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Sample records for chemotherapy cancer regional perfusion

  1. Treating gastrointestinal cancer by intervention, intraperitoneal hyperthermic perfusion chemotherapy, intravenous micro-pump chemotherapy

    International Nuclear Information System (INIS)

    157 cases of gastrointestinal cancer patients after resection were randomly divided into treated group and control group. The treated group (intraperitoneal hyperthermic perfusion chemotherapy combined with postoperative continuous intraarterial infusion and intravenous micro-pump chemotherapy) consisted of 72 cases, the control group (Intravenous chemotherapy), 85 cases. The peritoneal and hepatic metastasis rates and 3 a survival rate were studied. The intraperitoneal hyperthermic perfusion chemotherapy combined with the postoperative continuous intraarterial infusion and intravenous micro-pump chemotherapy is an effective way to control the recurrence on the peritoneal and hepatic metastasis of advanced gastrointestinal neoplasms after operation. (authors)

  2. Effect of cytoreductive surgery-assisted postoperative intraperitoneal hyperthermic perfusion chemotherapy combined with intravenous chemotherapy on serum malignant biological indicators of ovarian cancer patients

    Institute of Scientific and Technical Information of China (English)

    Xian-Lian Liu; Lei Yang

    2015-01-01

    Objective: To study the effect of cytoreductive surgery-assisted postoperative intraperitoneal hyperthermic perfusion chemotherapy combined with intravenous chemotherapy on serum malignant biological indicators of ovarian cancer patients.Methods:Advanced ovarian cancer patients who received cytoreductive surgery in our hospital from June 2010 to August 2014 were selected for study. Based on different postoperative chemotherapy schemes, patients undergoing intraperitoneal hyperthermic perfusion chemotherapy combined with intravenous chemotherapy were screened and enrolled in combination chemotherapy group; patients undergoing routine intravenous chemotherapy were screened and enrolled in intravenous chemotherapy group. Then contents of serum markers, proliferative genes and signaling pathway molecules of both groups were detected.Results:(1) Cell cycles: G0/G1 and S phase percentages in ovarian cancer biopsy tissues of combination chemotherapy group were lower than those of intravenous chemotherapy group; G2/M phase percentage was higher than that of intravenous chemotherapy group; (2) Tumor markers: after 1, 2, 3, 4, 5 and 6 chemotherapy cycles, compared with intravenous chemotherapy group, serum HE4 and sTWEAK contents of combination chemotherapy group trended to decrease significantly; (3) Proliferative genes: compared with intravenous chemotherapy group, mRNA contents of mortalin, CIP2A, GILZ and Ki-67 in serum of combination chemotherapy group trended to decrease significantly; (4) Signaling pathway molecules: mRNA contents of Crk, Dock180, Rac1 and YAP in serum of combination chemotherapy group showed a decreasing trend; mRNA contents of C3G, Rap1 and Hippo showed an increasing trend.Conclusion:Intraperitoneal hyperthermic perfusion chemotherapy combined with intravenous chemotherapy is helpful to kill ovarian cancer cells, inhibit expressions of proliferative genes and regulate functions of signaling pathways; it is an ideal chemotherapy scheme for ovarian

  3. Treatment and prevention of serious complications after arterial perfusion chemotherapy of esophageal cancer

    International Nuclear Information System (INIS)

    Objective: To investigate the cause of severe complications after arterial perfusion for esophageal cancer and the methods of prevention. Methods: 368 cases of esophageal cancer were treated with arterial perfusion of drugs for chemotherapy. The treatment numbers were 909 including 215 males and 153 females with the age ranging from 39 to 86. These patients were verified as esophageal cancers histopathologically. Selective angiography of the relevant esophageal segments and drugs for perfusion chemotherapy were undertaken. Results: The complications included one case of paralysis due to spinal cord injury, two cases with esophageal perforation and three cases of necrotic esophagitis. The case of paralysis died of original disease one month after the treatment. Of the cases of esophageal perforation, one formed the esophagus-trachea fistula and survived for eight months after being esophageal stent implantation and the other formed esophagus-mediastinum fistula and died of massive hemorrhage after six weeks. Three cases of necrotic esophagitis occurred at the normal segments of the esophagus and formed esophgeal perforation. Of these three cases, one formed esophago-bronchial fistula and survived up to now after creating drainage stoma of stomach. Two cases of the esophagus-mediastinum and esophagus-bronchus fistula died of severe infection. Conclusions: Severe complications of esophageal arterial catheterization with drugs for chemotherapy are rare. Less harmful, non-ionization contrast medium, low cellular toxicity drugs for chemotherapy with proper doses and concentrations should be selected together with optimal speed of infusion. Esophageal internal stent placement drainage stoma creation of stomach should be the useful adjunct for severe complications. (authors)

  4. Predicting response to neoadjuvant chemotherapy in primary breast cancer using volumetric helical perfusion computed tomography: a preliminary study

    International Nuclear Information System (INIS)

    To investigate whether CT-derived vascular parameters in primary breast cancer predict complete pathological response (pCR) to neoadjuvant chemotherapy (NAC). Twenty prospective patients with primary breast cancer due for NAC underwent volumetric helical perfusion CT to derive whole tumour regional blood flow (BF), blood volume (BV) and flow extraction product (FE) by deconvolution analysis. A pCR was achieved if no residual invasive cancer was detectable on pathological examination. Relationships between baseline BF, BV, FE, tumour size and volume, and pCR were examined using the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was performed to assess the parameter best able to predict response. Intra- and inter-observer variability was assessed using Bland-Altman statistics. Seventeen out of 20 patients completed NAC with four achieving a pCR. Baseline BF and FE were higher in patients who achieved a pCR compared with those who did not (P = 0.032); tumour size and volume were not significantly different (P > 0.05). ROC analysis revealed that BF and FE were able to identify responders effectively (AUC = 0.87; P = 0.03). There was good intra- and inter-observer agreement. Primary breast cancers which exhibited higher levels of perfusion before treatment were more likely to achieve a pCR to NAC. (orig.)

  5. Predicting response to neoadjuvant chemotherapy in primary breast cancer using volumetric helical perfusion computed tomography: a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Li, Sonia P.; Makris, Andreas [Academic Oncology Unit, Mount Vernon Cancer Centre, Middlesex (United Kingdom); Gogbashian, Andrew; Simcock, Ian C.; Stirling, J.J. [Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Middlesex (United Kingdom); Goh, Vicky [Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Middlesex (United Kingdom); Lambeth Wing, St Thomas' Hospital, Division of Imaging Sciences, Kings College London, London (United Kingdom)

    2012-09-15

    To investigate whether CT-derived vascular parameters in primary breast cancer predict complete pathological response (pCR) to neoadjuvant chemotherapy (NAC). Twenty prospective patients with primary breast cancer due for NAC underwent volumetric helical perfusion CT to derive whole tumour regional blood flow (BF), blood volume (BV) and flow extraction product (FE) by deconvolution analysis. A pCR was achieved if no residual invasive cancer was detectable on pathological examination. Relationships between baseline BF, BV, FE, tumour size and volume, and pCR were examined using the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was performed to assess the parameter best able to predict response. Intra- and inter-observer variability was assessed using Bland-Altman statistics. Seventeen out of 20 patients completed NAC with four achieving a pCR. Baseline BF and FE were higher in patients who achieved a pCR compared with those who did not (P = 0.032); tumour size and volume were not significantly different (P > 0.05). ROC analysis revealed that BF and FE were able to identify responders effectively (AUC = 0.87; P = 0.03). There was good intra- and inter-observer agreement. Primary breast cancers which exhibited higher levels of perfusion before treatment were more likely to achieve a pCR to NAC. (orig.)

  6. Cancer Chemotherapy

    Science.gov (United States)

    ... controlled way. Cancer cells keep growing without control. Chemotherapy is drug therapy for cancer. It works by killing the cancer ... It depends on the type and amount of chemotherapy you get and how your body reacts. Some ...

  7. Cancer Chemotherapy

    Science.gov (United States)

    ... cells grow and die in a controlled way. Cancer cells keep forming without control. Chemotherapy is drug ... Your course of therapy will depend on the cancer type, the chemotherapy drugs used, the treatment goal ...

  8. Regional assessment of treatment in lung cancer using lung perfusion and ventilation images

    International Nuclear Information System (INIS)

    In 30 patients with lung cancer undergoing non-surgical treatment, we performed perfusion lung imaging using 99mTc-MAA and inhalation lung studies using Technegas before and after treatment and evaluated regional perfusion and ventilation status in the lung regions where bronchogenic carcinoma was located. Regional ventilation status was preserved rather than perfusion counterpart (V>P) in 18 patients (18/30=60.0%) before treatment, while the former was better than the latter in 27 patients (27/30=90.0%) after treatment, indicating that regional ventilation status improved more significantly than regional perfusion counterpart after treatment (P=0.005). We also classified the therapeutic effect for regional perfusion and ventilation status as improved, unchanged, or worsened, respectively; improvement in regional perfusion status was observed in 17 patients (56.7%) and that in regional ventilation status in 24 patients (80.0%). There was a statistically significant correlation between improved regional perfusion and ventilation status (P=0.0018) when therapeutic effect was recognized. The patients who showed improvement in regional perfusion status after treatment always showed improved regional ventilation status, but 7 patients showed either unchanged or worsened regional perfusion status after treatment, although regional ventilation status was improved. In conclusion the pulmonary vascular beds seem more vulnerable to bronchogenic carcinoma and improvement in regional perfusion status was revealed to be more difficult than that in regional ventilation status after treatment. (author)

  9. Altered cerebral blood flow one month after systemic chemotherapy for breast cancer: a prospective study using pulsed arterial spin labeling MRI perfusion.

    Directory of Open Access Journals (Sweden)

    Kelly N H Nudelman

    Full Text Available Cerebral structural and functional alterations have been reported after chemotherapy for non-CNS cancers, yet the causative mechanism behind these changes remains unclear. This study employed a novel, non-invasive, MRI-based neuroimaging measure to provide the first direct longitudinal measurement of resting cerebral perfusion in breast cancer patients, which was tested for association with changes in cognitive function and gray matter density. Perfusion was measured using pulsed arterial spin labeling MRI in women with breast cancer treated with (N = 27 or without (N = 26 chemotherapy and matched healthy controls (N = 26 after surgery before other treatments (baseline, and one month after chemotherapy completion or yoked intervals. Voxel-based analysis was employed to assess perfusion in gray matter; changes were examined in relation to overall neuropsychological test performance and frontal gray matter density changes measured by structural MRI. Baseline perfusion was not significantly different across groups. Unlike control groups, chemotherapy-treated patients demonstrated significantly increased perfusion post-treatment relative to baseline, which was statistically significant relative to controls in the right precentral gyrus. This perfusion increase was negatively correlated with baseline overall neuropsychological performance, but was not associated with frontal gray matter density reduction. However, decreased frontal gray matter density was associated with decreased perfusion in bilateral frontal and parietal lobes in the chemotherapy-treated group. These findings indicate that chemotherapy is associated with alterations in cerebral perfusion which are both related to and independent of gray matter changes. This pattern of results suggests the involvement of multiple mechanisms of chemotherapy-induced cognitive dysfunction. Additionally, lower baseline cognitive function may be a risk factor for treatment

  10. Efficacy and safety assessment of short EOF program regional arterial infusion chemotherapy and conventional chemotherapy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Ming-Cai Shui; Lin Xiong

    2016-01-01

    Objective:To study the efficacy and safety of short EOF program regional arterial infusion chemotherapy and conventional chemotherapy for advanced gastric cancer.Methods: 66 cases of patients diagnosed of advanced gastric cancer in our hospital were enrolled for study, given preoperative short EOF program chemotherapy and randomly divided into two groups. Observation group received short EOF program regional arterial infusion chemotherapy and control group received short EOF program intravenous chemotherapy. Then number of apoptosis cells and contents of apoptosis genes in the tumor tissue, serum liver and kidney function indicators as well as cfDNA methylation degree of two groups were detected. Results:(1) indicators of efficacy: the number of apoptosis cells in gastric cancer tissue of observation group was more than that of control group, mRNA levels of Caspase-3, Caspase-9, Fas and FasL were higher than those of control group, and serum p16, RNF180, SFRP2, SOX17 and RUNX methylation ratios were lower than those of control group; (2) indicators of safety: serum RBP, CysC, ALT and AST contents of observation group were lower than those of control group.Conclusions:Short EOF program regional arterial infusion chemotherapy can more effectively kill cancer cells, reduce methylation degree of tumor-associated genes and decrease liver function and kidney function damage; both efficacy and safety of it are better than conventional chemotherapy.

  11. Perfusion CT allows prediction of therapy response in non-small cell lung cancer treated with conventional and anti-angiogenic chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Tacelli, Nunzia; Santangelo, Teresa; Remy, Jacques [University of Lille Nord de France, Department of Thoracic Imaging, Hospital Calmette (EA 2694), Lille (France); University of Lille Nord de France, Faculty of Medicine, Henri Warembourg, Lille (France); Scherpereel, Arnaud; Cortot, Alexis; Wallyn, Frederic [University of Lille Nord de France, Faculty of Medicine, Henri Warembourg, Lille (France); University of Lille Nord de France, Department of Pulmonary and Thoracic Oncology, Lille (France); Duhamel, Alain; Deken, Valerie [University of Lille Nord de France, Faculty of Medicine, Henri Warembourg, Lille (France); University of Lille Nord de France, Department of Medical Statistics, Lille (France); Klotz, Ernst [Siemens Healthcare, Computed Tomography Division, Forchheim (Germany); Lafitte, Jean-Jacques [University of Lille Nord de France, Faculty of Medicine, Henri Warembourg, Lille (France); University of Lille Nord de France, Department of Pulmonary and Thoracic Oncology, Lille (France); Pasteur Institute of Lille, INSERM unit 1019, CIIL, Lille (France); Remy-Jardin, Martine [University of Lille Nord de France, Department of Thoracic Imaging, Hospital Calmette (EA 2694), Lille (France); University of Lille Nord de France, Faculty of Medicine, Henri Warembourg, Lille (France); Hospital Calmette, Department of Thoracic Imaging, Lille cedex (France)

    2013-08-15

    To determine whether CT can depict early perfusion changes in lung cancer treated by anti-angiogenic drugs, allowing prediction of response. Patients with non-small cell lung cancer, treated by conventional chemotherapy with (Group 1; n = 17) or without (Group 2; n = 23) anti-vascular endothelial growth factor (anti-VEGF) drug (bevacizumab) underwent CT perfusion before (TIME 0) and after 1 (TIME 1), 3 (TIME 2) and 6 (TIME 3) cycles of chemotherapy. The CT parameters evaluated included: (1) total tumour vascular volume (TVV) and total tumour extravascular flow (TEF); (2) RECIST (Response Evaluation Criteria in Solid Tumours) measurements. Tumour response was also assessed on the basis of the clinicians' overall evaluation. In Group 1, significant reduction in perfusion was identified between baseline and: (1) TIME 1 (TVV, P = 0.0395; TEF, P = 0.015); (2) TIME 2 (TVV, P = 0.0043; TEF, P < 0.0001); (3) TIME 3 (TVV, P = 0.0034; TEF, P = 0.0005) without any significant change in Group 2. In Group 1: (1) the reduction in TVV at TIME 1 was significantly higher in responders versus non-responders at TIME 2 according to RECIST (P = 0.0128) and overall clinicians' evaluation (P = 0.0079); (2) all responders at TIME 2 had a concurrent decrease in TVV and TEF at TIME 1. Perfusion CT demonstrates early changes in lung cancer vascularity under anti-angiogenic chemotherapy that may help predict therapeutic response. (orig.)

  12. Perfusion CT allows prediction of therapy response in non-small cell lung cancer treated with conventional and anti-angiogenic chemotherapy

    International Nuclear Information System (INIS)

    To determine whether CT can depict early perfusion changes in lung cancer treated by anti-angiogenic drugs, allowing prediction of response. Patients with non-small cell lung cancer, treated by conventional chemotherapy with (Group 1; n = 17) or without (Group 2; n = 23) anti-vascular endothelial growth factor (anti-VEGF) drug (bevacizumab) underwent CT perfusion before (TIME 0) and after 1 (TIME 1), 3 (TIME 2) and 6 (TIME 3) cycles of chemotherapy. The CT parameters evaluated included: (1) total tumour vascular volume (TVV) and total tumour extravascular flow (TEF); (2) RECIST (Response Evaluation Criteria in Solid Tumours) measurements. Tumour response was also assessed on the basis of the clinicians' overall evaluation. In Group 1, significant reduction in perfusion was identified between baseline and: (1) TIME 1 (TVV, P = 0.0395; TEF, P = 0.015); (2) TIME 2 (TVV, P = 0.0043; TEF, P < 0.0001); (3) TIME 3 (TVV, P = 0.0034; TEF, P = 0.0005) without any significant change in Group 2. In Group 1: (1) the reduction in TVV at TIME 1 was significantly higher in responders versus non-responders at TIME 2 according to RECIST (P = 0.0128) and overall clinicians' evaluation (P = 0.0079); (2) all responders at TIME 2 had a concurrent decrease in TVV and TEF at TIME 1. Perfusion CT demonstrates early changes in lung cancer vascularity under anti-angiogenic chemotherapy that may help predict therapeutic response. (orig.)

  13. Chemotherapy for Testicular Cancer

    Science.gov (United States)

    ... chemotherapy and stem cell transplant for testicular cancer Chemotherapy for testicular cancer Chemotherapy (chemo) is the use ... Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices Blog Programs & Services ...

  14. Chemotherapy for Thyroid Cancer

    Science.gov (United States)

    ... cancer Next Topic Targeted therapy for thyroid cancer Chemotherapy for thyroid cancer Chemotherapy (chemo) uses anti-cancer drugs that are injected ... vein or muscle, or are taken by mouth. Chemotherapy is systemic therapy, which means that the drug ...

  15. Fusion imaging using a hybrid SPECT-CT camera improves port perfusion scintigraphy for control of hepatic arterial infusion of chemotherapy in colorectal cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Denecke, Timm; Lehmkuhl, Lukas; Peters, Nils; Pech, Maciej; Ricke, Jens; Felix, Roland; Amthauer, Holger [Charite-Universitatsmedizin Berlin - Klinik fur Strahlenheilkunde und PET-Zentrum Berlin, Campus Virchow-Klinikum, Berlin (Germany); Hildebrandt, Bert; Nicolaou, Annett; Riess, Hanno [Charite-Universitatsmedizin Berlin - Medizinische Klinik m.S. Haematologie Onkologie, Campus Virchow-Klinikum, Berlin (Germany)

    2005-09-01

    Exclusive and homogeneous perfusion of the liver is considered essential for the efficacy of hepatic arterial infusion of chemotherapy (HAI). The aim of this study was to evaluate port perfusion scintigraphy in colorectal cancer patients using a hybrid SPECT-CT system for control of minimally invasive intra-arterial port systems within the scope of a phase II trial. In 24 consecutive patients, the perfusion territories of intra-arterial hepatic port systems were assessed by port scintigraphy with{sup 99m}Tc-labelled macroaggregated albumin employing planar imaging, SPECT and SPECT-CT (acquired with a hybrid SPECT-CT camera). The results of blinded reading of the scintigraphic modalities concerning the intra- and extrahepatic perfusion pattern were compared with combined image analysis (angiography and contrast-enhanced dedicated CT) and patient history for validation. Extrahepatic perfusion was correctly seen in three patients, while suspected extrahepatic perfusion could be excluded in one. In 46 liver lobes, perfusion patterns were correctly visualised by SPECT-CT in 100% of cases (planar, 67%; SPECT, 86%). Assessing the perfusion pattern inside the liver on a segmental basis (segments, n=138), SPECT-CT revealed correct segmental assignment of tracer distribution in 100% and was significantly superior to SPECT alone (accuracy, 84%; p<0.001). The scintigraphic findings resulted in changes in therapeutic management in 8/24 patients (33%); in two of these the relevant findings were visualised only by SPECT-CT. In patients receiving HAI, port perfusion scintigraphy by fusion imaging with a hybrid SPECT-CT system provides important information for therapy optimisation and appears to be superior to SPECT alone. (orig.)

  16. Computed Tomography (CT) Perfusion as an Early Predictive Marker for Treatment Response to Neoadjuvant Chemotherapy in Gastroesophageal Junction Cancer and Gastric Cancer - A Prospective Study

    DEFF Research Database (Denmark)

    Lundsgaard Hansen, Martin; Fallentin, Eva; Lauridsen, Carsten;

    2014-01-01

    of, and after three series of chemotherapy. The CT perfusion scans were performed using a 320-detector row scanner. Tumour volume and perfusion parameters (arterial flow, blood volume and permeability) were computed on a dedicated workstation with a consensus between two radiologists. Response to...

  17. Changes in regional ventilation and perfusion in lung cancer patients during treatment

    International Nuclear Information System (INIS)

    Patients with central lung cancer and 43 patients with peripheral lung cancer of various sites were examined after surgical intervention on a multichannel unit using 133Xe. The regional distribution of alveolar ventilation and perfusion blood flow were evaluated in the preoperative period as well as at varying times after operation. Statistical analysis of the results has shown that a significant decrease in the ventilation and blood flow is observed in the zone with a focus of lesion in the preoperative period. At the same time even in the preoperative period a compensatory increase in the ventilation and blood flow occurs in the lower zone of the contralateral lung. An increase in the ventilation and blood flow in all the zones of the remaining lung is observed after pulmonectomy, lobectomy does not change pulmonary function and the operated lung does not regenerate its function. Regional perfusion and ventilation are changed in one direction, their ratio and hence the gaseous composition of the blood remain unchanged

  18. Clinical application of transarterial and intraperitoneal pump hyperthermia perfusion chemotherapy of stomach and colon carcinomas postoperatively

    International Nuclear Information System (INIS)

    Objective: To evaluate methods of the treatment for preventing cancer recurrence and metastasis after resection of stomach and colon carcinomas. Methods: Fifty patients with stomach and colon carcinomas 1-12 months post-operatively were divided into two groups according to the different chemotherapy methods. Twenty-four patients in group A were treated by regional transarterial and intraperitoneal pump hyperthermia perfusion chemotherapy. Twenty-six patients in group B were treated by transarterial perfusion chemotherapy as the control. They were followed up for 12-36 months. Results: Comparing with group B, the survival rate in group A was higher, and the hepatic metastasis and recurrent rates were lower. This was the obvious difference for the two groups (P<0.05). Conclusions: The joint treatment of regional transarterial and abdominal cavity pump hyperthermia perfusion is evidently effective and safe with effective prevention of cancer recurrence or metastasis. Also it may be helpful to restrain the growth of recurrence and metastasis, prolong the survival period and improve the living quality. (authors)

  19. Image-guided intensity modulated radiotherapy with chemotherapy for postoperative esophageal cancer patients with regional relapse

    International Nuclear Information System (INIS)

    The objective of this study is to evaluate the efficacy and morbidity of image-guided mage-Guided Intensity Modulated Radiotherapy with chemotherapy for postoperative esophageal cancer patients with regional relapse. Between April 2010 and July 2013, 21 patients who previously treated with radical surgery were irradiated with Novalis Tx for regional relapse. Twenty-eight lesions were treated with IG-IMRT with chemotherapy. Seven patients have already had chemoradiotherapy for preoperative or salvage intervention. The median dose of radiation was 66 Gy/4.5 weeks. Nineteen patients had received the pre/post operative chemo (radio) therapy (standard FP). Three patients refused chemotherapy and 18 patients have received concomitant weekly DOC + CDGP chemotherapy. The responses were evaluated according to RECIST criteria. Acute toxicities were evaluated according to CTCAE 3.0 criteria. Median follow-up was 18 months (3 to 42 months). The initial response rate and CR rate was 89% and 61%, respectively. The actuarial 3-year survival rate was 71%. Acute toxicity was limited to grade 2 toxicity including anorexia (14%), pain (25%) and leukopenia (25%). More than G2 late toxicity has not observed. IG-IMRT with chemotherapy can offer a short and well-tolerated treatment for regional relapse after radically operated patients. Efficacy and toxicity need to be evaluated over the long term, but initial results are encouraging. (author)

  20. 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.

  1. Neoadjuvant chemotherapy as ovarian cancer treatment: ever more used with major regional differences

    DEFF Research Database (Denmark)

    Fagö-Olsen, Carsten L; Ottesen, Bent; Kehlet, Henrik;

    2012-01-01

    The traditional first-line treatment for patients with advanced ovarian cancer with primary debulking surgery (PDS) and adjuvant chemotherapy is controversial as some authors report a potential benefit from the alternative treatment with neoadjuvant chemotherapy (NACT) and interval debulking...

  2. Chemotherapy in Prostate Cancer.

    Science.gov (United States)

    Hurwitz, Michael

    2015-10-01

    For approximately a decade, chemotherapy has been shown to prolong life in patients with metastatic castration-resistant prostate cancer (mCRPC). Since that time, however, only two agents have proven to prolong life (docetaxel and cabazitaxel). However, in the last year, the addition of chemotherapy to primary hormonal therapy became a standard of care for high-volume castration-sensitive metastatic disease. Here I will review current prostate cancer chemotherapies, mechanisms of resistance to those therapies, and ongoing clinical studies of chemotherapy combinations and novel chemotherapeutics. PMID:26216506

  3. Summated chemotherapy dose-intensity versus loco-regional response in locally advanced breast cancer: Its possible implications

    OpenAIRE

    Datta N; Rajkumar A; Basu R

    2003-01-01

    BACKGROUND : Summated dose-intensity (SDI) of chemotherapy regimen could influence the outcome in malignancies. AIMS : To evaluate the implication of SDI and identify key drugs for loco-regional response in locally advanced breast cancer (LABC). Settings and design: This retrospective study was based on audit of records of LABC patients who had received neoadjuvant chemotherapy (NACT). MATERIAL AND METHODS : Actual unit dose-intensity (UDI) of each drug and corresponding SDI of every doxorubi...

  4. Clinical significance of preoperative regional intra-arterial infusion chemotherapy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Cheng-Wu Zhang; Shou-Chun Zou; Dun Shi; Da-Jian Zhao

    2004-01-01

    AIM: Preoperative intra-arterial infusion chemotherapy could increase the radical resection rate of advanced gastric cancer, but its effect on the long-term survival has not been assessed. This study was designed to evaluate the clinical significance of preoperative intra-arterial infusion chemotherapy for advanced gastric cancer.METHODS: Clinicopathological data of 91 patients who underwent curative resection for advanced gastric cancer were collected. Among them, 37 patients undertaken preoperative intra-arterial infusion chemotherapy were used as the interventional chemotherapy group, and the remaining 54 patients as the control group. Eleven factors including clinicopathological variables, treatment procedures and molecular biological makers that might contribute to the long-term survival rate were analyzed using Cox multivariate regression analysis.RESULTS: The 5-year survival rate was 52.5% and 39.8%,respectively, for the interventional group and the control group (P<0.05). Cox multivariate regression analysis revealed that the TNM stage (P<0.001), preoperative intraarterial infusion chemotherapy (P = 0.029) and growth pattern (P = 0.042) were the independent factors for the long-term survival of patients with advanced gastric cancer.CONCLUSION: Preoperative intra-arterial infusion chemotherapy plays an important role in improving the prognosis of advanced gastric cancer.

  5. Neurotoxicity of cancer chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Miyoung Yang; Changjong Moon

    2013-01-01

    There is accumulating clinical evidence that chemotherapeutic agents induce neurological side effects, including memory deficits and mood disorders, in cancer patients who have undergone chemotherapeutic treatments. This review focuses on chemotherapy-induced neurodegeneration and hippocampal dysfunctions and related mechanisms as measured by in vivo and in vitro approaches. These investigations are helpful in determining how best to further explore the causal mechanisms of chemotherapy-induced neurological side effects and in providing direction for the future development of novel optimized chemotherapeutic agents.

  6. Hepatic vascular isolation and perfusion for patients with progressive unresectable liver metastases from colorectal carcinoma refractory to previous systemic and regional chemotherapy

    Czech Academy of Sciences Publication Activity Database

    Alexander, HR.; Libutti, S. K.; Barlett, D. L.; Pingpank, J. F.; Kranda, Karel; Helsabeck, C.; Beresnev, T.

    2002-01-01

    Roč. 95, č. 4 (2002), s. 730-736. ISSN 0008-543X R&D Projects: GA AV ČR KSK4055109 Keywords : colorectal carcinoma * liver metastases * regional chemotherapy Subject RIV: FD - Oncology ; Hematology Impact factor: 1.000, year: 2002

  7. Chemotherapy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Javier Sastre; Jose Angel García-Saenz; Eduardo Díaz-Rubio

    2006-01-01

    Metastatic gastric cancer remains a non-curative disease.Palliative chemotherapy has been demonstrated to prolong survival without quality of life compromise. Many single-agents and combinations have been confirmed to be active in the treatment of metastatic disease. Objective response rates ranged from 10-30% for single-agent therapy and 30-60% for polychemotherapy. Results of phase Ⅱ and Ⅲ studies are reviewed in this paper as well as the potential efficacy of new drugs. For patients with localized disease, the role of adjuvant and neoadjuvant chemotherapy and radiation therapy is discussed.Most studies on adjuvant chemotherapy failed to demonstrate a survival advantage, and therefore, it is not considered as standard treatment in most centres. Adjuvant immunochemotherapy has been developed fundamentally in Korea and Japan. A meta-analysis of phase Ⅲ trials with OK-432 suggested that immunochemotherapy may improve survival of patients with curatively resected gastric cancer. Based on the results of US Intergroup 0116study, postoperative chemoradiation has been Accepted as standard care in patients with resected gastric cancer in North America. However, the results are somewhat confounded by the fact that patients underwent less than a recommended D1 lymph node dissection and the pattern of recurrence suggested a positive effect derived from local radiotherapy without any effect on micrometastatic disease.Neoadjuvant chemotherapy or chemoradiation therapy remains experimental, but several phase Ⅱstudies are showing promising results. Phase Ⅲ trials are needed.

  8. Chemotherapy targeting cancer stem cells

    OpenAIRE

    Liu, Haiguang; Lv, Lin; Yang, Kai

    2015-01-01

    Conventional chemotherapy is the main treatment for cancer and benefits patients in the form of decreased relapse and metastasis and longer overall survival. However, as the target therapy drugs and delivery systems are not wholly precise, it also results in quite a few side effects, and is less efficient in many cancers due to the spared cancer stem cells, which are considered the reason for chemotherapy resistance, relapse, and metastasis. Conventional chemotherapy limitations and the cance...

  9. Safety research of colorectal cancer intraoperative rectal artery perfusion chemotherapy by Raltitrexed%直肠癌术中直肠上动脉灌注雷替曲塞化疗的安全性研究

    Institute of Scientific and Technical Information of China (English)

    于海龙; 白雪峰; 崔滨滨; 于志伟; 李栗; 贾云鹤

    2013-01-01

    Objective To explore the safety of rectal cancer radical mastectomy on selective rectum arterial infusion chemotherapy by Raltitrexed. Methods 172 patients with colorectal cancer radical mastectomy were divided into perfusion chemotherapy group (83 cases) and control group (89 cases). The control group used the conventional open surgery treatment, the perfusion chemotherapy group on the basis of the contrlo group was given the rectum arterial perfusion Raltitrexed in operation. The postoperative evaluation of each system toxic reaction, complications and before and after surgery blood white blood cell (WBC), red blood cell (RBC), platelet (PLT), urea nitrogen (BUN) and alanine aminotransferase (ALT) changes in two groups were evaluated. Results Postoperative of each system toxic reaction and complications in perfusion chemotherapy group compared with control group, the difference was statistically significant (P > 0.05); WBC and RBC, PLT, BUN and ALT before and after surgery in the two groups were not significantly changed, the difference was statistically significant in the two groups (P > 0.05). Conclusion Raltitrexed as water soluble thymidylic acid synthase (TS) specific inhibitors, can through the reduced folic acid methotrexate cell membrane by carrier cells actively absorb, inside the cell metabolism into various polymerization glutamic acid and long time play antitumor effect. The study proves the rectum cancer radical mastectomy in artery perfusion ray for song plug, it is a safe and feasible method.%目的 探讨直肠癌根治术中选择性直肠上动脉灌注雷替曲塞化疗的安全性.方法将172例行直肠癌根治术患者分为灌注化疗组(83例)和对照组(89例).对照组采用常规开腹手术治疗,灌注化疗组在常规开腹手术治疗基础上于术中经直肠上动脉灌注雷替曲塞.评价两组患者术后各系统的毒性反应、并发症以及两组患者手术前后血白细胞(WBC)、红细胞(RBC)、血小板(PLT)

  10. Changes in Global Function and Regional Ventilation and Perfusion on SPECT During the Course of Radiotherapy in Patients With Non-Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yuan Shuanghu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Department of Radiation Oncology, Shaexamndong Cancer Hospital and Institute, Jinan (China); Frey, Kirk A.; Gross, Milton D. [Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Hayman, James A. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Arenberg, Doug [Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Cai Xuwei [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Ramnath, Nithya; Hassan, Khaled [Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Moran, Jean; Eisbruch, Avraham; Ten Haken, Randall K. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Kong Fengming, E-mail: fengkong@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Radiation Oncology, Veterans' Affairs Health Center, Ann Arbor, Michigan (United States)

    2012-03-15

    Purpose: This study aimed to (1) examine changes in dyspnea, global pulmonary function test (PFT) results, and functional activity on ventilation (V)/perfusion (Q) single-photon emission computerized tomography (SPECT) scans during the course of radiation (RT), and (2) factors associated with the changes in patients with non-small-cell lung cancer (NSCLC). Methods and Materials: Fifty-six stage I to III NSCLC patients treated with definitive RT with or without chemotherapy were enrolled prospectively. Dyspnea was graded according to Common Terminology Criteria for Adverse Events version 3.0 prior to and weekly during RT. V/Q SPECT-computed tomography (CT) and PFTs were performed prior to and during RT at approximately 45 Gy. Functions of V and Q activities were assessed using a semiquantitative scoring of SPECT images. Results: Breathing improved significantly at the third week (mean dyspnea grade, 0.8 vs. 0.6; paired t-test p = 0.011) and worsened during the later course of RT (p > 0.05). Global PFT results did not change significantly, while regional lung function on V/Q SPECT improved significantly after {approx}45 Gy. The V defect score (DS) was 4.9 pre-RT versus 4.3 during RT (p = 0.01); Q DS was 4.3 pre-RT versus 4.0 during RT (p < 0.01). Improvements in V and Q functions were seen primarily in the ipsilateral lung (V DS, 1.9 pre-RT versus 1.4 during RT, p < 0.01; Q DS, 1.7 pre-RT versus 1.5 during RT, p < 0.01). Baseline primary tumor volume was significantly correlated with pre-RT V/Q DS (p < 0.01). Patients with central lung tumors had greater interval changes in V and Q than those with more peripheral tumors (p <0.05 for both V and Q DS). Conclusions: Regional ventilation and perfusion improved during RT at 45 Gy. This suggests that adaptive planning based on V/Q SPECT during RT may allow sparing of functionally recoverable lung tissue.

  11. Changes in Global Function and Regional Ventilation and Perfusion on SPECT During the Course of Radiotherapy in Patients With Non-Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: This study aimed to (1) examine changes in dyspnea, global pulmonary function test (PFT) results, and functional activity on ventilation (V)/perfusion (Q) single-photon emission computerized tomography (SPECT) scans during the course of radiation (RT), and (2) factors associated with the changes in patients with non-small-cell lung cancer (NSCLC). Methods and Materials: Fifty-six stage I to III NSCLC patients treated with definitive RT with or without chemotherapy were enrolled prospectively. Dyspnea was graded according to Common Terminology Criteria for Adverse Events version 3.0 prior to and weekly during RT. V/Q SPECT-computed tomography (CT) and PFTs were performed prior to and during RT at approximately 45 Gy. Functions of V and Q activities were assessed using a semiquantitative scoring of SPECT images. Results: Breathing improved significantly at the third week (mean dyspnea grade, 0.8 vs. 0.6; paired t-test p = 0.011) and worsened during the later course of RT (p > 0.05). Global PFT results did not change significantly, while regional lung function on V/Q SPECT improved significantly after ∼45 Gy. The V defect score (DS) was 4.9 pre-RT versus 4.3 during RT (p = 0.01); Q DS was 4.3 pre-RT versus 4.0 during RT (p < 0.01). Improvements in V and Q functions were seen primarily in the ipsilateral lung (V DS, 1.9 pre-RT versus 1.4 during RT, p < 0.01; Q DS, 1.7 pre-RT versus 1.5 during RT, p < 0.01). Baseline primary tumor volume was significantly correlated with pre-RT V/Q DS (p < 0.01). Patients with central lung tumors had greater interval changes in V and Q than those with more peripheral tumors (p <0.05 for both V and Q DS). Conclusions: Regional ventilation and perfusion improved during RT at 45 Gy. This suggests that adaptive planning based on V/Q SPECT during RT may allow sparing of functionally recoverable lung tissue.

  12. [Prostate cancer and chemotherapy].

    Science.gov (United States)

    Gravis, Gwenaelle; Salem, Naji; Bladou, Franck; Viens, Patrice

    2007-07-01

    Androgen deprivation in patients with metastatic prostate cancer produces palliation of symptoms, PSA decrease and tumoral regression in most patients. After a brief period of disease regression lasting 18 to 24 months nearly all pts will progress to androgen independence disease (HRPC) with progressive clinical deterioration and ultimately death. Chemotherapy with mitoxantrone has been shown to palliate symptoms but did not extend survival. Two large randomized trials showed a survival benefit for pts with HRPC treated with docetaxel with a reduction risk of death by 21-24%, and significant improvement in palliation of symptoms and quality of life. New agents targeting angiogenesis, apoptosis, signal transduction pathway, used alone or in combination with docetaxel currently are under trial in an attempt to provide much needed improvements in outcome. Questions remains in suspend when and who need to be treated, earlier, in high risk as in adjuvant setting? Current data have demonstrated that neoadjuvant or adjuvant chemotherapy is relatively safe and feasible. Further investigation through prospective randomize trials is critical to define the precise role of this modality in high risk populations. PMID:17845990

  13. [The role of regional intra-arterial chemotherapy in the combined treatment of locally advanced laryngeal cancer].

    Science.gov (United States)

    Mashkova, T A; Ol'shanskiĭ, M S; Panchenko, I G; Ovsiannikov, Iu M; Mal'tsev, A B

    2013-01-01

    The objective of the present study was to estimate the possibilities and prospects for the use of regional intra-arterial chemotherapy in the combined treatment of locally advanced laryngeal cancer. The results of the chemoradiotherapeutic treatment of 26 patients presenting with locally advanced laryngeal cancer were analysed. The chemical agents were selectively administered intra-arterially three times from the right-hand femoral access by the standard procedure at a total focal dose (TFD) of 26 and 50 gram prior to the onset of and during of radiotherapy. The very first administration of the chemical agent resulted in the 30% decrease the tumour size. It further decreased by 70% on the average after the TFD of 50 gram was achieved. It made possible the continuation of gamma-therapy up to the total therapeutic dose. As a result, complete regression of the tumour was documented. The dynamic endoscopic control study and CT of the larynx revealed recurrent laryngeal cancer in 1 of the 26 patients (3.8%). The remaining patients did not develop metastases during the 18 month follow-up period. It is concluded that the results of the present study confirm high (96.2%) effectiveness of the method employed in this study which allows it to be recommended for the organ-preserving treatment of locally advanced laryngeal cancer. PMID:24300761

  14. Regional Cerebral Perfusion in Progressive Supranuclear Palsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Yong; Lee, Ki Hyeong; Yoon, Byung Woo; Lee, Sang Bok; Jeon, Beom S. [Samsung Medical Center, Seoul (Korea, Republic of); Lee, Kyung Han; Lee, Myung Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1996-03-15

    Progressive supranuclear palsy (PSP) is a Parkinson-plus syndrome characterized clinically by supranuclear ophthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormaility and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using Tc-99m-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p<0.05). There was no correlation between the severity of the motor abnormality and any of the regional cerebral perfusion indices (p>0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex

  15. Perfusion CT findings in liver of patients with tumor during chemotherapy

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM: To investigate the microcirculation changes in liver of patients with tumor during chemotherapy by perfusion computed tomography (CT). METHODS: Sixty patients with tumor and 20 controls were enrolled in this study. Perfusion CT parameters of patients and controls were compared, including hepatic perfusion index (HPI), mean transit time (MTT), and permeability-surface area product (PS). Correlation between perfusion CT parameters, treatment cycle and alanine aminotransferase (ALT) level was studied. RES...

  16. Chemotherapy of lung cancer.

    OpenAIRE

    Papac, R J

    1981-01-01

    The potential for substantial improvement in the outcome of patients with carcinoma of the lung seem most likely to develop in the field of chemotherapy. In the past decade, striking advances in the management of small cell carcinoma have yielded response rates and longer survival. While the greatest improvement can be predicted for patients whose disease is limited in extent, combination chemotherapy and combined modality therapy generally are effective in causing tumor regression for the ma...

  17. Summated chemotherapy dose-intensity versus loco-regional response in locally advanced breast cancer: Its possible implications

    Directory of Open Access Journals (Sweden)

    Datta N

    2003-01-01

    Full Text Available BACKGROUND : Summated dose-intensity (SDI of chemotherapy regimen could influence the outcome in malignancies. AIMS : To evaluate the implication of SDI and identify key drugs for loco-regional response in locally advanced breast cancer (LABC. Settings and design: This retrospective study was based on audit of records of LABC patients who had received neoadjuvant chemotherapy (NACT. MATERIAL AND METHODS : Actual unit dose-intensity (UDI of each drug and corresponding SDI of every doxorubicin (n=116 cycles or non-doxorubicin (n=110 cycles based NACT received by 42 patients of LABC were summated. Cumulative dose-intensity (CDI for individual drugs and cumulative SDI (CSDI for the entire course of NACT were estimated and correlated with quantum of primary tumor, axillary and supraclavicular nodal responses. STATISTICAL ANALYSIS USED : Two-sided chi-square, t-test, step-wise regression was used. RESULTS : Dose-response curve between CSDI and corresponding responses for both primary and lymph nodes were sigmoid in shape for both doxorubicin or non-doxorubicin based NACT. Curves were best fitted using a cubic fit for all patients (r2 = 0.82, 0.84 and 0.93 for primary tumor, axillary and supraclavicular lymph nodes respectively. CSDI emerged as an important prognosticators for both primary (P< 0.001 and nodal (P< 0.001 responses. Individually, CDI of 5-fluorouracil for primary (P< 0.001, CDIs of doxorubicin (P< 0.001 and methotrexate (P=0.006 for axillary nodes and CDI of cyclophosphamide (P=0.001 for supraclavicular nodes were significant. CONCLUSIONS : Loco-regional responses in LABC are dependent on CSDI of NACT regimen. Drugs for high-dose intensification protocols could be identified and chosen based on the impact of CDI of individual drugs in NACT.

  18. Regional intra-arterial vs. systemic chemotherapy for advanced pancreatic cancer: a systematic review and meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Fenghua Liu

    Full Text Available OBJECTIVE: To investigate the efficacy and safety of regional intra-arterial chemotherapy (RIAC versus systemic chemotherapy for stage III/IV pancreatic cancer. METHODS: Randomized controlled trials of patients with advanced pancreatic cancer treated by regional intra-arterial or systemic chemotherapy were identified using PubMed, ISI, EMBASE, Cochrane Library, Google, Chinese Scientific Journals Database (VIP, and China National Knowledge Infrastructure (CNKI electronic databases, for all publications dated between 1960 and December 31, 2010. Data was independently extracted by two reviewers. Odds ratios and relative risks were pooled using either fixed- or random-effects models, depending on I(2 statistic and Q test assessments of heterogeneity. Statistical analysis was performed using RevMan 5.0. RESULTS: Six randomized controlled trials comprised of 298 patients met the standards for inclusion in the meta-analysis, among 492 articles that were identified. Eight patients achieved complete remission (CR with regional intra-arterial chemotherapy (RIAC, whereas no patients achieved CR with systemic chemotherapy. Compared with systemic chemotherapy, patients receiving RIAC had superior partial remissions (RR = 1.99, 95% CI: 1.50, 2.65; 58.06% with RIAC and 29.37% with systemic treatment, clinical benefits (RR = 2.34, 95% CI: 1.84, 2.97; 78.06% with RAIC and 29.37% with systemic treatment, total complication rates (RR = 0.72, 95% CI: 0.60, 0.87; 49.03% with RIAC and 71.33% with systemic treatment, and hematological side effects (RR = 0.76, 95% CI: 0.63, 0.91; 60.87% with RIAC and 85.71% with systemic treatment. The median survival time with RIAC (5-21 months was longer than for systemic chemotherapy (2.7-14 months. Similarly, one year survival rates with RIAC (28.6%-41.2% were higher than with systemic chemotherapy (0%-12.9%.. CONCLUSION: Regional intra-arterial chemotherapy is more effective and has fewer complications than

  19. Regional Cerebral Perfusion in Progressive Supranuclear Palsy

    International Nuclear Information System (INIS)

    Progressive supranuclear palsy (PSP) is a Parkinson-plus syndrome characterized clinically by supranuclear ophthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormaility and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using Tc-99m-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex

  20. Perfusion scintigraphy (/sup 99m/Tc MAA) during surgery for placement of chemotherapy catheter in hepatic artery: concise communication

    International Nuclear Information System (INIS)

    In 17 patients receiving regional hepatic chemotherapy, /sup 99m/Tc macroaggregated albumin imaging was used to aid arterial catheter placement and to assess perfusion patterns. Intraoperative imaging with a portable gamma camera allowed immediate monitoring of hepatic and extrahepatic perfusion patterns and assisted catheter manipulation when necessary to achieve optimal flow distribution. In all 12 patients with standard hepatic arterial anatomy, complete perfusion of both lobes of the liver was achieved, although three of them required intraoperative catheter manipulation and repeat imaging after initial placement. The remaining five patients had aberrant hepatic arterial anatomy, and complete perfusion was more difficult to achieve; they exemplified the need for dual catheters, ligation of accessory hepatic branches, and repeated imaging

  1. Neoadjuvant chemotherapy as ovarian cancer treatment

    DEFF Research Database (Denmark)

    Fagö-Olsen, Carsten L; Ottesen, Bent; Kehlet, Henrik;

    2012-01-01

    INTRODUCTION: The traditional first-line treatment for patients with advanced ovarian cancer with primary debulking surgery (PDS) and adjuvant chemotherapy is controversial as some authors report a potential benefit from the alternative treatment with neoadjuvant chemotherapy (NACT) and interval...... debulking surgery. The aim of this study was to investigate the use of NACT in Denmark in regard to increased use and regional differences. MATERIAL AND METHODS: Stage IIIC and IV ovarian cancer patients treated in the five Danish tertiary referral centres in the 2005-2010-period were included. The study...... is based on validated data from The Danish Gynaecological Cancer Database. RESULTS: Of the 1,367 eligible patients 1,069 were treated with PDS and 298 with NACT. In 2005-2007, 11% of patients were treated with NACT. In 2008-2010, this percentage had risen to 30% (p

  2. Chemotherapy of metastatic colon cancer

    Directory of Open Access Journals (Sweden)

    M. Yu. Fedyanin

    2012-01-01

    Full Text Available Colorectal cancer is one of the leading causes of cancer incidence and mortality. In 2008 inRussian Federation55 719 new cases of colorectal cancer were diagnosed and 37 911 patients died of this disease. A significant progress was achieved in metastatic colorectal cancer treatment during the last decades. A lot of treatment options became available: from 5-fluoruracil monotherapy to combined treatment treatment schemes including surgery. A group of patients with isolated liver metastases was distinguished, who can achieve 5-year survival rate of 40 % after systemic treatment and surgery. Today, based on clinical data and molecular analysis, we come close to individualized treatment of this patient group. In this literature review results of metastatic colorectal cancer chemotherapy are being analyzed and rational treatment tactic is proposed based on therapy goals. 

  3. Chemotherapy for bladder cancer: treatment guidelines for neoadjuvant chemotherapy, bladder preservation, adjuvant chemotherapy, and metastatic cancer

    DEFF Research Database (Denmark)

    Sternberg, Cora N; Donat, S Machele; Bellmunt, Joaquim;

    2007-01-01

    To determine the optimal use of chemotherapy in the neoadjuvant, adjuvant, and metastatic setting in patients with advanced urothelial cell carcinoma, a consensus conference was convened by the World Health Organization (WHO) and the Société Internationale d'Urologie (SIU) to critically review the...... published literature on chemotherapy for patients with locally advanced bladder cancer. This article reports the development of international guidelines for the treatment of patients with locally advanced bladder cancer with neoadjuvant and adjuvant chemotherapy. Bladder preservation is also discussed, as...

