteoporosis, yet few patients receive proper measures to prevent its development. We retrospectively searched prescription records to determine if patients receiving oral prednisolone were receiving prophylaxis or treatment for osteopenia and osteoporosis. Patients who were prescribed greater or equal to 7.5 milligrams of prednisolone for 6 months or longer during a 6- month period were identified through the prescription monitoring system. Demographic and clinical data were extracted from the patient records, and dual energy x-ray absorptiometry (DEXA) scans were retrieved, when available. Use of oral calcium, vitamin D and anti-resorptives was recorded. One hundred males and 65 females were receiving oral prednisolone for a mean (SD) duration of 40.4 (29.9) months in males and 41.2 (36.4) months in females. Twenty-one females (12.7%) and 5 (3%) males had bone mineral density measured by DEXA. Of those, 10 (47.6%) females and 3 (50%) males were osteoporotic and 11(52.4%) females and 2 (40%) males were osteopenic. Calcium and vitamin D were prescribed to the majority of patients (60% to 80%), but none were prescribed antiresorptive/anabolic therapy. Patients in this study were neither investigated properly nor treated according to the minimum recommendations for the management of GIOP. Physician awareness about the prevention and treatment of GIOP should be a priority for the local health care system. (author)

  16. An interim safety analysis of hepatocellular carcinoma patients administrating oral vitamin K with or without sorafenib

    OpenAIRE

    Jung, Dong-Hwan; Hwang, Shin; Song, Gi-Won; Ryoo, Baek-Yeol; Kim, Nayoung; Tak, Eunyoung; Hong, Hea-Nam

    2015-01-01

    Backgrounds/Aims Vitamin K may plays a role in controlling hepatocellular carcinoma (HCC) cell growth. In this study, we intended to present 5-year experience of 72 patients receiving oral vitamin K with or without sorafenib. Its end-point was to evaluate the safety of combination therapy using sorafenib and vitamin K. Methods An interim analysis was performed as a single-arm cross-sectional study, including 72 HCC patients who underwent liver resection or transplantation and administered ora...

  17. Periampullary carcinoma in a patient with agenesis of dorsal pancreas

    OpenAIRE

    Kapoor, A; Singh, RK

    2011-01-01

    Agenesis of dorsal pancreas is a rare developmental anomaly. We here report a case of agenesis of dorsal pancreas in a patient of periampullary carcinoma and highlight its implications on the management.

  18. Treatment outcomes for patients with chloroma receiving radiation therapy

    International Nuclear Information System (INIS)

    This study aims to analyse treatment outcomes, disease control and toxicity in patients with chloromas referred for radiation therapy (RT). Medical records were retrospectively reviewed for 41 patients with chloromas treated with RT at our institution. Twenty-five patients were treated with palliative intent, whereas sixteen received RT as a component of curative intent therapy in addition to systemic chemotherapy with or without haematopoietic stem cell transplant (HSCT). All patients received RT for chloroma (median dose 24 Gy). Median survival was 5.4 months after RT (95% confidence interval (CI) 3.5-12.6 months), and no significant difference in overall survival was identified based on prior treatment with systemic chemotherapy alone or HSCT. Patients treated with curative intent had a median survival of 26.2 months (95% CI 6.1-48.9 months) and a Kaplan-Meier estimate of 15% overall survival at 5 years. At the end of the study follow-up period, 38 patients were dead and three patients treated with curative intent remained alive. After palliative RT, 44% of patients experienced partial relief and 48% experienced complete symptomatic improvement without significant acute toxicities. RT provides timely symptom palliation for patients with chloromas with minimal morbidity, but the prognosis remains poor. Long-term remission can be achieved in selected patients with salvage chemotherapy and HSCT.

  19. Gastric fluid pH in patients receiving sodium citrate.

    Science.gov (United States)

    Viegas, O J; Ravindran, R S; Shumacker, C A

    1981-07-01

    Gastric fluid pH was measured following induction of anesthesia and placement of an endotracheal tube in 30 surgical patients undergoing elective operations. None of the patients received an anticholinergic drug before surgery. Fifteen patients who had been given 15 ml of sodium citrate 15 to 20 minutes before induction of anesthesia had a mean pH of 6.2 +/- 0.8. The control group, which also consisted of 15 patients, had a mean pH of 2.1 +/- 1.4. The increase in gastric pH noted following sodium citrate would result in reduced pulmonary reaction should aspiration occur. PMID:7195668

  20. Severe haemoptysis in patients with nonsmall cell lung carcinoma.

    Science.gov (United States)

    Razazi, Keyvan; Parrot, Antoine; Khalil, Antoine; Djibre, Michel; Gounant, Valerie; Assouad, Jalal; Carette, Marie France; Fartoukh, Muriel; Cadranel, Jacques

    2015-03-01

    Severe haemoptysis due to nonsmall cell lung cancer (NSCLC) is considered a grim condition, and there is still scarce data on its characteristics and outcome, despite new imaging and treatment modalities. This retrospective study sought to describe the clinical characteristics, pathophysiology and outcome of NSCLC-related haemoptysis. We included 125 consecutive patients with severe haemoptysis (>100 mL) at admission, 65 (52%) exhibiting squamous cell carcinoma. Tumour cavitation/necrosis was reported in 26 (21%) patients. 52 patients had received anticancer treatment, but none had received anti-angiogenic agents. Severe haemoptysis was related mainly to the bronchial artery (82%), and major pulmonary artery involvement was rare (6.4%). Interventional radiology was performed in 102 patients. Bleeding cessation was achieved in 108 (87%) out of 125 patients. The overall in-hospital and 1-year survival rates were 69% and 30%, respectively. Performance status (PS) ≥ 2 (OR 3.6, 95% CI 1.3-9.6), advanced stage (OR 8.6, 95% CI 2-37) and mechanical ventilation (OR 13, 95% CI 4.5-36) were independent predictors of in-hospital mortality. Performance status ≥ 2 (hazard ratio (HR) 2.4, 95% CI 1.5-3.7), advanced stage (HR 4, 95% CI 2.1-7.7), cancer progression (HR 2, 95% CI 1.01-2.7) and cavitation/necrosis (HR 1.7, 95% CI 1.21-3.2) were independently associated with 1-year mortality. Management of severe haemoptysis related to NSCLC should be improved, given our observed survival rates after hospital discharge. PMID:25359349

  1. Peritoneal implants without ascites. Preoperative CT diagnosis in colon carcinoma patients

    International Nuclear Information System (INIS)

    We evaluated the preoperative CT findings in 10 patients with colon carcinoma in whom peritoneal metastases had been surgically confirmed. Seven patients lacked ascites. No CT findings suggestive of peritoneal metastasis were observed in two patients without ascites even by retrospective evaluation. A large mass was observed in the cul-de-sac in another. In the remaining four patients, small peritoneal metastases ranging from 8 to 11 mm in diameter were observed at the omentum in two, along the falciform ligament in one, and at both the omentum and the iliac fossa in one; three of these patients had received no prospective diagnosis of peritoneal metastasis prior to the surgery. In patients with advanced colon carcinoma with suspected serosal invasion, the entire peritoneal cavity should be carefully examined and interpreted using CT in order to detect small peritoneal implants even when ascites is absent. (author)

  2. Renal cell carcinoma in patient with crossed fused renal ectopia

    OpenAIRE

    Ozgur Cakmak; Cemal Selcuk Isoglu; Ercument Aziz Peker; Huseyin Tarhan; Ulku Kucuk; Orcun Celik; Ferruh Zorlu; Yusuf Ozlem Ilbey

    2016-01-01

    Primary renal cell carcinomas have rarely been reported in patients with crossed fused renal ectopia. We presented a patient with right to left crossed fused kidney harbouring renal tumor. The most frequent tumor encountered in crossed fused renal ectopia is renal cell carcinoma. In this case, partial nephrectomy was performed which pave way to preservation of the uninvolved both renal units. Due to unpredictable anatomy, careful preoperative planning and meticulous delineation of renal vascu...

  3. 采用FACT-H & N评价核黄素磷酸钠对喉癌放疗患者生存质量的影响%Using FACT-H & N to evaluate the effect of riboflavin sodium phosphate on the qual- ity of life of patients with laryngeal carcinoma who received radiotherapy

    Institute of Scientific and Technical Information of China (English)

    丁荣楣; 王平; 马丽君; 田奕

    2015-01-01

    目的:采用FACT-H&N量表评价核黄素磷酸钠对喉癌放疗患者生存质量的影响。方法选取我院肿瘤科首次接受放射治疗的喉癌患者72例,随机分为观察组和对照组,每组36例。观察组自放疗开始每日应用核黄素磷酸钠20 mg静脉输液,直至放疗结束;对照组单纯放疗,不使用核黄素磷酸钠。观察两组患者放疗后放射性口咽黏膜炎的发生率和摄食量,分别于放疗前( D1)和放疗后( D2)采用FACT-H&N量表作为评测工具,评价放疗前后两组患者生存质量。结果观察组放射性口咽黏膜炎的发生率低于对照组,两组比较差异有统计学意义(P<0.05);观察组患者摄食量与对照组比较差异有统计学意义(P<0.05);生存质量方面,观察组在身体状况、社会家庭、情感及功能共性模块评分均高于对照组,在头颈部模块的附加条目领域得分低于对照组,两组比较差异有统计学意义(P<0.05)。结论核黄素磷酸钠可降低放射性口咽黏膜炎发生率,改善喉癌放疗患者摄食量下降,提高喉癌放疗患者生存质量,值得临床推广。%Objective Using FACT-H&N scale to evaluate the effect of riboflavin sodium phosphate on the quality of life of patients with laryngeal carcinoma who received radiotherapy. Methods Seventy-two patients with la-ryngeal carcinoma who underwent radiotherapy for the first time were randomly divided into observation group and con-trol group. Patients in observation group (n=36) accepted daily application of riboflavin sodium phosphate 20 mg in-travenous infusion throughout the course of radiotherapy. Patients in control group only received radiotherapy. The oc-currence of oropharyngeal mucositis and food intake after radiotherapy were assessed by FACT-HN scale to evaluate the quality of life of patients before (D1) and after (D2) radiotherapy. Results The incidence of oral mucositis in obser-vation group was lower than

  4. BIOCHEMICAL NUTRITIONAL PROFILE OF LIVER CIRRHOSIS PATIENTS WITH HEPATOCELLULAR CARCINOMA

    Directory of Open Access Journals (Sweden)

    Gabriela Zanatta PORT

    2014-03-01

    Full Text Available Context Liver cirrhosis patients with hepatocellular carcinoma present nutritional alterations and metabolic disorders that negatively impact the prognosis. Objective The objective is to identify alterations in the metabolism of macro and micronutrients among liver cirrhosis patients with and without hepatocellular carcinoma and their relation to the Child-Turcote-Pugh score and Barcelona Clinic Liver Cancer staging. Methods Analytical transversal study, with 31 hepatocellular carcinoma patients and 48 liver cirrhosis patients. Laboratorial exams were carried out. The existence of an association between the biochemical parameters and the disease severity as well as the presence of hepatocellular carcinoma was assessed. Results The metabolic-nutritional profile of liver cirrhosis patients caused by the hepatitis C virus and hepatocellular carcinoma showed alterations, specifically the lipid (total cholesterol, HDL and triglycerides, protein (albumin, creatinine and uric acid, iron (transferrin, iron and ferritin saturation, hematocrit and hemoglobin, zinc and B12 vitamin profiles. There is a relation between nutritional biochemical markers and the Child-Turcote-Pugh, as well as Barcelona Clinic Liver Cancer staging. Conclusions Considering the existence of alterations in the metabolism of nutrients in liver cirrhosis patients with and without hepatocellular carcinoma, and also that conventional nutritional assessment methods present limitations for this population, the biochemical laboratorial exams are valid to complement the diagnosis of the nutritional state in a quick and practical manner.

  5. Analysis of treatment and results in patients with advanced hypopharyngeal carcinomas

    International Nuclear Information System (INIS)

    Between 1991 and 1997, 42 patients with advanced stage III or IVA or IVB hypopharyngeal cancer received primary treatment at our clinic. Treatment and results in these cases were analyzed retrospectively. Thirty three patients with resectable hypopharyngeal carcinomas received 1-3 courses of neoadjuvant chemotherapy (NAC) involving a combination of cisplatin 60 mg/m2 and 5-fluorouracil 800 or 1,000 mg/m2 x 5 days, followed by total laryngopharyngectomy plus postoperative radiotherapy in 24 patients (group A) or followed by 70 Gy radiotherapy with radiation sensitizer in 9 patients because of self rejection of the operation (group B). Nine patients with unresectable hypopharyngeal carcinomas received neoadjuvant chemotherapy followed by radiotherapy or received radiotherapy only (group C). For the entire group, 5-year overall survival was 38% (group A 53%, group B 22%, group C 0%). The survival was statistically better (p<0.05) in group A than in group B. Better results were obtained for combined therapy including radical surgery in terms of overall survival. The response rate of NAC was 70%. In the patients who received operation, clinical and pathological CR rate was (8% in primary lesion, clinical CR rate was 5% and pathological CR rate was 23% in regional lymph nodes. Therefore sensitivity of the clinical CR evaluation was 50% in primary lesion and 20% in regional lymph nodes. Specificity of the clinical CR evaluation was 95% in primary lesion and 100% in regional lymph nodes. (author)

  6. The quality of voice in patients irradiated for laryngeal carcinoma

    International Nuclear Information System (INIS)

    Data from 150 patients with laryngeal carcinoma, consecutively treated primarily by radiotherapy from 1965 through 1974 was analyzed to assess the quality of voice. The voice appears to improve in majority of the successfully irradiated patients. In 76% of the evaluable patients in this group, the quality of voice appears to have attained normalcy or near normalcy. Smoking appears to have a negative influence. High incidence of bronchogenic carcinoma along with the negative influence of smoking on the quality of voice in this series of patients indicate that the patients should be advised against smoking in day-to-day clinical practice

  7. Metabolic syndrome among patients receiving clozapine: A preliminary estimate

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2011-01-01

    Full Text Available Objective : To study the prevalence of metabolic syndrome in patients receiving clozapine. Materials and Methods : For this study, 100 patients attending the psychiatry outpatient clinic of a tertiary care hospital who were receiving clozapine for more than three months were evaluated for the presence of metabolic syndrome using the International Diabetes Federation (IDF and modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III criteria. Results : Forty-six patients fulfilled IDF criteria and 47 met modified NCEP ATP-III criteria of metabolic syndrome. There was significant correlation between these two sets of criteria used to define the metabolic syndrome (Kappa value -0.821, P < 0.001. Among the individual parameters studied, increased waist circumference was the most common abnormality, followed by abnormal blood glucose levels and elevated triglyceride levels. All these abnormalities were seen in more than half (52-61% of the patients. When the sample was divided into two groups, i.e., those with and without metabolic syndrome, patients with metabolic syndrome had significantly higher body mass index and had spent more time in school. Logistic regression analysis revealed that these two variables together explained about 19% of the variance in metabolic syndrome (adjusted r 2 = 0193; F = 12.8; P < 0.001. Conclusion : The findings of the present study suggest that metabolic syndrome is highly prevalent in subjects receiving clozapine.

  8. Comparing treatment outcomes of different chemotherapy sequences during intensity modulated radiotherapy for advanced N-stage nasopharyngeal carcinoma patients

    OpenAIRE

    Sun, Xueming; Zeng, Lei; Chen, Chunyan; Huang, Ying; Han, Fei; Xiao, WeiWei; Liu, Shuai; Lu, Taixiang

    2013-01-01

    Background N-stage is related to distant metastasis of nasopharyngeal carcinoma (NPC) patients. We performed this study to compare the efficacy of different chemotherapy sequences in advanced N-stage (N2 and N3) NPC patients treated with intensity modulated radiotherapy (IMRT). Methods From 2001 to 2008, 198 advanced N-stage NPC patients were retrospectively analyzed. Thirty-three patients received IMRT alone. Concurrent chemoradiotherapy (CCRT) was delivered to 72 patients, neoadjuvant chemo...

  9. [Cognitive plasticity in Alzheimer's disease patients receiving cognitive stimulation programs].

    Science.gov (United States)

    Zamarrón Cassinello, Ma Dolores; Tárraga Mestre, Luis; Fernández-Ballesteros, Rocío

    2008-08-01

    The main purpose of this article is to examine whether cognitive plasticity increases after cognitive training in Alzheimer's disease patients. Twenty six patients participated in this study, all of them diagnosed with mild Alzheimer's disease, 17 of them received a cognitive training program during 6 months, and the other 9 were assigned to the control group. Participants were assigned to experimental or control conditions for clinical reasons. In order to assess cognitive plasticity, all patients were assessed before and after treatment with three subtests from the "Bateria de Evaluación de Potencial de Aprendizaje en Demencias" [Assessment Battery of Learning Potential in Dementia] (BEPAD). After treatment, Alzheimer's disease patients improved their performance in all the tasks assessing cognitive plasticity: viso-spatial memory, audio-verbal memory and verbal fluency. However, the cognitive plasticity scores of the patients in the control group decreased. In conclusion, this study showed that cognitive stimulation programs can improve cognitive functioning in mildly demented patients, and patients who do not receive any cognitive interventions may reduce their cognitive functioning. PMID:18674439

  10. Sorafenib Prevents Escape from Host Immunity in Liver Cirrhosis Patients with Advanced Hepatocellular Carcinoma

    OpenAIRE

    Yasukiyo Sumino; Takanori Mukozu; Hidenari Nagai; Yoshinori Igarashi; Koji Ishii; Kouichi Momiyama; Mie Shinohara; Noritaka Wakui; Masahiro Kanayama; Takenori Kanekawa; Kazunari Iida; Daigo Matsui

    2012-01-01

    Purpose. It has been reported that Th2 cytokines downregulate antitumor immunity, while activation of type T cells promotes antitumor immunity. The aim of this paper was to evaluate host immunity in liver cirrhosis (LC) patients with advanced hepatocellular carcinoma (aHCC) receiving sorafenib therapy. Methods. Forty-five adult Japanese LC patients received sorafenib for aHCC between 2009 and 2011 at our hospital. Sorafenib was administered at a dose of 200–800 mg/day for 4 weeks. Blood sampl...

  11. Hepatocellular carcinoma in extremely elderly patients: An analysis of clinical characteristics, prognosis and patient survival

    Institute of Scientific and Technical Information of China (English)

    Gengo Tsukioka; Akira Kojima; Yuichi Yamazaki; Toshiyuki Otsuka; Yutaka Matsuzaki; Fujio Makita; Daisuke Kanda; Katsuhiko Horiuchi; Tetsuya Hamada; Mieko Kaneko; Hideyuki Suzuki; Satoru Kakizaki; Masatomo Mori; Naondo Sohara; Ken Sato; Hitoshi Takagi; Hirotaka Arai; Takehiko Abe; Mitsuo Toyoda; Kenji Katakai

    2006-01-01

    AIM: To identify the clinical and prognostic features of patients with hepatocellular carcinoma (HCC) aged 80years or more.METHODS: A total of 1310 patients with HCC were induded in this study. Nin ety-one patients aged 80 years or more at the time of diagnosis of HCC were defined as the extremely elderly group. Two hundred and thirty-four patients aged ≥ 50 years but less than 60 years were regarded as the non-elderly group.RESULTS: The sex ratio (male to female) was significantly lower in the extremely elderly group (0.90:1)than in the non-elderly group (3.9:1, P<0.001). The positive rate for HBsAg was significantly lower in the extremely elderly group and the proportion of patients negative for HBsAg and HCVAb obviously increased in the extremely elderly group (P<0.001). There were no significant differences in the following parameters:diameter and number of tumors, Child-Pugh grading,tumor staging, presence of portal thrombosis or ascites,and positive rate for HCVAb. Extremely elderly patients did not often receive surgical treatment (P<0.001) and they were more likely to receive conservative treatment (P<0.01). There were no significant differences in survival curves based on the Kaplan-Meier methods in comparison with the overall patients between the two groups. However, the survival curves were significantly worse in the extremely elderly patients with stage Ⅰ/Ⅱ,stage Ⅰ/Ⅱ and Child-Pugh grade A cirrhosis in comparison with the non-elderly group. The causes of death did not differ among the patients, and most cases died of liverrelated diseases even in the extremely elderly patients.CONCLUSION: In the patients with good liver functions and good performance status, aggressive treatment for HCC might improve the survival rate, even in extremely elderly patients.

  12. Early results of combined chemotherapy followed by Co60 radiotherapy in patients with undifferentiated pulmonary carcinoma

    International Nuclear Information System (INIS)

    The results of combined treatment of a group of 17 patients with the diagnosis of microcellular pulmonary carcinoma are reported. The received chemotherapy with three drugs (cyclophosphamide, vincristine, methotrexate) and radiotherapy from Co60 by the sandwich method as suggested by the ALGB group. The obtained results resembled those reported from other clinical centres: 29% of the patients survived one year after treatment onset. Complete remission was achieved in 60% of cases, its mean duration was 11.3 months, and the mean survival time of these patients was 15.5 months. Side effects were slight, and the survival time of the patients achieving complete remission was evidently prolonged. (author)

  13. Results of clinical receiver operating characteristic study comparing ordered subset expectation maximization and filtered back projection images in FDG PET studies of hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Tae Joo; Lee, Jong Doo; Kim, Hee Joung; Kim, Myung Jin; Yoo, Hyung Sik [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

    2000-07-01

    The aims of this study is to validate the usefulness of ordered subset expectation maximization (OSEM) comparing with filtered back projection in terms of diagnostic ability for hepatocellular carcinoma (HCC). The data of fifty seven patients with HCC and 62 patients with normal liver was reconstructed using both OSEM and FBP. Mean age of the patients group was 54.4{+-}1.5 year. All patient underwent whole body and liver scan after the injection of 10 mCi of (F-18)FDG using dedicated whole body PET camera (GE, Advance). Interpretation of PET images were performed by 3 observers with random exposure of normal and diseased cases. Receiver operator characteristic (ROC) study was used for the validation of results. The area of ROC curve. Az was represented as below and this results revealed statistical differences (p<0.05). In PET studies of patients with HCC, OSEM showed better results that those of conventional FBP in terms of lesion detectability.

  14. [A Case of Composite Hepatocellular Carcinoma and Neuroendocrine Carcinoma in a Patient with Liver Cirrhosis Caused by Chronic Hepatitis B].

    Science.gov (United States)

    Yun, Eun Young; Kim, Tae Hyo; Lee, Sang Soo; Kim, Hong Jun; Kim, Hyun Jin; Jung, Woon Tae; Lee, Ok Jae; Song, Dae Hyun

    2016-08-25

    Primary hepatic neuroendocrine carcinoma (PHNEC) is rare and its origin is not clearly understood. The coexistence of PHNEC and hepaotcellular carcinoma has been reported in only a few cases. We report a rare case of combined PHNEC and hepaotcellular carcinoma in a patient with liver cirrhosis caused by chronic hepatitis B that resulted in aggressive behavior and poor prognosis. PMID:27554219

  15. Metastatic papillary carcinoma of the thyroid in a patient previously treated for Graves' disease.

    Science.gov (United States)

    Yunusa, Garba H; Kotze, Tessa; Brink, Anita

    2014-01-01

    Incidental papillary carcinoma of the thyroid in patients treated surgically for benign thyroid diseases including Graves' disease is a known phenomenon. However, the management of these patients remains an issue of concern and controversy for those who care for them. We report a case of metastatic papillary carcinoma of the thyroid in a patient previously treated for Graves' disease. The subject of this presentation is a 50-year-old lady who was diagnosed with Graves' disease at the age of 29, for which she had a subtotal thyroidectomy following failure of medical and radioactive iodine treatment. Three years later, the patient was referred to our nuclear medicine department with a clinical diagnosis of suspected metastatic lymph nodes presumably from a thyroid malignancy.She had an 123I diagnostic whole body scan that showed 123I avid areas in the thyroid bed as well as left cervical lymph nodes, which later turned out to be metastatic papillary carcinoma of the thyroid on histology. She was treated with therapeutic doses of 131I. Follow-up radioactive iodine scans and serum thyroglobulin assays showed no evidence of malignant thyroid tissue. The occurrence of papillary carcinoma of the thyroid after a subtotal thyroidectomy for Graves' disease is hereby reported. The need for vigilance and regular follow-up in patients who receive all forms of treatment for benign thyroid diseases is emphasized. PMID:24705115

  16. Tumor Marker Levels Before and After Curative Treatment of Hepatocellular Carcinoma as Predictors of Patient Survival.

    OpenAIRE

    Nanashima, Atsushi; Taura, Naota; Abo, Takafumi; Ichikawa, Tatsuki; Sakamoto, Ichiro; Nagayasu, Takeshi; Nakao, Kazuhiko

    2011-01-01

    BACKGROUND: α-fetoprotein (AFP) is used as a marker for hepatocellular carcinoma (HCC), which is influenced by hepatitis. Protein-induced vitamin K absence or antagonist II (PIVKA-II) is a sensitive diagnostic marker. Changes in these markers after treatment may reflect curability and predict outcome. METHODS: We conducted an analysis of prognosis in 470 HCC patients who received curative treatments, and examined the relationship between changes in AFP and PIVKA-II levels after 1 month of tre...

  17. Frequency of endometrial carcinoma in patients with postmenopausal bleeding

    International Nuclear Information System (INIS)

    Introduction: Postmenopausal bleeding (PMB) is defined as bleeding that occurs after 1 year of amenorrhea in a woman who is not receiving hormone replacement therapy (HRT). About 10% of women with postmenopausal bleeding have a primary or secondary malignancy. Common malignancies among them are endometrial cancer (80%), cervical cancer or an ovarian tumour. Endometrial cancer is the second most common cancer associated with hereditary non-polyposis colorectal cancer. Ninety percent of patients have benign causes. Objective: The objective of this study was to determine the frequency of endometrial carcinoma in patients with post-menopausal bleeding. Study Design: Descriptive case series study. Setting: Department of obstetrics and gynaecology, Lady Willingdon, Lahore. Duration of Study: This study was conducted over a period of six months from January, 1 2009 to June 30, 2009. Subjects and Methods: 50 cases with postmenopausal bleeding. Results: During the period of this study a total number of 50 consecutive patients who met inclusion criteria were enrolled in the study. Ages of the patients who presented with PMB ranged between 48 years and 80 years with a mean age of 59 years. Malignancy was found in 18 out of 50 cases (36%).Cases with endometrial CA were 14 out of 50 cases (28%) and CA cervix constituted 4 out of 50 cases (8%). Benign pathology was more frequent (64%). 13 of 50 cases (26%) had hyperplasia out of which 1 case (2%) was of atypical hyperplasia. Endometrial polyp was found in 4 of 50 cases (8%). 3 of 50 cases (6%) had chronic endometritis. 5 of 50 cases (10%) had chronic cervicitis. While 7 cases (14%) had postmenopausal bleeding due to decubitus ulcer of uterovaginal prolapse. Among malignancies (36%), endometrial cancer is the most frequent malignancy in women with postmenopausal bleeding with mean age of 65 years. Conclusion: In this study it was concluded that the majority of cases of PMB would be expected to be suffering from benign problems

  18. Impact of adjuvant therapy on survival of patients with early-stage uterine papillary serous carcinoma

    International Nuclear Information System (INIS)

    Purpose: To determine the efficacy of adjuvant therapy in patients with early-stage uterine papillary serous carcinoma. Methods and Materials: Data were collected on all surgically staged Stage I-II uterine papillary serous carcinoma patients. Statistical analyses were performed using the Kaplan-Meier and Cox proportional hazards regression methods. Results: Of 68 patients, 50 had Stage I and 18 had Stage II disease; 35 underwent adjuvant treatment, including radiotherapy in 26, chemotherapy in 7, and combined RT and chemotherapy in 2. The remaining 33 were treated expectantly. The median follow-up was 56 months (range 1-173). The 5-year overall survival rate was 69%. Of 19 patients with disease limited to the endometrium, 10 received no additional therapy, 3 of whom developed recurrence. However, all 9 women who underwent adjuvant treatment remained free of disease. Patients receiving adjuvant therapy with chemotherapy or radiotherapy had a prolonged 5-year overall and disease-free survival compared with those who were treated expectantly (85% vs. 54%, p = 0.002 for overall survival and 85% vs. 49%, p 0.01 for disease-free survival). In multivariate analysis, adjuvant therapy (p = 0.035) and the absence of lymphovascular space invasion (p = 0.001) remained as independent prognostic factors for improved survival. Conclusion: Adjuvant therapy with chemotherapy or radiotherapy improves the survival of women with early-stage uterine papillary serous carcinoma

  19. Chronic thyroiditis in patients with advanced breast carcinoma: metabolic and morphologic changes on PET-CT

    Energy Technology Data Exchange (ETDEWEB)

    Tateishi, Ukihide [University of Texas, MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama (Japan); University of Texas MD Anderson Cancer Center, Division of Diagnostic Imaging, Houston, TX (United States); Gamez, Cristina; Yeung, Henry W.D.; Macapinlac, Homer A. [University of Texas, MD Anderson Cancer Center, Department of Nuclear Medicine, Houston, TX (United States); Dawood, Shaheenah; Cristofanilli, Massimo [University of Texas, MD Anderson Cancer Center, Division of Breast Medical Oncology, Houston, TX (United States); Inoue, Tomio [Yokohama City University Graduate School of Medicine, Department of Radiology, Yokohama (Japan)

    2009-06-15

    To investigate clinical implications of FDG uptake in the thyroid glands in patients with advanced breast carcinoma by comparing metabolic and morphologic patterns on positron emission tomography (PET)/computed tomography (CT). The institutional review board waived the requirement for informed consent. A retrospective analysis was performed in 146 women (mean age 54 years) with advanced breast carcinoma who received systemic treatment. All patients underwent PET-CT before and after treatment. All PET-CT studies were reviewed in consensus by two reviewers. Morphologic changes including volume and mean parenchymal density of the thyroid glands were evaluated. Maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG) were determined to evaluate metabolic changes. These parameters were compared between patients with chronic thyroiditis who received thyroid hormone replacement therapy and those who did not. Of the 146 patients, 29 (20%) showed bilaterally diffuse uptake in the thyroid glands on the baseline PET-CT scan. The SUVmax showed a linear relationship with volume (r = 0.428, p = 0.021) and the mean parenchymal density (r = -0.385, p = 0.039) of the thyroid glands. In 21 of the 29 patients (72%) with hypothyroidism who received thyroid hormone replacement therapy, the volume, mean parenchymal density, SUVmax, and TLG of the thyroid glands showed no significant changes. In contrast, 8 of the 29 patients (28%) who did not receive thyroid hormone replacement therapy showed marked decreases in SUVmax and TLG. Diffuse thyroid uptake on PET-CT represents active inflammation caused by chronic thyroiditis in patients with advanced breast carcinoma. Diffuse thyroid uptake may also address the concern about subclinical hypothyroidism which develops into overt disease during follow-up. (orig.)

  20. Compliance to Therapy—Elderly Head and Neck Carcinoma Patients

    OpenAIRE

    Sharma, Aman; Madan, Renu; Kumar, Rajeev; Sagar, Prem; Kamal, Vineet K.; Thakar, Alok; Sharma, Atul; Bidhu K Mohanti

    2014-01-01

    Background Treatment compliance of elderly patients to intensive multi-modality cancer therapy can be challenging and has not been adequately addressed in developing countries. The present study evaluated compliance of elderly head and neck carcinomas patients to cancer-directed therapy. Methods Forty-seven elderly HNSCC patients were evaluated in the present study. Patients were assessed as per stage and site of disease, general condition, performance status, and any pre-existing co-morbidit...

  1. Descriptive Study of Patients Receiving Excision and Radiotherapy for Keloids

    International Nuclear Information System (INIS)

    Purpose: To review and describe our institution's outcomes in patients treated with external beam radiotherapy after keloid excision. Methods and Materials: This was a retrospective study. Patients who received radiotherapy between July 1994 and January 2004 after keloid excision were identified. A questionnaire was mailed regarding sociodemographic factors, early and late radiation toxicities, the need for additional therapy, and satisfaction level. All patients had received a total of 15 Gy in three daily 5-Gy fractions. Treatment started within 24 h after surgery and was delivered on a Siemens orthovoltage machine. The data were analyzed using the STATA statistical package. Results: A total of 234 patients were approached. The response rate was 41%, and 75% were female. The mean age was 36.5 years (range, 16-69 years). The patients were mainly of European (53.1%) or African (19.8%) descent. For early toxicity outcomes, 54.2% reported skin redness and 24% reported skin peeling. For late toxicity outcomes, 27% reported telangiectasia and 62% reported permanent skin color changes. No association was found with gender, skin color, or age for the late toxicity outcomes. Of the patients responding, 14.6% required adjuvant treatment. On a visual scale of 1-10 for the satisfaction level, 60% reported a satisfaction level of ≥8. Telangiectasia was the most significant predictor of a low satisfaction level (≤3, p < 0.005). Conclusion: The results of our study have shown that orthovoltage-based radiotherapy after surgical excision for keloids is a good method for the prevention of relapse. It is well tolerated, causes little toxicity, and leads to a high patient satisfaction level

  2. Adverse Events Lead to Drug Discontinuation More Commonly among Patients Who Receive Nafcillin than among Those Who Receive Oxacillin.

    Science.gov (United States)

    Viehman, J Alexander; Oleksiuk, Louise-Marie; Sheridan, Kathleen R; Byers, Karin E; He, Peimei; Falcione, Bonnie A; Shields, Ryan K

    2016-05-01

    Nafcillin and oxacillin are used interchangeably in clinical practice, yet few studies have evaluated the safety of these two agents. Our objective was to compare the differential tolerabilities of nafcillin and oxacillin among hospitalized patients. We conducted a retrospective cohort study of all patients who received 12 g/day of nafcillin or oxacillin for at least 24 h. Two hundred twenty-four patients were included. Baseline characteristics and comorbidities were similar among patients receiving nafcillin (n = 160) and those receiving oxacillin (n = 64). Hypokalemia, defined as a potassium level of ≤3.3 mmol/liter or ≤2.9 mmol/liter or as a ≥0.5-mmol/liter decrease from the baseline level, occurred more frequently among patients who received nafcillin (51%, 20%, and 56%, respectively) than among those who received oxacillin (17%, 3%, and 34%, respectively; P oxacillin (18% versus 6%; P = 0.03). Overall, 18% of patients who received nafcillin discontinued therapy prematurely due to adverse events, compared to 2% of patients who received oxacillin (P = 0.0004). Nafcillin treatment is associated with higher rates of adverse events and treatment discontinuation than oxacillin among hospitalized adult patients. These findings have important implications for patients in both inpatient and outpatient settings, particularly patients who require long-term therapy and cannot be monitored routinely. Future randomized controlled studies evaluating the efficacy, costs, and tolerability of nafcillin versus oxacillin are warranted. PMID:26976858

  3. Radioiodine therapy in management of thyroid carcinoma - A review of 138 patients

    International Nuclear Information System (INIS)

    Differentiated thyroid carcinomas are being treated by using a widely accepted protocol of surgery and radioiodine therapy followed by supplementation of thyroid hormones in the Nuclear Medicine Centre (NMC), Dhaka Medical College Hospital (DMCH) since 1990. In the present study 138 patients(Male-54, Female-84) with differentiated thyroid cancers received radioiodine therapy for ablation of residual thyroid tissue with a dose of 2.77-3.7 GBq (75-100 mCi), for lymph node metastases 5.55-6.5 GBq(150-175mCi), for lung metastases 5.55 GBq(150 mCi) and for bony metastases 7.4 GBq (200 mCi). Among 138 patients papillary carcinoma was observed in 94 cases (68%; Male-42, Female-52), follicular type was found in 30 cases (22%; Male-8, Female-22) and mixed type in 14 patients (10%, Male-4, Female-10). Single dose of 2.77-3.7 GBq(75-100 mCi) of radioiodine was received by all 138 patients. Among the unablated patients 62 received double doses totalling 9.25 GBq (250 mCi), 44 received three doses 12.95 GBq (350 mCi) and one patient received 8 doses 33.3 GBq (900 mCi). Out of 138 patients single dose ablated 76 cases and 62 remain unablated. Multiple doses ablated 28 patients and 34 still remain unablated and is under follow up. The success and failure in management of patients with differentiated thyroid cancer over 8 years period have been discussed here revealing a satisfactory outcome. (author)

  4. Changes in the prostacyctin sensitivity of thrombocytes after intravaginal radium irradiation of patients with corpus carcinoma

    International Nuclear Information System (INIS)

    The goal of this work was to investigate, to what extent the platelet sensitivity in comparison to prostacyclin (PGI2) should be seen as a responsible factor in the increase of the thrombosis rate. For this blood was examined from 22 patients with corpus carcinoma who had received an intravaginal Radium implant with a radiation dose of 960 mgeh to over 24 h. These patients were compared to a control group of 21 clinically healthy women. Even before the radiation therapy there was an increased aggregation rate of the thrombocytes in the carcinoma patients as well as a reduced sensitivity to PGI2. Under irradiation there was an even greater decrease in the sensitivity of the thrombocytes to PGI2. The aggregation speed increase statistically significantly and the number of thrombocytes decreased during the Radium irradiation. After the giving of heparin the sensitivity of the thrombocytes to PGI2 sank strongly. (orig./MG)

  5. Retrospective Evaluation of the Pancreatic Cancer Patients Who Received Chemoradiotherapy

    Directory of Open Access Journals (Sweden)

    Feryal Karaca

    2016-01-01

    Full Text Available Aim: Pancreatic cancer is a highly lethal malignancy and in locally advanced disease, chemotherapy (CT or chemoradiotherapy (CRT are implemented. The aim of this retrospective study was to investigate the general characteristics and survival of our patients receiving CRT. Material and Method: Between the years 2009-2013, 62 pancreatic cancer patients were taken into study who admitted to Van Training and Research Hospital. Eight patients who had whipple operation received radiotherapy (RT with concurrent CT. Fifty-four patients who were considered to be inoperable underwent CRT. As adjuvant treatment dose, 45 Gy (1,8 Gy/fx/day radiotherapy was administered to pancreas and regional lymph nodes. In patients who had taken definitive CRT, average 50.4 Gy (1.8 Gy/fx/day dose was given. Statistical analysis was carried out using SPSS 19 software package; Kaplan-Meier analysis method was used for survival and log-range test for comparisons. Results: Twenty-four patients (38.7% were female and 38 (61.3% were male. Eleven patients (17.7% were at stage IA, 16 (25.8% were stage IB, 13 (20.9% were stage IIA, 8 (12.9% were stage IIB and 14 (22.5% were staged as stage III. Two-year disease free survival (DFS; time from the date of biopsy until the date of recurrence was approximately 436 days and the median DFS was found to be 362 days. The average overall survival (OS time; time from the date of biopsy until the date of death were found to be approximately 854 days, the median survival time was found to be 916 days. Survival due to tumor localization (head, body and tail showed no significant difference statistically (log-range chi-square=0.366;p=0.833. Discussion: According to our single center experience, our data in pancreatic cancer patients were parallel with international data. In preclinical experiments, effective drug therapies for curative modalities are under investigation for pancreatic cancer patients.

  6. Renal cell carcinoma in dialysis patients. A single center experience

    International Nuclear Information System (INIS)

    Renal cell carcinoma (RCC) is a life-threatening complication of end-stage renal disease with an unclear pathogenesis. We evaluated RCC developing in patients undergoing dialysis. In 2624 patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis at our hospital between July 1993 and March 2004, we performed annual screening for RCC using abdominal computed tomography and ultrasonography. Patients diagnosed with RCC underwent radical nephrectomy as well as clinical and pathologic evaluation. RCC was detected in 44 patients (1.68%; 31 males and 13 females). The age of RCC patients was 55.5±11.1 years. Dialysis duration before RCC diagnosis was 11.2±7.2 years. Most RCC were early stage and low stage by TNM classification, 43 patients had N0M0 RCC, whereas one had N1M0. Tumor size was 2.9±1.9 cm. The predominant histological type of RCC was common or conventional cell-type carcinoma (clear cell carcinoma and granular cell carcinoma). Of patients, 5 (11.4%) had bilateral RCC, and satellite tumor lesions in RCC were detected in 13 (29.5%). In 36 patients (81.8%) RCC was accompanied by acquired cystic disease of the kidney. These patients had longer dialysis durations (P=0.01) and smaller tumors (P=0.048). RCC metastasized postoperatively in 4 patients (9.1%), while one (2.3%) died of cancer. Our dialysis patients showed a higher incidence of RCC than the general population. Prognosis was favorable because tumors were detected by screening when they were small. Therefore, periodical screening for RCC seems very important in dialysis patients. (author)

  7. Amrubicin in patients with platinum-refractory metastatic neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma of the gastrointestinal tract.

    Science.gov (United States)

    Araki, Tomonori; Takashima, Atsuo; Hamaguchi, Tetsuya; Honma, Yoshitaka; Iwasa, Satoru; Okita, Natsuko; Kato, Ken; Yamada, Yasuhide; Hashimoto, Hironobu; Taniguchi, Hirokazu; Kushima, Ryoji; Nakao, Kazuhiko; Boku, Narikazu; Shimada, Yasuhiro

    2016-09-01

    Although the same treatment strategy as used for small cell lung cancer, including second-line chemotherapy, is generally applied to metastatic neuroendocrine carcinoma (NEC) and mixed adenoneuroendocrine carcinoma (MANEC) of the gastrointestinal tract (GIT; GIT-NEC/MANEC), the efficacy of amrubicin (AMR) for GIT-NEC/MANEC is not well known. We retrospectively analyzed platinum-refractory GIT-NEC/MANEC patients who received AMR between February 2004 and July 2012 at the National Cancer Center Hospital. The AMR dose administered was 30-45 mg/m on days 1-3 every 3-4 weeks. The overall response rate according to Response Evaluation Criteria in Solid Tumors guidelines, version 1.0, progression-free survival, overall survival, and adverse events by National Cancer Institute-Common Terminology Criteria for Adverse Events guidelines, version 4.0 were evaluated. Nineteen patients received AMR. The response rate for 16 assessable patients was 18.8% (95% confidence interval, 4.1-45.7), the median progression-free survival was 3.8 months (2.3-5.3), and the median overall survival was 7.7 months (7.1-8.2). Grade 3/4 neutropenia occurred in 52.6% of patients and febrile neutropenia occurred in 10.5%. Other nonhematological toxicities were mild and treatment-related deaths were not observed. AMR may have a modest effect, with tolerable toxicities, on patients with platinum-refractory GIT-NEC/MANEC. Further prospective evaluations are warranted. PMID:27341105

  8. Emergent Bleeding in Patients Receiving Direct Oral Anticoagulants.

    Science.gov (United States)

    Summers, Richard L; Sterling, Sarah A

    2016-01-01

    Direct oral anticoagulants (DOACs) offer clinical advantages over warfarin, such as minimal medication and food interactions and fixed dosing without the need for routine monitoring of coagulation status. As with all anticoagulants, bleeding, either spontaneous or provoked, is the most common complication. The long-term use of these drugs is increasing, and there is a crucial need for emergency medicine service professionals to understand the optimal management of associated bleeding. This review aims to describe the indications and pharmacokinetics of available DOACs; to discuss the risk of bleeding; to provide a treatment algorithm to manage DOAC-associated emergency bleeding; and to discuss future directions in bleeding management, including the role of specific reversal agents, such as the recently approved idarucizumab for reversal of the direct thrombin inhibitor dabigatran. Because air medical personnel are increasingly likely to encounter patients receiving DOACs, it is important that they have an understanding of how to manage patients with emergent bleeding. PMID:27255877

  9. How health information is received by diabetic patients?

    Directory of Open Access Journals (Sweden)

    Firoozeh Zare-Farashbandi

    2015-01-01

    Full Text Available Background: Knowledge of correct information-seeking behavior by the patients can provide health specialists and health information specialists with valuable information in improving health care. This study aimed to investigate the passive receipt and active seeking of health information by diabetic patients. Materials and Methods: A survey method was used in this research on 6426 diabetic patients of whom 362 patients were selected by a no percentage stratified random sampling. The Longo information-seeking behavior questionnaire was used to collect data and they were analyzed by SPSS 20 software. Results: The most common information source by diabetic patients was practitioners (3.12. The minimum usage among the information sources were from charity organizations and emergency phone lines with a usage of close to zero. The amount of health information gained passively from each source has the lowest average of 4.18 and usage of this information in making health decision has the highest average score of 5.83. Analysis of the data related to active seeking of information showed that knowledge of available medical information from each source has the lowest average score of 3.95 and ability in using the acquired information for making medical decisions has the highest average score of 5.28. The paired t-test showed that differences between passive information receipt (41.68 and active information seeking (39.20 considered as statistically significant (P < 0.001. Conclusion: Because diabetic patients are more passive information receivers than active information seekers, the health information must be distributed by passive means to these patients. In addition, information-seeking behavior during different time periods should be investigated; to identify more effective distribution of health information.

  10. Depression and anxiety in patients with oral squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    PURPOSE: The aim of this study was to investigate symptoms of depression and anxiety in the patients with oral squamous cell carcinoma (OSCC). METHODS: 76 patients with oral squamous cell carcinoma participated in this program. All patients were rated with the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS). The mean scores of SAS and SDS were compared to those scores of the Norm of Chinese people. In addition, the different treatment results of the patients with different levels of anxiety and depression were studied. Further, the number of patients of SAS, SDS with more than 50 score were compared between primary cancer patients and recurrent cancer patients. RESULTS: The scores of SAS, SDS and the number of patients with more than 50 score in the patients group were obviously higher than those in Chinese Norm (P<0.01).The levels of anxiety and depression in 32 patients with recurrent cancer were more severe than those of 44 patients with primary cancer. The patients with anxiety and/or depression showed poor prognosis. CONCLUSION: Anxiety and depression are common symptoms in patients with OSCC and have negative effects on the prognosis, thus the psychological intervention for the patients must be carried out.

  11. Symptoms in patients receiving palliative care: a study on patient-physician encounters in general practice.

    OpenAIRE

    Borgsteede, S.D.; Deliens, L.; Beentjes, B.; Schellevis, F.; Stalman, W.A.B.; van Eijk, J T. M; Wal, G. van der

    2007-01-01

    Most people with an incurable disease prefer to stay and die at home, cared for by their general practitioner (GP). This paper aims at describing the prevalence of symptoms in patients receiving palliative care at home. Within the framework of a nation wide survey of general practice in the Netherlands, GPs received a questionnaire for all patients who died within the 1-year survey period to determine whether patients received palliative care (n = 2,194). The response rate was 73% (n = 1,608)...

  12. Outcome of Patients With Metastatic Sarcomatoid Renal Cell Carcinoma: Results From the International Metastatic Renal Cell Carcinoma Database Consortium

    DEFF Research Database (Denmark)

    Kyriakopoulos, Christos E; Chittoria, Namita; Choueiri, Toni K;

    2015-01-01

    BACKGROUND: Sarcomatoid renal cell carcinoma is associated with poor prognosis. Data regarding outcome in the targeted therapy era are lacking. PATIENTS AND METHODS: Clinical, prognostic, and treatment parameters in metastatic renal cell carcinoma patients with and without sarcomatoid histology...... of sRCC is needed to develop alternative therapeutics....

  13. Clinical outcomes in patients with isolated serous tubal intraepithelial carcinoma (STIC): A comprehensive review.

    Science.gov (United States)

    Patrono, Maria Guadalupe; Iniesta, Maria D; Malpica, Anais; Lu, Karen H; Fernandez, Rodrigo Orozco; Salvo, Gloria; Ramirez, Pedro T

    2015-12-01

    OBJECTIVE. Serous tubal intraepithelial carcinoma (STIC) is currently considered the precursor lesion of pelvic (i.e., ovarian or peritoneal) high-grade serous carcinoma. The incidence of STIC has been reported to range from 0.6% to 7% in BRCA mutations carriers. However, the clinical outcome of patients with 'isolated' STIC remains elusive. The aim of this study is to review the published literature on isolated STIC to determine outcomes of these ients and present a summary of management strategies. METHODS. A systematic English-language literature search was conducted in PubMed, MEDLINE-Ovid, Scopus, EBSCO host, Cochrane Library of articles published from February 2006 to April 2015. Study inclusion criteria for review were the following: risk-reducing salpingo-oophorectomy (RRSO), BRCA mutation carriers, non-BRCA mutation carriers, and benign surgical indication. Exclusion criteria were as follows: the presence of synchronous gynecological cancers, concurrent non-gynecological malignancies, the presence of ovarian intraepithelial lesions, and articles that did not include any clinical information and were restricted to pathology information only. RESULTS. A total of 78 patients with isolated STIC were included in our analysis. The median age for all patients was 53.7 years (range; 37-83). Surgical indication was RRSO in 67 patients with BRCA mutations or high-risk personal or family history. In the other 11 patients, an incidental STIC was detected after surgery for non-cancerous indications. Eleven (16.4%) patients received chemotherapy after the diagnosis of STIC. The follow-up time ranged from 2 to 150 months. Three (4.5%) patients with BRCA mutations were diagnosed with primary peritoneal carcinoma (PPC) during the follow-up at 43, 48 and 72 months after RRSO. CONCLUSIONS. The rate of primary peritoneal carcinoma in patients with BRCA mutations and isolated STIC is 4.5%. The role of adjuvant therapy remains elusive and routine surveillance with tumor markers

  14. Preoperative Subclinical Hyperthyroidism in Patients With Papillary Thyroid Carcinoma

    OpenAIRE

    Ahn, Dongbin; Sohn, Jin Ho; Jeon, Jae Han; Park, Junesik

    2014-01-01

    Objectives Numerous studies have reported the effects of subclinical hyperthyroidism on the cardiovascular system, osteoporosis, and metabolic syndrome. However, there are few studies examining the relationships between subclinical hyperthyroidism and thyroid cancer. The aim of this study was to investigate the relationships between preoperative subclinical hyperthyroidism and clinicopathological characteristics in patients with papillary thyroid carcinoma (PTC) in terms of thyroid-stimulatin...

  15. High immunosuppressive burden in advanced hepatocellular carcinoma patients

    OpenAIRE

    Lugade, Amit A.; Kalathil, Suresh; Miller, Austin; Iyer, Renuka; Thanavala, Yasmin

    2013-01-01

    The accumulation of immunosuppressive cells and exhausted effector T cells highlight an important immune dysfunction in advanced stage hepatocellular carcinoma (HCC) patients. These cells significantly hamper the efficacy immunotherapies and facilitate HCC progression. We have recently demonstrated that the multipronged depletion of immunosuppressive cells potentially restores effector T-cell function in HCC.

  16. Sorafenib induced tumor lysis syndrome in an advanced hepatocellular carcinoma patient

    Institute of Scientific and Technical Information of China (English)

    Wu-Shiung Huang; Chang-Hsu Yang

    2009-01-01

    A 55-year-old male patient with hepatitis B-related liver cirrhosis was found to have advanced hepatocellular carcinoma. His AFP was initially 9828 mg/L and rapidly dropped to 5597 mg/L in ten days after oral sorafenib treatment. However, he developed acute renal failure, hyperkalemia, and hyperuricemia 30 d after receiving the sorafenib treatment. Tumor lysis syndrome was suspected and intensive hemodialysis was performed. Despite intensive hemodialysis and other supportive therapy, he developed multiple organ failure (liver, renal, and respiratory failure) and metabolic acidosis. The patient expired 13 d after admission.

  17. Modified functional obturator for the consideration of facial growth in the mucoepidermoid carcinoma pediatric patient.

    Science.gov (United States)

    Kim, Soung Min; Park, Min Woo; Cho, Young Ah; Myoung, Hoon; Lee, Jong Ho; Lee, Suk Keun

    2015-10-01

    Mucoepidermoid carcinoma (MEC) is a common salivary gland tumor in a adults but is very rare in pediatric patients. The standard treatment of MEC is en bloc resection with wide safety margins and subsequent reconstruction of the jaw, but few surgeons or pediatric specialists have experience with this procedure. An 11-year-old boy received a hemi-maxillectomy with subsequent application of the modified functional obturator (MFO) by the functional matrix concept of Moss. And the patient's face showed normal growth pattern. The purpose of this report is to demonstrate the novel concept of pediatric maxillary reconstruction using MFO for the consideration of facial growth. PMID:26235731

  18. Hepatic arterial infusion chemotherapy for patients with huge unresectable hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Wei-Lun Tsai

    Full Text Available BACKGROUND AND AIM: The optimal treatment for huge unresectable hepatocellular carcinoma (HCC remains controversial. The outcome of transcatheter arterial chemoembolization (TACE for patients huge unresectable HCC is generally poor and the survival benefit of TACE in these patients is unclear. The aim of the study is to compare the effect of hepatic arterial infusion chemotherapy (HAIC versus symptomatic treatment in patients with huge unresectable HCC. METHODS: Since 2000 to 2005, patients with huge (size >8 cm unresectable HCC were enrolled. Fifty-eight patients received HAIC and 44 patients received symptomatic treatment. In the HAIC group, each patient received 2.4+1.4 (range: 1-6 courses of HAIC. Baseline characteristics and survival were compared between the HAIC and symptomatic treatment groups. RESULTS: The HAIC group and the symptomatic treatment group were similar in baseline characteristics and tumor stages. The overall survival rates at one and two years were 29% and 14% in the HAIC group and 7% and 5% in the symptomatic treatment group, respectively. The patients in the HAIC group had significantly better overall survival than the symptomatic treatment group (P<0.001. Multivariate analysis revealed that HAIC was the significant factor associated with the overall survival (relative risk: 0.321, 95% confidence interval: 0.200-0.515, P<0.001. None of the patients died due to immediate complications of HAIC. CONCLUSIONS: HAIC is a safe procedure and provides better survival than symptomatic treatment in patients with huge unresectable HCC.

  19. Standardizing of Pathology in Patients Receiving Neoadjuvant Chemotherapy.

    Science.gov (United States)

    Bossuyt, Veerle; Symmans, W Fraser

    2016-10-01

    The use of neoadjuvant systemic therapy for the treatment of breast cancer patients is increasing. Pathologic response in the form of pathologic complete response (pCR) and grading systems of partial response, such as the residual cancer burden (RCB) system, gives valuable prognostic information for patients and is used as a primary endpoint in clinical trials. The breast cancer and pathology communities are responding with efforts to standardize pathology in patients receiving neoadjuvant chemotherapy. In this review, we summarize the challenges that postneoadjuvant systemic therapy surgical specimens pose and how pathologists and the multidisciplinary team can work together to optimize handling of these specimens. Multidisciplinary communication is essential. A single, standardized approach to macroscopic and microscopic pathologic examination makes it possible to provide reliable response information. This approach employs a map of tissue sections to correlate clinical, gross, microscopic, and imaging findings in order to report the presence of pCR (ypT0 ypN0 and ypT0/is ypN0) versus residual disease, the ypT and ypN stage using the current AJCC/UICC staging system, and the RCB. PMID:27380637

  20. Management of Merkel cell carcinoma: Role of radiotherapy in elderly patients

    International Nuclear Information System (INIS)

    Purpose Merkel cell carcinoma carcinoma (M.C.C.) or primary cutaneous neuroendocrine carcinoma is a rare and aggressive malignancy affecting elderly. Optimal therapeutic strategy has not yet been established in elderly patients. Patients and methods From March 1996 to March 2007, 29 patients with Merkel cell carcinoma of were treated at the University Hospital of Amiens, France. Adjuvant radiotherapy (R.T.) was performed for 14 patients (50%) on the tumor bed with margins of 3 to 5 cm, an average dose of 46 Gy (30-60 Gy), by 2 Gy per fraction. Ten of them also received R.T. to the lymph node area at mean dose of 44.3 Gy (26-50 Gy). Duration of R.T. was 35 days. A retrospective analysis was conducted to better evaluate survival and prognostic factors. Results Median overall survival (O.S.) was 18.9 months (3-122) and the median time to progression (M.T.P.) 5.5 months (1-26). At 5 years, O.S. for irradiated patients was 47% (IC95: 12-82%) versus 27% (IC95: 5-49%) in cases of surgery alone (p = 0.032). The most frequent sites of recurrence were nodal (34.5%), local (24.1%) and metastatic (17.2%). For patients over 70 years, eight (36.5%) were free of disease at last news, 8 (36.5%) had died from cancer and six from other causes (27%). In this subgroup, M.T.P. was 6 months (2-19) and median O.S. of 19 months (4-87). There was no acute toxicity greater than grade 2. Conclusion Although limited by a retrospective analysis, this report suggests an advantage of postoperative R.T. for patients with M.C.C.. It combined low toxicity and improvement of survival. Prospective multicenter trials are needed to clarify and validate the optimal strategy. (authors)

  1. Periodontal disease in a patient receiving Bevacizumab: a case report

    Directory of Open Access Journals (Sweden)

    Gujral Dorothy M

    2008-02-01

    Full Text Available Abstract Introduction Bevacizumab is a monoclonal antibody that inhibits the action of vascular endothelial growth factor (VEGF thereby acting as an angiogenesis inhibitor. As a result, supply of oxygen and nutrients to tissues is impaired and tumour cell growth is reduced. Reported side effects due to bevacizumab are hypertension and increased risk of bleeding. Bowel perforation has also been reported. Periodontal disease in patients on bevacizumab therapy has not been reported before. Case Presentation We report a case of a forty-three year old woman who developed periodontitis whilst receiving bevacizumab for lung cancer. The periodontal disease remained stable on discontinuation of the drug. Conclusion Further investigations are needed to determine the mechanism for bevacizumab-induced periodontal disease.

  2. Substantiation of combined and complex radiotherapy of cervix uteri carcinoma (stage 1) from point of view of delayed results and occupational rehabilitation of patients

    International Nuclear Information System (INIS)

    A clinical evaluation of the results of treatment of 225 patients with cervix uteri carcinoma (stage 1) is presented. 113 patients received complex radiation and 112 patients - combined therapy. A better therapeutic effect was obtained in the complex radiation group. Combined therapy should be recommended only unless full-scale complex radiation treatment can be applied

  3. Statistical analysis of 32 patients with nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    In order to assess the clinical outcome and prognostic factors of patients with nasopharyngeal carcinoma (NPC) who were initially treated in the Department of Otorhinolaryngology, Head and Neck Surgery, Keio University School of Medicine between 1997 and 2006, statistical analyses were performed based on the patient medical records. Cause-specific survival (CSS) and disease-free survival (DFS) in all cases (stage I to IV, n=32) and advanced cases (stage III and IV, n=22) were estimated using the Kaplan-Meier method. The independent prognostic values of the clinical and therapeutic factors were determined using multivariate Cox proportional hazards models. The 5-year CSS/DFS were 43.4%/34.8% in all cases and 34.5%/29.8% in advanced cases. Multivariate analysis revealed that, in all cases, the independent prognostic factors for CSS were age (≥61 vs. ≤60, risk ratio (RR)=5.717, p=0.006), T-stage (3/4 vs. 1/2, RR=6.957, p=0.004), and the use of platinum agents (unused vs. used, RR=3.911, p=0.012), whereas those for DFS were T-stage (3/4 vs. 1/2, RR=3.499, p=0.019) and the use of platinum agents (unused vs. used, RR=2.947, p=0.028). In advanced cases, the use of platinum agents alone was significant for both CSS (RR=4.503, p=0.023) and DES (RR=4.218, p=0.014). The patients who received neoadjuvant chemotherapy (NAC) showed better CSS and DFS than the patients who did not (p=0.066 and p=0.025, respectively) in a univariate analysis (Log-rank test), although no significant difference was seen between these groups in the multivariate analysis. The advantage of the administration of platinum agents in the treatment of NPC was statistically corroborated even in our study with its small sample size. As agents combined with chemoradiotherapy, the efficacy of docetaxel alone did not seem comparable to that of platinum agents. The docetaxel-CDDP-5-FU regimen applied as NAC was suggested to be possibly beneficial for advanced cases of NPC. (author)

  4. Creation of complexity assessment tool for patients receiving home care

    Directory of Open Access Journals (Sweden)

    Maria Leopoldina de Castro Villas Bôas

    2016-06-01

    Full Text Available Abstract OBJECTIVE To create and validate a complexity assessment tool for patients receiving home care from a public health service. METHOD A diagnostic accuracy study, with estimates for the tool's validity and reliability. Measurements of sensitivity and specificity were considered when producing validity estimates. The resulting tool was used for testing. Assessment by a specialized team of home care professionals was used as the gold standard. In the tool's reliability study, the authors used the Kappa statistic. The tool's sensitivity and specificity were analyzed using various cut-off points. RESULTS On the best cut-off point-21-with the gold standard, a sensitivity of 75.5% was obtained, with the limits of confidence interval (95% at 68.3% and 82.8% and specificity of 53.2%, with the limits of confidence interval (95% at 43.8% and 62.7%. CONCLUSION The tool presented evidence of validity and reliability, possibly helping in service organization at patient admission, care type change, or support during the creation of care plans.