  4. Vascular Complications of Cancer Chemotherapy.

    Science.gov (United States)

    Cameron, Alan C; Touyz, Rhian M; Lang, Ninian N

    2016-07-01

    Development of new anticancer drugs has resulted in improved mortality rates and 5-year survival rates in patients with cancer. However, many of the modern chemotherapies are associated with cardiovascular toxicities that increase cardiovascular risk in cancer patients, including hypertension, thrombosis, heart failure, cardiomyopathy, and arrhythmias. These limitations restrict treatment options and might negatively affect the management of cancer. The cardiotoxic effects of older chemotherapeutic drugs such as alkylating agents, antimetabolites, and anticancer antibiotics have been known for a while. The newer agents, such as the antiangiogenic drugs that inhibit vascular endothelial growth factor signalling are also associated with cardiovascular pathology, especially hypertension, thromboembolism, myocardial infarction, and proteinuria. Exact mechanisms by which vascular endothelial growth factor inhibitors cause these complications are unclear but impaired endothelial function, vascular and renal damage, oxidative stress, and thrombosis might be important. With increasing use of modern chemotherapies and prolonged survival of cancer patients, the incidence of cardiovascular disease in this patient population will continue to increase. Accordingly, careful assessment and management of cardiovascular risk factors in cancer patients by oncologists and cardiologists working together is essential for optimal care so that prolonged cancer survival is not at the expense of increased cardiovascular events. PMID:26968393

  5. Effect of S-1 combined with cisplatin intraperitoneal circulatory hyperthermia perfusion treatment on malignant molecule expression in gastric cancer patients with ascites as well as side effect assessment

    Institute of Scientific and Technical Information of China (English)

    Shuo Jian

    2016-01-01

    Objective:To study the effect of S-1 combined with cisplatin intraperitoneal circulatory hyperthermia perfusion on malignant molecule expression in gastric cancer patients with ascites as well as the related side effect.Methods: Gastric cancer patients with ascites who were treated in our hospital from February 2012 to July 2015 were selected as research subjects and randomly divided into perfusion chemotherapy group and routine chemotherapy group, and then overall chemotherapy conditions, ascites FGF molecule content, peripheral blood immune function indexes and the degree of side effect were compared between two groups. Results:Average treatment cycles of perfusion chemotherapy group were more than those of routine chemotherapy group, and ascites drainage volume within two cycles of chemotherapy was significantly less than that of routine chemotherapy group; after two cycles of chemotherapy, bFGF, FGF-2, FGF19 and FGFR4 content in ascites of perfusion chemotherapy group were significantly lower than those of routine chemotherapy group, CD3+CD4+, CD3+CD56+ and CD3-CD56+ cell content in peripheral blood were higher than those of routine chemotherapy group, and CD3+CD8+ cell content was lower than that of routine chemotherapy group; during chemotherapy, the number of cases with decreased numeration of leukocyte, abnormal liver function, abnormal kidney function and diarrhea of perfusion chemotherapy group were significantly lower than those of routine chemotherapy group.Conclusions: S-1 combined with cisplatin intraperitoneal circulatory hyperthermia perfusion chemotherapy can more effectively improve treatment compliance, suppress ascites, kill gastric cancer cells and improve immune function. It has fewer side effect and is the ideal way to treat gastric cancer with ascites.

  6. Tomographic scintigraphy of regional myocardial perfusion

    International Nuclear Information System (INIS)

    Estimation of the extent of regional ischemia by scintigraphic methods has been hampered by the geometric constraints of two-dimensional imaging. Myocardial perfusion scintigraphy was performed using the Fresnel zone-plate tomographic camera after the injection of Tc-99m microspheres (20 to 40 μ) into a coronary artery. Coronary artery occlusion was performed in six dogs by embolization via a catheter guidewire system. Twenty millicuries of Tc-99m microspheres were injected into the left main coronary artery of the six occluded and three unoccluded dogs. Scintigraphy was performed in multiple projections in the living animal. Optical reconstruction of the holographic image provided tomographic gamma images of the heat. Scintigraphy was also performed with an Anger camera for comparison. The extent of the perfusion defect was measured by planimetry and expressed as a percentage of the ventricular area in that projection. The average of the right and left anterior oblique projections provided the most accurate estimate of the size of the perfusion defect (average error: 13.6 percent; range: 0 to 38.2 percent). Fresnel zone-plate imaging provided an accurate in vivo assessment of the extent of altered myocardial perfusion

  7. Treatment of gastric carcinoma with postoperative malignant intestinal obstruction via transcatheter arterial perfusion chemotherapy

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect of transcatheter arterial perfusion (TAP)chemotherapy for gastric carcinoma with postoperative malignant intestinal obstruction caused by abdominal cavity metastasis. Methods: 47 gastric carcinoma patients with incomplete malignant intestinal obstruction after surgery received TAP chemotherapy by Seldinger method, with cisplatin, hydroxycamptothecin and FUDR per month via celiac artery, superior mesenteric artery, inferior mesenteric artery, and bilateral internal iliac arteries respectively. All patients were administered 1 to 13 times. Results: The effective rate of transcatheter arterial prefusion chemotherapy was 38% (18/47)with survival period lasting from 35 days to 13 months at an average of 4.7 months. Conclusions: Transcatheter arterial perfusion chemotherapy has markedly therapeutic effect in palliating treatment of malignant intestinal obstruction within short term with increase of survival time. (authors)

  8. Chemotherapy and You: Support for People with Cancer

    Science.gov (United States)

    ... Terms Blogs and Newsletters Health Communications Publications Reports Chemotherapy and You: Support for People With Cancer Chemotherapy ... ePub This booklet covers: Questions and answers about chemotherapy. Answers common questions, such as what chemotherapy is ...

  9. Repopulation of Ovarian Cancer Cells After Chemotherapy

    OpenAIRE

    Telleria, Carlos M.

    2013-01-01

    The high mortality rate caused by ovarian cancer has not changed for the past thirty years. Although most patients diagnosed with this disease respond to cytoreductive surgery and platinum-based chemotherapy and undergo remission, foci of cells almost always escape therapy, manage to survive, and acquire the capacity to repopulate the tumor. Repopulation of ovarian cancer cells that escape front-line chemotherapy, however, is a poorly understood phenomenon. Here I analyze cancer-initiating ce...

  10. Clinical Study of MR Perfusion Imaging of Locally Advanced Breast Cancer to Neoadjuvant Chemotherapy using Magnetic%局部进展期乳腺癌新辅助化疗应用磁共振灌注成像的临床疗效研究

    Institute of Scientific and Technical Information of China (English)

    王长河

    2015-01-01

    Objective To explore the clinical application of magnetic resonance imaging neoadjuvant chemotherapy of locally advanced breast cancer, and analyze the feasibility of the method as a predictor of response to chemotherapy. Methods 12 cases of patients with breast cancer after neoadjuvant chemotherapy on tumor volume change into effect group and ineffective group, the rate of change in tumor volume loss, maximum signal comparison before and after chemotherapy and chemotherapy before the maximum signal loss rate from a correlation between the rate and tumor. Results The effect of chemotherapy group, the average tumor volume of (2.89±1.03) cm3, significantly lower than that before chemotherapy and after chemotherapy the tumor volume of invalid should group, the difference was statistically significant (P<0.05);group effect in patients receiving neoadjuvant chemotherapy, the maximum signal loss rate was (13±11.2)%, significantly below before chemotherapy and after chemotherapy should be related to invalid index group. Neoadjuvant chemotherapy after a period of treatment, loss rate change perfusion maximum signal between two groups was statistically significant (P>0.05). There was a positive correlation between the shrinking rate of mean values of maximum signal loss rate and tumor volume (r=0.313, P=0.44). Conclusion Neoadjuvant chemotherapy of locally advanced breast cancer can be early evaluation of the application of magnetic resonance imaging technology, but need further study to prove whether it can be used as a predictor of response to chemotherapy.%目的:探究局部进展期乳腺癌新辅助化疗中应用磁共振灌注成像的疗效,并分析该方法作为化疗反应预测因子的可行性。方法12例乳腺癌患者依据新辅助化疗后肿瘤体积的改变分为效应组和无效应组,比较化疗前后最大信号丢失率、肿瘤体积的变化以及化疗前最大信号丢失率与肿瘤退缩率之间的相关性。结果化疗后,

  11. CHEMOTHERAPY FOR MUSCLE INVASIVE BLADDER CANCER

    Directory of Open Access Journals (Sweden)

    I. G. Rusakov

    2014-08-01

    Full Text Available The paper considers treatment regimens for metastatic bladder cancer (MBC and gives the data of trials of the efficiency of using different chemotherapy schemes and regimens in patients with MBC.

  12. Cancer Chemotherapy - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Cancer Chemotherapy URL of this page: https://medlineplus.gov/languages/cancerchemotherapy.html Other topics A-Z A B ...

  13. Neoadjuvant chemotherapy in locally advanced colon cancer

    DEFF Research Database (Denmark)

    Jakobsen, Anders; Andersen, Fahimeh; Fischer, Anders;

    2015-01-01

    BACKGROUND: Neoadjuvant chemotherapy has proven valuable in several tumors, but it has not been elucidated in colon cancer. The present phase II trial addressed the issue in high-risk patients selected by computed tomography (CT) scan. MATERIAL AND METHODS: Patients with resectable colon cancer...... mutational status received three cycles of capecitabine 2000 mg/m(2) days 1-14 q3w and oxaliplatin 130 mg iv day 1 q3w. Wild-type patients received the same chemotherapy supplemented with panitumumab 9 mg/kg iv q3w. After the operation, patients fulfilling the international criteria for adjuvant chemotherapy......, i.e. high-risk stage II and III patients, received five cycles of the same chemotherapy without panitumumab. Patients not fulfilling the criteria were offered follow-up only. The primary endpoint was the fraction of patients not fulfilling the criteria for adjuvant chemotherapy (converted patients...

  14. Myocardial perfusion changes in patients irradiated for left-sided breast cancer and correlation with coronary artery distribution

    International Nuclear Information System (INIS)

    Purpose: To evaluate postradiation regional heart perfusion changes with single photon emission tomography (SPECT) myocardial perfusion imaging in 69 patients treated with tangential photon beams radiation therapy (RT) for left-sided breast cancer. To correlate SPECT changes with percent irradiated left ventricle (LV) volume and risk factors for coronary artery disease (CAD). Methods and Materials: Rest SPECT of the LV was acquired pre-RT and at 6-month intervals post-RT. The extent of defects (%) with a severity > 1.5 standard deviations below the mean was quantitatively analyzed for the distributions of the left anterior descending (LAD) artery, left circumflex (LCX) artery, and right coronary artery (RCA) based on computer assisted polar map reconstruction (i.e., bull's-eye-view). Changes in perfusion were correlated with percent irradiated LV receiving > 25 Gy (range 0-32%). Data on patient- and treatment-related factors were collected prospectively (e.g., cardiac premorbidity, risk factors for CAD, chemotherapy, and hormonal treatment). Results: In the LAD distribution, there were increased perfusion defects at 6 months (median 11%; interquartile range 2-23) compared with baseline (median 5%; interquartile range 1-14) (p<0.001). There were no increases in perfusion defects in the LCX or RCA distributions. In multivariate analysis, the SPECT perfusion changes in the LAD distribution at 6 months were independently associated with percent irradiated LV (p<0.001), hormonal therapy (p=0.005), and pre-RT hypercholesterolemia (p=0.006). The SPECT defects in the LAD distribution at 12 and 18 months were not statistically different from those at 6 months. The perfusion defects in the LAD distribution were limited essentially to the regions of irradiated myocardium. Conclusion: Tangential photon beam RT in patients with left-sided breast cancer was associated with short-term SPECT defects in the vascular distribution corresponding to the radiation portals. Factors

  15. Neoadjuvant Chemotherapy for Advanced Epithelial Ovarian Cancer

    International Nuclear Information System (INIS)

    Objective: To describe the experience at the National Cancer Institute (NCI) on the use of neoadjuvant chemotherapy as primary treatment for epithelial ovarian cancer among patients in stages IIIC and IV. Methods: We conducted a descriptive retrospective study (case series type) of patients diagnosed with epithelial ovarian cancer in stages IIIC and IV, treated at the NCI from January 1, 2003 to December 31,2006, who underwent neoadjuvant chemotherapy as primary treatment. Demographic characteristics and clinical outcomes are described. Results: Seventeen patients who fulfilled the above mentioned criteria were selected. Once neoadjuvant chemotherapy ended, 5 patients (29.4%) achieved complete or partial clinical response; 4 (23.8%) remained in stable condition, and 8 (47.6%) showed signs of progressive illness. Interval debulking surgery was performed on objective response patients. Maximum cytoreduction was achieved in 5 patients (100%); first relapse was reported at month 18 of follow-up; 2 disease-free survivors were identified in December, 2007; 8 (49%) reported some degree of non-severe chemotherapy-related toxicity. No mortality was related to chemotherapy, no post surgical complications were observed and no patient required advanced support management. Conclusions: Neoadjuvant chemotherapy, followed by optimal interval debulking surgery among selected patients, can be an alternative treatment for advanced epithelial ovarian cancer among women with irresecability or the critically ill. Further studies with improved design are required to confirm these findings.

  16. Chemotherapy for lung cancers: here to stay.

    Science.gov (United States)

    Kris, Mark G; Hellmann, Matthew D; Chaft, Jamie E

    2014-01-01

    Four decades of clinical research document the effectiveness of chemotherapy in patients with lung cancers. Chemotherapeutic agents can improve lung cancer symptoms, lengthen life in most patients with lung cancers, and enhance curability in individuals with locoregional disease when combined with surgery or irradiation. Chemotherapy's effectiveness is enhanced in patients with EGFR-mutant and ALK-positive lung cancers and can "rescue" individuals whose oncogene-driven cancers have become resistant to targeted agents. As immunotherapies become part of the therapeutic armamentarium for lung cancers, chemotherapeutic drugs have the potential to modulate the immune system to enhance the effectiveness of immune check point inhibitors. Even in this era of personalized medicine and targeted therapies, chemotherapeutic agents remain essential components in cancer care. PMID:24857127

  17. [Induction chemotherapy for locally advanced cervical cancer].

    Science.gov (United States)

    Morkhov, K Yu; Nechushkina, V M; Kuznetsov, V V

    2015-01-01

    The main methods of treatment for cervical cancer are surgery, radiotherapy or their combination. During past two decades chemotherapy are increasingly being used not only in patients with disseminated forms of this disease but also in patients undergoing chemoradiotherapy or as induction therapy. Possibilities of adjuvant chemotherapy for cervical cancer are being studied. According to A.D.Kaprin and V.V. Starinskiy in 2013 in Russia, 32% of patients with newly diagnosed cervical cancer underwent only radiation therapy, 32%--combined or complex treatment, 27.3%--only surgery, and just 8.7%--chemoradiotherapy. PMID:26087600

  18. Does the use of induction chemotherapy in oral cavity cancer compromise subsequent loco-regional treatment delivery: Results from a matched pair analysis

    Directory of Open Access Journals (Sweden)

    V M Patil

    2015-01-01

    Full Text Available BACKGROUND: Neoadjuvant chemotherapy is being increasingly used in patients with unresectable oral cavity cancers to make them resectable. However, its impact on locoregional treatment delivery in such setting remains poorly studied. AIMS: To evaluate the impact of neoadjuvant chemotherapy on delivery of further locoregional treatment. SETTINGS AND DESIGN: Mono institutional retrospective audit of patients with oral cavity squamous cell cancers treated with neoadjuvant triplet chemotherapy in India. MATERIALS AND METHODS: Patients receiving neoadjuvant chemotherapy (n = 14 from May 2012 to April 2014 were matched 1:2 to patients undergoing upfront surgery (n = 28 based on age (>60 or 60 and less, gender (male or female and subsite site (tongue and floor of mouth or buccoalveolar complex. Data regarding factors related to the delivery of locoregional treatment and toxicities were compiled. STATISTICAL ANALYSIS: Descriptive analysis in the form of median (range for continuous variables and frequencies for categorical variables. RESULTS: Patients undergoing neoadjuvant chemotherapy required more extensive resections and had greater operative time (460 vs. 415 min, P < 0.001. A greater incidence of locoregional wound complications was seen as a consequence (57.1% vs. 14.3%, P, 0.01. However, toxicities during radiotherapy were not substantially different between the two groups and compliance to radiation was also similar. Total package time of 100 days or less, was maintained in 90% of patients in both groups. CONCLUSIONS: Delivery of neoadjuvant chemotherapy does not impair the ability to deliver locoregional treatment.

  19. Preoperative Arterial Interventional Chemotherapy on Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    WANG Hui; LING HU-Hua; TANG Liang-dan; ZHANG Xing-hua

    2008-01-01

    Objective:To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer.Methods:Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with bulky cervical cancer.The patients received bleomycin 45 mg and cisplatin or oxaliplatin 80 mg/m2.Results:25 cases(including 8 cases with stage Ⅰ and 17 cases with stage Ⅱ)received one or two courses of preoperative interventional chemotherapy.The size of the focal lesions was decreased greatly and radical hysterectomy and lymphadenectomy were performed successfully in all the patients.All of the specimens were sent for pathological examination.Lymphocyte infiltration was found more obvious in the cancer tissues as compared with their counterpart before treatment.As a result,relevant vaginal bleeding was stopped completely shortly after the treatment.Conclusion:Arterial interventional chemotherapy was proved to reduce the local size of cervical cancer and thus control the hemorrhage efficiently.The patients with cervical cancer can receive radical hysterectomy therapy after the interventional chemotherapy.

  20. Systemic Chemotherapy in Advanced Pancreatic Cancer

    OpenAIRE

    Lee, Hee Seung; Park, Seung Woo

    2016-01-01

    Pancreatic cancer remains one of the most lethal cancers. These patients often have multiple symptoms, and integrated supportive care is critical in helping them remain well for as long as possible. Fluorouracil-based chemotherapy is known to improve overall survival (OS) by approximately 3 months, compared to the best supportive care alone. A 1997 study comparing gemcitabine and fluorouracil treatment of advanced pancreatic cancer patients showed an improvement in OS of 1 month in patients r...

  1. Targeting oncogenes to improve breast cancer chemotherapy.

    Science.gov (United States)

    Christensen, Laura A; Finch, Rick A; Booker, Adam J; Vasquez, Karen M

    2006-04-15

    Despite recent advances in treatment, breast cancer remains a serious health threat for women. Traditional chemotherapies are limited by a lack of specificity for tumor cells and the cell cycle dependence of many chemotherapeutic agents. Here we report a novel strategy to help overcome these limitations. Using triplex-forming oligonucleotides (TFOs) to direct DNA damage site-specifically to oncogenes overexpressed in human breast cancer cells, we show that the effectiveness of the anticancer nucleoside analogue gemcitabine can be improved significantly. TFOs targeted to the promoter region of c-myc directly inhibited gene expression by approximately 40%. When used in combination, specific TFOs increased the incorporation of gemcitabine at the targeted site approximately 4-fold, presumably due to induction of replication-independent DNA synthesis. Cells treated with TFOs and gemcitabine in combination showed a reduction in both cell survival and capacity for anchorage-independent growth (approximately 19% of untreated cells). This combination affected the tumorigenic potential of these cancer cells to a significantly greater extent than either treatment alone. This novel strategy may be used to increase the range of effectiveness of antitumor nucleosides in any tumor which overexpresses a targetable oncogene. Multifaceted chemotherapeutic approaches such as this, coupled with triplex-directed gene targeting, may lead to more than incremental improvements in nonsurgical treatment of breast tumors. PMID:16618728

  2. Chemotherapy

    Science.gov (United States)

    ... whose cancer is being treated with chemotherapy, your doctors, nurses, and other members of the cancer treatment team ... takes to follow their dreams. Talk with your doctors, nurses, family, and friends if you have any questions ...

  3. Adjuvant chemotherapy and cancer cure

    International Nuclear Information System (INIS)

    The use of chemotherapy as an adjuvant to surgery and/or radiotherapy is well founded in experimental tumor systems and appears to be effective in patients in some circumstances. It is clear from both clinical and experimental studies that (1) the dose is important, (2) the earlier chemotherapy is started after primary therapy the better, and (3) combination chemotherapy may be more effective than single-agent treatment. The better the estimation of risk of recurrence, the better the assessment of the risk-benefit ratio with adjuvant therapy. Salvage therapy as well as relative risk of recurrence are considerations in the choice of patients to be treated. Finally, some evidence is presented to indicate that alkylating agents may not be necessary in combination regimens for adjuvant therapy if effective antimetabolite combinations are available

  4. Cytoreductive Surgery and Intraperitoneal Chemotherapy in Patients with Peritoneal Metastases from Colorectal Cancer : Aspects of loco-regional treatment outcome, patient selection, and chemo-sensitivity

    OpenAIRE

    Cashin, Peter H.

    2012-01-01

    Previously, peritoneal metastases(PM) from colorectal cancer(CRC) have been considered a terminal and generalised form of cancer. A new treatment strategy combining cytoreductive surgery(CRS) and intraperitoneal chemotherapy(IPC) has recently shown promising results. The aim of this thesis was to investigate different aspects of this treatment in order to optimise the treatment and to clarify its potential as a new treatment option. Treatment outcome, patient selection, method of IPC (hyperth...

  5. Optimizing initial chemotherapy for metastatic pancreatic cancer.

    Science.gov (United States)

    Mantripragada, Kalyan C; Safran, Howard

    2016-05-01

    The two combination chemotherapy regimens FOLFIRINOX and gemcitabine plus nab-paclitaxel represent major breakthroughs in the management of metastatic pancreatic cancer. Both regimens showed unprecedented survival advantage in the setting of front-line therapy. However, their application for treatment of patients in the community is challenging because of significant toxicities, thus limiting potential benefits to a narrow population of patients. Modifications to the dose intensity or schedule of those regimens improve their tolerability, while likely retaining survival advantage over single-agent chemotherapy. Newer strategies to optimize these two active regimens in advanced pancreatic cancer are being explored that can help personalize treatment to individual patients. PMID:26939741

  6. Systemic chemotherapy for metastatic breast cancer

    Institute of Scientific and Technical Information of China (English)

    Yannan Zhao; Biyun Wang

    2015-01-01

    Breast cancer is the leading cause of cancer among women worldwide and the most common cancer in China. Many factors influence the treatment strategy for metastatic breast cancer (MBC). Chemotherapy should be administered to patients with hormone receptor-negative tumors, symptomatic visceral metastasis, and a short disease-free interval. Sequential single-agent chemotherapy has similar efficacy as combination agents in terms of overall survival and quality of life. Anthracyclines are the cornerstone of first-line treatment for MBC, and taxanes represent the second treatment option after resistance. When progression or intolerable toxicity occurs after optimal treatment, the alternative treatments include capecitabine, vinorel-bine, and gemcitabine. Ixabepilone and eribulin are relatively new effective single agents. A combination of cytotoxic agents for patients with rapid clinical progression can further improve the overall response rate and time to progression compared to single-agent treatment. For patients with MBC who were pretreated with anthracyclines in the neoadjuvant/adjuvant setting, a taxane-containing regimen such as docetaxel plus capecitabine or gemcitabine plus paclitaxel should be administered. Platinum-based therapies such as cisplatin or carboplatin have a role in the treatment of triple-negative breast cancer. Meanwhile, the efficacy of the addition of targeted drugs such as iniparib, bevacizumab, and cetuximab to chemotherapy remains unproven. Maintenance chemotherapy is routinely recommended in clinical practice at present. Patients who were previously treated with paclitaxel and gemcitabine have better progression-free and overall survival with maintenance chemotherapy according to a Korean phase Ⅲ clinical trial. Sequential maintenance treatment with capecitabine monotherapy after capecitabine-based combination chemotherapy (X-based X) appears favorable based on a series of domestic studies.

  7. Predictors for pneumonitis during local-regional radiotherapy in patients with advanced breast cancer previously treated with high dose chemotherapy and bone marrow transplant

    International Nuclear Information System (INIS)

    Purpose: High dose chemotherapy and autologous bone marrow rescue (HDC) are being increasingly used in patients with advanced breast cancer. Pulmonary toxicity is common following HDC, and may be exacerbated by local-regional radiation therapy (RT). We evaluated potential predictors for pulmonary toxicity in breast cancer patients treated with RT following HDC, in an effort to reduce overall lung toxicity. Methods: Thirty eight patients with breast cancer involving 10 or more axillary lymph nodes and treated in two prospective trials (CALGB 8782 and 9082) entailing induction CAF chemotherapy plus HDC (cytoxan, cisplatin, carmustine) followed by local regional RT (chest wall, supraclavicular fossa, ± internal mammary and axillary lymph nodes) were evaluated. Thirteen patients (Group A) developed new or progressive lung toxicity during RT, while 25 did not (Group B). Lung toxicity was defined as progressive pulmonary symptoms requiring the initiation of corticosteroids. A variety of pre-RT pulmonary parameters were reviewed in an attempt to identify quantitative predictors for the development of lung toxicity during RT. Pulmonary function tests (PFT's: FEV1 and DLCO) were obtained in all patients prior to and following induction CAF, and at regular intervals after HDC. To measure the degree of recent improvement or decline in the pre-RT PFT's, we calculated the ratio of the most recent PFT to the previous minimum. Differences between the means of the pulmonary parameters were tested for significance using the Student T-test. Results: There were no statistically significant differences between the two groups with respect to the mean preCAF, preHDC, or preRT DLCO's, as shown in the figure. The mean preCAF and preHDC FEV1's were higher in Group B (109%, 96%, respectively) than in Group A (96%, 89%). The most significant difference between the two groups was in the direction of the DLCO immediately prior to RT. In (12(13)) patients in Group A (the group with lung

  8. The value of postoperative hepatic regional chemotherapy in prevention of recurrence after radical resection of primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    Zhi Quan Wu; Jia Fan; Shuang Jian Qiu; Jian Zhou; Zhao You Tang

    2000-01-01

    @@ INTRODUCTION In China, primary liver cancer (PLC) ranks second in cancer mortality since the 1990s. In the field of PLC treatment, surgical resection remains the best,which includes large PLC resection, small PLC resection, re-resection of subclinical recurrence, as well as cytoreduction and sequential resection for unresectable PLC. However, recurrence and metastasis have become the major obstacles for further prolonging survival after resection.

  9. Chemotherapy of ovarian cancer in elderly patients

    Institute of Scientific and Technical Information of China (English)

    Tiffany A. Troso-Sandoval; Stuart M. Lichtman

    2015-01-01

    Epithelial ovarian cancer is primarily a disease of older women. Advanced age is risk factor for decreased survival. Optimal surgery and the safe and effective administration of chemotherapy are essential for prolonged progression-free and overall survival (OS). In this article, the available regimens in both the primary treatment and relapsed setting are reviewed.

  10. Can loco-regional irradiation be a routine supplement to high dose chemotherapy with autologous bone marrow transplant in women with poor prognosis breast cancer

    International Nuclear Information System (INIS)

    Purpose: High dose chemotherapy followed by bone marrow transplantation (BMT) is currently being performed in many women with localized, poor prognosis breast cancer. The purpose of this study was to examine patterns of care in radiation treatment as well as acute side effects in women who received breast or chest wall and regional nodal irradiation (XRT) post BMT. Methods: The records of 126 consecutive women with localized, poor prognosis breast cancer who received an autologous BMT at Emory University between (3(90)) and (7(96)) were retrospectively reviewed. Results: All 126 women underwent high dose chemotherapy with cyclophosphamide, carboplatinum and thiotepa followed by BMT. Loco - regional XRT after BMT was routinely recommended for patients with 10 or more positive axillary lymph nodes or inflammatory carcinoma. Overall, 90 patients received local +/- regional XRT; 11 patients prior to BMT and 79 patients post BMT. Three of these patients had a local relapse prior to beginning XRT post BMT. Thirty six patients did not receive XRT for the following reasons: major post BMT morbidity or insufficient hematological recovery (15 patients), less than 10 positive axillary lymph nodes (12 patients), or refusal/not referred (9 patients). Therefore, of the 103 patients (excludes those with less than 10 positive nodes) intended to receive post BMT irradiation, 14.5 % (15 patients- 2 with inflammatory carcinoma) were unable to receive it secondary to post BMT morbidity and 9% (9 patients) refused or were not referred. Of these 79 patients irradiated post BMT, 16 had stage IIA, 20 stage IIB, 27 stage IIIA and 16 inflammatory carcinoma (IIIB). The median time from transplant to irradiation was 82 days (range 44 - 641). Average dose to breast or chest wall was 49.5 Gy (range 42-55.8 Gy). Boost dose (mean 12 Gy, range 10-22 Gy) was given in 62% of patients. The median tumor bed/mastectomy scar dose was 60 Gy (range 42-72 Gy). Supraclavicular, posterior axillary and

  11. Prognostic Factors of Perioperative Chemotherapy and Cisplatin Heat Intraperitoneal Perfusion for Ovarian Cancer%围术期化疗联合顺铂腹腔热灌注治疗卵巢癌患者的预后影响因素分析

    Institute of Scientific and Technical Information of China (English)

    罗清钦; 胡承浩; 来瑞平; 明星

    2015-01-01

    Objective To investigate the prognostic factors of perioperative chemotherapy combined with cisplatin heat intraperitoneal perfusion for ovarian cancer .Methods 98 cases of ovarian cancer were divided into 2 group by random number table,the control group,48 cases,were given perioperative chemotherapy ,and the study group,50 cases,were given cisplatin heat intraperitoneal perfusion on the base of the control group ,clinical curative effects were compared between the 2 groups,and the prognostic factors were analyzed.Results The efficiency rate,median survival and progression free survival of the study group were significantly better than those of the control group (P<0.05).Kaplan-Meier survival analysis showed that age ,therapy,FI-GO stage,lymph node metastasis,tumor diameter were the prognostic risk factors ,Cox regression analysis showed that FIGO stage , lymph node metastasis and postoperative residual tumor diameter were the independent prognosis risk factors .Conclusion The short-term and long-term curative effects of perioperative chemotherapy combined with cisplatin heat intraperitoneal perfusion for ovarian cancer are remarkable ,the prognosis is closely related with clinical pathological factors ,such as FIGO stage,lymph node metastasis and postoperative residual tumor diameter .%目的:探讨围术期化疗联合顺铂腹腔热灌注治疗卵巢癌患者的预后影响因素。方法选取卵巢癌患者98例,采用随机数字表法将患者分为两组,对照组:48例,采用围术期化疗;研究组:50例,在对照组基础上采用腹腔热灌注治疗,比较两组临床疗效差异,并分析预后影响因素。结果研究组治疗有效率、中位生存期与无进展生存期明显优于对照组(P<0.05),Kaplan-Meier生存分析显示,年龄、治疗方案、FIGO分期、淋巴结转移、肿瘤直径是影响卵巢癌患者的预后危险因素,Cox回归分析FIGO分期、淋巴结转移与术后残余肿瘤直径

  12. Regional perfusion and ventilation of the lungs assessed by means of perfusion scintigraphy with Tc-99m microspheres and inhalation scintigraphy

    International Nuclear Information System (INIS)

    Regional lung function which is usually estimated prior to the surgical removal of a lung tumor to provide information about the remaining lung after surgery is generally assessed by means of perfusion scintigraphy. We tried to find out whether regional lung function computed from perfusion scans versus inhalation scintigraphy using 127Xe of sup(99m)Tc showed intraindividual differences in excess of 20%. For this purpose 18 patients with lung cancer (15 males and 3 females aged between 53 and 73 years) underwent spirometry, perfusion scintigraphy and inhalation scintigraphy using 127Xe or sup(99m)Tc aerosols. Regional lung function was assessed from FEV1 and the counts measured in regions of interest (ROIs) during pulmonary scintigraphy in the posterior view. In 12 patients regional lung function differed by at least 20% when measured by perfusion versus 127Xe inhalation scintigraphy. In 6 patients divergent data were also obtained when using perfusion versus sup(99m)Tc inhalation scintigraphy; and in 3 cases 127Xe inhalation data disagreed with those obtained with the sup(99m)Tc aerosol. For a more precise estimate of regional lung function following lung surgery in patients with severely reduced global lung function regional perfusion data should be supplemented by regional ventilation data using 127Xe (or 133Xe) inhalation scans. (Author)

  13. Enzalutamide in metastatic prostate cancer before chemotherapy

    DEFF Research Database (Denmark)

    Beer, Tomasz M; Armstrong, Andrew J; Rathkopf, Dana E;

    2014-01-01

    BACKGROUND: Enzalutamide is an oral androgen-receptor inhibitor that prolongs survival in men with metastatic castration-resistant prostate cancer in whom the disease has progressed after chemotherapy. New treatment options are needed for patients with metastatic prostate cancer who have not...... most common clinically relevant adverse events associated with enzalutamide treatment. CONCLUSIONS: Enzalutamide significantly decreased the risk of radiographic progression and death and delayed the initiation of chemotherapy in men with metastatic prostate cancer. (Funded by Medivation and Astellas...... skeletal-related event (hazard ratio, 0.72), a complete or partial soft-tissue response (59% vs. 5%), the time until prostate-specific antigen (PSA) progression (hazard ratio, 0.17), and a rate of decline of at least 50% in PSA (78% vs. 3%) (P<0.001 for all comparisons). Fatigue and hypertension were the...

  14. PERIOPERATIVE CHEMOTHERAPY IN LOCALLY ADVANCED GASTRIC CANCER

    Directory of Open Access Journals (Sweden)

    Thales Paulo BATISTA

    2013-09-01

    Full Text Available Gastric cancer is one of the most common cancers and a main cause of cancer-related death worldwide, since the majority of patients suffering of this malignancy are usually faced with a poor prognosis due to diagnosis at later stages. In order to improve treatment outcomes, the association of surgery with chemo and/or radiotherapy (multimodal therapy has become the standard treatment for locally advanced stages. However, despite several treatment options currently available for management of these tumors, perioperative chemotherapy has been mainly accepted for the comprehensive therapeutic strategy including an appropriated D2-gastrectomy. This manuscript presents a (nonsystematic critical review about the use of perioperative chemotherapy, with a special focus on the drugs delivery.

  15. Combining chemotherapy with radiation in breast cancer

    International Nuclear Information System (INIS)

    Breast cancer is one of the most important global health problems. Over the last years introduction of mammography screening and increased efficacy of adjuvant therapies resulted in the reduction of mortality in this malignancy. A proportion of patients with breast cancer has indications for adjuvant radiotherapy and chemotherapy, however optimal schedules of combining these two modalities remain controversial. In clinical practice typically chemotherapy and radiotherapy are used sequentially, but this strategy is not supported by the results of large clinical trials. There is theoretical rationale for the concomitant use of both modalities, but increased cardiotoxicity and skin reactions of anthracycline-based regimens do not allow for this strategy. Further investigations are essential to determine the safety of taxane-based schedules combined with radiotherapy, particularly with regard to pneumotoxicity. Concurrent chemo-radiotherapy with the use of selected schemes may be considered in patients with locally advanced cancer, but this strategy still should be verified in large randomized studies. (author)

  16. Uterine/Endometrial Cancer: Chemotherapy

    Science.gov (United States)

    ... About the Role of Heredity in Gynecologic Cancers CURE® Magazine Teams Up with the Foundation for Women’s ... PhD Sara Goldberger, LCSW-R Questions from Readers: HPV Transmission Questions from Readers: Paps and other tests ...

  17. Cancer chemotherapy: Challenges for the future

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, Kiyoji (ed.) (National Nagoya Hospital (Japan)); Saito, H. (Nagoya Univ. (Japan)); Carter, S.K. (ed.) (Bristol-Myers Squibb Company, New York (United States)); Bast, R.C. Jr (ed.) (Duke Univ., Durham, NC (United States). Medical Center)

    1992-01-01

    At this symposium the main topics were new strategies for cancer therapy based on biology and pharmacology. Presentations on the biology of tumor progression and regression covered the molecular basis of cancer suppression by human tumor suppressor genes, mutation of the p53 gene and accumulation of the p53 protein, tumor suppressor genes involved in the pathogenesis of lung cancer, and lessons learned from studies on tumor suppression by chromosome transfer. Many new reports on oncogenes provided the highlights for these chemotherapists present. For cancer therapy based on pharmacology, papers were presented on drug resistance such as P-glycoprotein (p170) multidrug resistance (MDR) transporter limitations on successful therapy for childhood tumors: possible circumvention of MDR by cyclosporin A, regulation of the MDR gene in response to environmental stimuli, and dose-intensive chemotherapies. On the subject of cancer therapy, lung cancer was the focus of attention, and the efficacy of combined modalities was reported and discussed.

  18. Computed Tomography (CT) Perfusion in Abdominal Cancer

    DEFF Research Database (Denmark)

    Hansen, Martin Lundsgaard; Norling, Rikke; Lauridsen, Carsten;

    2013-01-01

    Computed Tomography (CT) Perfusion is an evolving method to visualize perfusion in organs and tissue. With the introduction of multidetector CT scanners, it is now possible to cover up to 16 cm in one rotation, and thereby making it possible to scan entire organs such as the liver with a fixed...

  19. Application of CT perfusion imaging in radiotherapy for lung cancer

    International Nuclear Information System (INIS)

    Objective: To investigate the value of CT perfusion imaging in evaluation of therapeutic effect and prognosis in radiotherapy for lung cancer. Methods: Fifty-one cases of lung cancer who were unable or refused to be operated on, 36 males and 15 females, aged 37-80, underwent CT perfusion imaging, 29 of which only before radiotherapy and 22 before and after radiotherapy twice. The images were collected by cine dynamic scanning (5 mm/4 slices) and input into the GE AW4.0 workstation for data processing. The slice positions of CT imaging were determined according to the largest tumor size in CT scan. Regions of interest of tumor were drawn at the region corresponding to the original images of CT perfusion. Radiotherapy was performed after CT perfusion imaging. Relevant parameters, including blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS) were calculated. The treatment response after radiotherapy was evaluated by RECIST. At 2 -4 weeks after the treatment, CT examination was conducted once more. Results: The tests of the 51 patients showed that the BV was 13.6 ml·100 g-1, the BF was 129.5 ml·min-1 ·100 g-1, the MTT was 9.1 s, and the PS was 10.0 ml· min-1· 100 g-1 before radiotherapy. The tests of the 22 of the 51 patients showed that the values of BV and BF after radiotherapy were 7.6 ml· 100 g-1 and 97.8 ml·min-1· 100 g-1, respectively, both lower than those before radiotherapy (11.2 and 108.7 ml·min-1·100 g-1, respectively), however, both not significantly (t=1.28, 0.40, P>0.05); and the values of MTT and PS after radiotherapy were 8.9 s and 7.8 ml·min-1· 100 g-1, respectively, both not significantly higher than those before radiotherapy (7.2 s and 6.8 ml· min-1· 100 g-1, respectively, t=-1.15, -0.57, P>0.05). The mean area of tumor after radiotherapy was 1189.6 mm2, significantly less than that before radiotherapy (1920.3 mm2, t=3.98, P<0.05). The MTT of the SCLC patients was 12.9 s, significantly longer than

  20. Natural products for cancer chemotherapy

    OpenAIRE

    Demain, Arnold L.; Vaishnav, Preeti

    2011-01-01

    Summary For over 40 years, natural products have served us well in combating cancer. The main sources of these successful compounds are microbes and plants from the terrestrial and marine environments. The microbes serve as a major source of natural products with anti‐tumour activity. A number of these products were first discovered as antibiotics. Another major contribution comes from plant alkaloids, taxoids and podophyllotoxins. A vast array of biological metabolites can be obtained from t...

  1. Locally advanced pancreatic cancer. Looking beyond traditional chemotherapy and radiation.

    Science.gov (United States)

    Savir, Guy; Huber, Kathryn E; Saif, Muhammad Wasif

    2013-07-01

    About a third of all pancreatic cancer is found to be locally advanced at the time of diagnosis, where the tumor is inoperable but remains localized to the pancreas and regional lymphatics. Sadly, this remains a universally deadly disease with progression to distant disease being the predominant mode of failure and average survival under one year. Optimal treatment of these patients continues to be an area of controversy, with chemotherapy alone being the treatment preference in Europe, and chemotherapy followed by chemoradiation in selected patients, preferred in the USA. The aim of this paper is to summarize the key abstracts presented at the 2013 ASCO Annual Meeting that address evolving approaches to the management of locally advanced pancreatic cancer. The late breaking abstract (#LBA4003) provided additional European data showing non-superiority of chemoradiation compared to chemotherapy in locally advanced pancreatic cancer patients without distant progression following 4 months of chemotherapy. Another late breaking abstract, (#LBA4004), unfortunately showed a promising new complement to gemcitabine and capecitabine using immunotherapy in the form of a T-helper vaccine did not translate to improved survival in the phase III setting. PMID:23846922

  2. Effect of chemotherapy on pulmonary epithelial permeability in lung cancer

    International Nuclear Information System (INIS)

    The aim of this study is to investigate the effect of one-course chemotherapy on the pulmonary epithelial permeability. Eighteen patients (18 male; mean age: 59±10 years) with lung cancer (11 non-small cell, 7 small cell) inhaled 40 mCi (1,480 MBq) 99mTc-diethylenetriaminepentaacetic acid (DTPA). Thirty images of 1-min duration were acquired from posterior projection. The first 7 min of the decay-corrected time activity curves were used to calculate lung clearance half-time. Clearance half-times of 99mTc-DTPA from the peripheral regions of the lungs were 42 ± 19 min before and 56±34 min after chemotherapy ( p=0.009); from the central regions, clearance half-times were 112±94 min before and 160±125 min after chemotherapy ( p=0.005). This decrease in clearance rate might be related to decreasing mucociliary clearance rate due to the toxic effect of the chemotherapy regimen on cilia movement and/or mucus structure. 99mTc-DTPA radioaerosol study can be used to monitor the toxic effects of chemotherapy on the pulmonary epithelium and possibly on mucociliary function

  3. Reirradiation of recurrent breast cancer with and without concurrent chemotherapy

    Directory of Open Access Journals (Sweden)

    Kretschmer Matthias

    2008-09-01

    Full Text Available Abstract Background Treatment options for loco-regional recurrent breast cancer after previous irradiation are limited. The efficacy of chemotherapy might be hampered because of impaired tissue perfusion in preirradiated tissue. Thus, mastectomy or local excision and reconstructive surgery are the preferred treatments. However, in recent years evidence accumulates that a second breast conserving approach with reirradiation as part of the treatment might be feasible and safe and, furthermore, reirradiation might be an option for palliation. Here we report on the experience of a single community centre in reirradiation of recurrent breast cancer. Methods The report is based on 29 patients treated with reirradiation. All data were prospectively collected. The median age was 63 years (range 35 to 82 yrs. The interval between initial diagnosis and diagnosis before start of reirradiation was 11.6 months to 295.5 months. The mean total dose (initial dose and reirradiation dose was 106.2 Gy (range 80.4 to 126 Gy and the mean BED3 Gy 168,5 Gy (range 130,6 to 201,6. The mean interval between initial radiotherapy and reirradiation was 92.9 months (range 8.7 to 290.1. Inoperable or incompletely resected patients were offered concurrent chemotherapy with either 5-FU or capecitabine. All patients received 3D-conformal radiotherapy with 1.6 to 2.5 Gy/fraction five times weekly. The treatment volume comprised all visible lesions or lesions detectable on CT/MRI/FDG-PET/CT or the tumour bed or recurrent tumour. Results The local progression-free survival of all patients at one and two years was 81% and 63%. Patients who had no surgery of the recurrence (16/29 had local progression-free survival at one and two years of 72% and 25% with a median progression-free survival time of 17 months. Partial remission and good symptom relief was achieved in 56% (9/16 or complete response of symptoms and/or tumour in 44% (7/16. Patients who had no distant metastases and had at

  4. Reirradiation of recurrent breast cancer with and without concurrent chemotherapy

    International Nuclear Information System (INIS)

    Treatment options for loco-regional recurrent breast cancer after previous irradiation are limited. The efficacy of chemotherapy might be hampered because of impaired tissue perfusion in preirradiated tissue. Thus, mastectomy or local excision and reconstructive surgery are the preferred treatments. However, in recent years evidence accumulates that a second breast conserving approach with reirradiation as part of the treatment might be feasible and safe and, furthermore, reirradiation might be an option for palliation. Here we report on the experience of a single community centre in reirradiation of recurrent breast cancer. The report is based on 29 patients treated with reirradiation. All data were prospectively collected. The median age was 63 years (range 35 to 82 yrs). The interval between initial diagnosis and diagnosis before start of reirradiation was 11.6 months to 295.5 months. The mean total dose (initial dose and reirradiation dose) was 106.2 Gy (range 80.4 to 126 Gy) and the mean BED3 Gy 168,5 Gy (range 130,6 to 201,6). The mean interval between initial radiotherapy and reirradiation was 92.9 months (range 8.7 to 290.1). Inoperable or incompletely resected patients were offered concurrent chemotherapy with either 5-FU or capecitabine. All patients received 3D-conformal radiotherapy with 1.6 to 2.5 Gy/fraction five times weekly. The treatment volume comprised all visible lesions or lesions detectable on CT/MRI/FDG-PET/CT or the tumour bed or recurrent tumour. The local progression-free survival of all patients at one and two years was 81% and 63%. Patients who had no surgery of the recurrence (16/29) had local progression-free survival at one and two years of 72% and 25% with a median progression-free survival time of 17 months. Partial remission and good symptom relief was achieved in 56% (9/16) or complete response of symptoms and/or tumour in 44% (7/16). Patients who had no distant metastases and had at least an R1-resection had a local progression

  5. Positron Emission Tomography Imaging of Regional Pulmonary Perfusion and Ventilation

    OpenAIRE

    Musch, Guido; Venegas, Jose G.

    2005-01-01

    Positron emission tomography (PET) imaging is a noninvasive, quantitative method to assess pulmonary perfusion and ventilation in vivo. The core of this article focuses on the use of [13N]nitrogen (13N2) and PET to assess regional gas exchange. Regional perfusion and shunt can be measured with the 13N2–saline bolus infusion technique. A bolus of 13N2, dissolved in saline solution, is injected intravenously at the start of a brief apnea, while the tracer kinetics in the lung is measured by a s...

  6. Systemic Chemotherapy in Advanced Pancreatic Cancer

    Science.gov (United States)

    Lee, Hee Seung; Park, Seung Woo

    2016-01-01

    Pancreatic cancer remains one of the most lethal cancers. These patients often have multiple symptoms, and integrated supportive care is critical in helping them remain well for as long as possible. Fluorouracil-based chemotherapy is known to improve overall survival (OS) by approximately 3 months, compared to the best supportive care alone. A 1997 study comparing gemcitabine and fluorouracil treatment of advanced pancreatic cancer patients showed an improvement in OS of 1 month in patients receiving gemcitabine. Over the next 10 years, multiple randomized studies compared single-agent gemcitabine with combination chemotherapy and showed no effective survival improvement. However, the addition of erlotinib, an epidermal growth factor receptor (EGFR) inhibitor, was associated with a significant improvement in OS of approximately 2 weeks. However, adoption of this regimen has not been widespread because of its limited effect and added toxicity. Two clinical trials have recently prolonged OS in advanced pancreatic cancer patients by almost 1 year. The first compared FOLFIRINOX with gemcitabine alone, and was associated with a significant improvement in median survival. The second compared gemcitabine and nab-paclitaxel with gemcitabine alone, and was associated with improvements in OS. At present, these regimens are considered standard treatment for patients with good performance statuses. PMID:27114434

  7. Systemic Chemotherapy in Advanced Pancreatic Cancer.

    Science.gov (United States)

    Lee, Hee Seung; Park, Seung Woo

    2016-05-23

    Pancreatic cancer remains one of the most lethal cancers. These patients often have multiple symptoms, and integrated supportive care is critical in helping them remain well for as long as possible. Fluorouracil-based chemotherapy is known to improve overall survival (OS) by approximately 3 months, compared to the best supportive care alone. A 1997 study comparing gemcitabine and fluorouracil treatment of advanced pancreatic cancer patients showed an improvement in OS of 1 month in patients receiving gemcitabine. Over the next 10 years, multiple randomized studies compared singleagent gemcitabine with combination chemotherapy and showed no effective survival improvement. However, the addition of erlotinib, an epidermal growth factor receptor (EGFR) inhibitor, was associated with a significant improvement in OS of approximately 2 weeks. However, adoption of this regimen has not been widespread because of its limited effect and added toxicity. Two clinical trials have recently prolonged OS in advanced pancreatic cancer patients by almost 1 year. The first compared FOLFIRINOX with gemcitabine alone, and was associated with a significant improvement in median survival. The second compared gemcitabine and nabpaclitaxel with gemcitabine alone, and was associated with improvements in OS. At present, these regimens are considered standard treatment for patients with good performance statuses. PMID:27114434

  8. High-risk bladder cancer: improving outcomes with perioperative chemotherapy

    Directory of Open Access Journals (Sweden)

    Daniel Y.C. Heng

    2011-12-01

    Full Text Available Despite treatment with radical cystectomy and pelvic lymph node dissection, muscle invasive bladder cancer has a relapse rate of 50%. Patients can develop regionally advanced or metastatic disease that ultimately leads to death. The addition of neoadjuvant or adjuvant chemotherapy to reduce the risk of relapse and death has been extensively studied over the past two decades. Two contemporary trials coupled with a recent meta-analysis evaluating neoadjuvant chemotherapy demonstrated a modest but real improvement in overall survival. This has made neoadjuvant chemotherapy a standard of care. Clinical trials evaluating adjuvant chemotherapy in patients with high-risk disease have been plagued with statistical flaws and have, therefore, been unable to define the survival impact of this approach. It is hoped that ongoing adjuvant trials that are powered to detect small but meaningful clinical differences will clarify the benefit of chemotherapy after cystectomy. Since there are theoretical advantages and disadvantages to each of these approaches, both are widely used in North America. The evidence behind each approach and potential future developments in this field will be described.

  9. Chemotherapy of the patients with advanced head and neck cancers

    International Nuclear Information System (INIS)

    Purpose: Treatment of advanced head and neck carcinomas are a problem of worldwide. Cancer remains incurable when it is metastatic or unresectable, and only palliative treatment can improve quality of life of these patients. The aim of this retrospective study was to compare patients treated by radio / chemotherapy with a group of patients treated by radiotherapy alone. Patients and methods: 26 patients with advanced inoperable head and neck cancer were treated at our clinic between the years 1991-1995. Medium age was 62 (range 41-78). Primary tumor sites were: oropharynx in 4 cases, hypopharynx in 4 cases, larynx in 8 cases, oral cavity in 6 cases and parotid gland in 2 cases. The primary treatment consisted of radiotherapy alone in 13 patients, and a combination of radio / chemotherapy in 13 patients. Tumor size was T3 (8 patients) and T4 (18 patients), all of patients had metastases in regional lymph nodes (N1-N3). Chemotherapy was started after radiotherapy course and cisplatin was always included. The main side effects were myelotoxicity, nephrotoxicity, nausea and vomiting. Results: There are five patients with partial respons, four patients with stable disease and four patients with progressive disease. Medial stable disease time was 3,5 month in radio / chemotherapy group and 2,7 months in radiotherapy group. Median survival was 13,2 months for patients of radio / chemotherapy group and 11,5 months for patients of radiotherapy group. Conclusion: Addition of chemotherapy to radiotherapy improves survival of patients with advanced head and neck carcinoma and reliefs pain. (Full text)

  10. Impact of High-Dose Chemotherapy on the Ability to Deliver Subsequent Local-Regional Radiotherapy for Breast Cancer: Analysis of Cancer and Leukemia Group B Protocol 9082

    International Nuclear Information System (INIS)

    Purpose: To report, from Cancer and Leukemia Group B Protocol 9082, the impact of high-dose cyclophosphamide, cisplatin, and BCNU (HD-CPB) vs. intermediate-dose CPB (ID-CPB) on the ability to start and complete the planned course of local-regional radiotherapy (RT) for women with breast cancer involving ≥10 axillary nodes. Methods and Materials: From 1991 to 1998, 785 patients were randomized. The HD-CPB and ID-CPB arms were balanced regarding patient characteristics. The HD-CPB and ID-CPB arms were compared on the probability of RT initiation, interruption, modification, or incompleteness. The impact of clinical variables and interactions between variables were also assessed. Results: Radiotherapy was initiated in 82% (325 of 394) of HD-CPB vs. 92% (360 of 391) of ID-CPB patients (p = 0.001). On multivariate analyses, RT was less likely given to patients who were randomized to HD treatment (odds ratio [OR] = 0 .38, p < 0.001), older (p = 0.005), African American (p = 0.003), postmastectomy (p = 0.02), or estrogen receptor positive (p = 0.03). High-dose treatment had a higher rate of RT interruption (21% vs. 12%, p = 0.001, OR = 2.05), modification (29% vs. 14%, p = 0.001, OR = 2.46), and early termination of RT (9% vs. 2%, p = 0.0001, OR = 5.35), compared with ID. Conclusion: Treatment arm significantly related to initiation, interruption, modification, and early termination of RT. Patients randomized to HD-CPB were less likely to initiate RT, and of those who did, they were more likely to have RT interrupted, modified, and terminated earlier than those randomized to ID-CPB. The observed lower incidence of RT usage in African Americans vs. non-African Americans warrants further study.

  11. Chemotherapy of prostate cancer: present and future.

    Science.gov (United States)

    Trump, Donald; Lau, Yiu-Keung

    2003-06-01

    The role of chemotherapy in prostate cancer continues to evolve. In men with symptomatic androgen-independent prostate cancer, significant reduction in pain and analgesic requirements are achievable with mitoxantrone and glucocorticoid combinations compared with glucocorticoids alone. However, survival rates are not improved. Taxane-based combinations with estramustine phosphate or other new agents show promise. Prostate-specific antigen response rates with these combinations appear to be 1.5 to 2 times more frequent than with mitoxantrone-based combinations. Randomized trials of taxane versus mitoxantrone-based therapies are underway. New agents and applications of current agents in adjuvant settings should be explored if survival in men with prostate cancer is to be improved. PMID:12756087

  12. Radionuclide studies on ventilation and perfusion in different lung regions

    International Nuclear Information System (INIS)

    At present in the practice of radionuclide methods of investigation of the ventilation and blood flow one mistakes either a regional ventilated volume or the rate of indicator clearance from a given region for regional alveolar ventilation. The regional ventilation-perfusion ratio is obtained by dividing corresponding values expressed not in absolute but in relative units that causes erroneous results. A method proposed makes it possible to calculate regional distributions of ventilation, perfusion and their ratio as well as the values of mean time and the passage of an indicator through the alveolar-bronchial space and the vascular bed of the lungs strictly in accordance with the conditions of the clinical physiology of respiration. Measurements were taken according to an established method using either a gamma-chamber or a radiographic unit with autonomous detectors. To study the regional blood flow, 133Xe and sup(99m)Tc-MAA can be used

  13. Upfront Chemotherapy for Metastatic Prostate Cancer.

    Science.gov (United States)

    Lam, Elaine T; Flaig, Thomas W

    2015-12-01

    Traditionally, androgen deprivation therapy (ADT) has been the standard initial treatment for metastatic hormone-sensitive prostate cancer (mHSPC), with chemotherapy utilized in the castration-resistant setting. Data reported from three recent clinical trials shed new light on the role of upfront docetaxel in advanced or mHSPC. Two of these studies-CHAARTED and STAMPEDE-showed significant improvement in overall survival, while the third study, GETUG-AFU 15, showed no statistical difference. The CHAARTED study showed a 13.6-month survival improvement and the STAMPEDE study showed a 10-month survival improvement with ADT plus docetaxel, compared with ADT alone, in the hormone-sensitive setting. These numbers are remarkable when compared with the 2.9-month survival benefit from docetaxel in the metastatic castration-resistant setting, which has been the standard setting for the use of docetaxel in advanced prostate cancer. In this review, we describe the historical data for chemotherapy in the perioperative and metastatic prostate cancer settings, and the recent trials that are changing the paradigm in support of docetaxel in the upfront setting. PMID:26676900

  14. Pulmonary ventilation and perfusion studies in lung cancer

    International Nuclear Information System (INIS)

    In 46 patients with bronchogenic carcinoma, the diagnostic significance of pulmonary ventilation images by the continuous inhalation of Kr-81m gas, which has an extremely short half life, was studied in comparison with pulmonary perfusion images with Tc-99m MAA. The data were processed using digital analysis techniques. There were 15 cases with discrepancies between ventilation and perfusion. The V/Q ratios of the affected lung among the 43 patients showed values above 1.2 in nine cases and below 0.8 in six cases. The Kr-81m ventilation and Tc-99m perfusion images were compared before and after radiation therapy in eight patients. It was possible to assess the therapeutic effect on regional ventilation and regional perfusion, which could not be evaluated by chest x-ray alone, under the same conditions of normal breathing

  15. Postoperative adjuvant chemotherapy in rectal cancer operated for cure

    DEFF Research Database (Denmark)

    Petersen, Sune Høirup; Harling, Henrik; Kirkeby, Lene Tschemerinsky;

    2012-01-01

    Colorectal cancer is one of the most common types of cancer in the Western world. Apart from surgery - which remains the mainstay of treatment for resectable primary tumours - postoperative (i.e., adjuvant) chemotherapy with 5-fluorouracil (5-FU) based regimens is now the standard treatment...... in Dukes´ C (TNM stage III) colon tumours i.e. tumours with metastases in the regional lymph nodes but no distant metastases. In contrast, the evidence for recommendations of adjuvant therapy in rectal cancer is sparse. In Europe it is generally acknowledged that locally advanced rectal tumours receive...... preoperative (i.e., neoadjuvant) downstaging by radiotherapy (or chemoradiotion), whereas in the US postoperative chemoradiotion is considered the treatment of choice in all Dukes´ C rectal cancers. Overall, no universal consensus exists on the adjuvant treatment of surgically resectable rectal carcinoma...

  16. Chemotherapy Regimen Extends Survival in Advanced Pancreatic Cancer Patients

    Science.gov (United States)

    A four-drug chemotherapy regimen has produced the longest improvement in survival ever seen in a phase III clinical trial of patients with metastatic pancreatic cancer, one of the deadliest types of cancer.

  17. Premenopausal endocrine-responsive early breast cancer: who receives chemotherapy?

    OpenAIRE

    Regan, M. M.; Pagani, O; Walley, B; et al, ...; Stahel, R. A.

    2008-01-01

    BACKGROUND: The role of chemotherapy in addition to combined endocrine therapy for premenopausal women with endocrine-responsive early breast cancer remains an open question, yet trials designed to answer it have repeatedly failed to adequately accrue. The International Breast Cancer Study Group initiated two concurrent trials in this population: in Premenopausal Endocrine Responsive Chemotherapy (PERCHE), chemotherapy use is determined by randomization and in Tamoxifen and Exemestane Trial (...

  18. Distress, anxiety, and depression in cancer patients undergoing chemotherapy

    OpenAIRE

    Thomas Bejoy C; Devi Nandkumar; Sarita Gangadharan P; Pandey Manoj; Hussain Badridien M; Krishnan Rita

    2006-01-01

    Abstract Background Chemotherapy for cancer is an intense and cyclic treatment associated with number of side-effects. The present study evaluated the effect of chemotherapy on distress, anxiety and depression. Patients and methods A total of 117 patients were evaluated by using distress inventory for cancer (DIC2) and hospital anxiety and depression scale (HADS). Majority of the patients were taking chemotherapy for solid tumors (52; 44.4%). Results The mean distress score was 24, 18 (15.38%...

  19. Adjuvant chemotherapy in early breast cancer.

    Science.gov (United States)

    Ejlertsen, Bent

    2016-05-01

    these CMF regimens has not been compared within the context of a randomised trial. Shifting from the 77B's classic CMF regimen to the 82B four-weekly IV regimen or the 89B three-weekly IV regimen was associated with a 30% increased risk of a DFS event in a multivariate analysis of a population-based cohort study. Furthermore, the four-weekly regimen used in 82B was associated with a 40% increase in mortality. The strengths of the design include identical selection criteria, uniform and prospective registration of treatment, tumour and patient characteristics. Caution is still required due to the non-experimental design of the comparison. Another finding was a substantial difference in the risk of amenorrhoea; and while 15% of patients aged 40 or younger in 77B had regular menses throughout chemotherapy, the corresponding percentage was 37 in 82B and 47 in 89B. The DBCG in collaboration with a Swedish and a Dutch centre participating in the DBCG trial 89B compared CMF with ovarian ablation in premenopausal high-risk breast cancer patients with ER-positive tumours. No significant differences were found in DFS or OS in the preplanned analysis, suggesting that the benefits of CMF may, at least in part, be explained by ovarian suppression in premenopausal patients with ER-positive tumours. However, these results are not clinically useful by themselves as other chemotherapy regimens have been more efficacious, and knowledge is still lacking regarding the benefits from adding ovarian suppression to chemotherapy plus tamoxifen. The results from the DBCG 77B and 82C are in accordance with other large adjuvant trials and the EBCTCG meta-analyses. The benefits obtained with any individual anticancer drug are largely determined by the cancer (somatic) genome; and by being a molecular target of anthracyclines, TOP2A aberrations could obviously be associated with cancer drug benefits. In the DBCG 89D, a significant heterogeneity was observed between a beneficial effect on DFS and OS

  20. Repeated Positron Emission Tomography-Computed Tomography and Perfusion-Computed Tomography Imaging in Rectal Cancer: Fluorodeoxyglucose Uptake Corresponds With Tumor Perfusion

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to analyze both the intratumoral fluorodeoxyglucose (FDG) uptake and perfusion within rectal tumors before and after hypofractionated radiotherapy. Methods and Materials: Rectal cancer patients, referred for preoperative hypofractionated radiotherapy (RT), underwent FDG–positron emission tomography (PET)–computed tomography (CT) and perfusion-CT (pCT) imaging before the start of hypofractionated RT and at the day of the last RT fraction. The pCT-images were analyzed using the extended Kety model, quantifying tumor perfusion with the pharmacokinetic parameters Ktrans, ve, and vp. The mean and maximum FDG uptake based on the standardized uptake value (SUV) and transfer constant (Ktrans) within the tumor were correlated. Also, the tumor was subdivided into eight subregions and for each subregion the mean and maximum SUVs and Ktrans values were assessed and correlated. Furthermore, the mean FDG uptake in voxels presenting with the lowest 25% of perfusion was compared with the FDG uptake in the voxels with the 25% highest perfusion. Results: The mean and maximum Ktrans values were positively correlated with the corresponding SUVs (ρ = 0.596, p = 0.001 and ρ = 0.779, p trans values and SUVs within the subregions (mean, ρ = 0.413, p trans values were found to significantly increase. Conclusion: Highly perfused rectal tumors presented with higher FDG-uptake levels compared with relatively low perfused tumors. Also, intratumor regions with a high FDG uptake demonstrated with higher levels of perfusion than regions with a relatively low FDG-uptake. Early after hypofractionated RT, stable FDG uptake levels were found, whereas tumor perfusion was found to significantly increase.

  1. Weekly chemotherapy as Induction chemotherapy in locally advanced head and neck cancer for patients ineligible for 3 weekly maximum tolerable dose chemotherapy

    OpenAIRE

    Vijay Maruti Patil; Vanita Noronha; Amit Joshi; Vamshi Krishna Muddu; Sachin Dhumal; Supreeta Arya; Shashikant Juvekar; P Pai; Pankaj Chatturvedi; Arvind Chaukar Devendra; Sarbani Ghosh; Anil D′cruz; Prabhash Kumar

    2014-01-01

    Objective: To study the safety and efficacy of weekly chemotherapy as part of induction chemotherapy, in locally advanced head and neck cancer for patients, who are unfit for upfront radical treatment. Materials and Methods: It is a retrospective analysis of on-use weekly chemotherapy as Induction chemotherapy in locally advanced head and neck cancer, who are technically unresectable are unfit for upfront radical treatment. Induction chemotherapy given was a 2 drug combination of paclitaxel (...

  2. Change of SPARC expression after chemotherapy in gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Yong-Yin Gao; Xin-Yuan Zhang; Yi Ba; Ding-Zhi Huang; Ru-Bing Han; Xia Wang; Shao-Hua Ge; Hong-Li Li; Ting Deng; Rui Liu; Ming Bai; Li-Kun Zhou

    2015-01-01

    Objective:The expression of tumor biomarkers may change after chemotherapy. However, whether secreted protein acidic and rich in cysteine (SPARC) expression changes atfer chemotherapy in gastric cancer (GC) is unclear. hTis study investigated the inlfuence of chemotherapy on SPARC expression in GC. Methods:Immunohistochemistry was used to analyze SPARC expression in 132 GC cases (including 54 cases with preoperative chemotherapy and 78 cases without preoperative chemotherapy). SPARC expression of postoperative specimens with and without preoperative chemotherapy was assessed to analyze the inlfuence of chemotherapy on SPARC expression. Results:SPARC was highly expressed in GC compared with the desmoplastic stroma surrounding tumor cells and noncancerous tissues. High SPARC expression was correlated with invasion depth, lymph node, and TNM stage. After chemotherapy, a lower proportion of high SPARC expression was observed in patients with preoperative chemotherapy than in the controls. For 54 patients with preoperative chemotherapy, gross type, histology, depth of invasion, lymph node, TNM stage, and SPARC expression were related to overall survival. Further multivariate analysis showed that lymph node, histology, and SPARC expression atfer chemotherapy were independent prognostic factors. Conclusion:SPARC expression may change after chemotherapy in GC. SPARC expression should be reassessed for patients with GC atfer chemotherapy.

  3. Change of SPARC expression after chemotherapy in gastric cancer

    International Nuclear Information System (INIS)

    The expression of tumor biomarkers may change after chemotherapy. However, whether secreted protein acidic and rich in cysteine (SPARC) expression changes after chemotherapy in gastric cancer (GC) is unclear. This study investigated the influence of chemotherapy on SPARC expression in GC. Immunohistochemistry was used to analyze SPARC expression in 132 GC cases (including 54 cases with preoperative chemotherapy and 78 cases without preoperative chemotherapy). SPARC expression of postoperative specimens with and without preoperative chemotherapy was assessed to analyze the influence of chemotherapy on SPARC expression. SPARC was highly expressed in GC compared with the desmoplastic stroma surrounding tumor cells and noncancerous tissues. High SPARC expression was correlated with invasion depth, lymph node, and TNM stage. After chemotherapy, a lower proportion of high SPARC expression was observed in patients with preoperative chemotherapy than in the controls. For 54 patients with preoperative chemotherapy, gross type, histology, depth of invasion, lymph node, TNM stage, and SPARC expression were related to overall survival. Further multivariate analysis showed that lymph node, histology, and SPARC expression after chemotherapy were independent prognostic factors. SPARC expression may change after chemotherapy in GC. SPARC expression should be reassessed for patients with GC after chemotherapy

  4. Drug cocktail optimization in chemotherapy of cancer.

    Directory of Open Access Journals (Sweden)

    Saskia Preissner

    Full Text Available BACKGROUND: In general, drug metabolism has to be considered to avoid adverse effects and ineffective therapy. In particular, chemotherapeutic drug cocktails strain drug metabolizing enzymes especially the cytochrome P450 family (CYP. Furthermore, a number of important chemotherapeutic drugs such as cyclophosphamide, ifosfamide, tamoxifen or procarbazine are administered as prodrugs and have to be activated by CYP. Therefore, the genetic variability of these enzymes should be taken into account to design appropriate therapeutic regimens to avoid inadequate drug administration, toxicity and inefficiency. OBJECTIVE: The aim of this work was to find drug interactions and to avoid side effects or ineffective therapy in chemotherapy. DATA SOURCES AND METHODS: Information on drug administration in the therapy of leukemia and their drug metabolism was collected from scientific literature and various web resources. We carried out an automated textmining approach. Abstracts of PubMed were filtered for relevant articles using specific keywords. Abstracts were automatically screened for antineoplastic drugs and their synonyms in combination with a set of human CYPs in title or abstract. RESULTS: We present a comprehensive analysis of over 100 common cancer treatment regimens regarding drug-drug interactions and present alternatives avoiding CYP overload. Typical concomitant medication, e.g. antiemetics or antibiotics is a preferred subject to improvement. A webtool, which allows drug cocktail optimization was developed and is publicly available on http://bioinformatics.charite.de/chemotherapy.

  5. Radiation-induced myocardial perfusion abnormalities in breast cancer patients following external beam radiation therapy

    Directory of Open Access Journals (Sweden)

    Mohammad Eftekhari

    2015-01-01

    Full Text Available Objective(s: Radiation therapy for breast cancer can induce myocardial capillary injury and increase cardiovascular morbidity and mortality. A prospective cohort was conducted to study the prevalence of myocardial perfusion abnormalities following radiation therapy of left-sided breast cancer patients as compared to those with right–sided cancer. Methods: To minimize potential confounding factors, only those patients with low 10-year risk of coronary artery disease (based on Framingham risk scoring were included. All patients were initially treated by modified radical mastectomy and then were managed by postoperative 3D Conformal Radiation Therapy (CRT to the surgical bed with an additional 1-cm margin, delivered by 46-50 Gy (in 2 Gy daily fractions over a 5-week course. The same dose-adjusted chemotherapy regimen (including anthracyclines, cyclophosphamide and taxol was given to all patients. Six months after radiation therapy, all patients underwent cardiac SPECT for the evaluation of myocardial perfusion. Results: A total of 71 patients with a mean age of 45.3±7.2 years [35 patients with leftsided breast cancer (exposed and 36 patients with right-sided cancer (controls] were enrolled. Dose-volume histogram (DVH [showing the percentage of the heart exposed to >50% of radiation] was significantly higher in patients with left-sided breast cancer. Visual interpretation detected perfusion abnormalities in 42.9% of cases and 16.7% of controls (P=0.02, Odds ratio=1.46. In semiquantitative segmental analysis, only apical (28.6% versus 8.3%, P=0.03 and anterolateral (17.1% versus 2.8%, P=0.049 walls showed significantly reduced myocardial perfusion in the exposed group. Summed Stress Score (SSS of>3 was observed in twelve cases (34.3%, while in five of the controls (13.9%,(Odds ratio=1.3. There was no significant difference between the groups regarding left ventricular ejection fraction. Conclusion: The risk of radiation induced myocardial

  6. Perfusion study in the pulmonary hilar region by SPECT

    International Nuclear Information System (INIS)

    Alveoli in the hilar region comprise the peripheral area containing daughter branches from subsegmental or one more divisional peripheral bronchi. Pulmonary perfusion in hilar region was examined by SPECT (single photon emission CT) in ten normal volunteers. ROI (region of interest) in the axial images were set in the hilar region, the upper, middle and lower lung fields with 10.8 mm thickness. Counts/one pixel (C/P) were calculated in these ROI. There was a tendency of C/P increase from upper to lower lung field. And there were no significant differences in C/P increase between hilar region and other axial fields. In the chronic obstructive pulmonary diseases, however, ventilation studies in the previous reports using Xe dynamic CT or PET (positron emission tomography) showed differences between outer region and hilar region. This method will be expected to evaluate the pulmonary perfusion not only in the whole lung but in different lung areas, including the hilar region in the chronic obstructive pulmonary diseases. (author)

  7. Anticoagulation in combination with antiangiogenesis and chemotherapy for cancer patients: evidence and hypothesis

    Directory of Open Access Journals (Sweden)

    Wang J

    2016-07-01

    Full Text Available Ji Wang, Chengchu Zhu Department of Cardiothoracic Surgery, Taizhou Hospital, Wenzhou Medical University, Linhai, Zhejiang, People’s Republic of China Abstract: Hypercoagulable state and disorganized angiogenesis are two conspicuous characteristics during tumor progression. There are a considerable number of clinical trials focusing on the effects of anticoagulant and antiangiogenic drugs on the survival of cancer patients. Favorable outcomes have been observed. Excessive blood coagulation not only causes cancer-associated thrombosis, which is a common complication and is the second leading cause of death in patients, but also decreases intratumoral perfusion rates and drug delivery by reducing the effective cross-sectional area of blood vessels. Meanwhile, structural and functional abnormalities of the tumor microvasculature also compromise convective drug transport and create a hypoxic and acidic microenvironment. Vascular normalization strategy can temporarily recover the abnormal state of tumor vasculature by improving blood density, dilation, and leakiness, resulting in enhanced penetration of chemotherapies and oxygen within a short time window. In this article, we first review the evidence to support the opinion that anticoagulant and antiangiogenic therapy can improve cancer survival through several underlying mechanisms. Next, we speculate on the feasibility and value of the combined strategy and discuss whether such a combination has a synergistic antineoplastic effect in cancer patients by way of increasing blood vessel perfusion and drug distribution. Keywords: tumor microenvironment, anticoagulation, antiangiogenesis, vascular normalization, tumor perfusion

  8. Efficacy and safety of ultrasound-guided continuous hyperthermic intraperitoneal perfusion chemotherapy for the treatment of malignant ascites: a midterm study of 36 patients

    Directory of Open Access Journals (Sweden)

    Wu YB

    2016-01-01

    Full Text Available Yinbing Wu,1,2 Mingxin Pan,1 Shuzhong Cui,2 Mingchen Ba,2 Zulong Chen,2 Qiang Ruan2 1Second Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, 2Treatment Center of Body Cavitary Thermo-Perfusion, Cancer Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, People’s Republic of China Background: This study aimed to evaluate the efficacy and safety of ultrasound-guided continuous hyperthermic intraperitoneal perfusion chemotherapy (CHIPC for the treatment of malignant ascites (MA. Methods: Between July 2011 and June 2013, 36 MA patients were prospectively and consecutively hospitalized for three cycles of elective CHIPC under ultrasound guidance, maintained at a constant flow rate of 400–600 mL/min normal saline containing 5-fluorouracil plus mitomycin or carboplatin and at a constant temperature of 43°C±0.2°C, for 90 minutes. Main outcome measures were ascites resolution, Karnofsky performance status (KPS, and serum tumor biomarkers at 2 weeks after the last cycle of CHIPC. All the patients underwent uneventful CHIPC as scheduled, and vital signs remained stable over CHIPC. Results: At 2 weeks after the last cycle of CHIPC, MA completely and partially resolved in 26 (72.2% patients and eight (22.2% patients, respectively; mean KPS score increased from pretreatment 61±9 to posttreatment 76±9 (P<0.001, and serum carcinoembryonic antigen and carbohydrate antigens 12-5 and 19-9 significantly decreased (all P<0.01. Conclusion: The current study indicated that ultrasound-guided CHIPC is an effective and safe palliative treatment modality for MA with respect to MA resolution, patient’s general well-being, and systemic disease control. The long-term benefit of CHIPC on overall survival remains to be investigated in MA patients. Keywords: continuous hyperthermic intraperitoneal perfusion chemotherapy, malignant ascites, peritoneal carcinomatosis, ultrasound guidance, safety

  9. Pharmacokinetics of concomitant cisplatin and paclitaxel administered by hyperthermic intraperitoneal chemotherapy to patients with peritoneal carcinomatosis from epithelial ovarian cancer

    OpenAIRE

    Ansaloni, L.; Coccolini, F.; Morosi, L; Ballerini, A; Ceresoli, M; Grosso, G.; P. Bertoli; Busci, L M; Lotti, M.; Cambria, F; Pisano, M; Rossetti, D; Frigerio, L; D'Incalci, M; Zucchetti, M

    2014-01-01

    Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) is advised as a treatment option for epithelial ovarian cancer (EOC) with peritoneal carcinomatosis. This study was designed to define the pharmacokinetics of cisplatin (CDDP) and paclitaxel (PTX) administered together during HIPEC. Methods: Thirteen women with EOC underwent cytoreductive surgery (CRS) and HIPEC, with CDDP and PTX. Blood, peritoneal perfusate and tissue samples were harvested to determine drug exposure by high-perf...

  10. Is it relevant that intra-arterial chemotherapy may be effective for advanced pancreatic cancer?

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Unresectable pancreatic cancers have an extremely dismal prognosis and chemoresistant nature. The treatment of pancreatic cancer is still problematic.Gemcitabine is a promising new agent that has been studied recently for palliation of advanced pancreatic cancer. However, the response rates have been highly variable, and are often irreproducible. To improve this low response rate, various treatments are needed because no standard treatment exists. Intra-arterial chemotherapy is considered to take advantage of the first pass effect of the drug, generating higher local drug concentrations in tumor cells with lower toxicity.Regional intra-arterial chemotherapy may provide high levels of cytostatic concentrations within the tumor and, simultaneously, a low rate of systemic side effects compared with systemic administration of anti-neoplastic drugs. Intra-arterial chemotherapy has been introduced as an alternative treatment for advanced pancreatic cancer. Further clinical trials of this method should be subjected to a prospective randomized controlled study for advanced pancreatic cancer.

  11. A Review of Cancer Chemotherapy for Pet Animals

    OpenAIRE

    Norris, A. M.; Withrow, S.J.

    1984-01-01

    A review of the principles of cancer chemotherapy for pet animals is presented. The various pharmacological classes of antineoplastic drugs are described with specific references to those drugs that have been widely used in veterinary medicine.

  12. Combining Chemotherapy with Bevacizumab Improves Outcomes for Ovarian Cancer Patients

    Science.gov (United States)

    Results from two phase III randomized clinical trials suggest that, at least for some patients with ovarian cancer, adding the antiangiogenesis agent bevacizumab to chemotherapy increases the time to disease progression and may improve survival.

  13. Preoperative Chemotherapy, Radiation Improve Survival in Esophageal Cancer (Updated)

    Science.gov (United States)

    Patients with esophageal cancer who received chemotherapy and radiation before surgery survived, on average, nearly twice as long as patients treated with surgery alone, according to results of a randomized clinical trial published May 31, 2012, in NEJM.

  14. Natural health products and cancer chemotherapy and radiation therapy

    OpenAIRE

    Doreen Oneschuk; Jawaid Younus

    2011-01-01

    Complementary therapies, notably natural health products such as herbs and vitamins, are frequently used by cancer patients receiving chemotherapy and radiation therapy. There is much controversy as to whether these natural health products should be taken during conventional cancer treatments. Supporters of this practice cite beneficial effects of the antioxidant properties, while opponents are concerned about the potential for natural health product-chemotherapy/radiation related negative in...

  15. Assessing the Early Response of Advanced Cervical Cancer to Neoadjuvant Chemotherapy Using Intravoxel Incoherent Motion Diffusion-weighted Magnetic Resonance Imaging: A Pilot Study

    OpenAIRE

    Yan-Chun Wang; Dao-Yu Hu; Xue-Mei Hu; Ya-Qi Shen; Xiao-Yan Meng; Hao Tang; Zhen Li

    2016-01-01

    Background: Diffusion-weighted imaging (DWI) with the intravoxel incoherent motion (IVIM) model has shown promising results for providing both diffusion and perfusion information in cervical cancer; however, its use to predict and monitor the efficacy of neoadjuvant chemotherapy (NACT) in cervical cancer is relatively rare. The study aimed to evaluate the use of DWI with IVIM and monoexponential models to predict and monitor the efficacy of NACT in cervical cancer. Methods: Forty-two pati...

  16. Natural health products and cancer chemotherapy and radiation therapy

    Directory of Open Access Journals (Sweden)

    Doreen Oneschuk

    2011-12-01

    Full Text Available Complementary therapies, notably natural health products such as herbs and vitamins, are frequently used by cancer patients receiving chemotherapy and radiation therapy. There is much controversy as to whether these natural health products should be taken during conventional cancer treatments. Supporters of this practice cite beneficial effects of the antioxidant properties, while opponents are concerned about the potential for natural health product-chemotherapy/radiation related negative interactions. This involves understanding the role and effect on metabolizing enzymes. This review will highlight the present evidence for both the beneficial and negative consequences of the use of natural health products during chemotherapy and radiation therapy.

  17. Immune Modulation by Chemotherapy or Immunotherapy to Enhance Cancer Vaccines

    Directory of Open Access Journals (Sweden)

    Marc Mansour

    2011-08-01

    Full Text Available Chemotherapy has been a mainstay in cancer treatment for many years. Despite some success, the cure rate with chemotherapy remains unsatisfactory in some types of cancers, and severe side effects from these treatments are a concern. Recently, understanding of the dynamic interplay between the tumor and immune system has led to the development of novel immunotherapies, including cancer vaccines. Cancer vaccines have many advantageous features, but their use has been hampered by poor immunogenicity. Many developments have increased their potency in pre-clinical models, but cancer vaccines continue to have a poor clinical track record. In part, this could be due to an inability to effectively overcome tumor-induced immune suppression. It had been generally assumed that immune-stimulatory cancer vaccines could not be used in combination with immunosuppressive chemotherapies, but recent evidence has challenged this dogma. Chemotherapies could be used to condition the immune system and tumor to create an environment where cancer vaccines have a better chance of success. Other types of immunotherapies could also be used to modulate the immune system. This review will discuss how immune modulation by chemotherapy or immunotherapy could be used to bolster the effects of cancer vaccines and discuss the advantages and disadvantages of these treatments.

  18. Immune Modulation by Chemotherapy or Immunotherapy to Enhance Cancer Vaccines

    Energy Technology Data Exchange (ETDEWEB)

    Weir, Genevieve M. [Suite 411, 1344 Summer St., Immunovaccine Inc., Halifax, NS, B3H 0A8 (Canada); Room 11-L1, Sir Charles Tupper Building, Department of Microbiology & Immunology, Dalhousie University, 5850 College St, Halifax, NS, B3H 1X5 (Canada); Liwski, Robert S. [Room 11-L1, Sir Charles Tupper Building, Department of Microbiology & Immunology, Dalhousie University, 5850 College St, Halifax, NS, B3H 1X5 (Canada); Room 206E, Dr. D. J. Mackenzie Building, Department of Pathology, Dalhousie University, 5788 University Avenue, Halifax, NS, B3H 2Y9 (Canada); Mansour, Marc [Suite 411, 1344 Summer St., Immunovaccine Inc., Halifax, NS, B3H 0A8 (Canada)

    2011-08-05

    Chemotherapy has been a mainstay in cancer treatment for many years. Despite some success, the cure rate with chemotherapy remains unsatisfactory in some types of cancers, and severe side effects from these treatments are a concern. Recently, understanding of the dynamic interplay between the tumor and immune system has led to the development of novel immunotherapies, including cancer vaccines. Cancer vaccines have many advantageous features, but their use has been hampered by poor immunogenicity. Many developments have increased their potency in pre-clinical models, but cancer vaccines continue to have a poor clinical track record. In part, this could be due to an inability to effectively overcome tumor-induced immune suppression. It had been generally assumed that immune-stimulatory cancer vaccines could not be used in combination with immunosuppressive chemotherapies, but recent evidence has challenged this dogma. Chemotherapies could be used to condition the immune system and tumor to create an environment where cancer vaccines have a better chance of success. Other types of immunotherapies could also be used to modulate the immune system. This review will discuss how immune modulation by chemotherapy or immunotherapy could be used to bolster the effects of cancer vaccines and discuss the advantages and disadvantages of these treatments.

  19. Immune Modulation by Chemotherapy or Immunotherapy to Enhance Cancer Vaccines

    International Nuclear Information System (INIS)

    Chemotherapy has been a mainstay in cancer treatment for many years. Despite some success, the cure rate with chemotherapy remains unsatisfactory in some types of cancers, and severe side effects from these treatments are a concern. Recently, understanding of the dynamic interplay between the tumor and immune system has led to the development of novel immunotherapies, including cancer vaccines. Cancer vaccines have many advantageous features, but their use has been hampered by poor immunogenicity. Many developments have increased their potency in pre-clinical models, but cancer vaccines continue to have a poor clinical track record. In part, this could be due to an inability to effectively overcome tumor-induced immune suppression. It had been generally assumed that immune-stimulatory cancer vaccines could not be used in combination with immunosuppressive chemotherapies, but recent evidence has challenged this dogma. Chemotherapies could be used to condition the immune system and tumor to create an environment where cancer vaccines have a better chance of success. Other types of immunotherapies could also be used to modulate the immune system. This review will discuss how immune modulation by chemotherapy or immunotherapy could be used to bolster the effects of cancer vaccines and discuss the advantages and disadvantages of these treatments

  20. The role of neoadjuvant chemotherapy for breast cancer treatment.

    Science.gov (United States)

    Ikeda, Tadashi; Jinno, Hiromitsu; Matsu, Akira; Masamura, Shigeru; Kitajima, Masaki

    2002-01-01

    Neoadjuvant chemotherapy has become popular, especially for patients with advanced breast cancer. The pros and cons of neoadjuvant chemotherapy for treating breast cancer patients are reviewed. The advantages of neoadjuvant chemotherapy are 1) overall survival and recurrence-free survival rate are the same as post-operative chemotherapy, 2) serves as an in vivo sensitivity test, 3) increases the rate of breast conserving therapy, 4) facilitates the study of cancer biology. On the other hand, the disadvantages of neoadjuvant chemotherapy are 1) it modifies the stage, 2) treatment delay of PD cases, 3) residual intraductal component may be left behind after breast conserving surgery, 4) there are some cases of over-treatment. Combination chemotherapy is one possible way to increase the pathological CR rate, although the optimal order and cycles have not been determined. To avoid residual cancer cells after breast conserving surgery, the shrinkage pattern should be evaluated by MRI. Core needle biopsy should be performed before neoadjuvant chemotherapy to avoid over-treatment. It is essential to develop more effective regimens and stratify patients based on predictive factors. PMID:12196715

  1. Recent advances in the pharmacogenetics of cancer chemotherapy.

    Science.gov (United States)

    Watters, James W; McLeod, Howard L

    2002-12-01

    Patient response to chemotherapy varies widely between individuals. Pharmacogenetics is the study of inherited DNA polymorphisms that influence drug disposition and effects, the goal of which is the individualization of drug treatment. As unpredictable efficacy and high levels of systemic toxicity are common in cancer chemotherapy, pharmacogenetics is particularly appealing for oncology. Recent studies have shown that polymorphisms in genes involved in drug metabolism, nucleotide synthesis and DNA repair contribute to inter-patient variability in the efficacy and toxicity of many chemotherapy agents. This review will discuss recent developments in the most clinically relevant examples of cancer pharmacogenetics, and how genetic differences among individuals are shaping the future of cancer chemotherapy. PMID:12596358

  2. Chemotherapy-related cognitive impairment in older patients with cancer

    Science.gov (United States)

    Loh, Kah Poh; Janelsins, Michelle C.; Mohile, Supriya G.; Holmes, Holly M.; Hsu, Tina; Inouye, Sharon K.; Karuturi, Meghan S.; Kimmick, Gretchen G.; Lichtman, Stuart M.; Magnuson, Allison; Whitehead, Mary I.; Wong, Melisa L.; Ahles, Tim A.

    2016-01-01

    Chemotherapy-related cognitive impairment (CRCI) can occur during or after chemotherapy and represents a concern for many patients with cancer. Among older patients with cancer, in whom there is little clinical trial evidence examining side effects like CRCI, many unanswered questions remain regarding risk for and resulting adverse outcomes from CRCI. Given the rising incidence of cancer with age, CRCI is of particular concern for older patients with cancer who receive treatment. Therefore, research related to CRCI in older patients with cancers is a high priority. In this manuscript, we discuss current gaps in research highlighting the lack of clinical studies of CRCI in older adults, the complex mechanisms of CRCI, and the challenges in measuring cognitive impairment in older patients with cancer. Although we focus on CRCI, we also discuss cognitive impairment related to cancer itself and other treatment modalities. We highlight several research priorities to improve the study of CRCI in older patients with cancer. PMID:27197918

  3. Comparison of Intrahepatic and Pancreatic Perfusion on Fusion Images Using a Combined SPECT/CT System and Assessment of Efficacy of Combined Continuous Arterial Infusion and Systemic Chemotherapy in Advanced Pancreatic Carcinoma

    International Nuclear Information System (INIS)

    Purpose. The purpose of this study was to compare intrahepatic and pancreatic perfusion on fusion images using a combined single-photon emission computed tomography (SPECT)/CT system and to evaluate the efficacy of combined continuous transcatheter arterial infusion (CTAI) and systemic chemotherapy in the treatment of advanced pancreatic carcinoma. Materials and Methods. CTAI was performed in 33 patients (22 men, 11 women; age range, 35-77 years; mean age, 60 years) with stage IV pancreatic cancer with liver metastasis. The reservoir was transcutaneously implanted with the help of angiography. The systemic administration of gemcitabine was combined with the infusion of 5-fluorouracil via the reservoir. In all patients we obtained fusion images using a combined SPECT/CT system. Pancreatic perfusion on fusion images was classified as perfusion presence or as perfusion absent in the pancreatic cancer. Using WHO criteria we recorded the tumor response after 3 months on multislice helical CT scans. Treatment effects were evaluated based on the pancreatic cancer, liver metastasis, and factors such as intrahepatic and pancreatic perfusion on fusion images. For statistical analysis we used the chi-square test; survival was evaluated by the Kaplan Meier method (log-rank test). Results. On fusion images, pancreatic and intrahepatic perfusion was recorded as hot spot and as homogeneous distribution, respectively, in 18 patients (55%) and as cold spot and heterogeneous distribution, respectively, in 15 (45%). Patients with hot spot in the pancreatic tumor and homogeneous distribution in the liver manifested better treatment results (p < 0.05 and p < 0.01, respectively). Patients with hot spot both in the pancreatic cancer and in the liver survived longer than those with cold spot in the pancreatic cancer and heterogeneous distribution in the liver (median ± SD, 16.0 ± 3.7 vs. 8.0 ± 1.4 months; p < 0.05). Conclusions. We conclude that in patients with advanced pancreatic

  4. Deriving the Intrahepatic Arteriovenous Shunt Rate from CT Images and Biochemical Data Instead of from Arterial Perfusion Scintigraphy in Hepatic Arterial Infusion Chemotherapy

    International Nuclear Information System (INIS)

    The purpose of the present study was to elucidate a method for predicting the intrahepatic arteriovenous shunt rate from computed tomography (CT) images and biochemical data, instead of from arterial perfusion scintigraphy, because adverse exacerbated systemic effects may be induced in cases where a high shunt rate exists. CT and arterial perfusion scintigraphy were performed in patients with liver metastases from gastric or colorectal cancer. Biochemical data and tumor marker levels of 33 enrolled patients were measured. The results were statistically verified by multiple regression analysis. The total metastatic hepatic tumor volume (Vmetastasized), residual hepatic parenchyma volume (Vresidual; calculated from CT images), and biochemical data were treated as independent variables; the intrahepatic arteriovenous (IHAV) shunt rate (calculated from scintigraphy) was treated as a dependent variable. The IHAV shunt rate was 15.1 ± 11.9%. Based on the correlation matrixes, the best correlation coefficient of 0.84 was established between the IHAV shunt rate and Vmetastasized (p 2) was 0.75, which was significant at the 0.1% level with two significant independent variables (Vmetastasized and Vresidual). The standardized regression coefficients (β) of Vmetastasized and Vresidual were significant at the 0.1 and 5% levels, respectively. Based on this result, we can obtain a predicted value of IHAV shunt rate (p < 0.001) using CT images. When a high shunt rate was predicted, beneficial and consistent clinical monitoring can be initiated in, for example, hepatic arterial infusion chemotherapy.

  5. Changes in regional ventilation and perfusion of the lung after endoscopic laser treatment.

    OpenAIRE

    P. J. George; Clarke, G; Tolfree, S; Garrett, C P; Hetzel, M R

    1990-01-01

    To determine whether endoscopic laser treatment improves both ventilation and perfusion in patients with advanced lung cancer, krypton-81m ventilation and technetium-99m labelled macro-aggregate perfusion scanning was performed immediately before and two or four days after treatment in a consecutive series of 28 patients. Twelve patients had not received any other treatment before laser therapy and 16 had undergone previous treatments that included radiotherapy. Ventilation and perfusion were...

  6. Regional cortical hyper perfusion on perfusion CT during postical motor deficit: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Baik, Hye Jin [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2013-08-15

    Postictal neurologic deficit is a well-known complication mimicking the manifestation of a stroke. We present a case of a patient with clinical evidence of Todd's paralysis correlating with reversible postictal parenchymal changes on perfusion CT and magnetic resonance (MR) imaging. In this case, perfusion CT and MR imaging were helpful in the differential diagnosis of stroke-mimicking conditions.

  7. Long-term results of low dose daily cisplatin chemotherapy used concurrently with modestly accelerated radiotherapy in locally advanced squamous cell carcinomas of the head neck cancer region

    Directory of Open Access Journals (Sweden)

    Pramod Kumar Gupta

    2014-01-01

    Full Text Available Introduction: Concurrent single agent cisplatin (CDDP with radiotherapy (RT improves outcomes in locally advanced squamous cell carcinomas of the head neck (LA-SCCHN. CDDP at 100 mg/m 2 at 3 weekly intervals raise compliance, hospitalization, and supportive care issues. Low dose daily CDDP was delivered with RT to evaluate its compliance, long-term safety and efficacy. Patients and Methods: During the period of month between November 2005 and May 2007, 52 patients of stage III/IV LA-SCCHN were given with conventional RT in a phased manner (dose-70 Gy/35 fractions/6 weeks along with daily CDDP (6 mg/m 2 ; capped 10 mg-30 cycles over 6 weeks. No hospitalization or antiemetic cover was planned. Compliance, acute and late toxicity were recorded as per Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer grading system and survival outcomes were evaluated. Results : The median follow-up was 63 months. 43 (83% cases complied with RT schedule and >28 cycles of CDDP was administered in 38 (73% cases. Confluent mucositis was seen in 65%, Grade III/IV dysphagia in 67%; 77% required enteral feed and hospitalization in 15%. There were four treatment related deaths. At 5 years, the loco-regional control was 25% (median-11 months and the overall survival was 31% (median-11 months. The 5 years actuarial rates of late Grade III/IV toxicity was 24%. Late swallowing difficulty/aspiration were seen in 17%; xerostomia-40%; ototoxicity-6%; nephrotoxicity-4%; and no second malignancy. Conclusion: Low dose cisplatin with moderately accelerated RT schedule appears feasible and logistically suitable "out-patient" option without increasing long-term toxicity in LA-SCCHN cancer region.

  8. Breast Cancer Patients’ Cognitive Functioning Before and After Chemotherapy

    DEFF Research Database (Denmark)

    Andersen, Christina Maar; Pedersen, Anette Fischer; Mehlsen, Mimi Yung;

    evidence concerning cognitive functioning of breast cancer patients before and after chemotherapy. Methods: The databases PubMed and SSCI were searched for articles on the cognitive functioning of breast cancer patients receiving chemotherapy. The search took place from August to December 2010 and extended...... patients who were to receive chemotherapy scored higher on executive function than the controls (effect size (ES)=-0.202, p=0.011), but significantly lower on overall cognitive functioning as well as on the specific domains of attention, working memory, verbal learning and memory, motor function, visual...... learning and memory and visuospatial function (ES=0.248 to 0.407, p=0.000 to 0.010). Post-treatment, the patients who had received chemotherapy continued to score significantly lower than the controls on overall cognitive functioning and on the same specific domains as before treatment (ES=0.189 to 0...

  9. Factors affecting receipt of chemotherapy in women with breast cancer

    Directory of Open Access Journals (Sweden)

    Libby Morimoto

    2010-05-01

    Full Text Available Libby Morimoto1, Jenna Coalson1, Fionna Mowat1, Cynthia O’Malley21Exponent Health Sciences, Menlo Park, CA, USA; 2Amgen Global Epidemiology, Thousand Oaks, CA, USAAims: To review literature describing factors associated with receipt of chemotherapy for breast cancer, to better understand what factors are most relevant to women’s health and whether health disparities are apparent, and to assess how these factors might affect observational studies and outcomes research. Patterns of care for metastatic breast cancer, for which no standard-of-care exists, were of particular interest.Methods: Relevant studies written in English, Italian, French, or Spanish, published in 2000 or later, were identified through MEDLINE and reviewed. Review articles and clinical trials were excluded; all observational studies and surveys were considered. Articles were reviewed for any discussion of patient characteristics, hospital/physician/insurance characteristics, psychosocial characteristics, and clinical characteristics affecting receipt of chemotherapy by breast cancer patients.Results: In general, factors associated with increased likelihood of receiving chemotherapy included younger age, being Caucasian, having good general health and few co-morbidities, having more severe clinical disease, having responded well to previous treatment, and having breast cancer that is estrogen- or progesterone-receptor-negative. Many of the clinical factors found to increase the likelihood of receiving chemotherapy were consistent with current oncology guidelines. Of the relevant 19 studies identified, only six (32% reported data specific to metastatic cancer; most studies aggregated women with stage I–IV for purposes of analysis.Conclusion: Studies of patterns of care in breast cancer treatment can help identify challenges in health care provided to particular subgroups of women and can aid researchers in designing studies that account for such factors in clinical and

  10. Anticoagulation in combination with antiangiogenesis and chemotherapy for cancer patients: evidence and hypothesis.

    Science.gov (United States)

    Wang, Ji; Zhu, Chengchu

    2016-01-01

    Hypercoagulable state and disorganized angiogenesis are two conspicuous characteristics during tumor progression. There are a considerable number of clinical trials focusing on the effects of anticoagulant and antiangiogenic drugs on the survival of cancer patients. Favorable outcomes have been observed. Excessive blood coagulation not only causes cancer-associated thrombosis, which is a common complication and is the second leading cause of death in patients, but also decreases intratumoral perfusion rates and drug delivery by reducing the effective cross-sectional area of blood vessels. Meanwhile, structural and functional abnormalities of the tumor microvasculature also compromise convective drug transport and create a hypoxic and acidic microenvironment. Vascular normalization strategy can temporarily recover the abnormal state of tumor vasculature by improving blood density, dilation, and leakiness, resulting in enhanced penetration of chemotherapies and oxygen within a short time window. In this article, we first review the evidence to support the opinion that anticoagulant and antiangiogenic therapy can improve cancer survival through several underlying mechanisms. Next, we speculate on the feasibility and value of the combined strategy and discuss whether such a combination has a synergistic antineoplastic effect in cancer patients by way of increasing blood vessel perfusion and drug distribution. PMID:27536135

  11. [Prevention and management of appetite loss during cancer chemotherapy].