  5. Clinicopathologic characteristics of gastric carcinoma in elderly patients: A comparison with young patients

    Institute of Scientific and Technical Information of China (English)

    Dong-Yi Kim; Jae-Kyoon Joo; Seong-Yeob Ryu; Young-Kyu Park; Young-Jin Kim; Shin-Kon Kim

    2005-01-01

    AIM:To examine the clinicopathologic features of elderly patients with gastric carcinoma and to investigate the relationship between prognosis and age.METHODS: We reviewed the hospital records of 2 014patients with gastric carcinoma retrospectively to compare the clinicopathologic findings in elderly (age >70 years) and young (age <36 years) patients during the period from 1986 to 2000 in a tertiary referral center in Gwangju, Korea. Overall survival was the main outcome measure.RESULTS: Of the 2 014 patients, 194 (9.6%) were in the elderly group and 137 (6.8%) were in the young group.The elderly and young patients had similar distributions with respect to depth of invasion, nodal involvement, hepatic metastasis, peritoneal dissemination, tumor stage at the initial diagnosis, and type of surgery. Synchronous multiple carcinomas were found in 14/194 (7.2%) of the elderly group and 4/137 (2.9%) of the young group (P<0.05). Using the Borrmann classification, type Ⅳ was more frequent in the young patients than in the elderly patients (P<0.05).Significantly more elderly patients had a well or moderately differentiated histology, and more young patients had a poorly differentiated histology and signet ring cell carcinoma (P<0.001). The 5-year survival rates of elderly and young patients did not differ statistically (52.8% vs 46.5%,P = 0.5290). Multivariate analysis showed that the histologic type, nodal involvement and operative curability were significant prognostic factors, and age itself was not an independent prognostic factor of survival for elderly gastric carcinoma patients.CONCLUSION: Elderly patients with gastric carcinoma do not have a worse prognosis than young patients. The important prognostic factor is whether the patients undergo a curative resection.

  6. Breast magnetic resonance imaging in patients with occult breast carcinoma: evaluation on feasibility and correlation with histopathological findings

    Institute of Scientific and Technical Information of China (English)

    LU Hong; XU Yi-lin; ZHANG Shu-ping; LANG Rong-gang; Chi S.Zee; LIU Pei-fang; FU Li

    2011-01-01

    Background As an uncommon presentation, occult primary breast cancer remains a diagnostic and therapeutic challenge in clinical practice. This study aimed to retrospectively assess the feasibility of breast magnetic resonance imaging (MRI) in patients with malignant axillary lymphadenopathy and unknown primary malignancy, and correlation with histopathological characteristics.Methods A total of 35 women with occult breast carcinoma were evaluated with dynamic contrast-enhanced breast MRI. Whole seriate section was used in all cases. MRI performance was assessed and correlated with histopathological findings.Results Twenty-one of 35 patients were found to have primary breast carcinoma histologically. Twenty of the 21 patients had abnormal MR findings and 1 patient had a normal MRI study. Of the remaining 14 patients, 10 were negative on both MRI and surgery. Four had suspicious enhancement on MRI and no corresponding tumor was found. Lesions with mass enhancement were found in 55% (11/20) and ductual and segmental enhancement in 45%. The average diameter of the primary tumors was 15 mm. Invasive ductal carcinomas were found in 81% (17/21). One of 17 invasive ductual carcinomas was too small to be graded. Fourteen of the remaining 16 were classified as grade II and 2 as grade I. Thirty-two of the 35 patients had received estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 examinations and the 12 of 32 were triple-negative breast carcinoma.Conclusions Mass lesions with small size and lesions with ductal or segment enhancement are common MRI features in patients with occult breast cancer. The dominant types of primary tumors are invasive ductal carcinoma with moderate histopathological grade. The rate of triple-negative breast carcinoma may be higher in occult breast cancer.

  7. Prognosis of patients with esophageal squamous cell carcinoma after esophagectomy using the log odds of positive lymph nodes

    OpenAIRE

    Wu, San-Gang; Sun, Jia-Yuan; Yang, Li-Chao; Zhou, Juan; Li, Feng-Yan; Li, Qun; Lin, Huan-xin; Lin, Qin; He, Zhen-Yu

    2015-01-01

    To compare the log odds of positive lymph nodes (LODDS) with the number of positive lymph nodes (pN), lymph node ratio (LNR), removed lymph node (RLN) count, and negative lymph node (NLN) count in determining the prognosis of patients with esophageal squamous cell carcinoma (ESCC) after esophagectomy. The records of patients with ESCC who received esophagectomy were retrospectively reviewed. The log-rank test was used to compare curves for overall survival (OS), and Cox regression analysis wa...

  8. Clinicopathological features and treatment of extremity bone metastasis in patients with endometrial carcinoma: a case report and review

    Institute of Scientific and Technical Information of China (English)

    JIANG Guo-qing; GAO Yu-nong; GAO Min; ZHENG Hong; YAN Xin; WANG Wen; AN Na; CAO Kun

    2011-01-01

    Unlike other non-gynecologic solid tumors, such as breast cancer, lung cancer, metastasis to bone from endometrial carcinoma is rare, metastasis to extremity is extremely rare. We report a 51-year-old multiparous woman with FIGO Stage IVb Grade 2 endometrial adenocarcinoma which metastasized to left lower extremity bone. She received an amputation of left lower extremity below the knees, and a total abdominal hysterectomy and bilateral salpingo-oophorectomy, and followed by systemic chemotherapy, radiation therapy to the pelvis and progestational agent. She had a complete response to above treatments, and disease-free survival for 10 months. After recurrence, she received chemotherapy, radiotherapy and progestational agent once again. She had lived 56 months and is still alive by the time of report. Metastasis of endometrial carcinoma to extremity bone can rarely occur and should be considered when the patient with endometrial carcinoma complained of unexplained pain and swelling associated with extremity bone.

  9. Radiation-induced femoral neck fracture in patients cured of cervical carcinoma

    International Nuclear Information System (INIS)

    In the years 1948-1967 8275 patients with cervical carcinoma in various grades of progression were treated at the Institute of Oncology in Warsaw by radiotherapy from external fields. Five-year survival without signs of recurrence was obtained in 4204 cases, 3863 of them were irradiated from external fields with X-rays under conventional conditions, while 341 received Co60 radiotherapy. In 43 patients treated with X-rays and radium and regarded as cured radiological evidence of femoral neck fracture was obtained. These patients account for 1.1% of all cured patients. In the group treated with Co60 radiation in only 1 case femoral neck fracture was observed (0.3%). In the group of cured patients with femoral neck fracture the method of irradiation from external fields, the age, clinical course, radiological appearance of radiation-induced changes and the method of fracture management were analysed. (author)

  10. Stereotactic radiosurgery may contribute to overall survival for patients with recurrent head and neck carcinoma

    International Nuclear Information System (INIS)

    The aim of this study is to examine the effect of stereotactic radiosurgery (SRS) in the treatment of advanced, recurrent lesions for head and neck carcinoma both with and without lymph node involvement. Between April 2006 and July 2007, 22 patients (mean age 67 years) with advanced, recurrent head and neck carcinoma were treated with stereotactic radiosurgery. All of the patients except one had biopsy confirmed disease prior to stereotactic radiosurgery. Patients included 3 rT2, 8 rT3, and 9 rT4; 8 of the patients had lymph node metastases. Marginal SRS doses were 20-42 Gy delivered in two to five fractions. Starting one month after SRS, all patients received S-1 oral chemotherapy for one year. At an overall median follow-up of 24 months (range, 4-39 months), for the 14 locally recurrent patients without lymph node metastases, 9 patients (64.3%) had a complete response (CR), 1 patient (7.1%) had a partial response (PR), 1 patient (7.1%) had stable disease (SD), and 3 patients (21.4%) had progressive disease (PD). For the 8 patients with lymph node metastases, 1 patient with a single retropharyngeal (12.5%) had CR; the remaining 7 patients (87.5%) all progressed. Nine patients have died from their cancer. The overall actuarial 2-year survival for the patients with and without lymph node metastases is 12.5% and 78.6%, respectively. These results show the benefit of stereotactic radiosurgery salvage treatment for advanced, recurrent lesions, without lymph node metastases in previously irradiated head and neck cancer

  11. A mathematical prognosis model for pancreatic cancer patients receiving immunotherapy.

    Science.gov (United States)

    Li, Xuefang; Xu, Jian-Xin

    2016-10-01

    Pancreatic cancer is one of the most deadly types of cancer since it typically spreads rapidly and can seldom be detected in its early stage. Pancreatic cancer therapy is thus a challenging task, and appropriate prognosis or assessment for pancreatic cancer therapy is of critical importance. In this work, based on available clinical data in Niu et al. (2013) we develop a mathematical prognosis model that can predict the overall survival of pancreatic cancer patients who receive immunotherapy. The mathematical model incorporates pancreatic cancer cells, pancreatic stellate cells, three major classes of immune effector cells CD8+ T cells, natural killer cells, helper T cells, and two major classes of cytokines interleukin-2 (IL-2) and interferon-γ (IFN-γ). The proposed model describes the dynamic interaction between tumor and immune cells. In order for the model to be able to generate appropriate prognostic results for disease progression, the distribution and stability properties of equilibria in the mathematical model are computed and analysed in absence of treatments. In addition, numerical simulations for disease progression with or without treatments are performed. It turns out that the median overall survival associated with CIK immunotherapy is prolonged from 7 to 13months compared with the survival without treatment, this is consistent with the clinical data observed in Niu et al. (2013). The validity of the proposed mathematical prognosis model is thus verified. Our study confirms that immunotherapy offers a better prognosis for pancreatic cancer patients. As a direct extension of this work, various new therapy methods that are under exploration and clinical trials could be assessed or evaluated using the newly developed mathematical prognosis model. PMID:27338302

  12. Can non-selective beta-blockers prevent hepatocellular carcinoma in patients with cirrhosis?

    DEFF Research Database (Denmark)

    Thiele, Maja; Wiest, Reiner; Gluud, Lise Lotte;

    2013-01-01

    Hepatocellular carcinoma is the main liver-related cause of death in patients with compensated cirrhosis. The early phases are asymptomatic and the prognosis is poor, which makes prevention essential. We propose that non-selective beta-blockers decrease the incidence and growth of hepatocellular...... carcinoma via a reduction of the inflammatory load from the gut to the liver and inhibition of angiogenesis. Due to their effect on the portal pressure, non-selective beta-blockers are used for prevention of esophageal variceal bleeding. Recently, non-hemodynamic effects of beta-blockers have received...... reduce hepatic inflammation. Blockage of β-adrenoceptors also decrease angiogenesis by inhibition of vascular endothelial growth factors. Because gut-derived inflammation and neo-angiogenesis are important in hepatic carcinogenesis, non-selective beta-blockers can potentially reduce the development and...

  13. Study on the application value of CT perfusion imaging in patients with hepatic carcinoma

    Institute of Scientific and Technical Information of China (English)

    Yu-Gang Zhou; Cheng-Zhou Yu; Xi-Qun Liu

    2016-01-01

    Objective:To research and discuss the application value of CT perfusion imaging in patients with hepatic carcinoma.Methods: A total of 47 patients with hepatic carcinoma in our hospital from Januarey 2014 to August 2015 were selected as study group; meanwhile the contemporaneous 47 patients with benign liver disease were selected as control group. Then the CT perfusion imaging parameters of hepatic carcinoma patients in control group and study group, and hepatic carcinoma patients with different types and stages in study group were respectively compared and the relationship between above indexes and hepatic carcinoma were analyzed by Logistic Analysis.Results:The BF, BV, HAI, MTT, PS and HAP levels in study group were all higher than that in control group, while the PVP level was lower than that in control group, and the detection results between hepatic carcinoma patients with different stages in study group also had obvious difference, statistical results of patients with higher stages were all worse than those of patients with lower stages, but the above statistical results among hepatic carcinoma patients with different types had no obvious difference, and the above detection indexes all had close relations with hepatic carcinoma by Logistic Analysis. Conclusion:The application value of CT perfusion imaging in patients with hepatic carcinoma was high, and it had active reaction value for the lesion blood flow of patients with hepatic carcinoma, and it also had high clinical value for the stages of disease.

  14. Cell-mediated immunity in patients with carcinoma under immunotheraphy

    International Nuclear Information System (INIS)

    'In vivo' and 'in vitro' cellular immunity is evaluated in 32 patients with carcinoma under immunotheraphy with subcutaneous or endovenous glucan, transfer factor and levamisole. The immunotheraphy is done relatively by intradermal tests with common antigens, by sensitization with dinitrochlorinebenzene and lymphocytes culture from whole blood. The levels of blood serum of human T lymphotocyte soluble receptor for sheep erythrocytes are detected. (M.A.C.)

  15. Intraoperative electron radiation therapy (IOERT) in patients with locally recurrent renal cell carcinoma

    International Nuclear Information System (INIS)

    To analyze our experience with intraoperative electron radiation therapy (IOERT) followed by moderate doses of external beam radiation therapy (EBRT) in patients with locally recurrent renal cell carcinoma. From 1992 to 2010, 17 patients with histologically proven, locally recurrent renal cell carcinoma (median tumor size 7 cm) were treated by surgery and IOERT with a median dose of 15 Gy. All patients met the premise of curative intent including 7 patients with oligometastases at the time of recurrent surgery, which were resected and/or irradiated. The median time interval from primary surgery to local recurrence was 26 months. Eleven patients received additional 3D-conformal EBRT with a median dose of 40 Gy. Surgery resulted in free but close margins in 6 patients (R0), while 9 patients suffered from microscopic (R1) and 2 patients from macroscopic (R2) residual disease. After a median follow-up of 18 months, two local recurrences were observed, resulting in an actuarial 2-year local control rate of 91%. Eight patients developed distant failures, predominantly to liver and bone, resulting in an actuarial 2-year progression free survival of 32%. An improved PFS rate was found in patients with a larger time interval between initial surgery and recurrence (> 26 months). The actuarial 2-year overall survival rate was 73%. Lower histological grading (G1/2) was the only factor associated with improved overall survival. Perioperative complications were found in 4 patients. No IOERT specific late toxicities were observed. Combination of surgery, IOERT and EBRT resulted in high local control rates with low toxicity in patients with locally recurrent renal cell cancer despite an unfavorable surgical outcome in the majority of patients. However, progression-free and overall survival were still limited due to a high distant failure rate, indicating the need for intensified systemic treatment especially in patients with high tumor grading and short interval to recurrence

  16. High-dose Iodized Oil Transcatheter Arterial Chemoembolization For Patients With Large Hepatocellular Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Min-Shan Chen; Jin-Qing Li; Ya-Qi Zhang; Li-Xia Lu; Wei-Zhang Zhang; Yun-Fei Yuan; Yong-Ping Guo; Xiao-Jun Lin; Guo-Hui Li

    2002-01-01

    AIM: To conduct a randomized trial to evaluate the role ofusing high-dose iodized oil transcatheter arterialchemoembolization (TACE) in the treatment of largehepatocellular carcinoma(HCC).METHODS: From January 1993 to June 1998, 473 patientswith unresectable hepatocellular carcinoma were divided intotwo groups: 216 patients in group A received more than20mL iodized oil during the first TACE treatment; 257patients in group B received 5-15mL iodized oil in the sameway. The Child's classification and ICG-R15 for evaluatingthe liver function of the patients were done before thetreatment. During the TACE procedure the catheters wasinserted into the target artery selectively and the tumorvsssels were demonstrated with contrast medium in thehepatic angiography. The anticancer drugs mixed withiodized oil (Lipiodol) were Epirubicin and Mitomycin. Ingroup A, 112 cases received 20-29mL Lipiodol in the firstprocedure, 85 cases 30-39mL, 19 cases more than 40mL.The largest dose was 53 mL and the average dose was28.3mL. In group B, 119 cases received 5-10mL Lipiodol,138 cases received 11-15mL, and the average dose was11 .8mL.RESULTS: High-dose Lipiodol chemoembolization causedtolerable side effects and a little hurt to the liver function inthe patients with Child grade A or ICG-R15 < 20. But thepatients with child grade B or ICG-R15 > 20 had higher risk ofliver failure after high-dose TACE. More type Ⅰ and type Ⅱlipiodol accumulations in CT scan after 4 weeks of TACEwere seen in the group A patients than those in the group Bpatients( P< 0.01). The resection rate and complete tumornecrosis rate in group A were higher than those of group B(P < 0.05). The 1-, 2-, 3-year survival rates of group Apatients with Child grade A were 79.2%, 51.8% and 34.9%,respectively, better than those of group B (P<0.001).CONCLUSION: High-dose Lipiodol can result in morecomplete tumor necrosis by blocking both arteries and smallportal veins of the tumor. High-dose TACE for treatment

  17. Bone marrow changes in patients with thyroid carcinoma

    International Nuclear Information System (INIS)

    In 62 patients with thyroid carcinoma 79 MRI bone marrow examinations and 48 bone marrow scintigraphies were recorded before or following radioiodine therapy, to study the extent of bone marrow expansion. The results of both methods were the same. In 34/79 investigations normal findings were seen, in 18 the bone marrow expanded to the middle third and in 26 to the distal third of the femur. One patient showed bone marrow expansion to the tibia. These results were compared with the following data: Histology of tumor, TNM-staging, time passed since thyroidectomy, accumulated doses of radioiodine therapy, results of 131I scintigraphy, hematological changes, thyroglobulin level, age and sex. No significant correlations were found between these and the bone marrow imaging results. Bone marrow changes in patients before radioiodine therapy were similar to those in patients treated with up to 48 GBq 131I. Blind biopsy of the posterior iliac crest in five patients showed slightly pathological reactive changes. In only 2/17 follow-up studies an increase of bone marrow expansion was seen. In 8 patients localized findings indicating malignant infiltration were observed. In 4/8 patients metastases of thyroid carcinoma were known or confirmed by pathological radioiodine uptake and in 2/8 metastatic involvement was assumed because of an increased thyroglobulin level. (orig.)

  18. Efficacy and safety of axitinib in elderly patients with metastatic renal cell carcinoma.

    Science.gov (United States)

    Miyake, Hideaki; Harada, Ken-Ichi; Ozono, Seiichiro; Fujisawa, Masato

    2016-08-01

    The objective of this study was to analyze the impact of age on clinical outcomes of metastatic renal cell carcinoma (mRCC) patients receiving axitinib. This study included 144 consecutive mRCC patients who received axitinib for at least 12 weeks as second-line therapy in a routine clinical setting. The efficacy, safety and quality of life (QOL) were compared between patients aged <75 (n = 116) and ≥75 (n = 28) years. No significant differences in the clinicopathological characteristics were noted between younger and older patients. There was no significant difference in the response rate, clinical benefit rate or proportion of patients going on to receive third-line therapy between these two groups. In addition, the progression-free and overall survivals in older patients were similar to those in younger patients. There were no significant differences in the incidences of adverse events between these two groups, except for that of fatigue, which was significantly more frequent in older than younger patients. There was no significant difference in the incidence of the discontinuation of axitinib due to adverse events between the two groups. QOL assessment at 12 weeks after the introduction of axitinib using the Medical Outcomes Study 36-Item Short Form showed no significant differences in any of the eight scale scores between the two groups. Taken together, it might be possible to achieve clinical outcomes in older patients receiving axitinib comparable to those in younger patients, suggesting that advanced age should not be a contraindication to treatment with axitinib as a second-line setting in mRCC patients. PMID:27444960

  19. Treatment of elderly patients with metastatic renal cell carcinoma.

    Science.gov (United States)

    Zanardi, Elisa; Grassi, Paolo; Cavo, Alessia; Verzoni, Elena; Maggi, Claudia; De Braud, Filippo; Boccardo, Francesco; Procopio, Giuseppe

    2016-01-01

    The risk of developing renal cell carcinoma (RCC) increases with age, and given the constant gain in life expectancy of the general population, both localized RCC and metastatic RCC (mRCC) are more frequently observed in the elderly population. The elderly are a heterogeneous group of patients often characterized by the presence of comorbidities, different compliance to treatment and polypharmacy. Here we review the available data with the aim to analyze the safety and efficacy of new targeted therapies (TTs) in elderly mRCC patients. TTs seem to be effective in both older and younger patients, but elderly patients appear to show reduced tolerance to treatments compared to younger patients. Prospective trials are needed to better understand how to manage mRCC in elderly patients. PMID:26654225

  20. Compliance to Therapy—Elderly Head and Neck Carcinoma Patients

    Science.gov (United States)

    Sharma, Aman; Madan, Renu; Kumar, Rajeev; Sagar, Prem; Kamal, Vineet K.; Thakar, Alok; Sharma, Atul; Mohanti, Bidhu K.

    2014-01-01

    Background Treatment compliance of elderly patients to intensive multi-modality cancer therapy can be challenging and has not been adequately addressed in developing countries. The present study evaluated compliance of elderly head and neck carcinomas patients to cancer-directed therapy. Methods Forty-seven elderly HNSCC patients were evaluated in the present study. Patients were assessed as per stage and site of disease, general condition, performance status, and any pre-existing co-morbidities. Compliance was defined as patients who were able to complete cancer therapy as intended at primary clinic. Non-compliance to therapy was stratified as early, mid- and late-course non-compliance. Statistical analysis was done using STATA 9.1 software, chi-square/Fischer’s exact test to see strength of association between two categorical variables that could possibly affect compliance in elderly patients. Results Sixty-eight per cent of elderly patients were subjected to radical treatment, majority (42/47) presented in loco-regionally advanced stage (III–IV), most common site of malignancy was oropharynx (21/47). Sixty-two per cent of elderly HNSCC patients were compliance to cancer therapy. Median overall treatment time for patients subjected to radical radiation therapy was 52 (range 47–99) days, and for radical surgery and adjuvant radiotherapy was 109 (95–190) days. Compliance to therapy for elderly HNSCC patients was not significantly associated with advanced stage, poor general condition, intent of treatment or presence of co-morbidity. As regards to non-compliance, majority (14/18) of elderly patients showed mid-course treatment non-compliance. Conclusions Nearly two-thirds of elderly head and neck carcinoma patients were compliant to cancer-directed therapy. PMID:25232366

  1. Computed tomography of renal cell carcinoma in patients with terminal renal impairment

    International Nuclear Information System (INIS)

    Purpose: An increased incidence of renal tumors has been observed in patients with end-stage-renal-disease (ESRD). The very strong association with acquired renal cystic disease (ACRD) and increased incidence of the renal tumors (conventional renal cell carcinoma (CRCC), papillary renal cell carcinoma (PRCC) or papillary renal cell adenoma (PRCA)) was reported. This study discusses the role of computed tomography (CT) in detecting renal tumors in patients with renal impairment: pre-dialysis, those receiving dialysis or with renal allograft transplants. Materials and methods: Ten patients (nine male, one female) with renal cell tumors were enrolled into a retrospective study; two were new dialysis patients, three on long-term dialysis, and five were renal transplant recipients with history of dialysis. All patients underwent helical CT, a total of 11 procedures were performed. Sixteen-row detector system was used five times, and a 64-row detector system for the six examinations. All patients underwent nephrectomy of kidney with suspected tumor, 15 nephrectomies were performed, and 1 kidney was assessed during autopsy. CT findings were compared with macroscopic and microscopic assessments of the kidney specimen in 16 cases. Results: Very advanced renal parenchyma atrophy with small cysts corresponding to ESRD was found in nine patients, chronic pyelonephritis in remained one. A spontaneously ruptured tumor was detected incidentally in one case, patient died 2 years later. In the present study, 6.25% (1/16) were multiple PRCA, 12.5% (2/16) were solitary PRCC, 12.5% tumors (2/16) were solitary conventional renal cell carcinomas (CRCC's), 12.5% tumors (2/16) were multiple conventional renal cell carcinomas (CRCC's), 25% (4/16) were CRCC's combined with multiple papillary renal cell carcinomas with adenomas (PRCC's and PRCA's), and 25% (4/16) of the tumors were multiple PRCC's combined with PRCA's without coexisting CRCC's. Bilateral renal tumors were found in our study

  2. Computed tomography of renal cell carcinoma in patients with terminal renal impairment

    Energy Technology Data Exchange (ETDEWEB)

    Ferda, Jiri [Department of Radiology, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic)], E-mail: ferda@fnplzen.cz; Hora, Milan [Department of Urology, Charles University Hospital Plzen, Dr. Edvarda Benese 13, CZ-306 40 Plzen (Czech Republic); Hes, Ondrej [Institut of Pathology, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic); Reischig, Tomas [Department of Internal Medicine, Nephrology Unit, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic); Kreuzberg, Boris; Mirka, Hynek; Ferdova, Eva; Ohlidalova, Kristyna; Baxa, Jan [Department of Radiology, Charles University Hospital Plzen, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic); Urge, Tomas [Department of Urology, Charles University Hospital Plzen, Dr. Edvarda Benese 13, CZ-306 40 Plzen (Czech Republic)

    2007-08-15

    Purpose: An increased incidence of renal tumors has been observed in patients with end-stage-renal-disease (ESRD). The very strong association with acquired renal cystic disease (ACRD) and increased incidence of the renal tumors (conventional renal cell carcinoma (CRCC), papillary renal cell carcinoma (PRCC) or papillary renal cell adenoma (PRCA)) was reported. This study discusses the role of computed tomography (CT) in detecting renal tumors in patients with renal impairment: pre-dialysis, those receiving dialysis or with renal allograft transplants. Materials and methods: Ten patients (nine male, one female) with renal cell tumors were enrolled into a retrospective study; two were new dialysis patients, three on long-term dialysis, and five were renal transplant recipients with history of dialysis. All patients underwent helical CT, a total of 11 procedures were performed. Sixteen-row detector system was used five times, and a 64-row detector system for the six examinations. All patients underwent nephrectomy of kidney with suspected tumor, 15 nephrectomies were performed, and 1 kidney was assessed during autopsy. CT findings were compared with macroscopic and microscopic assessments of the kidney specimen in 16 cases. Results: Very advanced renal parenchyma atrophy with small cysts corresponding to ESRD was found in nine patients, chronic pyelonephritis in remained one. A spontaneously ruptured tumor was detected incidentally in one case, patient died 2 years later. In the present study, 6.25% (1/16) were multiple PRCA, 12.5% (2/16) were solitary PRCC, 12.5% tumors (2/16) were solitary conventional renal cell carcinomas (CRCC's), 12.5% tumors (2/16) were multiple conventional renal cell carcinomas (CRCC's), 25% (4/16) were CRCC's combined with multiple papillary renal cell carcinomas with adenomas (PRCC's and PRCA's), and 25% (4/16) of the tumors were multiple PRCC's combined with PRCA's without coexisting CRCC

  3. Diabetes, Prediabetes and the Survival of Nasopharyngeal Carcinoma: A Study of 5,860 Patients

    Science.gov (United States)

    OuYang, Pu-Yun; Su, Zhen; Tang, Jie; Lan, Xiao-Wen; Mao, Yan-Ping

    2014-01-01

    Background The incidence of diabetes is increasing. But the impact of diabetes and prediabetes on survival of patients with nasopharyngeal carcinoma (NPC) has received little evaluation. Methods In a cohort of 5,860 patients, we compared the disease specific survival (DSS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival (DMFS) of patients with diabetes, prediabetes and normoglycemia defined by pretreatment fasting plasma glucose (FPG) using Kaplan–Meier method, log-rank test and Cox proportional hazards model. Results Comparing to normoglycemic patients, the diabetic and the prediabetic were generally older, fatter, had hypertension, heart diseases and hyperlipaemia and usually received radiotherapy alone. But both the diabetic and the prediabetic had similar DSS, LRFS and DMFS to normoglycemic patients, even adjusting for such important factors as age, gender, smoking, drinking, hypertension, heart diseases, body mass index, hyperlipaemia, titer of VCA-IgA and EA-IgA, pathology, T-stage, N-stage, chemotherapy and radiotherapy (P>0.05 for all). Additionally, the findings remained unchanged in sensitivity analysis by excluding patients with known diabetes history and in subgroups of the various factors. Conclusions The diabetic and prediabetic NPC patients had similar survival to normoglycemic NPC patients. These data, in the largest reported cohort, are the first to evaluate the association between diabetes, prediabetes and the survival in NPC. The findings are relevant to patient management and provided evidence of the effect on this disease exerted by comorbidities. PMID:25350747

  4. Prolonged Survival in a Patient with a Pancreatic Acinar Cell Carcinoma.

    Science.gov (United States)

    Ploquin, Anne; Baldini, Capucine; Vuagnat, Perrine; Makhloufi, Samira; Desauw, Christophe; Hebbar, Mohamed

    2015-01-01

    Pancreatic acinar cell carcinoma (ACC) is a rare entity. Herein we present the case of a 50-year-old male patient with an unlimited mass on the pancreatic corpus and tail with peripancreatic effusion and multiple metastases in the liver and spleen. A liver biopsy showed a pancreatic ACC. The patient received 9 cycles of gemcitabine plus oxaliplatin (GEMOX regimen), which had to be stopped because of a persistent grade 2 neuropathy. A CT scan showed complete response after 14 years. At the age of 61 years, a localized prostatic cancer was diagnosed, treated by prostatectomy. The patient carried a BRCA2 mutation. None of the precedent case reports describe a chemosensibility to the GEMOX regimen. In spite of the lack of study in these patients, chemotherapy with oxaliplatin seems to be the most effective. Long survival can be expected. PMID:26600777

  5. Interleukin-2 based immunotherapy in patients with metastatic renal cell carcinoma

    DEFF Research Database (Denmark)

    Donskov, Frede

    2007-01-01

    neutrophils >6.0) were independent prognostic factors of short survival in patients with mRCC receiving IL-2, identifying subgroups with estimated 5-year survival rates of 60%, 25% and 0%, respectively. These features may help to select patients more likely to benefit from IL-2 based immunotherapy......The present thesis consists of 8 published articles focusing on interleukin-2 based immunotherapy in metastatic renal cell carcinoma (mRCC). This disease represents a significant challenge, as the tumor is resistant to current chemotherapy, hormonal therapy and radiation therapy. However, IL-2...... were harmful for the outcome of IL-2 based immunotherapy. In progressing patients, the leukocyte subsets in blood and tumor tissue remained unaffected by cytokine therapy. The fate of a patient with mRCC prior to IL-2 and IFN-alpha based immunotherapy cannot be determined by measuring baseline tumor...

  6. Radiation myelopathy in patients treated for carcinoma of bronchus using a six fraction regime of radiotherapy

    International Nuclear Information System (INIS)

    The adoption of a six-fraction regime of radiotherapy for patients with locally advanced carcinoma of the bronchus was followed by the appearance of radiation myelitis in eight cases. These were among a group of 130 patients given radiotherapy with anterior and posterior treatment fields, without shielding of the spinal cord. Radiation myelitis was found only in those where the calculated spinal-cord dose exceeded 3350 cGy(rad). The possible precipitating factors in the eight patients who suffered myelopathy were compared with those in the remaining 62 patients who also received spinal-cord doses calculated to be greater than 3350 cGy(rad). Only one difference was found - the haemoglobin concentration was significantly higher in those who suffered neuropathy compared with those who did not (P=0.05). (U.K.)

  7. Jinlong capsule decreases adverse reactions after transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Wukui Huang; Dengyao Liu; Lina You; Shufa Yang; Mo Liu; Peng Gu; Pingju Wang; Baikere Pahaerding; Xiwen Fan

    2015-01-01

    Objective The aim of this study was to analyze whether Jinlong capsule could decrease adverse reac-tions after transcatheter arterial chemoembolization (TACE) in patients with hepatocel ular carcinoma. Methods Eighty-two patients with hepatocel ular carcinoma were randomly divided into the control group and experimental group. On the first day after TACE, the experimental group started receiving four Jinlong capsules oral y three times daily, whereas the control group did not receive the treatment. Results The incidences of erythropenia and thrombocytopenia in the experimental group was lower than those in the control group (P = 0.040 and 0.033, respectively). The dif erences in serum levels of amino-transferase, albumin, potassium, and sodium between the two groups were significant (P = 0.034, 0.034, 0.013, and 0.044, respectively). The mean durations of stomachache and abdominal distension in the experimental group was significantly shorter than those in the control group (P = 0.004 and 0.021, respec-tively). However, there were no significant dif erences in the incidences of nausea, fever, and vomiting between the two groups (P = 0.490, 0.495, and 0.585, respectively). Conclusion The reduction in the incidence rate and duration of partial adverse reactions after TACE was observed in hepatocel ular carcinoma patients treated with Jinlong capsule compared to untreated patients, suggesting possible beneficial ef ects exerted by Jinlong capsule on the reduction of TACE-induced liver damage, thereby improving liver function and, consequently, the quality of life.

  8. Performance of a Nomogram Predicting Disease-Specific Survival After an R0 Resection for Gastric Cancer in Patients Receiving Postoperative Chemoradiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dikken, Johan L. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Surgery, Leiden University Medical Center, Leiden (Netherlands); Coit, Daniel G. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Baser, Raymond E.; Gönen, Mithat [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Goodman, Karyn A. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Brennan, Murray F. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Jansen, Edwin P.M. [Department of Radiotherapy, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Boot, Henk [Department of Gastroenterology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Velde, Cornelis J.H. van de [Department of Surgery, Leiden University Medical Center, Leiden (Netherlands); Cats, Annemieke [Department of Gastroenterology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Verheij, Marcel, E-mail: m.verheij@nki.nl [Department of Radiotherapy, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

    2014-03-01

    Purpose: The internationally validated Memorial Sloan-Kettering Cancer Center (MSKCC) gastric carcinoma nomogram was based on patients who underwent curative (R0) gastrectomy, without any other therapy. The purpose of the current study was to assess the performance of this gastric cancer nomogram in patients who received chemoradiation therapy after an R0 resection for gastric cancer. Methods and Materials: In a combined dataset of 76 patients from the Netherlands Cancer Institute (NKI), and 63 patients from MSKCC, who received postoperative chemoradiation therapy (CRT) after an R0 gastrectomy, the nomogram was validated by means of the concordance index (CI) and a calibration plot. Results: The concordance index for the nomogram was 0.64, which was lower than the CI of the nomogram for patients who received no adjuvant therapy (0.80). In the calibration plot, observed survival was approximately 20% higher than the nomogram-predicted survival for patients receiving postoperative CRT. Conclusions: The MSKCC gastric carcinoma nomogram significantly underpredicted survival for patients in the current study, suggesting an impact of postoperative CRT on survival in patients who underwent an R0 resection for gastric cancer, which has been demonstrated by randomized controlled trials. This analysis stresses the need for updating nomograms with the incorporation of multimodal strategies.

  9. Performance of a Nomogram Predicting Disease-Specific Survival After an R0 Resection for Gastric Cancer in Patients Receiving Postoperative Chemoradiation Therapy

    International Nuclear Information System (INIS)

    Purpose: The internationally validated Memorial Sloan-Kettering Cancer Center (MSKCC) gastric carcinoma nomogram was based on patients who underwent curative (R0) gastrectomy, without any other therapy. The purpose of the current study was to assess the performance of this gastric cancer nomogram in patients who received chemoradiation therapy after an R0 resection for gastric cancer. Methods and Materials: In a combined dataset of 76 patients from the Netherlands Cancer Institute (NKI), and 63 patients from MSKCC, who received postoperative chemoradiation therapy (CRT) after an R0 gastrectomy, the nomogram was validated by means of the concordance index (CI) and a calibration plot. Results: The concordance index for the nomogram was 0.64, which was lower than the CI of the nomogram for patients who received no adjuvant therapy (0.80). In the calibration plot, observed survival was approximately 20% higher than the nomogram-predicted survival for patients receiving postoperative CRT. Conclusions: The MSKCC gastric carcinoma nomogram significantly underpredicted survival for patients in the current study, suggesting an impact of postoperative CRT on survival in patients who underwent an R0 resection for gastric cancer, which has been demonstrated by randomized controlled trials. This analysis stresses the need for updating nomograms with the incorporation of multimodal strategies

  10. Hepatocellular carcinoma in elderly patients: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Brunot A

    2016-06-01

    Full Text Available Angélique Brunot, Samuel Le Sourd, Marc Pracht, Julien Edeline Department of Medical Oncology, Centre Eugene Marquis, Rennes, FranceAbstract: Hepatocellular carcinoma (HCC is the second most common cause of death by cancer in the world. Due to the delayed HCC development in hepatitis C carriers and nonalcoholic fatty liver disease, the incidence of HCC in the elderly is increasing and is becoming a global health issue. Elderly patients with HCC should be assessed through proper oncologic approach, namely, screening tools for frailty (Geriatric-8 or Vulnerable Elders Survey-13 and comprehensive geriatric assessment. This review of the literature supports the same treatment options for elderly patients as for younger patients, in elderly patients selected as fit following proper oncogeriatric assessment. Unfit patients should be managed through a multidisciplinary team involving both oncological and geriatrician professionals. Specific studies and recommendations for HCC in the elderly should be encouraged.Keywords: liver cancer, treatment, surgery, geriatric evaluation, sorafenib

  11. Late course accelerated hyperfractionation radiotherapy for elderly patients with esophageal carcinoma

    International Nuclear Information System (INIS)

    Objective: To study the clinical results and prognostic factors of late course accelerated hyperfractionation radiotherapy (LCAHR) in the treatment of esophageal carcinoma in the elderly. Methods: 105 over 60 year-old patients with esophageal carcinoma who received radical LCAHR, were retrospectively analysed. Radical tumoricidal dose of 67.9-72.0 Gy was delivered in 39-43 fractions over 42-53 days. Results: The 5-year local control rate was 63.7%. The 5-year disease-free survival and overall survival rate were 22.6% and 34.4%. Acute esophagitis and bronchitis were the most common but acceptable radioreactions Grade 1-2. No significant differences were found either in the clinical response or complication, between the 60-69 year and 70-80 year groups. By multivariate analysis, T stage and KPS score were two independent prognostic factors. Of 67 death cases, 31 died of local relapse, 23 of distant metastases, 8 of both and 5 of other causes. Conclusions: LCAHR toxicity, being tolerable for the older esophageal carcinoma patients, may improve their survival and quality of life

  12. Sarcopenia Predicts Early Dose-Limiting Toxicities and Pharmacokinetics of Sorafenib in Patients with Hepatocellular Carcinoma

    Science.gov (United States)

    Mir, Olivier; Coriat, Romain; Blanchet, Benoit; Durand, Jean-Philippe; Boudou-Rouquette, Pascaline; Michels, Judith; Ropert, Stanislas; Vidal, Michel; Pol, Stanislas; Chaussade, Stanislas; Goldwasser, François

    2012-01-01

    Background Sorafenib induces frequent dose limiting toxicities (DLT) in patients with advanced hepatocellular carcinoma (HCC). Sarcopenia has been associated with poor performance status and shortened survival in cancer patients. Patients and Methods The characteristics of Child Pugh A cirrhotic patients with HCC receiving sorafenib in our institution were retrospectively analyzed. Sorafenib plasma concentrations were determined at each visit. Toxicities were recorded during the first month of treatment, and sarcopenia was determined from baseline CT-scans. Results Forty patients (30 males) were included. Eleven (27.5%) were sarcopenic. Eighteen patients (45%) experienced a DLT during the first month of treatment. Sarcopenic patients experienced significantly more DLTs than non-sarcopenic patients did (82% versus 31%, p = 0.005). Grade 3 diarrhea was significantly more frequent in sarcopenic patients than in non-sarcopenic patients (45.5% versus 6.9%, p = 0.01), but not grade 3 hand foot syndrome reaction (9% versus 17.2%, p = 1). On day 28, median sorafenib AUC (n = 17) was significantly higher in sarcopenic patients (102.4 mg/l.h versus 53.7 mg/l.h, p = 0.013). Conclusions Among cirrhotic Child Pugh A patients with advanced HCC, sarcopenia predicts sorafenib exposure and the occurrence of DLT within the first month of treatment. PMID:22666367

  13. Sarcopenia predicts early dose-limiting toxicities and pharmacokinetics of sorafenib in patients with hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Olivier Mir

    Full Text Available BACKGROUND: Sorafenib induces frequent dose limiting toxicities (DLT in patients with advanced hepatocellular carcinoma (HCC. Sarcopenia has been associated with poor performance status and shortened survival in cancer patients. PATIENTS AND METHODS: The characteristics of Child Pugh A cirrhotic patients with HCC receiving sorafenib in our institution were retrospectively analyzed. Sorafenib plasma concentrations were determined at each visit. Toxicities were recorded during the first month of treatment, and sarcopenia was determined from baseline CT-scans. RESULTS: Forty patients (30 males were included. Eleven (27.5% were sarcopenic. Eighteen patients (45% experienced a DLT during the first month of treatment. Sarcopenic patients experienced significantly more DLTs than non-sarcopenic patients did (82% versus 31%, p = 0.005. Grade 3 diarrhea was significantly more frequent in sarcopenic patients than in non-sarcopenic patients (45.5% versus 6.9%, p = 0.01, but not grade 3 hand foot syndrome reaction (9% versus 17.2%, p = 1. On day 28, median sorafenib AUC (n = 17 was significantly higher in sarcopenic patients (102.4 mg/l.h versus 53.7 mg/l.h, p = 0.013. CONCLUSIONS: Among cirrhotic Child Pugh A patients with advanced HCC, sarcopenia predicts sorafenib exposure and the occurrence of DLT within the first month of treatment.

  14. Salvage brachytherapy for patients with locally persistent nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Purpose: Locally persistent nasopharyngeal carcinoma (NPC) carries an increased risk of local failure if additional treatment is not given. This study was conducted to evaluate the outcomes of patients with locally persistent NPC as treated by high-dose-rate (HDR) intracavitary brachytherapy, and to explore whether routine brachytherapy boost could improve the local control. Methods and Materials: Eighty-seven patients with locally persistent NPC treated during 1990-1998 with HDR intracavitary brachytherapy were retrospectively analyzed. Fibreoptic nasopharyngoscopy was performed 3-6 weeks after completion of the primary external radiation therapy (ERT). Biopsies were only taken from suspicious areas. Those with complete regression of local disease were put on observation. Eighty-seven patients were shown to have persistent viable disease at a median time of 6 weeks post-RT. The distribution according to Ho's staging system at initial diagnosis was as follows: Stage I-8, II-33, III-41, IV-5; T1-19, T2-48, T3-20; N0-32, N1-22, N2-28, N3-5. CT scan for restaging was not performed after the documentation of persistent disease. Our policy was to treat all patients with persistent disease with brachytherapy irrespective of the extent of disease just prior to brachytherapy. They were treated with HDR intracavitary brachytherapy, with either cobalt sources or an iridium source, giving 22.5-24 Gy in 3 weekly sessions in all but 4 patients. This dose was prescribed at a distance of 1.5 cm from the center of the surface as defined by the sources in the first six patients and subsequently reduced to 1 cm for the others. Twelve patients were treated with neoadjuvant chemotherapy. To compare the efficacy of brachytherapy, another 383 consecutive nonmetastatic patients, treated with curative intent by ERT, during the years 1990-1993, were evaluated. Multivariate analysis was performed using the Cox regression proportional hazards model. Results: The 5-year actuarial local

  15. Clinicopathological characteristics of renal cell carcinoma in a dialysis patient

    International Nuclear Information System (INIS)

    In order to clarify the clinicopathological features of renal cell carcinoma (RCC) occurring in chronic hemodialysis patients, we analyzed patient demographics, hemodialysis duration, pathological characteristics of the tumors and prognosis of these patients. We retrospectively reviewed the record of 16 patients who had undergone radical nephrectomy for RCC at Kawashima Hospital between November 1994 and December 2007. They ranged in age from 32 to 82 years old (mean age, 55.0), and comprised 14 males and 2 females. All the patients were clinical stage I. As for the underlying disease which caused renal failure, chronic glomerulonephritis was noted in 12 patients and diabetes mellitus was noted in 1 patient. The causes in 3 patients were unknown. The duration of hemodialysis ranged from 1 to 226 months, (90 months on average). As for the main diagnostic methods, CT was performed in 14 cases. Two patients demonstrated macroscopic hematuria Acquired cystic disease of the kidney (ACDK) was present in 10 patients (68.8%). Patients were divided two groups; patients who had undergone open surgery (group 1, N=7) and patients who had undergone retroperitoneoscopic surgery (group 2, N=9). The following factors were analyzed: operation time, bleeding volume, postoperative complications, hospitalization. Nephrectomy was performed for the right kidney in 8 patients, and for the left kidney in 8 patients. Operation time ranged from 90 to 150 minutes (average, 111 min), in group 1, and from 80 to 284 minutes (average, 146 min), in group 2. Bleeding volume ranged from 10 to 170 ml (average, 72 ml), in group 1, and from 10 to 50 ml (average, 15 ml), in group 2. Complications of nephrectomy were observed in 6 patients, but all were minor problems. As for hospitalization, in group 1 it was 20 days and in group 2 it was 12 days. Fifteen patients survived and are tumor free. One patient died of causes unrelated to RCC. (author)

  16. Quality-of-life assessment in patients undergoing treatment for oesophageal carcinoma.

    Science.gov (United States)

    O'Hanlon, D M; Harkin, M; Karat, D; Sergeant, T; Hayes, N; Griffin, S M

    1995-12-01

    In a prospective study of 69 patients being treated for oesophageal carcinoma, quality of life was assessed with the Rotterdam Symptom Checklist, a dysphagia score and an activities of daily living questionnaire. Significant correlations were found between the results of the Rotterdam Symptom Checklist, the dysphagia score and most aspects of the activities of daily living questionnaire. Eighteen patients underwent surgery, 43 radiotherapy or intubation, and eight a combination of surgery and other therapy. Patients undergoing surgery were significantly younger and had better scores in all parameters examined before operation, including significantly better scores in 'knowledge and communication' and 'mobility and fatigue'. The dysphagia score fell significantly after intervention both in patients undergoing surgery alone and in those receiving palliative therapy. The activities of daily living questionnaire showed significant improvements in two parameters in the surgical group ('self-care' and 'eating and drinking') and in none of the parameters assessed in the palliation group in 16 weeks. Quality-of-life assessment is useful in assessing quality of care and patient well-being after the diagnosis and treatment of oesophageal carcinoma. PMID:8548241

  17. Outcome and Safety of Sorafenib in Metastatic Renal Cell Carcinoma Dialysis Patients: A Systematic Review.

    Science.gov (United States)

    Leonetti, Alessandro; Bersanelli, Melissa; Castagneto, Bruno; Masini, Cristina; Di Meglio, Giovanni; Pellegrino, Benedetta; Buti, Sebastiano

    2016-08-01

    Few data are available about sorafenib use in patients with metastatic renal cell carcinoma (mRCC) undergoing hemodialysis. No systematic review has been previously performed about this issue. The objective of the present review is to investigate pharmacokinetics and clinical outcomes of sorafenib in mRCC patients undergoing hemodialysis. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, all the literature about mRCC dialysis patients receiving sorafenib, published from January 1946 to August 2015, was evaluated. Applying inclusion/exclusion criteria, 11 articles were selected for the analysis; 1 patient from our department was also included. The investigated outcomes were pharmacokinetics, toxicity, response rate, progression-free survival, and overall survival where available. A total of 36 patients were included. Median treatment duration was 6.0 months on overall population; median progression-free survival was 6.3 months (calculated on 19 patients); response rate was 22% (on 29 patients); median overall survival was 14.9 months (on 28 patients). Of note, 24 patients started sorafenib at reduced dose; 6 of 36 patients (17%) required dose reduction due to adverse events (AEs). Sorafenib treatment was discontinued in 7 patients (19%) because of AEs. Most of AEs were Grade 1-2; severe toxicities (Grade 4-5) included G4 anemia (1 case), G4 hypertension (1 case), G4 cerebellar hemorrhage (1 patient), and a case of G5 subarachnoid hemorrhage. This review confirmed the efficacy of sorafenib treatment in mRCC patients receiving hemodialysis. Nevertheless, drug toxicity seems to be increased in these patients, despite the initiation of therapy at reduced doses; therefore, sorafenib should be used with caution in dialysis patients. PMID:26899142

  18. Phase II trial of neoadjuvant gemcitabine and cisplatin in patients with resectable bladder carcinoma

    Directory of Open Access Journals (Sweden)

    Daniel Herchenhorn

    2007-10-01

    Full Text Available OBJECTIVES: Gemcitabine and cisplatin (GC is an active combination in the treatment of metastatic bladder cancer. We have prospectively analyzed the efficacy and tolerability of GC as neoadjuvant treatment of invasive bladder cancer MATERIALS AND METHODS: In this single-institution phase II trial, patients with muscle-invasive transitional cell carcinoma received three cycles of gemcitabine 1200 mg/m² on days 1 and 8 with cisplatin 75 mg/m² on day 1 prior to surgery. Radiologic response was evaluated by computed tomography and magnetic resonance imaging. All patients were referred to surgery after chemotherapy completion RESULTS: Between June 2002 and March 2005, 22 patients (19 males were enrolled. Median age was 63 years. Initial stage was II (T2 in 11 and III (T3-4 in 11 patients. Median follow-up is 26 months (4-43. Partial or complete radiologic response rate was documented in 13 out of 20 assessable patients (70%. One patient was excluded due to sarcomatoid carcinoma at definitive pathologic examination. Cystectomy was performed in 15 patients and pelvic radiotherapy in four patients. Nine out of 21 patients (43% relapsed and four (19% died due to disease progression. Complete pathologic response was observed in four patients (26.7% of 15. Median progression-free survival was 27 months (CI 95% not reached with median overall survival of 36 months (CI 95%: 28.7 - 43.3. Grade III/IV toxicity was infrequent, with no deaths due to chemotherapy CONCLUSIONS: The combination of GC is effective and well-tolerated when used as neoadjuvant therapy in muscle-invasive bladder cancer. Longer follow-up is necessary to evaluate its impact on the overall survival of these patients.

  19. Squamous cell carcinoma of the oropharynx--an analysis of treatment results in 289 consecutive patients

    International Nuclear Information System (INIS)

    In this retrospective study the results of primary and salvage treatment of oropharyngeal carcinoma were evaluated. A total of 289 consecutive patients (103 females and 186 males) were included in the study. Most tumours originated in the tonsil area (58%) and comprised stages I 8%, II 19%, III 46% and IV 28%. The primary treatment was delivered with curative intent in 276 cases (96%). Of these, 266 received primary radiotherapy. The median radiation dose was 62 Gy, given as laterally opposed fields to the primary tumour and bilateral neck. Eight patients were treated with primary surgery and two with chemotherapy as part of a curatively intended treatment programme including radiotherapy. Six patients received palliative treatment, and seven were not treated at all. Out of 276 tumours treated with curative intent, 173 reappeared; 72% recurred in T position, 38% in N position, and 12% at distant metastatic sites, some in combination. Salvage surgery was possible in 52 patients, and 24 treatments were successful. Salvage radiotherapy or cryotherapy was used in 22 patients and 4 were controlled. For the entire group, the 5-year locoregional tumour control, disease-specific survival and overall survival rates were 38%, 44% and 31%, respectively. For patients treated with curative intent, clinical T- and N-stage, stage, tumour size, gender, age, and pretreatment haemoglobin were significant prognostic parameters in a univariate analysis. The Cox multivariate analysis showed that T-stage, N-stage and gender were independent prognostic factors. It is concluded that T-stage, N-stage and gender are significant independent prognostic factors. The primary control of the carcinoma in the T-position is crucial for overall success, but salvage surgery is found to have a favourable success rate in patients suitable for relapse treatment

  20. Squamous cell carcinoma of the oropharynx--an analysis of treatment results in 289 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, L.V.; Grau, C.; Overgaard, J. [Aarhus Univ. Hospital (Denmark). Dept. of Experimental Clinical Oncology

    2001-01-01

    In this retrospective study the results of primary and salvage treatment of oropharyngeal carcinoma were evaluated. A total of 289 consecutive patients (103 females and 186 males) were included in the study. Most tumours originated in the tonsil area (58%) and comprised stages I 8%, II 19%, III 46% and IV 28%. The primary treatment was delivered with curative intent in 276 cases (96%). Of these, 266 received primary radiotherapy. The median radiation dose was 62 Gy, given as laterally opposed fields to the primary tumour and bilateral neck. Eight patients were treated with primary surgery and two with chemotherapy as part of a curatively intended treatment programme including radiotherapy. Six patients received palliative treatment, and seven were not treated at all. Out of 276 tumours treated with curative intent, 173 reappeared; 72% recurred in T position, 38% in N position, and 12% at distant metastatic sites, some in combination. Salvage surgery was possible in 52 patients, and 24 treatments were successful. Salvage radiotherapy or cryotherapy was used in 22 patients and 4 were controlled. For the entire group, the 5-year locoregional tumour control, disease-specific survival and overall survival rates were 38%, 44% and 31%, respectively. For patients treated with curative intent, clinical T- and N-stage, stage, tumour size, gender, age, and pretreatment haemoglobin were significant prognostic parameters in a univariate analysis. The Cox multivariate analysis showed that T-stage, N-stage and gender were independent prognostic factors. It is concluded that T-stage, N-stage and gender are significant independent prognostic factors. The primary control of the carcinoma in the T-position is crucial for overall success, but salvage surgery is found to have a favourable success rate in patients suitable for relapse treatment.

  1. Detection of the pancreas-specific gene in the peripheral blood of patients with pancreatic carcinoma

    OpenAIRE

    Kuroki, T; Tomioka, T.; TAJIMA, Y; Inoue, K.; Ikematsu, Y; Ichinose, K.; Furui, J; Kanematsu, T

    1999-01-01

    The prognosis of patients with pancreatic carcinoma remains very poor. To improve the therapeutic results, the early detection of this cancer is needed. The present study was performed to detect the pancreas-specific gene, chymotrypsinogen, in the peripheral blood from patients with pancreatic carcinoma by using reverse transcription polymerase chain reaction (RT-PCR) in order to evaluate the clinical significance of this gene. Ten patients with pancreatic carcinoma, two with acute pancreatit...

  2. Lapatinib versus hormone therapy in patients with advanced renal cell carcinoma: a randomized phase III clinical trial

    DEFF Research Database (Denmark)

    Ravaud, Alain; Hawkins, Robert; Gardner, Jason P;

    2008-01-01

    was compared with hormone therapy (HT) in patients with advanced renal cell carcinoma (RCC) that express EGFR and/or HER-2. PATIENTS AND METHODS: Patients with advanced RCC who had experienced disease progression through first-line cytokine therapy--stratified by Karnofsky performance status and number...... grades) for lapatinib were rash (44%) and diarrhea (40%). CONCLUSION: Lapatinib was well tolerated with equivalent overall efficacy to HT in advanced RCC patients who had experienced disease progression while receiving cytokines, and the study supports that lapatinib prolonged OS relative to HT...

  3. Alcohol in Primary Care. Differential characteristics between alcohol-dependent patients who are receiving or not receiving treatment.

    Science.gov (United States)

    Barrio, Pablo; Miquel, Laia; Moreno-España, Jose; Martínez, Alicia; Ortega, Lluisa; Teixidor, Lidia; Manthey, Jakob; Rehm, Jürgen; Gual, Antoni

    2016-01-01

    primary health care services for other reasons. The aim of the present study is to describe the differential characteristics of AD patients in primary care, distinguishing between those who receive treatment and those who do not, and their reasons for not seeking it. In a cross-sectional study patients were evaluated by their general practitioner (GP) and interviewed by a member of the research team. Sociodemographic, diagnostic and clinical data were collected. From 1,372 patients interviewed in Catalonia, 118 (8.6%) were diagnosed as AD. These patients showed a lower socioeconomic status (48.3% vs 33.3%, odds ratio 2.02), higher unemployment rates (32.2% vs 19.2 %, odds ratio 2.11), and greater psychological distress and disability. Patients with AD receiving treatment (16.9%), were older (44 vs 36 years of age), reported higher unemployment rates (66% vs 25.5%, odds ratio 6.32) and higher daily alcohol consumption (61.5 vs 23.7 grams), suggesting a more advanced disease. Patients with AD in general showed a higher degree of comorbidity compared to other patients, with patients in treatment showing the most elevated level. The main reasons given for not seeking treatment were shame, fear of giving up drinking and barriers to treatment. Taken together, the data suggest the need to implement earlier strategies for the detection and treatment of AD. PMID:26990264

  4. Prognostic significance of lymphangiogenesis in pharyngolaryngeal carcinoma patients

    International Nuclear Information System (INIS)

    Lymphatic vessel spread is considered a major route for head and neck squamous cell carcinoma metastasis. Formation of new lymphatic vessels could facilitate the process, raising the malignant potential of these tumours. Recent identification of lymphatic markers allows the study of the lymphangiogenesis phenomenon. We searched for molecular events involved in the lymphangiogenic process that could have prognostic value in laryngeal/pharyngeal carcinoma patients. 104 paraffin-embedded pharyngeal/laryngeal tumour samples were studied. Immunohistochemical analysis of podoplanin and double immunofluorescence analysis of Ki-67 and D2-40 were performed. Lymph vessel density (inside the tumour mass, at its periphery or considered as a whole) and the presence of tumour emboli inside lymphatics were recorded. The proliferative state of endothelial lymphatic cells was evaluated. Lymphatic vessels were detected inside the tumour mass (75%) and in the surrounding tissue (80%); some of them in a proliferative state. Tumour emboli were detected in a high proportion of the cases (45%). Lymphatic vessel density was higher in the pharyngeal cases (p = 0.0029), in greater size (p = 0.039), more advanced stage primary tumours (p = 0.006) and in carcinomas of patients with affected nodes (p = 0.019). The presence of tumour emboli and a high global vessel density were indicators of poor prognosis (recorded as death from tumour) in the laryngeal group (p = 0.015 and p = 0.027, respectively), but notably not in the pharyngeal one. Interestingly, high global vessel density showed a negative prognostic value among pathologically staged N0 laryngeal carcinomas (p = 0.03). The lymphangiogenic process correlated with aggressive tumour features (pN category, tumour size, tumour stage), but might play different roles in tumours arising from different anatomic sites. Our results suggest that detection of tumour emboli and assessment of global vessel density using the D2-40 antibody, may be

  5. Factors Associated with Post-Progression Survival in Patients with Advanced Hepatocellular Carcinoma Treated with Sorafenib

    Directory of Open Access Journals (Sweden)

    Taiga Otsuka

    2015-05-01

    Full Text Available Sorafenib exerts modest antitumor activity in patients with advanced hepatocellular carcinoma (HCC, and radiological progressive disease (rPD does not always correspond to so-called clinical progressive disease (cPD. We evaluated 101 patients who initiated sorafenib treatment for HCC and assessed post-progression survival (PPS using the Cox proportional hazards model. PPS was calculated from the date of the first rPD until the date of death or the last follow-up. Using Cox model analysis of the 76 patients who experienced first rPD, we identified the Child-Pugh class, Eastern Cooperative Oncology Group performance status, the best antitumor response during treatment (using Response Evaluation Criteria in Solid Tumors (RECIST Version 1.1 and α-fetoprotein levels as independent factors affecting PPS. When these factors were used to define scores ranging from zero to five with a cutoff value of two, PPS of patients who received best supportive care (BSC after rPD was not statistically significantly different from that of patients who received post-rPD therapy with scores ≥2 (p = 0.220. In contrast, the PPS for the post-rPD therapy group was significantly longer compared with the BSC patients with scores <2 (p < 0.001. Patients who scored ≥2 at their first rPD were judged cPD and as candidates for BSC.

  6. Advanced small cell carcinoma of the bladder: clinical characteristics, treatment patterns and outcomes in 960 patients and comparison with urothelial carcinoma.

    Science.gov (United States)

    Geynisman, Daniel M; Handorf, Elizabeth; Wong, Yu-Ning; Doyle, Jamie; Plimack, Elizabeth R; Horwitz, Eric M; Canter, Daniel J; Uzzo, Robert G; Kutikov, Alexander; Smaldone, Marc C

    2016-02-01

    To describe the clinical characteristics, treatment patterns and outcomes in advanced small cell bladder cancer (aSCBC) patients and compare to those with urothelial carcinoma (UC). Individuals in the National Cancer Data Base with a diagnosis of either nodal (TxN+M0) or distant metastatic (TxNxM1) disease were identified from 1998 to 2010. We assessed the relationships between stage, treatment modalities and survival in the aSCBC cohort and compared these to UC patients. In the 960 patient aSCBC cohort (62% M1), 50% received palliative therapy alone, 68% in M1 versus 21% in M0 groups (P carcinoma patients (n = 27,796, 45% M1) lived longer compared to aSCBC patients in the N+M0 group (17.3 months vs. 13.0 months, P = 0.0007). There were not clinically significant differences in OS between UC and aSCBC patients in the M1 group. Advanced SCBC is a rare disease with a poor survival and palliative therapy is common, especially in M1 patients. In comparison to UC, the outcomes for aSCBC patients are worse in those with lymph node only involvement but similar in those with distant disease. PMID:26679712

  7. Surgical cytoreduction in recurrent ovarian carcinoma in patients with complete response to paclitaxel-platinum

    DEFF Research Database (Denmark)

    Gronlund, Bo; Lundvall, L; Christensen, Ib Jarle;

    2005-01-01

    AIM: The objective was to analyse the impact of secondary cytoreductive surgery in patients with recurrent ovarian carcinoma. METHODS: Retrospective review of 572 consecutive patients with primary ovarian carcinoma. Thirty-eight patients with intraabdominal/pelvic recurrence consisted the study g...

  8. Radiation protection of thyroid cancer patients receiving I-131 therapy: Some considerations

    International Nuclear Information System (INIS)

    As a preliminary step to investigating the potential usefulness of external thermoluminescence dosimetry (TLD) in estimating parameters of radiation dose to the bladder and the gastric mucosa, 27 inpatients treated with Iodine 131 (60-200 mCi or 2.22-7.4 GBq) for differentiated thyroid carcinoma (19 receiving the iodine in a capsule and 8 in solution form) were studied. Doses and ages were similar in both group as was fluid intake (ad lib but carefully recorded for each case). The TLDs were placed over the urinary bladder and in standard positions in the epigastrium (xiphoid and left subcostal area) and total doses for 22 hours (bladder) as well as total doses and dose rates (epigastrium) at various times from 5 to 90 minutes were recorded. Both bladder dose and integral dose for 90 minutes over the stomach showed statistically significant positive linear correlation with the administered I-131 activity. No correlation with the amount of fluid intake was found. The 90 minute integral dose at the epigastrium per mCi administered was found to be higher in the capsule group by 70%. Six out of 27 patients reported some discomfort (6/19 and 0/8 for capsule and liquid group respectively, p=0.13). The possible significance of these findings is discussed. (author)

  9. Study on dosimetric difference of organ at risk between actual estimated receiving and pretreatment plan during intensity-modulated radiotherapy for nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Objective: To investigate the dosimetric difference of organ at risk (OAR) for planning and actual estimated during intensity-modulated radiotherapy (IMRT) for patients with nasopharyngeal carcinoma. Methods: Thirteen patients were enrolled to accept full course of IMRT. CT scans were acquired in the 10th, 20th, and 30th fractions during radiotherapy, respectively. OAR, including brain stem, spinal cord, parotid gland and submandibular gland, were delineated on repeated CT scans. The volume change of OAR were investigated. After that, the plans were copied to the new CT image to calculate the escalated average dose of OAR during radiotherapy (Actual estimated receiving dose minus planning dose). Results: The change trend of volume was decreasing gradually for parotid gland and submandibular gland during the 10th, 20th, and 30th times radiotherapy (all P =0.000). The maximum dose (Dmax) of brain stem and spinal cord and the 50% volume receiving dose (D50) of parotid gland increased significantly in the 10th, 20th, and 30th times during radiotherapy, respectively. The escalated average dose were 3.76 and 3.68 Gy for Dmax of brain stem and spinal cord (P =0.000, 0.000), 5.11 and 3.54 Gy for D50 of left and right parotid (P =0.001, 0.023), and 0.49 and 0.75 Gy for D50 of left and right submandibular gland (P =0.220, 0.230), respectively. Conclusions: The volume of parotid gland and submandibular gland significantly decreased after radiotherapy. The actual receiving dose of brain stem,spinal cord, and parotid gland increased significantly during radiotherapy. However, there was no significant change for the actual receiving dose of submandibular gland. (authors)

  10. T but not N stage predicts survival for patients with tonsillar carcinoma treated with external radiotherapy and brachytherapy

    International Nuclear Information System (INIS)

    Background. Our aim was to determine the efficacy of a therapeutic schedule including external radiation and brachytherapy in a consecutive and retrospective series of tonsillar carcinoma patients. Patients and methods. Ninety-six patients with tonsillar carcinoma were treated between 1988 and 2000 and were followed up for at least for three years. All patients were treated with accelerated hyperfractionated external radiotherapy, 68 patients had additional brachytherapy and 69 patients with advanced stages also received chemotherapy. There was no planned surgery even though 73% had N+ disease. Eleven patients with persistent neck nodes underwent ultimate salvage surgery. Results. The overall three-year survival (OS) was 70%. OS for the T stage was T1 90%, T2 89%, T3 54% and T4 60%. The corresponding numbers for the N stage were N0 61.5%, N1 73%, N2 78% and N3 66%. Accordingly OS was influenced by the T stage (p>0.001) rather than by N stage. Only four patients with salvage surgery had viable tumour cells in the specimen, their survival was not inferior. Discussion. The primary tumour stage is an essential determinant for survival in patients with irradiated tonsillar carcinoma. Neck dissection should be confined only as a salvage procedure

  11. Effects of holistic nursing on protection and control of nasopharyngeal carcinoma patient' oral mucosa damage during radiotherapy

    International Nuclear Information System (INIS)

    Objective: To explore if the overall care can effectively control nasopharyngeal carcinoma patients' oral mucosa damage during radiotherapy. Method: Forty-seven nasopharyngeal carcinoma patients were randomly divided into test group (24 cases) and control group (23 cases). Patients in test group received mental nursing,oral care and health guidance plus the routine nursing, and patients in control group just given routine nursing. Result: The damaged degree of oral mucosal was lighter in test group than that in control group, and the difference was statistically significant (χ2=5.181 and 4.449, both P<0.05). Conclusion: The damage of oral mucosa can controlled effectively by holistic nursing during radiotherapy. (authors)

  12. Clinical Studies of Postoperative Arterial Infusion Chemotherapy in Patients with Pathologic T3 Esophageal Squamous Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Baodong Liu; Zongjun Dong; Xiuyi Zhi; Qingsheng Xu

    2006-01-01

    OBJECTIVE To evaluate how arterial infusion chemotherapy after radical surgery influences long-term survival of patients with pathologic T3 (pT3) esophageal squamous carcinoma.METHODS We divided 190 patients with pathologic pT3 esophageal squamous carcinoma, confirmed by consecutive radical surgery, into an experimental group (surgery + intra-arterial infusion, 56 T3N0M0 and 52 T3N1M0 cases), and the remaining patients into a control group (surgery alone, 48 T3N0M0 and 34 T3N1M0 cases). The experimental group was sub-grouped into 56 cases (26 T3N0M0 and 30 T3N1M0 cases) receiving 1 or 2 periods of chemotherapy, while 52 cases (30 T3N0M0 and 22 T3N1M0 cases) underwent 3 or more than 3 periods of chemotherapy. We used one to seven courses of selected arterial infusion chemotherapy of cisplatin (80 mg/m2 of body-surface area) and fluorouracil (800 mg/m2) with or without epirubicin at 3~4 weeks post operation. The interval between each period was 3~4 weeks. All cases were followed-up for more than 5 years. Survival rates were calculated by the Kaplan-Meier methods and survival differences between patients with and without selected arterial infusion chemotherapy were compared with the Log-rank test. Prognostic variables were entered into a Cox regression analysis model controlling for age, site, lymph node status, and treatment received.RESULTS The overall survival rates were not significantly different between the experimental group and the control group, but there was better survival for patients who received 3 or more than 3 courses of chemotherapy. Lymph node status (N) was an important factor in the prognosis.CONCLUSION Trans-catheter arterial infusion chemotherapy is a safe and effective method of therapy. Postoperative selective arterial infusion chemotherapy can improve the survival rate in patients with esophageal squamous carcinoma who were previously treated by radical surgery.However, this modality of therapy needs further investigation.

  13. Comparing Relaxation Programs for Breast Cancer Patients Receiving Radiotherapy

    Science.gov (United States)

    In this study, women with breast cancer who have had surgery and are scheduled to undergo radiation therapy will be randomly assigned to one of two different stretching and relaxation programs or to a control group that will receive usual care.

  14. Treatment of patients with Huerthle cell thyroid carcinoma using [Lu-177-DOTAO, Tyr3]octreotate

    International Nuclear Information System (INIS)

    Full text of publication follows. Aim: Huerthle cell thyroid carcinoma (HCTC) is a variant of follicular thyroid carcinoma. Although radioiodine (I-131) is given for ablation of the thyroid remnant to enable serum thyroglobulin levels for follow-up, it is rarely used for the treatment of residual or metastatic disease, related to the Huerthle cell tumour's poor capacity of taking up radioiodine. Since thyroid tumour cells express somatostatin receptors, peptide receptor radionuclide therapy using radiopharmaceuticals such as [Lu-177-DOTA0,Tyr3]octreotate (Lu-177-octreotate) has been proposed as a potential treatment option. Materials and Methods: 15 patients with pathology proven HCTC treated with Lu-177-octreotate between January 2000 and April 2012 were studied. CT or MRI scans were analysed using SWOG criteria for response outcome. Thyroglobulin levels were analysed and a decrease of more than 50% was considered as a significant biochemical response. All patients had received radioiodine to ablate the thyroid remnant. Six patients received an additional treatment dose of I-131 (total cumulative dose range: 0.7 to 14.8 GBq I-131). Results: Acute side effects such as nausea, vomiting, pain, and hair loss were present during 22%, 2%, 8% and 27% of all administrations respectively. WHO grade 3 bone marrow toxicity for both platelets and leukocytes was present in 2% of all treatment cycles. No long-term side effects such as myelodysplasia or kidney failure were found during a median follow-up of 25 months (range 2-119 months). Twelve patients received the intended cumulative dose (22.2-29.6 GBq) of Lu-177-octreotate whereas 3 did not, due to persisting thrombocytopenia, concomitant cardiac atrial fibrillation, or to the diagnosis of rectal adenocarcinoma as a second primary tumour. In 11 out of the 12 remaining patients sufficient follow-up data were available for evaluation. Four (36%) patients had a partial response (PR) at 3 months after the last treatment

  15. A STUDY OF CLINICO-PATHOLOGICAL PARAMETERS IN PATIENTS OF CARCINOMA LARYNX

    Directory of Open Access Journals (Sweden)

    Kartikeya

    2016-04-01

    Full Text Available BACKGROUND Incidence of carcinoma larynx in India reported to be 1.3 to 8.8 per 100,000 populations in six different regions of the country. The main risk factors for development of carcinoma larynx are consumption of smoke tobacco and alcohol. The aim of this study was to evaluate clinico-pathological parameters in patients with carcinoma larynx. MATERIAL AND METHOD A total of 110 patients newly diagnosed with carcinoma larynx were included in this study after taking informed consent from the patient and clearance from the ethics committee. Previously treated larynx cancer patients with recurrence were excluded. RESULT Pain on swallowing was the commonest presenting symptom present in 101 (91.81% patients. Smoke tobacco consumption was present in 104 (94.54% patients, smokeless tobacco consumption was present in 12 (10.90% patients and alcohol consumption was present in 94 (85.45% patients with cancer larynx. Most of the patients had inadequate dietary intake as per recommended dietary allowance. CONCLUSIONS The most common site involved was supraglottis seen in 70 (63.63% patients. Most of the patients presented with stage III cancer in 43 (39.09% patients. Squamous cell carcinoma was the histopathological variant seen in all patients in our study. Moderately differentiated squamous cell carcinoma was the most common squamous cell carcinoma variant seen present in 62 (56.36% patients.

  16. Synchronous malignancies in patients with squamous cell carcinomas of the oral cavity

    International Nuclear Information System (INIS)

    Synchronous malignancies in patients with squamous cell carcinomas of the oral cavity (OCSCC) are occasionally encountered. In the current study we tried to evaluate their frequency, detectability by 18F-fluorodeoxyglucose (FDG) studies, and prognostic factors. A retrospective analysis of patients with primary OCSCC enrolled for 18F-FDG studies from 2002 to 2008 was performed. The detectability of synchronous second cancers by 18F-FDG studies was defined by the scoring of two interpreters. Prognostic factors for overall survival in patients receiving curative-intent treatment were assessed using the univariate Kaplan-Mayer analysis and the multivariate Cox regression model. Of 764 patients, 40 (5.2%) had synchronous malignancies. 18F-FDG studies detected 22 (48%) of 46 synchronous second cancers. For synchronous cancers at the hypopharynx, esophagus, or liver, the median survival of patients was no longer than 1 year, and the detection rates by 18F-FDG studies were 100, 86, and 25%, respectively. In the 33 patients receiving curative-intent treatment, the site of second cancer, complete surgical resection of all known tumors, and the oral habit of betel quid/areca nut chewing are significant prognostic factors in the univariate analysis, while the site of second cancer is the only significant prognostic factor in the multivariate analysis (p = 0.041). The site of second cancer is the most significant prognostic factor in OCSCC patients with synchronous malignancies receiving curative-intent treatment. 18F-FDG studies detect synchronous malignancies with poor prognosis in OCSCC patients except for hepatic cancers. In OCSCC patients with synchronous malignancies with poor prognosis, prospective studies comparing different treatment options should be further conducted. (orig.)

  17. SORAFENIB FOR OLDER PATIENTS WITH RENAL CELL CARCINOMA: SUBSET ANALYSIS FROM A RANDOMIZED TRIAL

    Directory of Open Access Journals (Sweden)

    T. Eisen

    2014-08-01

    Full Text Available Background. The perception that older cancer patients may be at higher risk than younger patients of toxic effects from cancer therapy but may obtain less clinical benefit from it may be based on the underrepresentation of older patients in clinical trials and the known toxic effects of cytotoxic chemotherapy. It is not known how older patients respond to targeted therapy.Methods.  This retrospective subgroup analysis of data from the phase 3, randomized Treatment Approach in Renal Cancer Global Evaluation Trial examined the safety and efficacy of sorafenib in older (age ≥ 70 years, n = 115 and younger patients (age <70 years, n = 787 who received treatment for advanced renal cell carcinoma. Patient demographics and progression-free survival were recorded. Best tumor response, clinical benefit rate (defined as complete response plus partial response plus stable disease, time to self-reported health status deterioration, and toxic effects were assessed by descriptive statistics. Health-related quality of life was assessed with a Cox proportion- al hazards model. Kaplan - Meier analyses were used to summarize time-to-event data.Results. Median progression-free survival was similar in sorafenib-treated younger patients (23.9 weeks; hazard ratio [HR] for progression compared with placebo = 0.55, 95% confidence interval [CI] = 0.47 to 0.66 and older patients (26.3 weeks; HR = 0.43, 95% CI = 0.26 to 0.69. Clinical benefit rates among younger and older sorafenib-treated patients were also similar (83.5% and 84.3%, respectively and were superior to those of younger and older placebo-treated patients (53.8% and 62.2%, respectively. Adverse events were predictable and manageable regardless of age. Sorafenib treatment delayed the time to self-reported health status deterioration among both older patients (121 days with sorafenib vs 85 days with placebo; HR = 0.66, 95% CI = 0.43 to 1.03 and younger patients (90 days with sorafenib vs 52 days with placebo

  18. SORAFENIB FOR OLDER PATIENTS WITH RENAL CELL CARCINOMA: SUBSET ANALYSIS FROM A RANDOMIZED TRIAL

    Directory of Open Access Journals (Sweden)

    T. Eisen

    2009-01-01

    Full Text Available Background. The perception that older cancer patients may be at higher risk than younger patients of toxic effects from cancer therapy but may obtain less clinical benefit from it may be based on the underrepresentation of older patients in clinical trials and the known toxic effects of cytotoxic chemotherapy. It is not known how older patients respond to targeted therapy.Methods.  This retrospective subgroup analysis of data from the phase 3, randomized Treatment Approach in Renal Cancer Global Evaluation Trial examined the safety and efficacy of sorafenib in older (age ≥ 70 years, n = 115 and younger patients (age <70 years, n = 787 who received treatment for advanced renal cell carcinoma. Patient demographics and progression-free survival were recorded. Best tumor response, clinical benefit rate (defined as complete response plus partial response plus stable disease, time to self-reported health status deterioration, and toxic effects were assessed by descriptive statistics. Health-related quality of life was assessed with a Cox proportion- al hazards model. Kaplan - Meier analyses were used to summarize time-to-event data.Results. Median progression-free survival was similar in sorafenib-treated younger patients (23.9 weeks; hazard ratio [HR] for progression compared with placebo = 0.55, 95% confidence interval [CI] = 0.47 to 0.66 and older patients (26.3 weeks; HR = 0.43, 95% CI = 0.26 to 0.69. Clinical benefit rates among younger and older sorafenib-treated patients were also similar (83.5% and 84.3%, respectively and were superior to those of younger and older placebo-treated patients (53.8% and 62.2%, respectively. Adverse events were predictable and manageable regardless of age. Sorafenib treatment delayed the time to self-reported health status deterioration among both older patients (121 days with sorafenib vs 85 days with placebo; HR = 0.66, 95% CI = 0.43 to 1.03 and younger patients (90 days with sorafenib vs 52 days with placebo

  19. Basal cell carcinoma of the scalp after radiation therapy for tinea capitis: 33 patients

    International Nuclear Information System (INIS)

    Occurrence of basal cell carcinoma (BCC) following radiotherapy for tinea capitis is well known. The aim of this study was to specify the clinical and histological features of these BCC seen in 33 patients (1995 000). Twenty seven men and six women were diagnosed with BCC. The age of onset varied between 32 an 62 years. Radiotherapy was received between 5 and 17 years of age. The interval between irradiation and the onset of carcinoma varied between 21 and 51 years. Total number of lesions was 55. Forty percent of BCC occurred on the occipital area, the number varied from 1 to 5 and the size from 2 to 45 mm. Clinically, the nodular type was found in 51% of cases. Pigment was present in 64% of cases. Histological study showed a nodular aspect in 76% and pigmentation in 63% of cases. Nodular and pigmented type were the predominant BCC occurring after radiotherapy for tinea capitis in our series. In the literature, BCC are the most frequent carcinomas occurring after radiotherapy (70-100%). Pigmentation was not described in other series. The nodular histological form was the most frequent. (author)

  20. Pregnancy and nasopharyngeal carcinoma: a prognostic evaluation of 27 patients

    International Nuclear Information System (INIS)

    In order to study the influence of pregnancy on the prognosis of nasopharyngeal carcinoma (NPC), the authors have retrospectively studied 27 patients who either were discovered to be pregnant during radiotherapy (9 patients, herein abbreviated as concurrent group) or became pregnant after treatment (18 patients, herein abbreviated as subsequent group). This material was collected from 811 NPC patients treated in their hospital from March 1958 to 1972. The results obtained are presented as follows: Concurrent pregnancy had a disastrous effect on the prognosis of NPC patients giving a five year survival of only 11% (1/9). This adverse influence was not observed in the subsequent group, yet the time of gestation seemed to be relevant to the prognosis. Two of the three patients who became pregnant within one year of the treatment died of disease, those who became pregnant beyond the second year after irradiation had the best prognosis. All seven patients who became pregnant after the second year of treatment survived. A total of 21 children were born to the patients of these two groups. They have been followed regularly for 10 to 20 years. No deformity, or retardation in growth or mentality was discovered, nor was there any evidence of radiation tumor or leukemia observed

  1. Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma. A follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Rong, X.; Tang, Y.; Lu, K.; Peng, Y. [Sun Yat-sen Memorial Hospital, Guangzhou (China). Dept. of Neurology; Chen, M. [Sun Yat-sen Univ., Guangzhou (China). Dept. of Nasopharyngeal Carcinoma

    2012-03-15

    The purpose of the current study was to investigate the long-term characteristics of radiation-induced cranial nerve injury in nasopharyngeal carcinoma (NPC) patients. We studied cranial nerve palsy (CNP) in 328 NPC patients who received radiotherapy between 1994 and 2006. Follow-up was 93.6% complete as of December 2009. A total of 72 patients with CNP were recruited for analysis (56 men and 16 women). Patients with evidence of residual or recurrent tumor accompanied by CNP were excluded. The characteristics of CNP and the relationship with the radiation fields as well as re-radiotherapy were evaluated. After a mean follow-up of 11.2 years, 72 patients were found to have developed CNP. The latency of palsy ranged from 0.6-16.0 years. For the 67 patients with first course radiation, the glossopharyngeal and vagus nerves were the most vulnerable combination, occurring in 57 patients (85.1%). Patients with facial-cervical field radiation had a significantly longer latency comparing with that of patients with facial-cervical split fields (p = 0.021). In the first 5 years, 49.3% of patients developed CNP, while 40.3% presented CNP in the second 5-year period. In patients with first course radiation, 61 patients had more than one CNP. With regard to the 5 patients with re-radiation, most of them had multiple upper cranial nerve injuries. Radiation therapy of NPC patients may lead to cranial neuropathy. Patients with facial-cervical radiation fields had a longer latency for the manifestation of CNP compared with those patients who were treated with split fields. In patients with re-radiotherapy, the frequency of upper cranial nerve injury increased greatly.

  2. Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma. A follow-up study

    International Nuclear Information System (INIS)

    The purpose of the current study was to investigate the long-term characteristics of radiation-induced cranial nerve injury in nasopharyngeal carcinoma (NPC) patients. We studied cranial nerve palsy (CNP) in 328 NPC patients who received radiotherapy between 1994 and 2006. Follow-up was 93.6% complete as of December 2009. A total of 72 patients with CNP were recruited for analysis (56 men and 16 women). Patients with evidence of residual or recurrent tumor accompanied by CNP were excluded. The characteristics of CNP and the relationship with the radiation fields as well as re-radiotherapy were evaluated. After a mean follow-up of 11.2 years, 72 patients were found to have developed CNP. The latency of palsy ranged from 0.6-16.0 years. For the 67 patients with first course radiation, the glossopharyngeal and vagus nerves were the most vulnerable combination, occurring in 57 patients (85.1%). Patients with facial-cervical field radiation had a significantly longer latency comparing with that of patients with facial-cervical split fields (p = 0.021). In the first 5 years, 49.3% of patients developed CNP, while 40.3% presented CNP in the second 5-year period. In patients with first course radiation, 61 patients had more than one CNP. With regard to the 5 patients with re-radiation, most of them had multiple upper cranial nerve injuries. Radiation therapy of NPC patients may lead to cranial neuropathy. Patients with facial-cervical radiation fields had a longer latency for the manifestation of CNP compared with those patients who were treated with split fields. In patients with re-radiotherapy, the frequency of upper cranial nerve injury increased greatly.

  3. Upper Tract Urothelial Carcinomas in Patients with Chronic Kidney Disease: Relationship with Diagnostic Challenge

    Directory of Open Access Journals (Sweden)

    Li-Jen Wang

    2014-01-01

    Full Text Available Chronic kidney disease and upper tract urothelial carcinomas display a bidirectional relationship. Review of the literature indicates that early diagnosis and correct localization of upper tract urothelial carcinomas in dialysis patients and kidney transplant recipients are important but problematic. Urine cytology and cystoscopy have limited sensitivity for the diagnosis of upper tract urothelial carcinomas in dialysis patients. Enhanced computed tomography and magnetic resonance imaging could prove useful for the detection and staging of upper tract urothelial carcinomas in dialysis patients. Renal ultrasound can detect hydronephrosis caused by upper tract urothelial carcinomas in kidney transplant recipients but cannot visualize the carcinomas themselves. High detection rates for upper tract urothelial carcinomas in kidney transplant recipients have recently been demonstrated using computed tomography urography, which appears to be a promising tool. To detect carcinomas in dialysis patients and kidney transplant recipients as early as possible, regular screening in asymptomatic patients and diagnostic work-up in symptomatic patients should be performed using a combination of urological and imaging methods. Careful assessment of subsequent recurrence within the contralateral upper urinary tract and the urinary bladder is necessary for dialysis patients and kidney transplant recipients with upper tract urothelial carcinomas.

  4. Anxiety and depression related to the hospitalization experience of patients receiving radioiodine ablation

    International Nuclear Information System (INIS)

    Full text of publication follows. Objective: the hospital rooms for radioiodine ablation of differentiated thyroid carcinoma are designed according to radiation safety lows where patients have to remain isolated. The aim of the present study is to investigate depression and anxiety levels of the patients associated with hospitalization experience for radioiodine ablation. Methods: 30 patients (8 M, 22 F; mean: 45±13 years old) with differentiated thyroid carcinoma were included into study. After withdrawal of thyroid hormone replacement at least for 3 weeks, the patients were subject of the ablation treatment. After routine psychiatric examination Hamilton Anxiety and Depression scales were administered to the patients before and after complement of hospitalization for 1-3 days. Results: according to the statistical analysis there was not any significant difference between Hamilton depression and anxiety scores and state and trait anxiety scores of the patients before and after treatment (P>0.05). However, 18 patients had depression, with major depression of six, and 21 had high anxiety levels, according to Hamilton Depression and Anxiety Scales. Conclusion: Although the patients with differentiated thyroid carcinoma do not experience anxiety or depression related to the hospitalization itself for radioiodine ablation they might frequently have depression or anxiety just before the treatment. (authors)

  5. Polymeric Nanoparticles to Combat Squamous Cell Carcinomas in Patients with Dystrophic Epidermolysis Bullosa

    OpenAIRE

    Manoukian, Martin A.C.; Ott, Susanne V.; Rajadas, Jayakumar; Inayathullah, Mohammed

    2014-01-01

    Skin cancer is the leading cause of malignancy in the United States, with Basal Cell Carcinoma, Squamous Cell Carcinoma , and Melanoma being the three most common diagnoses, respectively. Squamous Cell Carcinoma (SCC) is a particular concern for patients suffering from Dystrophic Epidermolysis Bullosa (DEB), a disease that affects the production and function of collagen VII, a protein that forms the anchoring fibrils which bind the epidermis to the dermis. Patients with DEB suffer from chroni...

  6. Upper Tract Urothelial Carcinomas in Patients with Chronic Kidney Disease: Relationship with Diagnostic Challenge

    OpenAIRE

    Li-Jen Wang; Shen-Yang Lee; Bin Tean Teh; Cheng-Keng Chuang; Joëlle Nortier

    2014-01-01

    Chronic kidney disease and upper tract urothelial carcinomas display a bidirectional relationship. Review of the literature indicates that early diagnosis and correct localization of upper tract urothelial carcinomas in dialysis patients and kidney transplant recipients are important but problematic. Urine cytology and cystoscopy have limited sensitivity for the diagnosis of upper tract urothelial carcinomas in dialysis patients. Enhanced computed tomography and magnetic resonance imaging cou...

  7. EVOLUTION OF SYNCHRONOUS BILATERAL BREAST CARCINOMA IN A YOUNG PATIENT.

    Science.gov (United States)

    Manea, Elena; Munteanu, Anca

    2016-01-01

    Bilateral breast cancer incidence is appreciated to be between 0.3 to 12% and is determined either by a hereditary load associated with chromosomal instability under the effect of environmental factors, or by the evolution in a particular hormonal context which gives biological aggressiveness. We present the case of a patient, aged 38 years, clinically, imagistic and bioptic diagnosed with left axillary lymph node metastases of breast carcinoma NST invasive G3, IHC-RE = 60%, RP = 30%, HER2neu = 2 +, Ki67 = 20%, in August 2013. Patient followed neoadjuvant chemotherapy treatment during September-October 2013. In December 2013 she was clinically and imaging diagnosed with bilateral breast cancer, for which surgical intervention was done which consisted of bilateral radical Madden mastectomy with bilateral axillary lymphadenectomy. BAP-invasive carcinoma NST: left breast-pT2mN3a G2, right breast--pT3mN3a G2, IHC-RE = 90%, RP =70% HER2neu = 2 +, Ki67 = 50%. During the period of January-March 2014, the patient followed adjuvant chemotherapy and Herceptin. Bilateral breast ultrasound assessment in April 2014 revealed: left axilla--liquid blade 29 / 6mm; right axilla--oval ganglion 9/5 mm. Abdominal and pelvic ultrasound: empty uterine cavity, bosselated contour; at left ovary level multiple cystic formations. During the period of May-June 2014, adjuvant radiation therapy and ovarian irradiationwas administered to the patient. Subsequently hormone therapy was initiated. Following CHT / ovarian irradiation patient continues to experience intermittent uterine bleeding, which is why a total hysterectomy with bilateral ovariectomy was done, and BAP: cervical, endometrialand left ovary with tumor multifocal infiltration with histopathological aspect of invasive breast carcinoma NST. Periodic imaging evaluations do not reveal local or distant recurrence. The particularity of this case is synchronous bilateral breast cancer diagnosis in a young patient complicated in its

  8. Screening for carcinoma in situ of the contralateral testis in patients with germinal testicular cancer

    DEFF Research Database (Denmark)

    Berthelsen, J G; Skakkebaek, N E; von der Maase, H;

    1982-01-01

    Two hundred and fifty biopsy specimens from the contralateral testis in patients with unilateral germinal testicular cancer were analysed by light microscopy for carcinoma-in-situ changes. Changes were found in 13 (5.2%) patients. One-third of patients with an atrophic contralateral testis (volume...... cryptorchidism or both had been screened. Since the natural course of carcinoma in situ in the contralateral testis of patients with germinal testicular cancer has not been established, the patients are being re-evaluated frequently. To date two patients with carcinoma in situ have developed a second cancer....

  9. Evaluation of irradiation in patient's environment receiving 131I therapy

    International Nuclear Information System (INIS)

    This article describes measurements made in the bed station of Clinic of Nuclear Medicine in St. Elizabeth Oncological Institute in Bratislava. There are treated thyroid cancer and thyrotoxicosis with the use of 131I. The aim of the measurements was to determine the possibility of the ambulation treatment of thyrotoxicosis or the possibility of shortening of the patient;s stay in the bed station that the effective dose would not be exceeded suggestions according to the publication of EURATOM. The measurements were made also with thyroid cancer patients but owing to clinical reasons the ambulation treating in this case is not permissible. Therefore this article does not describe the results of these measurements.The effective dose rates were measured in 0.25 m; 0.5 m; 1 m and 2 m distances from the patient's thyroid so the effective dose in the patient's surroundings could be determined. To the present time the results of effective dose rates measurements for 17 patients were evaluated by described way. The age of the patients was from 41 to 82 years, the administered quantity of 131I was from 259 to 481 MBq, in fractions 37 MBq, 74 MBq, or 111 MBq. The calculated effective half-life of 131I excretion from the patients body is crucial for the length of patient's necessary staying in the bed station, were from 4.2 days to 8 days. This great extend of values is given by by the different clinical parameters of the treated patients. After the analyse of them can be said that the effective half-life increases, when the patient is elder, has greater mass of thyroid and the accumulation is higher. At the present time authors don't suggest using the ambulation treatment of thyrotoxicosis by 131I. For discharging the patient from the hospital authors suggest to think criteria according to the model of behaviour D with the effective dose limit 0.5 mSv. For the households with children up to 2 years and/or pregnant women according to the model B with effective dose limit 0

  10. Efficacy of sorafenib on metastatic renal cell carcinoma in Asian patients: Results from a multicenter study

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    Shen Yijun

    2009-07-01

    Full Text Available Abstract Background The effects of sorafenib in the treatment of advanced renal cell carcinoma (RCC have been confirmed in an international collaborative phase III trial. This study aims to confirm similar efficacy and treatment-induced toxicities of sorafenib in the treatment of metastatic RCC in ethnic Chinese patients. Methods Ninety-eight consecutive and non-selected patients with pathologically confirmed metastatic RCC were treated according to an institutional treatment protocol. All patients were treated with 400 mg of sorafenib orally twice daily on a continuous basis until disease progression or intolerance to treatment occurred. Dose reduction to 400 mg once daily was required if grade 3 or 4 toxicities occurred. All patients except for 7 received nephrectomy in the course of their disease. All patients were assessed for tumor response, progression-free survival (PFS, overall survival (OS, and treatment-induced toxicities. Results The median follow-up time was 76 weeks (range 2–296 weeks for the entire group of patients. Radiologically confirmed complete response (CR, partial response (PR, stable disease (SD of more than 4 months, and disease progression as best objective responses were observed in 1 (1%, 23 (23.5%, 62 (63.3%, and 12 (12.2% patients, respectively. The tumor control rate (CR+PR+SD of >4 months was 87.8%. The 1-year estimated PFS and OS were 58.4% and 64.6%, respectively. The median progression-free survival (PFS time was 60 weeks (95% CI 41–79; and the median overall survival (OS time was not reached with a follow-up of 76 weeks. Reduction of sorafenib dose was required in 26 patients who developed grade 3 or 4 treatment-cause adverse-effects. An additional 9 patients discontinued sorafenib treatment due to severe adverse-effects. No grade 5 toxicity occurred. Multivariate analysis revealed that independent predictive factors for tumor response to sorafenib treatment included ECOG status, presence of lymph node

  11. Efficacy of sorafenib on metastatic renal cell carcinoma in Asian patients: Results from a multicenter study

    International Nuclear Information System (INIS)

    The effects of sorafenib in the treatment of advanced renal cell carcinoma (RCC) have been confirmed in an international collaborative phase III trial. This study aims to confirm similar efficacy and treatment-induced toxicities of sorafenib in the treatment of metastatic RCC in ethnic Chinese patients. Ninety-eight consecutive and non-selected patients with pathologically confirmed metastatic RCC were treated according to an institutional treatment protocol. All patients were treated with 400 mg of sorafenib orally twice daily on a continuous basis until disease progression or intolerance to treatment occurred. Dose reduction to 400 mg once daily was required if grade 3 or 4 toxicities occurred. All patients except for 7 received nephrectomy in the course of their disease. All patients were assessed for tumor response, progression-free survival (PFS), overall survival (OS), and treatment-induced toxicities. The median follow-up time was 76 weeks (range 2–296 weeks) for the entire group of patients. Radiologically confirmed complete response (CR), partial response (PR), stable disease (SD) of more than 4 months, and disease progression as best objective responses were observed in 1 (1%), 23 (23.5%), 62 (63.3%), and 12 (12.2%) patients, respectively. The tumor control rate (CR+PR+SD of >4 months) was 87.8%. The 1-year estimated PFS and OS were 58.4% and 64.6%, respectively. The median progression-free survival (PFS) time was 60 weeks (95% CI 41–79); and the median overall survival (OS) time was not reached with a follow-up of 76 weeks. Reduction of sorafenib dose was required in 26 patients who developed grade 3 or 4 treatment-cause adverse-effects. An additional 9 patients discontinued sorafenib treatment due to severe adverse-effects. No grade 5 toxicity occurred. Multivariate analysis revealed that independent predictive factors for tumor response to sorafenib treatment included ECOG status, presence of lymph node metastasis, and nephrectomy prior to the

  12. Acquired cystic disease and renal cell carcinoma in hemodialysis patients: A case report on three patients

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    Mijušković Mirjana

    2015-01-01

    Full Text Available Introduction. Renal cell carcinoma (RCC is derived from renal tubular epithelial cells and represents approximately 3.8% of all malignancies in adults. The incidence of renal cell carcinoma has been growing steadily and ranging from 0.6 to 14.7 for every 100,000 inhabitants. Patients with end-stage renal disease and acquired cystic kidney disease are at increased risk of developing RCC while undergoing dialysis treatment or after renal transplantation. Case report. We presented 3 patients undergoing hemodialysis, with acquired cystic kidney disease accompanied by the development of RCC. In all the patients tumor was asymptomatic and discovered through ultrasound screening in 2 patients and in 1 of the patients by post-surgery pathohistological analysis of the tissue of the kidney excised using nephrectomy. All the three patients had organ-limited disease at the time of the diagnosis and they did not require additional therapy after surgical treatment. During the follow- up after nephrectomy from 6 months to 7 years, local recurrence or metastasis of RCC were not diagnosed. Conclusion. Acquired cystic kidney disease represents a predisposing factor for the development of renal cell carcinoma in dialysis patients and requires regular ultrasound examinations of the abdomen aimed at early diagnosis of malignancies. Prognosis for patients with endstage renal disease and RCC is mostly good because these tumors are usually of indolent course.

  13. Positron emission tomography in patients with head and neck carcinoma

    International Nuclear Information System (INIS)

    PURPOSE: To examine the role of positron emission tomography (PET) with labeled fluorodeoxyglucose (FDG) in patients with primary neoplasms of the head and neck. MATERIALS and METHODS: Between (9(92)) and (9(94)), forty-four FDG PET scans were performed on 27 patients with head and neck neoplasms. FDG uptake at the tumor sites was quantified with standardized uptake values (SUV). There were seven women and 20 men. Median age was 70 (37 - 85). All patients had squamous cell carcinoma except two with esthesioneuroblastoma. In six patients the primary site was occult and treatment consisted of surgery followed by radiation. In the other patients, primary sites included nasopharynx (2), base of tongue (6), tonsil (4), larynx (2), piriform sinus (3) paranasal sinuses (3) and multiple (1). Three were Stage II, four were Stage III, 11 were Stage IV and three had recurrent disease. Gross disease was treated by radiation (2), twice daily radiation (8) or concurrent chemotherapy and radiation (11). The median follow-up of survivors is 12 months (6 - 30). RESULTS: All patients had baseline scans prior to radiation therapy. In the six patients with occult primaries, no primary lesions were discovered by PET scans. In the other 21 patients, all known primary sites, regional node metastases and distant metastases demonstrated increased uptake on PET imaging. In one patient distant metastases were suggested on PET (but without corroborating clinical or radiographic evidence) and in two patients additional regional node metastases were discovered. Eleven patients had PET scans at the conclusion of radiation therapy. Five patients had complete responses by PET, two had major responses and four had partial responses. However, all these patients had good clinical responses and none have failed locally. Five patients had six scans during follow-up (at 3 to 12 months) to differentiate radiation changes from persistent disease. In four patients the PET scans were negative and they are

  14. Increased Risk of Ischemic Stroke in Young Nasopharyngeal Carcinoma Patients

    International Nuclear Information System (INIS)

    Purpose: Radiation/chemoradiotherapy-induced carotid stenosis and cerebrovascular events in patients with nasopharyngeal carcinoma (NPC) can cause severe disability and even death. This study aimed to estimate the risk of ischemic stroke in this patient population over more than 10 years of follow-up. Methods and Materials: The study cohorts consisted of all patients hospitalized with a principal diagnosis of NPC (n = 1094), whereas patients hospitalized for an appendectomy during 1997 and 1998 (n = 4376) acted as the control group and surrogate for the general population. Cox proportional hazard model was performed as a means of comparing the stroke-free survival rate between the two cohorts after adjusting for possible confounding and risk factors. Results: Of the 292 patients with ischemic strokes, 62 (5.7%) were from the NPC cohort and 230 (5.3%) were from the control group. NPC patients ages 35–54 had a 1.66 times (95% CI, 1.16–2.86; p = 0.009) higher risk of ischemic stroke after adjusting for patient characteristics, comorbidities, geographic region, urbanization level of residence, and socioeconomic status. There was no statistical difference in ischemic stroke risk between the NPC patients and appendectomy patients ages 55–64 years (hazard ratio = 0.87; 95% CI, 0.56–1.33; p = 0.524) after adjusting for other factors. Conclusions: Young NPC patients carry a higher risk for ischemic stroke than the general population. Besides regular examinations of carotid duplex, different irradiation strategies or using new technique of radiotherapy, such as intensity modulated radiation therapy or volumetric modulated arc therapy, should be considered in young NPC patients.

  15. Risk factors of distant metastasis in patients with squamous cell carcinoma of the uterine cervix treated with postoperative irradiation

    International Nuclear Information System (INIS)

    This paper reports the results of a study of risk factors for recurrence in non-irradiated sites in patients with squamous cell carcinoma of the uterine cervix who received postoperative irradiation. It also discusses clinical experience with such patients, particularly those with a poor prognosis, based on a review of the literature. The study was conducted at the National Shikoku Cancer Center in 62 patients with squamous cell carcinoma of the uterine cervix (mean age=50.5, range=30-66) who received 10 MeV postoperative irradiation with a Linac between 1981 and 1990. An analysis was performed in terms of sites and times of recurrence, risk factors for distant metastasis, and groups at high risk for distant metastasis. Based on the results of the study as well as the review of the literature, it was concluded that squamous cell carcinoma of the uterine cervix is sensitive to radiation therapy and that the clinical outcome of local treatment is satisfactory. However, systemic chemotherapy should be considered for patients who are suspected of having minute distant metastasis at the time of surgical operation, i.e., those with moderate to severe vascular space invasion, multiple lymph node metastasis, parametrium infiltration, and/or endometrial infiltration. (K.H.)

  16. Thioredoxin reductase: a novel, independent prognostic marker in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Li, Chunyan; Peng, Yan; Mao, Binglang; Qian, Kun

    2015-07-10

    Here we found that hepatocellular carcinoma (HCC) patients with recurrence outcome and nonsurvivors had significantly increased thioredoxin reductase (TrxR) serum levels on reoperation (P risk factors showed that TrxR was an independent predictor of recurrence (hazard ratios [HR] = 4.19; 95% confidence intervals [CI]: 3.21-7.08) and overall survival (HR = 5.56; 95% CI: 3.42-10.21). The area under the receiver operating characteristic curve of TrxR was 0.837 (95% CI, 0.794-0.881) for recurrence outcome and 0.901 (95% CI, 0.869-0.933) for mortality, which was superior to high-sensitivity-C-reactive protein and a-fetoprotein (P indicator predictive of poor prognosis and early recurrence in patients with HCC, which offering reliable information for predicting survival. PMID:25970775

  17. The effect of strontium-89 therapy in a patient with cholangiocellular carcinoma

    International Nuclear Information System (INIS)

    A 77-year-old man was diagnosed as having cholangiocellular carcinoma. The patient underwent partial right hepatectomy in June 2008, and multiple bone metastases occurred approximately 9 months after surgery. He refused salvage chemotherapy and radiation therapy. Although he had been treated with opiate analgesics, he was unable to sit up owing to severe pain in the left ilium. He was hospitalized because of buttock pain and left leg numbness. Even a combination of fentanyl patch, gabapentin, and subarachnoid block was ineffective in controlling pain. Strontium-89 (89Sr) therapy was successful in eliminating the intractable pain, and there were no serious side effects during therapy. The patient was discharged from the hospital, and he received palliative care at home for a short period. (author)

  18. Sunitinib Does Not Accelerate Tumor Growth in Patients with Metastatic Renal Cell Carcinoma

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    Krastan B. Blagoev

    2013-02-01

    Full Text Available Preclinical studies have suggested that sunitinib accelerates metastases in animals, ascribing this to inhibition of the vascular endothelial growth factor receptor or the tumor’s adaptation. To address whether sunitinib accelerates tumors in humans, we analyzed data from the pivotal randomized phase III trial comparing sunitinib and interferon alfa in patients with metastatic renal cell carcinoma. The evidence clearly shows that sunitinib was not harmful, did not accelerate tumor growth, and did not shorten survival. Specifically, neither longer sunitinib treatment nor a greater effect of sunitinib on tumors reduced survival. Sunitinib did reduce the tumor’s growth rate while administered, thereby improving survival, without appearing to alter tumor biology after discontinuation. Concerns arising from animal models do not apply to patients receiving sunitinib and likely will not apply to similar agents.

  19. Infiltrative Hepatocellular Carcinoma: Assessment of Factors Associated With Outcomes in Patients Undergoing Hepatectomy.

    Science.gov (United States)

    Yan, Xiaopeng; Fu, Xu; Deng, Min; Chen, Jun; He, Jian; Shi, Jiong; Qiu, Yudong

    2016-05-01

    Data on infiltrative hepatocellular carcinoma (iHCC) receiving hepatectomy are unclear. Our study assessed the outcomes, effects of anatomical resection, and prognostic factors in a cohort of Chinese patients with iHCC undergoing hepatectomy.Data from 47 patients with iHCC undergoing hepatectomy were analyzed in a retrospective study. Independent prognostic factors of overall survival (OS) and recurrence-free survival (RFS) were identified using univariate and multivariate analyses. Correlations between microvascular invasion (MVI) and clinicopathological features were assessed using the χ test, Student t test, or the Mann-Whitney U test. Survival outcomes were estimated using the Kaplan-Meier method.The median OS was 27.37 months and the 1-year RFS rate were 61.7%. Alpha-fetoprotein (AFP) level was not a specific parameter in iHCC patients undergoing hepatectomy. Anatomic resection was significantly associated with increased RFS (P = 0.007). Patients showing MVI were observed with decreased RFS (P GGT), and LDH. Subgroup analysis indicated that in mild MVI group, survival outcome was significantly more favorable in patients with high LDH level (P = 0.019).iHCC patients are related with higher MVI rate and patients may still derive survival benefit from anatomic resection at early and intermediate stages. MVI classification could be used to identify iHCC patients with a poorer survival, especially those with a high preoperative LDH level. PMID:27175659

  20. Metabolism in patients with small cell lung carcinoma compared with patients with non-small cell lung carcinoma and healthy controls

    OpenAIRE

    d Staal-van,; Schols, A. M.; Dentener, M.A.; Ten, V.; Buurman, W A; Wouters, E. F.

    1997-01-01

    BACKGROUND: Weight loss is a frequently occurring problem in patients with lung cancer due to an increased resting energy expenditure (REE) and a decreased energy intake. The aim of the present study was to compare the metabolic and inflammatory characteristics of patients with small cell lung carcinoma (SCLC) and non-small cell lung carcinoma (NSCLC). The metabolic parameters of the lung cancer population were compared with those of a healthy control group. METHODS: REE was measured in...

  1. Tattoo allergy in patients receiving adjuvant radiotherapy for breast cancer.

    Science.gov (United States)

    Sewak, S; Graham, P; Nankervis, J

    1999-11-01

    Tattooing is routinely employed prior to radiotherapy treatment but allergies to tattoos are rare. New information on the incidence of tattoo allergy at St George Hospital is presented with details of two clinical cases. The literature on tattoo allergy has been unable to estimate the incidence of allergic reaction to tattoos because the total number of patients treated is unknown and not all patients were followed up. Our radiation oncology population for the first time has provided a known denominator, but wide confidence intervals prevent an accurate estimate of the incidence. Salient issues about tattoo allergy are highlighted based on a review of the published literature from 1966 to 1998. PMID:10901983

  2. Candida albicans infection in patients with oral squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Čanković Miloš

    2010-01-01

    Full Text Available Bacground/Aim. Systemic candidiasis in intensive care units remains an improtant problem due to antifungal resistance. Patients undergoing radiotherapy for head and neck cancer are at increased risk of developing oral candidiasis and they more frequent have prior fungi colonization. Due to identification of specific risk factors predisposing to fungal infection in order to threat such patients the aim of this study was to determine the presence of Candida species in patients with oral squamous cell carcinoma and compare it to the control subjects (patients with benign oral mucosal lesions. Methods. A total number of 30 consecutive oral cancer examined patients were included in this prospective study (24 men and 6 women with a mean age of 61.47 years, range 41-81 years. The control group consisted of 30 consecutive patients with histologically proven benign oral mucosal lesions (16 men and 14 women with a mean age of 54.53 years, range 16- 83 years. The samples for mycological examination were obtained by using sterile cotton swabs from the cancer lesion surface and in the patients of the control group from the benign mucosal lesion surface. Samples were inoculated in Sabouraud' dextrose agar. For identification purposes, Mackenzie germ tube test was performend on all isolates. Results. The prevalence of Candida was significantly higher in oral cancer patients than in control subjects (χ2 = 5.455, p = 0.020. Candida was found on nine of the 30 cancer surfaces; 5 (16.7% were identified as non-albicans Candida and 4 (13.3% as Candida albicans. In the control group, only Candida albicans was isolated from 2 (6.7% patients. In this study, no statistically significant differences in the presence of Candida species was found with respect to gender, age, smoking, alcohol consumption, wearing of dental protheses and the site of cancer lesion. Conclusion. The increased prevalence of yeasts on the surfaces of oral carcinoma indicates a need for their

  3. Outcomes of Locoregional Tumor Therapy for Patients with Hepatocellular Carcinoma and Transjugular Intrahepatic Portosystemic Shunts

    Energy Technology Data Exchange (ETDEWEB)

    Padia, Siddharth A., E-mail: spadia@uw.edu; Chewning, Rush H., E-mail: rchewnin@uw.edu; Kogut, Matthew J., E-mail: kogutm@uw.edu; Ingraham, Christopher R., E-mail: cringa@uw.edu; Johnson, Guy E., E-mail: gej@uw.edu [University of Washington Medical Center, Section of Interventional Radiology, Department of Radiology (United States); Bhattacharya, Renuka, E-mail: renuka@uw.edu [University of Washington Medical Center, Division of Gastroenterology and Hepatology, Department of Medicine (United States); Kwan, Sharon W., E-mail: shakwan@uw.edu; Monsky, Wayne L., E-mail: wmonsky@uw.edu; Vaidya, Sandeep, E-mail: svaidya@uw.edu [University of Washington Medical Center, Section of Interventional Radiology, Department of Radiology (United States); Hippe, Daniel S., E-mail: dhippe@uw.edu [University of Washington Medical Center, Department of Radiology (United States); Valji, Karim, E-mail: kvalji@uw.edu [University of Washington Medical Center, Section of Interventional Radiology, Department of Radiology (United States)

    2015-08-15

    PurposeLocoregional therapy for hepatocellular carcinoma (HCC) can be challenging in patients with a transjugular intrahepatic portosystemic shunt (TIPS). This study compares safety and imaging response of ablation, chemoembolization, radioembolization, and supportive care in patients with both TIPS and HCC.MethodsThis retrospective study included 48 patients who had both a TIPS and a diagnosis of HCC. Twenty-nine of 48 (60 %) underwent treatment for HCC, and 19/48 (40 %) received best supportive care (i.e., symptomatic management only). While etiology of cirrhosis and indication for TIPS were similar between the two groups, treated patients had better baseline liver function (34 vs. 67 % Child-Pugh class C). Tumor characteristics were similar between the two groups. A total of 39 ablations, 17 chemoembolizations, and 10 yttrium-90 radioembolizations were performed on 29 patients.ResultsAblation procedures resulted in low rates of hepatotoxicity and clinical toxicity. Post-embolization/ablation syndrome occurred more frequently in patients undergoing chemoembolization than ablation (47 vs. 15 %). Significant hepatic dysfunction occurred more frequently in the chemoembolization group than the ablation group. Follow-up imaging response showed objective response in 100 % of ablation procedures, 67 % of radioembolization procedures, and 50 % of chemoembolization procedures (p = 0.001). When censored for OLT, patients undergoing treatment survived longer than patients receiving supportive care (2273 v. 439 days, p = 0.001).ConclusionsAblation appears to be safe and efficacious for HCC in patients with TIPS. Catheter-based approaches are associated with potential increased toxicity in this patient population. Chemoembolization appears to be associated with increased toxicity compared to radioembolization.

  4. Outcomes of Locoregional Tumor Therapy for Patients with Hepatocellular Carcinoma and Transjugular Intrahepatic Portosystemic Shunts

    International Nuclear Information System (INIS)

    PurposeLocoregional therapy for hepatocellular carcinoma (HCC) can be challenging in patients with a transjugular intrahepatic portosystemic shunt (TIPS). This study compares safety and imaging response of ablation, chemoembolization, radioembolization, and supportive care in patients with both TIPS and HCC.MethodsThis retrospective study included 48 patients who had both a TIPS and a diagnosis of HCC. Twenty-nine of 48 (60 %) underwent treatment for HCC, and 19/48 (40 %) received best supportive care (i.e., symptomatic management only). While etiology of cirrhosis and indication for TIPS were similar between the two groups, treated patients had better baseline liver function (34 vs. 67 % Child-Pugh class C). Tumor characteristics were similar between the two groups. A total of 39 ablations, 17 chemoembolizations, and 10 yttrium-90 radioembolizations were performed on 29 patients.ResultsAblation procedures resulted in low rates of hepatotoxicity and clinical toxicity. Post-embolization/ablation syndrome occurred more frequently in patients undergoing chemoembolization than ablation (47 vs. 15 %). Significant hepatic dysfunction occurred more frequently in the chemoembolization group than the ablation group. Follow-up imaging response showed objective response in 100 % of ablation procedures, 67 % of radioembolization procedures, and 50 % of chemoembolization procedures (p = 0.001). When censored for OLT, patients undergoing treatment survived longer than patients receiving supportive care (2273 v. 439 days, p = 0.001).ConclusionsAblation appears to be safe and efficacious for HCC in patients with TIPS. Catheter-based approaches are associated with potential increased toxicity in this patient population. Chemoembolization appears to be associated with increased toxicity compared to radioembolization

  5. The possibilities of radioimmune and radiologic monitoring of the treatment of patients with rectal carcinoma

    International Nuclear Information System (INIS)

    Full text: The method of dynamic control (monitoring) of the treatment efficiency of the patients with rectal carcinoma was developed. Data of dynamic examination (every 10 days) of 174 patients with rectal carcinoma received a specific treatment at the clinic of NOSC of Uzbekistan (Tashkent) were presented. Complex examination of the patients included the data of conventional clinical, special and radionuclide methods (RIA CEA, AFP, IRI ACTH in serum, gamma scintigraphy of liver) was carried out. For a selection of 17 parameters the factor analysis was used. Diagnostic significance of every parameter was determined. CEA and AFP markers were included as indices of tumor activity, ACTH and IRI markers were used as characterization of an organism's response to therapy. In the results of the multifactor investigations the monitoring programs 'Diagnosis-1' and 'Diagnosis-2' were developed. These programs permit to evaluate the treatment efficiency and correct the treatment schemes the case of the absence of the effect. Programmes 'Diagnosis-1' and Diagnosis-2' have a high both the diagnostic (89.9 ± 0.9% and 87.1 ± 0.9 %) and the prognostic (85.2 ± 1.3 % and 83.2 ± 1.3 %) significance. It is concluded that use of radionuclide methods permit to provide an adequate treatment in every case of rectal carcinoma. We suggesting: Use the Diagnosis-1' for evaluation of efficiency of different methods of treatment (CEA-produced tumors of rectum). Use the 'Diagnosis-2' for evaluation of efficiency of treatment of the CEA un-produced tumors of rectum. For objective and quantitative evaluation of the cancer of rectum it is necessary to determine the CEA and AKTH level in blood serum

  6. Beam path toxicity in candidate organs-at-risk: Assessment of radiation emetogenesis for patients receiving head and neck intensity modulated radiotherapy

    International Nuclear Information System (INIS)

    Background: To investigate potential dose–response relationship between radiation-associated nausea and vomiting (RANV) reported during radiotherapy and candidate nausea/vomiting-associated regions of interest (CNV-ROIs) in head and neck (HNC) squamous cell carcinomas. Methods and material: A total of 130 patients treated with IMRT with squamous cell carcinomas of head and neck were evaluated. For each patient, CNV-ROIs were segmented manually on planning CT images. Clinical on-treatment RANV data were reconstructed by a review of the records for all patients. Dosimetric data parameters were recorded from dose–volume histograms. Nausea and vomiting reports were concatenated as a single binary “Any N/V” variable, and as a “CTC-V2+” variable. Results: The mean dose to CNV-ROIs was higher for patients experiencing RANV events. For patients receiving IMRT alone, a dose–response effect was observed with varying degrees of magnitude, at a statistically significant level for the area postrema, brainstem, dorsal vagal complex, medulla oblongata, solitary nucleus, oropharyngeal mucosa and whole brain CNV-ROIs. Conclusion: RANV is a common therapy-related morbidity facing patients receiving HNC radiotherapy, and, for those receiving radiotherapy-alone, is associated with modifiable dose to specific CNS structures

  7. GP96 is over-expressed in oral cavity cancer and is a poor prognostic indicator for patients receiving radiotherapy

    International Nuclear Information System (INIS)

    Oral cavity cancers (ORC) are the most common cancers, and standard treatment is radical surgery with postoperative radiotherapy. However, locoregional failure remains a major problem, indicating radioresistance an important issue. Our previous work has shown that GP96 contributed to radioresistance in nasopharyngeal and oral cancer cell lines. In this study, we determined clinical significance of GP96 in ORC by evaluation of GP96 expression and its association with disease prognosis in patients receiving radiotherapy Total of 79 ORC patients (77 males, median age: 48 years old) receiving radical surgery and postoperative radiotherapy between Oct 1999 and Dec 2004 were enrolled. Patients in pathological stages II, III and IV were 16.5%, 16.5% and 67%, respectively. For each patient, a pair of carcinoma tissue and grossly adjacent normal mucosa was obtained. GP96-expression was examined by western blot analysis, and the association with clinicopathological status was determined. Three-year locoregional control (LRC), distant metastasis-free survival (DMFS), disease-specific survival (DSS) and overall survival (OS) rates were 69%, 79%, 63% and 57%, respectively. We found that 55 patients (70%) displayed GP96-overexpression in the tumor tissue, which correlated with a higher pN stage (p = 0.020) and tumor depth (> 10 mm) (p = 0.045). Nodal extracapsular spreading (ECS) and GP96-overexpression predicted adverse LRC (p = 0.049 and p = 0.008). When stratified by nodal ECS, the adverse impact of GP96 remained significant in three-year LRC (p = 0.004). In multivariate analysis, GP96-overexpression was also an independent predictor of LRC, DSS and OS (p = 0.018, p = 0.011 and p = 0.012). GP96 may play roles in radioresistance which attributes to tumor invasiveness in oral cancer patients receiving radiotherapy. GP96 may serve as a novel prognostic marker of radiotherapy. However, further independent studies are required to validate our findings in a larger series

  8. Analysis of the testicular dose in patients undergoing radiotherapy for carcinoma of the prostate; Analisis de las dosis testiculares en pacientes sometidos a tratamiento radioterapico de carcinoma de prostata

    Energy Technology Data Exchange (ETDEWEB)

    Bejar Navarro, M. J.; Ordonez Marquez, J.; Hervas Moron, A.; Alvarez Rodriguez, S.; Garcia-Galloway, E.; Sanchez Casanueva, R.; Polo Rubio, A.; Rodriguez-Patron, R.; Yanowsky, K.; Gomez Dos Santos, V.

    2013-07-01

    The objectives of this work are: -Studying comparatively the doses received in testes in patients undergoing radiotherapy of prostate carcinoma with external beam radiation and brachytherapy of low rate using I-125 seeds. -Compare doses due to images of verification using Cone Beam CT (CBCT), with doses of radiotherapy treatment itself. -Determine the seminal alterations and cytogenetic after treatment with ionizing radiation (RTE or BQT) in patients diagnosed with prostate cancer and its relation with testicular dose. (Author)

  9. Results of Surgical Therapy in Patients with Medullary Thyroid Carcinoma.

    Science.gov (United States)

    Vlad, Mihaela; Zosin, Ioana; Timar, Bogdan; Lazar, Fulger; Vlad, Adrian; Timar, Romulus; Cornianu, Marioara

    2016-08-01

    Medullary thyroid carcinoma (MTC) is a rare form of malignancy, having an intermediate prognosis. Controversies exist regarding the best surgical approach. The aim of the study was to analyze the outcome in a group of patients with MTC, diagnosed and followed up in a single care center. We performed a retrospective analysis of all the patients diagnosed with MTC in the Department of Endocrinology from the County Emergency Hospital Timisoara between 1992 and 2012. The study group included 19 patients, 6 men (31.6 %), mean age 41.2 ± 12.5 years (20-72 years). The preoperative diagnosis was based on the protocol for nodular thyroid disease. Total or near-total thyroidectomy was performed in 10 out of 16 patients who could be operated. Postoperative follow-up included repeated measurements of serum calcitonin and imaging investigations. Nine out of the total of 19 (47.3 %) patients had hereditary forms of MTC. Most of the cases (84.2 %) were submitted to surgery. The median duration of follow-up was 84 months. The pTNM staging indicated that the majority of the patients with hereditary MTC were diagnosed in an earlier stage. Disease remission was achieved in 7 cases (43.8 %). Four patients, all with sporadic forms, died. Survival rates at 1, 5 and 10 years were significantly higher (p = 0.048) in patients with hereditary MTC. An early diagnosis of MTC allows a better surgical approach and an improved survival rate. We support the general recommendation that modified radical neck dissection is not necessary for all the patients with MTC. PMID:27574350

  10. Alternatives to albumin administration in hepatocellular carcinoma patients undergoing hepatectomy: an open,randomized clinical trial of efficacy and safety

    Institute of Scientific and Technical Information of China (English)

    YANG Jian; WANG Wen-tao; YAN Lü-nan; XU Ming-qing; YANG Jia-yin

    2011-01-01

    Background The value of artificial colloids in treating patients with liver disease is controversial. The effects of intravascular volume replacement regimens on liver function secondary to alteration of the postoperative inflammatory response are not known. In this study, we evaluated the effects of different volume replacement regimens in hepatocellular carcinoma patients undergoing hepatectomy to clarify whether albumin administration can be replaced by other volume replacement products.Methods Ninety consecutive hepatocellular carcinoma patients scheduled for hepatectomy were prospectively randomized to receive 20% human albumin (HA), 6% hydroxyethyl starch (HES) or lactated Ringer's solution (LR) for postoperative volume replacement. Hemodynamic, liver function and inflammatory response parameters were recorded on postoperative days one, three, and five throughout the investigation period.Results Significantly less volume was required in the HA and the HES groups. Although patients in all groups had similar baseline values, the plasma osmolality was significantly higher in the HA and HES groups. Total bilirubin (TB), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) increased from baseline in all groups, and did not differ significantly between groups. C-reactive protein (CRP) was significantly lower in the HES group compared with the other groups.Conclusions In hepatocellular carcinoma patients undergoing hepatectomy, HA can be replaced by HES or LR in well selected patients. Hemodynamic stability, liver function, and postoperative clinical outcomes could be equivalently achieved in the HES group; also, HES may exert more favorable effects on the acute phase response. (Registered in the Chinese Clinical Trial Registry, ChiCTR-TRC-10000790)

  11. Plaque, caries level and oral hygiene habits in young patients receiving orthodontic treatment

    DEFF Research Database (Denmark)

    Martignon, S; Ekstrand, K R; Lemos, M I;

    2010-01-01

    To assess plaque, caries, and oral hygiene habits amongst patients receiving fixed-orthodontic treatment at the Dental-Clinic, Universidad-El-Bosque, Bogotá, Colombia.......To assess plaque, caries, and oral hygiene habits amongst patients receiving fixed-orthodontic treatment at the Dental-Clinic, Universidad-El-Bosque, Bogotá, Colombia....