    Science.gov (United States)

    Tsujimura, Hideki; Yamada, Mitsugi; Asako, Eri; Kodama, Yukako; Sato, Tsuneo; Nabeya, Yoshihiro

    2014-10-01

    Appetite loss during cancer chemotherapy may lead to malnutrition and a decreased quality of life. To overcome this problem, evidence-based guidelines have been established for chemotherapy-induced emesis and mucositis. However, unsolved issues such as taste alimentation remain. Since the clinical picture of appetite loss is complex, individual management strategies depending on the type of the disease and treatment are required. PMID:25335699

  12. Investigation of Nausea and Vomiting in Cancer Patients Undergoing Chemotherapy

    OpenAIRE

    Maria Lavdaniti; Nikolaos Tsitsis

    2014-01-01

    Nausea and vomiting are the most important problems in patients undergoing chemotherapy, despite the recent improvements in the administration of antiemetic drugs. Through a review of the literature, we found that there are several nursing researches focusing on the effectiveness of interventions for the treatment of nausea and vomiting in cancer patients. The purpose of this study was to investigate the symptom of nausea and vomiting in patients undergoing chemotherapy. The study also invest...

  13. Technetium-99m labelled macroaggregated albumin arterial catheter perfusion scintigraphy: prediction of gastrointestinal toxicity in hepatic arterial chemotherapy.

    Science.gov (United States)

    Pelosi, E; Masaneo, I; Clara, R; Valetto, M R; Bellò, M; Zanon, C; Chiappino, I; Grosso, M; Mussa, A; Bisi, G

    2000-06-01

    Gastrointestinal toxicity from hepatic arterial infusion (HAI) of floxuridine in patients with liver metastases is probably due to extrahepatic perfusion or to partial escape of the drug from first-pass liver extraction. The aim of this study was to verify the role of technetium-99m-labelled macroaggregated albumin (99mTc-MAA) arterial catheter perfusion scintigraphy at the beginning of each chemotherapy cycle in decreasing or preventing gastrointestinal toxicity. We studied 167 consecutive patients. On the basis of the scintigraphic follow-up and the presence or absence of an intrahepatic arteriovenous shunt (IHAVS), we classified our patients into the following groups: (1) FU+ hepatic distribution pattern (DP), comprising 29 patients with regular scintigraphic follow-up who showed the expected distribution pattern at each control or a distribution pattern with transient alterations (extrahepatic escape) promptly reversed by the replacement of the catheter. Among these 29 patients there was one case of gastrointestinal toxicity. (2) FU- hepatic DP, comprising 128 patients who were evaluated with 99mTc-MAA only at the beginning of the first chemotherapy cycle, showed the expected distribution pattern and underwent HAI with no further scintigraphic evaluation. Among these 128 patients there were 28 cases of gastrointestinal toxicity. (3) FU+ pulmonary DP, comprising three patients with abnormally elevated pulmonary uptake (higher than 5%) and with regular scintigraphic follow-up. There were two cases of gastrointestinal toxicity among these three patients. (4) FU- pulmonary DP, comprising seven patients with abnormally elevated pulmonary uptake and without regular scintigraphic follow-up. There were four cases of gastrointestinal toxicity among these seven patients. The incidence of toxicity was significantly higher in group FU- hepatic DP than in group FU+ hepatic DP (21.9% vs 3.4%, Pscintigraphic follow-up is useful since it is able to promptly diagnose the

  14. Safety and radiation-enhancing effect of sodium glycididazole in loco regionally advanced laryngeal cancers previously treated with platinum-containing chemotherapy regimens: a preliminary report

    International Nuclear Information System (INIS)

    Purpose: To determine the safety and radiation-enhancing effect of sodium glycididazole in laryngeal squamous cell carcinoma (stage T3-4,N0-3,M0) with conventional radiotherapy. Patients and methods: Patients with locoregional advanced laryngeal cancer (stage T3-4,N0-3,M0) were included: group 1(control, n = 30)were not administered of sodium glycididazole; group 2 (test, n = 30) received sodium glycididazole at a dose of 700 mg/m2 intravenous infusion 30 minutes before radiotherapy three times a week. Surrogate end-points of efficacy were tumor and nodal size. Safety parameters were vomiting, nausea, mucositis, laryngeal edema, esophagus and skin reaction, dysphagia, dyspnea, neurological deficit. Patients were evaluated weekly during treatment for 7 weeks and thereafter monthly for 3 months. Results: In the test, the overall response rate was 88.89% (95% CI, 71.00-97.00%) at 7 weeks and 92.59% (95% CI, 76.00 to 99.00%) at 1 month of follow-up. In the control, the overall response rate was 62.5% (95% CI, 41.00 to 81.00%) at 7 weeks and 58.33% (95% CI, 37.00 to 78.00%) at 1 month of follow-up. The short-term locoregional response rate was better in the test group at 7 weeks (p = 0.027) and at 1 month (p = 0.005) of follow-up. The test group had significantly more nausea and vomiting in weeks 1 (p = 0.047), 2 (p = 0.007), and 3 (p = 0.01) of treatment. Conclusions: The study indicates sodium glycididazole is an effective radiation-enhancing agent that improves short-term locoregional control and is well tolerated in patients with loco regionally advanced laryngeal cancer. (authors)

  15. Neoadjuvant chemotherapy in advanced epithelial ovarian cancer: A survival study

    OpenAIRE

    Upasana Baruah; Debabrata Barmon; Amal Chandra Kataki; Pankaj Deka; Munlima Hazarika; Bhargab J Saikia

    2015-01-01

    Context: Patients with advanced ovarian cancer have a poor prognosis in spite of the best possible care. Primary debulking surgery has been the standard of care in advanced ovarian cancer; however, it is associated with high mortality and morbidity rates as shown in various studies. Several studies have discussed the benefit of neoadjuvant chemotherapy in patients with advanced ovarian cancer. Aims: This study aims to evaluate the survival statistics of the patients who have been managed with...

  16. Cytologic changes of ovarian epithelial cancer induced by neoadjuvant chemotherapy

    OpenAIRE

    Wang, Yiying; Wang, Yue; Zheng, Wenxin

    2013-01-01

    Objective: Neoadjuvant chemotherapy (NACT) followed by cytoreduction has now become a part of standard care for patients with advanced ovarian cancer. Cytologic changes of the cancer cells induced by NACT, however, sometimes may cause confusion in terms of pathologic diagnosis and therefore inappropriate management. The objective of this study was to characterize the histologic or cytologic features of the ovarian cancers from those patients who received NACT in order to improve the diagnosti...

  17. Dynamic volume perfusion CT in patients with lung cancer: Baseline perfusion characteristics of different histological subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Shi, Jingyun, E-mail: shijingyun89179@126.com [Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine (China); Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Schmid-Bindert, Gerald, E-mail: gerald.schmid-bindert@medma.uni-heidelberg.de [Division of Surgical Oncology and Thoracic Surgery, Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Fink, Christian, E-mail: Christian.Fink@akh-celle.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Sudarski, Sonja, E-mail: sonja_sudarski@gmx.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Apfaltrer, Paul, E-mail: Paul.Apfaltrer@medma.uni-heidelberg.de [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Pilz, Lothar R., E-mail: Lothar.Pilz@medma.uni-heidelberg.de [Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1, 68167 Mannheim (Germany); Liu, Bo, E-mail: bo.liu@siemens.com [Siemens Healthcare, No. 278, Zhouzhu Road, Shanghai, 201318 (China); Haberland, Ulrike, E-mail: ulrike.haberland@siemens.com [Siemens Healthcare Sector, H IM CR R and D PA SC, Siemensstraße 1, 91301 Forchheim (Germany); Klotz, Ernst, E-mail: ernst.klotz@siemens.com [Siemens Healthcare Sector, H IM CR R and D PA SC, Siemensstraße 1, 91301 Forchheim (Germany); and others

    2013-12-01

    Objective: To evaluate dynamic volume perfusion CT (dVPCT) tumor baseline characteristics of three different subtypes of lung cancer in untreated patients. Materials and methods: 173 consecutive patients (131 men, 42 women; mean age 61 ± 10 years) with newly diagnosed lung cancer underwent dVPCT prior to biopsy. Tumor permeability, blood flow (BF), blood volume (BV) and mean transit time (MTT) were quantitatively assessed as well as tumor diameter and volume. Tumor subtypes were histologically determined and compared concerning their dVPCT results. dVPCT results were correlated to tumor diameter and volume. Results: Histology revealed adenocarcinoma in 88, squamous cell carcinoma in 54 and small cell lung cancer (SCLC) in 31 patients. Tumor permeability was significantly differing between adenocarcinoma, squamous cell carcinoma and SCLC (all p < 0.05). Tumor BF and BV were higher in adenocarcinomathan in SCLC (p = 0.001 and p = 0.0002 respectively). BV was also higher in squamous cell carcinoma compared to SCLC (p = 0.01). MTT was not differing between tumor subtypes. Regarding all tumors, tumor diameter did not correlate with any of the dVPCT parameters, whereas tumor volume was negatively associated with permeability, BF and BV (r = −0.22, −0.24, −0.24, all p < 0.05). In squamous cell carcinoma, tumor diameter und volume correlated with BV (r = 0.53 and r = −0.40, all p < 0.05). In SCLC, tumor diameter und volume correlated with MTT (r = 0.46 and r = 0.39, all p < 0.05). In adenocarcinoma, no association between morphological and functional tumor characteristics was observed. Conclusions: dVPCT parameters are only partially related to tumor diameter and volume and are significantly differing between lung cancer subtypes.

  18. Dynamic volume perfusion CT in patients with lung cancer: Baseline perfusion characteristics of different histological subtypes

    International Nuclear Information System (INIS)

    Objective: To evaluate dynamic volume perfusion CT (dVPCT) tumor baseline characteristics of three different subtypes of lung cancer in untreated patients. Materials and methods: 173 consecutive patients (131 men, 42 women; mean age 61 ± 10 years) with newly diagnosed lung cancer underwent dVPCT prior to biopsy. Tumor permeability, blood flow (BF), blood volume (BV) and mean transit time (MTT) were quantitatively assessed as well as tumor diameter and volume. Tumor subtypes were histologically determined and compared concerning their dVPCT results. dVPCT results were correlated to tumor diameter and volume. Results: Histology revealed adenocarcinoma in 88, squamous cell carcinoma in 54 and small cell lung cancer (SCLC) in 31 patients. Tumor permeability was significantly differing between adenocarcinoma, squamous cell carcinoma and SCLC (all p < 0.05). Tumor BF and BV were higher in adenocarcinomathan in SCLC (p = 0.001 and p = 0.0002 respectively). BV was also higher in squamous cell carcinoma compared to SCLC (p = 0.01). MTT was not differing between tumor subtypes. Regarding all tumors, tumor diameter did not correlate with any of the dVPCT parameters, whereas tumor volume was negatively associated with permeability, BF and BV (r = −0.22, −0.24, −0.24, all p < 0.05). In squamous cell carcinoma, tumor diameter und volume correlated with BV (r = 0.53 and r = −0.40, all p < 0.05). In SCLC, tumor diameter und volume correlated with MTT (r = 0.46 and r = 0.39, all p < 0.05). In adenocarcinoma, no association between morphological and functional tumor characteristics was observed. Conclusions: dVPCT parameters are only partially related to tumor diameter and volume and are significantly differing between lung cancer subtypes

  19. Role of perfusion SPECT in prediction and measurement of pulmonary complications after radiotherapy for lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Farr, Katherina P.; Khalil, Azza A.; Grau, Cai [Aarhus University Hospital, Department of Oncology, Aarhus C (Denmark); Kramer, Stine; Morsing, Anni [Aarhus University Hospital, Department of Nuclear Medicine and PET Centre, Aarhus C (Denmark)

    2015-07-15

    The purpose of the study was to evaluate the ability of baseline perfusion defect score (DS) on SPECT to predict the development of severe symptomatic radiation pneumonitis (RP) and to evaluate changes in perfusion on SPECT as a method of lung perfusion function assessment after curative radiotherapy (RT) for non-small-cell lung cancer (NSCLC). Patients with NSCLC undergoing curative RT were included prospectively. Perfusion SPECT/CT and global pulmonary function tests (PFT) were performed before RT and four times during follow-up. Functional activity on SPECT was measured using a semiquantitative perfusion DS. Pulmonary morbidity was graded by the National Cancer Institute's Common Terminology Criteria for Adverse Events version 4 for pneumonitis. Patients were divided into two groups according to the severity of RP. A total of 71 consecutive patients were included in the study. Baseline DS was associated with chronic obstructive pulmonary disease. A significant inverse correlation was found between baseline DS and forced expiratory volume in 1 s and diffusing capacity of the lung for carbon monoxide. Patients with severe RP had significantly higher baseline total lung DS (mean 5.43) than those with no or mild symptoms (mean DS 3.96, p < 0.01). PFT results were not different between these two groups. The odds ratio for total lung DS was 7.8 (95 % CI 1.9 - 31) demonstrating the ability of this parameter to predict severe RP. Adjustment for other potential confounders known to be associated with increased risk of RP was performed and did not change the odds ratio. The median follow-up time after RT was 8.4 months. The largest DS increase of 13.3 % was associated with severe RP at 3 months of follow-up (p < 0.01). The development of severe RP during follow-up was not associated with changes in PFT results. Perfusion SPECT is a valuable method for predicting severe RP and for assessing changes in regional functional perfusion after curative RT comparable with

  20. Role of perfusion SPECT in prediction and measurement of pulmonary complications after radiotherapy for lung cancer

    International Nuclear Information System (INIS)

    The purpose of the study was to evaluate the ability of baseline perfusion defect score (DS) on SPECT to predict the development of severe symptomatic radiation pneumonitis (RP) and to evaluate changes in perfusion on SPECT as a method of lung perfusion function assessment after curative radiotherapy (RT) for non-small-cell lung cancer (NSCLC). Patients with NSCLC undergoing curative RT were included prospectively. Perfusion SPECT/CT and global pulmonary function tests (PFT) were performed before RT and four times during follow-up. Functional activity on SPECT was measured using a semiquantitative perfusion DS. Pulmonary morbidity was graded by the National Cancer Institute's Common Terminology Criteria for Adverse Events version 4 for pneumonitis. Patients were divided into two groups according to the severity of RP. A total of 71 consecutive patients were included in the study. Baseline DS was associated with chronic obstructive pulmonary disease. A significant inverse correlation was found between baseline DS and forced expiratory volume in 1 s and diffusing capacity of the lung for carbon monoxide. Patients with severe RP had significantly higher baseline total lung DS (mean 5.43) than those with no or mild symptoms (mean DS 3.96, p < 0.01). PFT results were not different between these two groups. The odds ratio for total lung DS was 7.8 (95 % CI 1.9 - 31) demonstrating the ability of this parameter to predict severe RP. Adjustment for other potential confounders known to be associated with increased risk of RP was performed and did not change the odds ratio. The median follow-up time after RT was 8.4 months. The largest DS increase of 13.3 % was associated with severe RP at 3 months of follow-up (p < 0.01). The development of severe RP during follow-up was not associated with changes in PFT results. Perfusion SPECT is a valuable method for predicting severe RP and for assessing changes in regional functional perfusion after curative RT comparable with

  1. Chemotherapy and anti-angiogenic drugs affect composition and coagulant phenotype of cell-derived vesicles in cancer patients

    NARCIS (Netherlands)

    Kleinjan, A.; Verhoeff, J.; Berckmans, R.; Kunst, P.; Van Doormaal, F.; Di Nisio, M.; Richel, D.; Kamphuisen, P.W.; Büller, H.R.; Nieuwland, R.

    2013-01-01

    Background: The relationship between chemotherapy and circulating microparticles in patients with cancer is complex. First, release of cancer cell-derived microparticles may contribute to resistance of cancer cells to chemotherapy. Second, chemotherapy and angiogenesis inhibiting agents promote a pr

  2. Targeting chemotherapy via arterial infusion for advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Zhi-yu CAO

    2011-10-01

    Full Text Available Objective To evaluate the clinical effects of chemotherapy via arterial infusion in treatment of advanced gastric cancer.Methods Forty-seven patients with advanced gastric cancer were given chemotherapy via arterial infusion.Chemotherapy plan was as follows: 5-Fluorouracil(Fu 500mg/m2,cyclophosphamide(MMX 10mg/m2,Hydroxycamptothecin(HPT 20mg/m2,once per week,2 weeks as a course,a total of 2-3 courses.Results After chemotherapy via arterial infusion,complete remission(CR was achieved in 1 case,partial remission(PR in 28 cases,stabilization of disease(SD in 16 cases,progression of disease(PD was found in 2 cases,and rate with response(CR+PR was 61.7%.Four of 28 PR patients underwent tumorectomy,the pathology revealed the presence of cancer cells around the vascular vessels,manifesting karyopyknosis,karyorrhexis,coagulation and necrosis of cytoplasm,intercellular edema,hyperplasia of fibroblasts,inflammatory cell infiltration,thickening of endothelium,and thrombosis.One,two and three-year survival rates were 70.2%,14.9% and 2.1%,respectively.The average survival period was 17.2 months.Conclusion Targeting chemotherapy via arterial infusion,as a part of the combined treatment,is beneficial to the patients with unresectable advanced gastric cancer.

  3. Second neoplasms following radiotherapy or chemotherapy for cancer

    Energy Technology Data Exchange (ETDEWEB)

    Penn, I.

    1982-02-01

    While radiotherapy and antineoplastic chemotherapy often control malignancies they may, paradoxically, cause new cancers to develop as long-term complications. Although almost any type of neoplasm can occur, radiation-induced malignancies are most likely to affect the myelopoietic tissues and the thyroid gland. The former tissues are also most frequently involved by chemotherapy. The combination of intensive radiotherapy and intensive chemotherapy is particularly leukemogenic. Acute myeloid leukemia has occurred with increased frequency following treatment of Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, ovarian cancer, polycythemia vera, carcinoma of the thyroid gland, and carcinoma of the breast. Radiation-induced malignancies usually occur in the field of irradiation. Tumors developing in an irradiated field include a substantial number of soft tissue sarcomas or osteosarcomas. There is a 20-fold increase of second cancers following treatment of childhood malignancies, mostly sarcomas of bone and soft tissues, but including leukemia, and carcinomas of the thyroid gland, skin, and breast. The latent period between radiotherapy and the appearance of a second cancer ranges from 2 years to several decades, often being 10-15 years. With chemotherapy the mean latent period is shorter, approximately 4 years. The mechanism of oncogenesis by radiotherapy or chemotherapy is poorly understood and probably involves a complex interplay of somatic mutation, co-oncogenic effects, depression of host immunity, stimulation of cellular proliferation, and genetic susceptibility.

  4. Second neoplasms following radiotherapy or chemotherapy for cancer

    International Nuclear Information System (INIS)

    While radiotherapy and antineoplastic chemotherapy often control malignancies they may, paradoxically, cause new cancers to develop as long-term complications. Although almost any type of neoplasm can occur, radiation-induced malignancies are most likely to affect the myelopoietic tissues and the thyroid gland. The former tissues are also most frequently involved by chemotherapy. The combination of intensive radiotherapy and intensive chemotherapy is particularly leukemogenic. Acute myeloid leukemia has occurred with increased frequency following treatment of Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, ovarian cancer, polycythemia vera, carcinoma of the thyroid gland, and carcinoma of the breast. Radiation-induced malignancies usually occur in the field of irradiation. Tumors developing in an irradiated field include a substantial number of soft tissue sarcomas or osteosarcomas. There is a 20-fold increase of second cancers following treatment of childhood malignancies, mostly sarcomas of bone and soft tissues, but including leukemia, and carcinomas of the thyroid gland, skin, and breast. The latent period between radiotherapy and the appearance of a second cancer ranges from 2 years to several decades, often being 10-15 years. With chemotherapy the mean latent period is shorter, approximately 4 years. The mechanism of oncogenesis by radiotherapy or chemotherapy is poorly understood and probably involves a complex interplay of somatic mutation, co-oncogenic effects, depression of host immunity, stimulation of cellular proliferation, and genetic susceptibility

  5. Estimation of regional pulmonary ventilation using perfusion lung scintigram

    International Nuclear Information System (INIS)

    Using perfusion lung scintigram, motion of the regional pulmonary area and lung edge during ventilation was analyzed in 30 patients with various respiratory diseases. Image at maximal inspiration (I) and expiration (E) were obtained after the intravenous injection of 99mTc macroaggregated albumin (222-370 MBq) using a scintillation camera coupling to a small digital computer. Radioactivity in each pixels (E and I) and number of pixels in the both lungs (AE and AI) were calculated from the image of E and I. Changes of the regional pulmonary radioactivity during ventilation were calculated according to an expression as (E-I)/I, and the image of (E-I)/I was obtained too. The image of (E-I)/I consisted of positive and negative components. The image of positive (E-I)/I visualized the motion of the regional pulmonary area, and sum of positive (E-I)/I in the both lungs was correlated with vital capacity (r = 0.83, p < 0.001). The image of negative (E-I)/I superimposed with the edges of the lung at maximal inspiration and expiration revealed the limits of the motion of the lung edge during ventilation. These results suggest that this technique is useful to estimate the regional pulmonary ventilation and motion of the lung edge. (author)

  6. Biomarkers for cancer-related fatigue and adverse reactions to chemotherapy in lung cancer patients

    OpenAIRE

    Sha, Fei; ZHUANG, SHANSHAN; Zhou, Li; Zhang, Liqun; YANG, YUXIAN; ZHANG, SHENGQI; Jiang, Yi; QIU, GUODONG; Chen, Chen; ZHENG, JIETING; ZHANG, SHUYAO

    2014-01-01

    This study was conducted to investigate the biomarkers that appear to be correlated with cancer-related fatigue (CRF) and the adverse reactions (ADRs) to chemotherapy. A total of 100 lung cancer patients were selected and CRF prior to and following chemotherapy was evaluated. The plasma levels of tumor necrosis factor (TNF)-α and interleukin (IL)-1 and the level of 17-hydroxycorticosteroid (17-OHCS) in the urine were analyzed and correlated with CRF and the ADRs associated with chemotherapy. ...

  7. Discovery – Methotrexate: Chemotherapy Treatment for Cancer

    Science.gov (United States)

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

  8. Neoadjuvant and Adjuvant Chemotherapy of Cervical Cancer.

    Science.gov (United States)

    Mallmann, Peter; Mallmann, Christoph

    2016-01-01

    Neoadjuvant chemotherapy is indicated in patients who can tolerate the side effects of a chemotherapy and with preoperative presentation of one of the following clinical risk situations: bulky disease with a maximal tumor diameter of > 4 cm, suspicious lymph nodes in magnetic resonance imaging (MRI), computed tomography (CT) scan or endosonography, histopathologically confirmed lymph node metastasis, or histopathologically documented risk factors such as G3 and L1V1. A neoadjuvant chemotherapy followed by surgery should be performed with cisplatin at a dosage of > 25 mg/m2 per week and an application interval of < 14 days. The previously published data suggests an improved rate of complete resection and reduced incidences of positive lymph nodes and parametric infiltration. Accordingly, the percentage of patients in need for adjuvant radiochemotherapy after operation can be significantly reduced. Some studies demonstrated a prolongation of progression-free and overall survival. Following the previously published studies, adjuvant chemotherapy after operation or after radiochemotherapy has no significant effect on the overall survival and, following the current guidelines, should be avoided. PMID:27614740

  9. Technetium-99m labelled macroaggregated albumin arterial catheter perfusion scintigraphy: prediction of gastrointestinal toxicity in hepatic arterial chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Pelosi, E.; Masaneo, I.; Valetto, M.R.; Bello, M.; Bisi, G. [Department of Nuclear Medicine, University of Turin, Turin (Italy); Clara, R.; Zanon, C.; Chiappino, I.; Mussa, A. [Division of Esophageal and Oncological Surgery, University of Turin, Turin (Italy); Grosso, M. [Division of Radiology, S. Croce e Carle Hospital, Cuneo (Italy)

    2000-06-01

    Gastrointestinal toxicity from hepatic arterial infusion (HAI) of floxuridine in patients with liver metastases is probably due to extrahepatic perfusion or to partial escape of the drug from first-pass liver extraction. The aim of this study was to verify the role of technetium-99m-labelled macroaggregated albumin ({sup 99m}Tc-MAA) arterial catheter perfusion scintigraphy at the beginning of each chemotherapy cycle in decreasing or preventing gastrointestinal toxicity. We studied 167 consecutive patients. On the basis of the scintigraphic follow-up and the presence or absence of an intrahepatic arteriovenous shunt (IHAVS), we classified our patients into the following groups: (1) FU+ hepatic distribution pattern (DP), comprising 29 patients with regular scintigraphic follow-up who showed the expected distribution pattern at each control or a distribution pattern with transient alterations (extrahepatic escape) promptly reversed by the replacement of the catheter. Among these 29 patients there was one case of gastrointestinal toxicity. (2) FU- hepatic DP, comprising 128 patients who were evaluated with {sup 99m}Tc-MAA only at the beginning of the first chemotherapy cycle, showed the expected distribution pattern and underwent HAI with no further scintigraphic evaluation. Among these 128 patients there were 28 cases of gastrointestinal toxicity. (3) FU+ pulmonary DP, comprising three patients with abnormally elevated pulmonary uptake (higher than 5%) and with regular scintigraphic follow-up. There were two cases of gastrointestinal toxicity among these three patients. (4) FU- pulmonary DP, comprising seven patients with abnormally elevated pulmonary uptake and without regular scintigraphic follow-up. There were four cases of gastrointestinal toxicity among these seven patients. The incidence of toxicity was significantly higher in group FU- hepatic DP than in group FU+ hepatic DP (21.9% vs 3.4%, P<0.05). In both the FU+ pulmonary DP and FU- pulmonary DP groups, the

  10. Regional heterogeneity changes in DCE-MRI as response to isolated limb perfusion in experimental soft-tissue sarcomas.

    NARCIS (Netherlands)

    Alić, L.; Vliet, M. van; Wielopolski, P.A.; Hagen, T.L.M. ten; Dijke, C.F. van; Niessen, W.J.; Veenland, J.F.

    2013-01-01

    Experimental evidence supports an association between heterogeneity in tumor perfusion and response to chemotherapy/radiotherapy, disease progression and malignancy. Therefore, changes in tumor perfusion may be used to assess early effects of tumor treatment. However, evaluating changes in tumor per

  11. Pathobiology of cancer chemotherapy-induced peripheral neuropathy (CIPN

    Directory of Open Access Journals (Sweden)

    Yaqin eHan

    2013-12-01

    Full Text Available Chemotherapy induced peripheral neuropathy (CIPN is a type of neuropathic pain that is a major dose-limiting side-effect of potentially curative cancer chemotherapy treatment regimens that develops in a ‘stocking and glove’ distribution. When pain is severe, a change to less effective chemotherapy agents may be required, or patients may choose to discontinue treatment. Medications used to alleviate CIPN often lack efficacy and/or have unacceptable side-effects. Hence the unmet medical need for novel analgesics for relief of this painful condition has driven establishment of rodent models of CIPN. New insights on the pathobiology of CIPN gained using these models are discussed in this review. These include mitochondrial dysfunction and oxidative stress that are implicated as key mechanisms in the development of CIPN. Associated structural changes in peripheral nerves include neuronopathy, axonopathy and/or myelinopathy, especially intra-epidermal nerve fiber (IENF degeneration. In patients with CIPN, loss of heat sensitivity is a hallmark symptom due to preferential damage to myelinated primary afferent sensory nerve fibers in the presence or absence of demyelination. The pathobiology of CIPN is complex as cancer chemotherapy treatment regimens frequently involve drug combinations. Adding to this complexity, there are also subtle differences in the pathobiological consequences of commonly used cancer chemotherapy drugs, viz platinum compounds, taxanes, vincristine, bortezomib, thalidomide and ixabepilone, on peripheral nerves.

  12. Neoadjuvant chemotherapy followed by radiotherapy should not be a standard approach for locally advanced cervical cancer

    International Nuclear Information System (INIS)

    Purpose: To investigate the role of neoadjuvant chemotherapy followed by radiotherapy in locally advanced cervical cancer. Methods and Materials: This study cites all known literature on the subject in the English language. Articles were selected for analysis by MEDLINE and CANCERLINE computer searches. In Phase II trials, the response rates of some selective series were analyzed. However, This article will specially emphasize the result of all Phase III randomized trials. Results: Several investigators did obtain promising results from Phase II trials of neoadjuvant chemotherapy, mostly cisplatin-based combinations, followed by radiotherapy. However, most Phase III trials failed to demonstrate any benefit in terms of loco-regional relapse and/or survival by up-front chemotherapy. Conclusion: The role of neoadjuvant chemotherapy remains to be defined, and the search for more active new agents must be continued. The neoadjuvant setting is still experimental and could not be recommended as a standard treatment at the present

  13. 膀胱癌术后膀胱内灌注化疗患者的症状特征及困扰分析%Analysis on the characteristics and distress of symptoms in patients with bladder perfusion chemotherapy after resection of bladder cancer

    Institute of Scientific and Technical Information of China (English)

    王小英; 张文玲; 赖伟红; 霍斯文; 何旋

    2015-01-01

    Objective To discuss the extent and characteristics of symptoms and symptom distress, and find the individualized management for patients undergoing bladder perfusion chemotherapy after transurethral bladder resection of bladder tumor. Methods The general information questionnaire, M. D. Anderson Symptom Inventory ( MDASI) and additional entries were used to investigate 84 patients undergoing bladder perfusion chemotherapy after transurethral bladder resection of bladder tumor. After individualized treatment, scores of symptoms were observed. Results Symptom score of patients in this group was (3. 12 ± 1. 02), which was at the mild level. Symptoms subscale score entries sorted successively as poor appetite, fatigue, disturbed sleep, nausea, and vomiting. Symptom distress score was (2. 85 ± 2. 02), which was at the mild level. Distress subscale score in the order of entries were work, mood and general activity, enjoyment of life, walking and relationship. Added entries score in the order were burning sensation in the bladder, bladder irritation and gastrointestinal reactions. Scores of some symptoms were significantly lower than before ( P < 0. 05 ). Conclusions Symptom distress is prevalent in patients undergoing bladder perfusion chemotherapy after transurethral bladder resection of bladder tumor, prompting that the intervention should be individualized according to the patient′s symptom distress features to alleviate their symptoms distress.%目的:分析膀胱癌经尿道膀胱肿瘤电切术后患者膀胱灌注化疗期间的症状及其对患者的困扰程度及特点,探讨患者不适症状的个体化干预方法。方法应用自编一般资料调查表、M. D. Anderson症状调查量表及增补条目,对84例膀胱癌术后膀胱灌注化疗患者进行调查分析。个体化干预后观察患者症状的改善情况。结果患者术后膀胱灌注化疗期间的症状分量表平均得分(3.12±1.02)分,属轻度;症状

  14. BRCA and Pancreatic Cancer: Selection of Chemotherapy

    Directory of Open Access Journals (Sweden)

    Richard Kim

    2012-03-01

    Full Text Available Germline mutations in BRCA genes are associated with increased risk of pancreatic cancer. There are pre clinical data which suggests that DNA cross linking agents should be used in pancreatic cancer patients with BRCA mutations. This review is an update from the 2012 American Society of Clinical Oncology (ASCO Gastrointestinal Cancers Symposium regarding recent developments in the treatment of pancreatic cancer with BRCA mutation. Only one study (Abstracts #217 was presented and it is described here.

  15. Study of regional lung ventilation and perfusion by xenon 133

    International Nuclear Information System (INIS)

    The present work consists of a regional lung exploration after injection of xenon 133, dissolved in physiological serum, followed a few minutes later by that of 99m Tc-labelled serumalbumin microspheres. The aim is three fold: first of all to study perfusion and ventilation by xenon 133, next to compare the results obtained after xenon 133 and 99 m Tc-labelled microsphere injection, lastly to establish the value of the technique and its routine application. This examination has not solved all problems of lung exploration by xenon 133. For example we deliberately kept to intraveinous injection of the gas dissolved in physiological serum, leaving aside the breathing test. Xenon 133 scintigraphy in our opinion will not tend to replace 99m Tc-labelled microsphere scintigraphy, which has irreplaceable morphological qualities, but will serve as an excellent complement. The basic advantage of xenon 133 is the regional ventilation estimate it provides allowing any anomaly of the lung parenchyma to be located immediately or conversely the functional value of the healthy lung to be established with a view to a surgical removal of a diseased zone

  16. Cancer Chemotherapy - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Portuguese (português) ... faible - français (French) Bilingual PDF Health Information Translations Hindi (हिन्दी) Chemotherapy हिन्दी (Hindi) Bilingual PDF ...

  17. Post-chemotherapy arthralgia and arthritis in lung cancer

    Directory of Open Access Journals (Sweden)

    Aref H Amiri

    2012-01-01

    Full Text Available Objective: Evaluate the characteristics of arthritis, arthralgia and musculoskeletal pain after chemotherapy in patients with lung cancer. Materials and Methods: In this study, we evaluate the characteristics of 17 patients with joint symptoms following receiving chemotherapy for lung cancer. Demographic information of patients including sex, age, time of rheumatologic findings after starting of chemotherapy, time of improvement after starting of medication, and relevant laboratory findings for each patient. Results: A total of seventeen patients (six women with mean age 41.2 ± 5.2 years and 11 men with mean age 42.5 ± 8.2 that received standard chemotherapy for lung cancer according to stage of disease. Joint symptoms usually began about seven months after the first session of chemotherapy. Patients had an average of two tender joints and 1 hr of morning stiffness. Four patients were positive for anti-nuclear antibody, and none of patient was positive for rheumatoid factor. Non-steroidal anti-inflammatory drugs, disease modifying anti-rheumatic drugs (DMARD, corticosteroids, and venlafaxine were prescribed. Four patients did not show an improvement. Follow-up was available for all patients. 11 patients showed favorable responses, characterized by a significant decrease (more than 50% in morning stiffness, pain, and tender joint counts after a mean of three months′ treatment. Two patients had complete resolution of symptoms and did not required further medications for arthritis, arthralgia or musculoskeletal pain. Conclusion: Chemotherapy-related arthropathy in lung cancer is not uncommon. Early treatment with NSAID, DMARD, and corticosteroids is effective in the majority of patients.

  18. Factors Influencing Chemotherapy Goal Perception in Newly Diagnosed Cancer Patients.

    Science.gov (United States)

    Gumusay, Ozge; Cetin, Bulent; Benekli, Mustafa; Gurcan, Gamze; Ilhan, Mustafa N; Bostankolu, Basak; Ozet, Ahmet; Uner, Aytug; Coskun, Ugur; Buyukberber, Suleyman

    2016-06-01

    Cancer patients who start receiving chemotherapy have difficulty in understanding the state of their disease, the prognosis, and the purpose of treatment. We used a survey to evaluate the extent of perception of chemotherapy goal among cancer patients. Two hundred sixteen cancer patients who received chemotherapy for the first time participated in the study. The presence of depression and anxiety was assessed using the "Hospital Anxiety and Depression Scale" (HAD). The consistency between the patients' perception of the chemotherapy goal and the physician's perception was described as "right," and the inconsistency was described as "wrong." Among the patients who participated in the survey, 53.2 % (n = 115) were receiving adjuvant treatment and 46.8 % (n = 101) were receiving palliative treatment for metastatic disease. The rate of right and wrong perception of the chemotherapy goal was 51.9 % (n = 108) and 32.2 % (n = 67), respectively, and the rate of confused patients was 18.9 % (n = 41). The level of education was shown to be the only parameter involved in accurate perception of the treatment purpose (hazard ratio (HR) = 0.444, p = 0.025, 95 % confidence interval (CI) 0.219-0.903). In this study, there was a 51.9 % consistency between the physician's perception and that of the patient regarding the purpose of treatment. We demonstrated that the level of education was the unique factor in accurate perception of chemotherapy goal among cancer patients. PMID:25851203

  19. Neoadjuvant chemotherapy in cervical cancer in pregnancy.

    Science.gov (United States)

    Ilancheran, Arunachalam

    2016-05-01

    Cervical cancer is the most common gynecological cancer encountered in pregnancy. The standard treatment of early cervical cancer is usually surgical removal of the cervix (in selected cases) or, more commonly, the uterus. However, when cervical cancer develops during pregnancy, definitive surgical treatment often needs to be postponed until the fetus reaches maturity. Neoadjuvant chemotherapy (NACT) is an innovative approach in the management of these patients. It helps in controlling the disease and delaying delivery. The paper presents a literature review of the history of NACT, as well as practice points and agenda for further research. PMID:26536815

  20. 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…

  1. Investigation of nausea and vomiting in cancer patients undergoing chemotherapy

    Directory of Open Access Journals (Sweden)

    Maria Lavdaniti

    2014-10-01

    Full Text Available Nausea and vomiting are the most important problems in patients undergoing chemotherapy, despite the recent improvements in the administration of antiemetic drugs. Through a review of the literature, we found that there are several nursing researches focusing on the effectiveness of interventions for the treatment of nausea and vomiting in cancer patients. The purpose of this study was to investigate the symptom of nausea and vomiting in patients undergoing chemotherapy. The study also investigated the impact of nausea and vomiting on patients’ ability to respond to daily activities. The study is descriptive; the sample included patients with different types of cancer and receiving chemotherapy. The inclusion criteria were: the histological diagnosis of cancer, the administration of chemotherapy and the knowledge of the Greek language. The questionnaires used were: the MASCC (vomiting questionnaire, the Memorial Symptom Assessment Scale and the scale of functional assessment of cancer therapy. Data collection took place in oncological hospitals of Thessaloniki and Athens in Greece. For statistical analysis we used the statistical package SPSS 15.0.

  2. Role of neoadjuvant chemotherapy in cancer cervix: A brief review

    OpenAIRE

    Aramita Saha; Anindya Mukherjee

    2013-01-01

    Neoadjuvant chemotherapy (NACT) represents a promising modality apart from or radiotherapy as initial treatment of locally advanced cervical cancer. The primary objectives of NACT in the treatment of cervical cancer include improvement in tumor characteristics, to allow avoidance of radiotherapy, to prolong disease-free and overall survival, and facilitation of fertility-sparing surgery. Though several studies have shown promising results of NACT on tumor response, downstaging, decrease in lo...

  3. Imaging of ventilation/perfusion ratio by gated regional spirometry

    International Nuclear Information System (INIS)

    Gated 133Xe images of patients rebreathing into a closed system can provide images of the distribution of lung volumes, ventilation and specific ventilation. These have been shown to be accurate, precise, and do not require unusually sophisticated equipment or skills. A mathematical transformation is used to correct the images for lung movement, which does not alter the total number of counts in the image. Perfusion images are gated to remove motion blurring but not transformed. Ventilation/perfusion images showing the distribution of V/Q ratio are then generated from the individual ventilation and perfusion images. (author)

  4. Intraperitoneal chemotherapy in the management of ovarian cancer: focus on carboplatin

    Directory of Open Access Journals (Sweden)

    Maurie Markman

    2009-02-01

    Full Text Available Maurie MarkmanUniversity of Texas MD Anderson Cancer Center, Houston, Texas, USAAbstract: Both pre-clinical studies and phase 1–2 clinical trials have provided strong support for the potential role of regional drug delivery in the management of epithelial ovarian cancer, a disease process whose major manifestations remain largely localized to the peritoneal cavity in the majority of individuals with this malignancy. The results of 3 phase 3 randomized trials have revealed the favorable impact of primary cisplatin-based intraperitoneal chemotherapy in women who initiate drug treatment with small-volume residual ovarian cancer following an attempt at optimal surgical cytoreduction. Concerns have been raised regarding the toxicity of regional treatment, particularly the side-effect profile associated with cisplatin. One rational approach to improving the tolerability of intraperitoneal chemotherapy is to substitute carboplatin for cisplatin. This review discusses the rationale for and data supporting regional treatment of epithelial ovarian cancer, and highlights the potential role for intraperitoneal carboplatin in this clinical setting.Keywords: ovarian cancer, intraperitoneal chemotherapy, cisplatin, carboplatin

  5. Chemotherapy-induced Peripheral Neuropathy | Division of Cancer Prevention

    Science.gov (United States)

    It usually starts in the hands and/or feet and creeps up the arms and legs. Sometimes it feels like a tingling or numbness. Other times, it’s more of a shooting and/or burning pain or sensitivity to temperature. It can include sharp, stabbing pain, and it can make it difficult to perform normal day-to-day tasks like buttoning a shirt, sorting coins in a purse, or walking. An estimated 30 to 40 percent of cancer patients treated with chemotherapy experience these symptoms, a condition called chemotherapy-induced peripheral neuropathy (CIPN). |

  6. Chemotherapy and radiotherapy in locally advanced cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Brunet, J. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Alonso, C. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Llanos, M. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Lacasta, A. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Fuentes, J. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Mendoza, L.A. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Badia, J.M. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Delgado, E. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain); Ojeda, B. [Dept. of Oncology, Hospital de La Santa Creu i Sant Pau, Barcelona (Spain)

    1995-12-31

    Radiotherapy has been standard therapy for locally advanced squamous cell cervical cancer. Neoadjuvant chemotherapy is being studied to improve responses and survival. We report a phase II study in locally advanced squamous cell cervical cancer (FIGO stages III and IV A) using chemotherapy with bleomycin, methotrexate and cisplatin (BMP) followed by radical radiotherapy. Of the 35 patients, 31 in stage III and 4 in stage IV A, 3 complete responses (CR) and 22 partial responses (PR) were achieved after chemotherapy treatment. Thirty-one patients completed radiotherapy; 19 achieved CR and 4 PR. Five-year actuarial survival for the entire group was 45% (95% confidence interval, 37-53%) with a median survival of 56 months. Patients with CR had a significantly better survival: The 5-year actuarial survival was 74% (95% CI, 59-89%). Recurrence developed at 4 to 19 patients. The most frequent side-effects were nausea and vomiting. Myelosuppression and impaired renal function also occurred. There was no evidence of radiotherapy toxicity enhancement. The stage and Karnofsky index were significant prognostic factors. It is concluded that MBP chemotherapy in advanced cervical cancer is effective and, followed by radiotherapy, allows a good control of this tumor. The group of patients with complete response have a low rate of recurrences and a long survival chance. (orig.).

  7. Meta-analysis of intraperitoneal chemotherapy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Da-Zhi Xu; You-Qing Zhan; Xiao-Wei Sun; Su-Mei Cao; Qi-Rong Geng

    2004-01-01

    AIM: To assess the efficacy and safety of intraperitoneal chemotherapy in patients undergoing curative resection for gastric cancer through literature review. METHODS: Medline (PubMed) (1980-2003/1), Embase (1980-2003/1), Cancerlit Database (1983-2003/1) and Chinese Biomedicine Database (1990-2003/1) were searched. Language was restricted to Chinese and English. The statistical analysis was performed by RevMan4.2 software provided by the Cochrane Collaboration. The results were expressed with odds ratio for the categorical variables. RESULTS: Eleven trials involving 1 161 cases were included. The pooled odds ratio was 0.51, with a 95% confidence interval (0.40-0.65). Intraperitoneal chemotherapy may benefit the patients after curative resection for locally advanced gastric cancer, and the combination of intraperitoneal chemotherapy with hyperthermia or activated carbon particles may provide more benefits to patients due to the enhanced antitumor activity of drugs. Sensitivity analysis and fail-safe number suggested that the result was comparatively reliable. However, of 11 trials, only 3 studies were of high quality. CONCLUSION: Intraperitoneal chemotherapy after curative resection for locally advanced gastric cancer may be beneficial to patients. Continuous multicenter, randomized, double blind, rigorously designed trials should be conducted to draw definitive conclusions.

  8. Neoadjuvant chemotherapy in advanced epithelial ovarian cancer: A survival study

    Directory of Open Access Journals (Sweden)

    Upasana Baruah

    2015-01-01

    Full Text Available Context: Patients with advanced ovarian cancer have a poor prognosis in spite of the best possible care. Primary debulking surgery has been the standard of care in advanced ovarian cancer; however, it is associated with high mortality and morbidity rates as shown in various studies. Several studies have discussed the benefit of neoadjuvant chemotherapy in patients with advanced ovarian cancer. Aims: This study aims to evaluate the survival statistics of the patients who have been managed with interval debulking surgery (IDS from January 2007 to December 2009. Materials and Methods: During the period from January 2007 to December 2009, a retrospective analysis of 104 patients who underwent IDS for stage IIIC or IV advanced epithelial ovarian cancer at our institute were selected for the study. IDS was attempted after three to five courses of chemotherapy with paclitaxal (175 mg/m 2 and carboplatin (5-6 of area under curve. Overall survival (OS and progression free survival (PFS were compared with results of primary debulking study from existing literature. OS and PFS rates were estimated by means of the Kaplan-Meier method. Results were statistically analyzed by IBM SPSS Statistics 19. Results: The median OS was 26 months and the median PFS was 18 months. In multivariate analysis it was found that both OS and PFS was affected by the stage, and extent of debulking. Conclusions: Neoadjuvant chemotherapy, followed by surgical cytoreduction is a promising treatment strategy for the management of advanced epithelial ovarian cancers.

  9. Studies on pulmonary ventilation-perfusion scintigraphy with Xe-133 in primary lung cancer, 1

    International Nuclear Information System (INIS)

    Regional lung ventilation-perfusion scintigraphy by xenon gas was performed on 14 normal cases (normal group) and 86 cases of primary lung cancer (lung cancer group). The patients were measured in a sitting position using a scintillation camera. In normal group, the value of V, Q was higher in the lower lung field than in the upper lung field, the value of MTT was rather delayed in the upper lung field than in the lower lung field, proving to that lung clearance was better in the lower lung field than in the upper lung field. In lung cancer group, VQ match (pattern I, II) was 61 cases (71%) and VQ mismatch (pattern III, IV) was 25 cases (29%). The pattern II (VQ matched defect) accounted for 63% in lung cancer group. In this pattern, the region of disorder of V and Q was corresponded respectively, but disorder grade was not always accorded. The pattern III (normal V and disordered Q) was mainly seen in AH group (hilar type) and D group (lymph node swelling type). The V/Q in lung cancer group was widely distributed to the range of 0 to 5.8. The value of MTT was rather delayed in all cases of lung cancer group than in the normal group, because delayed MTT in focal lesion was markedly affected to whole lung. (author)

  10. Antiemetic Therapy With or Without Olanzapine in Preventing Chemotherapy-Induced Nausea and Vomiting in Patients With Cancer Receiving Highly Emetogenic Chemotherapy | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase III trial studies antiemetic therapy with olanzapine to see how well they work compared to antiemetic therapy alone in preventing chemotherapy-induced nausea and vomiting in patients with cancer receiving highly emetogenic (causes vomiting) chemotherapy. Antiemetic drugs, such as palonosetron hydrochloride, ondansetron, and granisetron hydrochloride, may help lessen or prevent nausea and vomiting in patients treated with chemotherapy. |

  11. Perfusion lung scintigraphy in primary broncho-pulmonary cancer

    International Nuclear Information System (INIS)

    Research on primary broncho-pulmonary cancer has called extensively on scintigraphy and it seemed interesting to weigh up the pros and cons of the technique in this particular case. Our intention is to sum up objectively from recent documents the applications of scintigraphy in the study of primary broncho-pulmonary cancers and to attempt, on the basis of the results compiled, to show what benefits have been gained from this technique and to find out whether it has any pre-surgical value and of what kind. The technique was invariable; the tracer consists of human albumin macro-aggregates labelled with technetium 99m which by its short half-life and slight penetration enables four exposures to be taken during the same examination (front, back, right and left profiles), thus reducing the risks of mistaken diagnoses due to the use of a single incidence. Similarly the detection method was always the scintillation camera which explores the whole organ at once, considerably shortening the examination time. Lung scintigraphy by perfusion of labelled human albumin macro-aggregates offers the great advantage of being simple to use and harmless. It is easy to understand the important place it has taken in the range of methods available for lung circulation exploration

  12. Induction chemotherapy and radiotherapy in loco-regionally advanced epidermoid carcinoma of the anal canal

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy of induction chemotherapy in combination with radiotherapy for treatment of loco-regionally advanced epidermoid anal carcinoma. Methods and Materials: Thirty-one patients diagnosed during the period 1989-1994 with loco-regionally advanced cancer of the anal canal (PHITmax ≥ 4 cm or T4 or N+) were treated with induction chemotherapy consisting of one to three courses of carboplatin (300-375 mg/m2 i.v.) and 5-fluorouracil [5,000 mg/(m2 x 120 h) i.v.] followed by external beam irradiation ± surgery. Results: The toxicity of the chemotherapy was low. Twenty-nine patients were tumor free after the primary therapy. Kaplan-Meier analyses were made for overall survival, tumor-specific survival, freedom from recurrence, preservation of sphincter, and event-free survival. For these end points the 5-year data were 67, 85, 80, 69, and 51%, respectively. Conclusion: The results are promising but a well-designed randomized trial is needed to further elucidate the role of induction chemotherapy in the treatment of loco-regionally advanced anal carcinoma

  13. Understanding Chemotherapy

    Science.gov (United States)

    N ational C ancer I nstitute Understanding Chemotherapy What is chemotherapy? Chemotherapy is a cancer treatment that uses drugs to destroy cancer cells. It is also called “chemo.” Today, there are ...