  12. Autopsy findings in 14 patients with penile squamous cell carcinoma.

    Science.gov (United States)

    Chaux, Alcides; Reuter, Victor; Lezcano, Cecilia; Velazquez, Elsa; Codas, Ricardo; Cubilla, Antonio L

    2011-04-01

    The aim of this study was to describe pathologic features found at autopsy of 14 patients with penile cancer. Nine patients died from disseminated disease; 5 of them presented local/regional recurrences. Five patients died from other causes, 2 of them postoperatively. Local recurrence sites were corpus cavernosum, Buck's fascia and urethra, regional skin, and prostate. Metastatic sites were lymph nodes (9 cases), liver (7 cases), lungs (6 cases), heart (5 cases), adrenals, bone and skin (3 cases each), thyroid and brain (2 cases each), and pancreas, spleen, and pleura (1 case each). Patients with heart metastasis had arrhythmias. Patients who died and who did not die from penile cancer had different profiles: low-grade superficial tumors with usual and warty subtypes versus high-grade deeply invasive basaloid or hybrid verrucous/sarcomatoid carcinomas. A natural history model for penile cancer routes of spread is proposed: local intrapeneal, regional and systemic nodes, regional skin, liver, lungs, heart, and other multiple sites. PMID:19411278

  13. Peptic ulcer disease and other complications in patients receiving dexamethasone palliation for brain metastasis

    International Nuclear Information System (INIS)

    A retrospective analysis was done of 106 patients who received radiation therapy for brain metastasis. Dexamethasone therapy was instituted in 97 patients. Peptic ulcer disease developed in 5 of 89 patients (5.6 percent) who received a dosage of at least 12 mg a day, but did not occur in patients who received a lower dose or in those who did not receive steroids. The interval between institution of dexamethasone therapy and the development of peptic ulcer disease ranged from three to nine weeks. Two patients had perforated ulcers, one of whom required surgical resection. Peptic ulcer disease contributed to the general deterioration and death of three of the five patients. Overall, in 14 of the 89 patients (15.7 percent) a complication of steroid therapy developed in the form of peptic ulcer disease, steroid myopathy or diabetes mellitus (or a combination of these)

  14. Recombinant Human Thrombopoietin Treatment Promotes Hematopoiesis Recovery in Patients with Severe Aplastic Anemia Receiving Immunosuppressive Therapy

    OpenAIRE

    2015-01-01

    Objective. To assess the effectiveness of recombinant human thrombopoietin (rhTPO) in severe aplastic anemia (SAA) patients receiving immunosuppressive therapy (IST). Methods. Eighty-eight SAA patients receiving IST from January 2007 to December 2012 were included in this retrospective analysis. Of these, 40 subjects received rhTPO treatment (15000 U, subcutaneously, three times a week). rhTPO treatment was discontinued when the platelet count returned to normal range. Hematologic response, b...

  15. Improved Survival in Patients with Viral Hepatitis-Induced Hepatocellular Carcinoma Undergoing Recommended Abdominal Ultrasound Surveillance in Ontario: A Population-Based Retrospective Cohort Study

    OpenAIRE

    Thein, Hla-Hla; Campitelli, Michael A.; Yeung, Latifa T.; Zaheen, Ahmad; Yoshida, Eric M; Earle, Craig C

    2015-01-01

    The optimal schedule for ultrasonographic surveillance of patients with viral hepatitis for the detection of hepatocellular carcinoma (HCC) remains unclear owing to a lack of reliable studies. We examined the timing of ultrasonography in patients with viral hepatitis-induced HCC and its impact on survival and mortality risk while determining predictors of receiving surveillance before HCC diagnosis. A population-based retrospective cohort analysis of patients with viral hepatitis-induced HCC ...

  16. Relative Effectiveness of Letrozole Compared With Tamoxifen for Patients With Lobular Carcinoma in the BIG 1-98 Trial

    DEFF Research Database (Denmark)

    Metzger Filho, Otto; Giobbie-Hurder, Anita; Mallon, Elizabeth;

    2015-01-01

    PURPOSE: To evaluate the relative effectiveness of letrozole compared with tamoxifen for patients with invasive ductal or lobular carcinoma. PATIENTS AND METHODS: Patients diagnosed with early-stage invasive ductal carcinoma (IDC) or classic invasive lobular carcinoma (ILC) who were randomly...

  17. Survival in patients with hepatocellular carcinoma treated with intra-arterial {sup 131}I labelled lipiodol.

    Energy Technology Data Exchange (ETDEWEB)

    Butler, S.P.; Morris, D.L.; Ring, M.T.; King, J.; Parks, S.L.; Glenn, D.W. [St George Hospital, Kogarah, NSW, (Australia). Department of Nuclear Medicine

    1997-09-01

    Full text: The prognosis of untreated hepatocellular carcinoma (HCC) is dismal with a median survival of less than two months having been reported. {sup 131}l labelled Lipiodol as a treatment for hepatocellular carcinoma (HCC) has been shown to be as efficacious as intraarterial chemotherapy but with less toxicity than chemotherapy. 23 patients (19 men and four women, mean age 69 years, range 28 to 80 years) with unresectable Okuda Stage I (n = 23) or 11 (n = 2) HCC were treated over a three-year period. All patients had biopsy proved HCC and had not received any prior therapy. Before therapy, all patients underwent CT scans of abdomen and thorax and scintigraphic bone scans to exclude extrahepatic disease. Further, CT scanning of the liver was performed following the hepatic artery injection of unlabelled Lipiodol to ensure that the HCC was Lipiodol avid. 1 GBq of {sup 131}l labelled Lipiodol was injected into the hepatic artery followed by CT liver scanning at day 1 and day 60 to calculate tumour response. Whole body scintigraphic scanning was performed on days 1 and 21 for dosimetry calculations. Ten patients had a second dose of {sup 131}l Lipiodol due either increasing serum alpha feto-protein levels and/or tumour progression on CT scanning. Minimal toxicity was seen with this dose regime. Survival time was estimated from the time of treatment by the Kaplan-Meier method. For Okuda I, the median survival length was 12 months with actuarial survival rates of 91 per cent, 65 per cent, 59 per cent and 20 per cent at 3,6,9,12 and 24 months respectively. All Okuda II patients died within five months. Iodine-131 Lipiodol therapy is well tolerated and may prolong survival in certain HCC patients.

  18. Pedicle versus free flap reconstruction in patients receiving intraoperative brachytherapy.

    Science.gov (United States)

    Geiger, Erik J; Basques, Bryce A; Chang, Christopher C; Son, Yung; Sasaki, Clarence T; McGregor, Andrew; Ariyan, Stephan; Narayan, Deepak

    2016-08-01

    Introduction This study compared complication rates between pedicle flaps and free flaps used for resurfacing of intraoperative brachytherapy (IOBT) implants placed following head and neck tumour extirpation to help clarify the ideal reconstructive procedure for this scenario. Patients and methods A retrospective review of reconstructions with IOBT at our institution was conducted. Patient and treatment details were recorded, as were the number and type of flap complications, including re-operations. Logistic regressions compared complications between flap groups. Results Fifty free flaps and 55 pedicle flaps were included. On multivariate analysis, free flap reconstruction with IOBT was significantly associated with both an increased risk of having any flap complication (OR = 2.9, p = 0.037) and with need for operative revision (OR = 3.5, p = 0.048) compared to pedicle flap reconstruction. Conclusions In the setting of IOBT, free flaps are associated with an increased risk of having complications and requiring operative revisions. PMID:26983038

  19. Sunitinib treatment for patients with clear-cell metastatic renal cell carcinoma: clinical outcomes and plasma angiogenesis markers

    International Nuclear Information System (INIS)

    Sunitinib is a protein tyrosine kinase-inhibitor targeting VEGFR, c-kit and PDGFR. It has been approved for the treatment of metastatic renal-cell carcinoma and gastrointestinal stromal tumors. Although it has been shown to prolong disease-free and overall survival in renal-cell carcinoma patients, only 70% of the treated population receive a clinical benefit (CB) from the treatment. Markers that could predict clinical benefit to sunitinib would be an important aid in monitoring and following their treatment. We assessed the outcome and plasma proangiogenic factors in patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib in our institution. We have treated 42 patients with metastatic clear-cell renal carcinoma with sunitinib. Plasma concentrations of VEGF-A, sVEGFR2 and PDGF were determined by ELISA. At the time of analysis 39 patients were evaluable for response and 30 patients had obtained a clinical benefit (CB). Median progression-free survival was 268 days (8.93 months) and median overall survival was 487 days (16.23 months). Interestingly, disease stabilization or objective response resulted in comparable overall survival. Most treatment-related adverse events were of mild-to-moderate intensity with one treatment-related death. Plasma sVEGFR2 and PDGF levels had no predictive value. Fold-increase in plasma VEGF was significantly lower in patients that obtained a CB as compared to patients that progressed after two cycles of treatment. Plasma VEGF did not increase in patients with initial CB at the time of progression. Sunitinib showed substantial activity in mRCC. Disease stabilization or objective response resulted in comparable overall survival and both outcomes should be considered positive. Fold-increase in plasma VEGF predicts for CB and could be a candidate marker. Progression after initial CB is not associated with elevated plasma VEGF, implying a different mechanism of resistance

  20. Predicting postoperative vomiting among orthopedic patients receiving patient-controlled epidural analgesia using SVM and LR.

    Science.gov (United States)

    Wu, Hsin-Yun; Gong, Cihun-Siyong Alex; Lin, Shih-Pin; Chang, Kuang-Yi; Tsou, Mei-Yung; Ting, Chien-Kun

    2016-01-01

    Patient-controlled epidural analgesia (PCEA) has been applied to reduce postoperative pain in orthopedic surgical patients. Unfortunately, PCEA is occasionally accompanied by nausea and vomiting. The logistic regression (LR) model is widely used to predict vomiting, and recently support vector machines (SVM), a supervised machine learning method, has been used for classification and prediction. Unlike our previous work which compared Artificial Neural Networks (ANNs) with LR, this study uses a SVM-based predictive model to identify patients with high risk of vomiting during PCEA and comparing results with those derived from the LR-based model. From January to March 2007, data from 195 patients undergoing PCEA following orthopedic surgery were applied to develop two predictive models. 75% of the data were randomly selected for training, while the remainder was used for testing to validate predictive performance. The area under curve (AUC) was measured using the Receiver Operating Characteristic curve (ROC). The area under ROC curves of LR and SVM models were 0.734 and 0.929, respectively. A computer-based predictive model can be used to identify those who are at high risk for vomiting after PCEA, allowing for patient-specific therapeutic intervention or the use of alternative analgesic methods. PMID:27247165

  1. Yttrium-90 resin microspheres as an adjunct to sorafenib in patients with unresectable hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Mahvash A

    2016-02-01

    Full Text Available Armeen Mahvash,1 Ravi Murthy,1 Bruno C Odisio,1 Kanwal Pratap Raghav,2 Lauren Girard,2 Sheree Cheung,1 Van Nguyen,3 Joe Ensor,4 Sameer Gadani,5 Khaled M Elsayes,6 Reham Abdel-Wahab,1,7 Manal Hassan,1 Ahmed S Shalaby,1 James C Yao,1 Michael J Wallace,1 Ahmed O Kaseb2 1Department of Interventional Radiology, 2Department of Gastrointestinal Medical Oncology, 3Department of Pharmacy, 4Department of Statistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 5Department of Radiology, Saint Louis University Hospital, St Louis, MO, 6Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 7Department of Clinical Oncology, Assiut University Hospital, Assiut, Egypt Purpose: The safety and efficacy of the combined use of sorafenib and yttrium-90 resin microspheres (Y90 RMS to treat advanced hepatocellular carcinoma (HCC is not well established. We determined the incidence of adverse events with this combination therapy in patients with advanced HCC at our institution and analyzed the treatment and survival outcomes. Materials and methods: We reviewed the records of 19 patients with Barcelona Clinic Liver Cancer class B or C HCC who underwent treatment with Y90 RMS (for 21 sessions while receiving full or reduced doses of sorafenib between January 2008 and May 2010. Therapy response was evaluated using Response Evaluation Criteria in Solid Tumors. We evaluated median overall survival (OS and progression-free survival (PFS as well as hepatic and extrahepatic disease PFS and incidence of adverse events. Results: The median patient age was 67 years, and portal or hepatic venous invasion was present in eight patients (42%. Ten patients received reduced doses of sorafenib. The median Y90 radiation activity delivered was 41.2 mCi. The partial response of Response Evaluation Criteria in Solid Tumors was observed in four patients (19%. The median hepatic disease PFS was 7.82 months, extrahepatic

  2. Carcinoembryonic antigen (CEA) dynamics in stomach cancer patients receiving cryotherapy

    International Nuclear Information System (INIS)

    Radioimmunologic assays of blood serum carcinoembryonic antigen (CEA) level were conducted at major stages of treatment of gastric cancer by subtotal stomach resection and gastrectomy with preliminary cryotreatment and thawing of tumor. A short-term rise in CEA level occurred in 53.9 % of cases 3-4 days after combined therapy. A decrease in CEA concentration at discharge from hospital as compared with preoperative level and that registered 3-4 days after operation was observed in 50 and 75 % of cases of combined therapy, respectively, and 47.5 and 37.5 % of controls (surgery without cryotreatment). There was nocorrelation between cryotreatment and changes in CEA level in gastric ulcer patients

  3. Quantitative bone scintigraphy. A study in patients with prostatic carcinoma

    International Nuclear Information System (INIS)

    Quantitative bone scintigraphy was performed in patients with prostatic carcinoma before orchiectomy as well as two weeks, two and six months after operation. The count rate was recorded as serial gamma camera images over the lower thoracic and all lumbar vertebrae from 1 to 240 min and at 24 h after injection of 99Tcm-MDP. In almost all abnormal vertebrae an increased count rate was observed within one hour after injection. Most of the vertebrae which were considered normal at 4 h after injection, but had an increased 24h/4h ratio developed into abnormal vertebrae later in the study. The patients with normal bone scintigrams showed no change in 99Tcm-MDP uptake during the study. The reproducibility of quantitative bone scintigraphy was found to be ± 7% (1 SD). In response to therapy, most of the patients with abnormal bone scintigrams showed an increase in count rate two weeks after operation followed by a decrease to the pre-operative level after two months and a further decrease after six months. This so called 'flare phenomenon' was found to indicate 99Tcm-MDP in the vascular phase as well as an active bone uptake. In some of the patients the whole-body retention of 99Tcm-MDP after 24 h and the bone mineral density in the vertebrae were determined and found to be valuable in the interpretation of skeletal metastases and the assessment of response to therapy. (71 refs.)

  4. Plasma levels of osteocalcin and retinol binding protein-4 in patients with medullary thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Jabar Lotfi

    2014-04-01

    Conclusion: According to difference between plasma levels of osteocalcin and retinol binding protein-4 in patients suffered of medullary thyroid carcinoma comparison with normal subjects, it can be said that, probably medullary thyroid carcinoma has effect on bone and adipose tissue metabolism, so osteocalcin and retinol binding protein-4 hormones have potential to be used for confirmation of diagnosis or following treatment of medullary thyroid carcinoma.

  5. Replanning During Intensity Modulated Radiation Therapy Improved Quality of Life in Patients With Nasopharyngeal Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yang Haihua [Department of Radiation Oncology, Laboratory of Cellular and Molecular Radiation Oncology, Taizhou Hospital, Wenzhou Medical College, Taizhou, Zhejiang Province (China); Hu Wei, E-mail: huw@enzemed.com [Department of Radiation Oncology, Laboratory of Cellular and Molecular Radiation Oncology, Taizhou Hospital, Wenzhou Medical College, Taizhou, Zhejiang Province (China); Wang Wei; Chen Peifang; Ding Weijun [Department of Radiation Oncology, Laboratory of Cellular and Molecular Radiation Oncology, Taizhou Hospital, Wenzhou Medical College, Taizhou, Zhejiang Province (China); Luo Wei [Department of Radiation Medicine, University of Kentucky, Lexington, Kentucky (United States)

    2013-01-01

    Purpose: Anatomic and dosimetric changes have been reported during intensity modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). The purpose of this study was to evaluate the effects of replanning on quality of life (QoL) and clinical outcomes during the course of IMRT for NPC patients. Methods and Materials: Between June 2007 and August 2011, 129 patients with NPC were enrolled. Forty-three patients received IMRT without replanning, while 86 patients received IMRT replanning after computed tomography (CT) images were retaken part way through therapy. Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Head and Neck Quality of Life Questionnaire 35 were completed before treatment began and at the end of treatment and at 1, 3, 6, and 12 months after the completion of treatment. Overall survival (OS) data were compared using the Kaplan-Meier method. Results: IMRT replanning had a profound impact on the QoL of NPC patients, as determined by statistically significant changes in global QoL and other QoL scales. Additionally, the clinical outcome comparison indicates that replanning during IMRT for NPC significantly improved 2-year local regional control (97.2% vs 92.4%, respectively, P=.040) but did not improve 2-year OS (89.8% vs 82.2%, respectively, P=.475). Conclusions: IMRT replanning improves QoL as well as local regional control in patients with NPC. Future research is needed to determine the criteria for replanning for NPC patients undergoing IMRT.

  6. Efficacy and Safety of Transarterial Radioembolization Versus Chemoembolization in Patients With Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Moreno-Luna, Laura E., E-mail: morenoluna.laura@gmail.com; Yang, Ju Dong; Sanchez, William [College of Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology (United States); Paz-Fumagalli, Ricardo [College of Medicine, Mayo Clinic, Department of Radiology (United States); Harnois, Denise M.; Mettler, Teresa A. [College of Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology (United States); Gansen, Denise N. [College of Medicine, Mayo Clinic, Department of Radiology (United States); Groen, Piet C. de; Lazaridis, Konstantinos N.; Narayanan Menon, K. V.; LaRusso, Nicholas F. [College of Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology (United States); Alberts, Steven R. [College of Medicine, Mayo Clinic and Mayo Clinic Cancer Center, Department of Oncology (United States); Gores, Gregory J. [College of Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology (United States); Fleming, Chad J. [College of Medicine, Mayo Clinic, Department of Radiology (United States); Slettedahl, Seth W.; Harmsen, William S.; Therneau, Terry M. [College of Medicine, Mayo Clinic, Department of Health Sciences Research (United States); Wiseman, Gregory A.; Andrews, James C. [College of Medicine, Mayo Clinic, Department of Radiology (United States); Roberts, Lewis R., E-mail: roberts.lewis@mayo.edu [College of Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology (United States)

    2013-06-15

    Purpose. Intermediate-stage hepatocellular carcinoma (HCC) is usually treated with locoregional therapy using transarterial chemoembolization (TACE). Transarterial radioembolization (TARE) using {beta}-emitting yttrium-90 integral to the glass matrix of the microspheres is an alternative to TACE. This retrospective case-control study compared the outcomes and safety of TARE versus TACE in patients with unresectable HCC. Materials and Methods. Patients with unresectable HCC without portal vein thrombosis treated with TARE between 2005 and 2008 (n = 61) were retrospectively frequency-matched by age, sex, and liver dysfunction with TACE-treated patients (n = 55) in the Mayo Clinic Hepatobiliary Neoplasia Registry. Imaging studies were reviewed, and clinical and safety outcomes were abstracted from the medical records. Results. Complete tumor response was more common after TARE (12 %) than after TACE (4 %) (p = 0.17). When complete response was combined with partial response and stable disease, there was no difference between TARE and TACE. Median survival did not differ between the two groups (15.0 months for TARE and 14.4 months for TACE; p = 0.47). Two-year survival rates were 30 % for TARE and 24 % for TACE. TARE patients received fewer treatments (p < 0.001). Fifty-nine (97 %) TARE patients received outpatient treatment. In contrast, 53 (98 %) TACE patients were hospitalized for {>=}1 day (p < 0.001). Compared with TACE, TARE was more likely to induce fatigue (p = 0.003) but less likely to cause fever (p = 0.02). Conclusion. There was no significant difference in efficacy between TARE and TACE. TARE patients reported more fatigue but had less fever than TACE patients. Treatment with TARE required less hospitalization than treatment with TACE. These findings require confirmation in randomized trials.

  7. Efficacy and Safety of Transarterial Radioembolization Versus Chemoembolization in Patients With Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Purpose. Intermediate-stage hepatocellular carcinoma (HCC) is usually treated with locoregional therapy using transarterial chemoembolization (TACE). Transarterial radioembolization (TARE) using β-emitting yttrium-90 integral to the glass matrix of the microspheres is an alternative to TACE. This retrospective case-control study compared the outcomes and safety of TARE versus TACE in patients with unresectable HCC. Materials and Methods. Patients with unresectable HCC without portal vein thrombosis treated with TARE between 2005 and 2008 (n = 61) were retrospectively frequency-matched by age, sex, and liver dysfunction with TACE-treated patients (n = 55) in the Mayo Clinic Hepatobiliary Neoplasia Registry. Imaging studies were reviewed, and clinical and safety outcomes were abstracted from the medical records. Results. Complete tumor response was more common after TARE (12 %) than after TACE (4 %) (p = 0.17). When complete response was combined with partial response and stable disease, there was no difference between TARE and TACE. Median survival did not differ between the two groups (15.0 months for TARE and 14.4 months for TACE; p = 0.47). Two-year survival rates were 30 % for TARE and 24 % for TACE. TARE patients received fewer treatments (p < 0.001). Fifty-nine (97 %) TARE patients received outpatient treatment. In contrast, 53 (98 %) TACE patients were hospitalized for ≥1 day (p < 0.001). Compared with TACE, TARE was more likely to induce fatigue (p = 0.003) but less likely to cause fever (p = 0.02). Conclusion. There was no significant difference in efficacy between TARE and TACE. TARE patients reported more fatigue but had less fever than TACE patients. Treatment with TARE required less hospitalization than treatment with TACE. These findings require confirmation in randomized trials.

  8. Replanning During Intensity Modulated Radiation Therapy Improved Quality of Life in Patients With Nasopharyngeal Carcinoma

    International Nuclear Information System (INIS)

    Purpose: Anatomic and dosimetric changes have been reported during intensity modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). The purpose of this study was to evaluate the effects of replanning on quality of life (QoL) and clinical outcomes during the course of IMRT for NPC patients. Methods and Materials: Between June 2007 and August 2011, 129 patients with NPC were enrolled. Forty-three patients received IMRT without replanning, while 86 patients received IMRT replanning after computed tomography (CT) images were retaken part way through therapy. Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Head and Neck Quality of Life Questionnaire 35 were completed before treatment began and at the end of treatment and at 1, 3, 6, and 12 months after the completion of treatment. Overall survival (OS) data were compared using the Kaplan-Meier method. Results: IMRT replanning had a profound impact on the QoL of NPC patients, as determined by statistically significant changes in global QoL and other QoL scales. Additionally, the clinical outcome comparison indicates that replanning during IMRT for NPC significantly improved 2-year local regional control (97.2% vs 92.4%, respectively, P=.040) but did not improve 2-year OS (89.8% vs 82.2%, respectively, P=.475). Conclusions: IMRT replanning improves QoL as well as local regional control in patients with NPC. Future research is needed to determine the criteria for replanning for NPC patients undergoing IMRT.

  9. Transcatheter arterial Chemoembolization for infiltrative hepatocellular carcinoma: Clinical safety and efficacy and factors influencing patient survival

    Energy Technology Data Exchange (ETDEWEB)

    Han, Kichang; Kim, Jin Hyoung; Yoon, Hee Mang; Kim, Eun Joung; Gwon, Dong Il; Ko, Gi Young; Yoon, Hyun Ki; Ko, Heung Kyu [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2014-08-15

    To evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) in patients with infiltrative hepatocellular carcinoma (HCC) and to identify the prognostic factors associated with patient survival. Fifty two patients who underwent TACE for infiltrative HCC were evaluated between 2007 and 2010. The maximum diameter of the tumors ranged from 7 cm to 22 cm (median 15 cm). Of 46 infiltrative HCC patients with portal vein tumor thrombosis, 32 patients received adjuvant radiation therapy for portal vein tumor thrombosis after TACE. The tumor response by European Association for the Study of the Liver criteria was partial in 18%, stable in 47%, and progressive in 35% of the patients. The median survival time was 5.7 months (Kaplan-Meier analysis). The survival rates were 48% at six months, 25% at one year, and 12% at two years. In the multivariable Cox regression analysis, Child-Pugh class (p = 0.02), adjuvant radiotherapy (p 0.003) and tumor response after TACE (p = 0.004) were significant factors associated with patient survival. Major complications occurred in nine patients. The major complication rate was significantly higher in patients with Child-Pugh B than in patients with Child-Pugh A (p = 0.049, x{sup 2} test). Transcatheter arterial chemoembolization can be a safe treatment option in infiltrative HCC patients with Child Pugh class A. Child Pugh class A, radiotherapy for portal vein tumor thrombosis after TACE and tumor response are good prognostic factors for an increased survival after TACE in patients with infiltrative HCCs.

  10. Lean body mass-based levothyroxine replacement in young athyrotic patients with differentiated carcinoma of thyroid

    Directory of Open Access Journals (Sweden)

    Fatima Begum

    2013-01-01

    Full Text Available Objective: The objective of this study was to optimize dose of levothyroxine (LT4 based on lean body mass (LBM in young athyrotic patients with differentiated carcinoma of thyroid (DCT which has not been properly addressed in Bangladesh before. Materials and Methods: Sixty patients with DCT (age, range: 20-39 years having total thyroidectomy followed by radioiodine ablative therapy (RIT and 23 euthyroid volunteers were recruited. Clinical, biochemical parameters were obtained from all patients after 2 months of RIT and on LT4 replacement at a dose of 200 μg/day as first follow up visit and also from control subjects. Then 60 patients were divided into two groups consisting of 30 patients each. Patients of Group-I received LT4 replacement based on LBM measured by dual energy X-ray absorptiometry (DXA and Group-II continued LT4 replacement in conventional dose. Patients of both groups were assessed again for same parameters at 6 to 12 months at the second visit. Results: Optimized dose of LT4 based on LBM by DXA (131 ±23 μg/day significantly reduced thyroid hormones and kept thyroid stimulating hormone (TSH in expected levels in patients of Group-I at the second visit compared to patients of Group-II who continued conventional LT4 dose (200 μg/day. Hyperthyroid symptom scale (HSS was significantly reduced to 2 ± 1 in patients of Group-I but not in patients of Group-II, HSS, 8 ±1 ( P < 0.001. Conclusion: Optimization of LT4 dose based on LBM can avoid chronic exposure of mild excess of thyroid hormone in young patients with low risk DCT.

  11. Osteonecrosis in patients irradiated for head and neck carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Morrish, R.B. Jr.; Chan, E.; Silverman, S. Jr.; Meyer, J.; Fu, K.K.; Greenspan, D.

    1981-04-15

    One hundred patients irradiated for cancers of the oral cavity, oropharynx, and nasopharynx were evaluated for the occurrence of osteonecrosis and associated predisposing factors. Selection was based on availability of complete dental records, a minimum of six months follow-up, and treatment fields, which included maxilla and/or mandible. Bone doses were calculated by using radiotherapy treatment records, port films, and isodose distributions. Osteonecrosis developed in 19 of 78 dentulous patients and in 3 of 22 edentulous patients. The time of development of osteonecrosis varied; in 15 cases osteonecrosis occurred more than one year after treatment. The most important risk factor for the development of osteonecrosis was the radiation dose to bone, particularly in the less vascular mandible. Osteonecrosis developed in 85% of the dentulous patients and in 50% of the edentulous patients who received more than 7500 rads to the bone. None of the patients who received less than 6500 rads developed osteonecrosis. The risk was significantly greater when teeth were removed after therapy compared with those individuals with extractions before radiation or no extractions at all.

  12. Osteonecrosis in patients irradiated for head and neck carcinoma

    International Nuclear Information System (INIS)

    One hundred patients irradiated for cancers of the oral cavity, oropharynx, and nasopharynx were evaluated for the occurrence of osteonecrosis and associated predisposing factors. Selection was based on availability of complete dental records, a minimum of six months follow-up, and treatment fields, which included maxilla and/or mandible. Bone doses were calculated by using radiotherapy treatment records, port films, and isodose distributions. Osteonecrosis developed in 19 of 78 dentulous patients and in 3 of 22 edentulous patients. The time of development of osteonecrosis varied; in 15 cases osteonecrosis occurred more than one year after treatment. The most important risk factor for the development of osteonecrosis was the radiation dose to bone, particularly in the less vascular mandible. Osteonecrosis developed in 85% of the dentulous patients and in 50% of the edentulous patients who received more than 7500 rads to the bone. None of the patients who received less than 6500 rads developed osteonecrosis. The risk was significantly greater when teeth were removed after therapy compared with those individuals with extractions before radiation or no extractions at all

  13. Serum leptin and soluble leptin receptor (sLR) levels in patients with breast carcinoma

    International Nuclear Information System (INIS)

    Objective: To study the changes of serum leptin and soluble leptin receptor (sLR) levels in patients with breast carcinoma. Methods: Serum leptin (with RIA) and sLR (with ELISA) levels were determined in 68 patients with breast carcinoma 31 patients with benign breast disorders, and 40 controls. BMI was also examined in these subjects. Results: Serum leptin levels in the patients were significantly higher than those in the controls (P<0.01), even after correction for the BMI differences. Serum sLR levels were significantly lower than those in the controls (P<0.05), however, after correction for BMI differences, the levels in the two groups were not much different. Levels in patients with benign breast disorders were not much different from those in controls. Conclusion: Over expression of leptin was demonstrated in patients with breast carcinoma. Leptin might promote tumor growth and could be used as a tumor marker for breast carcinoma. (authors)

  14. A Review of Carcinomas Arising in the Head and Neck Region in HIV-Positive Patients

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    Bibianna Purgina

    2011-01-01

    Full Text Available The majority of malignancies arising in the head and neck among patients with AIDS are Kaposi sarcoma and non-Hodgkin lymphoma. Patients with HIV/AIDS are also at increased risk of developing several carcinomas of the head and neck. This paper focuses on these less common, albeit important, carcinomas. An English language literature search identified numerous population-based studies evaluating carcinomas in the head and neck of HIV-positive patients. Published results indicate that patients with HIV/AIDS are at an increased risk of developing mucosal squamous cell carcinoma, nasopharyngeal carcinoma, lymphoepithelial carcinoma of the salivary gland, and Merkel cell carcinoma in this anatomic region. Data also suggest that HIV-positive patients with these cancers present at a younger age, with more aggressive disease and worse prognosis compared to HIV-negative patients. Treatment involves surgical resection with or without radiation therapy and chemotherapy for locally advanced and metastatic disease. AIDS patients, however, are more likely to suffer radiation treatment complications. Highly active antiretroviral therapy (HAART has not altered the incidence of these malignancies.

  15. Efficacy and safety of thalidomide in patients with hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Hsueh-Erh Chiou; Tsang-En Wang; Ying-Yue Wang; Hui-Wen Liu

    2006-01-01

    AIM: To evaluate which patients with hepatocellular carcinoma (HCC) are most likely to respond to thalidomide treatment.METHODS: From July 2002 to July 2004, patients enrolled. We extracted relevant data from the patients' medical records, including history and type of hepatitis,comorbidity, serum α-fetoprotein (α-FP) level, volumetric changes in tumor, length of survival, and the dose,duration, side effects of thalidomide treatment. The tumor response was evaluated. On the basis of these data, the patients were divided into two groups: those with either partial response or stable disease (PR + SD group) and those with progressive disease (PD group).RESULTS: Two of 42 (5%) patients had a partial tumor response after treatment with thalidomide, 200 mg/d,and 9 (21%) had stable disease. Patients in the PR +SD group all had cirrhosis. Comparing patients with and without cirrhosis, the former were more likely to respond to thalidomide therapy (PR + SD: 100% vs PD:64.5%, P = 0.041 < 0.05). Thalidomide was significantly more likely to be effective in tumors smaller than 5 cm (PR + SD: 63.6% vs PD: 25.8%, P = 0.034 < 0.05).Compared with patients with progressive disease (PD),patients in the PR + SD group had a higher total dose of thalidomide (13669.4 ± 8446.0 mg vs 22022.7 ±11461.4 mg, P = 0.023 < 0.05) and a longer survival (181.0 ± 107.1 d vs 304.4 ± 167.1 d, P = 0.047 < 0.05).Patients with comorbid disease had a significantly greater incidence of adverse reactions than those without (93.8%vs 60.0%, P = 0.021 < 0.05). The average number of adverse reactions in each person with a comorbid condition was twice as high as in those without other diseases (2.2 ± 1.3 vs 1.1 ± 1.2; P = 0.022 < 0.05).CONCLUSION: Thalidomide therapy is most likely to be effective in patients with early stage small HCC, especially in those with other underlying diseases. A low dose (200 mg/d) of thalidomide is recommended to continue the treatment long enough to make it more

  16. Sorafenib for hepatocellular carcinoma patients beyond Milan criteria after orthotopic liver transplantation: a case control study

    Directory of Open Access Journals (Sweden)

    Teng Chieh-Lin

    2012-02-01

    Full Text Available Abstract Background Orthotopic liver transplantation (OLT is one of the most effective treatments for patients with hepatocellular carcinoma (HCC within the Milan criteria. However, for patients beyond these criteria, the recurrence rate is higher and the prognosis is worse. Sorafenib is the only drug showing survival benefits in advanced HCC patients; however, its role in patients beyond the Milan criteria after OLT remains unclear and requires further investigation. Methods As a case-control study, we retrospectively analyzed 17 Chinese patients beyond Milan criteria undergoing OLT for HCC. These patients were stratified into adjuvant (n = 5, palliative (n = 6, and control groups (n = 6. Results Nine of 11 patients who received sorafenib after OLT needed dose reduction due to more than grade 2 side effects. The disease-free survival rates for patients with or without adjuvant sorafenib were 100% versus 37.5% (p = 0.034 at 6 months, 66.7% versus 9.4% (p = 0.026 at 12 months, and 66.7% versus 0.0% (p = 0.011 at 18 months, respectively. The overall survival rates for patients in palliative and control groups were 66.7% versus 40.0% (p = 0.248 at 6 months, 66.7% versus 40.0% (p = 0.248 at 12 months, and 50.0% versus 20.0% (p = 0.17 at 18 months, respectively. Patients in the adjuvant group had better overall survival rates than those in the palliative and control groups (p = 0.031 at 24-month follow-up. Conclusions Adjuvant sorafenib could possibly extend both disease-free and overall survival for HCC patients beyond Milan criteria after OLT.

  17. Follow-up neurological evaluation in patients with small cell lung carcinoma treated with prophylactic cranial irradiation and chemotherapy

    International Nuclear Information System (INIS)

    The safety of prophylactic cranial irradiation (PCI) has recently been questioned, based on reports of computerized tomographic abnormalities mainly seen in children, who received PCI and chemotherapy, primarily for acute lymphocytic leukemia. In order to clarify the significance of these findings, we examined a series of adult patients who were long term survivors (18 to 48 months, median 26 months, after all treatment). These patients were treated with combination radiotherapy and chemotherapy for small cell lung carcinoma and received cranial irradiation in the absence of known brain involvement by tumor. Patients were divided into three groups: three patients who received PCI + intrathecal methotrexate (MTX) (Group 1), and ten who received only PCI (Group 2). An additional three patients (Group 3) were identified as long term survivors (41 to 70 months after all treatments) of a similar treatment program without any central nervous system (CNS) prophylaxis. All patients received an extensive evaluation of a variety of clinical parameters, EEG, and computer tomography (CT). Although CT abnormalities were detectable (mild cerebral atrophy in eight patients, encephalomalacia in one of the 13 patients with CNS prophylaxis, and mild atrophy in two of the three patients without CNS prophylaxis), no significant clinical abnormalities or EEG changes were detectable. While this group of patients is small, it is a unique cohort: adults who have received cranial irradiation in the absence of known brain tumor with long term follow-up. The precise role of CNS prophylaxis in the etiology of CT abnormalities is unclear, and the lack of clinically significant changes would suggest no contraindication to PCI when indicated

  18. A review on quality of life in keratinocyte carcinoma patients.

    Science.gov (United States)

    Waalboer-Spuij, R; Nijsten, T E C

    2013-06-01

    Health-related quality of life issues in patients with cutaneous malignancies is being re-explored. This is motivated by the heavy burden they put on dermatological care, it is more and more considered a chronic disease and new non-invasive therapies are being introduced. The purpose of this review is to identify the relevant quality of life (QOL) issues and to summarize the instruments used for investigating QOL in keratinocyte carcinoma patients. With a systematic literature search in Embase, MEDLINE OvidSP, PubMed publisher and Cochrane Central, 10 questionnaires and 4 studies reporting on quality of life issues were identified. Generic (UK Sickness Impact profile [UKSIP], Short Form 36-item Health Survey [SF-36], Functional Assessment of Cancer Therapy-General [FACT-G]) and dermatology specific (Dermatology Life Quality Index [DLQI] and Skindex-29, -16, -17) instruments demonstrated little to no QOL impairment. This may be explained by failing to capture the relevant domains such as "emotions", "appearance" and "anxiety". Skin cancer specific questionnaires (Skin Cancer Index [SCI], Skin Cancer Quality of Life Impact Tool [SCQOLIT] and Actinic Keratosis Quality of Life [AKQoL]) demonstrated good validity and responsiveness and represent the effect on QOL properly. However, there are some points of critique to these questionnaires. Optimal management of patients with actinic neoplasia syndrome and the selection and evaluation of therapies may benefit from the use of PROs in this ever increasing population. PMID:23670061

  19. Liver transplantation for patients with hepatocellular carcinoma at the Liver Cancer Institute of Fudan University, China

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian; HE Yi-feng; YANG Guo-huan; SONG Kang; YUAN Zhou; WANG Yu-qi; TANG Zhao-you; FAN Jia; WU Zhi-quan; QIU Shuang-jian; HUANG Xiao-wu; YU Yao; WANG Zheng; SUN Jian; XIAO Yong-sheng

    2005-01-01

    Background Selection of patients with hepatocellular carcinoma (HCC) for orthotopic liver transplantation (OLT) remains controversial. Since there is a trend to expand the transplant criteria for HCC patients, we reviewed the data of patients with HCC who had received OLT at our institute to determine their survival and prognostic factors.Methods A total of 67 patients with HCC who had undergone OLT from April 2001 through December 2003 were reviewed retrospectively. Selection OLT candidates with HCC was dependent on the anatomical characteristics and/or the severity of underlying liver cirrhosis. The 67 patients were followed up for more than 6 months after transplantation. Their survival rate was calculated by the Kaplan-Meier method. Univariate and multivariate analyses using the Cox proportional hazards regression model were performed to reveal the factors affecting the survival rate.Results No perioperative death occurred in this series. The 1- and 2-year cumulative survival rates were 90.0% and 65.6%, and the disease-free survival (DFS) rates were 77.5% and 62.5% respectively. Univariate analysis revealed the tumor size, portal vein tumor thrombus (PVTT), serum alpha-fetoprotein level, bilobular distribution of tumors, pTNM stage and histological differentiation were statistically significant factors affecting the DFS (P<0.05). Multivariate analysis showed tumor size and PVTT were independent and statistically significant factors affecting the DFS (P=0.005 and 0.010, respectively). In this series, all but 2 received systemic chemotherapy, among them 13 had tumor recurrence within 8 months after OLT.Conclusions OLT is indicated for patients with HCC, even for some patients with end-stage liver disease who may survive longer without tumor recurrence. Adjuvant chemotherapy may decrease the recurrence of HCC after OLT.

  20. Target volume and position variations during intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma

    Directory of Open Access Journals (Sweden)

    Tan W

    2013-11-01

    Full Text Available Wenyong Tan,* Yanping Li,* Guang Han, Jiaozhen Xu, Xiaohong Wang, Ying Li, Desheng HuDepartment of Radiation Oncology, Hubei Cancer Hospital, Wuhan, People's Republic of China*These authors contributed equally to this workPurpose: Considerable anatomical changes occur during intensity-modulated radiotherapy (IMRT for nasopharyngeal carcinoma (NPC. This study aimed to quantify volumetric and positional variations of the target volume during IMRT.Materials and methods: Twenty patients with locally advanced NPC who received concurrent (13 patients or sequential (seven patients chemoradiotherapy were prospectively recruited and underwent planning computed tomography (CT and six repeat CTs (every five fractions. Each repeat CT was rigidly registered to the planning CT. Gross tumor volume (GTV and elective clinical target volume (CTV were manually delineated on each axial CT image. CTVs of the primary tumor and lymph nodes were expanded with 5 mm margins to corresponding GTVs, with necessary modifications. Volume loss, system and random errors, and the mean and three-dimensional vector displacements were calculated and compared statistically.Results: Volumes of the primary tumor and small (>1 cm, ≤3 cm and large (>3 cm positive neck lymph nodes decreased at a rate of 2.6%, 3.7%, and 3.9% per treatment day, respectively. CTVs of the primary tumor, lymph nodes, and elective region decreased 1.5%, 2.3%, and 0.3% per treatment day, respectively. Average displacements of the GTVs and CTVs were <1.3 mm in all directions. GTVs and CTVs of the large and small lymph nodes shifted medially by 0.8–1.3 and 0.6–1.2 mm, respectively, on average. Average three-dimensional displacements of the GTVs and CTVs were 3.4–4.3 mm and 2.5–3.7 mm, respectively. Volume loss and displacements in most directions were significantly larger in patients receiving concurrent chemoradiotherapy than in those receiving sequential therapy. Volume loss and displacements of the

  1. Effects of Lipid Emulsions in Parenteral Nutrition of Esophageal Cancer Surgical Patients Receiving Enteral Nutrition: A Comparative Analysis

    Directory of Open Access Journals (Sweden)

    Wu-Ping Wang

    2013-12-01

    Full Text Available Background: Olive oil-based lipid emulsion (LE and medium chain triglyceride/long chain triglyceride (MCT/LCT emulsion are both LEs with low ω-6 polyunsaturated fat acids (PUFAs content. However, which one of these LEs is associated with a lower infection risk in patients receiving parenteral nutrition (PN remains unclear. The aim of the study was to compare the effects of the two LEs in PN in esophageal cancer patients undergoing surgery. Methods: Patients with resectable esophageal carcinoma were recruited and allocated randomly to two groups. The test group was given enteral nutrition (EN with PN containing olive oil-based LE after tumor resection for ≥7 days, and the patients in the control group were supported by EN with MCT/LCT emulsion-based PN after surgery for the same time period. Immunological markers and inflammatory indicators were tested and perioperative clinical outcomes were determined. The trial was registered in the Chinese Clinical Trial Register, number ChiCTR-TRC-13003562. 94 Patients were recruited, and grouped (olive oil-based LE, n = 46 and MCT/LCT, n = 48, matched for sex, age, body mass index, histological type, TNM stage, and nutrition risk screening (NRS 2002 score. Results: There were no differences in perioperative fever (>38 °C, infectious complications, length of hospital stay (>14 days, length of critical care stay (>2 days, time for oral food intake, and in-hospital mortality between the two groups. The test group showed a higher increase in IgG level compared with the MCT/LCT group (p = 0.028. There was no difference in other immunological markers and inflammatory indicators between the two groups. Conclusion: PN containing olive oil-based or MCT/LCT LEs had similar effects on perioperative outcome, cell-mediated immune function and inflammatory response in esophageal cancer patients who had undergone surgery and were receiving EN.

  2. Osteonecrosis in patients irradiated for head and neck carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Morrish, R.B. Jr.; Chan, E.; Silverman, S. Jr.; Meyer, J.; Fu, K.K.; Greenspan, D.

    1981-04-15

    One hundred patients irradiated for cancers of the oral cavity, oropharynx, and nasopharynx were evaluated for the occurrence of osteonecrosis and associated predisposing factors. Selection was based on availability of complete dental records, a minimum of six months follow-up, and treatment fields, which included maxilla and/or mandible. Bone doses were calculated by using radiotherapy treatment records, port films, and isodose distributions. Osteonecrosis developed in 19 of 78 dentulous patients and in 3 of 22 edentulous patients. The time of development of osteonecrosis varied; in 15 cases osteonecrosis occurred more than one year after treatment. The most important risk factor for the development of osteonecrosis was the radiation dose to bone, particularly in the less vascular mandible. Osteonecrosis 7500 rads to the bone. None of the patients who received less than 6500 rads developed osteonecrosis. The risk was significantly greater when teeth were removed after therapy compared with those individuals with extractions before radiation or no extractions at all.

  3. Osteonecrosis in patients irradiated for head and neck carcinoma

    International Nuclear Information System (INIS)

    One hundred patients irradiated for cancers of the oral cavity, oropharynx, and nasopharynx were evaluated for the occurrence of osteonecrosis and associated predisposing factors. Selection was based on availability of complete dental records, a minimum of six months follow-up, and treatment fields, which included maxilla and/or mandible. Bone doses were calculated by using radiotherapy treatment records, port films, and isodose distributions. Osteonecrosis developed in 19 of 78 dentulous patients and in 3 of 22 edentulous patients. The time of development of osteonecrosis varied; in 15 cases osteonecrosis occurred more than one year after treatment. The most important risk factor for the development of osteonecrosis was the radiation dose to bone, particularly in the less vascular mandible. Osteonecrosis 7500 rads to the bone. None of the patients who received less than 6500 rads developed osteonecrosis. The risk was significantly greater when teeth were removed after therapy compared with those individuals with extractions before radiation or no extractions at all

  4. Once-daily reirradiation for rectal cancer in patients who have received previous pelvic radiotherapy

    International Nuclear Information System (INIS)

    The purpose of this study is to assess the efficacy and toxicity using once-daily reirradiation for patients with rectal cancer having received previous pelvic radiotherapy. Between June 1997 and June 2008, 56 patients were identified having received previous pelvic radiotherapy and received reirradiation for rectal cancer. Reirradiation intent was palliative in 43 patients, and preoperative/postoperative in 13 patients. Eighty per cent of patients received concurrent chemotherapy (n=45). The median dose-fractionation reirradiation schedule was 39.6Gy in 22 fractions once daily (range 20–39.6Gy), and the median cumulative radiation dose was 87.3Gy. Seven patients experienced a grade 3 acute toxicity, with no grade 4 event. Fifty-one patients (91%) completed the treatment and five patients required a treatment break. The overall symptomatic response rate was 88% at three months post-reirradiation. There was one late effect of skin ulceration among patients reirradiated palliatively. Median overall survival was 39 months in patients undergoing radical surgery versus 15 months in patients reirradiated palliatively (P<0.001). Once-daily reirradiation to a total dose of ≤39.6Gy is relatively safe in the treatment of patients with rectal cancer after previous pelvic radiotherapy. It is effective in symptom control and provides an additional option in management of local recurrence.

  5. The Glasgow Prognostic Score, an inflammation based prognostic score, predicts survival in patients with hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Elevated Glasgow Prognostic Score (GPS) has been related to poor prognosis in patients with hepatocellular carcinoma (HCC) undergoing surgical resection or receiving sorafenib. The aim of this study was to investigate the prognostic value of GPS in patients with various stages of the disease and with different liver functional status. One hundred and fifty patients with newly diagnosed HCC were prospectively evaluated. Patients were divided according to their GPS scores. Univariate and multivariate analyses were performed to identify clinicopathological variables associated with overall survival; the identified variables were then compared with those of other validated staging systems. Elevated GPS were associated with increased asparate aminotransferase (P<0.0001), total bilirubin (P<0.0001), decreased albumin (P<0.0001), α-fetoprotein (P=0.008), larger tumor diameter (P=0.003), tumor number (P=0.041), vascular invasion (P=0.0002), extra hepatic metastasis (P=0.02), higher Child-Pugh scores (P<0.0001), and higher Cancer Liver Italian Program scores (P<0.0001). On multivariate analysis, the elevated GPS was independently associated with worse overall survival. Our results demonstrate that the GPS can serve as an independent marker of poor prognosis in patients with HCC in various stages of disease and different liver functional status

  6. Review of patients treated by carcinoma INCA basal in the last 5 years

    International Nuclear Information System (INIS)

    Full text: Objective: To evaluate the results based on the different stages with different options therapeutic and evaluate the final dose in radiotherapy for the management of these patients. Methodology: We conducted a retrospective analysis of 66 patients treated HC Basal cell carcinoma between the period from January 1, 2007 and June 30, 2011. Results: For stages T1 and T2 treated with surgery alone, was quantified one relative frequency (fr)of SVLE 0.81 (31/39). For RT -treated patients, there were no in the sample for T1 and T2 was quantified one fr. SVLE of 1 (3/3) at doses > 60 Gy. For those with positive margins who received postoperative adjuvant RT quantified one fr. SVLE of 1 (8 /8) For patients with T3 disease surgery was performed more average dose radiotherapy 54.2 Gy. obtaining a fr. SVLE 0.5 (2/ 4). In patients with T4 disease with surgery more RT (2) non-responders complete. The dose delivered was in the range of 50 to 60 Gy. The other two did not complete treatment. Conclusions: For the early stages results are comparable both in surgery RT as exclusive. For those operated with positive margins benefit from radiation treatment adjuvant with a minimum dose of 60 Gy. In the later stages there is a benefit in most radiotherapy combination of surgery, dose can be delivered mayores.REVISIÓ

  7. Radiotherapy in treatment of carcinoma of the parotid gland, an approach for the medically or technically inoperable patient

    International Nuclear Information System (INIS)

    Full text: Initial surgical resection is considered the standard of care for patients diagnosed with tumours involving the salivary glands. We reviewed our institutional outcomes of patients treated with initial radiation therapy (RT) for diagnosed carcinoma of the parotid gland. Methods: This review examined seventeen patients that received RT as initial therapy for tumours involving the parotid gland. Fifteen patients had primary salivary gland cancer, and two patients had metastatic carcinoma to the parotid gland. Sixteen patients (94.1%) following surgical evaluation had operative risk of facial nerve impairment or sacrifice with initial surgery, four (23.5%) had clinical objective evidence of nerve involvement at evaluation, five (29.4%) were poor surgical candidates and three (17.6%) refused initial surgery. Primary tumour stages ranged T2-T4b, and disease stages ranged II-IVb. RT median dose was 70 Gy, and median follow-up was 12 months. Results: Eleven patients (64.7%) achieved a clinical complete response (CR) to therapy. Of these CR patients eight (72.7%) received definitive RT and three (27.3%) underwent surgery following RT. Two surgical patients avoided facial nerve impairment while one required nerve sacrifice. The other six patients (35.3%) achieved an unfavourable response to RT and had unresectable or metastatic disease at follow-up. No long-term complications were reported. Conclusion: Initial radiation therapy for tumours involving the parotid gland is effective to achieve clinical CR, eliminate surgical resection for many patients, and decrease risk of facial nerve impairment or sacrifice for those patients requiring surgery following RT.

  8. Factors Associated with Outcomes and Response to Therapy in Patients with Infiltrative Hepatocellular Carcinoma

    Science.gov (United States)

    Mehta, Neil; Fidelman, Nicholas; Sarkar, Monika; Yao, Francis Y.

    2014-01-01

    Background & Aims Infiltrative hepatocellular carcinoma (iHCC) is characterized by its indistinct borders and lack of a typical pattern of contrast enhancement. There are few published data on iHCC. We assessed outcomes, effects of treatment, and prognostic factors in a large cohort of patients with iHCC. Methods We analyzed data from 155 patients (median age 60 years; 79% male; median level of α-fetoprotein [AFP] 347 ng/mL; median model for end-stage liver disease score [MELD] 13) with iHCC, based on contrast-enhanced computed tomography or magnetic resonance imaging, from 2002 to 2010 at the University of California, San Francisco Medical Center. All imaging study results were independently reviewed by 2 investigators. Results Most of the patients had tumors of Barcelona Clinic Liver Cancer stage C (70%) or D (22%). The median maximum tumor diameter was 11.3 cm; 41% of lesions were hypovascular, 82% had macrovascular invasion, and 52% had extra-hepatic metastases. Median survival was 4.0 months, and rates of survival at 6 and 12 months were 30% and 10%, respectively. On multivariate analysis, predictors of 6-month mortality were Child-Pugh class B or C cirrhosis; lack of tumor-directed therapy with chemoembolization (TACE), radiofrequency ablation, or sorafenib; AFP level >1000 ng/mL; female sex; MELD score; and maximum tumor diameter. The percentages of patients surviving 6 and 12 months were 17% and 2% for those that received no therapy (n=109), 73% and 36% for those that received sorafenib (n=11), and 45% and 17% for those that that received TACE (n=18) (all P values TACE or sorafenib appears to prolong survival and requires further investigation. PMID:23333661

  9. Carcinoma of the breast wire localisation post nuclear medicine sentinel lymph node imaging. Are radiologists receiving a significant dose?

    Energy Technology Data Exchange (ETDEWEB)

    Meades, R.T.; Frank, J.W.; Gada, V.; Ralleigh, G.; Satchithananda, K.; Barrett, N.; Nijran, K.S. [Imperial College Healthcare NHS Trust, London (United Kingdom); Svensson, W.E. [Imperial College Healthcare NHS Trust, London (United Kingdom); Charing Cross Hospital, Department of Nuclear Medicine, London (United Kingdom)

    2010-03-15

    To assess the radiation dose received by the radiologist when performing wire localisation for axillary radio-isotope sentinel node imaging-guided biopsy in patients with impalpable breast cancers treated with breast-preserving excision. When wire placement follows radio-isotope sentinel node imaging (RSNI) the radiologist is exposed to a radiation risk that has never been previously assessed. Radiation doses to radiologists performing ultrasound-guided localisation following nuclear medicine sentinel node imaging were measured for procedures on the day of surgery (20 MBq) and also on the day before surgery (40 MBq). These measurements were compared with theoretically calculated doses. Twelve patients showed comparable results between measurements and estimated doses. The mean measured dose was 1.8{mu}Sv (estimated 1.8{mu}Sv) for same-day and 4.8{mu}Sv (estimated 3.4{mu}Sv) for next-day surgery cases. At worst, radiologists who perform 36 wire localisations per year immediately following RSNI receive a radiation dose of 0.17 mSv. This study highlights the need to inform radiologists of the relative risk when performing pre-surgical localisation after RSNI. This risk should be justified locally in accordance with the total dose received by the localising radiologist. Particular consideration should be given to pregnant staff and the possibility of performing wire localisations before radio-isotope injection. (orig.)

  10. Evaluating the effect of zingiber officinalis on nausea and vomiting in patients receiving Cisplatin based regimens.

    Science.gov (United States)

    Fahimi, Fanak; Khodadad, Kian; Amini, Somayeh; Naghibi, Farzaneh; Salamzadeh, Jamshid; Baniasadi, Shadi

    2011-01-01

    Ginger, the rhizome of Zingiber officinalis, has long been used as herbal medicine for its antiemetic effect. For evaluating the effect of zingiber officinalis on nausea and vomiting (N and V) in patients receiving cisplatin based regimens, a randomized double-blind placebo-controlled cross-over clinical trial was carried out in patients receiving cisplatin in combination with other chemotherapeutic agents. The patients were randomly assigned to receive ginger capsules (rhizome of zingiber officinalis) or placebo in their first cycle of the study. All patients received standard antiemetics for chemotherapy induced nausea and vomiting (CINV). The patients were crossed-over to receive ginger or placebo in their next cycle of chemotherapy. Among 36 eligible patients who received both cycles of treatment, there were no difference in prevalence, severity, and duration of both acute and delayed N and V. Addition of ginger to the standard antiemetic regimen has shown no advantage in reducing acute and delayed N and V in patients with cisplatin-based regimen in this study. PMID:24250368

  11. Oral cavity squamous cell carcinoma in 260 patients aged 80 years or more

    International Nuclear Information System (INIS)

    Purpose: We report the experience of two French cancer centers in the treatment of oral cavity squamous cell carcinoma (SCC) in patients aged ≥80 years. Materials and methods: Two hundred and sixty patients aged ≥80 years with a primary oral cavity SCC were included in this retrospective analysis. Results: Sex ratio was near to 1. Tobacco or alcohol intoxication was the main risk factor for 66% of men and 16% of women and leukoplakia, lichen planus, or oral traumatism for 55% of women and 11% of men (p < 0.0001). Two hundred patients received a loco-regional (LR) treatment with a curative intent (surgery and/or radiotherapy), 29 with a palliative intent and 31 did not receive a LR treatment. Curative treatments were initially planned to be adapted to age in 118 patients (59%). The median disease-specific survival (DSS) was 29 months. In multivariate analysis, the independent prognostic factors for DSS were stage (HR = 0.42 [0.24-0.72]), age (HR = 0.43 [0.24-0.75]) and performance status (HR = 0.50 [0.27-0.95]). The median overall survival (OS) was 14 months. In multivariate analysis, the independent prognostic factors for OS were age (HR = 0.52 [0.35-0.79]), stage (HR = 0.56 [0.38-0.84]), tumor differentiation (HR = 0.60 [0.33-0.93]) and performance status (HR = 0.6 [0.37-0.97]). In patients treated with a curative intent, treatment adapted to age was not associated with a decreased overall survival or disease-specific survival as compared with the standard treatment. However, prophylactic lymph node treatment in stages I-II tumors decreased the rate of nodal recurrence from 38% to 6% (p = 0.01). Conclusion: This study emphasizes the need for prospective evaluation of standard and adapted schedules in elderly patients with oral cavity cancer.

  12. Multiple skin cancers in a single patient: Multiple pigmented Bowen′s disease, giant basal cell carcinoma, squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Ravi Saini

    2015-01-01

    Full Text Available Basal cell carcinoma (BCC and squamous cell carcinoma are the most common type of nonmelanoma skin cancers (NMSCs. Bowen′s disease (BD, a premalignant condition, has a marginal potential (3-5% to progress to invasive carcinoma. We report here a rarest of a rare case of multiple pigmented BD with overlying squamous cell cancer along with a giant neglected BCC on the scalp of a 76-year-old man. The occurrence of multiple BD and NMSC in a single patient compelled us to explore the following hypothesis: (1 The multiple precancerous and cancerous lesions can be due to common etiopathogenesis. Chronic ultraviolet exposure, immunosupresssion, human papillomavirus infection, dietary factors, and environmental factors including arsenic exposure were probed in to. (2 There is evolution of precancerous lesions into a different type of cancers in different time frame. (3 The new cancerous lesions are subsequent cancers that developed after neglected untreated primary cancer.

  13. Prevention of hepatocellular carcinoma in patients with chronic hepatitis B

    Institute of Scientific and Technical Information of China (English)

    Conrado; M; Fernández-Rodríguez; María; Luisa; Gutiérrez-García

    2014-01-01

    Patients with chronic hepatitis B are at significant risk for hepatocellular carcinoma(HCC). Globally,over half a million people each year are diagnosed with HCC,with marked geographical variations. Despite overwhelming evidence for a causal role of hepatitis B virus(HBV) infection in the development of HCC and a well-established relationship between high baseline hepatitis B viral load and cumulative risk of HCC,the molecular basis for this association has not been fully elucidated. In addition,a beneficial role for antiviral therapy in preventing the development of HCC has been difficult to establish. This review examines the biological and molecular mechanisms of HBV-related hepatocarcinogenesis,recent results on the effect of modern nucleos(t)ides on the rate of HCC development in high risk HBV cohorts and the potential mechanisms by which long-term antiviral therapy with potent inhibitors of HBV replication might reduce the risk of HCC in patients with chronic hepatitis B. Although evidence from randomized controlled trials shows the favourable effects of antiviral agentsin achieving profound and durable suppression of HBV DNA levels while improving liver function and histology,robust evidence of other long-term clinical outcomes,such as prevention of HCC,are limited.

  14. Three cases of presumed pneumocystis pneumonia in patients receiving bortezomib therapy for multiple myeloma

    Directory of Open Access Journals (Sweden)

    Christopher D. Swan

    2014-01-01

    Conclusion: 26S proteosome inhibitor therapy for multiple myeloma may be a risk factor for PCP and clinicians should adopt a high level of suspicion for PCP in patients receiving these medications until conclusive evidence is obtained.

  15. Serum Voriconazole Level Variability in Patients with Hematological Malignancies Receiving Voriconazole Therapy

    Directory of Open Access Journals (Sweden)

    Lalit Saini

    2014-01-01

    Full Text Available INTRODUCTION: Voriconazole plasma concentrations have been correlated with oral dosing in healthy subjects, but have been poorly characterized in ill patients with hematological malignancies receiving intensive chemotherapy.

  16. Complete pathologic response to pretransplant locoregional therapy for hepatocellular carcinoma defines cancer cure after liver transplantation: Analysis of 501 consecutively treated patients

    OpenAIRE

    Agopian, VG; Morshedi, MM; McWilliams, J.; Harlander-Locke, MP; Markovic, D.; Zarrinpar, A; Kaldas, FM; Farmer, DG; Yersiz, H; Hiatt, JR; Busuttil, RW

    2015-01-01

    Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. Objectives: To evaluate the rate, effect, and predictive factors of a complete pathologic response (cPR) in patients with hepatocellular carcinoma (HCC) undergoing locoregional therapy (LRT) before liver transplantation (LT). Background: Eligible patients with HCC receive equal model for end-stage liver disease prioritization, despite variable risks of tumor progression, waitlist dropout, and posttransplant recurrence. Pretrans...

  17. Expression level of augmenter of liver regeneration in patients with hepatic failure and hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Hai-YingYu; Dai-RongXiang; Hai-JunHuang; JunLi; Ji-FangSheng

    2010-01-01

    BACKGROUND: Augmenter of liver regeneration (ALR) is an important polypeptide in the process of liver regeneration. This study aimed to determine the expression level of ALR in different liver diseases and its significance. METHODS: We prepared murine polyclonal antibody against ALR protein from Balb/C mice and purified the IgG fraction, which specifically combined to ALR protein as shown by Western blotting. Serum ALR levels in patients with hepatocellular carcinoma (HCC), hepatic failure (HF), chronic hepatitis B, and healthy persons were compared by ELISA. ALR mRNA expression levels in liver tissues in some of these patients were also compared by real-time RT-PCR. Immunohistochemical analysis was carried out on HF and HCC liver tissues. RESULTS: Different serum ALR levels foreshowed completely different prognoses in 18 HF patients. Higher ALR levels were noted in 6 improved patients (1613.5±369.6 pmol/ml) than in 12 deteriorating patients (462.3±235.8 pmol/ml). Similar levels were found in 20 HCC patients (917.9±332. 7 pmol/ml), 24 chronic hepatitis B patients (969.2±332.5 pmol/ml) and 10 healthy persons (806.9±240.8 pmol/ml). ALR mRNA levels in HCC liver tissues [10E6.24 (1.74×106) copies/μl] were much higher than in those of HF patients receiving orthotopic liver transplantation [10E3.45 (2.82×103)copies/μl] or in healthy liver tissues [10E4.31 (2.04×104) copies/μl]. In immunohistochemical analysis, positive immunostaining in HCC liver tissue was more intense than that in HF liver tissue. CONCLUSION: Serum ALR level is helpful in estimating the survival time of patients with HF, and ALR may play an important role in hepatocarcinogenesis.

  18. Gamma-knife radiosurgery for brain metastasis of renal cell carcinoma. Results in 42 patients

    International Nuclear Information System (INIS)

    The present study provides data from clinical experience with gamma-knife radiosurgery (GK) in patients with brain metastasis from renal cell carcinoma (RCC) and shows the value of this less invasive treatment modality. Forty-two patients received GK. Twenty of the 42 cases had multiple brain metastases. Extracranial metastases were observed in the lung (38 cases), bone (12 cases), liver (9 cases), lymph node (5 cases) and skin (6 cases). Neurological symptoms seen in 40 patients were rapidly improved after GK in 32 patients (80%). Magnetic resonance imaging (MRI) evaluation after GK in 32 patients showed the disappearance of brain tumor in 9 patients (28%). Complete response was obtained by GK in tumors up to 30 mm in diameter. Repeated GK for newly developed lesions was conducted in 11 patients. Extracranial tumor resection was conducted in 7 cases (lung: 3, skin: 2, liver: 1, adrenal: 1). Chemoradiotherapy or immunotherapy was effective in 8 cases (lung: 5, liver: 2, bone: 1). The actual one-, two- and three-year survival rates were 44.9%, 16.8%, and 11.2%, respectively. The median survival time was 12.5 months. In univariate analysis, the patients with successfully treated extracranial metastases had significantly better prognosis. In multivariate analysis, the patients with Karnofsky performance scale (KPS)≥80%, who were treated by GK more than once and obtained complete response (CR) or partial response (PR) by GK, had significantly better prognosis. Gamma-knife radiosurgery for RCC is an effective non-invasive modality of treatment. It offers a high local control rate and an improved quality of life and survival rate. (author)

  19. What effects performance status of patients with hepatocellular carcinoma: stage of tumor versus underlying liver status

    International Nuclear Information System (INIS)

    Objective: To identify variables associated with poor performance status of hepatocellular carcinoma (HCC) patients and to compare impact of stage of liver disease and that of hepatoma on functional status of patient. Patients and Methods: We included 254 confirmed cases of liver cancer in a crosssectional analytical study carried out at Doctors Hospital Lahore. Patient's clinical, biochemical and radiological variables were correlated with Karnofsky's performance status (KPS) using pearson correlation. Model for End stage Liver Disease (MELD) and Cancer of Liver Italian Program (CLIP) were evaluated for predicting performance status using Receiver Operating Characteristic (ROC) curve. Results: Mean age of patients was 56.69 (±10.34) and male to female ratio was 2.47: 1 (181/73). On KPS evaluation 84 (33.1%) patients scored between 80-100, 147 (57.9%) had score of 50-70 while in 23 (9.1%) KPS score was between 0-40. Variables associated with poor performance status were bilirubin> 3mg/dl (p value 0.00), albumin< 2.5 g/dl (p value 0.00), creatinine > 1.2mg/dl (p 0.00), prothrombin time> 16seconds (p value 0.00), size of tumor >7cm (p value 0.02), tumor involving > 50% of liver mass (p value 0.00) and vascular invasion (p value 0.00). Both stage of liver disease as determined by MELD and stage of liver cancer as per CLIP scores had strong correlation (p value 0.00) with poor performance status of patient. Area under ROC curve was 0.764 for MELD score and 0.785 for CLIP score. Conclusion: Performance status of liver cancer patients is affected by both stage of liver disease and that of liver tumor. Patients with MELD score above 16 and CLIP score above 4 have poor performance status. (author)

  20. Predictive factors for gastroduodenal toxicity based on endoscopy following radiotherapy in patients with hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Purpose: The aim of this work was to determine predictive factors for gastroduodenal (GD) toxicity in hepatocellular carcinoma (HCC) patients who were treated with radiotherapy (RT). Patients and methods: A total of 90 HCC patients who underwent esophagogastroduodenoscopy (EGD) before and after RT were enrolled. RT was delivered as 30-50 Gy (median 37.5 Gy) in 2-5 Gy (median 3.5 Gy) per fraction. All endoscopic findings were reviewed and GD toxicities related to RT were graded by the Common Toxicity Criteria for Adverse Events, version 3.0. The predictive factors for the ≥ grade 2 GD toxicity were investigated. Results: Endoscopic findings showed erosive gastritis in 14 patients (16 %), gastric ulcers in 8 patients (9 %), erosive duodenitis in 15 patients (17 %), and duodenal ulcers in 14 patients (16 %). Grade 2 toxicity developed in 19 patients (21 %) and grade 3 toxicity developed in 8 patients (9 %). V25 for stomach and V35 for duodenum (volume receiving a RT dose of more than x Gy) were the most predictive factors for ≥ grade 2 toxicity. The gastric toxicity rate at 6 months was 2.9 % for V25 ≤ 6.3 % and 57.1 % for V25 > 6.3 %. The duodenal toxicity rate at 6 months was 9.4 % for V35 > 5.4 % and 45.9 % for V35 > 5.4 %. By multivariate analysis including the clinical factors, V25 for stomach and V35 for duodenum were the significant factors. Conclusion: EGD revealed that GD toxicity is common following RT for HCC. V25 for the stomach and V35 for the duodenum were the significant factors to predict ≥ grade 2 GD toxicity. (orig.)

  1. Predictive factors for gastroduodenal toxicity based on endoscopy following radiotherapy in patients with hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, H. [Sungkyunkwan Univ., Seoul (Korea, Republic of). Dept. of Health Sciences and Technology; Oh, D.; Park, H.C.; Han, Y.; Lim, D.H. [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of). Dept. of Radiation Oncology; Kang, S.W. [Korea Univ., Seoul (Korea, Republic of). Dept. of Radiologic Science; Paik, S.W. [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of). Dept. of Medicine

    2013-07-15

    Purpose: The aim of this work was to determine predictive factors for gastroduodenal (GD) toxicity in hepatocellular carcinoma (HCC) patients who were treated with radiotherapy (RT). Patients and methods: A total of 90 HCC patients who underwent esophagogastroduodenoscopy (EGD) before and after RT were enrolled. RT was delivered as 30-50 Gy (median 37.5 Gy) in 2-5 Gy (median 3.5 Gy) per fraction. All endoscopic findings were reviewed and GD toxicities related to RT were graded by the Common Toxicity Criteria for Adverse Events, version 3.0. The predictive factors for the {>=} grade 2 GD toxicity were investigated. Results: Endoscopic findings showed erosive gastritis in 14 patients (16 %), gastric ulcers in 8 patients (9 %), erosive duodenitis in 15 patients (17 %), and duodenal ulcers in 14 patients (16 %). Grade 2 toxicity developed in 19 patients (21 %) and grade 3 toxicity developed in 8 patients (9 %). V{sub 25} for stomach and V{sub 35} for duodenum (volume receiving a RT dose of more than x Gy) were the most predictive factors for {>=} grade 2 toxicity. The gastric toxicity rate at 6 months was 2.9 % for V{sub 25} {<=} 6.3 % and 57.1 % for V{sub 25} > 6.3 %. The duodenal toxicity rate at 6 months was 9.4 % for V{sub 35} > 5.4 % and 45.9 % for V{sub 35} > 5.4 %. By multivariate analysis including the clinical factors, V{sub 25} for stomach and V{sub 35} for duodenum were the significant factors. Conclusion: EGD revealed that GD toxicity is common following RT for HCC. V{sub 25} for the stomach and V{sub 35} for the duodenum were the significant factors to predict {>=} grade 2 GD toxicity. (orig.)

  2. Gastroduodenal Complications After Concurrent Chemoradiation Therapy in Patients With Hepatocellular Carcinoma: Endoscopic Findings and Risk Factors

    International Nuclear Information System (INIS)

    Purpose: Concurrent chemoradiation therapy (CCRT) is useful in advanced hepatocellular carcinoma (HCC), but little is known about radiation-induced gastroduodenal complications following therapy. To determine risk factors, we investigated the prevalence and patterns of gastroduodenal complications following CCRT using endoscopy. Methods and Materials: Enrolled in the study were 123 patients treated with CCRT for unresectable HCC between January 1998 and December 2005. Radiation-induced gastroduodenal complications were defined as radiation gastritis/duodenitis, radiation gastric/duodenal ulcer, or other gastroduodenal toxicity associated with radiation, based on Common Terminology Criteria for Adverse Events (CTCAE 3.0). Serious gastroduodenal complications were defined as events occurring within 12 months from completion of CCRT, those requiring prompt therapeutic intervention, or symptoms equivalent to Grade 3 or 4 radiation-related gastroduodenal toxicity, including nausea or vomiting, based on CTCAE 3.0. Results: A month after completion of CCRT, 65 (52.8%) patients displayed endoscopic evidence of radiation-induced gastroduodenal complications. Radiation gastric and duodenal ulcers were found in 32 (26.0%) and 20 (16.3%) patients, respectively; radiation gastritis and duodenitis were found in 50 (40.7%) and 42 (34.1%) patients, respectively. Radiation-related bleeding was observed in 13 patients (10.6%). Serious gastroduodenal complications occurred in 18 patients (14.6%) and were significantly more frequent in patients with liver cirrhosis than in those without cirrhosis (p = 0.043). There were no radiation-related deaths. Conclusions: Endoscopically detectable radiation-induced gastroduodenal complications were common in HCC following CCRT. Although serious complications were uncommon, the frequency was higher in patients with liver cirrhosis; thus, these patients should be closely monitored when receiving CCRT.

  3. Gastroduodenal Complications After Concurrent Chemoradiation Therapy in Patients With Hepatocellular Carcinoma: Endoscopic Findings and Risk Factors

    Energy Technology Data Exchange (ETDEWEB)

    Chon, Young Eun [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Seong, Jinsil [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Beom Kyung [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Cha, Jihye [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Seung Up; Park, Jun Yong; Ahn, Sang Hoon; Han, Kwang-Hyub; Chon, Chae Yoon [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Gastroenterology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Liver Cirrhosis Clinical Research Center, Seoul (Korea, Republic of); Shin, Sung Kwan, E-mail: kaarma@yuhs.ac [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Gastroenterology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Do Young, E-mail: dyk1025@yuhs.ac [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Gastroenterology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Liver Cirrhosis Clinical Research Center, Seoul (Korea, Republic of)

    2011-12-01

    Purpose: Concurrent chemoradiation therapy (CCRT) is useful in advanced hepatocellular carcinoma (HCC), but little is known about radiation-induced gastroduodenal complications following therapy. To determine risk factors, we investigated the prevalence and patterns of gastroduodenal complications following CCRT using endoscopy. Methods and Materials: Enrolled in the study were 123 patients treated with CCRT for unresectable HCC between January 1998 and December 2005. Radiation-induced gastroduodenal complications were defined as radiation gastritis/duodenitis, radiation gastric/duodenal ulcer, or other gastroduodenal toxicity associated with radiation, based on Common Terminology Criteria for Adverse Events (CTCAE 3.0). Serious gastroduodenal complications were defined as events occurring within 12 months from completion of CCRT, those requiring prompt therapeutic intervention, or symptoms equivalent to Grade 3 or 4 radiation-related gastroduodenal toxicity, including nausea or vomiting, based on CTCAE 3.0. Results: A month after completion of CCRT, 65 (52.8%) patients displayed endoscopic evidence of radiation-induced gastroduodenal complications. Radiation gastric and duodenal ulcers were found in 32 (26.0%) and 20 (16.3%) patients, respectively; radiation gastritis and duodenitis were found in 50 (40.7%) and 42 (34.1%) patients, respectively. Radiation-related bleeding was observed in 13 patients (10.6%). Serious gastroduodenal complications occurred in 18 patients (14.6%) and were significantly more frequent in patients with liver cirrhosis than in those without cirrhosis (p = 0.043). There were no radiation-related deaths. Conclusions: Endoscopically detectable radiation-induced gastroduodenal complications were common in HCC following CCRT. Although serious complications were uncommon, the frequency was higher in patients with liver cirrhosis; thus, these patients should be closely monitored when receiving CCRT.

  4. Assessment of hand dysfunction in patients receiving hemodialysis through arteriovenous fistula

    Directory of Open Access Journals (Sweden)

    Zeynep Tuna

    2015-06-01

    Full Text Available Objective: Patients receiving haemodialysis treatment generally tend to avoid using the upper extremity with arteriovenous (AV fistulae and it results in impairment of hand functions. Limited data are available about impairment associated with hand complications in those patients The aim of this pilot study is to evaluate the handgrip and pinching strengths and functional level of both hands in patients receiving haemodialysis. Methods: Fifteen chronic renal failure patients receiving haemodialysis (30-83 years and 11 age-matched healthy volunteers participated in the study. All the patients were undergoing treatment through arteriovenous fistulae in the upper extremity. Handgrip strength with a manual dynamometer and pinch strength with a pinchmeter were measured. Functional level of both hands was evaluated with Nine-Hole Peg Test. Results: Handgrip strengths of both hands were lower in patients receiving haemodialysis than healthy control group (p0.05. 9-Hole Peg Test results in both placement and removal showed a great significant difference in both hands with a statistical significance of p<0.001. Conclusion: Our first results revealed that chronic renal failure patients receiving haemodialysis treatment through arteriovenous fistulae in the upper extremity have a significant impairment in strength and functional level of hand. The lack of differences between two hands may be concluded that the upper extremity impairment in patients results from the disease course or haemodialysis treatment, not from the vascular access. J Clin Exp Invest 2015; 6 (2: 110-114

  5. Acute Respiratory Failure Caused by Hepatopulmonary Fistula in a Patient with Hepatocellular Carcinoma.

    Science.gov (United States)

    Lee, Jungsil; Kim, Yoon Jun; Kim, Hyung-Jun; Kim, Jee-Min; Kim, Young-Chan; Choi, Sun Mi

    2016-07-01

    A 59-year-old man presented with acute dyspnea following sudden productive cough and expectoration of a full cup of "blood-tinged" sputum. He had been diagnosed with hepatitis B virus-related hepatocellular carcinoma and had received transarterial chemoembolization 5 years ago for a 20-cm hepatic mass; he denied any history of hematemesis and the last esophagogastroduodenoscopy from a year ago showed absence of varix. Chest computed tomography (CT) with angiography showed new appearance of right basal lung consolidation but no bleeding focus. Despite the use of systemic antibiotics, the patient developed respiratory failure on day 7 of hospitalization. After intubation, a massive amount of brown sputum with anchovy-paste-like consistency was suctioned via the endotracheal tube. Bronchoscopic toileting was performed and the patient was extubated. In the ward, he continued to expectorate the brown sputum. On day 25 of hospitalization, a repeat CT scan showed simultaneous disappearance of the pneumonic consolidation and the necrotic fluid within the hepatic mass, suggesting the presence of a fistula. He has continued to receive systemic antibiotics, sorafenib, and entecavir, and follow up by respiratory and hepato-oncology specialists. PMID:27433178

  6. Predictive Factors for Radiation Pneumonitis in Hodgkin Lymphoma Patients Receiving Combined-Modality Therapy

    International Nuclear Information System (INIS)

    Purpose: This study sought to quantify the risk of radiation pneumonitis (RP) in Hodgkin lymphoma (HL) patients receiving mediastinal radiation therapy (RT) and to identify predictive factors for RP. Methods and Materials: We identified 75 patients with newly diagnosed HL treated with mediastinal RT and 17 patients with relapsed/refractory HL treated with mediastinal RT before or after transplant. Lung dose–volumetric parameters including mean lung dose and percentage of lungs receiving 20 Gy were calculated. Factors associated with RP were explored by use of the Fisher exact test. Results: RP developed in 7 patients (10%) who received mediastinal RT as part of initial therapy (Radiation Therapy Oncology Group Grade 1 in 6 cases). A mean lung dose of 13.5 Gy or greater (p = 0.04) and percentage of lungs receiving 20 Gy of 33.5% or greater (p = 0.009) significantly predicted for RP. RP developed in 6 patients (35%) with relapsed/refractory HL treated with peri-transplant mediastinal RT (Grade 3 in 4 cases). Pre-transplant mediastinal RT, compared with post-transplant mediastinal RT, significantly predicted for Grade 3 RP (57% vs. 0%, p = 0.015). Conclusions: We identified threshold lung metrics predicting for RP in HL patients receiving mediastinal RT as part of initial therapy, with the majority of cases being of mild severity. The risk of RP is significantly higher with peri-transplant mediastinal RT, especially among those who receive pre-transplant RT.

  7. Neoadjuvant targeted therapy in patients with renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    B. Ya. Alekseev

    2015-06-01

    Full Text Available Cytoreductive nephrectomy as an independent option in patients with metastatic renal cell carcinoma (mRCC cannot be considered as the only effective method, with rare exception, of a few patients with solitary metastases. Cytoreductive nephrectomy is now part of a multimodal approach encompassing surgical treatment and systemic drug therapy. Many retrospective and two prospective studies have demonstrated that it is expedient to perform cytoreductive nephrectomy. Immunotherapy should not be used as preoperatively in the era of cytokine therapy for mRCC due to that fact that it has no impact on primary tumor. In the current targeted therapy era, many investigators have concentrated attentionon the role of neoadjuvant targeted therapy for the treatment of patients with both localized and locally advanced mRCC. The potential benefits of neoadjuvant therapy for localized and locally advanced RCC include to make surgery easier and to increase the possibility of organsparing treatment, by decreasing the stage of primary tumor and the size of tumors. The possible potential advantages of neoadjuvant targeted therapy in patients with mRCC include prompt initiation of necessary systemic therapy; identification of patients with primary refractory tumors; and a preoperative reduction in the stage of primary tumor. Numerous retrospective and some prospective phase II studies have shown that neoadjuvant targeted therapy in patients with localized and locally advanced RCC is possible and tolerable and surgical treatment after neoadjuvant targeted therapy is safe and executable with a low incidence of complications. If neoadjuvant therapy is to be performed, it should be done within 2–4 months before surgery. Sorafenib and sunitinib are now most tested and suitable for neoadjuvant targeted therapy. Sorafenib is a more preferred drug due to its shorter half-life and accordingly to the possibility of discontinuing the drug immediately prior to

  8. Reversible skeletal disease and high fluoride serum levels in hematologic patients receiving voriconazole

    OpenAIRE

    Gerber, Bernhard; Guggenberger, Roman; Fasler, David; Nair, Gayathri; Manz, Markus G.; Stussi, Georg; Schanz, Urs

    2012-01-01

    We here investigate the occurrence of fluoride intake-associated alterations in patients with hematologic disease on triazol antifungal medication. Clinical, laboratory, and radiology data of overall 43 patients with hematologic malignancies taking voriconazole (n = 20), posaconazole (n = 8), and itraconazole (n = 4), and a hematologic patient control group (n = 11) are described. Bone pain and radiologic evidence of periostitis were exclusively observed in patients receiving long-term vorico...

  9. Sensori-neural hearing loss in patients treated with irradiation for nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    The present investigation has been carried out to evaluate the sensitivity of the inner ear to irradiation. Cochlear function was tested in a cohort of 22 patients before and 7-84 months after receiving external irradiation for nasopharyngeal carcinoma. The pre-irradiation sensori-neural hearing threshold at 500, 1000, 2000, and 4000 Hz was used as a baseline for the individual patient, and the observed sensori-neural hearing loss (SNHL) was calculated as the difference between pre- and post-irradiation values. The pre-irradiation hearing level or patient age was not correlated with the actual SNHL. In contrast, there was a significant correlation between the total radiation dose to the inner ear and the observed hearing impairment. SNHL was most pronounced in the high frequencies, with values up to 35 dB (4000 Hz) and 25 dB (2000 Hz) in some patients. The latent period for the complication appeared to be 12 months or more. The deleterious effect of irradiation on the hearing should be kept in mind both in treatment planning and in the follow-up after radiotherapy

  10. Serum metabolome profiles characterized by patients with hepatocellular carcinoma associated with hepatitis B and C

    Science.gov (United States)

    Saito, Takafumi; Sugimoto, Masahiro; Okumoto, Kazuo; Haga, Hiroaki; Katsumi, Tomohiro; Mizuno, Kei; Nishina, Taketo; Sato, Sonoko; Igarashi, Kaori; Maki, Hiroko; Tomita, Masaru; Ueno, Yoshiyuki; Soga, Tomoyoshi

    2016-01-01

    AIM: To clarify the characteristics of metabolite profiles in virus-related hepatocellular carcinoma (HCC) patients using serum metabolome analysis. METHODS: The serum levels of low-molecular-weight metabolites in 68 patients with HCC were quantified using capillary electrophoresis chromatography and mass spectrometry. Thirty and 38 of the patients suffered from hepatitis B virus-related HCC (HCC-B) and hepatitis C virus-related HCC (HCC-C), respectively. RESULTS: The main metabolites characteristic of HCC were those associated with glutathione metabolism, notably 13 γ-glutamyl peptides, which are by-products of glutathione induction. Two major profiles, i.e., concentration patterns, of metabolites were identified in HCC patients, and these were classified into two groups: an HCC-B group and an HCC-C group including some of the HCC-B cases. The receiver operating characteristic curve for the multiple logistic regression model discriminating HCC-B from HCC-C incorporating the concentrations of glutamic acid, methionine and γ-glutamyl-glycine-glycine showed a highly significant area under the curve value of 0.94 (95%CI: 0.89-1.0, P < 0.0001). CONCLUSION: The serum levels of γ-glutamyl peptides, as well as their concentration patterns, contribute to the development of potential biomarkers for virus-related HCC. The difference in metabolite profiles between HCC-B and HCC-C may reflect the respective metabolic reactions that underlie the different pathogeneses of these two types of HCC.

  11. Clinical factors related to long-term administration of sorafenib in patients with hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Sorafenib has been approved in the indication of unresectable hepatocellular carcinoma, but there are many cases in which administration of the drug is discontinued due to severe side effects. In this study, we compared the characteristics of patients who continued and discontinued sorafenib. Ninety-six patients (75 men and 21 women) were initiated on sorafenib from July 2009 through September 2011. The patient characteristics of interest included gender, age, etiology, Child-Pugh classification, treatment history and frequency, and levels of α-fetoprotein, des- gamma-carboxy prothrombin, aspartate amino acid transferase, and alanine aminotransferase. Duration of administration of sorafenib and reasons for its discontinuation were compared. Median overall survival was 11.8 months. Discontinuation of sorafenib within 90 days was identified as an independent prognostic factor for overall survival on multivariate analysis (P < 0.0001). Transarterial chemoembolization performed six times or more (P = 0.013) was also identified as an independent factor contributing to discontinuation of sorafenib within 90 days in multivariate analysis. Patients who received sorafenib for ≥90 days had significantly longer overall survival than those who discontinued it (P < 0.0001). Prolonged treatment with sorafenib is an important factor in achieving extended overall survival. We recommend starting sorafenib before latent liver damage has occurred as a result of too many transarterial chemoembolization procedures

  12. Efficacy, Safety, and Biomarkers of Single-Agent Bevacizumab Therapy in Patients with Advanced Hepatocellular Carcinoma

    OpenAIRE

    Boige, Valérie; Malka, David; Bourredjem, Abderrahmane; Dromain, Clarisse; Baey, Charlotte; Jacques, Nathalie; Pignon, Jean-Pierre; Vimond, Nadege; Bouvet-Forteau, Nathalie; De Baere, Thierry; Ducreux, Michel; Farace, Françoise

    2012-01-01

    The safety, efficacy, and potential biomarkers of activity of bevacizumab in patients with advanced hepatocellular carcinoma were assessed. Bevacizumab was active and well tolerated. The clinical value of circulating endothelial cells and interleukin-6 and -8 warrants further investigation.

  13. Diagnostic value of multidetector computed tomography for renal sinus fat invasion in renal cell carcinoma patients

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    Kim, Cherry, E-mail: cherrykim0505@gmail.com; Choi, Hyuck Jae, E-mail: choihj@amc.seoul.kr; Cho, Kyoung-Sik, E-mail: kscho@amc.seoul.kr

    2014-06-15

    Objective: Although renal sinus fat invasion has prognostic significance in patients with renal cell carcinomas (RCCs), there are no previous studies about the value of multidetector computed tomography (MDCT) about this issue in the current literature. Materials and methods: A total of 863 consecutive patients (renal sinus fat invasion in 110 patients (12.7%)) from single institutions with surgically-confirmed renal cell carcinoma who underwent MDCT between 2010 and 2012 were included in this study. The area under the curves (AUCs) of the receiver operating characteristic (ROC) analysis was used to compare diagnostic performance. Reference standard was pathologic examination. Weighted κ statistics were used to measure the level of interobserver agreement. Multivariate logistic regression model was used to find the predictors for renal sinus fat invasion. Image analysis was first performed with axial-only CT images. A second analysis was then performed with both axial and coronal CT images. A qualitative analysis was then conducted by two reviewers who reached consensus regarding tumor size, decreased perfusion, tumor margin, vessel displacement, and lymph node metastasis. The reference standard was pathologic evaluation. Results: The AUCs of the ROC analysis were 0.881 and 0.922 for axial-only images and 0.889 and 0.902 for combined images in both readers. The AUC of tumor size was 0.884, a similar value to that of the reviewers. In multivariate analysis, tumor size, a linear-nodular or nodular type of fat infiltration, and an irregular tumor margin were independent predicting factors for perinephric fat invasion. Conclusion: MDCT shows relatively high diagnostic performance in detecting perinephric fat invasion of RCC but suffers from a relatively low PPV related to low prevalence of renal sinus fat invasion. Applying tumor size alone we could get similar diagnostic performance to those of radiologists. Tumor size, fat infiltration with a nodular appearance, and

  14. Diagnostic value of multidetector computed tomography for renal sinus fat invasion in renal cell carcinoma patients

    International Nuclear Information System (INIS)

    Objective: Although renal sinus fat invasion has prognostic significance in patients with renal cell carcinomas (RCCs), there are no previous studies about the value of multidetector computed tomography (MDCT) about this issue in the current literature. Materials and methods: A total of 863 consecutive patients (renal sinus fat invasion in 110 patients (12.7%)) from single institutions with surgically-confirmed renal cell carcinoma who underwent MDCT between 2010 and 2012 were included in this study. The area under the curves (AUCs) of the receiver operating characteristic (ROC) analysis was used to compare diagnostic performance. Reference standard was pathologic examination. Weighted κ statistics were used to measure the level of interobserver agreement. Multivariate logistic regression model was used to find the predictors for renal sinus fat invasion. Image analysis was first performed with axial-only CT images. A second analysis was then performed with both axial and coronal CT images. A qualitative analysis was then conducted by two reviewers who reached consensus regarding tumor size, decreased perfusion, tumor margin, vessel displacement, and lymph node metastasis. The reference standard was pathologic evaluation. Results: The AUCs of the ROC analysis were 0.881 and 0.922 for axial-only images and 0.889 and 0.902 for combined images in both readers. The AUC of tumor size was 0.884, a similar value to that of the reviewers. In multivariate analysis, tumor size, a linear-nodular or nodular type of fat infiltration, and an irregular tumor margin were independent predicting factors for perinephric fat invasion. Conclusion: MDCT shows relatively high diagnostic performance in detecting perinephric fat invasion of RCC but suffers from a relatively low PPV related to low prevalence of renal sinus fat invasion. Applying tumor size alone we could get similar diagnostic performance to those of radiologists. Tumor size, fat infiltration with a nodular appearance, and

  15. Peripheral T-lymphocytes and delayed hypersensitivity in surgically and radiologically treated patients with early stages of larynx-carcinoma

    International Nuclear Information System (INIS)

    122 patients with squamous-cell-carcinoma of the larynx (T1-stage) were examined after surgical or radiological treatment. None of these patients showed evidence of tumor recurrence. Peripheral T-lymphocytes and delayed hypersensitivity were studied in all these patients. According to their treatment, the patients were allotted into three groups and compared with a control group, consisting of 20 patients with nonneoplastic head- and neck-disease. The main finding was a significant decrease in the peripheral T-lymphocytes in surgically- or radiologically-treated patients with a squamous-cell-carcinoma of the larynx (T1-stage). This reduction of T-cells must be interpreted as a congenital or acquired defect of the immunocompetent system. In about half of the control cases the DNCB-tests showed no evidence of delayed hypersensitivity. In view of these results and those reported in the literature, the test should be used critically. In contrast to our earlier findings, where patients received radiotherapy over large areas including big vessels, radiation over a smaller, localised area does not lead to a significant depression of peripheral T-lymphocytes. (orig.)

  16. Micronuclei frequency in peripheral blood lymphocytes of differentiated thyroid carcinoma patients before and after exposure to 131I therapy

    International Nuclear Information System (INIS)

    The study was carried out to assess the DNA damage due to the presence of thyroid carcinoma as well as post- therapeutic 131I exposure at 72h in peripheral blood lymphocytes in patient population. The study population consisted of 29 healthy donors and 22 patients of differentiated thyroid carcinoma. The blood samples of the patient population were collected pre- and post- 131I administration of therapeutic 131I dose (Range 1.6-9.3 GBq). The blood samples of study population were cultured and processed by cytokinesis-block micronuclei assay. The statistical analysis was performed by using Student's t-test for comparison between healthy donors and patient population ( pre-131I therapy) whereas paired t-test was used for comparing micronuclei frequency in patient population pre- and post- 131I therapy. This study has revealed an increased preexisting DNA damage in patients with thyroid cancer in comparison to healthy subjects. Further increase in DNA damage was observed in patient population after receiving therapeutic 131I exposure at 72 h. However, no dose dependency was observed, thereby indicating individual variation in DNA damage in response to in vivo 131I exposure

  17. Efficacy, Safety, and Biomarkers of Single-Agent Bevacizumab Therapy in Patients with Advanced Hepatocellular Carcinoma

    Science.gov (United States)

    Malka, David; Bourredjem, Abderrahmane; Dromain, Clarisse; Baey, Charlotte; Jacques, Nathalie; Pignon, Jean-Pierre; Vimond, Nadege; Bouvet-Forteau, Nathalie; De Baere, Thierry; Ducreux, Michel; Farace, Françoise

    2012-01-01

    Objective. Hepatocellular carcinoma (HCC) is a highly vascularized tumor in which neoangiogenesis contributes to growth and metastasis. We assessed the safety, efficacy, and potential biomarkers of activity of bevacizumab in patients with advanced HCC. Methods. In this phase II trial, eligible patients received bevacizumab, 5 mg/kg or 10 mg/kg every 2 weeks. The disease-control rate at 16 weeks (16W-DCR) was the primary endpoint. Circulating endothelial cells (CECs) and plasma cytokines and angiogenic factors (CAFs) were measured at baseline and throughout treatment. Results. The 16W-DCR was 42% (95% confidence interval, 27%–57%). Six of the 43 patients who received bevacizumab achieved a partial response (objective response rate [ORR], 14%). Grade 3–4 asthenia, hemorrhage, and aminotransferase elevation occurred in five (12%), three (7%), and three (7%) patients, respectively. During treatment, placental growth factor markedly increased, whereas vascular endothelial growth factor (VEGF)-A dramatically decreased (p < .0001); soluble VEGF receptor-2 (p < .0001) and CECs (p = .03) transiently increased on day 3. High and increased CEC counts at day 15 were associated with the ORR (p = .04) and the 16W-DCR (p = .02), respectively. Lower interleukin (IL)-8 levels at baseline (p = .01) and throughout treatment (p ≤ .04) were associated with the 16W-DCR. High baseline IL-8 and IL-6 levels predicted shorter progression-free and overall survival times (p ≤ .04). Conclusion. Bevacizumab is active and well tolerated in patients with advanced HCC. The clinical value of CECs, IL-6, and IL-8 warrants further investigation. PMID:22707516

  18. Metabolic syndrome in patients with severe mental illness undergoing psychiatric rehabilitation receiving high dose antipsychotic medication

    Directory of Open Access Journals (Sweden)

    Bapu V Ravindranath

    2012-01-01

    Full Text Available Background: To review evidence of chronic antipsychotic medication and the association with metabolic syndrome in mentally ill patients. This evidence was used to analyse a cohort of patients with severe mental illness and to deduce a correlation between the prevalence of metabolic syndrome and their dose regimens. Materials and Methods: Twenty-four male patients undergoing Psychiatric rehabilitation underwent a review of current medication and assessment of risk factors for metabolic syndrome. Assessment criteria was based upon National Cholesterol Education Programme expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III (NCEP ATP III criteria, incorporating waist circumference, raised triglycerides, reduced high density lipoprotein, raised blood pressure and fasting blood glucose. PubMed, Nature and Science Direct databases have been used to compile the medical and scientific background on metabolic syndrome and antipsychotic medication and the effect on patients particularly on high dose. Results: Out of 24 patients, 10 patients (41.7% were receiving high dose antipsychotics (HDA and four were on maximum dosage limits of 100%. 8.3% (2/24 patients were receiving only one first generation antipsychotics (FGA, 37.5% (9/24 patients were receiving only one second generation antipsychotic (SGA, 45.8% patients (11/24 were receiving two or more SGA only, and only one patient was receiving two or more FGA. One patient was receiving a combination of FGA and SGA. PRN ("as needed" therapy was not included in this study as their usage was limited. Clozapine was mostly prescribed in these patients (10/24, 41.6%. Four out of the 24 patients refused blood tests therefore were excluded from the following results. In the patients evaluated, 55% (11/20 had confirmed metabolic syndrome. In these patients with metabolic syndrome, 45.4% (5/11 were on HDA and 27.3% (3/11 were on maximum British National

  19. Pseudoangiomatous stromal hyperplasia (PASH) tumour at the surgical scar site in a patient of carcinoma breast.

    Science.gov (United States)

    Abrari, Andleeb

    2011-01-01

    A patient on follow-up post surgery for carcinoma breast, presented with a nodule under the surgical scar. The sinister eventuality of recurrent carcinoma was clinically considered first. The lesion was biopsied and the histopathology was diagnostic of pseudoangiomatous stromal hyperplasia tumour. The nodule was excised and the patient's clinical denouement has been uneventful in the 4 months which have elapsed after this event. PMID:22688488

  20. Choroid plexus carcinomas in children: MRI features and patient outcomes

    International Nuclear Information System (INIS)

    Choroid plexus carcinomas (CPC) are rare malignant intracranial neoplasms usually occurring in young children. The objectives of this study were to characterize the preoperative MRI features of CPC, determine the frequency of disseminated disease in the CNS at diagnosis, and assess patient outcomes. The preoperative cranial MR images of 11 patients with CPC were retrospectively reviewed for lesion location, lesion size, un-enhanced and enhanced MRI signal characteristics, and presence of disseminated intracranial tumor. Postoperative cranial and spinal MRI images were reviewed for residual, recurrent, and/or disseminated tumor. The study group included six male and five female patients ranging in age from 5 months to 5.3 years (median=1.8 years). CPC were located in the lateral (n=8), fourth (n=1), and third (n=1) ventricles, and foramen of Luschka (n=1). Mean tumor size was 5.2cm x 4.9cm x 5.0 cm. On short-TR images, CPC had heterogeneous, predominantly intermediate signal with foci of high signal in 45% of lesions from areas of hemorrhage. On long-TR/long-TE images, solid portions of CPC typically had heterogeneous, intermediate-to-slightly-high signal. Small zones of low signal on long-TR/long-TE images were seen in 55% of the lesions secondary to areas of hemorrhage and/or calcifications. Tubular flow voids representing blood vessels were seen in 55% of the lesions. Zones of high signal comparable to CSF were seen in 64% of CPC secondary to cystic/necrotic zones. All CPC showed prominent contrast enhancement. Irregular enhancing margins suggesting subependymal invasion were seen in 73% of the lesions. Findings consistent with edema in the brain adjacent to the enhancing lesions were seen in 73% of CPC. CPC caused hydrocephalus in 82% of patients at diagnosis. Two patients died from hemorrhagic complications from surgical biopsies. Disseminated tumor in the leptomeninges was present in 45% of patients at diagnosis and was associated with a poor prognosis. The 1

  1. A rare case of verrucous carcinoma of penis in an human immunodeficiency virus- infected patient

    Directory of Open Access Journals (Sweden)

    Tonita Mariola Noronha

    2015-01-01

    Full Text Available Cancer is a significant cause of morbidity and mortality in human immunodeficiency virus-infected subjects. Verrucous carcinoma is a peculiarly slow evolving, but relentlessly expanding variant of epidermoid carcinoma that is extremely reluctant to metastasize. A 60-year-old unmarried male patient presented with urethral discharge of 3 weeks duration. Dorsal slit of the prepuce revealed an ulceroproliferative growth measuring 3 cm Χ 3 cm arising from prepuce and involving glans. Biopsy from the growth in the prepuce showed histopathological features of verrucous carcinoma. Partial amputation of the penis was done. Human papillomavirus DNA by polymerase chain reaction was negative. The patient was started on antiretroviral therapy.

  2. Leptomeningeal carcinomatosis in a younger patient with signet-ring cell carcinoma

    OpenAIRE

    Kılıçkap, Saadettin; Ateş, Öztürk; Ateş, İrem Kor; Önder, Sevgen

    2011-01-01

    AbstractLeptomeningeal metastasis (LMM) occurs in about 3-8% of patients with systemic cancer. It is very rare in patients with signet-ring cell carcinoma. But, the prognosis is also very poor. We report a case of a younger woman with signet-ring cell carcinoma of primary origin unknown who presented with meningeal carcinomatosis.Keywords: Leptomeningeal metastasis; signet-ring cell carcinoma; prognosis. ÖzetLeptomenengeal metastazlar, sistemik kanserli hastaların yaklaşık %3-8’inde oluşur. B...

  3. Single-fraction radiation therapy in patients with metastatic Merkel cell carcinoma

    International Nuclear Information System (INIS)

    Merkel cell carcinoma (MCC) is an aggressive, polyomavirus-associated cancer with limited therapeutic options for metastatic disease. Cytotoxic chemotherapy is associated with high response rates, but responses are seldom durable and toxicity is considerable. Here, we report our experience with palliative single-fraction radiotherapy (SFRT) in patients with metastatic MCC. We conducted retrospective analyses of safety and efficacy outcomes in patients that received SFRT (8 Gy) to MCC metastases between 2010 and 2013. Twenty-six patients were treated with SFRT to 93 MCC tumors located in diverse sites that included skin, lymph nodes, and visceral organs. Objective responses were observed in 94% of the measurable irradiated tumors (86/92). Complete responses were observed in 45% of tumors (including bulky tumors up to 16 cm). “In field” lesion control was durable with no progression in 77% (69/89) of treated tumors during median follow-up of 277 days among 16 living patients. Clinically significant toxicity was seen in only two patients who had transient side effects. An exploratory analysis suggested a higher rate of in-field progression in patients with an immunosuppressive comorbidity or prior recent chemotherapy versus those without (30% and 9%, respectively; P = 0.03). Use of SFRT in palliating MCC patients was associated with an excellent in field control rate and durable responses at treated sites, and with minimal toxicity. SFRT may represent a convenient and appealing alternative to systemic chemotherapy for palliation, for which most patients with oligometastatic MCC are eligible. SFRT may also synergize with emerging systemic immune stimulants by lowering tumor burden and enhancing presentation of viral/tumor antigens

  4. A phase II trial of recombinant tumor necrosis factor in patients with advanced colorectal carcinoma.

    Science.gov (United States)

    Kemeny, N; Childs, B; Larchian, W; Rosado, K; Kelsen, D

    1990-08-15

    Sixteen previously treated (with only one prior regimen) patients with histologically proven metastatic or locally recurrent colorectal carcinoma were treated with recombinant tumor necrosis factor (rTNF) administered by 30-minute i.v. infusions twice daily for 5 consecutive days every other week for 8 weeks. Patients received 100 micrograms/m2 twice daily on day 1 of cycle 1 with escalation to 150 micrograms/m2 twice daily thereafter. Patients were concomitantly treated with indomethacin 25 mg every 6 hours and acetaminophen 650 mg every 4 hours to obviate fever and chills. Toxicities included: nausea/vomiting (69%), headache (25%), chills (69%), pain at tumor sites (63%), hypotension (31%), and hypertension (38%). Hematologic toxicity included leukopenia less than 2000 cells/mm3 (38%) and thrombocytopenia less than 100,000 cells/mm3 (13%). Liver function abnormalities occurred independently of the site or extent of metastatic disease and inconsistently in each treatment cycle. Four patients developed bilirubinemia greater than 2.5 x baseline values (range, 2.5 to 10.3 U/L); five patients had greater than 2.5 x elevations in alkaline phosphatase (range, 624 to 1663 U/L). Two patients developed retinal vein thrombosis in the absence of hemostatic abnormalities. In both instances, this complication occurred several weeks after completion of therapy. No objective responses were noted in 14 evaluable patients (95% confidence interval: 0 to 0.23). Three patients had stable disease for a median duration of 4.5 months. In conclusion, i.v. rTNF at this dose and schedule has no demonstrable antitumor efficacy. Twice-daily i.v. administration of this agent is associated with more hepatotoxicity than previously reported in trials using subcutaneous or once daily i.v. administration. Retinal vein thrombosis may be a late complication of i.v. rTNF at this dose and schedule. PMID:2386895

  5. DENDRITIC CELL-BASED VACCINE THERAPY IN PATIENTS WITH RENAL CELL CARCINOMA

    Directory of Open Access Journals (Sweden)

    D. A. Nosov

    2014-07-01

    Full Text Available Objective: to study the efficiency and tolerance of autologous vaccine therapy based on dendritic cells (DC in patients with renal cell carcinoma (RCC and to examine changes in immunological parameters and their association with the efficiency of the therapy. Subjects and methods. Twenty-nine patients with RCC received autologous vaccine therapy based on DC in 2002 to 2008. Therapy was performed in the induction mode in 16 patients before disease progression and in the adjuvant mode (8 vaccinations in 13 patients after radical nephrectomy (grade III or radical metastasectomy. Peripheral blood monocyte-derived DCs treated with autologous tumor lysate were used to prepare the vaccine. Results. In a group of 16 patients with distant metastases, partial regressions were recorded in 2 (12.5% patients and long (> 6-month stabilizations of a tumor process were observed in other 2 (12.5% patients. The median time prior to progression was 3 (range 1.5-12 months. Thirteen patients on adjuvant treatment did not achieve the median time to progression: 4 patients showed no signs of disease progression ?12 to ?25 months after metastasectomy. Patients with a clinical effect (disease regression or long stabilization showed a significant increase in the populations of CD3+CD8+ and CD3-CD16+ T lymphocytes (natural killers (NK cells after 3 vaccinations from 23.3 to 27.2% (p = 0.018 and from 15.17 to 20.3%, respectively (p = 0.03. Prior to vaccine therapy, the count of CD3+CD16+-NK cells was thrice greater in patients with the progressive disease than that in the donor group - 11.2 and 3.5%, respectively. The baseline count of CD4+CD25+ Т lymphocytes in patients with progressive disease was also significantly higher than that in patients with the clinical effect - 12.01 and 5.6%, respectively. Conclusion. In patients with RCC, DC-based vaccine therapy is able to induce a specific anti-tumor immune response that is transformed into the clinical effect in some

  6. Stratification of Hepatocellular Carcinoma Patients Based on Acetate Utilization

    Directory of Open Access Journals (Sweden)

    Elias Björnson

    2015-12-01

    Full Text Available Hepatocellular carcinoma (HCC is a deadly form of liver cancer that is increasingly prevalent. We analyzed global gene expression profiling of 361 HCC tumors and 49 adjacent noncancerous liver samples by means of combinatorial network-based analysis. We investigated the correlation between transcriptome and proteome of HCC and reconstructed a functional genome-scale metabolic model (GEM for HCC. We identified fundamental metabolic processes required for cell proliferation using the network centric view provided by the GEM. Our analysis revealed tight regulation of fatty acid biosynthesis (FAB and highly significant deregulation of fatty acid oxidation in HCC. We predicted mitochondrial acetate as an emerging substrate for FAB through upregulation of mitochondrial acetyl-CoA synthetase (ACSS1 in HCC. We analyzed heterogeneous expression of ACSS1 and ACSS2 between HCC patients stratified by high and low ACSS1 and ACSS2 expression and revealed that ACSS1 is associated with tumor growth and malignancy under hypoxic conditions in human HCC.

  7. Strontium-89 therapy and subarachnoid phenol block successfully eliminated intractable pain of metastasis in the patient with advanced urachal carcinoma

    International Nuclear Information System (INIS)

    We report a case of a 39-year-old man with intractable multifocal pain caused by metastatic urachal carcinoma to the bone. The patient underwent a partial cystectomy in May 2008, and lung metastasis occurred 9 months after the surgery. He then received salvage chemotherapy, but developed metastasis to the liver, brain, and bone. He was hospitalized due to a shoulder pain, a lower back pain, buttocks pain, numbness in both legs, and drop foot in right leg. MRI revealed metastases to the spine, and lumbar spinal canal stenosis with cauda equina compression. Even a combination of fentanyl-patch, oral acetaminophen, gabapentin and paroxetine was not effective for pain control. Strontium-89 therapy and subarachnoid phenol block successfully eliminated intractable pain. The patient could be discharged from hospital and received a palliative care at home for a short period of time. (author)

  8. Evaluation of electrolyte imbalance among tuberculosis patients receiving treatments in Southwestern Nigeria

    Directory of Open Access Journals (Sweden)

    Adebimpe Wasiu Olalekan

    2015-09-01

    Conclusion: Hyponatraemia, hyperkalaemia, and hypochloremia characterized some of the electrolyte imbalance among TB patients receiving treatments. The raised level of bicarbonate may be attributed to overcorrection of respiratory acidosis often found in patients with tuberculosis. Monitoring electrolytes is therefore an important component of TB management.

  9. Serum voriconazole level variability in patients with hematological malignancies receiving voriconazole therapy

    OpenAIRE

    Lalit Saini; Jack T Seki; Deepali Kumar; Atenafu, Eshetu G.; David EC Cole; Betty YL Wong; Andrea Božović; Brandwein, Joseph M

    2014-01-01

    INTRODUCTION: Voriconazole plasma concentrations have been correlated with oral dosing in healthy subjects, but have been poorly characterized in ill patients with hematological malignancies receiving intensive chemotherapy. METHODS: The relationship between orally administered voriconazole, plasma concentrations and liver toxicity was examined in a cohort of 69 primarily acute leukemia patients undergoing intensive chemotherapy. RESULTS: Oral administration of voriconazole was associated wit...

  10. Perturbation and Nonlinear Dynamic Analysis of Acoustic Phonatory Signal in Parkinsonian Patients Receiving Deep Brain Stimulation

    Science.gov (United States)

    Lee, Victoria S.; Zhou, Xiao Ping; Rahn, Douglas A., III; Wang, Emily Q.; Jiang, Jack J.

    2008-01-01

    Nineteen PD patients who received deep brain stimulation (DBS), 10 non-surgical (control) PD patients, and 11 non-pathologic age- and gender-matched subjects performed sustained vowel phonations. The following acoustic measures were obtained on the sustained vowel phonations: correlation dimension (D[subscript 2]), percent jitter, percent shimmer,…

  11. Nosocomial Pneumonia in Mechanically Ventilated Patients Receiving Ranitidine or Sucralfate as Stress Ulcer Prophylaxis

    Directory of Open Access Journals (Sweden)

    Smita Prakash

    2008-01-01

    We concluded that stress ulcer prophylaxis with ranitidine increases the risk for late- onset pneumonia in mechanically ventilated critically ill patients by favoring gastric colonization by gram- negative bacilli compared with sucralfate. In patients receiving mechanical ventilation, the use of sucralfate may be preferable to H 2 blockers.

  12. Long-term survival for COPD patients receiving noninvasive ventilation for acute respiratory failure

    DEFF Research Database (Denmark)

    Titlestad, Ingrid L; Lassen, Annmarie T; Vestbo, Jørgen

    2013-01-01

    controlled trials show lowered mortality rates in highly selected patients with acute exacerbation and respiratory failure, there are only few reports on long-term survival after receiving NIV. We present long-term all-cause mortality data from patients receiving NIV for the first time.......Implementation of noninvasive ventilation (NIV) as an add-on treatment has been routinely used in a non-intensive care setting since 2004 for patients with chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure at a university hospital in Denmark. Although randomized...

  13. Basal Cell Carcinomas in Gorlin Syndrome: A Review of 202 Patients

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Jones

    2011-01-01

    Full Text Available Gorlin syndrome (Naevoid Basal Cell Carcinoma Syndrome is a rare autosomal dominant syndrome caused by mutations in the PTCH gene with a birth incidence of approximately 1 in 19,000. Patients develop multiple basal cell carcinomas of the skin frequently in early life and also have a predisposition to additional malignancies such as medulloblastoma. Gorlin Syndrome patients also have developmental defects such as bifid ribs and other complications such as jaw keratocysts. We studied the incidence and frequency of basal cell carcinomas in 202 Gorlin syndrome patients from 62 families and compared this to their gender and mutation type. Our data suggests that the incidence of basal cell carcinomas is equal between males and females and the mutation type cannot be used to predict disease burden.

  14. Adjuvant sorafenib after heptectomy for Barcelona Clinic Liver Cancer-stage C hepatocellular carcinoma patients

    Science.gov (United States)

    Xia, Feng; Wu, Li-Li; Lau, Wan-Yee; Huan, Hong-Bo; Wen, Xu-Dong; Ma, Kuan-Sheng; Li, Xiao-Wu; Bie, Ping

    2016-01-01

    AIM: To investigate the efficacy and safety of adjuvant sorafenib after curative resection for patients with Barcelona Clinic Liver Cancer (BCLC)-stage C hepatocellular carcinoma (HCC). METHODS: Thirty-four HCC patients, classified as BCLC-stage C, received adjuvant sorafenib for high-risk of tumor recurrence after curative hepatectomy at a tertiary care university hospital. The study group was compared with a case-matched control group of 68 patients who received curative hepatectomy for HCC during the study period in a 1:2 ratio. RESULTS: The tumor recurrence rate was markedly lower in the sorafenib group (15/34, 44.1%) than in the control group (51/68, 75%, P = 0.002). The median disease-free survival was 12 mo in the study group and 10 mo in the control group. Tumor number more than 3, macrovascular invasion, hilar lymph nodes metastasis, and treatment with sorafenib were significant factors of disease-free survival by univariate analysis. Tumor number more than 3 and treatment with sorafenib were significant risk factors of disease-free survival by multivariate analysis in the Cox proportional hazards model. The disease-free survival and cumulative overall survival in the study group were significantly better than in the control group (P = 0.034 and 0.016, respectively). CONCLUSION: Our study verifies the potential benefit and safety of adjuvant sorafenib for both decreasing HCC recurrence and extending disease-free and overall survival rates for patients with BCLC-stage C HCC after curative resection. PMID:27340354

  15. Clinical Impact of Prolonged Diagnosis to Treatment Interval (DTI) Among Patients with Oropharyngeal Squamous Cell Carcinoma

    Science.gov (United States)

    Sharma, Sonam; Bekelman, Justin; Lin, Alexander; Lukens, J. Nicholas; Roman, Benjamin R.; Mitra, Nandita; Swisher-McClure, Samuel

    2016-01-01

    Purpose/Objective(s) We examined practice patterns using the National Cancer Database (NCDB) to determine risk factors for prolonged diagnosis to treatment interval (DTI) and survival outcomes in patients receiving chemoradiation for oropharyngeal squamous cell carcinoma (OPSCC). Methods and Materials We identified 6,606 NCDB patients with Stage III-IV OPSCC receiving chemoradiation from 2003-2006. We determined risk factors for prolonged DTI (>30 days) using univariate and multivariable logistic regression models. We examined overall survival (OS) using Kaplan Meier and multivariable Cox proportional hazards models. Results 3,586 (54.3%) patients had prolonged DTI. Race, IMRT, insurance status, and high volume facilities were significant risk factors for prolonged DTI. Patients with prolonged DTI had inferior OS compared to DTI ≤ 30 days (Hazard Ratio (HR)=1.12, 95% CI 1.04-1.20, p=0.005). For every week increase in DTI there was a 2.2% (95% CI 1.1%-3.3%, pacademic, or high-volume facilities were more likely to experience prolonged DTI (High vs. Low volume: 61.5% vs. 51.8%, adjusted OR 1.38, 95% CI 1.21-1.58; Academic vs. Community: 59.5% vs. 50.6%, adjusted OR 1.26, 95% CI 1.13-1.42; non-IMRT vs. IMRT: 53.4% vs. 56.5%; adjusted OR 1.17, 95% CI 1.04-1.31). Conclusions Our results suggest that prolonged DTI has a significant impact on survival outcomes. We observed disparities in DTI by socioeconomic factors. However, facility level factors such as academic affiliation, high volume, and IMRT also increased risk of DTI. These findings should be considered in developing efficient pathways to mitigate adverse effects of prolonged DTI. PMID:27086482

  16. Intratumoral Mistletoe (Viscum album L) Therapy in Patients With Unresectable Pancreas Carcinoma: A Retrospective Analysis.

    Science.gov (United States)

    Schad, Friedemann; Atxner, Jan; Buchwald, Dirk; Happe, Antje; Popp, Stephan; Kröz, Matthias; Matthes, Harald

    2014-07-01

    Pancreatic carcinoma remains one of the main causes for cancer-related death. Intratumoral application of anticancer agents is discussed as a promising method for solid tumors such as pancreatic cancer. Endoscopic ultrasound provides a good tool to examine and treat the pancreas. European mistletoe (Viscum album L) is a phytotherapeutic commonly used in integrative oncology in Central Europe. Its complementary use seeks to induce immunostimulation and antitumoral effects as well as alleviate chemotherapeutic side effects. Intratumoral mistletoe application has induced local tumor response in various cancer entities. This off-label use needs to be validated carefully in terms of safety and benefits. Here we report on 39 patients with advanced, inoperable pancreatic cancer, who received in total 223 intratumoral applications of mistletoe, endoscopic ultrasound guided or under transabdominal ultrasound control. No severe procedure-related events were reported. Adverse drug reactions were mainly increased body temperature or fever in 14% and 11% of the applications, respectively. Other adverse drug reactions, such as pain or nausea, occurred in less than 7% of the procedures. No severe adverse drug reaction was recorded. Patients received standard first- and second-line chemotherapy and underwent adequate palliative surgical interventions as well as additive subcutaneous and partly intravenous mistletoe application. A median survival of 11 months was observed for all patients, or 11.8 and 8.3 months for stages III and IV, respectively. Due to the multimodal therapeutic setting and the lack of a control group, the effect of intratumoral mistletoe administration alone remains unclear. This retrospective analysis suggests that intratumoral-applicated mistletoe might contribute to improve survival of patients with pancreatic cancer. In conclusion, the application is feasible and safe, and its efficacy should be evaluated in a randomized controlled trial. PMID:24363283

  17. AMG 386 in Combination With Sorafenib in Patients With Metastatic Clear Cell Carcinoma of the Kidney

    Science.gov (United States)

    Rini, Brian; Szczylik, Cezary; Tannir, Nizar M.; Koralewski, Piotr; Tomczak, Piotr; Deptala, Andrzej; Dirix, Luc Y.; Fishman, Mayer; Ramlau, Rodryg; Ravaud, Alain; Rogowski, Wojciech; Kracht, Karolyn; Sun, Yu-Nien; Bass, Michael B.; Puhlmann, Markus; Escudier, Bernard

    2015-01-01

    BACKGROUND This study evaluated the tolerability and antitumor activity of AMG 386, a peptibody (a peptide Fc fusion) that neutralizes the interaction of angiopoietin-1 and angiopoietin-2 with Tie2 (tyrosine kinase with immunoglobulin-like and EGF-like domains 2), plus sorafenib in patients with clear cell metastatic renal cell carcinoma (mRCC) in a randomized controlled study. METHODS Previously untreated patients with mRCC were randomized 1:1:1 to receive sorafenib 400 mg orally twice daily plus intravenous AMG 386 at 10 mg/kg (arm A) or 3 mg/kg (arm B) or placebo (arm C) once weekly (qw). Patients in arm C could receive open-label AMG 386 at 10 mg/kg qw plus sorafenib following disease progression. The primary endpoint was progression-free survival (PFS). RESULTS A total of 152 patients were randomized. Median PFS was 9.0, 8.5, and 9.0 months in arms A, B, and C, respectively (hazard ratio for arms A and B vs arm C, 0.88; 95% confidence interval [CI], 0.60–1.30; P = .523). The objective response rate (95% CI) for arms A, B, and C, respectively, was 38% (25%–53%), 37% (24%–52%), and 25% (14%–40%). Among 30 patients in arm C who had disease progression and subsequently received open-label AMG 386 at 10 mg/kg qw, the objective response rate was 3% (95% CI, 0%–17%). Frequently occurring adverse events (AEs) included diarrhea (arms A/B/C, 70%/67%/56%), palmar-plantar erythrodysesthesia syndrome (52%/47%/54%), alopecia (50%/45%/50%), and hypertension (42%/49%/46%). Fifteen patients had grade 4 AEs (arms A/B/C, n = 3/7/5); 4 had fatal AEs (n = 2/1/1), with 1 (abdominal pain, arm B) considered possibly related to AMG 386. CONCLUSIONS In patients with mRCC, AMG 386 plus sorafenib was tolerable but did not significantly improve PFS compared with placebo plus sorafenib. PMID:22692704

  18. PET as a substitute for second-look surgery in patients with advnaced epithelia ovarian carcinomas

    International Nuclear Information System (INIS)

    To compare the prognostic value o PET with second look laparotomy(SLL) in patients with advanced ovarian carcinoma following primary chemotherapy. 55 patients undergone cytoreductive surgery and adjuvant chemotherapy for epithelial ovarian carcinoma were enrolled in this study. 30 patients underwent SLL after primary treatment. 25 patients underwent PET after primary treatment without SLL. We retrospectively reviewed the medical records of 55 patients for comparison of relapse-free interval. Ovarian carcinomas recurred in 12 of 55 patients. FDG PET detected the recurrence of ovarian carcinoma in 8 patients(sensitivity=66.7%; specificity=88.7%; p=0.003), and better than CT/MRI (sensitivity=41.7%; specificity=58.2%; p>0.05). The median duration of survival after SLL was 29.6 months and that after PET was 30.9 months(p>0.05). FDG PET can be a sustitute for SLL for following up patients who have had ovarian carcinoma, especially with high risk for recurrence

  19. Maxillary sinus carcinoma

    International Nuclear Information System (INIS)

    Primary site control, anatomical site of failure, survival, and complications of treatment were determined in a retrospective review of primary maxillary sinus carcinoma. Sixty-one patients were treated by radiation followed by surgery and 35 by radiation alone. Primary tumor control was achieved in 69% of patients receiving combined treatment, 14% of patients treated with radiation alone, and 49% of all patients. Local control did not differ with histological type. Virtually all epidermoid and undifferentiated carcinoma recurrences occurred within 2 years, but 27% of adenocarcinomas recurred after 2 years

  20. Decreased Platelet Count in Patients Receiving Continuous Veno-Venous Hemofiltration: A Single-Center Retrospective Study

    OpenAIRE

    Wu, Buyun; Gong, Dehua; Xu, Bin; He, Qunpeng; Liu, Zhihong; Ji, Daxi

    2014-01-01

    Background A decreased platelet count may occur and portend a worse outcome in patients receiving continuous renal replacement therapy (CRRT). We aim to investigate the incidence of decreased platelet count and related risk factors in patients receiving CRRT. Methods In this retrospective study, we screened all patients receiving continuous veno-venous hemofiltration (CVVH) at Jinling Hospital between November 2008 and October 2012. The patients were included who received uninterrupted CVVH f...

  1. Matrix Metalloproteinase-2, Squamous Cell Carcinoma Antigen, and Tissue Polypeptide-Specific Antigen Expression in Egyptian Patients with Cervical Carcinoma: Relationship with Prognosis

    Directory of Open Access Journals (Sweden)

    Maha Imam Ahmed

    2004-01-01

    Full Text Available Matrix metalloproteinases (MMPs, a family of proteolytic enzymes produced by both stromal and tumor cells, appear to have a key role in the events leading to local invasion and metastasis by malignant neoplasms. In the present study, we evaluated the role of MMP-2, squamous cell carcinoma antigen (SCCA, and tissue polypeptide – specific antigen (TPS in cervical neoplasia. Using Western blotting and enzyme immunoassay (EIA, we analyzed 50 patients with cervical carcinoma (CC and 25 normal controls for expression of MMP-2 in tissue cell lysates. We also quantified SCCA and TPS with microparticle immunoassay and EIA, respectively. The results were correlated with human papilloma virus (HPV infection, clinicopathological findings, and disease outcome. The cutoff point for each marker was estimated from receiver operating characteristic curves. Logistic regression analysis was performed to estimate the odds ratio (OR and 95% confidence interval (CI for each marker. MMP-2, SCCA, and TPS protein expression were significantly higher in patients with CC than in normal controls. While TPS was the best marker for discriminating between patients and controls, MMP-2 was associated with an advanced tumor stage (OR, 13.9 [95% CI, 1.4-133.9] and poor histological grade (OR, 10.2 [95% CI, 1.7-60.5]. Moreover, independent of the effect of an advanced CC stage and grade, the patients' age, and the presence of HPV infection, MMP-2 was considered a strong predictor for CC recurrence (OR, 8.1 [95% CI, 1.3- 49.1]. Tissue markers may be used to select high-risk patients for early detection of and adjuvant therapy for recurrence. Our MMP-2 findings are particularly relevant to the development of protease inhibitors as a new cancer therapy approach.