  14. Regional Pulmonary Perfusion, Inflation, and Ventilation Defects in Bronchoconstricted Patients with Asthma

    OpenAIRE

    Harris, R. Scott; Winkler, Tilo; Tgavalekos, Nora; Musch, Guido; Melo, Marcos F. Vidal; Schroeder, Tobias; Chang, Yuchiao; Venegas, José G.

    2006-01-01

    Rationale: Bronchoconstriction in asthma leads to heterogeneous ventilation and the formation of large and contiguous ventilation defects in the lungs. However, the regional adaptations of pulmonary perfusion (Q̇) to such ventilation defects have not been well studied.

  15. Infrared Spectroscopy in Cancer Diagnosis and Chemotherapy Monitoring

    Science.gov (United States)

    Tolstorozhev, G. B.; Bel'kov, M. V.; Skornyakov, I. V.; Butra, V. A.; Pekhnyo, V. I.; Kozachkova, A. N.; Tsarik, N. I.; Kutsenko, I. P.; Sharykina, N. I.

    2014-07-01

    We demonstrate that IR spectroscopic analysis can be used in diagnosis and chemotherapy monitoring for cancers of various organs at the molecular level. We used Fourier transform IR spectroscopy to study human breast and thyroid tumor tissues which were removed during surgery. The characteristic frequencies of C = O stretching vibrations in the IR spectra of tissues of pathological foci were compared with data from histological examination. In the IR spectra of healthy tissues or for benign tumors, the most intense absorption bands ν(C = O) are located in the interval 1675-1650 cm-1. When malignant neoplasms are present in the organs, the intensity of the bands in this range of the spectrum is reduced, while the intensities of the absorption bands in the 1710-1680 cm-1 interval increase. We also studied lung tissue for mice of the C57B1/6 line for healthy tissue and after implantation of B-16 melanoma tumor. The IR spectra of healthy mouse lung tissue and mouse lung tissue with B-16 melanoma metastases in the region of the C = O stretching vibrations display the same differences. We found that when lung malignancy was treated with the optimal dose of a synthesized drug based on palladium complexes of methylenediphosphonic acid, the spectroscopic signs of the presence of metastases in the lungs disappear, and the IR spectrum of the lung tissue after treatment practically coincides with the spectrum of healthy lung tissue.

  16. Multidisciplinary management of stage III breast cancer: chemotherapy, surgery and radiotherapy

    International Nuclear Information System (INIS)

    A prospective study, in which women with clinically stage III breast cancer underwent multidisciplinary therapy by using primary (neoadjuvant) chemotherapy, followed randomly by loco-regionally therapy, either with surgery or radiotherapy; and postoperative systemic chemotherapy, in both groups of treatment, was conduced at the Peruvian Institute of Neoplasic Diseases. This is a randomized, prospective, descriptive, interventionist and analytical clinical study. Clinical response to primary chemotherapy was positive in 80,23% of cases, complete resolution was observed in 18,60% of cases, partial resolution in 61,63% of cases and there was absolutely no response in 19,77% of cases. No residual neoplasm, pathologically proven, was observed in 8,33% of surgical cases. We demonstrated that high-dose primary chemotherapy, using only 2 drugs (cyclophosphamide and 5-fluorouracil), used here because of its lower price, brought similar results compared to anthracycline-containing regimens. Recurrence rates were similar and showed no significative differences in both groups of treatment. Both, the disease-free survival (DFS) and overall survival (OS), were similar in both groups of treatment. We also demonstrated that in patients who underwent surgery, the lower the number of axillary lymph node metastases, the higher the overall survival (OS) time. Patients with clinically stage III (A or B) breast cancer, showed similar clinical responses to neoadjuvant chemotherapy, they also showed similar recurrence rates, DFS and OS, when treated with radical mastectomy or radiotherapy. (authors)

  17. 76 FR 51034 - Availability of Draft NTP Monograph on Potential Developmental Effects of Cancer Chemotherapy...

    Science.gov (United States)

    2011-08-17

    ... Chemotherapy During Pregnancy; Request for Comments; Announcement of a Panel Meeting To Peer Review Draft... of the Draft NTP Monograph on Potential Developmental Effects of Cancer Chemotherapy During Pregnancy... of Cancer Chemotherapy During Pregnancy, which has been prepared by the NTP Office of...

  18. CMEA cooperative trials in chemotherapy of lung cancer patients

    International Nuclear Information System (INIS)

    TA comparative analysis of the immediate and short-term results of chemo- and radiotherapy of 174 patients with well differentiated inoperable lung cancer has been performed. The data were presented by the participants of the CMEA cooperative trial (the Hungarian People's Reg public, the USSR and the Czechoslovak Socialist Republic over the period of 1976-1980). Comparative analysis has shown that the use of adjuvant chemotherapy tends to improve an immediate therapeutic effect. In well differentiated squamous cell carcinoma, a marked positive effect was obtained in 48.6% of the patients as compared to 31.2% in radiotherapy alone. However, judging by the survival rates such differences in favor of chemotherapy were not revealed. After conservative treatment (radio- and chemotherapy) of patients with differentiated lung cancer in the inoperable stage 55.7% survived for 1, 17.27% for 2, 8.55% for 3 yrs. Direct correlation between the immediate effect of radio- and chemotherapy and the survival of the patients was revealed. Of 67 patients with a marked immediate effect 49 (73.1%) lived over 1 year, 8 out of 9 patients lived for 3 yrs

  19. Regional pulmonary perfusion following human heart-lung transplantation

    International Nuclear Information System (INIS)

    Ventilation and perfusion scans were obtained in six subjects who had undergone heart-lung transplantation with consequent denervation of the cardiopulmonary axis. Two of the subjects had developed obliterative bronchiolitis, which is believed to be a form of chronic rejection. Their pulmonary function tests demonstrated airflow obstruction and their scintigraphic studies were abnormal. In the remaining four subjects without obstructive airways disease, ventilation and planar perfusion scans were normal. Single photon emission computed tomography imaging of pulmonary perfusion in these patients revealed a layered distribution of blood flow indistinguishable from that of normal individuals. It is concluded that neurogenic mechanisms have little influence on the pattern of local pulmonary blood flow at rest

  20. Regional pulmonary perfusion following human heart-lung transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Lisbona, R.; Hakim, T.S.; Dean, G.W.; Langleben, D.; Guerraty, A.; Levy, R.D. (Royal Victoria Hospital, Montreal, Quebec (Canada))

    1989-08-01

    Ventilation and perfusion scans were obtained in six subjects who had undergone heart-lung transplantation with consequent denervation of the cardiopulmonary axis. Two of the subjects had developed obliterative bronchiolitis, which is believed to be a form of chronic rejection. Their pulmonary function tests demonstrated airflow obstruction and their scintigraphic studies were abnormal. In the remaining four subjects without obstructive airways disease, ventilation and planar perfusion scans were normal. Single photon emission computed tomography imaging of pulmonary perfusion in these patients revealed a layered distribution of blood flow indistinguishable from that of normal individuals. It is concluded that neurogenic mechanisms have little influence on the pattern of local pulmonary blood flow at rest.

  1. Use of the percutaneously implantable catheter-port system for the long term regional chemotherapy in patients with colorectal cancer metastasis in liver

    International Nuclear Information System (INIS)

    The function and safety of a percutaneously implantable catheter-port system were studied in 20 patients with colorectal cancer metastasis in liver. The operation was performed in x-ray operation room equipped with angiography system 'Angiostar' (Siemens, Germany). For implantation the catheter Cobra 5F (Terumo, Japan), arterial port systems Celsite T302 (B/Braun, Germany) or Inport APP (Isomed, France) were used. The implantation of the percutaneously implantable catheter-port system was technologically successful for all patients. During follow-up of patients 14 side effects and complications were observed in 9 cases (45 %). The usage of a percutaneously implantable catheter-port system simplifies the recurrent chemo infusion in hepatic artery and improves the patients quality of life. In case of side effects the remedial surgical procedures and interventional radiology methods were carried out.

  2. Regional ventilation, pulmonary perfusion and gas exchange in supine and prone positions

    OpenAIRE

    Mure, Margareta

    1999-01-01

    The rationale for treating patients with acute lung injury in the prone position springs from a number of observations. Clinical reports have documented improved oxygenation when patients are turned prone. Regional vascular conductance is higher in dorsal lung regions regardless of posture. Lung perfusion in dogs is similarly distributed in prone and supine positions. Ventilation to perfusion matching is better in the prone than supine position. These observations provided t...

  3. Regional hyperthermia combined with chemotherapy in paediatric, adolescent and young adult patients: current and future perspectives.

    Science.gov (United States)

    Seifert, Georg; Budach, Volker; Keilholz, Ulrich; Wust, Peter; Eggert, Angelika; Ghadjar, Pirus

    2016-01-01

    Here we evaluate the current status of clinical research on regional hyperthermia (RHT) in combination with chemotherapy or radiation therapy in paediatric oncology.Data were identified in searches of MEDLINE, Current Contents, PubMed, and references from relevant articles using medical subject headings including hyperthermia, cancer, paediatric oncology, children, radiation therapy and chemotherapy. Currently, only two RHT centres exist in Europe which treat children. Clinical RHT research in paediatric oncology has as yet been limited to children with sarcomas and germ cell tumours that respond poorly to or recur after chemotherapy. RHT is a safe and effective treatment delivering local thermic effects, which may also stimulate immunological processes via heat-shock protein reactions. RHT is used chiefly in children and adolescents with sarcomas or germ cell tumours located in the abdomino-pelvic region, chest wall or extremities to improve operability or render the tumour operable. It could potentially be combined with radiation therapy in a post-operative R1 setting where more radical surgery is not possible or combined with chemotherapy instead of radiation therapy in cases where the necessary radiation dose is impossible to achieve or would have mutilating consequences. RHT might also be an option for chemotherapy intensification in the neoadjuvant first-line treatment setting for children and adolescents, as was recently reflected in the promising long-term outcome data in adults with high-risk soft tissue sarcomas (EORTC 62961/ESHO trial).The limited data available indicate that combining RHT with chemotherapy is a promising option to treat germ cell tumours and, potentially, sarcomas. RHT may also be beneficial in first-line therapy in children, adolescents and young adults. The research should focus on optimising necessary technical demands and then initiate several clinical trials incorporating RHT into interdisciplinary treatment of children

  4. Regional hyperthermia combined with chemotherapy in paediatric, adolescent and young adult patients: current and future perspectives

    International Nuclear Information System (INIS)

    Here we evaluate the current status of clinical research on regional hyperthermia (RHT) in combination with chemotherapy or radiation therapy in paediatric oncology. Data were identified in searches of MEDLINE, Current Contents, PubMed, and references from relevant articles using medical subject headings including hyperthermia, cancer, paediatric oncology, children, radiation therapy and chemotherapy. Currently, only two RHT centres exist in Europe which treat children. Clinical RHT research in paediatric oncology has as yet been limited to children with sarcomas and germ cell tumours that respond poorly to or recur after chemotherapy. RHT is a safe and effective treatment delivering local thermic effects, which may also stimulate immunological processes via heat-shock protein reactions. RHT is used chiefly in children and adolescents with sarcomas or germ cell tumours located in the abdomino-pelvic region, chest wall or extremities to improve operability or render the tumour operable. It could potentially be combined with radiation therapy in a post-operative R1 setting where more radical surgery is not possible or combined with chemotherapy instead of radiation therapy in cases where the necessary radiation dose is impossible to achieve or would have mutilating consequences. RHT might also be an option for chemotherapy intensification in the neoadjuvant first-line treatment setting for children and adolescents, as was recently reflected in the promising long-term outcome data in adults with high-risk soft tissue sarcomas (EORTC 62961/ESHO trial). The limited data available indicate that combining RHT with chemotherapy is a promising option to treat germ cell tumours and, potentially, sarcomas. RHT may also be beneficial in first-line therapy in children, adolescents and young adults. The research should focus on optimising necessary technical demands and then initiate several clinical trials incorporating RHT into interdisciplinary treatment of children

  5. Gene sensitizes cancer cells to chemotherapy drugs

    Science.gov (United States)

    NCI scientists have found that a gene, Schlafen-11 (SLFN11), sensitizes cells to substances known to cause irreparable damage to DNA.  As part of their study, the researchers used a repository of 60 cell types to identify predictors of cancer cell respons

  6. Cancer chemotherapy of the upper aero digestive tract

    International Nuclear Information System (INIS)

    Tumours of the upper aero digestive tract represent the sixth most frequent kind of cancer in France and throughout the world. If the localised forms may be controlled in the long run in two thirds of cases by surgery or radiotherapy, only one third of locally advanced forms are accessible to a cure after association from radiotherapy and chemotherapy. Besides, with a median of survival less than six months, metastatic tumours present a catastrophic spontaneous prognosis among patients with a medical ground that is often heavily deteriorated by prolonged exposure to alcohol and tobacco. Thus, there is a necessity to implement adapted therapeutic strategies to each patient and based on satisfactory proof levels of effectiveness. Optimisation of existing chemotherapy protocols and development of new therapies, in particular of targeted therapies, remain an important objective in the hope to improve results of treatments in locally advanced and metastatic cancers of the oral cavity. (authors)

  7. The effect of thoracic irradiation for cancer of the breast on ventilation, perfusion and pulmonary permeability

    International Nuclear Information System (INIS)

    Regional and overall lung function was studied in 14 women during a one-year follow-up after postmastectomy irradiation for cancer of the breast. The dose was 40 Gy in the chest wall and 20-40 Gy in the apex of the lung. Immediately after irradiation there was a slight increase in pulmonary clearance of 99TCm-DTPA compared to baseline values. This increase, however, was not restricted to the field of irradiation. Three months after irradiation there were regional defects in the ventilation and perfusion scintigrams in 11 of the patients. At the same time there was a greater decrease in total lung capacity, vital capacity and diffusion capacity for CO than in ventilation and perfusion. One year after irradiation the lung function impairment had only insignificantly regressed. It is concluded that local lung irradiation may cause persistent regional and generalized lung function impairment. The early increase in pulmonary clearance of 99Tcm-DTPA could not be used as a predictor of subsequent lung function impairment. (orig.)

  8. Postoperative Chemotherapy Followed by Conformal Concomitant Chemoradiotherapy in High-Risk Gastric Cancer

    International Nuclear Information System (INIS)

    Purpose: To analyze the efficacy, toxicity, and pattern of relapse after adjuvant cisplatin-based chemotherapy followed by three-dimensional irradiation and concomitant LV5FU2 chemotherapy (high-dose leucovorin and 5-fluorouracil bolus plus continuous infusion) in the treatment of completely resected high-risk gastric cancer. Methods and Materials: This was a retrospective analysis of 52 patients with high-risk gastric cancer initially treated by total/partial gastrectomy and lymphadenectomy between January 2002 and June 2007. Median age was 54 years (range, 36–75 years). Postoperative treatment consisted of 5-fluorouracil and cisplatin chemotherapy. Adjuvant chemotherapy was followed by three-dimensional conformal radiotherapy in the tumor bed and regional lymph nodes at 4500 cGy/25 fractions in association with concomitant chemotherapy. Concomitant chemotherapy consisted of a 2-h infusion of leucovorin (200 mg/m²) followed by a bolus of 5-fluorouracil (400 mg/m²) and then a 44-h continuous infusion of 5-fluorouracil (2400–3600 mg/m²) given every 14 days, for three cycles (LV5FU2 protocol). Results: Five-year overall and disease-free survival were 50% and 48%, respectively. Distant metastases and peritoneal spread were the most frequent sites of relapse (37% each). After multivariate analysis, only pathologic nodal status was significantly associated with disease-free and overall survival. Acute toxicities were essentially gastrointestinal and hematologic. One myocardial infarction and one pulmonary embolism were also reported. Eighteen patients had a radiotherapy program interruption because of acute toxicity. All patients but 2 have completed radiotherapy. Conclusion: Postoperative cisplatin-based chemotherapy followed by conformal radiotherapy in association with concurrent 5-fluorouracil seemed to be feasible and resulted in successful locoregional control.

  9. Postoperative Chemotherapy Followed by Conformal Concomitant Chemoradiotherapy in High-Risk Gastric Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Quero, Laurent, E-mail: laurent.quero@sls.aphp.fr [Department of Radiation Oncology, Saint-Louis Hospital, Paris (France); Bouchbika, Zineb; Kouto, Honorine; Baruch-Hennequin, Valerie [Department of Radiation Oncology, Saint-Louis Hospital, Paris (France); Gornet, Jean-Marc [Department of Gastroenterology, Saint-Louis Hospital, Paris (France); Munoz, Nicolas [Department of General Surgery, Saint-Louis Hospital, Paris (France); Cojean-Zelek, Isabelle [Department of Medical Oncology, Croix Saint-Simon Hospital, Paris (France); Houdart, Remi [Department of Digestive Surgery, Croix Saint-Simon Hospital, Paris (France); Panis, Yves [Department of Colorectal Surgery, Beaujon Hospital, Clichy (France); Valleur, Patrice [Department of Digestive Surgery, Lariboisiere Hospital, Paris (France); Aparicio, Thomas [Department of Gastroenterology, Avicenne Hospital, Bobigny (France); Maylin, Claude; Hennequin, Christophe [Department of Radiation Oncology, Saint-Louis Hospital, Paris (France)

    2012-06-01

    Purpose: To analyze the efficacy, toxicity, and pattern of relapse after adjuvant cisplatin-based chemotherapy followed by three-dimensional irradiation and concomitant LV5FU2 chemotherapy (high-dose leucovorin and 5-fluorouracil bolus plus continuous infusion) in the treatment of completely resected high-risk gastric cancer. Methods and Materials: This was a retrospective analysis of 52 patients with high-risk gastric cancer initially treated by total/partial gastrectomy and lymphadenectomy between January 2002 and June 2007. Median age was 54 years (range, 36-75 years). Postoperative treatment consisted of 5-fluorouracil and cisplatin chemotherapy. Adjuvant chemotherapy was followed by three-dimensional conformal radiotherapy in the tumor bed and regional lymph nodes at 4500 cGy/25 fractions in association with concomitant chemotherapy. Concomitant chemotherapy consisted of a 2-h infusion of leucovorin (200 mg/m Superscript-Two ) followed by a bolus of 5-fluorouracil (400 mg/m Superscript-Two ) and then a 44-h continuous infusion of 5-fluorouracil (2400-3600 mg/m Superscript-Two ) given every 14 days, for three cycles (LV5FU2 protocol). Results: Five-year overall and disease-free survival were 50% and 48%, respectively. Distant metastases and peritoneal spread were the most frequent sites of relapse (37% each). After multivariate analysis, only pathologic nodal status was significantly associated with disease-free and overall survival. Acute toxicities were essentially gastrointestinal and hematologic. One myocardial infarction and one pulmonary embolism were also reported. Eighteen patients had a radiotherapy program interruption because of acute toxicity. All patients but 2 have completed radiotherapy. Conclusion: Postoperative cisplatin-based chemotherapy followed by conformal radiotherapy in association with concurrent 5-fluorouracil seemed to be feasible and resulted in successful locoregional control.

  10. Phase ii/iii study of intraperitoneal chemotherapy after neoadjuvant chemotherapy for ovarian cancer: ncic ctg ov.21

    OpenAIRE

    Mackay, H.J.; Provencheur, D.; Heywood, M; Tu, D; Eisenhauer, E A; Oza, A. M.; Meyer, R

    2011-01-01

    Three large randomized clinical trials have shown a survival benefit in women with stage iii epithelial ovarian cancer (eoc) who receive intraperitoneal (IP) chemotherapy after optimal primary debulking surgery. The most recent Gynecologic Oncology Group study, gog 172, showed an improvement in median overall survival of approximately 17 months. That result led to a U.S. National Cancer Institute (nci) clinical announcement recommending that IP chemotherapy be considered for this group of wom...

  11. Utility of SPECT Lung Perfusion Scans in Assessing the Early Changes in Pulmonary Function after Radiotherapy for Patients with Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    Wenjie Zhang; Rong Zheng; Luiun Zhao; Luhua Wang; Shengzu Chen

    2005-01-01

    OBJECTIVE Radiation-induced lung injury commonly follows radiotherapy (RT) fortumors within and near the thorax. Lung function is usually measured by pulmonary function tests (PFTs). But RT-induced regional changes of pulmonary function cannot be accurately evaluated by PFTs. Lung perfusion scintigraphy compared with other radiographic methods can assess well regional pulmonary physiological function, and a 3-dimensional conformal radiotherapy planning system can quantitatively calculate irradiation dosage. The purpose of this study is to assess, by lung perfusion scintigraphy, early changes in the pulmonary function of patients with lung cancer when receiving thoracic 3-dimensional conformal radiotherapy (3D-CRT).METHODS Nineteen patients receiving thoracic 3D-CRT for lung cancer were studied. A single photon emission computed tomography (SPECT)lung perfusion scan, X-ray or CT scan before RT and after 40~50Gy radiation were performed. Pre-RT SPECT lung perfusion images were classified by comparing lung perfusion defects with radiological abnormalities before RT. Grade 0: There was no lung perfusion defect in the area of radiological abnormality. Grade 1: The size of the radiological abnormality was similar to the area of the lung perfusion defect. Grade 2: The area of the lung perfusion defect was bigger than the size of the radiological abnormality and extended to one lobe of the lung. Grade 3: The area of lung perfusion defect exceeded one lobe of the lung. The radiation field with more than 20 Gy was drawn as a region of interest (ROI). The proportion of radioactive dose within this ROI relative to total lung dose in one slice was calculated.RESULTS All patients had lung perfusion defects, nine patients with grade 1,five patients with grade 2 and five patients with grade 3 damage,respectively. All tumors in the 19 patients were reduced in CT or X-ray images to various degrees after 40~50 Gy radiation. The mean proportion of ROI in 19 patients was 53.7±29

  12. Effect of progesterone combined with chemotherapy on epithelial ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    陈晓军; 丰有吉

    2003-01-01

    Objective To identify an effective auxiliary therapy for epithelial ovarian cancer. Methods Progesterone acetate given at 250 mg intramuscularly twice a week for 1 month followed by increased administration to 500 mg intramuscularly every two weeks for 3 years was used in combination with platinum based chemotherapy to treat patients with epithelial ovarian cancer as a first-line therapy. Prognoses of the patients receiving progesterone combined with chemotherapy (progesterone group) and those receiving chemotherapy only (control group) were compared. Results Three-year recurrence and survival conditions of the progesterone and control groups were as follows. Stage Ⅰa: no patient relapsed or died in either group. Stage Ⅰb-Ⅰc: three-year recurrence rates were 14.2% and 37.5%, respectively (P=0.2845); three-year survival rates were 92.3% and 87.5% (P=0.7221). Stage Ⅱ: 1 patient relapsed and died among the 3 patients in the progesterone group; among the 4 patients in the control group, 1 patient relapsed, none died. Stage Ⅲ: three-year recurrence rates were 30.8% and 64.3%, respectively (P=0.1170); three-year survival rates were 85.7% and 42.9%, respectively (P=0.005). Stage Ⅳ: 4 patients relapsed and 1 patient died among the 7 patients in the progesterone group; both the patients in the control group relapsed and died. Conclusions The results indicated that progesterone combined with platinum based chemotherapy as a first-line therapy may improve the prognosis of advanced epithelial ovarian cancer, but would not change the prognosis of early stage epithelial ovarian cancer.

  13. Determining Chemotherapy Tolerance in Older Patients With Cancer

    OpenAIRE

    Kim, Jerome; Hurria, Arti

    2013-01-01

    Older adults with cancer constitute a heterogeneous group of patients who pose unique challenges for oncology care. One major concern is how to identify patients who are at a higher risk for chemotherapy intolerance, because a standard oncology workup may not always be able to distinguish an older individual’s level of risk for treatment-related complications. Geriatric oncologists incorporate tools used in the field of geriatrics, and have developed the Comprehensive Geriatric Assessment to ...

  14. Adjuvant Radio-chemotherapy for extrahepatic biliary tract cancers

    Directory of Open Access Journals (Sweden)

    Mentha Gilles

    2011-06-01

    Full Text Available Abstract Background Extrahepatic biliary duct cancers (EBDC are uncommon malignancies characterized by a poor prognosis with high rate of loco-regional recurrence. The purpose of the present study is to assess the feasibility and the potential impact of adjuvant radiotherapy (RT in a series of patients treated in one institution. Methods Twenty three patients with non-metastatic bile duct cancer treated surgically with curative intent (4 gallbladder, 7 ampullary and 12 cholangiocarcinoma received 3D conformal external beam RT to a median total dose of 50.4Gy. Concurrent chemotherapy based on 5-FU was delivered to 21 patients (91%. Surgical margins were negative in 11 patients (48%, narrow in 2 (9%, and microscopically involved in 8 (35%. Eleven patients (55% had metastatic nodal involvement. The average follow-up time for all patients was 30 months (ranging from 3-98. Results Acute gastrointestinal grade 2 toxicity (RTOG scale was recorded in 2 patients (9%. Nausea or vomiting grade 1 and 2 was observed in 8 (35% and 2 patients (9% respectively. Only one patient developed a major late radiation-induced toxicity. The main pattern of recurrence was both loco-regional and distant (liver, peritoneum and/or lung. No difference was observed in loco-regional control according to the tumor location. The 5-year actuarial loco-regional control rate was 48.3% (67% and 30% for patients operated on with negative and positive/narrow/unknown margins respectively, p = 0.04. The 5-year actuarial overall survival was of 35.9% for the entire group (61.4% in case of negative margins and 16.7% in case of positive/narrow/unknown margins, p = 0.07. Conclusions Postoperative RT with 50-60 Gy is feasible with acceptable acute and late toxicities. The potential benefit observed in our series may support the use of adjuvant RT in patients with locally advanced disease. Prospective randomized trials are warranted to confirm definitively the role of RT in this tumor

  15. Adjuvant Radio-chemotherapy for extrahepatic biliary tract cancers

    International Nuclear Information System (INIS)

    Extrahepatic biliary duct cancers (EBDC) are uncommon malignancies characterized by a poor prognosis with high rate of loco-regional recurrence. The purpose of the present study is to assess the feasibility and the potential impact of adjuvant radiotherapy (RT) in a series of patients treated in one institution. Twenty three patients with non-metastatic bile duct cancer treated surgically with curative intent (4 gallbladder, 7 ampullary and 12 cholangiocarcinoma) received 3D conformal external beam RT to a median total dose of 50.4Gy. Concurrent chemotherapy based on 5-FU was delivered to 21 patients (91%). Surgical margins were negative in 11 patients (48%), narrow in 2 (9%), and microscopically involved in 8 (35%). Eleven patients (55%) had metastatic nodal involvement. The average follow-up time for all patients was 30 months (ranging from 3-98). Acute gastrointestinal grade 2 toxicity (RTOG scale) was recorded in 2 patients (9%). Nausea or vomiting grade 1 and 2 was observed in 8 (35%) and 2 patients (9%) respectively. Only one patient developed a major late radiation-induced toxicity. The main pattern of recurrence was both loco-regional and distant (liver, peritoneum and/or lung). No difference was observed in loco-regional control according to the tumor location. The 5-year actuarial loco-regional control rate was 48.3% (67% and 30% for patients operated on with negative and positive/narrow/unknown margins respectively, p = 0.04). The 5-year actuarial overall survival was of 35.9% for the entire group (61.4% in case of negative margins and 16.7% in case of positive/narrow/unknown margins, p = 0.07). Postoperative RT with 50-60 Gy is feasible with acceptable acute and late toxicities. The potential benefit observed in our series may support the use of adjuvant RT in patients with locally advanced disease. Prospective randomized trials are warranted to confirm definitively the role of RT in this tumor location

  16. Cost Effectiveness of Integrated Medicine in Patients With Cancer Receiving Anticancer Chemotherapy

    OpenAIRE

    Coriat, Romain; Boudou-Rouquette, Pascaline; Durand, Jean-Philippe; Forgeot d'Arc, Priscille; Martin, Idalie; Mir, Olivier; Ropert, Stanislas; Alexandre, Jérôme; Goldwasser, François

    2012-01-01

    The hospital-home monitoring program is a cost-effective strategy for offering ambulatory chemotherapy treatment to patients with cancer and has become the authors' standard procedure for ambulatory chemotherapy.

  17. Chemotherapy in cancer of the esophagus

    OpenAIRE

    Kok, Tjebbe

    1997-01-01

    textabstractAl though cancer of the esophagus has been recogni zed as a fatal disease as long ago as the start of the Christian era, the present outlook remains dismal. Less than 10 percent of patients with seemingly localized disease, surgically treated with curative intent, will survive five years or more. Dysphagia, the initial symptom in most patients, usually occurs late in the course of the disease, when the esophageal wall has been infiltrated or penetrated. At this time, in the majori...

  18. Proton Beam Therapy and Concurrent Chemotherapy for Esophageal Cancer

    International Nuclear Information System (INIS)

    Purpose: Proton beam therapy (PBT) is a promising modality for the management of thoracic malignancies. We report our preliminary experience of treating esophageal cancer patients with concurrent chemotherapy (CChT) and PBT (CChT/PBT) at MD Anderson Cancer Center. Methods and Materials: This is an analysis of 62 esophageal cancer patients enrolled on a prospective study evaluating normal tissue toxicity from CChT/PBT from 2006 to 2010. Patients were treated with passive scattering PBT with two- or three-field beam arrangement using 180 to 250 MV protons. We used the Kaplan-Meier method to assess time-to-event outcomes and compared the distributions between groups using the log–rank test. Results: The median follow-up time was 20.1 months for survivors. The median age was 68 years (range, 38–86). Most patients were males (82%) who had adenocarcinomas (76%) and Stage II-III disease (84%). The median radiation dose was 50.4 Gy (RBE [relative biologic equivalence]) (range, 36–57.6). The most common grade 2 to 3 acute toxicities from CChT/PBT were esophagitis (46.8%), fatigue (43.6%), nausea (33.9%), anorexia (30.1%), and radiation dermatitis (16.1%). There were two cases of grade 2 and 3 radiation pneumonitis and two cases of grade 5 toxicities. A total of 29 patients (46.8%) received preoperative CChT/PBT, with one postoperative death. The pathologic complete response (pCR) rate for the surgical cohort was 28%, and the pCR and near CR rates (0%–1% residual cells) were 50%. While there were significantly fewer local-regional recurrences in the preoperative group (3/29) than in the definitive CChT/PBT group (16/33) (log–rank test, p = 0.005), there were no differences in distant metastatic (DM)-free interval or overall survival (OS) between the two groups. Conclusions: This is the first report of patients treated with PBT/CChT for esophageal cancer. Our data suggest that this modality is associated with a few severe toxicities, but the pathologic response and

  19. Proton Beam Therapy and Concurrent Chemotherapy for Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Steven H., E-mail: shlin@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Komaki, Ritsuko; Liao Zhongxing [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wei, Caimiao [Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Myles, Bevan [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Guo Xiaomao [Department of Radiation Oncology, Fudan University Cancer Hospital, Shanghai (China); Palmer, Matthew [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mohan, Radhe [Department of Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Swisher, Stephen G.; Hofstetter, Wayne L. [Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ajani, Jaffer A. [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Cox, James D. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-07-01

    Purpose: Proton beam therapy (PBT) is a promising modality for the management of thoracic malignancies. We report our preliminary experience of treating esophageal cancer patients with concurrent chemotherapy (CChT) and PBT (CChT/PBT) at MD Anderson Cancer Center. Methods and Materials: This is an analysis of 62 esophageal cancer patients enrolled on a prospective study evaluating normal tissue toxicity from CChT/PBT from 2006 to 2010. Patients were treated with passive scattering PBT with two- or three-field beam arrangement using 180 to 250 MV protons. We used the Kaplan-Meier method to assess time-to-event outcomes and compared the distributions between groups using the log-rank test. Results: The median follow-up time was 20.1 months for survivors. The median age was 68 years (range, 38-86). Most patients were males (82%) who had adenocarcinomas (76%) and Stage II-III disease (84%). The median radiation dose was 50.4 Gy (RBE [relative biologic equivalence]) (range, 36-57.6). The most common grade 2 to 3 acute toxicities from CChT/PBT were esophagitis (46.8%), fatigue (43.6%), nausea (33.9%), anorexia (30.1%), and radiation dermatitis (16.1%). There were two cases of grade 2 and 3 radiation pneumonitis and two cases of grade 5 toxicities. A total of 29 patients (46.8%) received preoperative CChT/PBT, with one postoperative death. The pathologic complete response (pCR) rate for the surgical cohort was 28%, and the pCR and near CR rates (0%-1% residual cells) were 50%. While there were significantly fewer local-regional recurrences in the preoperative group (3/29) than in the definitive CChT/PBT group (16/33) (log-rank test, p = 0.005), there were no differences in distant metastatic (DM)-free interval or overall survival (OS) between the two groups. Conclusions: This is the first report of patients treated with PBT/CChT for esophageal cancer. Our data suggest that this modality is associated with a few severe toxicities, but the pathologic response and clinical

  20. Androgen receptor status predicts response to chemotherapy, not risk of breast cancer in Indian women

    Directory of Open Access Journals (Sweden)

    Chakraborty Anurupa

    2010-08-01

    Full Text Available Abstract Background Considerably little is known about the biological role and clinical significance of androgen receptor expression in breast cancer. The objectives of this study were to characterize AR-CAG repeat genotypes in a cohort of women with breast cancer and to determine the influence of AR on response to neoadjuvant chemotherapy and clinical outcome. Materials and methods Genotyping of the AR CAG repeat region was done on 70 patients and 80 healthy aged- matched female controls. To assess response to NACT, tissue samples from 30 LABC cases were evaluated quantitatively by real time for AR mRNA expression. The clinical response was correlated with both the pre and post chemotherapy AR expression. The CAG alleles did not show differences between cases and controls when the mean of short, long and average length of both CAG alleles was considered. However, analysis when done defining short allele as CAGn Conclusions Although, expansion of the CAGn in the AR gene doesn't show any major effect on breast cancer risk, patients with positive AR expression, pre neoadjuvant chemotherapy, were found to be good responders and a decrease in mRNA level of AR gene related to the chemotherapy-induced apoptosis could serve as an important independent predictor of response to NACT.

  1. Methylation status at HYAL2 predicts overall and progression-free survival of colon cancer patients under 5-FU chemotherapy.

    Science.gov (United States)

    Pfütze, Katrin; Benner, Axel; Hoffmeister, Michael; Jansen, Lina; Yang, Rongxi; Bläker, Hendrik; Herpel, Esther; Ulrich, Alexis; Ulrich, Cornelia M; Chang-Claude, Jenny; Brenner, Hermann; Burwinkel, Barbara

    2015-12-01

    DNA methylation variations in gene promoter regions are well documented tumor-specific alterations in human malignancies including colon cancer, which may influence tumor behavior and clinical outcome. As a subset of colon cancer patients does not benefit from adjuvant chemotherapy, predictive biomarkers are desirable. Here, we describe that DNA methylation levels at CpG loci of hyaluronoglucosaminidase 2 (HYLA2) could be used to identify stage II and III colon cancer patients who are most likely to benefit from 5-flourouracil (5-FU) chemotherapy with respect to overall survival and progression-free survival. PMID:26453961

  2. Intravenous chemotherapy for resected gastric cancer: meta-analysis of randomized controlled trials

    Institute of Scientific and Technical Information of China (English)

    Jian-Kun Hu; You-Ping Li; Zhi-Xin Chen; Zong-Guang Zhou; Bo Zhang; Jing Tian; Jia-Ping Chen; Li Wang; Chao-Hua Wang; Hong-Yan Chen

    2002-01-01

    AIM: To assess the safety and efficacy of different intravenous chemotherapeutic regimens in patients with gastric carcinomas who had undergone gastrectomy.METHODS: A meta-analysis of all the relevant randomized controlled trials (RCTs) was performed. Language was restricted to Chinese and English. RCTs were identified from Medline and Embase (1980-2001/4), and Chinese Biowere checked at the same time. We included randomized and quasi-randomized trials comparing the efficacy of intravenous chemotherapy after gastrectomy with that of surgery alone in patients with confirmed gastric carcinomas who had undergone gastrectomy. Selection criteria were: randomized or quasi-randomized trials with following-up results; Trials could be double-blind, single-blind or not blind; Chemotherapy groups were given intravenous chemotherapy after gastrectomy without neo-adjuvant chemotherapy, intraperitoneal hyperthermic perfusion, radiotherapy or chemoimmunotherapy; Controlled group included those receiving gastrectomy alone. The following data were extracted: the number of survival and death by the end of the follow-up; the different agents and doses of the intravenous chemotherapy; the baseline of the chemotherapy group and the controlled arm; the serious adverse events; the statistical consideration; cost-effectiveness analysis. The statistical analysis was performed by RevMan4.1 software which was provided by the Cochrane Collaboration. A Pvalue of <0.05 was considered statistically significant. Metaanalysis was done with random effects model. Heterogeneity was checked by chi-square test. Sensitivity analysis was performed by excluding the trials in which Jadad-scale was only 1 score. The result was expressed with odds ratio (OR) for the categorical variable.RESULTS: Fourteen trials involving 4543 patients were included. Meta-analysis was done with random effects model. Heterogeneity and sensitivity analysis were performed also. The effect of intravenous chemotherapy after

  3. Clinical predictors of anticipatory emesis in patients treated with chemotherapy at a tertiary care cancer hospital

    OpenAIRE

    Qureshi, Fawad; Shafi, Azhar; Ali, Sheeraz; Siddiqui, Neelam

    2016-01-01

    Objective: To determine the clinical predictors of anticipatory emesis in patients treated with chemotherapy at a tertiary care cancer hospital. Methods: This was a cross-sectional study conducted on 200 patients undergoing first line chemotherapy with minimum of two cycles at inpatient department and chemotherapy bay of Shaukat Khanum Memorial Cancer Hospital and Research Centre Pakistan. Anticipatory nausea and vomiting develops before administration of chemotherapy. Clinical signs and symp...

  4. Current trends in the chemotherapy of colorectal cancer.

    Science.gov (United States)

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

    2012-01-01

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

  5. Plastic Surgery in the Multimodal Treatment Concept of Soft Tissue Sarcoma: Influence of Radiation, Chemotherapy, and Isolated Limb Perfusion on Plastic Surgery Techniques

    OpenAIRE

    Kapalschinski, Nicolai; Goertz, Ole; Harati, Kamran; Kueckelhaus, Maximilian; Kolbenschlag, Jonas; Lehnhardt, Marcus; Hirsch, Tobias

    2015-01-01

    Surgical intervention is the mainstay treatment for soft tissue sarcomas (STSs). The significance of adjuvant and neoadjuvant therapies, such as chemotherapy, radiation, and isolated limb perfusion, remains under controversial discussion. The goal of this review is to discuss the effects of the aforementioned treatment modalities and their timing of application in plastic surgery techniques. Furthermore, options of reconstruction in cases of complications caused by adjuvant and neoadjuvant th...

  6. Mathematical models in cell biology and cancer chemotherapy

    CERN Document Server

    Eisen, Martin

    1979-01-01

    The purpose of this book is to show how mathematics can be applied to improve cancer chemotherapy. Unfortunately, most drugs used in treating cancer kill both normal and abnormal cells. However, more cancer cells than normal cells can be destroyed by the drug because tumor cells usually exhibit different growth kinetics than normal cells. To capitalize on this last fact, cell kinetics must be studied by formulating mathematical models of normal and abnormal cell growth. These models allow the therapeutic and harmful effects of cancer drugs to be simulated quantitatively. The combined cell and drug models can be used to study the effects of different methods of administering drugs. The least harmful method of drug administration, according to a given criterion, can be found by applying optimal control theory. The prerequisites for reading this book are an elementary knowledge of ordinary differential equations, probability, statistics, and linear algebra. In order to make this book self-contained, a chapter on...

  7. Adjuvant endocrine and chemotherapy for early breast cancer

    International Nuclear Information System (INIS)

    Objective: Present the results of the 1995 World Overview which will be held in Oxford England two weeks before ASTRO. Discuss the interpretation and application of these results. Review current research topics on the use of adjuvant endocrine and chemotherapy for early breast cancer. The survival benefits from adjuvant chemotherapy in premenopausal women and adjuvant tamoxifen in postmenopausal women are well established. Each will reduce the annual odds of death by about 25% resulting in a 10 year survival difference of 8-10%. By the time of this presentation, the results of the 1995 Adjuvant Therapy Overview should be with 10+ years of follow-up, and if possible these will be summarized. Current efforts to improve on previous results are focused on the following areas: Optimal chemotherapy dose. Decreasing dose will compromise patient survival. It is not as certain that increasing dose will have as much impact in improving survival. The NSABP was unable to demonstrate an improvement in survival by modestly increasing the dose of cyclophosphamide alone. However, recent results of a Canadian study of CEF (cyclophosphamide, epidoxorubicin, and 5-fluorouracil) and an Intergroup trial of an intense 16 week polychemotherapy program keep alive the possibility that dose escalation is still a very important question. An NSABP trial evaluating even greater cyclophosphamide dose escalation, an Intergroup evaluation of different doxorubicin doses, and two Intergroup trials evaluating very high dose chemotherapy and bone marrow transplantation should provide definitive evidence regarding the importance of dose. Drug sequence. A study from Milan suggests that initial treatment with single agent doxorubicin followed by CMF will be superior to alternating doxorubicin and CMF. This has not been confirmed yet, and the reason for increased benefit from such a sequence is not entirely clear. This concept is being explored further in an Intergroup trial comparing four cycles of

  8. Regional habit of coca chewing: Brain perfusion study

    International Nuclear Information System (INIS)

    A comparison was made of brain perfusion findings obtained using single photon emission computed tomography (SPECT) and 99Tcm-HMPAO (hexamethyl propylene amine oxime) in a study involving, on the one hand, cocaine dependent, HIV negative volunteers with different degrees of addiction (group G-II) and coca leaf chewers (group G-III) and, on the other, an abstinent control group (G-I). Urinary concentrations, determined by immunoassay, of benzolmethylecgonines (bmecg) - cocaine metabolites - were correlated with brain perfusion results. The maximum age of the subjects was 44 years. The results of neuropsychomotor examinations were normal for all of them. The number of persons in the different groups was as follows: three in G-I (control); seven in G-II (moderate and heavy cocaine users); and ten in G-III (continuous or intermittent coca leaf chewers). Cerebral SPECT readings were obtained with 30 mCi of 99Tcm-MPAO, after the appropriate quality checks on the instruments and radiochemicals. In G-I there were no perfusion irregularities and the urinary concentration were negative. In G-II (6/7) patchy asymmetric hypoperfusion was observed, with bmecg values of up to 17,000 ng/mL. In G-III (7/10) there appeared asymmetric areas of moderate hypoperfusion with left predominance and bmecg values above those of G-I, reaching 1000 ng/mL. Hypoperfused basal ganglions were observed in some G-II cases and, to a lesser extent, in G-III. The greats (in terms of number and dimensions) perfusion irregularities, with the highest bmecg values and the greatest probability of morbidity, occurred among the cocaine addicts (G-II). Among the coca leaf chewers (G-III), moderate spotted hypoperfusion was observed, also with left predominance and with moderate bmecg values. The study should be broadened in order to substantiate the findings. (author). 9 refs, 3 figs, 2 tabs

  9. Genotyping panel for assessing response to cancer chemotherapy

    Directory of Open Access Journals (Sweden)

    Hampel Heather

    2008-06-01

    Full Text Available Abstract Background Variants in numerous genes are thought to affect the success or failure of cancer chemotherapy. Interindividual variability can result from genes involved in drug metabolism and transport, drug targets (receptors, enzymes, etc, and proteins relevant to cell survival (e.g., cell cycle, DNA repair, and apoptosis. The purpose of the current study is to establish a flexible, cost-effective, high-throughput genotyping platform for candidate genes involved in chemoresistance and -sensitivity, and treatment outcomes. Methods We have adopted SNPlex for genotyping 432 single nucleotide polymorphisms (SNPs in 160 candidate genes implicated in response to anticancer chemotherapy. Results The genotyping panels were applied to 39 patients with chronic lymphocytic leukemia undergoing flavopiridol chemotherapy, and 90 patients with colorectal cancer. 408 SNPs (94% produced successful genotyping results. Additional genotyping methods were established for polymorphisms undetectable by SNPlex, including multiplexed SNaPshot for CYP2D6 SNPs, and PCR amplification with fluorescently labeled primers for the UGT1A1 promoter (TAnTAA repeat polymorphism. Conclusion This genotyping panel is useful for supporting clinical anticancer drug trials to identify polymorphisms that contribute to interindividual variability in drug response. Availability of population genetic data across multiple studies has the potential to yield genetic biomarkers for optimizing anticancer therapy.

  10. Multi drug resistance to cancer chemotherapy: Genes involved and blockers

    International Nuclear Information System (INIS)

    During the last three decades, important and considerable research efforts had been performed to investigate the mechanism through which cancer cells overcome the cytotoxic effects of a variety of chemotherapeutic drugs. Most of the previously published work has been focused on the resistance of tumor cells to those anticancer drugs of natural source. Multidrug resistance (MDR) is a cellular cross-resistance to a broad spectrum of natural products used in cancer chemotherapy and is believed to be the major cause of the therapeutic failures of the drugs belonging to different naturally obtained or semisynthetic groups including vinca alkaloids, taxans, epipodophyllotoxins and certain antibiotics. This phenomenon results from overexpression of four MDR genes and their corresponding proteins that act as membrane-bound ATP consuming pumps. These proteins mediate the efflux of many structurally and functionally unrelated anticancer drugs of natural source. MDR may be intrinsic or acquired following exposure to chemotherapy. The existence of intrinsically resistant tumor cell clone before and following chemotherapeutic treatment has been associated with a worse final outcome because of increased incidence of distant metasis. In view of irreplaceability of natural product anticancer drugs as effective chemotherapeutic agents, and in view of MDR as a major obstacle to successful chemotherapy, this review is aimed to highlight the genes involved in MDR, classical MDR blockers and gene therapy approaches to overcome MDR. (author)

  11. Non-contrast-enhanced preoperative assessment of lung perfusion in patients with non-small-cell lung cancer using Fourier decomposition magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, Gregor, E-mail: gregor.sommer@usb.ch [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg (Germany); Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Petersgraben 4, 4031 Basel (Switzerland); Bauman, Grzegorz, E-mail: gbauman@wisc.edu [Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg (Germany); Department of Medical Physics in Radiology (E020), German Cancer Research Center (DKFZ), Heidelberg (Germany); Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue, Madison, 53705 WI (United States); Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br [Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg (Germany); Department of Radiology, University Hospital of the School of Medicine of Ribeirao Preto – University of Sao Paulo, Ribeirao Preto (Brazil); Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik Heidelberg gGmbH, Amalienstr. 5, 69126 Heidelberg (Germany); Draenkow, Christopher, E-mail: c.draenkow@thoraxklinik-heidelberg.de [Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg (Germany); Department of Surgery, Thoraxklinik Heidelberg gGmbH, Amalienstr. 5, 69126 Heidelberg (Germany); Heussel, Claus Peter, E-mail: heussel@uni-heidelberg.de [Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg (Germany); Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik Heidelberg gGmbH, Amalienstr. 5, 69126 Heidelberg (Germany); and others

    2013-12-01

    Objective: To investigate non-contrast-enhanced Fourier decomposition MRI (FD MRI) for assessment of regional lung perfusion in patients with Non-Small-Cell Lung Cancer (NSCLC) in comparison to dynamic contrast-enhanced MRI (DCE MRI). Methods: Time-resolved non-contrast-enhanced images of the lungs were acquired prospectively in 15 patients using a 2D balanced steady-state free precession (b-SSFP) sequence. After non-rigid registration of the native image data, perfusion-weighted images were calculated by separating periodic changes of lung proton density at the cardiac frequency using FD. DCE MRI subtraction datasets were acquired as standard of reference. Both datasets were analyzed visually for perfusion defects. Then segmentation analyses were performed to describe perfusion of pulmonary lobes semi-quantitatively as percentages of total lung perfusion. Overall FD MRI perfusion signal was compared to velocity-encoded flow measurements in the pulmonary trunk as an additional fully quantitative reference. Results: Image quality ratings of FD MRI were significantly inferior to those of DCE MRI (P < 0.0001). Sensitivity, specificity, and accuracy of FD MRI for visual detection of perfusion defects were 84%, 92%, and 91%. Semi-quantitative evaluation of lobar perfusion provided high agreement between FD MRI and DCE MRI for both entire lungs and upper lobes, but less agreement in the lower parts of both lungs. FD perfusion signal showed high linear correlation with pulmonary arterial blood flow. Conclusion: FD MRI is a promising technique that allows for assessing regional lung perfusion in NSCLC patients without contrast media or ionizing radiation. However, for being applied in clinical routine, image quality and robustness of the technique need to be further improved.