  2. Effect of Auricular Acupressure on Uremic Pruritus in Patients Receiving Hemodialysis Treatment: A Randomized Controlled Trial

    OpenAIRE

    Cui-na Yan; Wei-guo Yao; Yi-jie Bao; Xiao-jing Shi; Hui Yu; Pei-hao Yin; Gui-zhen Liu

    2015-01-01

    Background. Uremic pruritus (UP) is a common symptom in patients undergoing maintenance hemodialysis for end-stage renal disease (ESRD). Objective. To determine the clinical efficacy of auricular acupressure therapy on pruritus in hemodialysis patients and to explore possible underlying mechanisms. Methods. Patients receiving maintenance hemodialysis at a referral medical center were recruited and assigned to intervention (n = 32) and control (n = 30) groups. The intervention group underwent ...

  3. Nausea and vomiting in patients receiving acupuncture, sham acupuncture or standard care during radiotherapy

    OpenAIRE

    Enblom, Anna

    2008-01-01

    Background and aim: Many patients with cancer experience emesis (nausea and vomiting) during radiotherapy. The overall aim of this thesis was to improve the situation for patients with risk for emesis during radiotherapy, by evaluating emesis in patients receiving verum (genuine) acupuncture, sham (simulated) acupuncture or standard care during radiotherapy. Methods: In study I, a cross-sectional sample (n=368) treated with radiotherapy over various fields answered a study-specific questionna...

  4. Pursuit and practice of complementary therapies by cancer patients receiving conventional treatment.

    OpenAIRE

    Downer, S. M.; Cody, M. M.; McCluskey, P; Wilson, P D; Arnott, S. J.; Lister, T. A.; Slevin, M L

    1994-01-01

    OBJECTIVES--To determine what proportion of oncology patients receiving conventional medical treatment also use complementary treatments; to assess which complementary treatments are the most popular and to assess patients' motivation for using them; to evaluate associated advantages and risks. DESIGN--Postal screening questionnaire followed by semistructured interview. SETTING--Two hospitals in inner London. SUBJECTS--600 unselected oncology patients aged 18 or over who had known their diagn...

  5. Coping strategies and socio-demographic characteristics among Jordanian caregivers of patients receiving hemodialysis

    OpenAIRE

    Eman Alnazly

    2016-01-01

    Individuals who care for family members receiving chronic hemodialysis (HD) are likely to experience burdens that may adversely impact their patients. Effective coping strategies are shaped by various factors, including sociodemographic characteristics. To assess the relationship between caregivers and their patients, we studied 225 family-member caregivers of chronic HD patients through answering the Ways of Coping Questionnaire-Revised. Sociodemographic data, including caregiver age, gender...

  6. The incidence of malignant disease in patients receiving cytotoxic therapy for rheumatoid arthritis.

    OpenAIRE

    Kirsner, A B; Farber, S. J.; Sheon, R P; Finkel, R I

    1982-01-01

    One hundred and twenty-six patients with definite or classical rheumatoid arthritis admitted to hospital between 1965 and 1974 for cytotoxic therapy were studied for the presence and type of malignant disease. Each of the cytotoxic treated patients was age and sex matched to a rheumatoid arthritis patient admitted to hospital during the same years but who did not receive cytotoxic therapy. There was no increase in malignancy in the cytotoxic treated group over the control group.

  7. Management of critically ill patients receiving noninvasive and invasive mechanical ventilation in the emergency department

    OpenAIRE

    Rose, Louise

    2012-01-01

    Patients requiring noninvasive and invasive ventilation frequently present to emergency departments, and may remain for prolonged periods due to constrained critical care services. Emergency clinicians often do not receive the same education on management of mechanical ventilation or have similar exposure to these patients as do their critical care colleagues. The aim of this review was to synthesize the evidence on management of patients requiring noninvasive and invasive ventilation in the ...

  8. Can Intensity-Modulated Radiotherapy Preserve Oral Health-Related Quality of Life of Nasopharyngeal Carcinoma Patients?

    International Nuclear Information System (INIS)

    Purpose: To investigate the changes in salivary function and oral health-related quality of life for patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy (IMRT). Methods and Materials: A total of 57 patients with early-stage nasopharyngeal carcinoma received IMRT. The parotid and whole saliva flow was measured, and the Medical Outcomes Study 36-item short form, European Organization for Research and Treatment of Cancer Quality of Life questionnaire-C30, European Organization for Research and Treatment of Cancer Quality of Life questionnaire 35-item head-and-neck module, and Oral Health Impact Profile questionnaires were completed at baseline and 2, 6, 12, 18, and 24 months after IMRT. Results: Parotid saliva flow recovered fully after 1 year and maintained. Whole saliva flow recovered partially to 40% of baseline. A general trend of deterioration in most quality of life scales was observed after IMRT, followed by gradual recovery. Persistent oral-related symptoms were found 2 years after treatment. Conclusion: IMRT for early-stage nasopharyngeal carcinoma could only partially preserve the whole salivary function and oral health-related quality of life.

  9. Can Intensity-Modulated Radiotherapy Preserve Oral Health-Related Quality of Life of Nasopharyngeal Carcinoma Patients?

    Energy Technology Data Exchange (ETDEWEB)

    Pow, Edmond H.N., E-mail: ehnpow@hku.hk [Oral Rehabilitation, University of Hong Kong Faculty of Dentistry, Hong Kong Special Administrative Region (China); Kwong, Dora L.W.; Sham, Jonathan S.T.; Lee, Victor H.F.; Ng, Sherry C.Y. [Department of Clinical Oncology, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong Special Administrative Region (Hong Kong)

    2012-06-01

    Purpose: To investigate the changes in salivary function and oral health-related quality of life for patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy (IMRT). Methods and Materials: A total of 57 patients with early-stage nasopharyngeal carcinoma received IMRT. The parotid and whole saliva flow was measured, and the Medical Outcomes Study 36-item short form, European Organization for Research and Treatment of Cancer Quality of Life questionnaire-C30, European Organization for Research and Treatment of Cancer Quality of Life questionnaire 35-item head-and-neck module, and Oral Health Impact Profile questionnaires were completed at baseline and 2, 6, 12, 18, and 24 months after IMRT. Results: Parotid saliva flow recovered fully after 1 year and maintained. Whole saliva flow recovered partially to 40% of baseline. A general trend of deterioration in most quality of life scales was observed after IMRT, followed by gradual recovery. Persistent oral-related symptoms were found 2 years after treatment. Conclusion: IMRT for early-stage nasopharyngeal carcinoma could only partially preserve the whole salivary function and oral health-related quality of life.

  10. Intracranial Metastasis in a Patient with Hepatocellular Carcinoma and Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Akinobu Tawada

    2014-03-01

    Full Text Available A 76-year-old man was referred to our hospital with visual disturbance, weakness of the left upper and lower limbs, and gait disturbance. He had previously received transarterial chemoembolization for hepatocellular carcinoma (HCC 3 and 10 years ago. When he had received radiofrequency ablation for HCC recurrence 2 years ago, total gastrectomy was also performed for his gastric cancer. Subsequently, sorafenib had been administrated for concomitant lung metastatic tumors. On admission, MRI revealed an intra-axial tumor with perifocal edema. The level of carcinoembryonic antigen, but not alpha-fetoprotein, markedly increased. The tumor was successfully removed by craniotomy and pathological examination revealed that it was composed of adenocarcinoma, which was consistent with the primary gastric cancer. After surgery, his neurological disturbances rapidly resolved. Additional gamma-knife treatment was also performed for another small brain metastasis detected after craniotomy. Subsequently, sorafenib administration was discontinued and S-1 was administered postoperatively. Successful treatment of intracranial metastasis of gastric cancer is important and meaningful, even in patients with multiple primary malignancies.

  11. Phase I and II studies of the combination of recombinant human interferon-gamma and 5-fluorouracil in patients with advanced colorectal carcinoma.

    Science.gov (United States)

    Ajani, J A; Rios, A A; Ende, K; Abbruzzese, J L; Edwards, C; Faintuch, J S; Saks, S; Gutterman, J U; Levin, B

    1989-04-01

    Based on the in vitro and in vivo data suggesting synergistic cytolysis by the combination of 5-fluorouracil and interferon-gamma against a variety of malignant cell lines including a human colon carcinoma cell line (HT-29), we initiated studies in patients with advanced colon or rectal carcinoma. Forty-six patients received 5-fluorouracil as an intravenous injection on days 1-5 and recombinant human interferon-gamma as an intramuscular injection on days 1-14, followed by a rest period of 14 days; courses were repeated every 28 days. In the phase I study, cohorts of two patients received a stepwise dose level increase to achieve the maximum tolerated dose (MTD), at which a total of six patients were studied. The dose levels constituting the MTD were as follows: 5-fluorouracil (500 g/m2/day) and recombinant gamma-interferon (0.5 mg/m2/day). Four patients achieved a partial response in the phase I study. In the phase II study, 30 patients received therapy at the MTD. Among 29 evaluable patients in the phase II study, two patients achieved a partial response. Common toxicities included malaise, fever, anorexia, nausea and vomiting, and diarrhea. Transient severe myelosuppression was common but did not result in significant morbidity. Our data suggest that the combination of 5-fluorouracil and recombinant gamma-interferon did not have the same antitumor effect in patients as it had in the preclinical experiments. PMID:2499663

  12. Clinical characteristics and outcome of a cohort of 101 patients with hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Christian Rabe; Tillmann Pilz; Christoph Klostermann; Marc Berna; Hans H. Schild; Tilman Sauerbruch; Wolfgang H. Caselmann

    2001-01-01

    AIM To conduct a cohort study of 101 patients with hepatocellular carcinoma (HCC) presenting to a tertiary care medical referral center in Germany between 1997 and 1999.METHODS AND RESULTS Data were retrospectively analyzed by chart review. In 95cases (72 males and 23 females) sufficient data were available for analysis. Twenty-five (29%)of 8.5 patients were HBsAg or anti-HBc positive,21/85 (25%) were anti-HCV positive, and 6/85(7%) were positive for both HBV and HCV-markers. Age was significantly lower in HBV-positive patients than in the other two groups.Thirty-one (34%) of 90 patients had histories of alcohol abuse, In 79/ 94 (84%) patients,cirrhosis was diagnosed. Of these cirrhotic patients, 29/79 (37%) belonged to Child-Pugh's group (CHILD) A, 32/79 (40%) to CHILD B, and 18/79 (23%) to CHILD C. AFP was elevated in 61/91 (67%) patients. A single tumor nodule was found in 38/94 (40%), more than one nodule in 31/94 (34%), and 25/94 (26%) had a diffusely infiltrating tumor, i.e. the tumor margins could not be seen on imaging procedures. Portal vein thrombosis was present in 19/ 94 (20%).Imaging data consistent with lymph node metastases were found in 10/92 (11%), while distant metastases were found in 8/93 (9%).According to Okuda 28/94 (30%) were grouped to stage Ⅰ, 53/94 (56%) were grouped to stage Ⅱ, and 13/94 (14%) were grouped to stage Ⅲ.Survival data were available for 83 patients. The Kaplan-Meier estimate for median survival was 8.4 months. Factors influencing survival were the Okuda score, the presence of portal vein thrombosis, and the presence of ascites. The presence of non-complicated liver cirrhosis by itself, distant metastases, or infection with hepatitis viruses did not influence survival. AFP positivity by itself did not influence survival,though patients with an AFP value greater than 100μg/L did experience shortened survival.Treatment besides tamoxifen or supportive care was associated with prolonged survival. The influence of therapy on

  13. Clinical application of percutanously interventional therapeusis in patients with hepatocellular carcinoma accompanied with bile duct thrombosis

    International Nuclear Information System (INIS)

    Objective: To explore the method and value of percutanously interventional therapeusis for treatment of obstructive jaundice caused by hepatocellular carcinoma accompanied with bile duct thrombosis. Methods: Sixteen cases bile duct thrombosis proved by pathology and imaging examinations were retrospectively analyzed. According to the clinical symptoms, all the patients received percutaneous transhepatic biliary drainage (PTBD) including permanent external drainage, temporary internal drainage and implantation of covered stents. Serum total bilirubin (TBIL) after the interventional therapeusis were measured and compared with that before the treatments by t test to evaluate the efficacy of these treatments. The relief of clinical symptoms was also reviewed to evaluate the efficacy of these treatments. The relief of clinical symptoms was also reviewed to evaluate the efficacy of these treatments. The patients were followed up within 2 years. Results: The PTBD was successfully performed in 16 cases. Permanent external drainage, temporary internal drainage and imalantation of covered stents were performed in 2 patients, 7 patients and 7 patients respectively. TBIL after the interventional therapy decreased significantly (t=7.366, P<0.01) to (161.2 ± 80.5) μmol/L averagely from (261.9 ± 77.2) μmol/L before the treatments. All the patients died before the end of followed-up. The average survival time was 204 days (30 to 391 d) and the median survival time was 200 days. Bleeding and infection were the main complications, which could be controlled successfully by routine treatments. Conclusion: With high achievement ratio and good efficacy, percutanously interventional therapeusis are good choices for the treatments of obstructive jaundice due to bile duct thrombosis. (authors)

  14. Clinical features and prognostic factors in patients with bone metastases from hepatocellular carcinoma after liver transplantation

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    He Jian

    2011-11-01

    Full Text Available Abstract Background Little is known about the clinical features and prognostic factors of bone metastases of hepatocellular carcinoma (HCC following liver transplantation (LT. Methods All adult patients undergoing LT from 2001 to 2010 were reviewed. Patients with HCC bone metastases after LT received external beam radiotherapy(EBRT during this period. Demographic variables, laboratory values, and tumor characteristics were determined before LT and EBRT. Total radiation dose ranged from 8 to 60 Gy(median dose 40.0 Gy. Results The trunk was the most common site of bone metastases with finding of expansile soft-tissue masses in 23.3% of patients. Overall pain relief from EBRT occurred in 96.7% (29/30. No consistent dose-response relationship was found for palliation of with doses between 30 and 56 Gy (P = 0.670. The median survivals from the time of bone metastases was 8.6 months. On univariate and multivariate analyses, better survival was significantly associated with a better Karnofsky performance status (KPS and well-controlled intrahepatic tumor, but not with lower alpha-fetoprotein levels. The median time from LT to bone metastases was 7.1 months. Patients exceeding the Shanghai criteria presented with bone metastases earlier than those within the Fudan criteria. Patients with soft-tissue extension always had later bone metastases. The majority of deaths were caused by liver failure due to hepatic decompensation or tumor progression. Conclusion The prognostic factors of bone metastases of HCC following LT are KPS and well-controlled intrahepatic. Even though survival is shorter for these patients, EBRT provides effective palliation of pain.

  15. Invasive aspergillosis causing small bowel infarction in a patient of carcinoma breast undergoing chemotherapy

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    Jain Vinod

    2006-01-01

    Full Text Available Abstract Background To report a 45 year old lady presenting with proximal jejunal gangrene due to invasive Aspergillosis. The patient was undergoing adjuvant chemotherapy for advance carcinoma of breast (Stage IV. Methods The patient was referred to our surgical emergency for acute abdominal symptoms for 6 hours. Histopathology revealed bowel wall necrosis and vascular invasion by Aspergillus Fumigatus. Postoperative recovery was uneventful and the patient received Amphotericin-B (1 mg/kg/day for invasive aspergillosis. Invasive pulmonary aspergillosis was confirmed by isolating Aspergillus Fumigatus from bronchoalveolar lavage and by a positive circulating galactomannan test (ELISA Assay. Results Detailed history revealed dry cough and two episodes of haemoptesis for 2 weeks. Haemogram and counts revealed anemia and neutropenia. Plain X – ray of the abdomen showed multiple air fluid levels and ultrasound of the abdomen revealed distended bowel loops. On exploration small bowel was found to be gangrenous. The patient was successfully managed by supportive treatment and conventional intravenous Amphotericin-B for 2 weeks. The lady was discharged one week after completion of antifungal therapy and one month later she underwent toilet mastectomy. The lady came to follow up for 1 year and she is currently under hormone therapy. Conclusion With the emergence of new and powerful immunosuppressive, anticancer drugs and potent antibiotics the survival of transplant and critically ill patients has remarkably increased but it has shown a significant rise in the incidence of invasive opportunistic fungal infections. We conclude hat the diagnosis of invasive gastrointestinal aspergillosis may be considered in a neutropenic patient with acute abdominal symptoms.

  16. Prognostic Nomogram for Patients with Nasopharyngeal Carcinoma after Intensity-Modulated Radiotherapy.

    Directory of Open Access Journals (Sweden)

    Shixiu Wu

    Full Text Available This study was aimed to define possible predictors of overall survival in nasopharyngeal carcinoma (NPC. Patients were treated with intensity-modulated radiation therapy (IMRT, to establish an effective prognostic nomogram that could provide individualized predictions of treatment outcome in this setting. We reviewed the records of 533 patients with non-metastatic NPC who underwent IMRT with or without concurrent chemotherapy at the Department of Radiation Oncology of Sun Yat-Sen University from 2002 to 2009; none of these patients received induction or adjuvant chemotherapy. These data sets were used to construct a nomogram based on Cox regression. Nomogram performance was determined via a concordance index (C-index and a calibration curve which was compared with the TNM staging system for NPC. The results were validated in an external cohort of 442 patients from the Department of Radiation Oncology of Wenzhou Medical College who were treated during the same period. Results showed that the greatest influence on survival were primary gross tumor volume, age, tumor stage and nodal stage (2002 Union for International Cancer Control [UICC] staging system, which were selected into the nomogram. The C-index of the nomogram for predicting survival was 0.748 (95%CI, 0.704-0.785, which was statistically higher than that of TNM staging system (0.684, P<0.001. The calibration curve exhibited agreement between nomogram-predicted and the actual observed probabilities for overall survival. In the validation cohort, the nomogram discrimination was superior to the TNM staging system (C-index: 0.768 vs 0.721; P = 0.026. In conclusion, the nomogram proposed in this study resulted in more-accurate prognostic prediction for patients with NPC after IMRT and compared favorably to the TNM staging system; this individualized information will aid in patient counseling and may be used for de-escalation trials in the future.

  17. Trimethoprim-sulfamethoxazole induced hyperkalaemia in elderly patients receiving spironolactone: nested case-control study

    OpenAIRE

    Antoniou, Tony; Gomes, Tara; Mamdani, Muhammad M.; Yao, Zhan; Hellings, Chelsea; Garg, Amit X.; Matthew A Weir; Juurlink, David N.

    2011-01-01

    Objectives To characterise the risk of admission to hospital for hyperkalaemia in elderly patients treated with trimethoprim-sulfamethoxazole in combination with spironolactone. Design Population based nested case-control study. Setting Ontario, Canada, from 1 April 1992 to 1 March 2010. Participants Cases were residents of Ontario aged 66 years or above receiving chronic treatment with spironolactone and admitted to hospital with hyperkalaemia within 14 days of receiving a prescription for e...

  18. Percutaneous treatment of hepatocellular carcinoma in patients with cirrhosis: A comparison of the safety of cryoablation and radiofrequency ablation

    International Nuclear Information System (INIS)

    Purpose: To compare the safety of image-guided percutaneous cryoablation and radiofrequency ablation in the treatment of hepatocellular carcinoma in patients with cirrhosis. Materials and methods: This retrospective HIPAA-compliant study received institutional review board approval. Forty-two adult patients with cirrhosis underwent image-guided percutaneous ablation of hepatocellular carcinoma from 2003 to 2011. Twenty-five patients underwent 33 cryoablation procedures to treat 39 tumors, and 22 underwent 30 radiofrequency ablation procedures to treat 39 tumors. Five patients underwent both cryoablation and radiofrequency ablation procedures. Complication rates and severity per procedure were compared between the ablation groups. Potential confounding patient, procedure, and tumor-related variables were also compared. Statistical analyses included Kruskal–Wallis, Wilcoxon rank sum, and Fisher's exact tests. Two-sided P-values <0.05 were considered significant. Results: The overall complication rates, 13 (39.4%) of 33 cryoablation procedures versus eight (26.7%) of 30 radiofrequency ablation procedures and severe/fatal complication rates, two (6.1%) of 33 cryoablation procedures versus one (3.3%) of 30 radiofrequency ablation procedures, were not significantly different between the ablation groups (both P = 0.26). Severe complications included pneumothoraces requiring chest tube insertion during two cryoablation procedures. One death occurred within 90 days of a radiofrequency ablation procedure; all other complications were managed successfully. Conclusion: No significant difference was seen in the overall safety of image-guided percutaneous cryoablation and radiofrequency ablation in the treatment of hepatocellular carcinoma in patients with cirrhosis

  19. Tailored Selection of First-Line Cisplatin-Based Chemotherapy in Patients with Metastatic Urothelial Carcinoma of Bladder

    Science.gov (United States)

    Hsieh, Meng-Che; Huang, Cheng-Hua; Chiang, Po-Hui; Chen, Yen-Yang; Tang, Yeh; Su, Yu-Li

    2016-01-01

    Purpose: Methotrexate, vinblastine, doxorubicin plus cisplatin (MVAC) and gemcitabine plus cisplatin (GC) are both effective first-line chemotherapy. We explore the responsive variables of MVAC and GC for patients with metastatic urothelial carcinoma of bladder (mUCB). Materials and Methods: Patients who were initially diagnosed to have mUCB and received MVAC or GC as metastatic first-line chemotherapy between 2000 and 2014 at Kaohsiung Chang Gung Memorial Hospital were reviewed. Totally, 130 patients were enrolled into our study. Univariable Cox proportional hazard models were constructed for OS. Hazard ratio (HR) and 95% confidence intervals (CIs) was also presented. Results: There were 50 patients (38%) in the MVAC group and 80 patients (62%) in the GC group. The median OS was insignificantly different between MVAC and GC groups, accounting for 17.0 and 14.4 months (P = 0.214), respectively. OS of MVAC group was significantly longer with regard to age ≦ 60 years (HR: 0.38, 95% CI: 0.12-0.97, P = 0.036), pure urothelial carcinoma (HR: 0.56, 95% CI: 0.34-0.90, P = 0.015), > 1 metastatic sites (HR: 0.19, 95% CI: 0.08-0.44, P = 3(HR: 0.45, 95% CI: 0.25-0.81, P = 0.006), while OS with GC group was significantly longer with regard to variant urothelial carcinoma (HR: 0.56, 95% CI: 0.34-0.90, P = 0.015). Conclusions: Our study disclosed the predictive factors of different regimen for mUCB. These results have clinical implication for physicians who treat patients with mUCB. PMID:27390610

  20. Incidence and predictors of Lhermitte’s sign among patients receiving mediastinal radiation for lymphoma

    International Nuclear Information System (INIS)

    To prospectively examine the risk of developing Lhermitte’s sign (LS) in patients with lymphoma treated with modern-era chemotherapy followed by consolidation intensity-modulated radiation therapy. We prospectively interviewed all patients with lymphoma who received irradiation to the mediastinum from July 2011 through April 2014. We extracted patient, disease, and treatment-related variables from the medical records of those patients and dosimetric variables from treatment-planning systems and analyzed these factors to identify potential predictors of LS with Pearson chi-square tests. During the study period 106 patients received mediastinal radiation for lymphoma, and 31 (29 %) developed LS. No correlations were found between LS and any of the variables examined, including total radiation dose, maximum point dose to the spinal cord, volume receiving 105 % of the dose, and volumes receiving 5 or 15 Gy. In this group of patients, treatment with chemotherapy followed by intensity-modulated radiation therapy led to 29 % developing LS; this symptom was independent of radiation dose and seemed to be an idiosyncratic reaction. This relatively high incidence could have resulted from prospective use of a structured interview

  1. SPARING CYSTECTOMY IN PATIENTS WITH TRANSITIONAL-CELL CARCINOMA OF THE URINARY BLADDER

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    V. B. Matveyev

    2014-07-01

    Full Text Available Objective: to study the results of sparing cystectomy in patients with urinary bladder cancer (UBC.Subjects and methods. The study has covered 82 patients with transitional-cell UBC (T1-4aN0M0 who received radiotherapy (RT and thenunderwent radical cystectomy at the N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, in 1980 to2007. Among them there were 76 (92.7% males and 6 (7.3% females. The median age was 55.2±10.8 years. Superficial (T1 and inva-sive (Т2—4а carcinomas were detected in 33 (40.2% and 49 (59.8% patients, respectively. Category N+ was identified in 3 (3.7% patients.All the patients received RT to the bladder area (median total focal dose (TFD 56±12.3 Gy and regional metastatic zones (median TFD40.0±0.0 Gy. A full effect of irradiation was achieved in 44 (53.7% patients, of whom 41 (93.2% developed local relapses. All the 82patients underwent radical cystectomy: that with ureterostomy in 28 (34.1% cases, Bricker’s operation in 45 (54.4%, Studer’s operationin 4 (4.9%, and rectal urinary bladder in 5 (6.1%. The median follow-up was 32.7±31.9 months.Results. The median interval between RT and cystectomy was 12.5±5.1 months; the median time of surgery was 360 (60—480 min; themedian blood loss was 1515.2±1227.8 ml. Intraoperative and postoperative complications developed in 10 (12.2% and 40 (48.6%patients, respectively. Repeated operations were performed in 7 (8.4% cases. Mortality was 4.9%. A urinary derivation technique failed toaffect the incidence of complications and the rates of mortality (p > 0.05. Histological studies revealed transitional-cell carcinoma in thedistant specimens in 80 (97.6% cases. Recurrences developed in 40 (48.8% of the 82 patients following an average of 32.9 (1—150months of cystectomy: local relapses in 5 (6.1% cases; distant metastases in 29 (35.4%; a local relapse and distant metastases in 5 (6.1%;urethral recurrence in 1 (1.2% patient. Five-year overall

  2. SPARING CYSTECTOMY IN PATIENTS WITH TRANSITIONAL-CELL CARCINOMA OF THE URINARY BLADDER

    Directory of Open Access Journals (Sweden)

    V. B. Matveyev

    2009-01-01

    Full Text Available Objective: to study the results of sparing cystectomy in patients with urinary bladder cancer (UBC.Subjects and methods. The study has covered 82 patients with transitional-cell UBC (T1-4aN0M0 who received radiotherapy (RT and thenunderwent radical cystectomy at the N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, in 1980 to2007. Among them there were 76 (92.7% males and 6 (7.3% females. The median age was 55.2±10.8 years. Superficial (T1 and inva-sive (Т2—4а carcinomas were detected in 33 (40.2% and 49 (59.8% patients, respectively. Category N+ was identified in 3 (3.7% patients.All the patients received RT to the bladder area (median total focal dose (TFD 56±12.3 Gy and regional metastatic zones (median TFD40.0±0.0 Gy. A full effect of irradiation was achieved in 44 (53.7% patients, of whom 41 (93.2% developed local relapses. All the 82patients underwent radical cystectomy: that with ureterostomy in 28 (34.1% cases, Bricker’s operation in 45 (54.4%, Studer’s operationin 4 (4.9%, and rectal urinary bladder in 5 (6.1%. The median follow-up was 32.7±31.9 months.Results. The median interval between RT and cystectomy was 12.5±5.1 months; the median time of surgery was 360 (60—480 min; themedian blood loss was 1515.2±1227.8 ml. Intraoperative and postoperative complications developed in 10 (12.2% and 40 (48.6%patients, respectively. Repeated operations were performed in 7 (8.4% cases. Mortality was 4.9%. A urinary derivation technique failed toaffect the incidence of complications and the rates of mortality (p > 0.05. Histological studies revealed transitional-cell carcinoma in thedistant specimens in 80 (97.6% cases. Recurrences developed in 40 (48.8% of the 82 patients following an average of 32.9 (1—150months of cystectomy: local relapses in 5 (6.1% cases; distant metastases in 29 (35.4%; a local relapse and distant metastases in 5 (6.1%;urethral recurrence in 1 (1.2% patient. Five-year overall

  3. The Study of Laparoscopic Nephrectomy Effectiveness in Patients with Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Kochoyan T.M.

    2011-06-01

    Full Text Available The aim of the study is to assess the effectiveness of short-term and long-term results in patients with renal cell carcinoma being operated on using open surgery and laparoscopy. Materials and Methods. There were studied 214 patients with renal cell carcinoma with radical nephrectomy. 164 patients underwent laparoscopy, and 50 patients were operated on using open surgery technique. Conclusion. The comparative analysis of short-term and long-term results of renal cell carcinoma surgical treatment and long-term survival of patients depending on the approach — by an open surgery and by an endoscopic technique — showed the laparoscopic approach to be absolutely acceptable and oncologically adequate.

  4. Nursing care of patients receiving interventional therapy for hepatic artery stenosis after liver transplantation

    International Nuclear Information System (INIS)

    Objective: To discuss the perioperative nursing care of patients who is going to receive interventional therapy for hepatic artery stenosis after liver transplantation and to provide useful reference for reducing surgery-related complication and for improving the prognosis of patients. Methods: Based on the patient's condition and operative requirement,we provided effective nursing care for 20 patients who were admitted to receive the interventional therapy for hepatic artery stenosis after liver transplantation. The nursing care included preoperative preparation,postoperative nursing and medical guidance at the time of discharge. Results: Interventional therapy was successfully performed in all 20 cases, and no hemorrhagic tendency or acute thrombosis occurred. Marked symptomatic improvement was obtained in all patients. Conclusion: The interventional therapy is an effective treatment for hepatic artery stenosis after liver transplantation. Intensive perioperative nursing care can well prevent the occurrence of surgery-related complications and can surely improve the therapeutic results. (authors)

  5. Reversible Encephalopathy and Delirium in patients with chronic renalfailure who had received Ciprofloxacin

    International Nuclear Information System (INIS)

    We describe four patients with chronic renal failure (CRF) who developedsignificant neurotoxicity after receiving short-term ciprofloxacin. Three ofthem had developed encephalopathy with myoclonic jerks and one patient haddelirium. All patients had advanced chronic renal failure (mean estimatedcreatinine clearance 16+-6 ml/min), although they were not yet on renalreplacement therapy). The mean received dose of ciprofloxacin was 2150+-1300mg and symptoms started to appear after the first 24 hours of drug intake.Investigations ruled out other possible causes of these neurologicalpresentations and withdrawal of ciprofloxacin was followed by completeresolution, after a mean of 8.5+- 4 days. Advanced renal failure in allpatients and underlying neurologic disease in two patients may havepredisposed them to the neurotoxicity. The report of these cases should helpto draw the attention of clinicians to the potential occurrence of theseadverse effects in patients with CRF. (author)

  6. Peripheral lipodystrophy measure by DEXA in patients receiving HIV protease inhibitors

    International Nuclear Information System (INIS)

    Full text: Protease inhibitors in combination with HIV reverse transcriptase inhibitors are now recommended as standard anti-retroviral therapy. A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance, which correlates closely with abdominal obesity, has been associated with HIV protease inhibitors. 62 HIV-infected patients, 43 receiving protease inhibitors and 19 protease inhibitor-naive, had dual energy X-ray absorptiometry (DEXA) measurements using the Lunar DPXL performed of the total body to assess body fat distribution. Each group had a comparable mean age and body mass index. Patients receiving protease inhibitors had significantly lower mean fat mass overall and in each region except for the central abdomen when compared to the protease inhibitor-naive group. This study demonstrates that DEXA total body measurement using the Lunar DPXL may be a useful tool in detecting regionalized fat loss in HIV positive patients receiving protease inhibitors and has potential for assessing its therapy

  7. Chemotherapy and low-dose radiotherapy in the treatment of HIV-infected patients with carcinoma of the anal canal

    International Nuclear Information System (INIS)

    Purpose: To determine the efficacy and tolerance of a standardized protocol of chemotherapy and low-dose radiotherapy in the treatment of anal cancer in human immunodeficiency virus (HIV)-infected patients. Methods and Materials: Between 1987 and 1995, eight HIV-positive patients with squamous cell carcinoma of the anal canal, four of whom had acquired immunodeficiency syndrome (AIDS), received therapy at the Kaiser Permanente Medical Center. All patients were treated using a combined modality approach consisting of lowdose radiotherapy (30 Gy in 15 fractions delivered 5 days/week), and chemotherapy [1000 mg/m2 of 5-fluorouracil (5-FU) delivered on days 1-4 and 29-32 as a continuous infusion over 96 h, and 10 mg/m2 of mitomycin C delivered as a bolus injection on day 1]. Patients have been followed from 4 to 81 months (mean 41, median 38). Results: All eight patients completed the therapy with minor variations to the protocol, and all have attained a clinical complete response. Four patients are alive and free of disease, and four died as a result of complications of AIDS, but remained free of anal carcinoma. There were no mortalities from the protocol and the morbidity was acceptable. Only one patient each was noted to have Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Grade 4 hematologic and gastrointestinal acute toxicity, and no Grade 4 skin toxicity was noted. Conclusion: This combined therapy is effective for HIV-infected patients and appears to be tolerable with acceptable toxicities. It is best applied to patients who are HIV positive, or who have AIDS without concurrent major opportunistic infections. This approach is reasonable and affords patients a reasonably good chance at sphincter preservation by avoiding abdominoperineal resection. The optimal therapy for HIV-positive patients with advanced AIDS remains less well defined

  8. Hyperglycemia in Hospitalized Patients Receiving Parental Nutrition Is Associated with Increased Morbidity and Mortality: A Review

    Directory of Open Access Journals (Sweden)

    Puja Rajender Kumar

    2011-01-01

    Full Text Available Parenteral Nutrition (PN is a valuable life saving intervention which can improve the nutritional status of hospitalized malnourished patients. PN is associated with complications including the development of hyperglycemia. This paper aims to provide a descriptive systematic review regarding the effects of PN-induced hyperglycemia in hospitalized patients, either in the intensive care unit or ward, while formulating and complementing existing guidelines on the administration of PN and glucose monitoring in hospitalized patients. Medline and Pubmed were searched for relevant articles describing complications arising from the development of hyperglycemia in patients receiving PN; four relevant studies were identified in the search. These articles had different glycemic targets and patient populations, and their protocols varied with regards to glycemic control. However, there was consistency regarding the association between hyperglycemia and mortality in patients receiving PN. These studies highlight the need for guidelines regarding monitoring and initiation of therapy in hyperglycemic patients. Unfortunately, all the currently available studies are retrospective in design; a large, prospective, randomized controlled trial regarding glycemic control in patients receiving PN is required for the development of standardized protocols.

  9. Identifying drivers of overall satisfaction in patients receiving HIV primary care: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Bich N Dang

    Full Text Available OBJECTIVE: This study seeks to understand the drivers of overall patient satisfaction in a predominantly low-income, ethnic-minority population of HIV primary care patients. The study's primary aims were to determine 1 the component experiences which contribute to patients' evaluations of their overall satisfaction with care received, and 2 the relative contribution of each component experience in explaining patients' evaluation of overall satisfaction. METHODS: We conducted a cross-sectional study of 489 adult patients receiving HIV primary care at two clinics in Houston, Texas, from January 13-April 21, 2011. The participation rate among eligible patients was 94%. The survey included 15 questions about various components of the care experience, 4 questions about the provider experience and 3 questions about overall care. To ensure that the survey was appropriately tailored to our clinic population and the list of component experiences reflected all aspects of the care experience salient to patients, we conducted in-depth interviews with key providers and clinic staff and pre-tested the survey instrument with patients. RESULTS: Patients' evaluation of their provider correlated the strongest with their overall satisfaction (standardized β = 0.445, p<0.001 and accounted for almost half of the explained variance. Access and availability, like clinic hours and ease of calling the clinic, also correlated with overall satisfaction, but less strongly. Wait time and parking, despite receiving low patient ratings, did not correlate with overall satisfaction. CONCLUSIONS: The patient-provider relationship far exceeds other component experiences of care in its association with overall satisfaction. Our study suggests that interventions to improve overall patient satisfaction should focus on improving patients' evaluation of their provider.

  10. Predictors of Increased Risk of Hepatocellular Carcinoma in Patients with Type 2 Diabetes

    Science.gov (United States)

    Si, Won Keun; Chung, Jung Wha; Cho, Junhyeon; Baeg, Joo Yeong; Jang, Eun Sun; Yoon, Hyuk; Kim, Jaihwan; Shin, Cheol Min; Park, Young Soo; Hwang, Jin-Hyeok; Jeong, Sook-Hyang; Kim, Nayoung; Lee, Dong Ho; Lim, Soo

    2016-01-01

    Epidemiological data indicate that type 2 diabetes is associated with increased risk of hepatocellular carcinoma (HCC). However, risk stratification for HCC has not been fully elucidated in diabetic population. The aim of this study was to identify potential predictors of HCC in diabetic patients without chronic viral hepatitis. A cohort of 3,544 diabetic patients without chronic viral hepatitis or alcoholic cirrhosis was established and subjects were randomly allocated into a derivation and a validation set. A scoring system was developed by using potential predictors of increased risk of HCC from the Cox proportional hazards model. The performance of the scoring system was tested for validation by using receiver operating characteristics analysis. During median follow-up of 55 months, 36 cases of HCC developed (190 per 100,000 person-years). The 5- and 10-year cumulative incidences of HCC were 1.0%, and 2.2%, respectively. Multivariate Cox regression analysis showed that age > 65 years, low triglyceride levels and high gamma-glutamyl transferase levels were independently associated with an increased risk of HCC. DM-HCC risk score, a weighted sum of scores from these 3 parameters, predicted 10-year development of HCC with area under the receiver operating characteristics curve of 0.86, and discriminated different risk categories for HCC in the derivation and validation cohort. In conclusion, old age, low triglyceride level and high gamma-glutamyl transferase level may help to identify individuals at high risk of developing HCC in diabetic patients without chronic viral hepatitis or alcoholic cirrhosis. PMID:27359325

  11. Enhanced skin toxicity with concomitant cetuximab and radiotherapy in patients with locally advanced head and neck squamous cell carcinoma

    International Nuclear Information System (INIS)

    Purpose: When associated with radiotherapy the monoclonal antibodies such as cetuximab might be exacerbate skin toxicity. The aim of this study was to retrospectively analyze acute dermatological toxicity in ten consecutive patients with locally advanced head and neck squamous cell carcinoma treated from march 2008 to May 2009 according to Bonner protocol. Patients and methods: We have treated with radiotherapy and cetuximab ten patients with locally advanced head and neck squamous cell carcinoma of the oropharynx, hypopharynx, larynx or oral cavity, stage 3-4B and non metastatic. All our patients were 3D planned and scheduled for conventional fractionation 70 Gy/35 fractions over 47 days, five days weekly. Uninvolved neck received 50 Gy and gross nodal disease received 70 Gy as the primary tumor. Cetuximab was administered one week before radiotherapy at a loading dose of 400 mg per square meter of body surface area over 120 minutes, followed by weekly 60 minutes infusions at 250 mg per square meter for the duration of radiotherapy. Results: In eight patients (80%) grade 3 radiation dermatitis occurred as early as with 28 Gy at a median dose of 42 Gy (range 28-60 Gy). the median radiotherapy dose was 6 Gy with an overall treatment time of 57.7 days (range 41-70 days). were administered 78 cycles of cetuximab, one patient discontinued after five cycles due to infusion reactions. There was no correlation between toxicity and acne-like rash due to cetuximab. Conclusion: Our results albeit in disagreement with the original study are rather similar with the experience of other European centers that encounter grade 3-4 radiation dermatitis in 49% of their patients or Australian centers that reported 79% of same degree of toxicity. (authors)

  12. Enhanced skin toxicity with concomitant cetuximab and radiotherapy in patients with locally advanced head and neck squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Bujor, L.; Grillo, I.M.; Pimentel, N. [Hospital Santa Maria, Radioterapia, Lisboa (Portugal); Macor, C.; Catarina, M. [Hospital Santa Maria, ORL, Lisboa (Portugal); Ribeiro, L. [Hospital Santa Maria, Oncologia, Lisboa (Portugal)

    2009-10-15

    Purpose: When associated with radiotherapy the monoclonal antibodies such as cetuximab might be exacerbate skin toxicity. The aim of this study was to retrospectively analyze acute dermatological toxicity in ten consecutive patients with locally advanced head and neck squamous cell carcinoma treated from march 2008 to May 2009 according to Bonner protocol. Patients and methods: We have treated with radiotherapy and cetuximab ten patients with locally advanced head and neck squamous cell carcinoma of the oropharynx, hypopharynx, larynx or oral cavity, stage 3-4B and non metastatic. All our patients were 3D planned and scheduled for conventional fractionation 70 Gy/35 fractions over 47 days, five days weekly. Uninvolved neck received 50 Gy and gross nodal disease received 70 Gy as the primary tumor. Cetuximab was administered one week before radiotherapy at a loading dose of 400 mg per square meter of body surface area over 120 minutes, followed by weekly 60 minutes infusions at 250 mg per square meter for the duration of radiotherapy. Results: In eight patients (80%) grade 3 radiation dermatitis occurred as early as with 28 Gy at a median dose of 42 Gy (range 28-60 Gy). the median radiotherapy dose was 6 Gy with an overall treatment time of 57.7 days (range 41-70 days). were administered 78 cycles of cetuximab, one patient discontinued after five cycles due to infusion reactions. There was no correlation between toxicity and acne-like rash due to cetuximab. Conclusion: Our results albeit in disagreement with the original study are rather similar with the experience of other European centers that encounter grade 3-4 radiation dermatitis in 49% of their patients or Australian centers that reported 79% of same degree of toxicity. (authors)

  13. Basal like carcinoma of breast in patient with neurofibromatosis I: An association or co-existence?

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    Sree Rekha Jinkala

    2013-01-01

    Full Text Available Neurofibromatosis I (NF I, an autosomal dominant disorder is associated with increased risk of benign and malignant peripheral nerve sheath tumors and central nervous system tumors. There are only few case reports of breast carcinoma in known patients of NF I. We report a case of basal like carcinoma of the breast in a 69-year-old lady who had NF I. Considering the rare association of carcinomas with NF I and finding that both the NF I gene and a breast cancer pre-disposition gene, BRCA 1 are located in close proximity on chromosome 17q makes the association of these two conditions intriguing.

  14. Metastasis-Induced Acute Pancreatitis in a Patient with Small Cell Carcinoma of the Lungs

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    Hajime Tanaka

    2009-09-01

    Full Text Available Context Pancreatic metastases are relatively common in advanced lung cancers (both small cell lung carcinoma and non-small cell lung carcinoma, but metastasis-induced acute pancreatitis is very unusual. Case report A 51-year-old woman with small cell carcinoma of the lung developed acute pancreatitis as the initial manifestation. Abdominal ultrasonography revealed multiple pancreatic metastases which were confirmed by magnetic resonance imaging. Conventional treatment did not improve her condition. However, aggressive chemotherapy resulted in a dramatic recovery from the acute pancreatitis and significant improvement in her general condition. Conclusion When cases of acute pancreatitis in patients with small cell lung carcinoma are encountered, we must consider the possibility of metastasis-induced acute pancreatitis and that, should pancreatic metastases be found in these patients, chemotherapy may provide substantial benefit.

  15. Synchronous lung tumours in a patient with metachronous colorectal carcinoma and a germline MSH2 mutation.

    LENUS (Irish Health Repository)

    Canney, A

    2012-02-01

    Mutations of DNA mismatch repair genes are characterised by microsatellite instability and are implicated in carcinogenesis. This mutation susceptible phenotype has been extensively studied in patients with hereditary non-polyposis colon carcinoma, but little is known of the contribution of such mutations in other tumour types, particularly non-small-cell lung carcinoma. This report describes the occurrence of two synchronous lung tumours, one mimicking a metastatic colon carcinoma, in a male patient with a history of metachronous colonic carcinoma. Immunohistochemistry supported a pulmonary origin for both lesions. Mismatch repair protein immunohistochemistry showed loss of MSH2 and MSH6 expression in both colonic tumours and in one lung tumour showing enteric differentiation. Subsequent mutational analysis demonstrated a deleterious germline mutation of the MSH2 mismatch repair gene. The significance of these findings and the practical diagnostic difficulties encountered in this case are discussed.

  16. Retrospective Evaluation of Patients with Hepatocellular Carcinoma: Single-Center Experience

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    Tuncer Temel1

    2015-03-01

    Full Text Available Objective: Primary liver cancer is one of the most common and lethal type of tumors in the world. Hepatocellular forms compose about 80% of all primary liver tumors. Our aim is to evaluate the patients with hepatocellular carcinoma admitted to our clinic retrospectively. Methods: First we identified viral hepatitis serology and whether antiviral treatment was administered before the diagnosis and the period until the development of hepatocellular carcinoma for each case with hepatocellular carcinoma. Child-Pugh stage in cirrhotic cases, the stage of viral hepatitis in non-cirrhotic cases, and the treatment method suggested for hepatocellular carcinoma and the average life expectancy (for the patients whose life expectancy is known were evaluated. Alpha-feto protein levels and computerized tomography, ultrasound, magnetic resonance imaging findings were evaluated retrospectively. Correlation between alpha-feto protein levels and tumor numbers were evaluated statistically. Results: Total of 69 patients were evaluated. The median age at presentation was 62.8 (ranging from 25 to 80 years. Median (overall survival OS was 7.0 (ranging from 0 to 145 months in all patients. 18 patients (41.9% were Child-Pugh Class A, 12 (27.9% patients were Child-Pugh Class B and 13 (30.2% patients were Child-Pugh Class C. It was found that patients with severely high alpha-feto protein levels (>200 ng/ml, have 4 fold risk of multiple liver masses (OR: 4.05, 95% CI: 1.22-13.42. For the characterization of a liver mass as hepatocellular carcinoma, the diagnostic effectiveness of computerized tomography was 54.3%, and that of magnetic resonance imaging was 55.8%. Conclusion: As a result the patients with hepatocellular carcinoma can be diagnosed with combination of laboratory findings and imaging techniques. Alpha-feto protein levels are important for follow up of such patients and identifying the multiple mass presences.

  17. SERUM INTERLEUKIN-18 LEVEL AS A PROGNOSTIC MARKER IN PATIENTS WITH COLORECTAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    韩明勇; 于金明; 郑树; 郭其森; 王家林; 彭佳萍; 董奇

    2004-01-01

    Objective: Interleukin-18(IL-18) is a cytokine with many functions. This study was to investigate the serum levels of IL-18 and their clinical significance in patients with colore3ctaql carcinomas. Methods: Peripheral blood samples were obtained from 106 patients with colorectal carcinoma and 60 volunteers. The serum IL-18 levels were determined in each sample with an enzyme-linked immunosorbent assay (ELISA). Results: In patients before 1997, the mean IL-18 level was 338.46 pg/ml; in patients after 1997, the mean IL-18 level was 328.85 pg/ml, there is no evidence of loss of IL-18 immunoreactivity after prolonged storage at -80℃. The mean serum IL-18 level in 106 patients with colorectal carcinoma was significantly higher compared with the 60 healthy volunteers (P0.05). The survival rate of patients with IL-18 levels ≥346 pg/ml (n=47 patients) was significantly worse compared with patients who had IL-18 levels <346 pg/ml(n=57 patients). The 5-year-survival rates were 5.3% and 18.6%, respectively. Multivariate analysis using a Cox proportional hazards model identified the serum IL-18 level as an independent prognostic factor for survival Conclusion: The serum IL-18 level has a significant correlation with survival curve. The serum IL-18 level may represent a significant postoperative prognostic determinant in patients with colorectal carcinoma.

  18. Short-term Effect of Chemotherapy Concomitant with Multiple Autologous Immunocytes on Patients with Colorectal Carcinoma

    Directory of Open Access Journals (Sweden)

    Junquan Liu

    2013-12-01

    Full Text Available Objective: To compare the differences of cellular immunological functional changes and survival time of chemotherapy concomitant with multiple autologous immunocytes with single chemotherapy on patients with colorectal carcinoma (CRC. Methods: Of the 83 CRC patients, 43 were treated with single chemotherapy (single chemotherapy group while the other 40 were given chemotherapy concomitant with multiple autologous immunocytes (combined chemotherapy group. Blood cell separator was applied to collect autologous peripheral blood mononuclear (PBMC which was used to induce the cultures of peripheral blood CD3AK cell, CIK cell, dendritic cell (DC, γδT cell and NK cell based on routine approaches. Peripheral blood CD3+, CD4+, CD8+, CD19+, CD16+, CD56+, CD4/CD8 and γδT cell ratio as well as the positive expression rates of perforin, granular enzyme B and CD107a in PBMC were determined by flow cytometer. Same chemotherapy (oxaliplatin + CF + 5-FU was intravenously given to both groups, while in combination group, 4, 6, 9, 11 and 10 patients received 3, 6, 7, 10 and > 16 courses of treatment, respectively. Results: Subgroup of immunocytes and absolute value in combined chemotherapy group were evidently higher than in single chemotherapy group, but there was no significant difference in Karnofsky score. In addition, combined chemotherapy group was apparently higher after treatment than treatment before and single chemotherapy group in the results of perforin, granular enzyme B (GranB and CD107a in PBMC. Additionally, 1-, 2- and 5-year survival rates in combined chemotherapy group (in phases Ⅱ , Ⅲ and Ⅳ were 70.0% (28/40, 20.0% (8/40 and 10.0% (4/40, higher than those in single chemotherapy group [23.2% (10/43, 7.0% (3/43 and 4.6% (2/43], respectively, in which the differences in phases Ⅱ and Ⅲ were more significant (P <0.05, but no difference was observed between two groups in 5-year survival rate in patients in phase Ⅳ . Conclusion

  19. The observation and nursing for advanced hepatocellular carcinoma patients treated with Sorafenib

    International Nuclear Information System (INIS)

    Objective: To summarize the author's experience which was obtained in observing and nursing the adverse reactions of advanced hepatocellular carcinoma patients who were treated with Sorafenib. Methods: The adverse reactions and their severity observed in 34 patients with advanced hepatocellular carcinoma who were treated with Sorafenib were retrospectively analyzed. Results: Side effects or toxic reaction were observed in all the patients, which included neutropenia, foot-hand syndrome (FHS), fatigue, diarrhea, hypertention, rash, etc. Five patients had to cut down the dose of Sorafenib in order to relieve the symptom, among them one patient had grade 4 FHS, 3 patients had grade 3 FHS and one patient had grade 3 neutropenia. Conclusion: Being familiar with sorafenib's adverse reaction, closely observing the patients condition and affording appropriate nursing measures, all the above items can definitely improve the therapeutic results and patient's living quality. (authors)

  20. A rare case of verrucous carcinoma of penis in an human immunodeficiency virus- infected patient

    OpenAIRE

    Tonita Mariola Noronha; Girisha, Banavasi S; Shubha P Bhat; Carol M Christy; Sripathi Handattu; Fernandes, Michelle S.

    2015-01-01

    Cancer is a significant cause of morbidity and mortality in human immunodeficiency virus-infected subjects. Verrucous carcinoma is a peculiarly slow evolving, but relentlessly expanding variant of epidermoid carcinoma that is extremely reluctant to metastasize. A 60-year-old unmarried male patient presented with urethral discharge of 3 weeks duration. Dorsal slit of the prepuce revealed an ulceroproliferative growth measuring 3 cm Χ 3 cm arising from prepuce and involving glans. Biopsy from t...

  1. Patients receiving lithium therapy have a reduced prevalence of neurological and cardiovascular disorders.

    Science.gov (United States)

    Prosser, James M; Fieve, Ronald R

    2016-11-01

    A variety of evidence from laboratory and animal studies suggests that lithium has neurotrophic and cytoprotective properties, and may ameliorate or prevent some disease states. We investigated whether such a protective effect can be observed in human psychiatric patients receiving lithium therapy. We carried out a retrospective chart review of 1028 adult psychiatric male and female outpatients attending four lithium clinics in metropolitan New York City. Patients were divided into two groups based on lithium usage, and the prevalence of neurological and cardiovascular disorders was compared. The main outcome measures were the occurrence in the two patient groups of a variety of neurological disorders and myocardial infarction. Odds ratios were calculated to assess the risk of having a disorder for patients receiving lithium compared to patients not receiving lithium: for seizures, the odds ratio was 0.097; for amyotrophic lateral sclerosis, the odds ratio was 0.112; for dementia not otherwise specified, the odds ratio was 0.112; and for myocardial infarction, the odds ratio was 0.30. Logistical regression analysis showed that lithium treatment is a significant negative predictive factor in the prevalence of each of these disease states, when age, duration of clinic attendance, and use of anti-psychotic medications are taken into account. Our results show that patients receiving regular lithium treatment have a reduced prevalence of some neurological disorders and myocardial infarctions. One possible explanation of these results is that a protective effect of lithium observed in laboratory and animal studies may also be present in human patients receiving regular lithium therapy. PMID:27328427

  2. The assessment of anticoagulant activity to predict bleeding outcome in atrial fibrillation patients receiving dabigatran etexilate.

    Science.gov (United States)

    Chang, Yao-Ting; Hu, Yu-Feng; Liao, Jo-Nan; Chern, Chang-Ming; Lin, Yenn-Jiang; Chang, Shih-Lin; Wu, Cheng-Hsueh; Sung, Shih-Hsien; Wang, Kang-Ling; Lu, Tse-Min; Chao, Tze-Fan; Lo, Li-Wei; Hsu, Li-Chi; Chung, Chih-Ping; Chang, Peter M-H; Hsu, Wei-Hsuan; Chiou, Chuen-Wang; Chen, Shih-Ann

    2016-06-01

    Special circumstances may require the measurement of the anticoagulant effect of dabigatran etexilate. No data currently link any given coagulation test to bleeding outcomes in patients receiving dabigatran etexilate for atrial fibrillation. Nonvalvular atrial fibrillation patients receiving dabigatran etexilate of 110 mg (DE110) or 150 mg (DE150) were consecutively enrolled. The hemoclot thrombin inhibitor (HTI) assay, prothrombin time, and activated partial thromboplastin time (APTT) measurements were correlated with bleeding events during a prospective follow-up. There were 17 bleeding events (8.2%) in 208 patients (74.7 ± 10.3 years old, 67.9% male, median follow-up: 364 days), whereas 15 patients with bleeding events used DE110. Compared with DE110, the patients receiving DE150 were younger and more often male and had lower HAS-BLED and CHA2DS2VASc scores and better renal function. Patients' HTI levels were very variable (DE110, 10-90th percentile: 20.5-223.9 ng/ml). A receiver-operator characteristic curve gave a median cutoff HTI level of 117.7 ng/ml to predict bleeding events (C-statistics: 0.65; P = 0.036), but no cutoff could be determined for prothrombin time or APTT. Based on the Kaplan-Meier analysis, a dabigatran etexilate level greater than 117.7 ng/ml was associated with a higher bleeding rate (15.4% vs. 4.9%, P = 0.01). After multivariate Cox regression analysis, HTI levels, history of stroke, and male sex were independent risk factors for bleeding events. Dabigatran etexilate-HTI levels were independently associated with bleeding in patients receiving routine clinical care. Blood sampling at multiple time points might be needed to increase reliability because of high variation of dabigatran etexilate-HTI levels. PMID:26991859

  3. Synchronous carcinoma of the gallbladder in a patient with intrahepatic bile duct carcinoma.

    Science.gov (United States)

    Taniai, N; Onda, M; Tajiri, T; Yoshida, H; Naitou, Z

    2000-01-01

    An 83-year-old woman, diagnosed as having cholelithiasis, was admitted to the Department of Surgery, Nippon Medical School, with right hypochondrial pain. Ultrasonography and computed tomography revealed a mass in the gallbladder fundus and a hypovascular tumor in the anterior segment of the liver. Magnetic resonance imaging showed stenosis of the intrahepatic bile duct and dilatation of its proximal portion. She was diagnosed as having intrahepatic bile duct carcinoma combined with gallbladder carcinoma. At laparotomy, there was evidence of multiple peritoneal metastases and intraoperative histological examination of the gallbladder tumor revealed adenocarcinoma. Accordingly, only cholecystectomy and needle biopsy of the liver tumor was performed. Histological examination of the gallbladder revealed papillary adenocarcinoma invading the muscularis propria with medullary growth or intermediate stroma. There was no microvessel invasion, no perineural invasion and no lymph node involvement. On the other hand, the liver tumor was a cholangiocarcinoma with a well-differentiated tubular pattern. Therefore, this was a rare case of synchronous carcinoma of the gallbladder associated with intrahepatic bile duct carcinoma. PMID:10690592

  4. A patient who has survived for a long period with repeated radiotherapy for multifocal extrahepatic metastases from hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Although significant advances in the treatment of intrahepatic lesions, it is reported that the prognosis for patients with hepatocellular carcinoma (HCC) who have extrahepatic metastasis remains poor. We report a patient with lung, liver, brain, bone and subcutaneous metastasis from HCC who has survived more than 7 years maintaining relatively good performance status as a result of repeated therapies. A 55-year-old male patient with HCC underwent right lobectomy of the liver and cholecystectomy in September 2006. He received wedge resection for lung metastasis twice (July 2009, January 2011) and Gamma Knife stereotactic radiosurgery for brain metastasis (April 2011). Over the last 3 years, he has developed metastasis in subcutaneous tissues, muscle, and bone with pain. He has undergone 7 courses of radiotherapy for subcutaneous tissues, muscle, and bone metastasis and been prescribed sorafenib and he is still capable of all self-care.

  5. A patient who has survived for a long period with repeated radiotherapy for multifocal extrahepatic metastases from hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Sunmi; Shim, Hye Kyung [Inje University Haeundae Paik Hospital, Busan (Korea, Republic of)

    2013-12-15

    Although significant advances in the treatment of intrahepatic lesions, it is reported that the prognosis for patients with hepatocellular carcinoma (HCC) who have extrahepatic metastasis remains poor. We report a patient with lung, liver, brain, bone and subcutaneous metastasis from HCC who has survived more than 7 years maintaining relatively good performance status as a result of repeated therapies. A 55-year-old male patient with HCC underwent right lobectomy of the liver and cholecystectomy in September 2006. He received wedge resection for lung metastasis twice (July 2009, January 2011) and Gamma Knife stereotactic radiosurgery for brain metastasis (April 2011). Over the last 3 years, he has developed metastasis in subcutaneous tissues, muscle, and bone with pain. He has undergone 7 courses of radiotherapy for subcutaneous tissues, muscle, and bone metastasis and been prescribed sorafenib and he is still capable of all self-care.

  6. C-reactive protein in patients with advanced metastatic renal cell carcinoma: Usefulness in identifying patients most likely to benefit from initial nephrectomy

    International Nuclear Information System (INIS)

    C-reactive protein (CRP) is considered a useful serum marker for patients with RCC. However, its clinical utility in advanced metastatic renal cell carcinoma (AM-RCC), particularly in deciding whether to perform nephrectomy at the onset, is not well studied. We retrospectively evaluated 181 patients with AM-RCC, including 18 patients underwent potentially curative surgery, 111 underwent cytoreductive nephrectomy, and 52 received medical treatment only. CRP cutoff points were determined by receiver operating characteristic (ROC) curve analysis. Kaplan-Meier and Cox regression analyses were used for survival tests. ROC analysis suggested that grouping patients according to 3 CRP ranges was a rational model. Patients with highly elevated CRP (≥67.0 mg/L) presented remarkably poor prognosis despite treatment (nephrectomy or medical treatment only). Cox regression models demonstrated that risk factors of overall survival for patients who underwent nephrectomy were the CRP ranges defined in this study (≤18.0 mg/L, >18.0 and <67.0 mg/L, and ≥67.0 mg/L), ECOG PS (0, 1, and ≥2), and number of metastatic organ sites (0–1 and ≥2). The retrospective design is a limitation of this study. Our study demonstrated that the serum CRP level is a statistically significant prognostic parameter for patients with AM-RCC. The data also indicated that pretreatment serum CRP level provides useful prognostic information that helps in deciding whether to perform initial nephrectomy for patients with AM-RCC

  7. Clostridium difficile Infection: A Rarity in Patients Receiving Chronic Antibiotic Treatment for Crohn’s Disease

    Science.gov (United States)

    Roy, Abhik; Lichtiger, Simon

    2016-01-01

    Background Prolonged antibiotic use is limited by several adverse effects, one of which is Clostridium difficile infection (CDI). The aim of this study was to determine the incidence of CDI in patients receiving chronic antibiotic treatment for Crohn’s disease (CD). Methods We conducted a retrospective review of 100 patients with CD for which ≥6 months of outpatient antibiotic therapy was prescribed. Data were collected regarding demographics, CD phenotype, treatment history, and CDI. The incidence of CDI in our patient population was calculated and compared with historical controls. Results 100 patients were studied—60% of men, mean age 23.9 years at CD diagnosis. Eighty-two percent had disease involving the ileum, and 33% had disease involving the colon. The mean duration of antibiotic therapy was 39.6 months (range, 6–217 months). The most commonly prescribed classes of antibiotics were fluoroquinolones (84%), penicillins (57%), and cephalosporins (32%). Forty-nine percent of patients were treated with concomitant thiopurines, 45% with budesonide, and 41% with biologics. The overall incidence of CDI was 2%. This incidence of CDI was lower than previously reported for non-CD patients receiving chronic antibiotics for continuous-flow left ventricular assist device infections (12.5%) and orthopedic prosthesis infections (22.2%). Conclusions The incidence of CDI is rare in patients receiving chronic antibiotic treatment for CD, and it seems significantly lower than for non-CD populations reported in the literature. PMID:26650148

  8. Evaluation of effective dose received by patients undergoing Cardiac Angiography Computed Tomography (CT) and Conventional Angiography

    International Nuclear Information System (INIS)

    Cardiac Angiography is a field of studies that utilizes the energy of radiation to study the coronary arteries of the heart. Patients undergoing this procedure has a probability of receiving an over dose of radiation that may further cause stochastic effect. The main objective of this research is to compare and clarify an approach for minimal effective dose receive by patients between procedures of Cardiac Angiography Computerized Tomography (CT) and Conventional Angiography. Based on this study, the patients recorded are based in Hospital University Sains Malaysia, Kubang Kerian, Kelantan. The Dose-Length-Product (DLP) was extracted from the Computed Tomography Dose Index (CTDI); meanwhile the Dose-Area-Product (DAP) was extracted from the modalities console screen. These relevant data are the means to clarify the effective dose receive by patients. The result shows that patients who undergo Conventional Angiography had a mean effective dose of 8.50 ± 6.41 mSv. Meanwhile, as for Cardiac Angiography Computerized Tomography, the patients had a mean effective dose of 7.08 ± 2.42 mSv. A significant difference in effective dose was seen between the two procedures. Cardiac Angiography CT provides high accurate diagnostic information with less radiation dose to patients compared to Conventional Angiography. (author)

  9. Cardiac Arrest in a Heart Transplant Patient Receiving Dexmedetomidine During Cardiac Catheterization.

    Science.gov (United States)

    Schwartz, Lawrence Israel; Miyamoto, Shelley D; Stenquist, Scott; Twite, Mark David

    2016-06-01

    Dexmedetomidine is an α-2 agonist with a sedative and cardiopulmonary profile that makes it an attractive anesthetic in pediatric cardiac patients. Cardiac transplant patients may suffer from acute cellular rejection of the cardiac conduction system and, therefore, are at an increased risk of the electrophysiological effect of dexmedetomidine. We present such a patient who had a cardiac arrest while receiving dexmedetomidine during cardiac catheterization. Because acute cellular rejection of the cardiac conduction system is difficult to diagnose, dexmedetomidine should be used with caution in pediatric heart transplant patients. PMID:26721807

  10. Mortality Predicted Accuracy for Hepatocellular Carcinoma Patients with Hepatic Resection Using Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Herng-Chia Chiu

    2013-01-01

    Full Text Available The aim of this present study is firstly to compare significant predictors of mortality for hepatocellular carcinoma (HCC patients undergoing resection between artificial neural network (ANN and logistic regression (LR models and secondly to evaluate the predictive accuracy of ANN and LR in different survival year estimation models. We constructed a prognostic model for 434 patients with 21 potential input variables by Cox regression model. Model performance was measured by numbers of significant predictors and predictive accuracy. The results indicated that ANN had double to triple numbers of significant predictors at 1-, 3-, and 5-year survival models as compared with LR models. Scores of accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC of 1-, 3-, and 5-year survival estimation models using ANN were superior to those of LR in all the training sets and most of the validation sets. The study demonstrated that ANN not only had a great number of predictors of mortality variables but also provided accurate prediction, as compared with conventional methods. It is suggested that physicians consider using data mining methods as supplemental tools for clinical decision-making and prognostic evaluation.