  12. Non-contrast-enhanced preoperative assessment of lung perfusion in patients with non-small-cell lung cancer using Fourier decomposition magnetic resonance imaging

    International Nuclear Information System (INIS)

    Objective: To investigate non-contrast-enhanced Fourier decomposition MRI (FD MRI) for assessment of regional lung perfusion in patients with Non-Small-Cell Lung Cancer (NSCLC) in comparison to dynamic contrast-enhanced MRI (DCE MRI). Methods: Time-resolved non-contrast-enhanced images of the lungs were acquired prospectively in 15 patients using a 2D balanced steady-state free precession (b-SSFP) sequence. After non-rigid registration of the native image data, perfusion-weighted images were calculated by separating periodic changes of lung proton density at the cardiac frequency using FD. DCE MRI subtraction datasets were acquired as standard of reference. Both datasets were analyzed visually for perfusion defects. Then segmentation analyses were performed to describe perfusion of pulmonary lobes semi-quantitatively as percentages of total lung perfusion. Overall FD MRI perfusion signal was compared to velocity-encoded flow measurements in the pulmonary trunk as an additional fully quantitative reference. Results: Image quality ratings of FD MRI were significantly inferior to those of DCE MRI (P < 0.0001). Sensitivity, specificity, and accuracy of FD MRI for visual detection of perfusion defects were 84%, 92%, and 91%. Semi-quantitative evaluation of lobar perfusion provided high agreement between FD MRI and DCE MRI for both entire lungs and upper lobes, but less agreement in the lower parts of both lungs. FD perfusion signal showed high linear correlation with pulmonary arterial blood flow. Conclusion: FD MRI is a promising technique that allows for assessing regional lung perfusion in NSCLC patients without contrast media or ionizing radiation. However, for being applied in clinical routine, image quality and robustness of the technique need to be further improved

  13. Unintended hepatic adverse events associated with cancer chemotherapy.

    Science.gov (United States)

    Senior, John R

    2010-01-01

    Chemotherapy is meant to be toxic, but it is particularly aimed at the tumor cells. Collateral damage may occur to normal cells and tissues, especially if they are fairly rapidly regenerating, as is the case for bone marrow cells, intestinal epithelial cells, and liver cells after hepatic injury. The liver has a great capacity to resist injury, overcome it, and to regenerate, even after quite massive injury (resection of 50%-65%, for example). This capacity may make it susceptible to chemotherapeutic toxicity, and a struggle between injury and adaptation, leading to recovery and tolerance or to failure and death. If the chemotherapy is aimed just at delaying progression of the cancer for a few weeks or months, it may not be worth the risk of irreversible liver injury developing in that time. Close clinical observation and sound clinical judgment are required. PMID:19858501

  14. Pneumatosis cystoides intestinalis after fluorouracil chemotherapy for rectal cancer

    Institute of Scientific and Technical Information of China (English)

    Kenji Mimatsu; Takatsugu Oida; Atsushi Kawasaki; Hisao Kano; Youichi Kuboi; Osamu Aramaki; Sadao Amano

    2008-01-01

    Pneumatosis cystoides intestinalis (PCI) is a relatively rare condition characterized by intraluminal gas in the gastrointestinal tract.Several chemotherapeutic agents have been reported to be associated with PCI,although fluorouracil-related PCI is extremely rare.We report a case of a 76-year old man who received adjuvant chemotherapy for rectal cancer with fluorouracil (FU) and leucovorin (LV).After 1 cycle of the treatment,he presented with diarrhea and abdominal pain.Abdominal radiogram revealed the presence of free air under the diaphragm and intramural gas in the intestine.Laparotomy was performed,showing a suspected diagnosis of perforation in the gastrointestinal tract.Intraoperative findings revealed penumatosis of the intestine without evidence of perforation.He was treated supportively and his symptoms improved.In conclusion,we should consider the possibility of PCI occurring in patients with malignancies during chemotherapy treatment.

  15. Postoperative radio-chemotherapy in locally advanced gastric cancer

    International Nuclear Information System (INIS)

    Background: Overall 5 years survival for surgically excised gastric cancer is 30%. Adjuvant treatment may improve the surgical results. Aim: To assess treatment results and toxicity in patients with surgically excised gastric cancer, treated with adjuvant radiotherapy and concomitant continuous 5-Fluorouracil (5-FU). Material and Methods: Forty one patients aged 32 to 73 years (29 males) with stage II-IVA gastric cancer, subjected to a total or subtotal gastrectomy and D2 nodal dissection between 1997 to 2006, were studied. They received adjuvant radiotherapy to the gastric bed and draining lymphatic nodes in a total dose of 50.4 Gy in 28 fractions and chemotherapy with continuous infusion 5-FU, 200 mg/m2/day. Results were compared to historical controls matched according to demographic parameters and tumor characteristics. Results: Eighteen patients were in stage II, 10 in stage IIIA, nine in stage IIIB and four in stage IVA. Twelve patients had an N0 nodal status, 15 were N1, nine were N2 and five were N3. After a mean follow up of 32 months, 26 patients (63%) were alive. Five year overall survival was 49.6% for surgery plus radiochemotherapy compared to 30.7% for the historical group subjected only to surgery (p =0.002). Radiotherapy was associated with grade 1-2 toxicity and treatment was completed without interruptions in all patients. Chemotherapy was delayed temporarily in 3 patients. Conclusions: Adjuvant radio-chemotherapy improved overall survival in gastric cancer, compared to historical controls subjected only to surgical treatment

  16. Effect of Auricular Acupressure on Acute Nausea and Vomiting Induced by Chemotherapy among Breast Cancer Patients

    OpenAIRE

    Mohammad Eghbali; Shokoh Varaei; Seyedeh Fatemeh Jalalinia; Mozhgan Aalam Samimi; Kiarash Sa’atchi; Mir Saeed Yekaninejad

    2015-01-01

      Background & Aim: Approximately 75% of patients with cancer experience acute nausea and vomiting (24 hours after chemotherapy). The aim of this study was to determine the effect of auricular acupressure in relieving acute nausea and vomiting among women with breast cancer receiving chemotherapy .   Methods & Materials: This study was a posttest only randomized clinical trial conducted on 48 women with breast cancer receiving chemotherapy in Imam Khomeini and Hazrat Rasoul Akra...

  17. The Association of Transporter Genes Polymorphisms and Lung Cancer Chemotherapy Response

    OpenAIRE

    Wang, Ying; Yin, Ji-Ye; Li, Xiang-ping; Chen, Juan; Qian, Chen-yue; Zheng, Yi; Fu, Yi-Lan; Chen, Zi-Yu; Zhou, Hong-Hao; Liu, Zhao-Qian

    2014-01-01

    Lung cancer is one of the most common cancers and is the leading cause of death worldwide. Platinum-based chemotherapy is the main treatment method in lung cancer patients. Our previous studies indicated that single nucleotide polymorphisms (SNPs) in some transporter genes played important role in platinum-based chemotherapy efficacy. The aim of this study was to investigate the association of SNPs in transporter genes and platinum-based chemotherapy efficacy. The main polymorphisms on transp...

  18. WISP1 Polymorphisms Contribute to Platinum-Based Chemotherapy Toxicity in Lung Cancer Patients

    OpenAIRE

    Juan Chen; Jiye Yin; Xiangping Li; Ying Wang; Yi Zheng; Chenyue Qian; Ling Xiao; Ting Zou; Zhan Wang; Junyan Liu; Wei Zhang; Honghao Zhou; Zhaoqian Liu

    2014-01-01

    Platinum-based chemotherapy toxicity is always one of the serious problems from which lung cancer patients suffer. The genetic polymorphism of WISP1 was revealed to be associated with susceptibility and platinum-based chemotherapy response in our previous studies. In this study, we aimed to investigate the relationship of WISP1 genetic polymorphisms with platinum-based chemotherapy toxicity in lung cancer patients. A total of 412 lung cancer patients were enrolled in this study, and 28 polym...

  19. Prediction of postoperative loss of lung function in patients with malignant lung mass. Quantitative regional ventilation-perfusion scanning

    International Nuclear Information System (INIS)

    The quantitative measurement of regional ventilation and perfusion distribution is simply and reliably accomplished by using routinely available radioactive gas and perfusion lung scanning agents, and a large field-of-view gamma camera with an on-line computer. The preoperative prediction of postsurgical loss in lung function can be made accurately by using the quantitative ventilation-perfusion lung scan technique. Either a regional ventilation study or perfusion study may be used for the prediction, but analysis of regional ventilation distribution appears to be a better parameter than that of perfusion distribution for the prediction of postoperative loss of FEV1. In the rare case of a patient with a marked ventilation-perfusion deficit, quantitative distribution of both ventilation and perfusion may be needed for an accurate assessment of postsurgical lung function. 18 references

  20. Lung cancer perfusion: can we measure pulmonary and bronchial circulation simultaneously?

    International Nuclear Information System (INIS)

    To describe a new CT perfusion technique for assessing the dual blood supply in lung cancer and present the initial results. This study was approved by the institutional review board. A CT protocol was developed, and a dual-input CT perfusion (DI-CTP) analysis model was applied and evaluated regarding the blood flow fractions in lung tumours. The pulmonary trunk and the descending aorta were selected as the input arteries for the pulmonary circulation and the bronchial circulation respectively. Pulmonary flow (PF), bronchial flow (BF), and a perfusion index (PI, = PF/ (PF + BF)) were calculated using the maximum slope method. After written informed consent was obtained, 13 consecutive subjects with primary lung cancer underwent DI-CTP. Perfusion results are as follows: PF, 13.45 ± 10.97 ml/min/100 ml; BF, 48.67 ± 28.87 ml/min/100 ml; PI, 21 % ± 11 %. BF is significantly larger than PF, P < 0.001. There is a negative correlation between the tumour volume and perfusion index (r = 0.671, P = 0.012). The dual-input CT perfusion analysis method can be applied successfully to lung tumours. Initial results demonstrate a dual blood supply in primary lung cancer, in which the systemic circulation is dominant, and that the proportion of the two circulation systems is moderately dependent on tumour size. (orig.)

  1. A rehabilitation program for lung cancer patients during postthoracotomy chemotherapy

    Directory of Open Access Journals (Sweden)

    Hoffman AJ

    2014-03-01

    Full Text Available Amy J Hoffman,1 Ruth Ann Brintnall,2 Alexander von Eye,3 Lee W Jones,4 Gordon Alderink,5 Lawrence H Patzelt,6 Jean K Brown7 1College of Nursing, Michigan State University, East Lansing, MI, USA; 2Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, MI, USA; 3Psychology Department, Michigan State University, East Lansing, MI, USA; 4Duke Center for Cancer Survivorship Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA; 5Frederik Meijer Honors College, Grand Valley State University, Grand Rapids, MI, USA; 6Spectrum Health, Grand Rapids, MI, USA and College of Human Medicine, Michigan State University, East Lansing, MI, USA; 7School of Nursing, University at Buffalo, the State University of New York, Buffalo, NY, USA Objective: The objective of this pilot study was to describe the effects of a 16-week home-based rehabilitative exercise program on cancer-related fatigue (CRF, other symptoms, functional status, and quality of life (QOL for patients with non-small cell lung cancer (NSCLC after thoracotomy starting within days after hospital discharge and continuing through the initiation and completion of chemotherapy. Materials and methods: Five patients with NSCLC completed the Brief Fatigue Inventory (measuring CRF severity and the MD Anderson Symptom Inventory (measuring symptom severity before and after thoractomy, and at the end of each week of the 16-week exercise program. Additionally, the Medical Outcomes Study Short Form-36 (measuring physical and mental functional status and the Quality of Life Index (measuring QOL were completed before and after thoracotomy, after weeks 3, 6, 12, and 16 (the end of the exercise program. Further, the 6-minute walk test (measuring functional capacity was administered before thoracotomy, prior to the initiation of chemotherapy and/or radiation therapy, and at the end of the 16-week exercise program, after completion of chemotherapy. Results: Participants had a

  2. Improvement in regional ventilation and perfusion after radiotherapy for unresectable carcinoma of the bronchus

    International Nuclear Information System (INIS)

    Ventilation/perfusion scans were obtained in 45 patients with unresectable carcinoma of the bronchus. Of these 45 patients, 35 were reinvestigated shortly after radiotherapy and 17 of them had additional later follow-up studies. Both ventilation and perfusion were always abnormal in the lung affected by the tumor; perfusion was usually more impaired than ventilation. These abnormalities were difficult to detect or to evaluate from the standard chest radiograph. After radiotherapy, ventilation improved in 83% and perfusion in 86% of the patients. This improvement was associated with amelioration of breathlessness, which improved in 74% of the patients. Slow but progressive deterioration of regional ventilation and perfusion were subsequently observed. This was often associated with the development of radiation fibrosis. Spirometric measurements (VC, FEV1) were moderately impaired at the initial assessment (83% and 66% of predicted, respectively), probably due to coexisting chronic airway obstruction, and did not show significant changes after radiotherapy or during the follow-up. Radionuclide studies of regional perfusion and ventilation proved more sensitive and more specific than tests of overall lung function for the functional assessment and follow-up of patients with unresectable carcinoma of the bronchus

  3. Determination of the regional ventilation-perfusion ratio by means of xenon-133

    International Nuclear Information System (INIS)

    Knowledge of the regional ventilation/perfusion ratio is of great interest for the diagnosis and therapy of disorders of pulmonary function. By injecting intravenously a bolus of Xe-133 during breathholding and by recording the influx of activity into the lung with a scintillation camera and analogue tape storage, the regional perfusion of the lungs can be determined, using the count-rate increase per unit time. Once the maximum count-rate is reached the patient is allowed to breathe normally. The slope of the count-rate decrease over the lungs is a measure of ventilation. The regional ventilation/perfusion ratio is calculated by dividing these two indices. Regional disturbances of the ratio are the most frequent cause of hypoxia. The demonstration of such disturbances are therefore of significance in the diagnosis and therapeutic control of pulmonary diseases. (orig.)

  4. Cancer immunotherapy via combining oncolytic virotherapy with chemotherapy: recent advances

    Directory of Open Access Journals (Sweden)

    Simpson GR

    2016-01-01

    Full Text Available Guy R Simpson,1 Kate Relph,1 Kevin Harrington,2 Alan Melcher,3 Hardev Pandha1 1Department of Clinical and Experimental Medicine, Targeted Cancer Therapy, Faculty of Health and Medical Sciences, University of Surrey, Guildford, 2Targeted Therapy, The Institute of Cancer Research/The Royal Marsden NIHR Biomedical Research Centre, London, 3Targeted and Biological Therapies,Oncology and Clinical Research, Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK Abstract: Oncolytic viruses are multifunctional anticancer agents with huge clinical potential, and have recently passed the randomized Phase III clinical trial hurdle. Both wild-type and engineered viruses have been selected for targeting of specific cancers, to elicit cytotoxicity, and also to generate antitumor immunity. Single-agent oncolytic virotherapy treatments have resulted in modest effects in the clinic. There is increasing interest in their combination with cytotoxic agents, radiotherapy and immune-checkpoint inhibitors. Similarly to oncolytic viruses, the benefits of chemotherapeutic agents may be that they induce systemic antitumor immunity through the induction of immunogenic cell death of cancer cells. Combining these two treatment modalities has to date resulted in significant potential in vitro and in vivo synergies through various mechanisms without any apparent additional toxicities. Chemotherapy has been and will continue to be integral to the management of advanced cancers. This review therefore focuses on the potential for a number of common cytotoxic agents to be combined with clinically relevant oncolytic viruses. In many cases, this combined approach has already advanced to the clinical trial arena. Keywords: oncolytic virotherapy, chemotherapy, immunogenic cell death

  5. Impact of concurrent chemotherapy on definitive radiotherapy for women with FIGO IIIb cervical cancer

    International Nuclear Information System (INIS)

    The purpose of this retrospective study is to investigate the impact of concurrent chemotherapy on definitive radiotherapy for the International Federation of Gynecology and Obstetrics (FIGO) IIIb cervical cancer. Between 2000 and 2009, 131 women with FIGO IIIb cervical cancer were treated by definitive radiotherapy (id est (i.e.) whole pelvic external beam radiotherapy for 40-60 Gy in 20-30 fractions with or without center shielding and concomitant high-dose rate intracavitary brachytherapy with 192-iridium remote after loading system for 6 Gy to point A of the Manchester method). The concurrent chemotherapy regimen was cisplatin (40 mg/m2/week). After a median follow-up period of 44.0 months (range 4.2-114.9 months) and 62.1 months for live patients, the five-year overall survival (OS), loco-regional control (LRC) and distant metastasis-free survival (DMFS) rates were 52.4, 80.1 and 59.9%, respectively. Univariate and multivariate analyses revealed that lack of concurrent chemotherapy was the most significant factor leading to poor prognosis for OS (HR=2.53; 95% CI 1.44-4.47; P=0.001) and DMFS (HR=2.53; 95% CI 1.39-4.61; P=0.002), but not for LRC (HR=1.57; 95% CI 0.64-3.88; P=0.322). The cumulative incidence rates of late rectal complications after definitive radiotherapy were not significantly different with or without concurrent chemotherapy (any grade at five years 23.9 vs 21.7%; P=0.669). In conclusion, concurrent chemotherapy is valuable in definitive radiotherapy for Japanese women with FIGO IIIb cervical cancer. (author)

  6. A pilot study of weekly docetaxel chemotherapy combined with regional hyperthermia for pretreated stage Ⅲ non-small cell lung cancer%多西紫杉醇每周方案联合局部射频热疗用于治疗失败的局部晚期非小细胞肺癌的初步研究

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective:To evaluate the feasibility and therapeutic effect of chemotherapy combined with regional radio frequency hyperthermia for pretreated locally advanced non-small cell lung cancer. Methods: 29 patients with stage Ⅲb nonsmall cell lung cancer were enrolled in present study, administered chemotherapy up to 4 cycles and radio frequency hyperthermia up to 32 times. The primary end points were grade 3, 4 hematological or non-hematological toxicities and progression free survival, the secondary end points were response rate, tumor control rate and overall survival. Method of Kaplan-Meier was used to do the survival analysis. Results: 21 patients completed whole treatment. The most common grade 3, 4 toxicity was neutropenia (24.1%). Median progression free survival was 4 months (range 0-13 months), one year progression free survival rate was 10.3%. Overall response rate was 25.9%, tumor control rate was 66.6%. Median overall survival was 11 months (range 2-18+ months), one year overall survival rate was 44.8%. Conclusion: Treatment of chemotherapy in conjunction with regional hyperthermia was safe and well tolerant, and it showed an impressive tumor control rate and an acceptable one year progression free survival.

  7. Cancer, Health Literacy, and Happiness: Perspectives from Patients under Chemotherapy

    Directory of Open Access Journals (Sweden)

    Sara Maria Oliveira Pinto

    2013-01-01

    Full Text Available Cancer is a dreaded disease that affects all dimensions of human life. In this context, issues related to the quality of life—as happiness, perception about health status, or health literacy—are important. This study aims to analyze the following topics the perception: the Portuguese cancer patients have about their health status while undergoing chemotherapy, the satisfaction with the information relating to their health, their level of happiness, and their vision of the future. An observational, cross-sectional, and descriptive study was developed. Data were collected between May and July 2012 in the day hospital of a central hospital in northern Portugal. The sample was composed of 92 cancer patients who were asked to answer a questionnaire during chemotherapy. The results indicate that, despite this life-threatening disease, patients consider themselves fairly happy and have an optimistic view of the future. Information about their health condition and religious beliefs was important coping mechanisms to help dealing with the suffering caused by the disease. The study highlights the importance of providing care in a holistic way. Nurses must be alert and available to listen, answer questions, provide supporting structures, or refer to other professionals when needed.

  8. Metronomic chemotherapy in metastatic breast cancer Impact on VEGF

    International Nuclear Information System (INIS)

    Background: Anticancer chemotherapy is thought to be effective by means of direct cytotoxicity on tumor cells. Alternative mechanisms of efficacy have been ascribed to several common anticancer agents; including cyclophosphamide (CTX) and capecitabine (Cap) when given at lower doses for prolonged period (metronomic chemotherapy) postulating an antiangiogenic activity as well, Aim of work :To evaluate the action and tolerability of metronomic chemotherapy (MC) and its impact on serum vascular endothetial growth factor (VEGF) levels in metastatic breast cancer (MBC) patients. Patients and methods: In this study we evaluated the clinical efficacy and tolerability of low dose, capecitabine (500 mg twice daily) together with oral cyclophosphamide (CTX) (a dose of 50 mg once daily) in patients with metastatic breast cancer. Vascular endothelial growth factor (VEGF), an angiogenic marker, was measured in the serum samples; at base line, and after 2 and 6 months of therapy. Results: Sixty patients were evaluable. One achieved complete response (CR), 12 partial responses (PR), and 21 stable diseases (SD), while 26 were with progressive disease (PD). The overall response rate was 21.7% with overall disease control (CR, PR, and SD) 56.7%. The median time to progression was 7±2.59 months and overall survival 16 ±8.02 months. Toxicity was mild, Palmar-plantar erythrodythesia was the must common side effect and was observed in 22 patients (37%), leucopenia (Gl + 2) was the most common hematological toxicity, and it was reported in 27% of the cases. The median VEGF level was significantly declined after 2 and 6 months of therapy compared to the base line among the patients with disease control (CR, PR, and SD). In multivariate logisatic regression analysis, patients with post-menopausal, positive hormonal receptors, negative HER-2/Neu, and one, metastatic site, were statistically significant and have a better disease control rate. Coclcusions: MC induced drop in VEGF, and was

  9. Neoadjuvant Chemotherapy in Neuroendocrine Bladder Cancer: A Case Report.

    Science.gov (United States)

    Prelaj, Arsela; Rebuzzi, Sara Elena; Magliocca, Fabio Massimo; Speranza, Iolanda; Corongiu, Emanuele; Borgoni, Giuseppe; Perugia, Giacomo; Liberti, Marcello; Bianco, Vincenzo

    2016-01-01

    BACKGROUND Small cell carcinoma of the urinary bladder is a rare and aggressive form of bladder cancer that mainly presents at an advanced stage. As a result of its rarity, it has been described in many case reports and reviews but few retrospective and prospective trials, showing there is no standard therapeutic approach. In the literature the best therapeutic strategy for limited disease is the multimodality treatment and most authors have extrapolated treatment algorithms from the therapy recommendations of small cell lung cancer. CASE REPORT A 71-year-old male patient was referred to our hospital with gross hematuria and dysuria. Imaging and cystoscopy revealed a vegetative lesion of the bladder wall. A transurethral resection of the bladder was performed. Pathological examination revealed a pT2 high-grade urothelial carcinoma with widespread neuroendocrine differentiation. Multimodal treatment with neoadjuvant platinum-based chemotherapy was performed. A CT scan performed after chemotherapy demonstrated a radiological complete response. The patient underwent radical cystectomy and lymphadenectomy. The histopathological finding of bladder and node specimen confirmed a pathological complete response. A post-surgery CT scan showed no evidence of local or systemic disease. Six months after surgery, the patient is still alive and disease-free. CONCLUSIONS A standard treatment strategy of small cell cancer of the urinary bladder is not yet well established, but a multimodal treatment of this disease is the best option compared to surgical therapy alone. The authors confirm the use of neoadjuvant chemotherapy in limited disease of small cell carcinoma of the urinary bladder. PMID:27072610

  10. Systemic Chemotherapy for Progression of Brain Metastases in Extensive-Stage Small Cell Lung Cancer

    OpenAIRE

    Nagla Abdel Karim; Ananta Bhatt; Lauren Chiec; Richard Curry

    2015-01-01

    Lung cancer is the most common cause of cancer related mortality in men and women. Approximately 15% of lung cancers are small cell type. Chemotherapy and radiation are the mainstay treatments. Currently, the standard chemotherapy regimen includes platinum/etoposide. For extensive small cell lung cancer, irinotecan and cisplatin have also been used. Patients with relapsed small cell lung cancer have a very poor prognosis, and the morbidity increases with brain metastases. Approximately 10%–14...

  11. Postmastectomy Radiotherapy for Locally Advanced Breast Cancer Receiving Neoadjuvant Chemotherapy

    OpenAIRE

    Icro Meattini; Sara Cecchini; Vanessa Di Cataldo; Calogero Saieva; Giulio Francolini; Vieri Scotti; Pierluigi Bonomo; Monica Mangoni; Daniela Greto; Jacopo Nori; Lorenzo Orzalesi; Donato Casella; Roberta Simoncini; Massimiliano Fambrini; Simonetta Bianchi

    2014-01-01

    Neoadjuvant chemotherapy (NAC) is widely used in locally advanced breast cancer (BC) treatment. The role of postmastectomy radiotherapy (PMRT) after NAC is strongly debated. The aim of our analysis was to identify major prognostic factors in a single-center series, with emphasis on PMRT. From 1997 to 2011, 170 patients were treated with NAC and mastectomy at our center; 98 cases (57.6%) underwent PMRT and 72 cases (42.4%) did not receive radiation. At a median follow-up period of 7.7 years (r...

  12. Comparison of Regional Brain Perfusion Levels in Chronically Smoking and Non-Smoking Adults

    Directory of Open Access Journals (Sweden)

    Timothy C. Durazzo

    2015-07-01

    Full Text Available Chronic cigarette smoking is associated with numerous abnormalities in brain neurobiology, but few studies specifically investigated the chronic effects of smoking (compared to the acute effects of smoking, nicotine administration, or nicotine withdrawal on cerebral perfusion (i.e., blood flow. Predominately middle-aged male (47 ± 11 years of age smokers (n = 34 and non-smokers (n = 27 were compared on regional cortical perfusion measured by continuous arterial spin labeling magnetic resonance studies at 4 Tesla. Smokers showed significantly lower perfusion than non-smokers in the bilateral medial and lateral orbitofrontal cortices, bilateral inferior parietal lobules, bilateral superior temporal gyri, left posterior cingulate, right isthmus of cingulate, and right supramarginal gyrus. Greater lifetime duration of smoking (adjusted for age was related to lower perfusion in multiple brain regions. The results indicated smokers showed significant perfusion deficits in anterior cortical regions implicated in the development, progression, and maintenance of all addictive disorders. Smokers concurrently demonstrated reduced blood flow in posterior brain regions that show morphological and metabolic aberrations as well as elevated beta amyloid deposition demonstrated by those with early stage Alzheimer disease. The findings provide additional novel evidence of the adverse effects of cigarette smoking on the human brain.

  13. EFFECTS OF NEOADJUVANT CHEMOTHERAPY ON MDR1 AND MRP GENE EXPRESSION IN PRIMARY BREAST CANCER

    Institute of Scientific and Technical Information of China (English)

    刘杏娥; 孙晓东; 吴金民

    2004-01-01

    Objective: To investigate the effects of neoadjuvant chemotherapy on the expression of drug resistance genes,multidrug resistance-1 (MDR1) and multidrug resistance-associated protein (MRP), in patients with primary breast cancer. Methods: MDR1 and MRP expression were detected by semi-quantitative RT-PCR in 20 patients with primary breast cancer, before and after chemotherapy.Results: Before chemotherapy, MDR1 and MRP expression can be detected in 15 cases (75%) and 18 cases (90%)respectively. After chemotherapy, expression of MDR1 is not significantly different from that before chemotherapy, but expression of MRP is significantly different from that before chemotherapy. Conclusion: Expression of drug resistance gene MRP, but not MDR1, is enhanced in patients with primary breast cancer submitted to neoadjuvant chemotherapy.

  14. Multimodal treatment combining chemotherapy, hyperthermia and radiotherapy for ovarian cancer

    International Nuclear Information System (INIS)

    There has been increasing interest in the use of heat in the treatment of cancer. Theoretically cells are the most sensitive to ionizing radiation at mitosis, whereas the cycle phase that is the most resistant to ionizing radiation namely late in the DNA. Synthetic phase (late S) is the most sensitive to hyperthermia. Hyperthermia has been reported to enhance the cytocidal effects of several active chemotherapeutic agents. When thermal potentiation of chemotherapeutic agents against malignant cells is contemplated, normal tissues have a relatively high ambient blood flow which increases in response to thermal stress, thereby dissipating heat, compared to tumors. Tumors, with relatively poor blood flow and a responsive neovasculature, are in capable of augmenting flow and acting as a heat reservoir. This is the phenomenon of a heat reservoir which is one factor to enhance the cytocidal effects of several active anticancer agents for enhancing the uptake in tumor. The importance is in the adjuvant chemotherapy treated for post operative, advanced and recurrent ovarian cancer. Heating enhances the effects of radiotherapy and chemotherapy. Thirty patients with ovarian cancer were subjected to the multidisciplinary treatment with combination of hyperthermochemotherapy and radiation. The 30 patients consisted of 18 with endometrioid adenocarcinoma and 7 with serious post operative or recurrent status. Two types of equipments with rediofrequencies of 70 MHz (BSD-1000) or 434 MHZ (TAG MED·HS 434) were used for hyperthermia. Chemotherapeutic agents such as adriamycin, cis DDP, cyclophosphamide and etoposide were injected intravenously. Arterial infusion with reservoir was very effective in advanced stage of ovarian cancer. No severe or fatal side effects were observed. Hyperthermochemotherapy is useful and effective for the postoperative management or the treatment of recurrent cancer of the ovary. (J.P.N.)

  15. Postmastectomy radiotherapy and chemotherapy in patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Sung Ja; Chung, Woong Ki; Nam, Taek Keun; Nah, Byung Sik; Song, Ju Young; Park, Seung Jin [Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2004-03-15

    To evaluate the treatment outcomes after postmastectomy radiotherapy (PMRT) and chemotherapy in patients with breast cancer. The PMRT were retrospectively analyzed in 83 patients with stage II-III female breast cancer treated between 1989, and 1995. The median age was 46 years (range, 23-77); Seventy-seven patients had modified radical mastectomies. 5 radical mastectomies and 1 simple mastectomy. Three patients (4%) had pathologically negative axillae, and the remaining 80 (96%) had positive axillae. Eleven, 23, 44 and 5 patients had pathological stages IIA, IIB, IIIA, and IIIB, retrospectively. Eighty (96%) patients were treated with hockey-stick fields. The median dose of PMRT was 50.4 Gy, in 1.8 Gy fractions. Adjuvant systemic chemotherapy was given to 74 patients (89%). CMF-based or doxorubicin-containing regimens were given to 54 patients (65%). The median follow-up time was 82 months (range, 8-171) after the mastectomy. The 5 and 10-year overall survival rates for all patients were 65 and 49%, respectively. The univariate and multivariate analyses of the factors affecting the overall survival revealed the stage to be the most significant prognostic factor ({rho} = 0.002), followed by the combination of chemotherapy. Thirteen patients (16%) developed a LRF, at an interval of 4-48 months after radiotherapy, with a median of 20 months. The only significant prognostic factor affecting LRF was the combination of chemotherapy, in both the univariate and multivariate analyses. With respect to the sequence of chemoradiation, the sequence had no statistical significance ({rho} = 0.90). According to the time interval from mastectomy to the onset of radiotherapy, the LRFR of the patients group treated by RT within or after 6 month postmastectomy 6 months were 14 vs. 27%, respectively ({rho} = 0.24). One third of the patients (26/83) developed distant metastasis, in 2-29 months, after radiotherapy, with a median of 21 months. The most commonly involved site was bone in

  16. Evaluation of pulmonary perfusion in lung regions showing isolated xenon-133 ventilation washout defects

    International Nuclear Information System (INIS)

    Xenon-133 washout phase imaging is often used to help determine whether the etiology of a perfusion defect is embolic or due to pulmonary parenchymal pathology, such as chronic obstructive pulmonary disease. This study was designed to evaluate the pulmonary blood flow patterns associated with isolated defects on xenon washout images. Scintigraphic lung studies were reviewed until 100 cases with abnormal ventilation results were obtained. Ventilation abnormalities were compared with the corresponding perfusion scan results at the same anatomic site. Of the 208 individual lung regions with xenon abnormalities, 111 showed isolated washout defects (that is, with normal washin). Ninety-four of these 111 sites showed either normal perfusion or a small, nonsegmental corresponding perfusion defect. Three segmental perfusion defects were noted in association with isolated xenon retention. In each of these cases, however, the patient was felt actually to have pulmonary embolism. Thus, it is recommended that, for interpretation of scintigraphic images in the assessment of pulmonary embolism, lung pathology associated with isolated xenon retention not be considered a potential cause for large or segmental perfusion defects

  17. Patterns of disturbed myocardial perfusion in patients with coronary artery disease. Regional myocardial perfusion in angina pectoris

    International Nuclear Information System (INIS)

    Fifty patients who presented with angina pectoris were studied to examine the disturbances of regional myocardial perfusion during stress. Each patient underwent 16-point precordial mapping of the ECG during an exercise test, and coronary and left ventricular angiography. Regional myocardial perfusion was assessed using an atrial pacing test and a short-lived radionuclide, krypton-81m. Eleven patients had negative exercise tests and uniform increases in myocardial activity of krypton-81m of 98 +/- 18.0% during pacing. Ten patients performed 30,000-43,000 J in positive exercise tests. These patients showed abnormal coronary anatomy and increases in myocardial activity of krypton-81m to remote and jeopardized myocardium at the onset of pacing. However, further pacing produced a decrease in activity in the affected segment of 68.0 +/- 9.0% accompanied by ST-segment depression and angina. Twelve patients achieved 26,000-32,000 J in positive exercise tests and had significant coronary artery disease. Atrial pacing produced increased activity of krypton-81m to remote myocardium. The jeopardized segment at first showed no change and then a decrease in regional activity of krypton-81m (89.0 +/- 17%) accompanied by ST-segment depression and chest pain. Seventeen patients achieved only 7000-22,000 J in positive exercise tests. These patients showed abnormal coronary anatomy and developed decreases in regional activity of krypton-81m to the affected segment of myocardium starting at the onset of atrial pacing and decreasing by 88 +/- 0 7.0% below control. We conclude that different patterns of disturbed myocardial distribution of krypton-81m are present during stress-induced ischemia in patients with coronary artery disease. There was a close temporal relationship between these disturbances and ST-segment depression

  18. Late results of chemotherapy of the advanced ovarian cancer

    International Nuclear Information System (INIS)

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

  19. STOCHASTIC MODELS FOR OPTIMAL DRUG ADMINISTRATION IN CANCER CHEMOTHERAPY

    Directory of Open Access Journals (Sweden)

    Tirupathi Rao. P

    2010-05-01

    Full Text Available Stochastic models play a prominent role in analysis and designing of processes at various places like, biological, physical, medical and other areas. One of the important areas of concentration in medical sciences is developing optimal operating strategies for drug administration in chronic diseases like, Cancer, TB, Leprosy etc. In this paper, we develop a suitable stochastic model for optimal drug administration in cancer chemotherapy problem. The analysis for drug administration period is discussed. The sensitivity of the model with respect to the parameters is also studied with numerical llustrations. Average time for mutant cell duration in the tumor during the drug administration and absence of drug spells are derived. This study is very much useful for health care takers.Developing software and automation of these models will make this work more user friendly.

  20. Neoadjuvant chemotherapy for high-grade advanced gastric cancer.

    Science.gov (United States)

    Yonemura, Y; Sawa, T; Kinoshita, K; Matsuki, N; Fushida, S; Tanaka, S; Ohoyama, S; Takashima, T; Kimura, H; Kamata, T

    1993-01-01

    Fifty-five patients with high-grade advanced gastric cancer in whom the presence of stage IV was confirmed by preoperative diagnostic imaging were treated with PMUE therapy by a combined use of cisplatin (CDDP) 75 mg/m2, mitomycin C (MMC) 10 mg/body, etoposide 150 mg/body, and UFT (a combination of 1-(2-tetrahydrofuryl)-5-fluorouracil and uracil in a molar ratio of 1:4) 400 mg/day. CDDP and MMC was administered intravenously on the first day, followed by etoposide 50 mg/day on the 3rd, 4th, and 5th days. All the patients had measurable lesions that were evaluated by computed tomography scanning before and after the treatments. These patients were allocated randomly to two groups. Of these cases, 29 belonged to the neoadjuvant chemotherapy (NAC) group to whom PMUE therapy was given preoperatively; the remaining 26 patients underwent operation first and received PMUE thereafter (control group). Background factors did not differ significantly between the two groups. The response rate was higher in the NAC group than in the control group (62% in the former versus 35% in the latter). The resectability rates were 79% and 88% in the NAC and control groups, respectively. However, the rate of potentially curable cases was higher in the NAC group than in the control group (38% in the former versus 15% in the latter). Among the nonresection cases, the prognosis was highly unfavorable in both groups. In the resection cases, however, the survival rate was significantly better in the NAC group than in the control group. These results may indicate that in patients with high-grade, advanced gastric cancer initial chemotherapy (neoadjuvant chemotherapy) and then surgery should be considered. PMID:8511923

  1. Changes in soluble CEA and TIMP-1 levels during adjuvant chemotherapy for stage III colon cancer

    DEFF Research Database (Denmark)

    Aldulaymi, Bahir; Christensen, Ib Jarle; Sölétormos, György; Jess, Per; Nielsen, Svend Erik; Brünner, Nils; Nielsen, Hans J.

    2010-01-01

    Tissue inhibitor of metalloproteinases-1 (TIMP-1) has been suggested to be a valuable marker in colorectal cancer (CRC), but the effects of chemotherapy on TIMP-1 levels are unknown. The present study evaluated the effect of chemotherapy on TIMP-1 levels in comparison with carcinoembryonic antige...... (CEA) levels in patients with stage III colon cancer.......Tissue inhibitor of metalloproteinases-1 (TIMP-1) has been suggested to be a valuable marker in colorectal cancer (CRC), but the effects of chemotherapy on TIMP-1 levels are unknown. The present study evaluated the effect of chemotherapy on TIMP-1 levels in comparison with carcinoembryonic antigen...

  2. Extrafascial hysterectomy in IB2 cervical cancer after radio chemotherapy

    International Nuclear Information System (INIS)

    Aim: To evaluate overall and disease free survival in cervical cancer IB2 patients with concomitant chemoradiotherapy and posterior extrafascial hysterectomy treatment. Methods: Between July 2005 to December 2009, a total of 31 eligible patients with IB2 cervical cancer were treated with chemoradiotherapy and posterior hysterectomy in the Carlos Van Buren Hospital Oncology Unit. Radiotherapy consisted in external pelvic radiation and a utero-vaginal brachytherapy with low rate doses to get preoperatory doses between 70 and 75 Gy to the A point and a concomitant Cisplatin based chemotherapy. After this treatment, the patients received extrafascial hysterectomy 4 to 6 weeks completed chemoradiotherapy. Results: The mean age was 41 ± 8 years. 81% of the patients had an spinocelular carcinoma. The extrafascial hysterectomy was made between 4 to 6 weeks post-radiation in 85% of the patients. 79% and 13% of the patients received 5 and 4 chemotherapy cycles respectively. The median follow up was 38 months. The 5 years overall survival and disease free survival estimates were 86% and 79% respectively. There was a significant difference between subgroups of patients with and without macroscopic residual disease in the operatory specimen (p<0.001). Conclusion: Our survival is similar to published results with the same treatment. The presence of macroscopic residual disease in the hysterectomy specimen could be a factor of prognostic value

  3. Tea Polyphenols and Their Roles in Cancer Prevention and Chemotherapy

    Directory of Open Access Journals (Sweden)

    Q. Ping Dou

    2008-07-01

    Full Text Available Many plant-derived, dietary polyphenols have been studied for their chemopreventive and chemotherapeutic properties against human cancers, including green tea polyphenols, genistein (found in soy, apigenin (celery, parsley, luteolin (broccoli, quercetin (onions, kaempferol (broccoli, grapefruits, curcumin (turmeric, etc. The more we understand their involved molecular mechanisms and cellular targets, the better we could utilize these “natural gifts” for the prevention and treatment of human cancer. Furthermore, better understanding of their structure-activity relationships will guide synthesis of analog compounds with improved bio-availability, stability, potency and specificity. This review focuses on green tea polyphenols and seeks to summarize several reported biological effects of tea polyphenols in human cancer systems, highlight the molecular targets and pathways identified, and discuss the role of tea polyphenols in the prevention and treatment of human cancer. The review also briefly describes several other dietary polyphenols and their biological effects on cancer prevention and chemotherapy.

  4. Preoperative concurrent CBDCA chemotherapy and accelerated hyperfractionated radiotherapy for squamous cell carcinoma of the maxillary region

    International Nuclear Information System (INIS)

    Between 1994 and 2000, 28 patients with T3/T4 squamus cell carcinoma of the maxillary region (maxillary sinus, 22; maxillary gingiva, 4; maxillary bone, 1; buccal mucosa, 1) had accelerated hyperfractionated radiotherapy combined with simultaneous CBDCA chemotherapy preoperatively, at Chiba Cancer Center Hospital. The protocol consisted of combined therapy with accelerated hyperfractionated irradiation of 1.6 Gy, twice a day, to a total dose of 32.0-51.2 Gy and concurrent intra-arterial or intravenous infusion of CBDCA 20-30 mg/body/day for a cumulative total dose of 270-480 mg. After completion of the preoperative combined therapy, the clinical CR rate was 17.9%, and the good PR·CR rate was 32.1%. According to the initial findings and response to the combined therapy, all patients had maxillectomy (subtotal, 3; total, 16; extended, 9) 4 weeks after completion of the preoperative combined therapy. Postoperatively, the complete pathologic response (Ohboshi and Shimozato's classification, grade III and IV) rate was 28.6%. And the actuarial local control rate was 85.7%, with a mean follow-up of 46.2 months. Based on these results, we believe this preoperative therapy with CBDCA chemotherapy and accelerated hyperfractionated radiation is a significant choice as treatment for squamous cell cancer of the maxillary region. (author)

  5. Dynamic measurement of regional ventilation and perfusion of the lung with 133Xe

    International Nuclear Information System (INIS)

    A method for measuring regional distribution of ventilation and perfusion with Xe-133 during tidal breathing was developed with normal subjects, and compared with current breath-holding techniques in patients and in animals. Normal values for a ventilation index during washin, a perfusion index, and a washout slope index were determined in both supine and upright normal subjects. Comparisons of tidal-breathing and breath-holding measurements in patients with localized bullous disease of the lung showed roughly equal values for perfusion index by the two methods, but the tidal-breathing method was more sensitive to abnormalities in ventilation index. During occlusion of branches of the pulmonary artery in animals, the tidal-breathing and breath-holding methods were again comparable in the measurement of perfusion indices, but the tidal-breathing method provided a more sensitive assessment of ventilatory changes due to partial bronchial occlusion in animals. This technique appears superior to standard methods and is well suited to dynamic measurement of regional ventilation and perfusion in a number of experimental and clinical circumstances

  6. Quality of Life and Nutritional Status Among Cancer Patients on Chemotherapy

    OpenAIRE

    Nunilon Vergara; Jose Enrique Montoya; Herdee Gloriane Luna; Jose Roberto Amparo; Gloria Cristal-Luna

    2013-01-01

    Objectives: Malnutrition is prevalent among cancer patients, and maybe correlated with altered quality of life. The objective of this study is to determine whether quality of life among cancer patients on chemotherapy at the National Kidney and Transplant Institute- Cancer Unit differs from patients with normal nutrition based on the Subjective Global Assessment scale.Methods: A cross sectional study was conducted among cancer patients admitted for chemotherapy at the National Kidney and Tran...

  7. Sequencing chemotherapy and radiotherapy in locoregional advanced breast cancer patients after mastectomy – a retrospective analysis

    International Nuclear Information System (INIS)

    Combined chemo- and radiotherapy are established in breast cancer treatment. Chemotherapy is recommended prior to radiotherapy but decisive data on the optimal sequence are rare. This retrospective analysis aimed to assess the role of sequencing in patients after mastectomy because of advanced locoregional disease. A total of 212 eligible patients had a stage III breast cancer and had adjuvant chemotherapy and radiotherapy after mastectomy and axillary dissection between 1996 and 2004. According to concerted multi-modality treatment strategies 86 patients were treated sequentially (chemotherapy followed by radiotherapy) (SEQgroup), 70 patients had a sandwich treatment (SW-group) and 56 patients had simultaneous chemoradiation (SIM-group) during that time period. Radiotherapy comprised the thoracic wall and/or regional lymph nodes. The total dose was 45–50.4 Gray. As simultaneous chemoradiation CMF was given in 95.4% of patients while in sequential or sandwich application in 86% and 87.1% of patients an anthracycline-based chemotherapy was given. Concerning the parameters nodal involvement, lymphovascular invasion, extracapsular spread and extension of the irradiated region the three treatment groups were significantly imbalanced. The other parameters, e.g. age, pathological tumor stage, grading and receptor status were homogeneously distributed. Looking on those two groups with an equally effective chemotherapy (EC, FEC), the SEQ- and SW-group, the sole imbalance was the extension of LVI (57.1 vs. 25.6%, p < 0.0001). 5-year overall- and disease free survival were 53.2%/56%, 38.1%/32% and 64.2%/50%, for the sequential, sandwich and simultaneous regime, respectively, which differed significantly in the univariate analysis (p = 0.04 and p = 0.03, log-rank test). Also the 5-year locoregional or distant recurrence free survival showed no significant differences according to the sequence of chemo- and radiotherapy. In the multivariate analyses the sequence had no

  8. Weekly chemotherapy as Induction chemotherapy in locally advanced head and neck cancer for patients ineligible for 3 weekly maximum tolerable dose chemotherapy

    Directory of Open Access Journals (Sweden)

    Vijay Maruti Patil

    2014-01-01

    Full Text Available Objective: To study the safety and efficacy of weekly chemotherapy as part of induction chemotherapy, in locally advanced head and neck cancer for patients, who are unfit for upfront radical treatment. Materials and Methods: It is a retrospective analysis of on-use weekly chemotherapy as Induction chemotherapy in locally advanced head and neck cancer, who are technically unresectable are unfit for upfront radical treatment. Induction chemotherapy given was a 2 drug combination of paclitaxel (80 mg/m 2 and carboplatin AUC 2. The decision to give weekly induction chemotherapy was given on the basis of presence of 2 more following features: Poor performance status (ECOG PS 2-3, presence of uncontrolled co morbidities, BMI below 18.5 kg/m 2 and age more than 60 years. The Statistical Package for the Social Sciences software (SPSS version 16.0 was used for analysis. The response rates, toxicity (accordance with CTCAE vs. 4.02, completion rate (Cp of radical intent treatment post neoadjuvant chemotherapy (NACT, progression-free survival (PFS and overall survival (OS are reported. Results: Fifteen patients were considered for such therapy. Fourteen out of fifteen patients completed NACT. The median numbers of planned weekly cycles were 6 (3-8. Response (CR + PR was seen in 10 patients. Overall grade 3-4 toxicity was seen in 6 patients. No toxicity related mortality was noted. The calculated completion rate (Cp of radical intent treatment post NACT was 46.7%. The median PFS and OS were 10.36 months (95% CI 6.73-14.00 months and 16.53 months (95% CI 4.22-28.84. Conclusion: Use of induction chemotherapy with weekly regimen is safe and effective selected cohort of patients with locally advanced disease who are unfit for upfront radical treatment.