  11. Mortality predicted accuracy for hepatocellular carcinoma patients with hepatic resection using artificial neural network.

    Science.gov (United States)

    Chiu, Herng-Chia; Ho, Te-Wei; Lee, King-Teh; Chen, Hong-Yaw; Ho, Wen-Hsien

    2013-01-01

    The aim of this present study is firstly to compare significant predictors of mortality for hepatocellular carcinoma (HCC) patients undergoing resection between artificial neural network (ANN) and logistic regression (LR) models and secondly to evaluate the predictive accuracy of ANN and LR in different survival year estimation models. We constructed a prognostic model for 434 patients with 21 potential input variables by Cox regression model. Model performance was measured by numbers of significant predictors and predictive accuracy. The results indicated that ANN had double to triple numbers of significant predictors at 1-, 3-, and 5-year survival models as compared with LR models. Scores of accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of 1-, 3-, and 5-year survival estimation models using ANN were superior to those of LR in all the training sets and most of the validation sets. The study demonstrated that ANN not only had a great number of predictors of mortality variables but also provided accurate prediction, as compared with conventional methods. It is suggested that physicians consider using data mining methods as supplemental tools for clinical decision-making and prognostic evaluation. PMID:23737707

  12. Quantitative evaluation of radiodine ablation of the thyroid in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Full text: We have developed a novel method of quantitative analysis of post radioiodine ablation scans for differentiated carcinoma of the thyroid to enable an objective comparison of patients receiving recombinant TSH with those who have had withdrawal of thyroid hormone supplements. Reliance on visual estimation of the completeness of thyroid ablation can have errors related to observer variation and variation in the settings of the display. Traditionally a neck uptake of 2 (chi squared). Low values of minimum X2 correlate well with an absence of uptake in residual thyroid tissue. In areas with increased activity, comparison with the fitted curve is used to give a value in units of statistical error or standard deviation (S.D.). The method has been tested in a series of 36 consecutive patients following radioiodine ablation. The patients were divided visually into three groups: complete ablation (17), normal excretion into the oesophagus (7) and focal residual uptake in tumor or normal thyroid (12). In the complete ablation group the maximum variation from the fitted curve ranged from 2.0 to 4.1 S.Ds. (with a mean of 2.7 f 0.14 S.E.). In patients with a visible linear uptake in the oesophageal region the variation ranged from 3.0 - 4.5 S.Ds.. In those patients with focal uptake the variation ranged from 4.8 S.Ds. to 83 S.Ds.. This technique has proved to be a valuable method of quantitative thyroid ablation especially when there are equivocal areas of low focal uptake. The technique can be applied to equally to any situation where it is necessary to confirm that variation in uptake is within normal limits where the background activity changes, e.g. with the changing shape of an organ, or where it is difficult to define a 'normal' symmetrical region of interest. (author)

  13. Impaired DNA repair as assessed by the ''comet'' assay in patients developing thyroid carcinoma after radiotherapy

    International Nuclear Information System (INIS)

    A defective cellular response to DNA lesions induced be genotoxic agents may be associated to an increased cancer proneness. This has been clearly identified in some rare but extensively studied genetic diseases such as xeroderma pigmentosum (XP), ataxia telangiectasia (AT) and Fanconi anemia (FA). In practical oncology, most patients receive genotoxic therapeutic agents and the presence of so far unidentified sensitive genotypes could account for an increased susceptibility to cancer in a subgroup of exposed patients. The thyroid gland of children is especially sensitive to the carcinogenic effect of ionizing radiation. Evidence for risk is reported even at doses as low as 0.1 Gy, and the excess relative risk to develop a thyroid tumor following a radiation dose of 1 Gy in childhood is of 7.7 [l]. In order to determine if a defect in repair of DNA strand breaks could be involved, as an early step, in the development of secondary thyroid tumors after radiotherapy, we examined, using the alkaline single cell gel electrophoresis assay (SCGE or 'comet'), the response to in vitro γ-rays exposure of lymphocytes of a small group of patients who developed thyroid carcinoma after radiotherapy for a primary tumor. Because of its practical advantages, the alkaline comet assay offers the opportunity to question the role of DNA strand beaks rejoining capacity of the individual in the radiation induced carcinogenesis of thyroid tumors. This preliminary study of a small group of patients with therapeutic irradiation at childhood for a primary tumor indicates that, at the time of blood sampling, lymphocytes of some of these patients demonstrated reduced rejoining capacity. These results suggest that the comet assay might help to distinguish a subgroup of individuals at risk for radiation induced genomic instability and encourage further investigation. (authors)

  14. Effect of Intermittent Androgen Blockade on the Quality of Life of Patients with Advanced Prostate Carcinoma

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To investigate the effect of intermittent androgen blockade (IAB) on the quality of life (QOL) of patients with advanced prostatic carcinoma (APC).METHODS Investigations on the QOL of 51 APC patients receiving IAB treatment, totaling 3 times, i.e. 6 months before and after, and 12 months after treatment, were perform using the EORTC QLQ-C30 measuring scale and QLQ-PR25 scale.RESULTS Although IAB became an economic burden for the families, it was lessened during the intermission (P<0.05). The overall health status significantly improved 6 months after IAB treatment (P<0.01), especially during the intermission (P<0.05), with a total or local easement of pain (P<0.01) and an improvement of urinary function (P<0.01). Although there was impairment,to various degrees, in many functions of the patients on the 6th month of treatment, such as the physical function (P<0.05), role function (P<0.05), the emotional (P<0.01) and the social functions (P<0.01), with an enhancement of fatigue (P<0.01), these functions gradually recovered by the 12th month as the intermission started. Treatment-related symptoms such as flushing and mammary swelling significantly emerged on the 6th treatment month (P<0.01), and lessened on the 12th (P<0.01). During the treatment period,therewas an notable drop in sexual interest (P<0.01), with a deprivation of sex life, but revived to various degrees during the intermission (P<0.01).CONCLUSION Although IAB treatment of APC patients did impair the physiologic and psychologic status of patients to varying degrees, these were improved and restored during the intermission.

  15. Effect of gemcitabine heat perfusion chemotherapy combined with carboplatin chemotherapy embolization on serum indexes in patients with hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Wei Zhou; Xing-Yuan Wang; Kun Zhou

    2015-01-01

    Objective:To study the effects of Gemcitabine heat perfusion chemotherapy combined with carboplatin chemotherapy embolization on serum indexes in patients with hepatocellular carcinoma.Methods:90 cases of hepatocellular carcinoma patients were enrolled and randomly divided into two groups. Observation group received gemcitabine heat perfusion chemotherapy combined with carboplatin chemotherapy embolization, control group received gemcitabine conventional perfusion chemotherapy combined with carboplatin chemotherapy embolization. Malignant biological indicators of serum and liver tissue apoptosis regulation of gene expression of the two groups were compared.Results: (1) Serum malignant biological indicators: serum DKK1, TK1, HIF-1 alpha mRNA and protein content of the observation group were lower than that of the control group; (2) Promoting apoptosis gene: MTS1 in liver tissue, Caspase 3 and Bax mRNA and protein contents of the observation group was higher than that of the control group; (3) Apoptosis suppressor genes: liver cancer tissues Plk1, Bcl - 2 and Survivn mRNA and protein contents of the observation group was higher than that of the control group.Conclusion:Gemcitabine hot perfusion chemotherapy plus carboplatin chemotherapy embolism helps to inhibit tumor biological behavior, induce liver cancer cells apoptosis, and it is an ideal treatment for primary liver cancer.

  16. Quality of life after oesophagectomy in patients with carcinoma of oesophagus: A prospective study

    Directory of Open Access Journals (Sweden)

    VPN Ramakrishnaiah

    2014-01-01

    Full Text Available Background: The present study was done to see if quality of life improves following oesophagectomy for carcinoma of oesophagus. Materials and Methods: This was a prospective study done from June 2007 to July 2009. All patients undergoing oesophagectomy and cervical anastomoses for squamous cell carcinoma and adenocarcinoma of oesophagus were included in the study. Quality of life assessment was done using EORTC QLQ C-30 and its oesophagus specific module (OES-18 before surgery and at 3, 6, 9 and 12 months. Results: There were 55 patients who underwent oesophagectomy for carcinoma of oesophagus. On the EORTC functional scale it was noted that patients undergoing transhiatal oesophagectomy showed significant improvement of emotional function only. Patients undergoing transthoracic oesophagectomy showed a decrease in functional scores in the first three months which improved later but this change was not significant. On the EORTC symptom scale, patients undergoing transhiatal oesophagectomy showed significant improvement of constipation but not in other symptoms. Patients undergoing transthoracic oesophagectomy showed an increase in symptoms for the first three months followed by a decrease which was significant with respect to scores for constipation and pain. On the EORTC oesophagus specific symptom scores, patients in both groups showed significant improvement of dysphagia and eating. Conclusion: Patients with carcinoma of oesophagus undergoing transhiatal oesophagectomy may not show significant improvement in quality of life. However there will be significant improvement in dysphagia and eating. Patients undergoing transthoracic oesophagectomy may show an initial decrease in the quality of life.

  17. Estimation of the Dose of Radiation Received by Patient and Physician During a Videofluoroscopic Swallowing Study.

    Science.gov (United States)

    Morishima, Yoshiaki; Chida, Koichi; Watanabe, Hiroshi

    2016-08-01

    Videofluoroscopic swallowing study (VFSS) is considered the standard diagnostic imaging technique to investigate swallowing disorders and dysphagia. Few studies have been reported concerning the dose of radiation a patient receives and the scattering radiation dose received by a physician during VFSS. In this study, we investigated the dose of radiation (entrance skin dose, ESD) estimated to be received by a patient during VFSS using a human phantom (via a skin-dose monitor sensor placed on the neck of the human phantom). We also investigated the effective dose (ED) and dose equivalent (DE) received by a physician (wearing two personal dosimeters) during an actual patient procedure. One dosimeter (whole body) was worn under a lead apron at the chest, and the other (specially placed to measure doses received by the lens of the eye) outside the lead apron on the neck collar to monitor radiation doses in parts of the body not protected by the lead apron. The ESD for the patient was 7.8 mGy in 5 min. We estimated the average patient dose at 12.79 mGy per VFSS procedure. The physician ED and DE during VFSS were 0.9 mSv/year and 2.3 mSv/year, respectively. The dose of radiation received by the physician in this study was lower than regulatory dose limits. However, in accordance with the principle that radiation exposure should be as low as reasonably achievable, every effort should be made (e.g., wearing lead glasses) to reduce exposure doses. PMID:27318941

  18. Treatment of portal vein tumor thrombosis in patients with hepatocellular carcinoma by TACE

    International Nuclear Information System (INIS)

    Objective: To evaluate the therapeutic effect of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma with tumor thrombosis of portal vein. Methods: One hundred and six patients of hepatocellular carcinoma with tumor thrombosis of portal vein under treatment of TACE were observed before and after the procedure. Results: After TACE tumor size reduced >50% in 23 patients, <50% in 25, no significant change in 44. The size of tumor enlarged in 12. The disappearance of portal vein tumor thrombosis accessed in 14, with reduction in 39, and no significant change in 51. Two patients died within thrombosis accessed in 14, with reduction in 39, and no significant change in 51. Two patients died within on week. Conclusion: TACE provides good therapeutic effect on hepatocellular carcinoma with tumor thrombosis of portal vein. (authors)

  19. SUBCLINICAL HEPATIC ENCEPHALOPATHY DETECTED THROUGH PSYCHOMETRIC TESTS IN PATIENTS WITH HEPATIC CELLULAR CARCINOMA AND CIRRHOSIS

    Institute of Scientific and Technical Information of China (English)

    李薇; 吴积坰; 李惠芳; 顾海蔚; 范晓方

    2002-01-01

    Objective To study subclinical hepatic encephalopathy (SHE) in patients with hepatic cellular carcinoma by using psychometric tests.Methods 112 cases of hepatic cellular carcinoma complicated with cirrhosis and 65 controls were detected with number connection test (NCT), digital span test (DSP) and digital symbol test (DSY).Results The abnormal rate of NCT, DSY and DSP in patients was 23.2% (26/112), 14.3% (16/112) and 11.6%(13/112) respectively. Patients in the Child-Pugh B group had a significantly higher abnormal rate than that in the Child-Pugh A group.Conclusion SHE has an incidence of 25.0% (28/112) in patients with hepatic cellular carcinoma and cirrhosis in this study population; its occurrence is associated with the severity of liver impairment.

  20. Thyroid function and ultrasonically determined thyroid size in patients receiving long-term lithium treatment.

    Science.gov (United States)

    Perrild, H; Hegedüs, L; Baastrup, P C; Kayser, L; Kastberg, S

    1990-11-01

    Thyroid function was investigated in 100 manic-depressive patients. Goiter was more common in patients treated with lithium for 1-5 years (44%) or more than 10 years (50%) than in patients who never received lithium (16%). Smoking contributed significantly to thyroid size and goiter. In nonsmoking patients, ultrasonically determined thyroid volume was significantly related to treatment duration. The mechanism behind this increased thyroid volume is unclear, as most patients had normal serum thyrotropin levels and no thyroid autoimmunity. Subclinical or overt hypothyroidism was found in 4% and 21% of patients treated for 1-5 and more than 10 years, respectively. Since few hypothyroid patients had autoimmunity or goiter, lithium may affect the thyroid gland directly. PMID:2221166

  1. Somatostatin receptor expression, tumour response, and quality of life in patients with advanced hepatocellular carcinoma treated with long-acting octreotide

    OpenAIRE

    Cebon, J

    2006-01-01

    Octreotide may extend survival in hepatocellular carcinoma (HCC). Forty-one per cent of HCCs have high-affinity somatostatin receptors. We aimed to determine the feasibility, safety, and activity of long-acting octreotide in advanced HCC; to identify the best method for assessing somatostatin receptor expression; to relate receptor expression to clinical outcomes; and to evaluate toxicity. Sixty-three patients with advanced HCC received intramuscular long-acting octreotide 20 mg monthly until...

  2. Improvement in Xerostomia Related Quality of Life of Oral Cavity and Oropharyngeal Squamous Cell Carcinoma Patients Treated with IMRT Compared to Conventional RT

    OpenAIRE

    Aseem Rai Bhatnagar; Rameshwaram Sharma; Prashant Kumbhaj

    2013-01-01

    BACKGROUND: The incidence of head and neck squamous cell cancer is quite high in India as compared to the developed countries. Conventional RT for the majority of head and neck cancers is delivered using two parallel opposed radiation beams and parotid glands receive a significant radiation dose (>50 Gy) resulting in permanent xerostomia. MATERIALS AND METHODS: For this study, we evaluated 64 patients with oral cavity and oropharyngeal squamous cell carcinomas, treated by IMRT / Conventio...

  3. Long-term use of metformin and the molecular subtype in invasive breast carcinoma patients – a retrospective study of clinical and tumor characteristics

    International Nuclear Information System (INIS)

    Metformin may exhibit inhibitory effects on cancer cells by inhibiting mTOR signaling pathway. The aim of our retrospective study was to examine if patients with breast carcinoma (BC) and diabetes mellitus (DM) receiving metformin have a lower stage of carcinoma in comparison to patients not receiving metformin, and if the use of metformin correlates with the molecular subtype of BC. A chart review of 253 patients with invasive BC and DM (128 on metformin and 125 not on metformin) was performed. Control group consisted of 320 consecutive patients with invasive BC without DM. BC subtypes were classified by immunohistochemical surrogates as luminal A (estrogen receptor [ER] + and/or progesterone receptor [PR]+, HER-2-), luminal B (ER + and/or PR+, HER-2+), HER-2 (ER-, PR-, HER-2+), triple-negative/basal (ER-, PR-, HER-2-). Patients on metformin had a lower proportion of T3 or T4 tumors than patients who were not receiving metformin (16% vs. 26%; p = 0.035). No statistical difference was found between the two study groups in N stage. Patients with DM on metformin, with DM not on metformin and the control group had different molecular subtypes of BC (p = 0.01): the luminal A subtype was found in 78%, 83% and 71%, the luminal B in 12.6%, 9% and 11%, HER-2 in 0.8%, 1.6% and 8%, and the triple-negative/basal-like subtype in 8.6%, 6.4% and 10%, respectively. Our data indicate that long-term use of metformin use correlates with molecular subtype of BC in diabetics on metformin in comparison to diabetics not on metformin and patients without DM. However, most likely, different distribution of the molecular subtypes of BC in these three groups of patients was caused by other risk factors for breast carcinoma, such as age of patients or obesity

  4. Longitudinal change in renal function after nephroureterectomy in patients with upper tract urothelial carcinoma

    Directory of Open Access Journals (Sweden)

    Chih-Yuan Chou

    2015-06-01

    Conclusion: In this study, it was found that the average renal function of the patients with upper tract urothelial carcinoma is not as good as the general population. More than half of the normal renal function patients have new onset chronic kidney disease after surgery. For preventing further deterioration of renal function, the implication of partial nephrectomy or segmental ureterectomy for selected patients with localized urothelial carcinoma should be re-examined. Besides, neoadjuvant chemotherapy should be considered for those who are not good candidates for local treatment.

  5. Caregiver Burden in Patients Receiving Ranibizumab Therapy for Neovascular Age Related Macular Degeneration

    OpenAIRE

    Rishma Gohil; Roxanne Crosby-Nwaobi; Angus Forbes; Ben Burton; Phil Hykin; Sobha Sivaprasad

    2015-01-01

    Purpose To assess the caregiver burden and factors determining the burden in patients receiving ranibizumab therapy for neovascular AMD (nAMD). Methods This is a cross-sectional questionnaire survey of 250 matched patient caregiver dyads across three large ophthalmic treatment centres in United Kingdom. The primary outcome was the subjective caregiver burden measured using caregiver reaction assessment scale (CRA). Objective caregiver burden was determined by the caregiver tasks and level of ...

  6. Predictors of mortality in patients with extensively drug-resistant Acinetobacter baumannii pneumonia receiving colistin therapy.

    Science.gov (United States)

    Choi, Ik Sung; Lee, Yu Ji; Wi, Yu Mi; Kwan, Byung Soo; Jung, Kae Hwa; Hong, Woong Pyo; Kim, June Myong

    2016-08-01

    The ratio of the area under the free (unbound) concentration-time curve to minimum inhibitory concentration (fAUC/MIC) was proposed to be the pharmacokinetic/pharmacodynamic index most strongly linked to the antibacterial effect of colistin against Acinetobacter baumannii. A retrospective study of patients who received colistin to treat pneumonia caused by extensively drug-resistant (XDR) A. baumannii over a 4-year period was performed to assess the impact of the colistin MIC on mortality. A total of 227 patients were included in the analysis. The 7-day and 14-day mortality rates of patients with XDR A. baumannii pneumonia receiving colistin therapy were 15.0% and 23.8%, respectively. In the multivariate analysis, Acute Physiology and Chronic Health Evaluation (APACHE) II score, days from index culture to first dose of colistin, underlying tumour and septic shock at presentation were independent predictors of mortality in patients with XDR A. baumannii pneumonia receiving colistin therapy. In the univariate analysis, the colistin dose based on ideal body weight (IBW) correlated with patient outcome. Therefore, the use of IBW appeared to be more appropriate to calculate the colistin dosage. In addition, these results highlight the clinical significance of colistin MIC in patients with XDR A. baumannii pneumonia receiving colistin therapy. Although MICs were in the 'susceptible' range, patients infected with isolates with high colistin MICs showed a poorer clinical response rate than patients infected with isolates with low colistin MICs. Further clinical studies are needed to evaluate the roles of colistin MIC for predicting mortality in XDR A. baumannii pneumonia with a high colistin MIC. PMID:27423416

  7. Virologic response and breakthrough in chronic hepatitis B Egyptian patients receiving lamivudine therapy

    OpenAIRE

    Ismail, Sohair; Hafez, Hanan Abdel; Darweesh, Samar K.; Kamal, Kamal Hassan; ESMAT, GAMAL

    2014-01-01

    Background Lamivudine monotherapy is effective in suppressing hepatitis B virus (HBV) replication to undetectable levels by PCR, in ameliorating liver disease and to some extent in achieving HBsAg seroconversion. This study aimed at assessing the virological and biochemical responses as well as breakthrough in HBeAg-negative chronic HBV (CHB) Egyptian patients receiving lamivudine therapy. Methods This retrospective study included 140 CHB patients with positive serum HBV-DNA by quantitative P...

  8. Management of critically ill patients receiving noninvasive and invasive mechanical ventilation in the emergency department

    OpenAIRE

    Rose, Louise

    2012-01-01

    Louise RoseLawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, CanadaAbstract: Patients requiring noninvasive and invasive ventilation frequently present to emergency departments, and may remain for prolonged periods due to constrained critical care services. Emergency clinicians often do not receive the same education on management of mechanical ventilation or have similar exposure to these patients as do their critical care colleagues. The aim of this review wa...

  9. Multi-scale symbolic entropy analysis provides prognostic prediction in patients receiving extracorporeal life support

    OpenAIRE

    Lin, Yen-Hung; Huang, Hui-Chun; Chang, Yi-Chung; Lin, Chen; Lo, Men-Tzung; Liu, Li-Yu Daisy; Tsai, Pi-Ru; Chen, Yih-Sharng; Ko, Wen-Je; Ho, Yi-Lwun; Chen, Ming-Fong; Peng, Chung-Kang; Buchman, Timothy G.

    2014-01-01

    Introduction: Extracorporeal life support (ECLS) can temporarily support cardiopulmonary function, and is occasionally used in resuscitation. Multi-scale entropy (MSE) derived from heart rate variability (HRV) is a powerful tool in outcome prediction of patients with cardiovascular diseases. Multi-scale symbolic entropy analysis (MSsE), a new method derived from MSE, mitigates the effect of arrhythmia on analysis. The objective is to evaluate the prognostic value of MSsE in patients receiving...

  10. Multi-scale symbolic entropy analysis provides prognostic prediction in patients receiving extracorporeal life support

    OpenAIRE

    Lin, Yen-Hung; Huang, Hui-Chun; Chang, Yi-Chung; Lin, Chen; Lo, Men-Tzung; Liu, Li-Yu Daisy; Tsai, Pi-Ru; Chen, Yih-Sharng; Ko, Wen-Je; Ho, Yi-Lwun; Chen, Ming-Fong; Peng, Chung-Kang; Buchman, Timothy G.

    2014-01-01

    Introduction Extracorporeal life support (ECLS) can temporarily support cardiopulmonary function, and is occasionally used in resuscitation. Multi-scale entropy (MSE) derived from heart rate variability (HRV) is a powerful tool in outcome prediction of patients with cardiovascular diseases. Multi-scale symbolic entropy analysis (MSsE), a new method derived from MSE, mitigates the effect of arrhythmia on analysis. The objective is to evaluate the prognostic value of MSsE in patients receiving ...

  11. Short-term Effect of Chemotherapy Concomitant with Multiple Autologous Immunocytes on Patients with Colorectal Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Liu Junquan; Zhu Yun; Zhang Nanzheng; Chen Fuxing; Chen Ling; Zhang Song; Yang Wanying; Zhou Zhonghai; Lv Xiaoting

    2013-01-01

    Objective:To compare the differences of cellular immunological functional changes and survival time of chemotherapy concomitant with multiple autologous immunocytes with single chemotherapy on patients with colorectal carcinoma (CRC). Methods: Of the 83 CRC patients, 43 were treated with single chemotherapy (single chemotherapy group) while the other 40 were given chemotherapy concomitant with multiple autologous immunocytes (combined chemotherapy group). Blood cell separator was applied to collect autologous peripheral blood mononuclear (PBMC) which was used to induce the cultures of peripheral blood CD3AK cell, CIK cell, dendritic cell (DC), γδT cell and NK cell based on routine approaches. Peripheral blood CD3+, CD4+, CD8+, CD19+, CD16+, CD56+, CD4/CD8 andγδT cell ratio as well as the positive expression rates of perforin, granular enzyme B and CD107a in PBMC were determined by lfow cytometer. Same chemotherapy (oxaliplatin + CF + 5-FU) was intravenously given to both groups, while in combination group, 4, 6, 9, 11 and 10 patients received 3, 6, 7, 10 and>16 courses of treatment, respectively. Results:Subgroup of immunocytes and absolute value in combined chemotherapy group were evidently higher than in single chemotherapy group, but there was no significant difference in Karnofsky score. In addition, combined chemotherapy group was apparently higher after treatment than treatment before and single chemotherapy group in the results of perforin, granular enzyme B (GranB) and CD107a in PBMC. Additionally, 1-, 2- and 5-year survival rates in combined chemotherapy group (in phases Ⅱ, Ⅲand Ⅳ) were 70.0%(28/40), 20.0%(8/40) and 10.0%(4/40), higher than those in single chemotherapy group [23.2% (10/43), 7.0% (3/43) and 4.6%(2/43)], respectively, in which the differences in phases Ⅱand Ⅲwere more signiifcant (P Conclusion:Chemotherapy concomitant with multiple autologous immunocytes can improve the immunological function and prolong survival time for

  12. Capecitabine and oxaliplatin as second-line treatment in patients with carcinoma of unknown primary site

    DEFF Research Database (Denmark)

    Møller, Anne Kirstine Hundahl; Pedersen, Karen Damgaard; Abildgaard, Julie Rafn;

    2010-01-01

    Treatment of patients with carcinoma of unknown primary site (CUP) remains a challenge, and no effective second-line treatment has been identified. In CUP patients who are non-responsive or relapse early after first-line platinum/taxane-based regimens, it is likely that gastrointestinal (GI) trac...

  13. The efficacy of voice therapy in patients after treatment for early glottic carcinoma

    NARCIS (Netherlands)

    van Gogh, CDL; Leeuw, IMV; Boon-Kamma, BA; Rinkel, RNPM; de Bruin, MD; Langendijk, JA; Kuik, DJ; Mahieu, HF

    2006-01-01

    BACKGROUND. After treatment for early glottic carcinoma, a considerable]lumber of patients end tip with voice problems that interfere with daily life activities. The objective of this randomized and controlled study was to assess the efficacy of voice therapy in these patients. METHODS. Of 177 patie

  14. Elective Neck Dissection in Patients With Head and Neck Adenoid Cystic Carcinoma

    DEFF Research Database (Denmark)

    Amit, Moran; Na'ara, Shorook; Sharma, Kanika; Ramer, Naomi; Ramer, Ilana; Agbetoba, Abib; Glick, Joelle; Yang, Xinjie; Lei, Delin; Bjoerndal, Kristine; Godballe, Christian; Mücke, Thomas; Klaus-Dietrich, Wolff; Eckardt, André M; Copelli, Chiara; Sesenna, Enrico; Palmer, Frank; Ganly, Ian; Gil, Ziv

    2015-01-01

    BACKGROUND: Adenoid cystic carcinoma (ACC) accounts for 3-5 % of all head and neck malignancies. Investigations of outcomes from elective neck dissection (END) for patients with ACC are sparse. This study aimed to assess the impact of END on the survival of patients with ACC. METHODS: This...

  15. Thyroid carcinoma, cataract and hearing loss in a patient after irradiation for facial hemangioma

    International Nuclear Information System (INIS)

    A rare case of a patient irradiated on the right side of the face for a large hemangioma during early childhood is reported. This patient suffers from sensorineural hearing loss in the right ear and a cataract of the right eye, and she underwent surgery for Hurtle cell carcinoma of the thyroid gland. The literature discussing radiation-induced hearing loss is reviewed. (author)

  16. A massive neglected giant basal cell carcinoma in a schizophrenic patient treated successfully with vismodegib

    DEFF Research Database (Denmark)

    Andersen, Rosa Marie; Lei, Ulrikke

    2015-01-01

    The small molecule vismodegib is a great treatment alternative to patients challenged, e.g. psychiatric disorders, suffering from severe basal cell carcinoma of the skin in which surgery or other treatment modalities is not possible because of patient's wish or condition. We present a case of a 73...

  17. Recall of UVB-induced erythema in breast cancer patient receiving multiple drug chemotherapy

    DEFF Research Database (Denmark)

    Andersen, Klaus Ejner; Lindskov, R

    1984-01-01

    One day after sunbathing, a breast cancer patient received intravenous methotrexate, cyclophosphamide and 5-fluorouracil and had a recall of her UV erythema over the following week. Phototesting with UVA and UVB prior to and after a subsequent chemotherapy treatment showed a UVB-induced recall of...

  18. Incidence of cardiac conduction disorders in patients with rheumatic disease receiving hydroxychloroquine

    Directory of Open Access Journals (Sweden)

    Vijaya Prasanna Parimi

    2015-06-01

    Conclusion: This study highlights need for periodic cardiac evaluation of patients receiving long-term antimalarials. Reversibility of antimalarial toxicity is also highlighted in this study. Conduction disorders observed were similar to that expected in general population thus adding further evidence on safety of HCQ. [Int J Basic Clin Pharmacol 2015; 4(3.000: 565-567

  19. Acupressure in Controlling Nausea in Young Patients Receiving Highly Emetogenic Chemotherapy | Division of Cancer Prevention

    Science.gov (United States)

    RATIONALE: Acupressure wristbands may prevent or reduce nausea and caused by chemotherapy. It is not yet known whether standard care is more effective with or without acupressure wristbands in controlling acute and delayed nausea. PURPOSE: This randomized phase III trial is studying how well acupressure wristbands work with or without standard care in controlling nausea in young patients receiving highly emetogenic chemotherapy. |

  20. Hemoglobin Targets and Blood Transfusions in Hemodialysis Patients without Symptomatic Cardiac Disease Receiving Erythropoietin Therapy

    OpenAIRE

    Foley, Robert N.; Curtis, Bryan M.; Parfrey, Patrick S.

    2008-01-01

    Background and objectives: Optimal hemoglobin targets for chronic kidney disease patients receiving erythropoiesis-stimulating agents remain controversial. The effects of different hemoglobin targets on blood transfusion requirements have not been well characterized, despite their relevance to clinical decision-making.

  1. Intrapulmonary Penetration of Voriconazole in Patients Receiving an Oral Prophylactic Regimen

    OpenAIRE

    Capitano, Blair; Potoski, Brian A.; Husain, Shahid; Zhang, Shimin; Paterson, David L.; Studer, Sean M.; McCurry, Kenneth R.; VENKATARAMANAN, Raman

    2006-01-01

    Voriconazole penetrated well into the pulmonary epithelial lining fluid (ELF) in lung transplant patients receiving oral prophylaxis. The ELF concentrations exceeded those of the plasma, with an average ELF-to-plasma ratio of 11 (±8). A strong association between plasma and ELF concentrations (r2 = 0.95) was noted.

  2. Cognitive/Attentional Distraction in the Control of Conditioned Nausea in Pediatric Cancer Patients Receiving Chemotherapy.

    Science.gov (United States)

    Redd, William H.; And Others

    1987-01-01

    Investigated use of cognitive/attentional distraction (via commercially available video games) to control conditioned nausea in pediatric cancer patients receiving chemotherapy. Video game-playing resulted in significantly less nausea. The introduction and withdrawal of the opportunity to play video games produced significant changes (reduction…

  3. Mucin-1 and its relation to grade, stage and survival in ovarian carcinoma patients

    International Nuclear Information System (INIS)

    Mucin-1 is known to be over-expressed by various human carcinomas and is shed into the circulation where it can be detected in patient’s serum by specific anti-Mucin-1 antibodies, such as the tumour marker assays CA 15–3 and CA 27.29. The prognostic value of Mucin-1 expression in ovarian carcinoma remains uncertain. One aim of this study was to compare the concentrations of Mucin-1 in a cohort of patients with either benign or malignant ovarian tumours detected by CA 15–3 and CA 27.29. Another aim of this study was to evaluate Mucin-1 expression by immunohistochemistry in a different cohort of ovarian carcinoma patients with respect to grade, stage and survival. Patients diagnosed with and treated for ovarian tumours were included in the study. Patient characteristics, histology including histological subtype, tumour stage, grading and follow-up data were available from patient records. Serum Mucin-1 concentrations were measured with ELISA technology detecting CA 15–3 and CA 27.29, Mucin-1 tissue expression was determined by immunohistochemistry using the VU4H5 and VU3C6 anti-Mucin-1 antibodies. Statistical analysis was performed by using SPSS 18.0. Serum samples of 118 patients with ovarian tumours were obtained to determine levels of Mucin-1. Median CA 15–3 and CA 27.29 concentrations were significantly higher in patients with malignant disease (p< 0.001) than in patients with benign disease. Paraffin-embedded tissue of 154 patients with ovarian carcinoma was available to determine Mucin-1 expression. The majority of patients presented with advanced stage disease at primary diagnosis. Median follow-up time was 11.39 years. Immunohistochemistry results for VU4H5 showed significant differences with respect to tumour grade, FIGO stage and overall survival. Patients with negative expression had a mean overall survival of 9.33 years compared to 6.27 years for patients with positive Mucin-1 expression. This study found significantly elevated Mucin-1 serum

  4. Squamous cell carcinoma of the anal canal treated with chemoradiotherapy in a patient with HIV.

    Science.gov (United States)

    Sugimoto, Aya; Nakazuru, Shoichi; Sakakibara, Yuko; Nishio, Kumiko; Yamada, Takuya; Ishida, Hisashi; Yajima, Keishiro; Uehira, Tomoko; Mori, Kiyoshi; Mita, Eiji

    2016-01-01

    Since the introduction of combination antiretroviral therapy (ART), the life expectancy has increased for patients infected with human immunodeficiency virus (HIV). This has been associated with reductions in the incidences of some AIDS-defining malignancies, such as Kaposi sarcoma and non-Hodgkin lymphoma, but has coincided with an increased incidence of non-AIDS-defining malignancies, such as anal cancer. However, anal cancers are rare in patients with HIV in Japan. We report the case of an HIV-infected patient with anal cancer treated with chemoradiotherapy. A 37-year-old man receiving ART for HIV infection presented with a 1-month history of left inguinal lymphadenopathy and anal pain. Magnetic resonance imaging and computed tomography revealed a 56-mm mass, left inguinal lymphadenopathy, and left external iliac lymphadenopathy. The mass had infiltrated from the anal canal to the right levator ani and corpus spongiosum. Colonoscopy revealed a tumor with an ulcer in the anal canal. Histological examination of the tumor biopsy specimens confirmed the diagnosis of squamous cell carcinoma. The patient was diagnosed with anal cancer (T4N2M1 stage IV), and he received 5-fluorouracil (1000mg/m(2) on days 1-4 and 29-32) plus mitomycin C (10mg/m(2) on days 1 and 29) and concurrent radiotherapy (total dose, 59.4Gy in 33 fractions) along with ART. The treatment-related adverse events were grade 4 leukopenia and neutropenia, grade 3 thrombocytopenia, and grade 2 radiation dermatitis. Moreover, CD4 suppression was observed:the CD4 count decreased from 190 cells/μl before chemoradiotherapy to 138 cells/μl after 3 months, but increased to 210 cells/μl after 1 year. Because of the grade 4 leukopenia and neutropenia, the dose of 5-fluorouracil was reduced to 800mg/m(2) on days 29-32. A complete response was confirmed on magnetic resonance imaging, and colonoscopy confirmed the disappearance of the anal cancer. The patient is living with no signs of recurrence at 2 years

  5. Radioiodine-induced changes in lymphocyte subsets in patients with differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Tofani, A.; Sciuto, R.; Cioffi, R.P.; Pasqualoni, R.; Rea, S.; Festa, A.; Maini, C.L. [Department of Nuclear Medicine, Regina Elena Cancer Institute, Rome (Italy); Gandolfo, G.M.; Arista, M.C. [Department of Clinical Pathology, Regina Elena Cancer Institute, Rome (Italy)

    1999-08-01

    This study evaluated changes in lymphocyte subsets in patients with thyroid carcinoma who received iodine-131 for diagnostic and therapeutic purposes. Twenty thyroid cancer patients were entered in the study after total thyroidectomy: ten patients (group A) underwent whole-body scintigraphy with 185 MBq of {sup 131}I and the other ten (group B) received 3700 MBq of {sup 131}I therapy. All patients were in a hypothyroid state at the time of administration of {sup 131}I and started l-thyroxine 150 {mu}g/day 3 days after {sup 131}I administration. Free and bound triiodothyronine and thyroxine, thyroid-stimulating hormone, thyroglobulin, thyroglobulin antibodies, thyroid peroxidase/microsomal antibodies, white blood cell, lymphocyte counts and lymphocyte subsets were serially determined at baseline and at days 2, 7, 15, 30 and 60 after {sup 131}I administration. Twenty healthy age- and sex-matched individuals were used as a reference population for lymphocyte subset values. In group A only a reduction in NK cells at days 7 (P=0.043) and 15 (P=0.037) was observed. In group B, patients showed a delayed reduction in the total lymphocyte count at days 15, 30 and 60 (P=0.008, 0.004 and 0.018, respectively), and a decrease in B cells throughout the study (at days 7, 15, 30 and 60: P=0.006, 0.0017, 0.0017 and 0.0017 respectively). A transient decrease in NK cells was observed at days 15 (P=0.025) and 30 (P=0.008). Among T cells, the helper phenotype (CD4+) was mainly affected, resulting in a reduction in the CD4+/CD8+ ratio at day 60 (P=0.046). Comparing the two groups, the numbers of B lymphocytes at day 30 (P=0.023) and NK cells at days 2 (P=0.037) and 30 (P=0.023) were significantly lower in group B. Neither group showed any clinical sign of immunosuppression during the follow-up period. In patients with thyroid cancer the sensitivity of lymphocytes to the effects of {sup 131}I administered for diagnostic or therapeutic purposes depends upon lymphocyte phenotype and {sup

  6. Reliability of CT-based tumor volumetry after intraarterial chemotherapy in patients with small carcinoma of the oral cavity and the oropharynx

    International Nuclear Information System (INIS)

    The aim of the study was to evaluate the feasibility and consistency of CT-based tumor volumetry in patients with early carcinoma of the oral cavity and the oropharynx before and after intraarterial (IA) chemotherapy, comparing these data with clinical remission rates. Included in the study were 61 patients (mean age 59.3 years; 47 men) with histologically proven small carcinoma of the oral cavity or the oropharynx (local tumor stages T1/2). Patients received IA chemotherapy with high-dose cisplatin as part of a multimodal therapeutic regimen and underwent both clinical and radiological examination before and 4 weeks after local chemotherapy. Clinical evaluation of tumor response was possible in all patients (61/61). Radiological assessment of tumor volume was feasible in 42 of 61 patients (69%), but failed in 19 (31%) due to the absence of deep tumoral spread, lack of contrast enhancement or severe dental artifacts. Patients in whom evaluation was possible according to volumetric and clinical criteria revealed comparable remission rates: overall response 54.8% versus 52.4%, stable disease 40.4% versus 47.6%, and tumor progression 4.8% versus 0.0%. Because volume calculation was not feasible in approximately one-third of the patients, it cannot be recommended as a reliable indicator for treatment response in patients with small carcinoma of the oral cavity. (orig.)

  7. Efficacy of prophylactic anti-diarrhoeal treatment in patients receiving Campto for advanced colorectal cancer.

    Science.gov (United States)

    Duffour, J; Gourgou, S; Seitz, J F; Senesse, P; Boutet, O; Castera, D; Kramar, A; Ychou, M

    2002-01-01

    This study assessed the efficacy of combined prophylactic and curative anti-diarrhoeal medication in advanced colorectal patients treated by irinotecan. Thirty-four pre-treated eligible patients were evaluated. There were 44% women, the median age was 65 and 38% of the patients had a 0 performance status. The patients received sucralfate(4g/d) and nifuroxazide(600 mg/d) prophylactic treatment on days 0-7. In the case of severe diarrhoea, preventive treatment was replaced by loperamide(12 mg/d) and diosmectite (9 g/d). Grade 3 delayed diarrhoea occurred in 18% of patients (90% CI: [9.5-28.9]) and 4.6% of cycles. No grade 4 delayed diarrhoea was observed. Twenty-nine patients (85%) received the preventive treatment at cycle 1, while 14% (90% CI: [6.2-25.7]) experienced grade 3 delayed diarrhoea in 3.7% of cycles for a median 4.5 days. The objective response rate was 8% (90% CI [1.4-23.1]) among the 25 assessable patients. Preventive combined treatment is effective in reducing the incidence of severe delayed diarrhoea, and it should be proposed to patients treated with mono-therapy Campto(r) and evaluated in poly-chemotherapy protocols. PMID:12552984

  8. Frequent POLE1 p.S297F mutation in Chinese patients with ovarian endometrioid carcinoma

    International Nuclear Information System (INIS)

    The catalytic subunit of DNA polymerase epsilon (POLE1) functions primarily in nuclear DNA replication and repair. Recently, POLE1 mutations were detected frequently in colorectal and endometrial carcinomas while with lower frequency in several other types of cancer, and the p.P286R and p.V411L mutations were the potential mutation hotspots in human cancers. Nevertheless, the mutation frequency of POLE1 in ovarian cancer still remains largely unknown. Here, we screened a total of 251 Chinese samples with distinct subtypes of ovarian carcinoma for the presence of POLE1 hotspot mutations by direct sequencing. A heterozygous somatic POLE1 mutation, p.S297F (c.890C>T), but not p.P286R and p.V411L hotspot mutations observed in other cancer types, was identified in 3 out of 37 (8.1%) patients with ovarian endometrioid carcinoma; this mutation was evolutionarily highly conserved from Homo sapiens to Schizosaccharomyces. Of note, the POLE1 mutation coexisted with mutation in the ovarian cancer-associated PPP2R1A (protein phosphatase 2, regulatory subunit A, α) gene in a 46-year-old patient, who was also diagnosed with ectopic endometriosis in the benign ovary. In addition, a 45-year-old POLE1-mutated ovarian endometrioid carcinoma patient was also diagnosed with uterine leiomyoma while the remaining 52-year-old POLE1-mutated patient showed no additional distinctive clinical manifestation. In contrast to high frequency of POLE1 mutations in ovarian endometrioid carcinoma, no POLE1 mutations were identified in patients with other subtypes of ovarian carcinoma. Our results showed for the first time that the POLE1 p.S297F mutation, but not p.P286R and p.V411L hotspot mutations observed in other cancer types, was frequent in Chinese ovarian endometrioid carcinoma, but absent in other subtypes of ovarian carcinoma. These results implicated that POLE1 p.S297F mutation might be actively involved in the pathogenesis of ovarian endometrioid carcinoma, but might not be actively

  9. Frequent POLE1 p.S297F mutation in Chinese patients with ovarian endometrioid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Zou, Yang; Liu, Fa-Ying; Liu, Huai; Wang, Feng [Key Laboratory of Women' s Reproductive Health of Jiangxi Province, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Central Laboratory, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Li, Wei [Key Laboratory of Women' s Reproductive Health of Jiangxi Province, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Central Laboratory, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Graduate School of Nanchang University, Nanchang, Jiangxi 330031 (China); Huang, Mei-Zhen [Graduate School of Nanchang University, Nanchang, Jiangxi 330031 (China); Jiangxi Provincial Cancer Institute, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi 330029 (China); Huang, Yan; Yuan, Xiao-Qun [Key Laboratory of Women' s Reproductive Health of Jiangxi Province, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Central Laboratory, Jiangxi Provincial Maternal and Child Health Hospital, Nanchang, Jiangxi 330006 (China); Graduate School of Nanchang University, Nanchang, Jiangxi 330031 (China); Xu, Xiao-Yun [Graduate School of Nanchang University, Nanchang, Jiangxi 330031 (China); Jiangxi Provincial Cancer Institute, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi 330029 (China); Huang, Ou-Ping, E-mail: huangouping@gmail.com [Jiangxi Provincial Cancer Institute, Jiangxi Provincial Cancer Hospital, Nanchang, Jiangxi 330029 (China); He, Ming, E-mail: jxhm56@hotmail.com [Department of Pharmacology and Molecular Therapeutics, Nanchang University School of Pharmaceutical Science, Nanchang 330006 (China)

    2014-03-15

    The catalytic subunit of DNA polymerase epsilon (POLE1) functions primarily in nuclear DNA replication and repair. Recently, POLE1 mutations were detected frequently in colorectal and endometrial carcinomas while with lower frequency in several other types of cancer, and the p.P286R and p.V411L mutations were the potential mutation hotspots in human cancers. Nevertheless, the mutation frequency of POLE1 in ovarian cancer still remains largely unknown. Here, we screened a total of 251 Chinese samples with distinct subtypes of ovarian carcinoma for the presence of POLE1 hotspot mutations by direct sequencing. A heterozygous somatic POLE1 mutation, p.S297F (c.890C>T), but not p.P286R and p.V411L hotspot mutations observed in other cancer types, was identified in 3 out of 37 (8.1%) patients with ovarian endometrioid carcinoma; this mutation was evolutionarily highly conserved from Homo sapiens to Schizosaccharomyces. Of note, the POLE1 mutation coexisted with mutation in the ovarian cancer-associated PPP2R1A (protein phosphatase 2, regulatory subunit A, α) gene in a 46-year-old patient, who was also diagnosed with ectopic endometriosis in the benign ovary. In addition, a 45-year-old POLE1-mutated ovarian endometrioid carcinoma patient was also diagnosed with uterine leiomyoma while the remaining 52-year-old POLE1-mutated patient showed no additional distinctive clinical manifestation. In contrast to high frequency of POLE1 mutations in ovarian endometrioid carcinoma, no POLE1 mutations were identified in patients with other subtypes of ovarian carcinoma. Our results showed for the first time that the POLE1 p.S297F mutation, but not p.P286R and p.V411L hotspot mutations observed in other cancer types, was frequent in Chinese ovarian endometrioid carcinoma, but absent in other subtypes of ovarian carcinoma. These results implicated that POLE1 p.S297F mutation might be actively involved in the pathogenesis of ovarian endometrioid carcinoma, but might not be actively

  10. Des-gamma-carboxy prothrombin as an important prognostic indicator in patients with small hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Kenichi Hakamada; Norihisa Kimura; Takuya Miura; Hajime Morohashi; Keinosuke Ishido; Masaki Nara; Yoshikazu Toyoki; Shunji Narumi; Mutsuo Sasaki

    2008-01-01

    AIM:To clarify the effect of a high des-gamma-carboxy prothrombin (DCP) level on the invasiveness and prognosis of small hepatocellular carcinoma.METHODS:Among 142 consecutive patients with known DCP levels,who underwent hepatectomy because of hepatocellular carcinoma,85 patients met the criteria for small hepatocellular carcinoma,i.e.one≤5 cm sized single tumor or no more than three≤3 cm sized tumors.RESULTS:The overall survival rate of the 142 patients was 92.1% for 1 year,69.6% for 3 years,and 56.9% for 5 years.Multivariate analysis showed that microscopic vascular invasion (P = 0.03) and serum DCP≥400mAU/mL (P = 0.02) were independent prognostic factors.In the group of patients who met the criteria for small hepatocellular carcinoma,DCP≥400 mAU/mL was found to be an independent prognostic factor for recurrence-free (P = 0.02) and overall survival (P = 0.0005).In patients who did not meet the criteria,the presence of vascular invasion was an independent factor for recurrence-free (P = 0.02) and overall survivals (P = 0.01).In 75% of patients with small hepatocellular carcinoma and high DCP levels,recurrence occurred extrahepatically.CONCLUSION:For small hepatocellular carcinoma,a high preoperative DCP level appears indicative for tumor recurrence.Because many patients with a high preoperative DCP level develop extrahepatic recurrence,it is necessary to screen the whole body.

  11. A new cluster-based oversampling method for improving survival prediction of hepatocellular carcinoma patients.

    Science.gov (United States)

    Santos, Miriam Seoane; Abreu, Pedro Henriques; García-Laencina, Pedro J; Simão, Adélia; Carvalho, Armando

    2015-12-01

    Liver cancer is the sixth most frequently diagnosed cancer and, particularly, Hepatocellular Carcinoma (HCC) represents more than 90% of primary liver cancers. Clinicians assess each patient's treatment on the basis of evidence-based medicine, which may not always apply to a specific patient, given the biological variability among individuals. Over the years, and for the particular case of Hepatocellular Carcinoma, some research studies have been developing strategies for assisting clinicians in decision making, using computational methods (e.g. machine learning techniques) to extract knowledge from the clinical data. However, these studies have some limitations that have not yet been addressed: some do not focus entirely on Hepatocellular Carcinoma patients, others have strict application boundaries, and none considers the heterogeneity between patients nor the presence of missing data, a common drawback in healthcare contexts. In this work, a real complex Hepatocellular Carcinoma database composed of heterogeneous clinical features is studied. We propose a new cluster-based oversampling approach robust to small and imbalanced datasets, which accounts for the heterogeneity of patients with Hepatocellular Carcinoma. The preprocessing procedures of this work are based on data imputation considering appropriate distance metrics for both heterogeneous and missing data (HEOM) and clustering studies to assess the underlying patient groups in the studied dataset (K-means). The final approach is applied in order to diminish the impact of underlying patient profiles with reduced sizes on survival prediction. It is based on K-means clustering and the SMOTE algorithm to build a representative dataset and use it as training example for different machine learning procedures (logistic regression and neural networks). The results are evaluated in terms of survival prediction and compared across baseline approaches that do not consider clustering and/or oversampling using the

  12. A Patient with Primary Squamous Cell Carcinoma of the Thyroid Intermingled with Follicular Thyroid Carcinoma that Remains Alive more than 8 Years after Diagnosis

    OpenAIRE

    Jung, Tae Sik; Oh, Young Lyun; Min, Young-Ki; Lee, Myung-Shik; Lee, Moon-Kyu; Kim, Kwang-Won; Chung, Jae Hoon

    2006-01-01

    Primary squamous cell carcinoma of the thyroid is an extremely rare tumor with a highly aggressive clinical course. We report here on a patient with primary squamous cell carcinoma of the thyroid who remains alive more than 8 years after diagnosis. A 56-year-old man presented with a hoarse voice and a rapidly progressing mass on the right side of the thyroid gland. The patient underwent a total thyroidectomy without neck lymph node dissection. Histopathologic findings revealed primary squamou...

  13. Remission and rheumatoid arthritis: Data on patients receiving usual care in twenty-four countries

    DEFF Research Database (Denmark)

    Sokka, Tuulikki; Hetland, Merete Lund; Mäkinen, Heidi;

    2008-01-01

    OBJECTIVE: To compare the performance of different definitions of remission in a large multinational cross-sectional cohort of patients with rheumatoid arthritis (RA). METHODS: The Questionnaires in Standard Monitoring of Patients with RA (QUEST-RA) database, which (as of January 2008) included 5......,848 patients receiving usual care at 67 sites in 24 countries, was used for this study. Patients were clinically assessed by rheumatologists and completed a 4-page self-report questionnaire. The database was analyzed according to the following definitions of remission: American College of Rheumatology (ACR......) definition, Disease Activity Score in 28 joints (DAS28), Clinical Disease Activity Index (CDAI), clinical remission assessed using 42 and 28 joints (Clin42 and Clin28), patient self-report Routine Assessment of Patient Index Data 3 (RAPID3), and physician report of no disease activity (MD remission). RESULTS...

  14. Radiotherapy of bile duct carcinoma

    International Nuclear Information System (INIS)

    Twenty-six patients with cholangiocarcinoma and nineteen patients with carcinoma of the gallbladder treated with external radiotherapy were analyzed. Of the twenty-six patients, eighteen had cancer of the hepatic hilus (Klatskin), four intrahepatic and the remaining four extrahepatic cholangiocarcinoma. All but two of the patients had advanced disease. Thirty-three patients received primary irradiation for unresectable tumors, ten patients adjuvant irradiation after non-curative gross tumor resection, and two patients preoperative radiotherapy. Patients with cholangiocarcinoma who underwent radiotherapy with relatively small radiation field tolerated the treatment well, but there was no significant difference in survival according to field size or radiation doses (TDF). On the other hand, patients with carcinoma of gallbladder were treated with larger field size and lower dose. In the patients without gross tumor resection, those receiving radiation doses≥90 TDF had significantly longer survival than 2) had longer survival (p=0.07). The patients with gross tumor resection had significantly longer survival than that without resection in both cholangiocarcinoma and carcinoma of gallbladder. Postmortem examination revealed tumor recurrence even in the patients with gross tumor resection, but widespread distant metastases were present simultaneously. Cholangitis and liver abscess were special and lethal conditions related to these carcinomas, and intensive therapy must be developed for these conditions. External radiotherapy may be effective in the treatment of bile duct carcinoma in terms of palliation and survival. (author)

  15. Experience with combination of nimotuzumab and intensity-modulated radiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma

    Directory of Open Access Journals (Sweden)

    Zhai RP

    2015-11-01

    Full Text Available Rui-ping Zhai, Hong-mei Ying, Fang-fang Kong, Cheng-run Du, Shuang Huang, Jun-jun Zhou, Chao-su Hu Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China Aim: To evaluate the efficacy and safety of using nimotuzumab in combination with intensity-modulated radiotherapy (IMRT in the primary treatment of locoregionally advanced nasopharyngeal carcinoma.Methods: Between December 2009 and December 2013, 38 newly diagnosed patients with stage III–IV nasopharyngeal carcinoma were treated with IMRT and nimotuzumab concomitantly. The distribution of disease was stage III in 20 (52.6%, stage IV A in 9 (23.7%, and stage IV B in 9 (23.7%. All the patients received at least two cycles of cisplatin-based neoadjuvant chemotherapy followed by nimotuzumab 200 mg/week concurrently with IMRT. Acute and late radiation-related toxicities were graded according to the Acute and Late Radiation Morbidity Scoring Criteria of Radiation Therapy Oncology Group.Results: With a median follow-up of 39.7 months (range, 13.3–66.5 months, the estimated 3-year local recurrence-free survival, regional recurrence-free survival, distant metastasis-free survival, progression failure-free survival, and overall survival rates were 92.8%, 92.9%, 89.5%, 78.7%, and 87.5%, respectively. The median cycle for nimotuzumab addition was 6 weeks. Grade 3 radiation-induced mucositis accounted for 36.8% of treated people. No skin rash and infusion reaction were observed, distinctly from what is reported in cetuximab-treated patients.Conclusion: Nimotuzumab plus IMRT showed promising outcomes in terms of locoregional control and survival, without increasing the incidence of radiation-related toxicities for patients. Keywords: nasopharyngeal carcinoma, intensity-modulated radiotherapy, nimotuzumab

  16. Interval Between Hysterectomy and Start of Radiation Treatment Is Predictive of Recurrence in Patients With Endometrial Carcinoma

    International Nuclear Information System (INIS)

    Purpose: Adjuvant radiation therapy (RT) has been shown to improve local control in patients with endometrial carcinoma. We analyzed the impact of the time interval between hysterectomy and RT initiation in patients with endometrial carcinoma. Methods and Materials: In this institutional review board-approved study, we identified 308 patients with endometrial carcinoma who received adjuvant RT after hysterectomy. All patients had undergone hysterectomy, oophorectomy, and pelvic and para-aortic lymph node evaluation from 1988 to 2010. Patients' demographics, pathologic features, and treatments were compared. The time interval between hysterectomy and the start of RT was calculated. The effects of time interval on recurrence-free (RFS), disease-specific (DSS), and overall survival (OS) were calculated. Following univariate analysis, multivariate modeling was performed. Results: The median age and follow-up for the study cohort was 65 years and 72 months, respectively. Eighty-five percent of the patients had endometrioid carcinoma. RT was delivered with high-dose-rate brachytherapy alone (29%), pelvic RT alone (20%), or both (51%). Median time interval to start RT was 42 days (range, 21-130 days). A total of 269 patients (74%) started their RT <9 weeks after undergoing hysterectomy (group 1) and 26% started ≥9 weeks after surgery (group 2). There were a total of 43 recurrences. Tumor recurrence was significantly associated with treatment delay of ≥9 weeks, with 5-year RFS of 90% for group 1 compared to only 39% for group 2 (P<.001). On multivariate analysis, RT delay of ≥9 weeks (P<.001), presence of lymphovascular space involvement (P=.001), and higher International Federation of Gynecology and Obstetrics grade (P=.012) were independent predictors of recurrence. In addition, RT delay of ≥9 weeks was an independent significant predictor for worse DSS and OS (P=.001 and P=.01, respectively). Conclusions: Delay in administering adjuvant RT after

  17. Interval Between Hysterectomy and Start of Radiation Treatment Is Predictive of Recurrence in Patients With Endometrial Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Cattaneo, Richard [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States); Hanna, Rabbie K. [Division of Gynecologic Oncology, Department of Women' s Health Services, Henry Ford Hospital, Detroit, Michigan (United States); Jacobsen, Gordon [Public Health Science, Henry Ford Hospital, Detroit, Michigan (United States); Elshaikh, Mohamed A., E-mail: melshai1@hfhs.org [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States)

    2014-03-15

    Purpose: Adjuvant radiation therapy (RT) has been shown to improve local control in patients with endometrial carcinoma. We analyzed the impact of the time interval between hysterectomy and RT initiation in patients with endometrial carcinoma. Methods and Materials: In this institutional review board-approved study, we identified 308 patients with endometrial carcinoma who received adjuvant RT after hysterectomy. All patients had undergone hysterectomy, oophorectomy, and pelvic and para-aortic lymph node evaluation from 1988 to 2010. Patients' demographics, pathologic features, and treatments were compared. The time interval between hysterectomy and the start of RT was calculated. The effects of time interval on recurrence-free (RFS), disease-specific (DSS), and overall survival (OS) were calculated. Following univariate analysis, multivariate modeling was performed. Results: The median age and follow-up for the study cohort was 65 years and 72 months, respectively. Eighty-five percent of the patients had endometrioid carcinoma. RT was delivered with high-dose-rate brachytherapy alone (29%), pelvic RT alone (20%), or both (51%). Median time interval to start RT was 42 days (range, 21-130 days). A total of 269 patients (74%) started their RT <9 weeks after undergoing hysterectomy (group 1) and 26% started ≥9 weeks after surgery (group 2). There were a total of 43 recurrences. Tumor recurrence was significantly associated with treatment delay of ≥9 weeks, with 5-year RFS of 90% for group 1 compared to only 39% for group 2 (P<.001). On multivariate analysis, RT delay of ≥9 weeks (P<.001), presence of lymphovascular space involvement (P=.001), and higher International Federation of Gynecology and Obstetrics grade (P=.012) were independent predictors of recurrence. In addition, RT delay of ≥9 weeks was an independent significant predictor for worse DSS and OS (P=.001 and P=.01, respectively). Conclusions: Delay in administering adjuvant RT after

  18. Use of diffusion-weighted magnetic resonance imaging in cervical lymph node metastasis from nasopharyngeal carcinoma receiving intensity modulated radiation therapy

    International Nuclear Information System (INIS)

    Objective: To investigate the value of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficients (ADC) in detecting metastatic lymph nodes from nasopharyngeal carcinoma (NPC), and predicting the response of these nodes to concurrent chemoradiation (CRT). Methods: Eighteen patients with pathologically proven NPC received conventional magnetic resonance imaging (MRI) and DWI before treatment,weekly during treatment, and one month after treatment.DWI was performed using a single-shot echo-planar (SSEPI) MR imaging sequence with b values of 0 and 1500 s/mm2. ADC maps were reconstructed for all patients and ADC values were calculated for each lymph node and tongue muscle. Totally fifty-two morphologically abnormal lymph nodes were analyzed. The ADC values of the metastatic lymph nodes before treatment were compared between those with the short axis ≥10 mm (n=32) and those with the short axis <10 mm (n=20), and the dynamic changes in ADC values of the lymph nodes before, during, and after therapy were observed and recorded. Results: The average ADC of the 32 lymph nodes with the short axis ≥ 10 mm was (0.71±0.12)×10-3mm/s, not significantly different from that of the 20 lymph nodes with the short axis < 10 mm [(0.73±0.16)×10-3mm/s, t=1.11, P=0.27]. The average ADC values of these lymph nodes before treatment was significantly lower than that of the tongue muscle (t=19.35, P<0.0001). During CRT, the ADC values of the lymph nodes increased gradually,with the most evident change in the first two weeks before reaching a relatively flat plateau thereafter. The ADC value of the residual lymph nodes after CRT was significantly higher than that before treatment (t=12.72, P<0.0001), however, not statistically significant different from that of the normal tongue muscle (t=0.34, P=0.73). Conclusions: DWI plays an important role in diagnosing the metastatic lymph nodes from NPC and is feasible for observation of the early response of the lymph

  19. Detection of erbB2 copy number variations in plasma of patients with esophageal carcinoma

    International Nuclear Information System (INIS)

    Mortality is high in patients with esophageal carcinoma as tumors are rarely detected before the disease has progressed to an advanced stage. Here, we sought to isolate cell-free DNA released into the plasma of patients with esophageal carcinoma, to analyze copy number variations of marker genes in the search for early detection of tumor progression. Plasma of 41 patients with esophageal carcinoma was prospectively collected before tumor resection and chemotherapy. Our dataset resulted heterogeneous for clinical data, resembling the characteristics of the tumor. DNA from the plasma was extracted to analyze copy number variations of the erbB2 gene using real-time PCR assays. The real-time PCR assays for erbB2 gene showed significant (P = 0.001) copy number variations in the plasma of patients with esophageal carcinoma, as compared to healthy controls with high sensitivity (80%) and specificity (95%). These variations in erbB2 were negatively correlated to the progression free survival of these patients (P = 0.03), and revealed a further risk category stratification of patients with low VEGF expression levels. The copy number variation of erbB2 gene from plasma can be used as prognostic marker for early detection of patients at risk of worse clinical outcome in esophageal cancer

  20. Significance of systemic lymphadenectomy in regard to the extent of metastatic lymph node involvement in patients operated for gastric carcinoma

    OpenAIRE

    Stevanović Dejan; Radovanović Dragan L.; Pavlović Ivan 1; Mitrović Nebojša S.; Vuković Milena; Radojević Dejan

    2003-01-01

    Introduction Formation of lymphatic metastasis is an important prognostic factor in treatment of gastric carcinoma. In this paper we would like to point to the importance of systematic lymphadenectomy in regard to extent of metastatic lymph node involvement in patients with gastric carcinoma. Material and methods This investigation included 114 patients with diagnosis of gastric carcinoma undergoing systematic lymphadenectomy. We analyzed metastatic lymph node involvement considering: 1. tumo...