  9. Effect of systemic vein chemotherapy and internal iliac arterial embolization infusion chemotherapy on angiogenesis and malignant degree of cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Gang Chen

    2016-01-01

    Objective:To analyze the effect of systemic vein chemotherapy and internal iliac arterial chemoembolization on angiogenesis and malignant degree of cervical cancer.Methods: A total of 108 cases of patients with middle and advanced cervical cancer were included in the research, and the time range of the research was from February 2014 to December 2015. According to different means of chemotherapy, included patients were divided into observation group 54 cases and control group 54 cases, control group received systemic vein chemotherapy, observation group received internal iliac arterial infusion chemotherapy and embolization treatment, and then differences in the levels of angiogenesis-related indicators, blood flow parameters within tumor, serum illness-related indicators, cervical tumor tissue proliferation-related indicators,etc. were compared between two groups after treatment.Results:Serum VEGFR-2, HIF-1α, vWF and Lam values of observation group after chemotherapy were lower than those of control group; PI, VI, FI, VFI and Vmax values of observation group after treatment were lower than those of control group while RI value was higher than that of control group; serum SCC-Ag, TK1, HE4, CYFRA21-1, IGF-Ⅱ and Gal-9 values of observation group after chemotherapy were lower than those of control group; miR-26b, SCD-1, Cyclin D1 and TLR4 protein expression levels in tumor tissue of observation group after treatment were lower than those of control group while miR-99b protein expression level was higher than that of control group.Conclusions: Internal iliac arterial infusion chemotherapy and embolization can significantly decrease tumor angiogenesis and inhibit tumor cell proliferation, and it is a perfect means of interventional chemotherapy.

  10. Dual-energy perfusion-CT in recurrent pancreatic cancer. Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, F.; Skornitzke, S.; Kauczor, H.U.; Stiller, W.; Klauss, M. [Heidelberg Univ. (Germany). Clinic of Diagnostic and Interventional Radiology; Hackert, T. [Heidelberg Univ. (Germany). Clinic of Surgery; Grenacher, L. [Diagnostik Muenchen (Germany). Diagnostic Imaging Center

    2016-06-15

    To evaluate the diagnostic performance of dual energy (DE) perfusion-CT for the differentiation between postoperative soft-tissue formation and tumor recurrence in patients after potentially curative pancreatic cancer resection. 24 patients with postoperative soft-tissue formation in the conventional regular follow-up CT acquisition after pancreatic cancer resection with curative intent were included prospectively. They were examined with a 64-row dual-source CT using a dynamic sequence of 34 DE acquisitions every 1.5 s (80 ml of iodinated contrast material, 370 mg/ml, flow rate 5 ml/s). Weighted average (linearly blended M0.5) 120 kVp-equivalent dual-energy perfusion image data sets were evaluated with a body-perfusion CT tool for estimating blood flow, permeability, and blood volume. Diagnosis was confirmed by histological study (n=4) and by regular follow-up. Final diagnosis was local recurrence of pancreatic cancer in 15 patients and unspecific postoperative tissue formation in 9 patients. The blood-flow values for recurrence tissue trended to be lower compared to postoperative tissue formation with 16.6 ml/100 ml/min and 24.7 ml/100 ml/min, respectively for weighted average 120 kVp-equivalent image data, which was not significant (n.s.) (p=0.06, significance level 0.05). Permeability- and blood-volume values were only slightly lower in recurrence tissue (n.s.). DE perfusion-CT is feasible in patients after pancreatic cancer resection and a promising functional imaging technique. As only a trend for lower perfusion values in local recurrence compared to unspecific postoperative alterations was found, the perfusion differences are not yet sufficient to differentiate between malignancy and unspecific postoperative alterations for this new technique. Further studies and technical improvements are needed to generate reliable data for this clinically highly relevant differentiation.

  11. Dual-energy perfusion-CT in recurrent pancreatic cancer. Preliminary results

    International Nuclear Information System (INIS)

    To evaluate the diagnostic performance of dual energy (DE) perfusion-CT for the differentiation between postoperative soft-tissue formation and tumor recurrence in patients after potentially curative pancreatic cancer resection. 24 patients with postoperative soft-tissue formation in the conventional regular follow-up CT acquisition after pancreatic cancer resection with curative intent were included prospectively. They were examined with a 64-row dual-source CT using a dynamic sequence of 34 DE acquisitions every 1.5 s (80 ml of iodinated contrast material, 370 mg/ml, flow rate 5 ml/s). Weighted average (linearly blended M0.5) 120 kVp-equivalent dual-energy perfusion image data sets were evaluated with a body-perfusion CT tool for estimating blood flow, permeability, and blood volume. Diagnosis was confirmed by histological study (n=4) and by regular follow-up. Final diagnosis was local recurrence of pancreatic cancer in 15 patients and unspecific postoperative tissue formation in 9 patients. The blood-flow values for recurrence tissue trended to be lower compared to postoperative tissue formation with 16.6 ml/100 ml/min and 24.7 ml/100 ml/min, respectively for weighted average 120 kVp-equivalent image data, which was not significant (n.s.) (p=0.06, significance level 0.05). Permeability- and blood-volume values were only slightly lower in recurrence tissue (n.s.). DE perfusion-CT is feasible in patients after pancreatic cancer resection and a promising functional imaging technique. As only a trend for lower perfusion values in local recurrence compared to unspecific postoperative alterations was found, the perfusion differences are not yet sufficient to differentiate between malignancy and unspecific postoperative alterations for this new technique. Further studies and technical improvements are needed to generate reliable data for this clinically highly relevant differentiation.

  12. Purine Nucleoside Phosphorylase mediated molecular chemotherapy and conventional chemotherapy: A tangible union against chemoresistant cancer

    International Nuclear Information System (INIS)

    apoptotic- and tumour- suppressor proteins. Inclusion of PNP-GDEPT in regular chemotherapy regimens can lead to significant enhancement of the cancer cell susceptibility to the combined treatment. Overall, these data will underpin the development of regimens that can benefit patients with late stage ovarian cancer leading to significantly improved efficacy and increased quality of life

  13. Perception of Side Effects of Chemotherapy among Cancer Patients in B.P. Koirala Memorial Cancer Hospital Bharatpur, Nepal

    OpenAIRE

    Sharmila Gurung; Radha Acharya Pandey

    2016-01-01

    jdjBackground & Objectives: These side effects of chemotherapy affect the patients’ daily life and quality of life adversely. It affects the different body system resulting in physical and non physical (psychosocial) side effects. Cancer patients demand information to understand chemotherapy-related adverse effects and actions to be taken. The aim of the study is to find out the perception of side effects of chemotherapy among cancer patients.Materials and methods: A descriptive cross-sec...

  14. Regional ventilation and perfusion in patients with status asthmaticus. Chapter 15

    International Nuclear Information System (INIS)

    The 81Krsup(m) ventilation technique has been used for assessing regional ventilation of six patients in status asthmaticus, and after the administration of bronchodilators. A 99Tcsup(m) perfusion scan was also performed on two of the patients. Standard chest radiographs taken during status asthmaticus showed large volume lungs and generalized oligaemia, without detecting regional alteration in the lung fields. 81Krsup(m) scans, on the contrary, showed not only an increase in lung volume (compared with scans obtained during the remission phase), but also the presence of multiple areas of reduced ventilation in both lungs. These areas had a characteristic segmental, sub-segmental or lobar appearance, as best demonstrated on the lateral views. In the two patients studied with both 81Krsup(m) and 99Tcsup(m) microspheres, regional perfusion was also found to be grossly abnormal. Following bronchodilators, an immediate reduction in lung volume and a more homogeneous distribution of regional ventilation were observed. A progressively more uniform distribution of both ventilation and perfusion was noticed during follow-up: after three weeks of treatment both ventilation and perfusion scans were either normal or showed minor abnormalities. (author)

  15. Regional distribution of perfusion and ventilation in hamartoangiomyomatosis of the lung

    International Nuclear Information System (INIS)

    We investigated regional distribution of perfusion and ventilation in three cases of hamartoangiomyomatosis (HAM) by 133Xe gas and 99mTc-MAA. In two cases, 133Xe washout were dominantly delayed in middle lung field and in the third case, it was delayed in upper lung field. This distribution was different from the result in the other chronic obstructive pulmonary disease (COPD). In most cases of COPD, 133Xe washout was prominently delayed in the lower lung field. Distribution of pulmonary perfusion in HAM were consistent with that of ventilation as in COPD. (author)

  16. Ventilation-perfusion scans in neonatal regional pulmonary emphysema complicating ventilatory assistance

    International Nuclear Information System (INIS)

    Two cases of ventilator-related neonatal lobar overexpansion with similar radiographic appearance, but probably different pathogenesis, are presented. In one infant, persistent interstitial lobar emphysema was confirmed by markedly decreased perfusion shown on scintigraphy; this information was of great value in predicting the beneficial effect of lobectomy. In the other case, ventilation and perfusion scans indicated functional value of the emphysematous lobe and correctly suggested conservative management. Radioisotope lung scans may provide valuable information regarding lung function in regional pulmonary emphysema associated with assisted ventilation in neonatal respiratory distress syndrome, and thus determine patient management

  17. Assessment of SPECT ventilation-perfusion imaging in patients with lung cancer

    International Nuclear Information System (INIS)

    Ventilation and perfusion SPECT images during tidal breathing were studied in 15 cases of lung cancer using 81mKr gas and 99mTc-microspheres. Furthermore, functional images of V/Q ratio and Q/V ratio were prepared, and their clinical significance is discussed with reference to general lung function. There was a decrease in %VC and %FEVi.0 in 7 of 15 cases, and an increase of AaDo2 in the blood gas analysis in 12 of 15 cases. Both planar and SPECT images showed ventilation and perfusion abnormalities in all 15 cases. Of these, 12 patients showed matched ventilation and perfusion defects, 2 patients a dead-space effect and 1 patient a shunt effect. In comparing planar and SPECT images, depiction of ventilation and perfusion impairments were equally clear in 11 cases, but in 3, showing a lobar or segmental defect with a shunt effect, the SPECT images were superior. In a patient with markedly impaired function of the affected lung, the remaining function could not be depicted by SPECT. From the above, it seems that better information can be obtained for understanding the ventilation and perfusion states of lung cancer by adding the SPECT images to the planar image. (orig.)

  18. Predicting response to chemotherapy with early-stage lung cancer.

    Science.gov (United States)

    Rosell, Rafael; Taron, Miquel; Massuti, Bartomeu; Mederos, Nuria; Magri, Ignacio; Santarpia, Mariacarmela; Sanchez, Jose Miguel

    2011-01-01

    A recent meta-analysis of 11,107 patients with non-small cell lung cancer who had undergone surgical resection showed that the 5-year survival benefit of adjuvant chemotherapy was 4%, and that of adjuvant chemoradiotherapy was 5%. Two trials have shown a trend toward improved survival with adjuvant paclitaxel plus carboplatin. However, the benefit of adjuvant treatment remains suboptimal. We must distinguish between patients who will not relapse-and who can thus be spared adjuvant treatment-and those who will-for whom adjuvant treatment must be personalized. Several gene expression signatures, generally containing nonoverlapping genes, provide similar predictive information on clinical outcome, and a model combining several signatures did not perform better than did each of the signatures separately. The invasiveness gene signature, containing 186 genes, includes genes involved in the nuclear factor κB pathway, the RAS-mitogen-activated protein kinase pathway, and epigenetic control of gene expression. A 15-gene signature has identified JBR.10 patients who are more sensitive to adjuvant chemotherapy. PMID:21263267

  19. Postmastectomy radiotherapy for locally advanced breast cancer receiving neoadjuvant chemotherapy.

    Science.gov (United States)

    Meattini, Icro; Cecchini, Sara; Di Cataldo, Vanessa; Saieva, Calogero; Francolini, Giulio; Scotti, Vieri; Bonomo, Pierluigi; Mangoni, Monica; Greto, Daniela; Nori, Jacopo; Orzalesi, Lorenzo; Casella, Donato; Simoncini, Roberta; Fambrini, Massimiliano; Bianchi, Simonetta; Livi, Lorenzo

    2014-01-01

    Neoadjuvant chemotherapy (NAC) is widely used in locally advanced breast cancer (BC) treatment. The role of postmastectomy radiotherapy (PMRT) after NAC is strongly debated. The aim of our analysis was to identify major prognostic factors in a single-center series, with emphasis on PMRT. From 1997 to 2011, 170 patients were treated with NAC and mastectomy at our center; 98 cases (57.6%) underwent PMRT and 72 cases (42.4%) did not receive radiation. At a median follow-up period of 7.7 years (range 2-16) for the whole cohort, median time to locoregional recurrence (LRR) was 3.3 years (range 0.7-12.4). The 5-year and 10-year actuarial LRR rate were 14.5% and 15.9%, respectively. At the multivariate analysis the factors that significantly correlated with survival outcome were ≥ 4 positive nodes (HR 5.0, 1.51-16.52; P = 0.035), extracapsular extension (HR 2.18, 1.37-3.46; P = 0.009), and estrogen receptor positive disease (HR 0.57, 0.36-0.90; P = 0.003). Concerning LRR according to use of radiation, PMRT reduced LRR for patient with clinical T3 staged disease (P = 0.015). Our experience confirmed the impact of pathological nodal involvement on survival outcome. PMRT was found to improve local control in patients presenting with clinical T3 tumors, regardless of the response to chemotherapy. PMID:25045694

  20. Management of Inflammatory Breast Cancer After Neoadjuvant Chemotherapy

    International Nuclear Information System (INIS)

    Purpose: To assess the benefit of breast surgery for inflammatory breast cancer (IBC). Methods and Materials: This retrospective series was based on 232 patients treated for IBC. All patients received primary chemotherapy followed by either exclusive radiotherapy (118 patients; 51%) or surgery with or without radiotherapy (114 patients; 49%). The median follow-up was 11 years. Results: The two groups were comparable apart from fewer tumors <70 mm (43% vs. 33%, p = 0.003), a higher rate of clinical stage N2 (15% vs. 5%, p = 0.04), and fewer histopathologic Grade 3 tumors (46% vs. 61%, p <0.05) in the no-surgery group. The addition of surgery was associated with a significant improvement in locoregional disease control (p = 0.04) at 10 years locoregional free interval 78% vs. 59% but with no significant difference in overall survival rates or disease-free intervals. Late toxicities were not significantly different between the two treatment groups except for a higher rate of fibrosis in the no-surgery group (p <0.0001) and more lymphedema in the surgery group (p = 0.002). Conclusion: Our data suggest an improvement in locoregional control in patients treated by surgery, in conjunction with chemotherapy and radiotherapy, for IBC. Efforts must be made to improve overall survival.

  1. 3-dimensional conformal radiation therapy plus arterial infusion chemotherapy for locally advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Objective: To improve the therapeutic response and survival of locally advanced pancreatic cancer treated with radiochemotherapy. Methods: Fifty-nine patients with stage II-III pancreatic cancer were divided into two groups: 33 patients were treated with three-dimensional conformed radiotherapy (3DCRT) plus regional intra-arterial infusion chemotherapy (CT) and 26 patients received 3DCRT alone. Results: The response (pain-alleviating) rates were 78.8% in 3DCRT + CT group and 80.8% in 3DCRT group, while the overall response (CR + PR) rates were 78.8% and 42.3% (P < 0.01), respectively. The 1-, 2-, 3-year survival rates were 72.2%, 48.5%, 9.1% and 50.0%, 15.4%, 3.9%, with the difference in the 2-year survival between these two groups statistically significant (P < 0.01). Conclusions: Three dimensional conformal radiation therapy combined with regional intra-arterial infusion chemotherapy is an effective treatment for unresectable locally advanced pancreatic cancer

  2. Pre-operative chemotherapy and radiotherapy in breast cancer

    International Nuclear Information System (INIS)

    Primary systemic treatment of breast cancer with cytotoxics yields a high response rate and allows conservative surgical procedures in bulky tumours. In order to maximise local control of disease, two innovations were introduced in a pilot study. The first was to identify the good responders after three cycles of chemotherapy and to treat them with three additional cycles. The second was to also give this group of patients a full dose of radiotherapy before surgery with the aim of verifying the rate of pathological complete remissions in view of a possible treatment of breast primary with chemoradiotherapy only. Patients were treated with doxorubicin 60 mg/m2 and cyclophosphamide, 600 mg/m2 both intravenously on day 1, every 21 days for three courses. Partial or complete responders received three more courses followed by radiotherapy (50 Gy plus a 10 Gy boost). The others underwent immediate surgery. A total of 32 patients (median age, 50 years; range 28-69 years); performance status, 0-1; T2 22, T3 8, T4 2) were enrolled and were evaluable for response and side-effects. 9 patients had only three cycles of chemotherapy due to absence of response and 23 patients had six cycles of chemotherapy. Overall, 7 patients had a complete remission, 16 a partial remission and 9 had stable disease, for an overall response rate of 72% (95% confidence interval 53-86%). In the group of patients that completed the programme, two complete pathological remissions were observed and 5 patients had only microfoci of tumour. No toxic death or grade III-IV toxicities were observed. Mild or moderate side-effects included mucositis, nausea/vomiting and leucopenia. In conclusion, our results indicate that the addition of radiotherapy to pre-operative chemotherapy did not significantly enhance the incidence of pathological complete remissions. New primary treatment approaches should be explored in this subset of patients in order to improve outcome. (Copyright (c) 1998 Elsevier Science B

  3. Nanotechnological carriers for cancer chemotherapy: the state of the art.

    Science.gov (United States)

    Estanqueiro, Marilene; Amaral, Maria Helena; Conceição, Jaime; Sousa Lobo, José Manuel

    2015-02-01

    Cancer is a term used for a heterogeneous group of malignant diseases in which abnormal cells divide without control and are able to invade other tissues, resulting in metastasis. According to the last data of World Health Organization the incidence and mortality rates of cancer are high and tend to increase. Chemotherapy is usually used in cancer treatments, but due to the lack of specificity of drugs, is associated to various and damaging side effects that have a severe impact on patients quality of life. Nanotechnology is actually an important area of interest in science and technology, which has been extensively explored during the last decade, particularly in the development of carriers for cytotoxic drugs. These carriers include vesicular and particulate systems such as liposomes, niosomes, transfersomes, ethosomes, micelles, dendrimers, and polymeric, protein and lipid nanoparticles. Polymer-drug conjugates and antibody-drug conjugates have also been studied. The present review is an attempt to contemplate the studied nanocarriers in the field of anticancer drugs delivery, their advantages and disadvantages and future perspectives. PMID:25591851

  4. Role of neoadjuvant chemotherapy in cancer cervix: A brief review

    Directory of Open Access Journals (Sweden)

    Aramita Saha

    2013-01-01

    Full Text Available Neoadjuvant chemotherapy (NACT represents a promising modality apart from or radiotherapy as initial treatment of locally advanced cervical cancer. The primary objectives of NACT in the treatment of cervical cancer include improvement in tumor characteristics, to allow avoidance of radiotherapy, to prolong disease-free and overall survival, and facilitation of fertility-sparing surgery. Though several studies have shown promising results of NACT on tumor response, downstaging, decrease in local recurrence, improved progression free survival, yet its role is controversial and plenty of study results are waiting to establish its efficacy. After reviewing the available literatures in the internet, and focusing the light of our continuous 3 years experience, we have made an effort to find out the relevance of NACT in cancer cervix. NACT is feasible and produces impressive responses in cervical carcinoma, as has been demonstrated by several phase II and phase III trials. Some meta-analysis suggested that NACT followed by surgery improves overall survival compared with nonstandard radiotherapy alone.

  5. Magnetic nanoparticle hyperthermia as an adjuvant cancer therapy with chemotherapy

    Science.gov (United States)

    Petryk, Alicia Ailie

    Magnetic nanoparticle hyperthermia (mNPH) is an emerging cancer therapy which has shown to be most effective when applied in the adjuvant setting with chemotherapy, radiation or surgery. Although mNPH employs heat as a primary therapeutic modality, conventional heat may not be the only cytotoxic effect. As such, my studies have focused on the mechanism and use of mNPH alone and in conjunction with cisplatinum chemotherapy in murine breast cancer cells and a related in vivo model. MNPH was compared to conventional microwave tumor heating, with results suggesting that mNPH (mNP directly injected into the tumor and immediately activated) and 915 MHz microwave hyperthermia, at the same thermal dose, result in similar tumor regrowth delay kinetics. However, mNPH shows significantly less peri-tumor normal tissue damage. MNPH combined with cisplatinum also demonstrated significant improvements in regrowth delay over either modality applied as a monotherapy. Additional studies demonstrated that a relatively short tumor incubation time prior to AMF exposure (less than 10 minutes) as compared to a 4-hour incubation time, resulted in faster heating rates, but similar regrowth delays when treated to the same thermal dose. The reduction of heating rate correlated well with the observed reduction in mNP concentration in the tumor observed with 4 hour incubation. The ability to effectively deliver cytotoxic mNPs to metastatic tumors is the hope and goal of systemic mNP therapy. However, delivering relevant levels of mNP is proving to be a formidable challenge. To address this issue, I assessed the ability of cisplatinum to simultaneously treat a tumor and improve the uptake of systemically delivered mNPs. Following a cisplatinum pretreatment, systemic mNPs uptake was increased by 3.1 X, in implanted murine breast tumors. Additional in vitro studies showed the necessity of a specific mNP/ Fe architecture and spatial relation for heat-based cytotoxicity in cultured cells.

  6. Relative dose intensity of systemic chemotherapy in an outpatient cancer center

    OpenAIRE

    Christine Uptigrove; Kari Vavra; Claire Saadeh; Gordan Srkalovic

    2010-01-01

    Objective. This study was undertaken to determine the average relative dose intensity (RDI) of chemotherapy administered to patients in a community-based outpatient cancer center. Methods. A retrospective review of medical records in an outpatient cancer center was conducted for patients initiating systemic chemotherapy in 2007 for a diagnosis of lymphoma, breast, lung, ovary, or colon cancer. Eighty-four records meeting the inclusion criteria were reviewed for demographi...

  7. Measuring decision quality: psychometric evaluation of a new instrument for breast cancer chemotherapy

    OpenAIRE

    Lee, Clara N.; Wetschler, Matthew H; Chang, Yuchiao; Belkora, Jeffrey K; Moy, Beverly; Partridge, Ann; Sepucha, Karen R

    2014-01-01

    Background: Women diagnosed with early stage (I or II) breast cancer face a highly challenging decision – whether or not to undergo adjuvant chemotherapy. We developed a decision quality instrument for chemotherapy for early stage breast cancer and sought to evaluate its performance. Methods: Cross-sectional, mailed survey of recent breast cancer survivors, providers, and healthy controls and a retest survey of survivors. The decision quality instrument includes questions on knowledge and per...

  8. Prognostic nomogram for nonresectable pancreatic cancer treated with gemcitabine-based chemotherapy

    OpenAIRE

    Hamada, T; Nakai, Y.; Yasunaga, H.; Isayama, H; Matsui, H; Takahara, N; Sasaki, T.; Takagi, K.; Watanabe, T.; Yagioka, H; Kogure, H; Arizumi, T.; N Yamamoto; Ito, Y.; Hirano, K

    2014-01-01

    Background: A nomogram is progressively being used as a useful predictive tool for cancer prognosis. A nomogram to predict survival in nonresectable pancreatic cancer treated with chemotherapy has not been reported. Methods: Using prospectively collected data on patients with nonresectable pancreatic cancer receiving gemcitabine-based chemotherapy at five Japanese hospitals, we derived a predictive nomogram and internally validated it using a concordance index and calibration plots. Results: ...

  9. Effect of Prone Position on Regional Shunt, Aeration, and Perfusion in Experimental Acute Lung Injury

    OpenAIRE

    Richter, Torsten; Bellani, Giacomo; Harris, R. Scott; Melo, Marcos F. Vidal; Winkler, Tilo; Venegas, Jose G.; Musch, Guido

    2005-01-01

    Rationale: The prone position is used to improve gas exchange in patients with acute respiratory distress syndrome. However, the regional mechanism by which the prone position improves gas exchange in acutely injured lungs is still incompletely defined. Methods: We used positron emission tomography imaging of [13N]nitrogen to assess the regional distribution of pulmonary shunt, aeration, perfusion, and ventilation in seven surfactant-depleted sheep in supine and prone positions. Results: In t...

  10. Relationship of regional myocardial perfusion to segmental wall motion. A physiologic basis for understanding the presence and reversibility of asynergy

    International Nuclear Information System (INIS)

    Experimental work has shown that even small reductions in muocardial perfusion impair contractile performance. We, therefore, studied the relationship between regional perfusion, assessed by thallium-201 scintigraphy and segmental wall motion, quantitated on biplane contrast ventriculograms, in patients with coronary artery disease. We evaluated 270 segments in 54 patients, including 27 without evidence of myocardial infarction. Most normally perfused regions (125 of 140) contracted normally, whereas those with scintigraphic defects at rest were usually asynergic (42 of 46). Surprisingly, 57% (48 of 84) of regions with exercise-induced perfusion defects were also asynergic, including 48% (25 of 52) of those in patients without myocardial infarction. In 22 patients who had intervention ventriculograms, improvement of perfusion abnormalities at rest correlated closely with reversibility of asynergy. Although there was an association between the location and severity of coronary artery stenosis and segmental wall motion, myocardial perfusion during exercise was a significantly better predictor of asynergy. These findings suggest that resting asynergy may occur even in patients without previous infarction, predominantly in regions with jeopardized perfusion. Asynergy in regions with exercise-induced perfusion abnormalities may, therefore, be an indicator of resting ischemia and may be reversible by coronary artery revascularization

  11. Adjuvant Radio-chemotherapy for extrahepatic biliary tract cancers

    OpenAIRE

    Mentha Gilles; Roth Arnaud D; Bonet Beltrán Marta; Allal Abdelkarim S

    2011-01-01

    Abstract Background Extrahepatic biliary duct cancers (EBDC) are uncommon malignancies characterized by a poor prognosis with high rate of loco-regional recurrence. The purpose of the present study is to assess the feasibility and the potential impact of adjuvant radiotherapy (RT) in a series of patients treated in one institution. Methods Twenty three patients with non-metastatic bile duct cancer treated surgically with curative intent (4 gallbladder, 7 ampullary and 12 cholangiocarcinoma) r...

  12. Prognostic signiifcance ofthe pre-chemotherapy lymphocyte-to-monocyte ratio inpatients withpreviously untreated metastatic colorectal cancer receiving FOLFOX chemotherapy

    Institute of Scientific and Technical Information of China (English)

    GuiNanLin; PanPanLiu; DongYingLiu; JieWenPeng; JianJunXiao; ZhongJunXia

    2016-01-01

    Background:As a surrogate marker of systemic inlfammation, the lymphocyte‑to‑monocyte ratio (LMR) is an independent prognostic factor for various malignancies. This study investigated the prognostic signiifcance of the pre‑chemotherapy LMR in patients with previously untreated metastatic colorectal cancer (mCRC) receiving chemotherapy. Methods:The present study included newly diagnosed mCRC patients treated between January 2005 and Decem‑ber 2013 with FOLFOX chemotherapy, speciifcally oxaliplatin 180mg/m2 on day 1, with leucovorin 400mg/m2 administered as a 2‑hour infusion before the administration of 5‑lfuorouracil 400mg/m2 as an intravenous bolus injection, and 5‑lfuorouracil 2400mg/m2 as a 46‑h infusion immediately after 5‑lfuorouracil bolus injection. The LMR was calculated as the absolute count of lymphocytes divided by the absolute count of monocytes. COX proportional hazards analysis was performed to evaluate the association of LMR with survival outcomes. Results:A total of 488 patients were included. Patients with high pre‑chemotherapy LMR experienced signiif‑cant improvements in progression‑free survival (PFS, 9.2 vs. 7.6months,P<0.001) and overall survival (OS, 19.4 vs. 16.6months,P<0.001) compared with patients with low pre‑chemotherapy LMR. Subsequent COX multivariate analysis showed that high pre‑chemotherapy LMR (≥3.11) was an independent favorable prognostic factor for PFS and OS. Additionally, patients whose LMR remained high (high–high subgroup), increased (low–high subgroup), or decreased (high–low subgroup) following chemotherapy showed better results in terms of PFS and OS than patients whose LMR remained low (low–low subgroup) after chemotherapy. Conclusions:For patients with previously untreated mCRC receiving FOLFOX chemotherapy, an elevated pre‑chem‑otherapy LMR is an independent favorable prognostic factor for PFS and OS, and changes in the LMR before and after chemotherapy seem to predict the

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

    Directory of Open Access Journals (Sweden)

    Hohenforst-Schmidt W

    2013-07-01

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

  14. A multi-target approach to pancreatic cancer treatment using radiation and concurrent dual targeting chemotherapy

    International Nuclear Information System (INIS)

    Pancreatic cancer has a survival rate of less than 5% five years after diagnosis. Treatment for pancreatic cancer consists of surgery, chemotherapy, and radiation therapy. Despite this multimodality approach local regional reoccurrence of pancreatic cancer is common. In many cases pancreatic cancer recurrence is due to the therapeutic resistance of pancreatic cancer cells. While the genetics of pancreatic cancer are highly complex, about 90% of all pancreatic cancers exhibit a constitutively active KRAS oncogene. Common characteristics of this mutation are constitutive activation of the pro-survival transcription factor NF-kB and increased activity of pyruvate dehydrogenase kinase. NF-kB controls cell survival, angiogenesis, and invasion while PDH kinase causes the shift commonly seen in cancer metabolism to aerobic glycolysis (Warburg metabolism). We hypothesized that by blocking the pro-survival signals from NF-kB with the inhibitor Dimethylamino-parthenolide (DMAPT) and by shifting the metabolism from Warburg metabolism back to oxidative metabolism by using Dichloroacetate (DCA that we can increase the effectiveness of radiation therapy in treating pancreatic carcinomas clinically). This study examined the effectiveness of Dimethylamino-parthenolide (DMAPT) and Dichloroacetate (DCA) to induce cytotoxicity and increase radiation-induced cell killing in human pancreatic cancer cells MIA PaCa-2, BxPc-3, and AsPc-1. We found that dual treatment of the three pancreatic cancer cell lines: altered Warburg metabolism; decreased cell viability; altered cell cycle distribution; increased population doubling times; and increased radiation-induced cell killing after single and fractionated doses through inhibition of split dose and DNA double strand break repair. In summary, we have established that dual treatment with DMAPT and DCA is not only cytotoxic but also significantly enhances radiation-induced cell killing of human pancreatic cancer cells in vitro. (author)

  15. Retrospective analysis of outcomes and prognostic factors of chemotherapy for small-cell lung cancer

    OpenAIRE

    Minami S; Ogata Y; Ihara S; Yamamoto S; Komuta K

    2016-01-01

    Seigo Minami, Yoshitaka Ogata, Shouichi Ihara, Suguru Yamamoto, Kiyoshi Komuta Department of Respiratory Medicine, Osaka Police Hospital, Osaka, Japan Background: Small-cell lung cancer (SCLC) is responsive to initial chemotherapy but becomes resistant to cytotoxic drugs. The aim of this study was to evaluate what proportion of patients with SCLC had received the first- and further-line chemotherapy and which patients had benefited from chemotherapy. Methods: We retrospectively reviewed medi...

  16. Factors affecting the quality of life of cancer patients undergoing chemotherapy: A questionnaire study

    OpenAIRE

    Sema Üstündag; Ayten Demir Zencirci

    2015-01-01

    Objective: This descriptive and cross-sectional study was undertaken to determine the factors affecting cancer patients′ quality of life. Methods: We collected data from 352 chemotherapy patients of an Outpatient Chemotherapy Unit in a state hospital. We included volunteered chemotherapy patients with a signed informed consent and at least 50 Karnofsky Performance Scale points. We gathered data by Personal Information Form and Nightingale Symptom Assessment Scale (N-SAS) and analyzed via basi...

  17. Thiolated chitosan-modified PLA-PCL-TPGS nanoparticles for oral chemotherapy of lung cancer

    OpenAIRE

    Jiang, Liqin; Li, Xuemin; Liu, Lingrong; Zhang, Qiqing

    2013-01-01

    Oral chemotherapy is a key step towards ‘chemotherapy at home’, a dream of cancer patients, which will radically change the clinical practice of chemotherapy and greatly improve the quality of life of the patients. In this research, three types of nanoparticle formulation from commercial PCL and self-synthesized d-α-tocopheryl polyethylene glycol 1000 succinate (PLA-PCL-TPGS) random copolymer were prepared in this research for oral delivery of antitumor agents, including thiolated chitosan-mo...

  18. Retrospective analysis of third-line chemotherapy in advanced non-small cell lung cancer

    OpenAIRE

    Ali Murat Tatli; Deniz Arslan; Mukremin Uysal; Sema Sezgin Goksu; Seyda Gulenay Gunduz; Hasan Senol Coskun; Mustafa Ozdogan; Burhan Savas; Hakan Sat Bozcuk

    2015-01-01

    Background: First- and second-line chemotherapies have been demonstrated to be effective in treatment of patients with inoperable, advanced non-small cell lung cancer (NSCLC), although the role of third-line chemotherapy remains unclear. The present investigation assessed treatment outcomes in patients with advanced NSCLC who received third-line and higher chemotherapy. Patients and Methods: This retrospective study included consecutive patients with advanced NSCLC who received at least t...

  19. The prevalence of chemotherapy side effects of cancerous patients on oral health

    OpenAIRE

    EshghyarN; Bateby M

    2001-01-01

    Different methods can be used to treat the malignant disease; surgery, radiotherapy, chemotherapy, and even cryotherapy are different approach to reach the best treatment for patients. The aim of this cross sectional study was to evaluate the prevalence of oral side effects followed by chemotherapy of cancerous patients in Imam Khomeini hospital. This study was conducted on 80 patients who were under chemotherapy more than once and their oral lesions were evaluated considering their physical ...

  20. Perfusion computed tomography in colorectal cancer: Protocols, clinical applications and emerging trends

    Institute of Scientific and Technical Information of China (English)

    Guang-Yao Wu; Prasanna Ghimire

    2009-01-01

    Perfusion computed tomography (CT) has emerged as a novel functional imaging technique with gradually increasing importance in the management of colorectal cancer (CRC). By providing the functional tumor microvasculature, it also helps the assessment of therapeutic response of anti-angiogenic drugs as it may reflect tumor angiogenesis. Perfusion CT has been applied in clinical practice to delineate inflammatory or neoplastic lymph nodes irrespective of their size,identify micro-metastases and to predict metastases in advance of their development. It is of increasing significance for preoperative adjuvant therapies and avoidance of unnecessary interventions. Despite controversies regarding the techniques employed, its validity and reproducibility, it can be advantageous in the management of CRCs in which the prognosis is dependent on preoperative staging. With recent advances in the perfusion CT techniques, and incorporation to other modalities like positron emission tomography, perfusion CT will be a novel tool in the overall management of CRCs. This article aims at reviewing the existing clinical applications and recent advances of perfusion CT with a reference to future development in the management of CRCs.

  1. Neutralizing S1P inhibits intratumoral hypoxia, induces vascular remodelling and sensitizes to chemotherapy in prostate cancer.

    Science.gov (United States)

    Ader, Isabelle; Gstalder, Cécile; Bouquerel, Pierre; Golzio, Muriel; Andrieu, Guillaume; Zalvidea, Santiago; Richard, Sylvain; Sabbadini, Roger A; Malavaud, Bernard; Cuvillier, Olivier

    2015-05-30

    Hypoxia promotes neovascularization, increased tumor growth, and therapeutic resistance. The transcription factor, hypoxia-inducible factor 1α (HIF-1α), has been reported as the master driver of adaptation to hypoxia. We previously identified the sphingosine kinase 1/sphingosine 1-phosphate (SphK1/S1P) pathway as a new modulator of HIF-1α under hypoxia. Taking advantage of a monoclonal antibody neutralizing extracellular S1P (sphingomab), we report that inhibition of S1P extracellular signaling blocks HIF-1α accumulation and activity in several cancer cell models exposed to hypoxia. In an orthotopic xenograft model of prostate cancer, we show that sphingomab reduces hypoxia and modifies vessel architecture within 5 days of treatment, leading to increased intratumoral blood perfusion. Supporting the notion that a transient vascular normalization of tumor vessels is the mechanism by which sphingomab exerts its effects, we demonstrate that administration of the antibody for 5 days before chemotherapy is more effective at local tumor control and metastatic dissemination than any other treatment scheduling. These findings validate sphingomab as a potential new normalization agent that could contribute to successful sensitization of hypoxic tumors to chemotherapy. PMID:25915662

  2. INFLUENCE OF NEOADJUVANT INTRAARTERIAL INFUSION CHEMOTHERAPY ON APOPTOSIS AND MULTIDRUG RESISTANCE ASSOCIATED GENES OF ENDOMETRIAL CANCER

    Institute of Scientific and Technical Information of China (English)

    朱雪琼; 岳天孚; 张颖; 惠京; 王德华

    2002-01-01

    Objective: Through investigating the influence of neoadjuvant intraarterial infusion chemotherapy (NIAC) on the timing changes of apoptosis, PCNA and multiple drug resistance associated genes of endometrial cancer, to study the mechanism of chemotherapy and to define the best operation time. Methods: Twenty patients were subjected to neoadjuvant consecutive uterine arterial infusion with CDDP 100 mg and ADM 50 mg. The biopsy of endometrial tumor tissues was performed before, immediate after and 1, 2-2+3 w, 3+3-4 w after chemotherapy. Apoptosis index (AI) was estimated by a combination of histologic and TUNEL assays. Proliferative index (PI) was examined by SABC immunohistochemical staining. Expressions of multidrug resistance 1 (MDR1), multidrug resistance-associated protein (MRP) and lung resistance protein (LRP) were detected by reverse transcription polymerase chain reaction (RT-PCR). Results: The AI of endometrial cancer cells immediate after and 1, 2-2+3 w, after chemotherapy were 3.03%, 3.47% and 5.04%, respectively, much higher than that before chemotherapy which was 2.31%. After chemotherapy, AI/PI gradually increased. It was highest in 2-2+3 w, while 3+3-4 w after chemotherapy the AI and AI/PI were both significantly lower than that before chemotherapy. The expression of MDR1, MRP and LRP all decreased temporarily after chemotherapy, while 3+3-4 w after chemotherapy they all increased to levels higher than that before chemotherapy, but the difference were not significant (P>0.05). Conclusion: Neoadjuvant consecutive intra-arterial infusion chemotherapy via uterine artery can inhibit tumor cells proliferation and induce apoptosis effectively. To evaluate the response of intra-arterial chemotherapy the change of apoptosis index and cell proliferation should be analyzed. The most suitable time for the operation is 3 weeks after intra-arterial infusion chemotherapy.

  3. Long-term cognitive function following chemotherapy in patients with testicular cancer

    DEFF Research Database (Denmark)

    Pedersen, Anders Degn; Rossen, Philip; Mehlsen, Mimi Yung;

    2009-01-01

    Cancer patients frequently report cognitive complaints following chemotherapy, but the results from the available studies, mainly of women with breast cancer, are inconsistent. Our aim was to compare cognitive function of men with testicular cancer (TC) who had orchiectomy and chemotherapy...... similar performances on cognitive tests (p values adjusted for multiple comparisons: .63-1.00). Moreover, there was no difference in the proportion of cognitively impaired patients in the chemotherapy group (5.6%) compared to the nonchemotherapy group (8.3%) (chi2 = 0.22, p = .64). Our results...... are discordant with previous findings indicating cognitive impairment following chemotherapy and suggest that TC patients do not need to fear long-term cognitive consequences following chemotherapy....

  4. Intra-arterial chemotherapy for invasive bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ozono, Seiichiro; Kim, Sung-Chul; Takashima, Kenji [Nara Medical Univ., Kashihara (Japan)] [and others

    1999-02-01

    The present investigation was conducted to examine the effects of intra-arterial chemotherapy (IAC) for patients with invasive bladder cancer. A total of 37 patients were treated with IAC at Nara Medical University and its affiliated hospitals between January, 1993 and August, 1997. There were 27 patients in the poor risk group. The remaining 10 patients underwent anti-tumor IAC. Thirty of the 37 patients received chemotherapeutic agents via a reservoir, and the remaining 7 patients received a one-shot injection of agents followed by transcatheter arterial embolization (TAE). In the reservoir group, there were 18 patients who received IAC in combination with radiation therapy. As a result, reduction of tumor size was noted in 53%, and the 3-year cause-specific survival rate was 54% in all cases. There was a significant difference in the 3-year survival rate between the radiation-treated group and the group without radiation. The adverse events included anemia, leukopenia, thrombocytopenia and gastrointestinal symptoms, but none of them were severe. The results of the present study indicate that IAC is useful in the treatment of invasive bladder cancer for poor risk patients. (author)

  5. Intra-arterial chemotherapy for invasive bladder cancer

    International Nuclear Information System (INIS)

    The present investigation was conducted to examine the effects of intra-arterial chemotherapy (IAC) for patients with invasive bladder cancer. A total of 37 patients were treated with IAC at Nara Medical University and its affiliated hospitals between January, 1993 and August, 1997. There were 27 patients in the poor risk group. The remaining 10 patients underwent anti-tumor IAC. Thirty of the 37 patients received chemotherapeutic agents via a reservoir, and the remaining 7 patients received a one-shot injection of agents followed by transcatheter arterial embolization (TAE). In the reservoir group, there were 18 patients who received IAC in combination with radiation therapy. As a result, reduction of tumor size was noted in 53%, and the 3-year cause-specific survival rate was 54% in all cases. There was a significant difference in the 3-year survival rate between the radiation-treated group and the group without radiation. The adverse events included anemia, leukopenia, thrombocytopenia and gastrointestinal symptoms, but none of them were severe. The results of the present study indicate that IAC is useful in the treatment of invasive bladder cancer for poor risk patients. (author)

  6. Screening of Psychological Distress in Cancer Patients During Chemotherapy: A Cross-sectional Study

    Science.gov (United States)

    Singh, Raja Paramjeet Banipal; Singh, Harminder; Singh, Chiranjeev Jhajj; Kaur, Kanwardeep Tiwana

    2015-01-01

    Objective: The objective of this prospective, noninterventional, 8-months, observational study was to analyze and compare depression, anxiety, and stress (DAS) levels and their impacting factors in homogenous surviving cancer patients receiving chemotherapy as compared to normal control. Materials and Methods: A prospective and descriptive study was carried out jointly by Pharmacology and Oncology departments of a tertiary care center in Malwa region of Punjab. The data was collected by administering the validated questionnaire/response (21-item Depression Anxiety and Stress Scale (DASS-21)) after taking ethical approval and informed consent. Results: All eligible 300 subjects participated in the study and they were compared with 300 matched control. The mean age of the cases (cancer patients) and controls was 50.58 ± 13.64 and 46.1 ± 11.78 (mean (M) ± standard deviation (SD)) years. Statistical significant difference was observed in mean ‘scoring of DAS’ in cancer patients when compared with control groups. Anxiety mean scoring showed a statistical significant difference in groups (according to chemotherapy cycles given and duration of disease). Stress was more observed in breast cancer patients. Conclusion: Holistic approach in cancer management including psychological evaluation and its solution at appropriate time/stage signifies the need of time as the present study revealed that the percentage of DAS as per the DASS scale was 90, 56, and 28%, respectively. A judicious diagnosis with an apposite intercession including psychological consultation with social support at appropriate time may alleviate the extra burden of psychological disorder, rather enhance the quality of life of cancer-affected rural population. PMID:26600699

  7. Chemotherapy versus support cancer treatment in advanced gastric cancer: a meta-analysis

    Directory of Open Access Journals (Sweden)

    L. Casaretto

    2006-04-01

    Full Text Available The aim of the present study was to compare the efficacy of chemotherapy and support treatment in patients with advanced non-resectable gastric cancer in a systematic review and meta-analysis of randomized clinical trials that included a comparison of chemotherapy and support care treatment in patients diagnosed with gastric adenocarcinoma, regardless of their age, gender or place of treatment. The search strategy was based on the criteria of the Cochrane Base, using the following key words: 1 randomized clinical trials and antineoplastic combined therapy or gastrointestinal neoplasm, 2 stomach neoplasm and drug therapy, 3 clinical trial and multi-modality therapy, 4 stomach neoplasm and drug therapy or quality of life, 5 double-blind method or clinical trial. The search was carried out using the Cochrane, Medline and Lilacs databases. Five studies fulfilled the inclusion criteria, for a total of 390 participants, 208 (53% receiving chemotherapy, 182 (47% receiving support care treatment and 6 losses (1.6%. The 1-year survival rate was 8% for support care and 20% for chemotherapy (RR = 2.14, 95% CI = 1.00-4.57, P = 0.05; 30% of the patients in the chemotherapy group and 12% in the support care group attained a 6-month symptom-free period (RR = 2.33, 95% CI = 1.41-3.87, P < 0.01. Quality of life evaluated after 4 months was significantly better for the chemotherapy patients (34%; RR = 2.07, 95% CI = 1.31-3.28, P < 0.01 with tumor mass reduction (RR = 3.32, 95% CI = 0.77-14.24, P = 0.1. Chemotherapy increased the 1-year survival rate of the patients and provided a longer symptom-free period of 6 months and an improvement in quality of life.

  8. Importance of radiation therapy for breast cancer patients treated with high-dose chemotherapy and stem cell transplant

    International Nuclear Information System (INIS)

    Purpose: To determine local-regional failure rates in breast cancer patients treated with surgery and high-dose chemotherapy with stem cell transplant and to relate local-regional failure to the use and timing of radiation treatment. Methods and Materials: We retrospectively reviewed the records of 165 breast cancer patients treated on institutional protocols with surgery and high-dose chemotherapy with stem cell transplant. All patients had either Stage III disease, 10 or more positive axillary lymph nodes, or 4 or more positive axillary lymph nodes following neoadjuvant chemotherapy. Twelve patients had inflammatory breast cancer. Thirteen patients treated with breast preservation and 5 patients who died from toxicity within 30 days of transplant were excluded from the analyses of local-regional recurrences. In the remaining 147 patients, 108 were treated with adjuvant radiation and 39 were not. The disease stage distribution for these two groups was comparable. The median follow-up for surviving patients was 35 months. Results: The 3- and 5-year actuarial disease-free survival (DFS) for the entire group was 60% and 51%, respectively. The 5-year rates of freedom from isolated local-regional recurrence were 95% in the patients treated with adjuvant radiation and 86% in the patients who did not receive radiation (p 0.014, log rank comparison). The 5-year rates of any local-regional recurrence as a first event (isolated recurrences plus those with simultaneous local-regional and distant recurrences) were 92% versus 82%, respectively for patients whose treatment did and did not include radiation (p = 0.038). We could not demonstrate a correlation of the timing of radiation with the risk of local-regional recurrence. Conclusions: These data indicate that high-dose chemotherapy does not negate the importance of radiation in optimizing local-regional control in patients with high-risk breast cancer. Given the results of recent randomized trials studying postmastectomy

  9. Postmastectomy Radiotherapy for Locally Advanced Breast Cancer Receiving Neoadjuvant Chemotherapy

    Directory of Open Access Journals (Sweden)

    Icro Meattini

    2014-01-01

    Full Text Available Neoadjuvant chemotherapy (NAC is widely used in locally advanced breast cancer (BC treatment. The role of postmastectomy radiotherapy (PMRT after NAC is strongly debated. The aim of our analysis was to identify major prognostic factors in a single-center series, with emphasis on PMRT. From 1997 to 2011, 170 patients were treated with NAC and mastectomy at our center; 98 cases (57.6% underwent PMRT and 72 cases (42.4% did not receive radiation. At a median follow-up period of 7.7 years (range 2–16 for the whole cohort, median time to locoregional recurrence (LRR was 3.3 years (range 0.7–12.4. The 5-year and 10-year actuarial LRR rate were 14.5% and 15.9%, respectively. At the multivariate analysis the factors that significantly correlated with survival outcome were ≥4 positive nodes (HR 5.0, 1.51–16.52; P=0.035, extracapsular extension (HR 2.18, 1.37–3.46; P=0.009, and estrogen receptor positive disease (HR 0.57, 0.36–0.90; P=0.003. Concerning LRR according to use of radiation, PMRT reduced LRR for patient with clinical T3 staged disease (P=0.015. Our experience confirmed the impact of pathological nodal involvement on survival outcome. PMRT was found to improve local control in patients presenting with clinical T3 tumors, regardless of the response to chemotherapy.