  1. Decreased expression of mucin 18 is associated with unfavorable postoperative prognosis in patients with clear cell renal cell carcinoma

    OpenAIRE

    Bai, Qi; Liu, Li; Long, Qilai; Xia, Yu; Wang, Jiajun; Xu, Jiejie; Guo, Jianming

    2015-01-01

    Background: MUC18 is correlated with tumor progression and metastasis in types of malignancy. But the role of MUC18 in clear cell renal cell carcinoma remains unclear. In this study, we aimed to investigate the expression of MUC18 and its correlation with clinical outcomes in clear cell renal cell carcinoma. Patients and Methods: Immunohistochemical staining was performed in samples from 288 patients with clear cell renal cell carcinoma. We used Kaplan-Meier method and Cox proportional hazard...

  2. Partial cystectomy in a 76 year old patient suffering from small cell carcinoma of the urinary bladder

    OpenAIRE

    Starownik, Radosław; Korolczuk, Agnieszka; Bar, Krzysztof; Płaza, Paweł; Kiś, Jacek; Muc, Kamil; Bar, Marek

    2013-01-01

    Small cell carcinomas of the urinary bladder originating from the neuroendocrine cells are extremely rare. We present a case of a 76–year–old patient with small cell carcinoma of the urinary bladder. The patient had hematuria and cystoscopy revealed a tumor located in a urinary bladder diverticulum. Partial resection of the bladder wall with diverticulectomy was performed. Microscopic examination established the diagnosis of neuroendocrine carcinoma, which was confirmed by immunohistochemistr...

  3. Graves’ Disease and Papillary Thyroid Carcinoma in a Patient with Active Sarcoidosis

    Directory of Open Access Journals (Sweden)

    Şefika Burçak Polat

    2012-12-01

    Full Text Available Sarcoidosis is a systemic granulomatous disease of unknown etiology. In most cases, mediastinal lymph nodes and lung parenchyma are involved. In addition, the eyes, skin, abdominal organs, central nervous system or the joints might be involved during the course of the disease. Sarcoidosis has been found to be related with other autoimmune diseases such as thyroiditis. In this report, we present the case of a patient in whom hyperthroidism was found and Graves’ disease and papillary thyroid carcinoma were diagnosed while being investigated with a preliminary diagnosis of sarcoidosis. A 50-year-old male patient was admitted to our chest diseases clinic with the complaints of cough with colorless sputum, joint pain, weakness, weight loss (36 kgs, palpitations, tremor of the hands and pain in the right eye. Mediastinal lympadenopathy was detected on CT scan. Laboratory tests demonstrated hypercalcemia and low levels of parathyroid hormone (PTH. Eye examination revealed uveitis. Bronchoscopy was planned to confirm the diagnosis of sarcoidosis. Thyroid function test was performed and the patient turned out to have hyperthyroidism with high free T4 and low TSH levels. TSH receptor antibody titer was 71 U/L (0- 14 U/L. Ultrasonographic examination demonstrated enlarged thyroid gland and heterogeneous parenchyma with increased blood flow pattern. 4- and 24-hour radioiodine uptakes were 30% and 60%, respectively and scintigraphy findings were compatible with diffuse toxic goiter. On Hertel exophthalmometer, the measurements of the right and left eye were 23 and 24 mm, respectively. The diagnosis of Graves’ disease was made and thionamide therapy was started. Since active ophthalmopathy was present and the patient did not want to receive medical therapy for a long time, surgery was the best option for definitive therapy. The patient was prepared for the surgery with lugol solution (3x10 drops daily and after eutyroidism was achieved, bilateral total

  4. Squamous cell carcinoma of hypopharynx in a patient with history of celiac disease

    Institute of Scientific and Technical Information of China (English)

    A Akhavan; A Seifadini

    2012-01-01

    Celiac disease is a gluten-related malabsorption in small intestine occurring in genetically susceptible patients. In this disease the risk of many malignancies is increased the most important of which being non-Hodgkin lymphoma of small intestine. Other malignancies include adenocarcinoma of small intestine and squamous cell carcinoma of esophagus and melanoma. As to our knowledge so far only one case of celiac disease associated with hypopharyngeal squamous cell carcinoma has been reported. In this article we presented a patient suffering from celiac disease with squamous cell carcinoma of hypopharynx. She underwent chemotherapy and radiation therapy, unfortunately however she died because of progress of disease. So, in patients with celiac disease we should pay attention to various malignancies and when cases of cancers are accompanied by malabsorption we must think of celiac disease involvement.

  5. Spiral CT vesiculography: a new method for examining patients with histologically confirmed prostate carcinoma

    International Nuclear Information System (INIS)

    Purpose: Development of an imaging method for detection of seminal vesicle invasion in patients with histologically proven carcinoma of the prostate. Materials and methods: In 24 patients with histologically proven carcinoma of the prostate we preoperatively performed an antegrade vaso-vesiculography with non-ionic, iodine-containing contrast agent followed by a spiral CT of the seminal vesicles. Results: In 21 patients we achieved both a bilateral and a bulging enhancement of the seminal vesicle lumen. The method is introduced and described in detail. Conclusions: Intraductal application of contrast agent just before spiral CT results in unfold and bulging enhanced seminal vesicles. From the differentiation of the lumen, the wall, and the surrounding fat of the seminal vesicles as well as the enhanced ejaculatory ducts we expect information on tumourous infiltration in cases of histologically proven carcinomas of the prostate. (orig.)

  6. Supraglottic carcinoma: Impact of radiation therapy on outcome of patients with positive margins and extracapsular nodal disease

    Energy Technology Data Exchange (ETDEWEB)

    Devineni, V.R.; Simpson, J.R.; Sessions, D.; Spector, J.G.; Hayden, R.; Fredrickson, J.; Fineberg, B. (Radiation Oncology Center, Washington University Medical Center, St. Louis, MO (USA))

    1991-07-01

    Seventy-nine patients with supraglottic carcinoma treated between 1966 and 1985 are reviewed. All patients were treated with surgery and postoperative radiation therapy. Thirty-five percent of the patients had positive margins at the site of resection of the primary tumor. Of the 25 patients who had positive nodal disease, 13 patients (52%) had either extracapsular extension or soft-tissue or adjacent organ invasion, referred to in composite as grave signs. The median follow-up of the patients was 4.9 years and all patients were followed for a minimum of 3 years. The disease-free survival for all patients was 76% at 2 years and 71% at 3 years. The locoregional control rate for all patients was 70%. This study demonstrates that there is no difference in local recurrence or disease-free survival, or time to recurrence relative to the status of the surgical margins, which may be a benefit of the postoperative radiation therapy. This study also demonstrates that there is an increase in the number of patients with grave signs with increasing nodal stage. The rate of neck recurrence in patients with grave signs was substantially higher (54%) than in patients without grave signs (8%), even though these patients also had positive lymph nodes. Interestingly, there was also a higher rate of local recurrence among patients who had grave signs. Patients receiving doses higher than 6000 cGy to the primary site had fewer local failures, although within each group of patients with positive or negative surgical margins the differences in survival were minimal.

  7. Supraglottic carcinoma: Impact of radiation therapy on outcome of patients with positive margins and extracapsular nodal disease

    International Nuclear Information System (INIS)

    Seventy-nine patients with supraglottic carcinoma treated between 1966 and 1985 are reviewed. All patients were treated with surgery and postoperative radiation therapy. Thirty-five percent of the patients had positive margins at the site of resection of the primary tumor. Of the 25 patients who had positive nodal disease, 13 patients (52%) had either extracapsular extension or soft-tissue or adjacent organ invasion, referred to in composite as grave signs. The median follow-up of the patients was 4.9 years and all patients were followed for a minimum of 3 years. The disease-free survival for all patients was 76% at 2 years and 71% at 3 years. The locoregional control rate for all patients was 70%. This study demonstrates that there is no difference in local recurrence or disease-free survival, or time to recurrence relative to the status of the surgical margins, which may be a benefit of the postoperative radiation therapy. This study also demonstrates that there is an increase in the number of patients with grave signs with increasing nodal stage. The rate of neck recurrence in patients with grave signs was substantially higher (54%) than in patients without grave signs (8%), even though these patients also had positive lymph nodes. Interestingly, there was also a higher rate of local recurrence among patients who had grave signs. Patients receiving doses higher than 6000 cGy to the primary site had fewer local failures, although within each group of patients with positive or negative surgical margins the differences in survival were minimal

  8. Upregulation of Circulating PD-L1/PD-1 Is Associated with Poor Post-Cryoablation Prognosis in Patients with HBV-Related Hepatocellular Carcinoma

    OpenAIRE

    Zeng, Zhen; Shi, Feng; Zhou, Lin; Zhang, Min-Na; Chen, Yan; Chang, Xiu-Juan; Lu, Yin-Ying; Bai, Wen-lin; Jian-hui QU; Wang, Chun-Ping; Wang, Hong; Lou, Min; Wang, Fu-Sheng; Ji-yun LV; Yang, Yong-Ping

    2011-01-01

    Background The programmed cell death-1 receptor/programmed cell death-1 ligand (PD-1/PD-L1) pathway plays a crucial role in tumor evasion from host immunity. This study was designed to evaluate the association between circulating PD-L1/PD-1 and prognosis after cryoablation in patients with HBV-related hepatocellular carcinoma (HCC). Methodology/Principal Findings In the present study, 141 HBV-related HCC patients were enrolled and of those 109 patients received cryoablation. Circulating PD-L1...

  9. Ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) in patients with breast lesion marked by the localized needle

    International Nuclear Information System (INIS)

    Early diagnosis of a breast cancer is very important and challenging aspect in imaging the lesion in the breast. The small lesions visible in imaging exams, in majority of cases are not palpable in clinical testing. The aim of the work is to make a comparison between the clinical features and radiological image in patients with impalpable breast cancer in clinical testing. 338 operating procedures of the breast tumors removal were conducted after preliminary marking them by the localized needle. The lesion in the breast was shown in the mammography or ultrasonography exam. In histopathology exam the breast cancer was confirmed in 131 women. The ductal carcinoma in situ (DCIS) occurred in 41 (31 %) women and the invasive ductal carcinoma (IDC) in 91 (69 %) women. Microcalcifications find out to be characteristic for the DCIS. The shape of the spicular lesion is characteristic for the invasive carcinoma. DCIS in mammography exam is bigger than invasive carcinoma. 1. The mammography exam is the basic method for the detection of the breast cancer and the best method for the detection of DCIS, which is often visible in the form of microcalcifications. 2. The average size of the DCIS in mammography exam is twice as large than in ultrasonography and three times larger than in histopathology exam. 3. Size of the lesion in microscopic and macroscopic exam is equal with size of the lesion in ultrasound exam and the diameter of the solid center in the mammography and because of that reason, presence of the processes around the malignant tumor, which is visible in mammography exam should not have influenced the qualification for the surgical treatment. (author)

  10. Effect of Desmopressin in Reducing Bleeding after Cardiac Surgery in Patients Receiving Anti-Platelet Agents

    Directory of Open Access Journals (Sweden)

    Kamran Shadvar

    2016-07-01

    Full Text Available Background: Severe bleeding is an important cause of morbidity and mortality in cardiac surgery using the cardiopulmonary bypass (CPB pump. Desmopressin, a synthetic analogue of vasopressin, is used to prevent postoperative bleeding in patients with renal insufficiency. The aim of the present study was to evaluate the effect of desmopressin in reducing blood loss after cardiac surgery in patients receiving antiplatelet drugs. Methods: In this prospective clinical trial, 40 patients undergoing coronary artery bypass grafting (CABG surgery with CPB, aged over 18 years, and on antiplatelet therapy for a week before surgery were divided in two groups. Case and control groups received nasal desmopressin spray and nasal normal saline spray, respectively. Patient vital signs, blood loss, administration of blood products, prescription drugs to improve the coagulation status, serum and whole intake and output of patients, need for a second surgery to control the bleeding, remaining sternum open, mortality due to bleeding, duration of intensive care unit (ICU stay and mechanical ventilation were recorded. Results: In the case and control groups there were no differences in duration of operation, mechanical ventilation and length of ICU stay. There was no significant difference in terms of postoperative bleeding and intake of blood products between two groups (P>0.05. Reoperation due to bleeding in the case and control groups was observed in 3 (15%, and 1 (5% patient(s, respectively (P=0.3. Conclusion: Desmopressin has no significant effect on reducing the amount of bleeding after cardiac surgery in patients receiving anti-platelet agents. Keywords: CABG; cardio pulmonary bypass pump; hemorrhage; desmopressin 

  11. Immunological Evaluation of -Thalassemia Major Patients Receiving Oral Iron Chelator Deferasirox

    International Nuclear Information System (INIS)

    Objective: To determine the immune abnormalities and occurrence of infections in transfusion-dependent -thalassemia major patients receiving oral iron chelator deferasirox (DFX). Study Design: An observational study. Place and Duration of Study: Hematology Clinics, King Khalid University Hospital, Riyadh, Saudi Arabia, from July to December 2010. Methodology: Seventeen patients with -thalassemia major (12 females, median age 26 years) receiving deferasirox (DFX) for a median duration of 27 months were observed for any infections and had their immune status determined. Immune parameters studied included serum immunoglobulins and IgG subclasses, serum complement (C3 and C4) and anti-nuclear antibody (ANA) level, total B and T-lymphocytes, CD4+ and CD8+ counts, CD4+/CD8+ ratio, and natural killer (NK) cells. Immunological parameters of the patients were compared with age, gender, serum ferritin level and splenectomy status. Lymphocyte subsets were also compared with age and gender matched normal controls. Results: A considerable reduction in serum ferritin was achieved by DFX from a median level of 2528 to 1875 mol/l. Serum IgG levels were increased in 7 patients. Low C4 levels were found in 9 patients. Total B and T-lymphocytes were increased in 14 patients each, while CD4+, CD8+ and NK cells were increased in 13, 12 and 11 patients respectively. Absolute counts for all lymphocyte subsets were significantly higher compared to the normal controls (p=0.05 for all parameters). Raised levels of IgG were associated with older age, female gender, splenectomized status and higher serum ferritin levels but this did not reach statistical significance except for the higher ferritin levels (p=0.044). Increased tendency to infections was not observed. Conclusion: Patients with -thalassemia major receiving DFX exhibited significant immune abnormalities. Changes observed have been described previously, but could be related to DFX. The immune abnormalities were not associated with

  12. Improved Outcomes of Breast-Conserving Therapy for Patients With Ductal Carcinoma in Situ

    Energy Technology Data Exchange (ETDEWEB)

    Halasz, Lia M. [Harvard Radiation Oncology Program, Boston, MA (United States); Sreedhara, Meera [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, MA (United States); Chen, Yu-Hui [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA (United States); Bellon, Jennifer R.; Punglia, Rinaa S.; Wong, Julia S.; Harris, Jay R. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, MA (United States); Brock, Jane E., E-mail: jebrock@partners.org [Department of Pathology, Brigham and Women' s Hospital, Boston, MA (United States)

    2012-03-15

    Purpose: Patients treated for ductal carcinoma in situ (DCIS) with breast-conserving surgery (BCS) and radiation therapy (RT) at our center from 1976 to 1990 had a 15% actuarial 10-year local recurrence (LR) rate. Since then, improved mammographic and pathologic evaluation and greater attention to achieving negative margins may have resulted in a lower risk of LR. In addition, clinical implications of hormone receptor and HER-2 status in DCIS remain unclear. We sought to determine the following: LR rates with this more modern approach; the relation between LR and HER-2 status; and clinical and pathologic factors associated with HER-2{sup +} DCIS. Methods and Materials: We studied 246 consecutive patients who underwent BCS and RT for DCIS from 2001 to 2007. Of the patients, 96 (39%) were Grade III and the median number of involved tissue blocks was 3. Half underwent re-excision and 222 (90%) had negative margins (>2 mm). All received whole-breast RT (40-52 Gy) and 99% (244) received a tumor bed boost (8-18 Gy). Routine estrogen receptor (ER), progesterone receptor (PR), and HER-2 immunohistochemistry was instituted in 2003. Results: With median follow-up of 58 months, there were no LRs. Seven patients (3%) developed contralateral breast cancer (4 invasive and 3 in situ). Among 163 patients with immunohistochemistry, 124 were ER/PR{sup +}HER-2{sup -}, 27 were ER/PR{sup +}HER-2{sup +}, 6 were ER{sup -}/PR{sup -}HER-2{sup +}, and 6 were ER{sup -}/PR{sup -}HER-2{sup -}. On univariable analysis, HER-2{sup +}was significantly associated with Grade III, ER{sup -}/PR{sup -}, central necrosis, comedo subtype, more extensive DCIS, and postmenopausal status. On multivariable analysis, Grade III and postmenopausal status remained significantly associated with HER-2{sup +}. Conclusions: In an era of mammographically identified DCIS, larger excisions, widely negative margins and the use of a tumor bed boost, we observed no LR regardless of ER/PR/HER-2 status. Factors associated

  13. Improved Outcomes of Breast-Conserving Therapy for Patients With Ductal Carcinoma in Situ

    International Nuclear Information System (INIS)

    Purpose: Patients treated for ductal carcinoma in situ (DCIS) with breast-conserving surgery (BCS) and radiation therapy (RT) at our center from 1976 to 1990 had a 15% actuarial 10-year local recurrence (LR) rate. Since then, improved mammographic and pathologic evaluation and greater attention to achieving negative margins may have resulted in a lower risk of LR. In addition, clinical implications of hormone receptor and HER-2 status in DCIS remain unclear. We sought to determine the following: LR rates with this more modern approach; the relation between LR and HER-2 status; and clinical and pathologic factors associated with HER-2+ DCIS. Methods and Materials: We studied 246 consecutive patients who underwent BCS and RT for DCIS from 2001 to 2007. Of the patients, 96 (39%) were Grade III and the median number of involved tissue blocks was 3. Half underwent re-excision and 222 (90%) had negative margins (>2 mm). All received whole-breast RT (40–52 Gy) and 99% (244) received a tumor bed boost (8–18 Gy). Routine estrogen receptor (ER), progesterone receptor (PR), and HER-2 immunohistochemistry was instituted in 2003. Results: With median follow-up of 58 months, there were no LRs. Seven patients (3%) developed contralateral breast cancer (4 invasive and 3 in situ). Among 163 patients with immunohistochemistry, 124 were ER/PR+HER-2−, 27 were ER/PR+HER-2+, 6 were ER−/PR−HER-2+, and 6 were ER−/PR−HER-2−. On univariable analysis, HER-2+was significantly associated with Grade III, ER−/PR−, central necrosis, comedo subtype, more extensive DCIS, and postmenopausal status. On multivariable analysis, Grade III and postmenopausal status remained significantly associated with HER-2+. Conclusions: In an era of mammographically identified DCIS, larger excisions, widely negative margins and the use of a tumor bed boost, we observed no LR regardless of ER/PR/HER-2 status. Factors associated with HER-2+DCIS included more extensive DCIS, Grade III, ER

  14. Knowledge received by hospital patients-a factor connected with the patient-centred quality of nursing care.

    Science.gov (United States)

    Leino-Kilpi, Helena; Gröndahl, Weronica; Pekonen, Arja; Katajisto, Jouko; Suhonen, Riitta; Valkeapää, Kirsi; Virtanen, Heli; Salanterä, Sanna

    2015-12-01

    The main purpose of this study was to evaluate and analyse the connection between the level of quality of nursing care and knowledge received by patients (N = 266, n = 226), response rate was 85%. The data were collected using two structured instruments: one measuring the quality of nursing care experienced by patients (The Good Nursing Care Scale, GNCS) and one measuring the received knowledge of hospital patients (RKHP). The data were collected at one (out of five) Finnish university hospitals, in all medical wards during 5 weeks in 2009. A clear association between the level of the quality of nursing care and the level of received knowledge was found: on the total level of instruments, correlation was strong (r = 0.705). Support of empowerment (GNCS) had statistically significant strong correlation between biophysiological knowledge (RKHP), (r = 0.718), and experiential knowledge (r = 0.633), (P ≤ 0.01). Furthermore, there was a strong correlation between nursing activities and biophysiological knowledge (r = 0.637). Higher age, sufficient advance information and better self-perceived health status were associated both with the level of the quality of nursing care and level of received knowledge. In the future, a special attention should be paid to the sufficient information for patients before their hospital stays. PMID:24689487

  15. Patients' perceptions of their cosmetic appearance more than ten years after radiotherapy for basal cell carcinoma

    International Nuclear Information System (INIS)

    Of 47 elderly patients treated by simple radiotherapeutic techniques for basal cell carcinomas, 12 are alive and free of disease more than 10 years after treatment. They were asked to rate their perception of the current cosmetic appearance of their lesions on a scale consisting of: excellent, very good, good, mediocre, and poor. Six of the 12 rated their cosmetic appearance as excellent, three considered it very good, and three called it good. Despite undeniable objective deterioration of the cosmetic appearance of irradiated basal cell carcinomas, patients appear to be pleased with the results. (author)

  16. Helicobacter pylori vacA Genotypes in Chronic Gastritis and Gastric Carcinoma Patients from Macau, China.

    Science.gov (United States)

    Pinto-Ribeiro, Ines; Ferreira, Rui M; Batalha, Sellma; Hlaing, Thazin; Wong, Sio In; Carneiro, Fatima; Figueiredo, Ceu

    2016-01-01

    Helicobacter pylori is the major triggering factor for gastric carcinoma, but only a small proportion of infected patients develop this disease. Differences in virulence observed among H. pylori strains, namely in the vacuolating cytotoxin vacA gene, may contribute to this discrepancy. Infection with vacA s1, i1 and m1 strains increases the risk for progression of gastric premalignant lesions and for gastric carcinoma. However, in East Asian countries most of the H. pylori strains are vacA s1, regardless of the patients' clinical status, and the significance of the vacA i1 and m1 genotypes for gastric carcinoma in this geographic area remains to be fully elucidated. The aim of the present study was to investigate this relationship in 290 patients from Macau, China. Using very sensitive and accurate genotyping methods, we detected infection with vacA i1 and with vacA m1 strains in, respectively, 85.2% and 52.6% of the patients that were infected with single genotypes. The prevalence of cagA-positive strains was 87.5%. No significant associations were observed between vacA genotypes or cagA and gastric carcinoma. It is worth noting that 37.5% of the infected patients had coexistence of H. pylori strains with different vacA genotypes. Additional studies directed to other H. pylori virulence factors should be performed to identify high risk patients in East Asia. PMID:27164143

  17. Distribution of Pneumocystis carinii pneumonia in patients receiving aerosol pentamidine as prophylaxis

    International Nuclear Information System (INIS)

    This paper reviews the records and chest radiographs of 64 patients with acquired immunodeficiency syndrome and Pneumocystis carinii pneumonia. Parenchymal abnormalities were present in 63 of 64 patients (98%). Pleural effusion (six of 64 patients [9%]), adenopathy (five of 64 [8%]), and cystic changes (five of 64 [8%]) were uncommon. Patients receiving prophylaxis with aerosol pentamidine (n = 23) and those with a history of prior P carinii pneumonia (n = 10) were more likely to have an upper-lobe predominance of involvement by P carinii pneumonia than were patients lacking these factors (n = 31). A failure of deposition and/or retention of the aerosol pentamidine in the former, and structural changes resulting from previous P carinii pneumonia in the latter, may be responsible

  18. The incidence of anxiety and its correlates in cancer patients receiving radiotherapy

    International Nuclear Information System (INIS)

    Objective: To observe the incidence of anxiety in radiotherapy cancer patients in relation to their age, gender, education, marital status, performance status and type of disease. Design: Data regarding socio-demographic variables and disease type was recorded on a data capture form. The presence of anxiety was measured by administering taylor Manifest Anxiety Scale, Whereas patients, performance status was measured by administering Kernosky Performance Status Scale. Setting: Patients coming to the Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and research center for their treatment were included in this study. Subjects and methods: A consecutive sample of 113 patients was taken and followed up to study the incidence of anxiety. Data over various parameters like age, gender, education, marital status, disease type and performance status was recorded. Results: Fifty percent of cancer patients receiving radiotherapy were found to be suffering from anxiety. Among 89% of patients, anxiety lowered after the therapy, in 3% it increased and remained static in 8% Patients with low education and low performance status presented with high anxiety. Among all the patients, no significant relationship between anxiety and gender, age, marital status and site of the disease was observed. Conclusion: Correlates other than radiotherapy procedure can also cause anxiety in patients by further research is required to establish those correlates of anxiety. It is recommended that all radiotherapy patients should be provided education and procedural information designed to familiarize them with the forthcoming experience in order to reduce their anxiety. (author)

  19. Therapeutic dendritic cell vaccination of patients with metastatic renal cell carcinoma - A clinical, phase 1/2 trial

    DEFF Research Database (Denmark)

    Berntsen, A.; Trepiakas, R.; Wenandy, L.;

    2008-01-01

    with a DC- based vaccine in patients with metastatic renal cell carcinoma. Twenty-seven patients with progressive cytokine-refractory metastatic renal cell carcinoma were vaccinated with DCs loaded with either a cocktail of survivin and telomerase peptides or tumor lysate depending on their HLA-A2...

  20. Evaluation of urologic morbidity after radiotherapy for cervical carcinoma by urodynamic examinations and patient voiding schemes: a prospective study

    DEFF Research Database (Denmark)

    Lajer, Henrik; Thranov, Ingrid R; Bagi, Per;

    2002-01-01

    To assess urologic morbidity in a 5-year period by urodynamic examinations and patient voiding schemes after radiotherapy and brachytherapy for cervical carcinoma.......To assess urologic morbidity in a 5-year period by urodynamic examinations and patient voiding schemes after radiotherapy and brachytherapy for cervical carcinoma....

  1. Complete en bloc urinary exenteration for synchronous multicentric transitional cell carcinoma with sarcomatoid features in a hemodialysis patient

    Directory of Open Access Journals (Sweden)

    Tiberio M. Siqueira Jr

    2006-10-01

    Full Text Available The incidence of transitional cell carcinoma (TCC in patients submitted to hemodialysis is low. The presence of TCC with sarcomatoid features in this cohort is even scarcer. Herein, we describe a very rare case of synchronous multicentric muscle invasive bladder carcinoma with prostate invasion in a hemodialysis patient, submitted to complete en bloc urinary exenteration.

  2. The importance of knowing the home conditions of patients receiving long-term oxygen therapy

    Directory of Open Access Journals (Sweden)

    Godoy I

    2012-07-01

    Full Text Available Ilda Godoy,1 Suzana Erico Tanni,2 Carme Hernández,3 Irma Godoy21Department of Nursing, Botucatu School of Medicine, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil; 2Department of Pulmonology, Botucatu School of Medicine, Universidade Estadual Paulista, São Paulo, Brazil; 3Integrated Care Unit, Hospital Clinic, Barcelona, SpainPurpose: Long-term oxygen therapy (LTOT is one of the main treatments for patients with chronic obstructive pulmonary disease. Patients receiving LTOT may have less than optimal home conditions and this may interfere with treatment. The objective of this study was, through home visits, to identify the characteristics of patients receiving LTOT and to develop knowledge regarding the home environments of these patients.Methods: Ninety-seven patients with a mean age of 69 plus or minus 10.5 years were evaluated. This study was a cross-sectional descriptive analysis. Data were collected during an initial home visit, using a questionnaire standardized for the study. The results were analyzed retrospectively.Results: Seventy-five percent of the patients had chronic obstructive pulmonary disease, and 11% were active smokers. The patients’ mean pulse oximetry values were 85.9% plus or minus 4.7% on room air and 92% plus or minus 3.9% on the prescribed flow of oxygen. Most of the patients did not use the treatment as prescribed and most used a humidifier. The extension hose had a mean length of 5 plus or minus 3.9 m (range, 1.5–16 m. In the year prior to the visit, 26% of the patients received emergency medical care because of respiratory problems. Few patients reported engaging in leisure activities.Conclusion: The home visit allowed us to identify problems and interventions that could improve the way LTOT is used. The most common interventions related to smoking cessation, concentrator maintenance and cleaning, use of a humidifier, and adjustments of the length of the connector hose. Therefore, the home visit

  3. Comparing treatment outcomes of different chemotherapy sequences during intensity modulated radiotherapy for advanced N-stage nasopharyngeal carcinoma patients

    International Nuclear Information System (INIS)

    N-stage is related to distant metastasis of nasopharyngeal carcinoma (NPC) patients. We performed this study to compare the efficacy of different chemotherapy sequences in advanced N-stage (N2 and N3) NPC patients treated with intensity modulated radiotherapy (IMRT). From 2001 to 2008, 198 advanced N-stage NPC patients were retrospectively analyzed. Thirty-three patients received IMRT alone. Concurrent chemoradiotherapy (CCRT) was delivered to 72 patients, neoadjuvant chemotherapy (NACT) + CCRT to 82 patients and CCRT + adjuvant chemotherapy (AC) to 11 patients. The 5-year overall survival rate, recurrence-free survival rate, distant metastasis-free survival rate and progress-free survival rate were 47.7% and 73.1%(p<0.001), 74.5% and 91.3% (p = 0.004), 49.2% and 68.5% (p = 0.018), 37.5% and 63.8% (p<0.001) in IMRT alone and chemoradiotherapy group. Subgroup analyses indicated that there were no significant differences among the survival curves of CCRT, NACT + CCRT and CCRT + AC groups. The survival benefit mainly came from CCRT. However, there was only an improvement attendency in distant metastasis-free survival rate of CCRT group (p = 0.107) when compared with RT alone group, and NACT + CCRT could significantly improve distant metastasis-free survival (p = 0.017). For advanced N-stage NPC patients, NACT + CCRT might be a reasonable treatment strategy

  4. The impact of time factors on overall survival in patients with nasopharyngeal carcinoma: a population-based study

    International Nuclear Information System (INIS)

    Nasopharyngeal carcinoma (NPC) is most common in Southeast Asia. The purpose of this study is to investigate the correlation between wait time and length of radiotherapy and overall survival (OS) of NPC patients in Taiwan. From Taiwan’s National Health Insurance Research Database, this nationwide population-based cohort study identified 3605 NPC patients who received radiotherapy between 2008 and 2011. The impact of time factors on NPC survival rates was estimated with Kaplan-Meier survival curves. A multivariable Cox hazards regression model tested the significance of results after adjustment for other covariables. In all, 317 patients had wait times >4 weeks, 1404 patients had longer duration of radiotherapy (i.e., >10 weeks) and 499 died. Patients with wait times > 4 weeks and length of radiotherapy ≤ 10 weeks didn’t have significantly inferior survival. Patients with wait times >4 weeks and length of radiotherapy >10 weeks had significantly lower OS than other groups, with an adjusted hazard ratio of 1.7 (95 % CI, 1.10–2.60). Time was a significant prognostic factor for NPC patients who had both >4 weeks wait times and length of radiotherapy >10 weeks. Patients with wait time > 4 weeks and length of radiotherapy ≤ 10 weeks had a trend toward an inferior survival

  5. Lamivudine treatment in patients with HBV-related hepatocellular carcinoma--using an untreated, matched control cohort.

    Directory of Open Access Journals (Sweden)

    Piao,Cheng-Yu

    2005-10-01

    Full Text Available

    Lamivudine is widely used to treat patients with hepatitis B. However, the outcomes in patients with hepatocellular carcinoma (HCC treated with lamivudine have not been established. This study was conducted to evaluate the outcomes of lamivudine treatment for patients with HCC using an untreated, matched control group. Thirty patients with controlled HCC orally received lamivudine. As controls, 40 patients with HCC who were not treated with lamivudine and matched for clinical features were selected. The lamivudine-treated and untreated groups were compared with respect to changes in liver function, HCC recurrence, survival, and cause of death. In the lamivudine-treated group, there was significant improvement in the Child-Pugh score at 24 months after starting treatment, while no improvement was observed in the untreated group. There was no significant difference in the cumulative incidence of HCC recurrence and survival between the groups. However, there was a significant difference in the cumulative incidence of death due to liver failure (P= 0.043. A significant improvement in liver function was achieved by lamivudine treatment, even in patients with HCC. These results suggest that lamivudine treatment for patients with HCC may prevent death due to liver failure. Further prospective randomized studies using a larger number of patients are required.

  6. Positron emission tomography scan for predicting clinical outcome of patients with recurrent cervical carcinoma following radiation therapy

    Directory of Open Access Journals (Sweden)

    Daya Nand Sharma

    2012-01-01

    Materials and Methods: Twenty two patients of post irradiated recurrent cervical carcinoma (PIRCC were enrolled in this prospective study. 18-fluorodeoxyglucose (FDG PET imaging was performed in each patient before the salvage therapy. The maximum standardized uptake value (SUVmax and metabolic tumor volume (MTV were measured and correlated with cumulative progression free survival (PFS. Results: Median age of patients was 42 years. Majority of patients had stage III disease at the initial presentation and all 22 patients had received prior definitive RT. The median recurrence free period was 11 months. Salvage therapy consisted of surgical resection or re-irradiation depending upon the various clinical and radiological factors. Median SUVmax was 5.8 (range 1.8-50.6 and median MTV was 43 cm 3 (range 5.8-243. The cumulative PFS for all patients was 20% at 30 months. The one-year PFS was 28% for patients with SUVmax value of >5.8 versus 42% for those with SUVmax value of 43 cm 3 versus 45% for those with MTV value of <43 cm 3 (P value 0.8. Conclusion: Our preliminary experience has suggested that FDG uptake on PET scan can predict the clinical outcome of PIRCC patients. Further randomized studies may be conducted with large sample size and longer follow up to establish its definite predictive value.

  7. Expression of nerve growth factor and heme oxygenase-1 predict poor survival of breast carcinoma patients

    International Nuclear Information System (INIS)

    Nerve growth factor (NGF) is a neurotrophin and has been suggested to induce heme oxygenase-1 (HO1) expression. Although the role of HO1 in tumorigenesis remains controversial, recent evidence suggests NGF and HO1 as tumor-progressing factors. However, the correlative role of NGF and HO1 and their prognostic impact in breast carcinoma is unknown. We investigated the expression and prognostic significance of the expression of NGF and HO1 in 145 cases of breast carcinoma. Immunohistochemical expression of NGF and HO1 was observed in 31% and 49% of breast carcinoma, respectively. The expression of NGF and HO1 significantly associated with each other, and both have a significant association with histologic grade, HER2 expression, and latent distant metastasis. The expression of NGF and HO1 predicted shorter overall survival of breast carcinoma by univariate and multivariate analysis. NGF expression was an independent prognostic indicator for relapse-free survival by multivariate analysis. The combined expression pattern of NGF and HO1 was also an independent prognostic indicator of overall survival and relapse-free survival. The patients with tumors expressing NGF had the shortest survival and the patients with tumor, which did not express NGF or HO1 showed the longest survival time. This study has demonstrated that individual expression of NGF or HO1, and the combined NGF/HO1 expression pattern could be prognostic indicators for breast carcinoma patients

  8. Sleep, Mood, and Quality of Life in Patients Receiving Treatment for Lung Cancer

    Science.gov (United States)

    Dean, Grace E.; Redeker, Nancy S.; Wang, Ya-Jung; Rogers, Ann E.; Dickerson, Suzanne S.; Steinbrenner, Lynn M.; Gooneratne, Nalaka S.

    2014-01-01

    Purpose/Objectives To distinguish relationships among subjective and objective characteristics of sleep, mood, and quality of life (QOL) in patients receiving treatment for lung cancer. Design Descriptive, correlational study. Setting Two ambulatory oncology clinics. Sample 35 patients with lung cancer. Methods The following instruments were used to measure the variables of interest: Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale, Functional Assessment of Cancer Treatment–Lung (FACT-L), a sleep diary, and a motionlogger actigraph. Main Research Variables Sleep, mood, and QOL. Findings Significant differences were found between sleep diary and actigraph measures of sleep efficiency (p = 0.002), sleep latency (p = 0.014), sleep duration (p < 0.001), and wake after sleep onset (p < 0.001). Poor sleepers (PSQI score greater than 5) were significantly different from good sleepers (PSQI score of 5 or lower) on sleep diary measures of sleep efficiency and sleep latency and the FACT-L lung cancer symptom subscale, but not on mood or actigraphy sleep measures. Conclusions Although patients with lung cancer may report an overall acceptable sleep quality when assessed by a single question, those same patients may still have markedly increased sleep latencies or reduced total sleep time. The findings indicate the complexity of sleep disturbances in patients with lung cancer. Lung cancer symptoms had a stronger association with sleep than mood. Research using prospective methods will help to elucidate their clinical significance. Implications for Nursing Patients receiving treatment for lung cancer are at an increased risk for sleep disturbances and would benefit from routine sleep assessment and management. In addition, assessment and management of common symptoms may improve sleep and, ultimately, QOL. Knowledge Translation A high frequency of sleep disturbances in patients receiving treatment for lung cancer was evident, and poor sleepers had

  9. Differentiation of adrenal tumors in patients with hepatocellular carcinoma: Adrenal adenoma versus metastasis

    International Nuclear Information System (INIS)

    Objective: To investigate whether computed tomography (CT) attenuation test for differential diagnosis of adrenal nodule is applicable in patients with hepatocellular carcinoma (HCC) which shows similar image characteristics to adrenal adenoma. Materials and methods: This retrospective study was approved by our institutional review board, and the requirement for informed consent from study patients was waived. Searching picture archiving and communication system, we identified 3678 patients with HCC who underwent upper abdominal unenhanced CT scans between April 2002 and March 2010, and 114 adrenal nodules (39 adenomas and 75 metastases) were included for analysis. Ten nodules were confirmed pathologically while 104 had imaging diagnosis (enlarged or emerged during the study period). Size, CT number, and the internal characteristics of the lesions were recorded. Results: Mean CT numbers of adrenal adenomas were significantly lower than those of metastases (P < 0.0001, t-test) on unenhanced CT. Thresholds of 17 and 33 Hounsfield units (HU) provided the following sensitivity, specificity, and accuracy: 46.2%, 100%, and 81.6% at 17 HU, and 94.9%, 89.3%, and 91.2% at 33 HU, respectively. The area under receiver operating characteristic curve for the CT number test was 0.96. Metastases were significantly larger than adrenal adenoma (P = 0.009, t-test). However, the accuracy of testing using mass size was 64.0% at most. All adenomas and metastases were depicted as homogeneous masses with the exception of two metastases that presented as heterogeneous masses (necrotic or lipomatous). Conclusion: Adrenal adenomas can be differentiated from HCC metastases using CT number on unenhanced CT

  10. Differentiation of adrenal tumors in patients with hepatocellular carcinoma: Adrenal adenoma versus metastasis

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    Yasaka, Koichiro, E-mail: koyasaka@gmail.com [Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Gonoi, Wataru; Akai, Hiroyuki; Katsura, Masaki; Akahane, Masaaki [Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Kiryu, Shigeru [Department of Radiology, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639 (Japan); Ohtomo, Kuni [Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan)

    2013-08-15

    Objective: To investigate whether computed tomography (CT) attenuation test for differential diagnosis of adrenal nodule is applicable in patients with hepatocellular carcinoma (HCC) which shows similar image characteristics to adrenal adenoma. Materials and methods: This retrospective study was approved by our institutional review board, and the requirement for informed consent from study patients was waived. Searching picture archiving and communication system, we identified 3678 patients with HCC who underwent upper abdominal unenhanced CT scans between April 2002 and March 2010, and 114 adrenal nodules (39 adenomas and 75 metastases) were included for analysis. Ten nodules were confirmed pathologically while 104 had imaging diagnosis (enlarged or emerged during the study period). Size, CT number, and the internal characteristics of the lesions were recorded. Results: Mean CT numbers of adrenal adenomas were significantly lower than those of metastases (P < 0.0001, t-test) on unenhanced CT. Thresholds of 17 and 33 Hounsfield units (HU) provided the following sensitivity, specificity, and accuracy: 46.2%, 100%, and 81.6% at 17 HU, and 94.9%, 89.3%, and 91.2% at 33 HU, respectively. The area under receiver operating characteristic curve for the CT number test was 0.96. Metastases were significantly larger than adrenal adenoma (P = 0.009, t-test). However, the accuracy of testing using mass size was 64.0% at most. All adenomas and metastases were depicted as homogeneous masses with the exception of two metastases that presented as heterogeneous masses (necrotic or lipomatous). Conclusion: Adrenal adenomas can be differentiated from HCC metastases using CT number on unenhanced CT.

  11. Can relaxation interventions reduce anxiety in patients receiving radiotherapy? outcomes and study validity

    International Nuclear Information System (INIS)

    This study piloted the use of three relaxation interventions in an attempt to reduce levels of anxiety in patients who are immobilised for radiotherapy treatment of head and neck cancers, as well as trying to validate the study methodology. In addition to receiving normal radiation therapy treatment, 14 patients were assigned to either a control group not receiving the relaxation intervention or one of three validated relaxation intervention techniques; music therapy, aromatherapy or guided imagery. Patients in the intervention groups underwent the relaxation technique daily for the first seven days of treatment. On days 1, 3, 5 and 7 of treatment patients were required to complete the State Anxiety Inventory survey. While caution should be taken in accepting the results due to the small numbers of patients involved in the study and the non-randomised assignment of patients within the study, the results of the study demonstrate a clinically significant reduction in anxiety levels in each of the three relaxation interventions compared to the control group. The study demonstrated good study validity due to the ease of implementation, the unambiguous results generated, and the use of already validated anxiety intersections and measurement tools. Copyright (2001) Australian Institute of Radiography

  12. Immunohistochemical expression of HER-2/neu in patients with lung carcinoma and its prognostic significance

    International Nuclear Information System (INIS)

    Background. The HER-2 protein or p185her2 is a membrane receptor with tyrosine kinase activity encoded by HER-2/neu gene. Overexpression of HER-2/neu has been observed in many human cancers, including lung cancer. In the study, the expression of HER-2 protein is determined in the spectrum of lung cancer (adenocarcinoma, squamous cell carcinoma and small cell carcinoma). Patients and methods. The study population consisted of two groups: 19 patients that had undergone surgical treatment and 10 patients that had undergone fiber-optic bronchoscopy and biopsy for primary diagnosis only. Tissue specimens were neutral formaldehyde-fixed and paraffin-embedded. Standard histochemical and immunohistochemical staining were used for diagnosis. Expression of HER-2/neu protein was determined by immunohistochemical staining with Hercep Test (DAKO). The results were graded 0-1 as negative and 2-3 as positive. Results. Overall incidence of HER-2/neu overexpression was 34.4% (10 of 29). Higher incidence was found in the patients with adenocarcinoma 45.4% (5 of 11). In squamous cell carcinoma and small cell carcinoma, the overexpression incidence was 30.7% (4 of 13) and 20% (1 of 5), respectively. No statistically significant difference was seen given the age and gender. HER-2/neu overexpression was more pronounced in the patients with advanced tumour: all patients with squamous cell carcinoma and HER-2/neu overexpression had stage IIIB and stage IV disease, while 80 % of adenocarcinoma patients with HER-2/neu overexpression had stage IIIA and IIIB disease. Conclusions. These results are satisfactory and encourage us to continue this work in the follow-up study to evaluate HER-2/neu role as predictive and prognostic factor for the patients with lung cancer. (author)

  13. SIDE EFFECTS OF SUNITINIB MANIFESTED ON SKIN OF PATIENTS DIAGNOSED WITH RENAL CELL CARCINOMA: CASE-CONTROL STUDY

    Directory of Open Access Journals (Sweden)

    Bojana Petrović

    2009-10-01

    Full Text Available Sunitinib is a small, lipophilic, synthetic molecule that interferes with tyrosinekinase domain of vascular endothelial growth factor receptor, and prevents its activation after binding the vascular endothelial growth factor. Both in vitro and in vivo, sunitinib inhibits angiogenesis, and suppress growth of metastases, which depends on newly formed blood vessels. It was approved by FDA (U.S. Food and Drug Administration in January 2006 for the treatment of advanced renal-cell cancer and imatinib-resistant gastrointestinal stromal tumours.Among other adverse effects, it causes skin desquamation on fingers and toes, whitening of hair, eyebrows, mustache and beard. The aim of our study was to prove the causal relationship between sunitinib administration and skin adverse effects.The study involved the patients with metastasized renal cell carcinoma treated at the Institute for Radiology and Oncology of Serbia, in Belgrade. There were twelve patients (mean age 53.3 ± 11.1 years who took sunitinib 50 mg daily, for 4 weeks (“cases”. Control group was composed of fourteen patients (mean age 54.6 ± 9.8 years on standard therapy with interferon alpha (6 MJ three times weekly and vinblastine 10mg, two days per cycle. The control patients were matched with “cases” by age, sex, phase of the disease and nephrectomy.Out of the patients who received sunitinib, eleven (92% patients developed desquamation on fingers and toes, whitening of hair, eyebrows, mustache and beard, while none of the skin adverse effects was observed in the control group (OR = 143. The distribution of hypertension, heart diseases and diabetes mellitus in the groups was not significantly different (p>0.05.There is a strong association between administration of sunitinib in patients with renal cell carcinoma and observed skin adverse effects.

  14. Phase I trial of systemic intravenous infusion of interleukin-13-Pseudomonas exotoxin in patients with metastatic adrenocortical carcinoma

    International Nuclear Information System (INIS)

    Adrenocortical carcinoma (ACC) is a rare but lethal malignancy without effective current therapy for metastatic disease. IL-13-PE is a recombinant cytotoxin consisting of human interleukin-13 (IL-13) and a truncated form of Pseudomonas exotoxin A (PE). The main objectives of this Phase I dose-escalation trial were to assess the maximum-tolerated dose (MTD), safety, and pharmacokinetics (PK) of IL-13-PE in patients with metastatic ACC. Eligible patients had confirmed IL-13 receptor alpha 2 (IL-13Rα2) expressions in their tumors. IL-13-PE at dose of 1–2 μg/kg was administered intravenously (IV) on day 1, 3, and 5 in a 4-week cycle. Six patients received 1 μg/kg and two patients received 2 μg/kg of IL-13-PE. Dose-limiting toxicity was observed at 2 μg/kg, at which patients exhibited thrombocytopenia and renal insufficiency without requiring dialysis. PK analysis demonstrated that at MTD, the mean maximum serum concentration (Cmax) of IL-13-PE was 21.0 ng/mL, and the terminal half-life of IL-13-PE was 30–39 min. Two (25%) of the eight patients had baseline neutralizing antibodies against PE. Three (75%) of the remaining four tested patients developed neutralizing antibodies against IL-13-PE within 14–28 days of initial treatment. Of the five patients treated at MTD and assessed for response, one patient had stable disease for 5.5 months before disease progression; the others progressed within 1–2 months. In conclusion, systemic IV administration of IL-13-PE is safe at 1 μg/kg. All tested patients developed high levels of neutralizing antibodies during IL-13-PE treatment. Use of strategies for immunodepletion before IL-13-PE treatment should be considered in future trials

  15. Basosquamous carcinoma in an Indian patient with oculocutaneous albinism

    Directory of Open Access Journals (Sweden)

    Ranjan Nitin

    2009-01-01

    Full Text Available A middle-aged man with type IA OCA presented to us with a large ulcerated plaque of three year duration over the forehead. Histopathology showed basosquamous carcinoma in the form of distinct areas of basal and squamous differentiation. Metastasis workup was negative. Complete surgical excision, strict photoprotection and regular follow-up were advised. A timely recognition of this potentially aggressive neoplasm is the key to curative treatment.

  16. Basosquamous carcinoma in an Indian patient with oculocutaneous albinism

    OpenAIRE

    Ranjan Nitin; Singh Satyendra; Arif Sayeedul

    2009-01-01

    A middle-aged man with type IA OCA presented to us with a large ulcerated plaque of three year duration over the forehead. Histopathology showed basosquamous carcinoma in the form of distinct areas of basal and squamous differentiation. Metastasis workup was negative. Complete surgical excision, strict photoprotection and regular follow-up were advised. A timely recognition of this potentially aggressive neoplasm is the key to curative treatment.

  17. Esophageal Squamous Cell Carcinoma Patients Have an Increased Risk of Coexisting Colorectal Neoplasms

    OpenAIRE

    Baeg, Myong Ki; Choi, Myung-Gyu; Jung, Yun Duk; Ko, Sun-Hye; Lim, Chul-Hyun; Kim, Hyung Hun; Kim, Jin Su; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Kim, Sang-Woo

    2016-01-01

    Background/Aims Esophageal squamous cell carcinoma (ESCC) and colorectal neoplasms (CRNs) share risk factors. We aimed to investigate whether the CRN risk is increased in ESCC patients. Methods ESCC patients who underwent a colonoscopy within 1 year of diagnosis were retrospectively analyzed. Patients were matched 1:3 by age, gender, and body mass index to asymptomatic controls. CRN was defined as the histological confirmation of adenoma or adenocarcinoma. Advanced CRN was defined as any of t...

  18. EVALUATION OF RENAL FUNCTION IN PATIENTS WITH RENAL CELL CARCINOMA BEFORE AND AFTER RADICAL NEPHRECTOMY

    OpenAIRE

    M I Kogan; Gusev, A. A.; S. V. Evseyev

    2014-01-01

    There is an increase in the number of patients with renal cell carcinoma (RCC) every year. At the same time radical nephrectomy (RN) remains the standard treatment of renal malignancies and the most common surgical procedure for this pathology. A considerable number of patients with kidney cancer have diminished renal function that worsens after removal of functioning kidney tissue together with a tumor. This promotes retained low overall survival rates in patients with RCC, by improving canc...

  19. Unusual mammography findings of patients with ductal carcinoma in situ (DCIS of the breast.

    Directory of Open Access Journals (Sweden)

    F Ismail

    2008-12-01

    Full Text Available Abstract The early detection of carcinoma is the highlight of mammography. We present two patients with pathological diagnosis of DCIS with unusual mammographic findings for which one needs to have a higher index of suspicion. The first patient presented with multifocal disease requiring biopsy of all visible lesions and the second patient (twenty four years old presented with segmental distribution of calcifications, which may have been missed had a single-view baseline mammogram not been done.

  20. OVEREXPRESSIONS OF Ha-ras AND p53 PREDICT THE PROGNOSIS OF PATIENTS WITH NON-SMALL-CELL LUNG CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    李庆昌; 林东; 王妍; 邱雪杉; 王恩华

    2004-01-01

    Objective: To understand the relationship between the expression of ras and p53 and histological types, degree of differentiation, TNM classification, stage, and patients'prognoses of non-small-cell lung cancer, we examined Haras and p53 production in 143 non-small-cell lung carcinomas. Methods: One hundred and forty-three paraffin-embedded surgically resected specimens of primary non-small-cell lung carcinomas (57 squamous cell carcinomas, 63 acinar adenocarcinomas, 15 bronchioloalveolar carcinomas, and 8 large-cell carcinomas) were stained by streptavidin-peroxidase immunohistochemical method using anti-Ha-ras monoclonal and anti-p53monoclonal (DO-1) antibodies. Results: Ha-ras was found in 68% (87 of 143) of lung carcinomas. The positive rate of Ha-ras staining in well differentiated carcinoma was 89%,significantly higher than that in moderately differentiated carcinoma (66%, P<0.05) and that in poorly differentiated carcinoma (48%, P<0.01). The 5-year survival rates of patients whose tumors had no (39%, P<0.01) or moderate (33%, P<0.05) Ha-ras production were significantly higher than that of patients whose tumors had strong staining (14%) for Ha-ras. Sixty percent lung carcinomas (86 of 143)had p53 accumulation. Patients whose tumors did not express p53 survived, on average, significantly longer after tumor resection than did patients whose tumors expressed p53. With increasing p53 accumulation, the average length of survival after tumor resection significantly decreased.Conclusion: Ha-ras overproduction and p53 accumulation correlate with unfavorable prognoses of patients with nonsmall-cell lung carcinomas. Ha-ras production in non-smallcell lung carcinoma was related to the degree of differentiation.

  1. Characteristics of Patients Who Receive Home Health Services and Expectations of Caregivers

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    Yasemin Çayır1

    2013-09-01

    Full Text Available Objective: It is expected that Home Health Services (HHS reduce unnecessary health spending as well as decrease burden on hospitals, and provide high capacity to use available resources more efficiently. Thus we sought to assess these services including patients’ characteristics and caregiver’s expectation and satisfaction from HHS. Methods: Fifty-seven patient and their caregivers were included in the study. Patients’ daily life activities were evaluated with Katz scale and socio-demographic and clinical characteristics of patients were also recorded. Further caregiver’s expectations and satisfaction from HHS was evaluated with the help of a standard form. Analysis was done with the SPSS software. Results: The mean age was 68.7±19.2 years. Out of total, 61.4% of patients (n=35 were female. Diagnoses according to the frequency were as follows: hemophilia (n=15; 26.3%, Alzheimer (n=12; 21.1%, terminal cancer (n=10; 17.5%, chronic obstructive pulmonary disease (n=6; 10.5%, Parkinson (n=4; 7%, the patients received postoperative care (n=4; 7%. Out of those who receive HHS, 42.1% patients had pressure ulcer during the evaluation. As the duration of being bedridden increases so chances of presence of pressure ulcer was significantly increased (p<0.05. Total 59.6% caregivers were waiting to examine patients in their home. The opinion survey shows that 89.5% of caregivers thought there would be a reduction in the frequency of hospitalization if patients utilize HHS appropriately, and 82.5% of caregivers believed that already benefited enough from the HHS. Conclusion: HHS was given with professional team will meet expectations of patients and their relatives as well as decrease frequency of hospitalization and will prevent unnecessary applications to the outpatient clinics. In order to enable more people in need to benefit from this service, family physicians should identify their patients requiring HHS and give them appropriate guidance.

  2. Cilostazol add-on therapy in patients with mild dementia receiving donepezil: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Masafumi Ihara

    Full Text Available GOAL: Combinatorial therapy directed at both vascular and neurodegenerative aspects of dementia may offer a promising strategy for treatment of dementia, which often has a multifactorial basis in the elderly. We investigated whether the phosphodiesterase III inhibitor cilostazol, which is often used in the prevention of stroke and peripheral artery disease, may delay cognitive decline in the elderly receiving donepezil. METHODS: Medical records were retrospectively surveyed to identify patients who had received donepezil for more than one year and had undergone Mini-Mental State Examination (MMSE at least at two time points. Those with an initial MMSE score of less than 27 points were subjected to analysis (n = 156, with a cut-point of 21/22 applied to assign them to mild (n = 70 and moderate/severe (n = 86 dementia. The change of total MMSE score per year was compared between patients who had received donepezil and those given both donepezil and cilostazol. FINDINGS: In patients with mild dementia who had received donepezil and cilostazol (n = 34; 77.2±6.8 years old, the annual change in MMSE score was -0.5±1.6 during an observational period of 28.6±11.7 months, with those receiving donepezil only (n = 36; 78.4±6.5 years old scoring less (-2.2±4.1 during 30.4±12.8 months with a statistical intergroup difference (p = 0.022. Multivariate analysis showed that absence of cilostazol treatment was the only significant predictor of MMSE decline. A positive effect of cilostazol was found in three subscale scores of MMSE, orientation for time or place and delayed recall. By clear contrast, in patients with moderate/severe dementia, there were no intergroup differences in decrease of total or subscale MMSE scores between the two groups. CONCLUSIONS: These results suggest potential for cilostazol treatment in the suppression of cognitive decline in patients receiving donepezil with mild dementia but not in those with moderate

  3. Radioimmunological vasopressin determination in the urine of patients suffering from hypertension and lung carcinomas

    International Nuclear Information System (INIS)

    The AVP content of the 24 h urine was investigated in 43 patients suffering from hypertension and 80 patients suffering from bronchial carcinoma. With 103.2 +- 52.4 ng, the AVD content of the 24 h urine of 21 untreated hypertensives was highly significantly (p < 0.005) increased compared to that of healthy persons (67.5 +- 34.3 n = 45). During antihypertensive therapy, an AVP value of 80.4 +- 40.5 different from that of untreated patients (p < 0.05) was measured in 64 24 h urines. High AVD values in hypertensives were attributed to a possible stimulation of AVP secretion by renin-angiotensin. Of 67 patients in whom the diagnosis 'bronchial carcinoma' had been histologically-cytologically confirmed, three with small-cell carcinomas had 203.0, 337.8, and 692.5 ng AVP/24 h urine without exhibiting the clinical symptoms of a Schwartz-Bartter syndrome. The other 64 patients had an AVP value of 53.0 +- 31.9. The fraction of lung carcinomas secreting AVP appears to be relatively high. (orig.)

  4. An aggressive merkel cell carcinoma in a patient with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Sevda Gizlenti

    2014-12-01

    Full Text Available Merkel cell carcinoma (MCC is a rare cutaneous tumor arising from neuroendocrine cells and Merkel cells. Early diagnosis and treatment is important because of its aggressive course. We here report a 61 years old man with chronic renal failure, 3x5 cm mass on his right leg and inguinal-paraaortic lymph node metastases and resulting in death. MCC in the literature of the AIDS disease, organ transplantation, immunosuppressive therapy areas, and additional malignancies (multiple myeloma, chronic lymphocytic leukemia, non-Hodgkin's lymphoma, and melanoma have been reported in patients with increased incidence. Up to date a patient with renal transplantation and Merkel cell carcinoma have been reported in the literature, Merkel cell carcinoma with chronic renal failure have not been reported.

  5. Simultaneous choroid plexus carcinoma and pilocytic astrocytoma in a pediatric patient.

    Science.gov (United States)

    Karami, Kristophe J; Poulik, Janet; Rabah, Raja; Krass, Joshua; Sood, Sandeep

    2010-01-01

    Simultaneous primary brain tumors in pediatric patients without prior chemotherapy or radiotherapy, phacomatosis, or known familial history are a rare occurrence. The authors report the case of a 4-year-old boy with simultaneous choroid plexus carcinoma and pilocytic astrocytoma with features of oligodendroglioma. Magnetic resonance imaging studies revealed diffuse heterogeneously enhancing left intraventricular and posterior fossa tumors initially believed most consistent with multicentric choroid plexus carci