  10. Concomitant postoperative radio-chemotherapy in high risk patients with cervical cancer stage IB and HA

    International Nuclear Information System (INIS)

    The aim of the study was to compare the treatment results, prognostic factors and toxicity of radiotherapy when used alone or in combination with Cisplatin in patients with early stage cervical cancer - clinical stage I and MA by RGO, who are in high risk group due to: positive (metastatic) lymph nodes (N+), positive resection line (R+) and have hydronephrosis. For a 5-year period (2007-2012) there were 252 patients with cervical cancer stage IB and MA, who were operated by Wertheim - Meigs, 165 of them received postoperative chemotherapy (Cisplatin) and external beam radiotherapy, while the remaining 87 external beam radiotherapy only. In pelvic region the total dose was 50Gy in daily dose 2Gy in 5 fractions/ week simultaneously with Cisplatin 40 mg/m2 once/ week to total dose 200 - 250 mg.There is an improvement with 8% of 5-years overall survival in the radio-chemotherapy group. Study results signify statistically significant advantage in total survival rate when using combined radio-chemotherapy in patients without accompanying hydronephrosis (p=0.00001), who had negative resection line R0 (p=0,003) and were in 11 clinical stage (p=0.012). There is also a statistically significant correlation between patients with T2 tumors with positive (metastatic) lymph nodes (N+) - 63.2% (p=0.01) and those with T2 tumors with positive resection line (R+) - 56.6% (p=0.01). There was local recurrence in 50% of patients with R+, and in patients with hydronephrosis when N+. Patients in the group on simultaneous radio- and chemotherapy experienced an acceptable early hematological (grade 1) and intestinal toxicity. Use of Cisplatin improves the treatment results. Local recurrence in 50% of R+ patient, as well as in those with accompanying hydronephrosis due to parailliac lymph nodes metastases raise the question for precise p re-treatment staging and the need of dose increase above 50 Gy, regardless the use of Cisplatin. Key words: Cervical Cancer. Radio-Chemotherapy. Factors of

  11. Effect of direct moxibustion at Sihua points on cytokine of chemotherapy patients with lung cancer

    Institute of Scientific and Technical Information of China (English)

    张去飞

    2013-01-01

    Objective To observe the effect of direct moxibustion at Sihua points on immune function and life qualityof chemotherapy patients with non-small cell lung cancer.Methods Eighty cases were randomly divided into a chemotherapy and moxibustion group(group A)and

  12. Systemic Chemotherapy for Progression of Brain Metastases in Extensive-Stage Small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Nagla Abdel Karim

    2015-01-01

    Full Text Available Lung cancer is the most common cause of cancer related mortality in men and women. Approximately 15% of lung cancers are small cell type. Chemotherapy and radiation are the mainstay treatments. Currently, the standard chemotherapy regimen includes platinum/etoposide. For extensive small cell lung cancer, irinotecan and cisplatin have also been used. Patients with relapsed small cell lung cancer have a very poor prognosis, and the morbidity increases with brain metastases. Approximately 10%–14% of small cell lung cancer patients exhibit brain metastases at the time of diagnosis, which increases to 50%–80% as the disease progresses. Mean survival with brain metastases is reported to be less than six months, thus calling for improved regimens. Here we present a case series of patients treated with irinotecan for progressive brain metastases in small cell lung cancer, which serves as a reminder of the role of systemic chemotherapy in this setting.

  13. Clinical trial of post-chemotherapy consolidation thoracic radiotherapy for extensive-stage small cell lung cancer

    International Nuclear Information System (INIS)

    Background and purpose: To define the rate of development of symptomatic chest failures in extensive stage small cell lung cancer (ES-SCLC) after undergoing post-chemotherapy chest radiotherapy (RT). Materials and methods: Patients had ES-SCLC, attained an objective response to chemotherapy and signed study consent. Target accrual was 33 patients. Patients were offered prophylactic cranial irradiation (PCI) as per department policy. PCI (25 Gy/10 fractions) and chest RT (40 Gy/15 fractions) were given simultaneously 4–8 weeks after chemotherapy completion. Thoracic target volume was the post-chemotherapy residual chest disease plus margin. Patients were evaluated for RT toxicities, local control, disease-free and overall survival. Results: Thirty-two patients were evaluable. Twenty-nine patients completed RT without delay. There were 4 complete responses and 28 partial responses to chemotherapy. All study patients received PCI. Maximal acute RT toxicity was grade 2 esophagitis (18 patients). There were no RT-related deaths. Median time to disease progression and overall survival were 4.2 and 8.3 months, respectively (median follow-up = 21.8 months). Of 16 chest recurrences, 7 were in the irradiated region and 5 were symptomatic. Conclusions: Post-chemotherapy consolidation chest RT for ES-SCLC patients on this trial was well tolerated and associated with symptomatic chest recurrences in only 5/32 treated patients.

  14. Combination chemotherapy and radiotherapy for squamous cell carcinoma of the anal region

    International Nuclear Information System (INIS)

    During 1977-81, thirteen patients of squamous cell carcinoma of the anal region have been treated by combined chemotherapy and radiotherapy at J.K. Cancer Institute, Kanpur. All these cases were biopsy proved and they did not receive radiotherapy or/and surgery prior to this treatment as either they refused for surgery or were found unfit either due to advance stage or low general condition or poor operation risk. All these cases responded to this treatment. Complete response was observed in 10 cases (76.8 per cent) and partial response in 3 cases (23.2 per cent). The overall duration of response varied from 11 to 62 months with a median of 46 months. (author)

  15. APOPTOSIS AND PROLIFERATION OF TUMOR CELLS IN LOCALLY ADVANCED CERVICAL CANCER AFTER NEOADJUVANT INTRAARTERIAL CHEMOTHERAPY

    Institute of Scientific and Technical Information of China (English)

    朱雪琼; 岳天孚; 惠京; 张颖; 王德华

    2003-01-01

    Objective: Through observing the clinical response to neoadjuvant intraarterial chemotherapy in locally advanced cervical cancer and investigating the changes of p53 protein expression, proliferation and apoptosis of tumor cells after chemotherapy, to study the relationship between biological markers and chemotherapeutic response. Methods: 20 women with locally advanced squamous cervical cancer received consecutive infusion chemotherapy of five days of cisplatin and adriamycin via the superselective uterine artery. The response to chemotherapy was evaluated by gynecologic examination and ultrasonography 3 weeks after chemotherapy. The changes of apoptotic index (AI), proliferation index (PI) and p53 expression of tumor cells were detected by immunohistochemical technique. Results: The clinical response rate of locally advanced squamous cervical cancer to uterine artery infusion chemotherapy was 70%. No change of PI was found 3 weeks after treatment, but AI significantly increased from 2.79±0.76 to 4.29±1.13 (P<0.01), and AI/PI from 5.68±1.21 to 9.00±1.95 (P<0.05). On the contrary, the expression of p53 was significantly decreased (P<0.05). Patients who responded to chemotherapy showed higher PI before chemotherapy and significantly increased AI and AI/PI after chemotherapy than non-responders (P<0.05). Conclusion: Higher PI was an indication for neoadjuvant intraarterial chemotherapy. One more cycle of chemotherapy should be given to those who have significantly increased AI or AI/PI after chemotherapy, while definite treatment such as surgery or/and radiotherapy should be immediately given to those patients without increased AI or AI/PI.

  16. Cancer chemotherapy of the upper aero digestive tract; Chimiotherapie des cancers des voies aerodigestives superieures

    Energy Technology Data Exchange (ETDEWEB)

    Vedrine, L.; Chargari, C.; Le Moulec, S.; Fayolle, M.; Ceccaldi, B.; Bauduceau, O. [Hopital d' Instruction des Armees du Val-de-Grace, Service d' Oncologie et Radiotherapie, 75 - Paris (France)

    2008-03-15

    Tumours of the upper aero digestive tract represent the sixth most frequent kind of cancer in France and throughout the world. If the localised forms may be controlled in the long run in two thirds of cases by surgery or radiotherapy, only one third of locally advanced forms are accessible to a cure after association from radiotherapy and chemotherapy. Besides, with a median of survival less than six months, metastatic tumours present a catastrophic spontaneous prognosis among patients with a medical ground that is often heavily deteriorated by prolonged exposure to alcohol and tobacco. Thus, there is a necessity to implement adapted therapeutic strategies to each patient and based on satisfactory proof levels of effectiveness. Optimisation of existing chemotherapy protocols and development of new therapies, in particular of targeted therapies, remain an important objective in the hope to improve results of treatments in locally advanced and metastatic cancers of the oral cavity. (authors)

  17. Efficacy and safety of oxaliplatin chemotherapy programs as adjuvant treatment in colorectal cancer after surgery

    Institute of Scientific and Technical Information of China (English)

    杨莉萍

    2013-01-01

    Objective To compare the efficacy and safety of 5-fluorouracil and calcium folinatc combined with oxaliplatin(FOLFOX) program with capecitabine regimen combined oxaliplatin(XELOX) program as adjuvant chemotherapy in advanced colorectal cancer after surgery.

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

    International Nuclear Information System (INIS)

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

  19. Research Progress of Nutrition Support for Patients with Lung Cancer 
During Chemotherapy

    Directory of Open Access Journals (Sweden)

    Yiqiao LUO

    2014-12-01

    Full Text Available Primary lung cancer is one of the most common malignancies. Nowadays, both its morbidity and mortality rank first, patients with lung cancer are often goes with some affiliating symptoms such as malnutrition and weight loss. The side effects of cytotoxicity during chemotherapy may lead to further deteriorate of the nutritional status and worsen the anti-tumor therapy’s efficacy and the patients’ quality of life. With the development of palliative treatment and the higher request of patients for quality of life, nutritional support will be an important adjunctive treatment to maintain a good nutritional status and enhance the patients’ immunity during chemotherapy. It will play an active role in improving tolerability of chemotherapy and prognosis for patients with lung cancer. Here is a review about research progress of nutrition support treatment during chemotherapy for the patients with lung cancer.

  20. A meta-analysis of bevacizumab combined with chemotherapy in the treatment of ovarian cancer

    Directory of Open Access Journals (Sweden)

    T S Wang

    2014-01-01

    Full Text Available Introduction: Angiogenesis plays an important role in the biology of ovarian cancer. The clinical efficacy and side effects of bevacizumab, the vascular endothelial growth factor inhibitor, on survival and toxicity in women with this ovarian cancer, was not conclusive. We performed this systematic review and meta-analysis in order to clarify the efficacy of bevacizumab combined with chemotherapy in the treatment of ovarian cancer. Materials and Methods: We searched the electronic database of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and CNKI for clinical controlled trials of comparing bevacizumab combined with chemotherapy and chemotherapy alone in the treatment of ovarian cancer. The primary outcomes of eligible studies included median progression-free survival (PFS, overall survival (OS, and toxicities such as enterobrosis, hypertension, albuminuria, congestive heart failure (CHF, neutrophils, thrombosis, and bleeding. The Hazard ratio (HR and relative risk were used for the meta-analysis and were expressed with 95% confidence intervals (CIs. All the statistical analyses were carried out by  Stata 11.0 software (http://www.stata.com; Stata Corporation, College Station, TX, USA. Results: We included 5 studies with 1798 cases in the bevacizumab combined with the chemotherapy group and 1810 subjects in the chemotherapy alone group. The pooled results showed that bevacizumab + chemotherapy compared with chemotherapy alone can significant prolong the median PFS (HR, 0.64; 95% CI, 0.46-0.82; P 0.05; the toxicity analysis showed that the enterobrosis, hypertension, albuminuria, neutrophils, thrombosis, and bleeding were significantly increased in the bevacizumab + chemotherapy group compared with chemotherapy alone (Pall 0.05. Conclusion: Bevacizumab combined with chemotherapy prolonged the median PFS in patients with ovarian cancer but also increase the risk of developing enterobrosis, hypertension, albuminuria, neutrophils

  1. ROLES OF RADIATION DOSE AND CHEMOTHERAPY IN THE ETIOLOGY OF STOMACH CANCER AS A SECOND MALIGNANCY

    NARCIS (Netherlands)

    van den Belt-Dusebout, Alexandra W.; Aleman, Berthe M. P.; Besseling, Gijs; de Bruin, Marie L.; Hauptmann, Michael; van 't Veer, Mars B.; de Wit, Ronald; Ribot, Jacques G.; Noordijk, Evert M.; Kerst, J. Martijn; Gietema, Jourik A.; van Leeuwen, Flora E.

    2009-01-01

    Purpose: To evaluate the roles of radiation dose, chemotherapy, and other factors in the etiology of stomach cancer in long-term survivors of testicular cancer or Hodgkin lymphoma. Methods and Materials: We conducted a cohort study in 5,142 survivors of testicular cancer or Hodgkin lymphoma treated

  2. Roles of radiation dose and chemotherapy in the etiology of stomach cancer as a second malignancy

    DEFF Research Database (Denmark)

    van den Belt-Dusebout, Alexandra W; Aleman, Berthe M P; Besseling, Gijs;

    2009-01-01

    PURPOSE: To evaluate the roles of radiation dose, chemotherapy, and other factors in the etiology of stomach cancer in long-term survivors of testicular cancer or Hodgkin lymphoma. METHODS AND MATERIALS: We conducted a cohort study in 5,142 survivors of testicular cancer or Hodgkin lymphoma treat...

  3. Automated scoring of regional lung perfusion in children from contrast enhanced 3D MRI

    Science.gov (United States)

    Heimann, Tobias; Eichinger, Monika; Bauman, Grzegorz; Bischoff, Arved; Puderbach, Michael; Meinzer, Hans-Peter

    2012-03-01

    MRI perfusion images give information about regional lung function and can be used to detect pulmonary pathologies in cystic fibrosis (CF) children. However, manual assessment of the percentage of pathologic tissue in defined lung subvolumes features large inter- and intra-observer variation, making it difficult to determine disease progression consistently. We present an automated method to calculate a regional score for this purpose. First, lungs are located based on thresholding and morphological operations. Second, statistical shape models of left and right children's lungs are initialized at the determined locations and used to precisely segment morphological images. Segmentation results are transferred to perfusion maps and employed as masks to calculate perfusion statistics. An automated threshold to determine pathologic tissue is calculated and used to determine accurate regional scores. We evaluated the method on 10 MRI images and achieved an average surface distance of less than 1.5 mm compared to manual reference segmentations. Pathologic tissue was detected correctly in 9 cases. The approach seems suitable for detecting early signs of CF and monitoring response to therapy.

  4. Role of perfusion SPECT in prediction and measurement of pulmonary complications after radiotherapy for lung cancer

    DEFF Research Database (Denmark)

    Farr, Katherina P; Kramer, Stine; Khalil, Azza A; Morsing, Anni; Grau, Cai

    2015-01-01

    radiotherapy (RT) for non-small-cell lung cancer (NSCLC). METHODS: Patients with NSCLC undergoing curative RT were included prospectively. Perfusion SPECT/CT and global pulmonary function tests (PFT) were performed before RT and four times during follow-up. Functional activity on SPECT was measured using a...... semiquantitative perfusion DS. Pulmonary morbidity was graded by the National Cancer Institute's Common Terminology Criteria for Adverse Events version 4 for pneumonitis. Patients were divided into two groups according to the severity of RP. RESULTS: A total of 71 consecutive patients were included in the study....... Baseline DS was associated with chronic obstructive pulmonary disease. A significant inverse correlation was found between baseline DS and forced expiratory volume in 1 s and diffusing capacity of the lung for carbon monoxide. Patients with severe RP had significantly higher baseline total lung DS (mean 5...

  5. Korean Medicine Therapy as a Substitute for Chemotherapy for Metastatic Breast Cancer: A Case Report

    OpenAIRE

    Lee, Dong-Hyun; Kim, Sung-Su; Seong, Shin; Kim, Nari; Han, Jae-Bok

    2015-01-01

    A 46-year-old Korean woman was diagnosed with stage III breast cancer and underwent 8 cycles of neoadjuvant chemotherapy, breast conservation surgery and adjuvant radiotherapy. However, the cancer recurred in the right upper lung (RUL) and the right pulmonary hilum after 8 months. The RUL nodule was removed through a wedge resection, and the pathologic finding was revealed as a metastatic adenocarcinoma. Adjuvant chemotherapy was recommended, but she refused it because she feared adverse reac...

  6. Blood Flow and Glucose Metabolism in Stage IV Breast Cancer: Heterogeneity of Response During Chemotherapy

    OpenAIRE

    Krak, Nanda; Hoeven, John; Hoekstra, Otto; Twisk, Jos; Wall, Ernst; Lammertsma, A. A.

    2008-01-01

    textabstractObjective: The purpose of the study was to compare early changes in blood flow (BF) and glucose metabolism (MRglu) in metastatic breast cancer lesions of patients treated with chemotherapy. Methods: Eleven women with stage IV cancer and lesions in breast, lymph nodes, liver, and bone were scanned before treatment and after the first course of chemotherapy. BF, distribution volume of water (Vd), MRglu/BF ratio, MRgluand its corresponding rate constants K1and k3were compared per tum...

  7. Selection criteria for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Ingmar Konigsrainer

    2011-01-01

    Peritoneal carcinomatosis in gastric cancer is associated with a dismal prognosis. Systemic chemotherapy is not effective because of the existence of a blood-peritoneal barrier. Cytoreductive surgery and intraperitoneal chemotherapy can improve survival and quality of life in selected patients. Patient selection for this multimodal approach is one of the most critical issues, and calls for interdisciplinary evaluation by radiologists, medical and surgical oncologists, and anaesthetists. This article sets forth criteria for selection of gastric cancer patients suffering from peritoneal carcinomatosis.

  8. Acceptance of oral chemotherapy in breast cancer patients - a survey study

    OpenAIRE

    Sohn Christof; Domschke Christoph; Bruckner Thomas; Reinhardt Judith; Schneeweiss Andreas; Schott Sarah; Eichbaum Michael H

    2011-01-01

    Abstract Background Oral (p.o.) chemotherapy treatments gained increasing importance in the palliative treatment of metastatic breast cancer (MBC). Aim of this survey was to evaluate the acceptance of p.o. treatment and patients' individual attitudes towards it. Methods A specific 14 item-questionnaire was designed. Patients suffering from breast cancer receiving a newly launched p.o. or i.v. chemotherapy treatment were prospectively evaluated during 4 months of time. 224 questionnaires using...

  9. Chemotherapy-induced Fatigue among Jordanian Cancer Patients: What are the Contributing Factors?

    OpenAIRE

    Kholoud Abu Obead; Sameer Yaser; Maysaa Khattab; Faisal Al-badainah; Laila Saqer; Nehaya Al-dosouqi

    2014-01-01

    Background: The purposes of this study were to examine the impact of chemotherapy treatment on Jordanian cancer patients’ fatigue and to correlate their fatigue with selected sociodemographic variables at the beginning of treatment and after four weeks of treatment. Methods: This was a single group quasi-experimental correlational design study that enrolled 43 patients diagnosed with cancer who required chemotherapy treatment. Fatigue was measured according to the Piper Fati...

  10. Use of early chemotherapy for hormone-sensitive prostate cancer: time for CHAARTED

    OpenAIRE

    Aragon-Ching, Jeanny B.

    2015-01-01

    CHAARTED was an ECOG-led phase III trial looking at early chemotherapy with the use of docetaxel in addition to androgen deprivation therapy (ADT) versus ADT alone in hormone-sensitive prostate cancer. The positive results of the trial showing marked improvement in overall survival in those who received chemotherapy with ADT have revolutionized the treatment of metastatic castration-sensitive prostate cancer. In addition to overall survival, secondary endpoints such as time to castration resi...

  11. ORAL AND SYSTEMIC SIDE EFFECTS OF CANCER CHEMOTHERAPY AND EFFECT OF BENZYDAMINE MOUTHWASH IN ORAL MUCOSITIS

    OpenAIRE

    Anagha Shete et al

    2012-01-01

    Aim: To check the effectiveness of 0.15% Benzydamine hydrochloride on oral mucositis secondary to cancer chemotherapyMethods: In the past few years, multiple cases were referred to our department for the management of oral manifestations of cancer chemotherapy for various malignancies. Out of these patients, we selected 5 patients and used a simple, inexpensive treatment modality in consideration with patient’s affordability and convenience. They were prescribed 0.15% Benzydamine hydrochlorid...

  12. Gastrojejunostomy followed by induction chemotherapy for incurable gastric cancer with outlet obstruction

    Institute of Scientific and Technical Information of China (English)

    Yasuhiro; Okumura; Manabu; Ohashi; Souya; Nunobe; Tomohiro; Iwanaga; Tatsuo; Kanda; Yoshiaki; Iwasaki

    2010-01-01

    A 72-year-old male gastric cancer patient with outlet obstruction underwent laparoscopic exploration. The examination disclosed intraperitoneal free cancer cells with no overt peritoneal, lymphatic, or hepatic metastasis. The patient underwent laparoscopy-assisted gastroje-junostomy (LAGJ) and started chemotherapy with S-1 plus cisplatin on postoperative day 13. Three course of the chemotherapy shrank the tumor markedly. Then, the patient underwent gastrectomy with a curative intent. Laparotomy revealed no ...

  13. Serum vitamin B12 and folate status among patients with chemotherapy treatment for advanced colorectal cancer

    OpenAIRE

    Byström, Per; Björkegren, Karin; Larsson, Anders; Johansson, Linda; Berglund, Åke

    2009-01-01

    Background There are conflicting results on the role of cobalamin and folate for epidemiology and carcinogenesis in colorectal cancer patients and the need of supplementation for prevention of chemotherapy toxicity. Patients and methods Serum cobalamin, folate, and homocysteine were analysed before and during the treatment of 93 patients with advanced colorectal cancer (ACRC) with first-line chemotherapy treatment. This cohort was compared with a healthy control group of 224 individuals. Resu...

  14. Altered resting state functional brain network topology in chemotherapy-treated breast cancer survivors

    OpenAIRE

    Bruno, Jennifer; Hosseini, SM Hadi; Kesler, Shelli

    2012-01-01

    Many women with breast cancer, especially those treated with chemotherapy, experience cognitive decline due in part to neurotoxic brain injury. Recent neuroimaging studies suggest widespread brain structural abnormalities pointing to disruption of large-scale brain networks. We applied resting state functional magnetic resonance imaging and graph theoretical analysis to examine the connectome in breast cancer survivors treated with chemotherapy relative to healthy comparison women. Compared t...

  15. Role of Scintimammography in Assessing the Response of Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer

    OpenAIRE

    Trehan, Romeeta; Seam, Rajeev K; Manoj K. Gupta; Sood, Ashwani; Dimri, Kislay; Mahajan, Rohit

    2014-01-01

    Locally advanced breast cancer (LABC) is a common cancer in the developing countries. Neoadjuvant chemotherapy (NACT) is a very important step in the treatment of such tumors and hence that the disease can be down staged and made amenable for surgery. All the tumors do not respond to the therapy equally. Hence, it becomes very important to predict the response of chemotherapy in such cases. This study evaluated the role of scintimammography in assessing the response to NACT in 23 patients wit...

  16. Thallium-201 perfusion scintigraphy in the evaluation of late myocardial damage in left-side breast cancer treated with adjuvant radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate late myocardial damage after adjuvant radiotherapy using a mixed-beam (photons plus electrons) technique to treat the internal mammary lymph nodes in left-side breast cancer. Methods and Materials: A bicycle ergometer stress test coupled with thallium-201 perfusion scintigraphy and analysis by single-photon computed tomography (CT) was performed on 19 patients treated with left-side breast/chest wall and internal mammary radiation for breast cancer between 1987 and 1993. To be sure that we would evaluate late toxicity caused by the irradiation, patients had to fulfill the following eligibility criteria: left-side breast cancer, treatment between 1987 and 1993 and no recurrence during follow-up, age ≤75 years, no known risk for coronary artery disease, no previous chemotherapy, internal mammary field treated with an association of photons and electrons, and CT scan-based treatment planning. Results: Median age at scintigraphy was 59 years. Two patients did not reach optimal exercise level and were not evaluable. Among the 17 evaluable patients representing 91.6 patient years of follow-up, there were no perfusion defects by visual or quantitative analysis. Conclusion: The mixed-beam technique seemed to spare the heart from harmful irradiation and to protect the myocardium. Results need to be confirmed on the long-term use of this technique

  17. An Epigenomic Approach to Improving Response to Neoadjuvant Cisplatin Chemotherapy in Bladder Cancer.

    Science.gov (United States)

    Xylinas, Evanguelos; Hassler, Melanie R; Zhuang, Dazhong; Krzywinski, Martin; Erdem, Zeynep; Robinson, Brian D; Elemento, Olivier; Clozel, Thomas; Shariat, Shahrokh F

    2016-01-01

    Bladder cancer is among the five most common cancers diagnosed in the Western world and causes significant mortality and morbidity rates in affected patients. Therapeutic options to treat the disease in advanced muscle-invasive bladder cancer (MIBC) include cystectomy and chemotherapy. Neoadjuvant cisplatin-based combination chemotherapy is effective in MIBC; however, it has not been widely adopted by the community. One reason is that many patients do not respond to neoadjuvant chemotherapy, and no biomarker currently exists to identify these patients. It is also not clear whether a strategy to sensitize chemoresistant patients may exist. We sought to identify cisplatin-resistance patterns in preclinical models of bladder cancer, and test whether treatment with the epigenetic modifier decitabine is able to sensitize cisplatin-resistant bladder cancer cell lines. Using a screening approach in cisplatin-resistant bladder cancer cell lines, we identified dysregulated genes by RNA sequencing (RNAseq) and DNA methylation assays. DNA methylation analysis of tumors from 18 patients receiving cisplatin-based chemotherapy was used to confirm in vitro results. Cisplatin-resistant bladder cancer cells were treated with decitabine to investigate epigenetic sensitization of resistant cell lines. Our results show that HOXA9 promoter methylation status is associated with response to cisplatin-based chemotherapy in bladder cancer cell lines and in metastatic bladder cancer. Bladder cancer cells resistant to cisplatin chemotherapy can be sensitized to cisplatin by the DNA methylation inhibitor decitabine. Our data suggest that HOXA9 promoter methylation could serve as potential predictive biomarker and decitabine might sensitize resistant tumors in patients receiving cisplatin-based chemotherapy. PMID:27598218

  18. INDUCTION, ACCUMULATION, AND PERSISTENCE OF SISTER CHROMATID EXCHANGES IN WOMEN WITH BREAST CANCER RECEIVING CYCLOPHOSPHAMIDE, ANDRIAMYCIN, AND 5-FLUOROACIL CHEMOTHERAPY

    Science.gov (United States)

    The induction, stimulation, and persistence of sister chromatid exchanges (SCE's) and high SCE frequency cells (HFC's) was measured in peripheral lymphocytes of women with breast cancer before chemotherapy and on multiple occasions during and after therapy. Chemotherapy consisted...

  19. The evolving role of cytotoxic chemotherapy in the management of patients with metastatic prostate cancer.

    Science.gov (United States)

    Diamond, Elan; Garcias, María del Carmen; Karir, Beerinder; Tagawa, Scott T

    2015-02-01

    Prostate cancer (PC) is the most common cancer in men in the United States. Although outcomes are excellent for early-stage disease, survival for men with metastatic PC is limited. While older studies did not supported the use of chemotherapy in PC, the efficacy of taxane chemotherapy plus prednisone is now well established in men with metastatic castration resistant PC (CRPC). The results of CHAARTED trial have further expanded the use of chemotherapy to patients with metastatic hormone-sensitive disease. The clinical efficacy of taxanes over other chemotherapeutics may be a result of its ability to inhibit microtubule-dependent trafficking of proteins such as the androgen-receptor (AR). Ongoing research uses chemotherapy earlier in the disease course as well as explores the utility of combining cytotoxic chemotherapy with biologic agents. PMID:25762124

  20. Cell kinetic modelling and the chemotherapy of cancer

    CERN Document Server

    Knolle, Helmut

    1988-01-01

    During the last 30 years, many chemical compounds that are active against tumors have been discovered or developed. At the same time, new methods of testing drugs for cancer therapy have evolved. nefore 1964, drug testing on animal tumors was directed to observation of the incfease in life span of the host after a single dose. A new approach, in which the effects of multiple doses on the proliferation kinetics of the tumor in vivo as well as of cell lines in vitro are investigated, has been outlined by Skipper and his co-workers in a series of papers beginning in 1964 (Skipper, Schabel and Wilcox, 1964 and 1965). They also investigated the influence of the time schedule in the treatment of experimental tumors. Since the publication of those studies, cell population kinetics cannot be left out of any discussion of the rational basis of chemotherapy. When clinical oncologists began to apply cell kinetic concepts in practice about 15 years ago, the theoretical basis was still very poor, in spite of Skipper's pro...

  1. Neoadjuvant Chemotherapy in Triple Negative Breast Cancer: An Observational Study.

    Science.gov (United States)

    Shao, Zhiying; Chaudhri, Shalini; Guo, Meng; Zhang, Longzhen; Rea, Daniel

    2016-01-01

    Triple negative breast cancer (TNBC) is a phenotype of breast cancer with aggressive clinical behavior. Because of the absence of optimal treatment, the prognosis of this disease is poor. The main purpose of this study was to detect the response to neoadjuvant chemotherapy (NACT) in a TNBC cohort and compare the long-term survival between patients with and without pathological complete response (pCR). A total of 53 patients diagnosed with TNBC from 2005 to 2013 who received NACT at the University Hospital Birmingham were enrolled in this study. Overall survival (OS) and progression-free survival (PFS) were compared between the pCR group and non-pCR group. Demographic information and clinical or pathologic parameters were also analyzed to explore potential predictive and prognostic factors. Fourteen patients (26.4%) achieved pCR to NACT. In univariate analysis, patients with pCR had longer PFS time (p = 0.013) and OS time (p = 0.054) compared with their counterparts without pCR. In multivariate analysis, the existence of lymphovascular invasion (LVI) significantly reduced OS (HR = 17.404, 95% CI = 2.923-103.644) and PFS (HR = 7.776, 95% CI = 1.645-36.753). The achievement of pCR to NACT can significantly postpone the incidence of disease progression in patients with TNBC. There is not enough evidence showing its influence on ultimate survival. LVI may be a more potent prognostic factor than pCR in the TNBC cohort. PMID:27131315

  2. Usefulness of concurrent chemotherapy and radiotherapy of head and neck cancer

    International Nuclear Information System (INIS)

    The usefulness of concurrent chemotherapy and radiotherapy in head and neck cancer was reviewed based on the results of randomized comparative trials. First, the schedules of chemotherapy and radiotherapy were assessed. Chemotherapy was classified into 4 categories according to the schedules: neo-adjuvant chemotherapy, concurrent chemotherapy, alternating chemotherapy, and adjuvant chemotherapy. Each schedules has its own purpose, e.g., tumor reduction, prevention of remote metastasis, and radiosensitizing effect. The most important purpose is the improvement of long-term outcome. Meta-analysis by Munro showed that the survival rate after neo-adjuvant chemotherapy was a mere 3.7%, as opposed to 12.1% for concurrent chemotherapy. Second, the results of 10 randomized comparative trials in the literature were reviewed. The radiation doses were 40-70 Gy. BLM, MTX, 5-FU, and MMC were administered in 7 trials, and 2 drugs, 5-FU and CDDP, and 5-FU and MMC, were combined in 3 trials. A statistically significant improvement in long-term outcome was only found in one study. In 7 studies it was reported that improvement of results is prospective, but further examination is necessary. Augmentation of the acute radiation effects by concurrent chemotherapy has been reported in many studies. A more adequate randomized comparative study should be carried out based on these findings. (K.H.)

  3. Lung cancer chemotherapy agents increase procoagulant activity via protein disulfide isomerase-dependent tissue factor decryption.

    Science.gov (United States)

    Lysov, Zakhar; Swystun, Laura L; Kuruvilla, Sara; Arnold, Andrew; Liaw, Patricia C

    2015-01-01

    Lung cancer patients undergoing chemotherapy have an elevated risk for thrombosis. However, the mechanisms by which chemotherapy agents increase the risk for thrombosis remains unclear. The aim of this study was to determine the mechanism(s) by which lung cancer chemotherapy agents cisplatin, carboplatin, gemcitabine, and paclitaxel elicit increased tissue factor activity on endothelial cells, A549 cells, and monocytes. Tissue factor activity, tissue factor antigen, and phosphatidylserine exposure were measured on chemotherapy-treated human umbilical vein endothelial cells (HUVEC), A549 cells, and monocytes. Cell surface protein disulfide isomerase (PDI) and cell surface free thiol levels were measured on HUVEC and A549 non-small cell lung carcinoma cells. Treatment of HUVECs, A549 cells, and monocytes with lung cancer chemotherapy significantly increased cell surface tissue factor activity. However, elevated tissue factor antigen levels were observed only on cisplatin-treated and gemcitabine-treated monocytes. Cell surface levels of phosphatidylserine were increased on HUVEC and monocytes treated with cisplatin/gemcitabine combination therapy. Chemotherapy also resulted in increased cell surface levels of PDI and reduced cell surface free thiol levels. Glutathione treatment and PDI inhibition, but not phosphatidylserine inhibition, attenuated tissue factor activity. Furthermore, increased tissue factor activity was reversed by reducing cysteines with dithiothreitol. These studies are the first to demonstrate that lung cancer chemotherapy agents increase procoagulant activity on endothelial cells and A549 cells by tissue factor decryption through a disulfide bond formation in a PDI-dependent mechanism. PMID:24911456

  4. Incidence of chemotherapy-induced amenorrhea in non-menopausal women with breast cancer

    Directory of Open Access Journals (Sweden)

    Shahrbanoo Keihanian

    2009-01-01

    Full Text Available , , 2, , (Received 14 January, 2009; Accepted 17 June, 2009AbstractBackground and purpose: Although adjunct chemotherapy may increase life in non-menopausal breast cancer patients, however, it may cause short-term complications such as nausea, vomiting, alopecia, as well as long-term complications in ovarian failure and premature menopausal. The objective of this study was to investigate chemotherapy-induced secondary amenorrhea in non-menopausal women with breast cancer.Materials and methods: A descriptive design (case series was preformed on fifty breast cancer patients, non-menopausal (normal mense and chemotherapy in Ramsar Emam Sajad Hospital Oncology unit from 2007 to 2008. Sampling was consecutive. Data gathering method was questionnaire & blood sampling (FSH & Progesterone for prior and 12 months after the end of chemotherapy. Data was analyzed by paired-t, independent-t and one-way ANOVA tests.Results: Results showed that 62% of patients were amenorrhea 12 months after the end of chemotherapy. Results showed that there was no meaningful relationship between age, hormone therapy, disease stage, node-positive and ER & PR status to amenorrhea; however, there was a meaningful relationship between duration of treatment, type and dose of chemotherapy to amenorrhea.Conclusion: In pre-menopausal patients with breast cancer, receiving cytotoxic chemotherapy against tumor cells, amenorrhea may occur do to ovarian failure.J Mazand Univ Med Sci 2009; 19(70: 9-17 (Persian

  5. Chemotherapy related toxicity in locally advanced non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Bahl Amit

    2006-01-01

    Full Text Available Background: For inoperable non-small cell lung cancer combined chemotherapy and radiotherapy plays an important role as a therapeutic modality. The aim of the present study was to analyze neoadjuvant chemotherapy related acute toxicity in locally advanced lung cancer (stage IIIA and IIIB in Indian patients using Cisplatin and Etoposide combination chemotherapy. Material and methods: Forty patients of locally advanced Non small cell lung cancer received three cycles neoadjuvant chemotherapy using Injection Cisplatin and Etoposide. The patients were taken for Radical radiotherapy to a dose of 60 Gray over 30 fractions in conventional fractionation after completing chemotherapy. Chemotherapy associated toxicity was assessed using common toxicity criteria (CTC v2.0 Results: Forty patients were available for final evaluation. Median age of presentation of patients was fifty-six years. Thirteen patients had Non small cell lung cancer stage IIIA while twenty-seven patients had Stage IIIB disease. Anemia was the most common hematological toxicity observed (seen in 81% of patients. Nausea and vomiting were the most common non -hematological toxicity seen. Sensory neuropathy was seen in 38%of patients. 88% patients developed alopecia. Seven patients developed febrile neutropenias. Conclusion: Neo-adjuvant chemotherapy using Cisplatin and Etoposide continues to be a basic regimen in the Indian set up despite availability of higher molecules, since it is cost effective, well tolerated and therapeutically effective. Blood transfusions, growth factors and supportive care can be used effectively to over come toxicity associated with this regimen.

  6. Treatment of platinum-resistant recurrent ovarian cancer using a "predictive molecule targeted routine chemotherapy" system

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiao-dong; WEI Feng-hua; ZHANG Yi; HE Shu-rong; YANG Li

    2009-01-01

    Background Correct drug selection, the key to successful chemotherapy, is one of the most difficult clinical decisions for the treatment of platinum-resistant recurrent ovarian cancer worldwide. The exact procedures for choosing drugs are undefined, currently relying on clinical trials and personal experience, which often results in disappointing outcomes. Here, we propose a new drug selection method, the "predictive molecule targeted routine chemotherapy", to choose relatively sensitive routine drugs and avoid relatively resistant routine drugs based on the specific predictive molecule expression of the individual tumor tissue.Methods From January 2004 to June 2008,26 cases of platinum-resistant recurrent ovarian cancer were prospectively recruited. Their routine chemotherapy drug choice was based on the expression of 6 predictive molecules (including p53) as determined by immunohistochemistry (the predictive molecule targeted routine chemotherapy group). A further 18 cases of platinum-resistant recurrent ovarian cancer were treated by experience and formed the control group. The response rate and the overall survival were compared between the two groups.Results The response rate to second-line chemotherapy was 28% in the control group and 77% in the predictive molecule targeted routine chemotherapy group (P=0.002). The response rate to third-line chemotherapy was 14% in the control group and 33% in the predictive molecule targeted routine chemotherapy group (P=0.268). The median overall survival of the predictive molecule targeted routine chemotherapy group (88 weeks) was significantly longer than the median overall survival of the control group (56 weeks) (P=0.0315).Conclusion The predictive molecule targeted routine chemotherapy is a new effective protocol for choosing drugs when treating platinum-resistant recurrent ovarian cancer.

  7. Arterial devices for regional hepatic chemotherapy: transaxillary versus laparotomic access.

    Science.gov (United States)

    Arru, M; Aldrighetti, L; Gremmo, F; Ronzoni, M; Angeli, E; Caterini, R; Ferla, G

    2000-01-01

    Introduction. Intra-Arterial Hepatic Chemotherapy (IAHC) based on floxuridine (FUdR) infusion is an effective treatment for hepatic metastases from colorectal cancer. A percutaneously implanted intra-arterial device may overcome the surgical stress of the laparotomic placement allowing an increase in the number of patients treated by IAHC. The aim of the present study is the comparative analysis of surgical and percutaneous transaxillary approaches to implant the catheter into the hepatic artery (HA) for IAHC. Materials and Methods. Between September 1993 and February 1999, 56 patients received an implantable infu-sion system [SynchroMed(R) (Medtronic, USA) or Port-a-cath(R) (Deltec, USA) connected to an external infusion pump (CADD(R) , Deltec, USA)] for IAHC. Twenty-eight patients (LPT group) underwent laparotomy to implant the catheter into the HA, the other 28 patients (PCT group) received a percutaneous catheter into the HA through a transaxillary percutaneous access. Indications for the laparotomic placement were: 1) synchronous metastases not suitable [technically unresectable or large (>40% of liver parenchyma) or multiple (> 3) metas-tases] for hepatic resection during colorectal surgery; 2) metachronous metastases treated by radical hepatic resection and subsequent adjuvant IAHC. Indications for percutaneous placement were: 1) metachronous metastases not suitable [see above] for hepatic resection; 2) metachronous metastases suitable for hepatic resection after neoadjuvant IAHC for tumor downstaging. All patients received IAHC based on continuous infusion of FU-dR (dose escalation 0.15-0.30 mg/kg/day for 14 days every 28 days) plus dexamethasone 28 mg. For the purpose of the study, the LPT group and the PCT group were comparatively analyzed in terms of age, gender, primary diagnosis, vascular anatomy of HA, ligation/embolization of aberrant HA, previous intestinal or hepatic surgery, contextual systemic chemotherapy, concomitant diseases. Safety and

  8. Can perfusion MRI predict response to preoperative treatment in rectal cancer?

    International Nuclear Information System (INIS)

    Background and purpose: Dynamic contrast-enhanced MRI (DCE-MRI) provides information on perfusion and could identify good prognostic tumors. Aim of this study was to evaluate whether DCE-MRI using a novel blood pool contrast-agent can accurately predict the response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Materials and methods: Thirty patients underwent DCE-MRI before and 7–10 weeks after chemoradiotherapy. Regions of interest were drawn on DCE-MRI with T2W-images as reference. DCE-MRI-based kinetic parameters (initial slope, initial peak, late slope, and AUC at 60, 90, and 120 s) determined pre- and post-CRT and their Δ were compared between good (TRG1–2) and poor (TRG3–5) responders. Optimal thresholds were determined and sensitivities, specificities, positive predictive values (PPV), and negative predictive values (NPV) were calculated. Results: Pre-therapy, the late slope was able to discriminate between good and poor responders (−0.05 × 10−3 vs. 0.62 × 10−3, p < 0.001) with an AUC of 0.90, sensitivity 92%, specificity 82%, PPV 80%, and NPV 93%. Other pre-CRT parameters showed no significant differences, nor any post-CRT parameters or their Δ. Conclusions: The kinetic parameter ‘late slope’ derived from DCE-MRI could potentially be helpful to predict before the onset of neoadjuvant chemoradiotherapy which tumors are likely going to respond. This could allow for personalized treatment-options in rectal cancer patients

  9. Clinical study of regional ventilation and perfusion of pulmonary disease by ventilatory steady state measurement with Xe-133

    International Nuclear Information System (INIS)

    Ventilatory steady state measurement with Xe-133 were performed to evaluate regional ventilation (V radical) and perfusion (Q radical) in 60 cases of primary lung cancer and 39 cases of pulmonary diseases-chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, sarcoidosis, mitral stenosis with pulmonary hypertension (PH), pulmonary alveolar proteinosis, bronchial adenoma and pulmonary embolism. Of 60 cases of lung cancer, 11 cases showed V radicalQ radical mismatch (18%). Even in the V radicalQ radical matched defect cases, a different grade of disorder was seen in V radical and Q radical and the grade of Q radical was severer than the grade of V radical. Of 38 cases irradiated by Linac X-ray, 3 cases whose V radical, Q radical were disordered a little before irradiation recovered completely to normal range after irradiadiation. Of 38 cases who performed the radiation therapy, radiation injury of lung was recognized in 22 cases. In the cases of recovered V radical, Q radical after irradiation, radiation injury of lung occurred, and then V radical, Q radical disordered and returned to pre-irradiation value. In the cases that recovered little in V radical, Q radical, radiation injury of lung occurred, and then V radical, Q radical could not return to pre-irradiation value. In 39 cases of pulmonary diseases, 7 cases of sarcoidosis showed normal V radical and Q radical value. 13 cases of COPD was available to evaluate the regional pulmonary function in MTT (Mean Transit Time). V radical, Q radical were slightly disordered and MTT proloned slightly in 10 cases of diffuse pulmonary fibrosis where a marked fibrosis lesion was remarkable. Six cases of PH showed significant correlation between the left ventricular mean pressure and the perfusion ratio of upper and lower lung field. (J.P.N.)

  10. Clinical study of regional ventilation and perfusion of pulmonary disease by ventilatory steady state measurement with Xe-133

    Energy Technology Data Exchange (ETDEWEB)

    Nishi, Fumiaki

    1984-12-01

    Ventilatory steady state measurement with Xe-133 were performed to evaluate regional ventilation (V radical) and perfusion (Q radical) in 60 cases of primary lung cancer and 39 cases of pulmonary diseases-chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, sarcoidosis, mitral stenosis with pulmonary hypertension (PH), pulmonary alveolar proteinosis, bronchial adenoma and pulmonary embolism. Of 60 cases of lung cancer, 11 cases showed V radicalQ radical mismatch (18%). Even in the V radicalQ radical matched defect cases, a different grade of disorder was seen in V radical and Q radical and the grade of Q radical was severer than the grade of V radical. Of 38 cases irradiated by Linac X-ray, 3 cases whose V radical, Q radical were disordered a little before irradiation recovered completely to normal range after irradiadiation. Of 38 cases subjected to radiation therapy, radiation injury of lung was recognized in 22 cases. In the cases of recovered V radical, Q radical after irradiation, radiation injury of lung occurred, and then V radical, Q radical disordered and returned to pre-irradiation value. In the cases that recovered little in V radical, Q radical, radiation injury of lung occurred, and then V radical, Q radical could not return to pre-irradiation value. In 39 cases of pulmonary diseases, 7 cases of sarcoidosis showed normal V radical and Q radical value. 13 cases of COPD was available to evaluate the regional pulmonary function in MTT (Mean Transit Time). V radical, Q radical were slightly disordered and MTT proloned slightly in 10 cases of diffuse pulmonary fibrosis where a marked fibrosis lesion was remarkable. Six cases of PH showed significant correlation between the left ventricular mean pressure and the perfusion ratio of upper and lower lung field. (J.P.N.).

  11. Regional perfusion of the lungs in patients with chronic nonspecific pulmonary diseases based on scintigraphy data

    International Nuclear Information System (INIS)

    Perfusion scintigraphy of lungs with 99mTc-albumin microspheres was used for a study of changes of regional perfusion of lesser circulation in patients with chronic bronchitis of a varying degree of disturbed pulmonary hemodynamics. Even before a stable rise of pulmonary vascular resistance and developmemt of pulmonary arterial hypertension, chronic bronchitis was characterized by redistribution of blood flow from the lower parts of lungs to the upper ones, which progressed with disturbance of pulmonary arterial circulation and the development of chronic cor pulmonale. The use of scintigraphic indices of the upper and lower parts (U/L) prefusion ratio led to adequate assessment of a degree of redistribution of the pulmonary blood flow in patients with chronic bronchitis

  12. Retrospective analysis of outcomes and prognostic factors of chemotherapy for small-cell lung cancer

    Directory of Open Access Journals (Sweden)

    Minami S

    2016-04-01

    Full Text Available Seigo Minami, Yoshitaka Ogata, Shouichi Ihara, Suguru Yamamoto, Kiyoshi Komuta Department of Respiratory Medicine, Osaka Police Hospital, Osaka, Japan Background: Small-cell lung cancer (SCLC is responsive to initial chemotherapy but becomes resistant to cytotoxic drugs. The aim of this study was to evaluate what proportion of patients with SCLC had received the first- and further-line chemotherapy and which patients had benefited from chemotherapy. Methods: We retrospectively reviewed medical records of patients with SCLC who had been treated with the best supportive care alone and the first-, second-, or third-line chemotherapy at the Osaka Police Hospital from June 2007 until March 2015. Results: Among 145 patients diagnosed with SCLC and eligible for analysis, 118 patients received chemotherapy. We added five patients who initiated the second-line chemotherapy during the study period at our institution. Sixty-five and 31 patients received the second- and third-line chemotherapies, respectively. Multivariate logistic regression analysis detected age ≥75 years (odds ratio, 2.80; 95% confidence interval, 1.01–7.75; P=0.047 and European Clinical Oncology Group Performance Status (ECOG PS 3–4 (14.3; 4.86–41.9; P<0.01 as factors disturbing the introduction of chemotherapy. Multivariate Cox hazard analyses also detected ECOG PS 2–4 (3.34; 2.00–5.58; P<0.01 as a factor decreasing overall survival after the first-line chemotherapy, and C-reactive protein level ≥1.0 mg/dL (2.67; 1.30–5.47; P<0.01 and progression-free survival after the first-line chemotherapy ≥6 months (2.85; 1.50–5.43; P<0.01 as factors influencing overall survival after the second-line chemotherapy. Conclusion: Approximately two-thirds and one-third of the patients who receive chemotherapy proceed to the second- and third-line chemotherapies, respectively. Several factors, such as age, ECOG PS, C-reactive protein level, and progression-free survival after

  13. The utility of SPECT lung perfusion cans in assessing the changes in pulmonary function after radiotherapy for patients with lung cancer

    International Nuclear Information System (INIS)

    Objective: To assess the pulmonary function by lung perfusion scintigraphy in lung cancer patients treated with thoracic conform.al radiotherapy. Materials: Between June and December 2003, 21 lung cancer patients treated with thoracic radiotherapy (RT) performed Single photon emission computed tomography (SPECT) lung perfusion scans before RT and after 40 Gy-50 Gy radiation. Seventeen of these patients receiving thoracic 3-dimension conformal radiotherapy were included in this study. Severn patients had small cell lung carcinoma, 8 squamous cell carcinoma, and 2 no classification. There are 15 male and 2 female. The median age was 56 years, with a range of 46-78 years. SPECT lung perfusion scans were obtained following the intravenous administration of 185 MBq (5 mCi) of technetium-99m-labeled macroaggregated albumin (MAA). Images of static (ANT, POST, RAO, RPO, LAO, LPO, RLAT, LLAT) and tomography (transverse, sagittal, coronal) were acquired after injection using a dual-head SPECT (GE MillenniumTM VGV, Hawkeye) with low energy high resolution collimator, All patients were in supine with their arms above their head. Every attempt was made to have all of the scans and the radiation treatment delivered with the patient in a similar position. At the same time X-ray or CT scan were performed. The pre-RT CT or X-ray of the thorax and SPECT images were visually reviewed to assess the presence of hypoperfusion. Each of post-RT SPECT scan was also visually compared with the pre-RT SPECT image to detect whether or not reperfusion of previously under perfused areas. Furthermore, each pre-RT and post-RT SPECT image set was visually registered with the pre-RT planning CT images; the 3-D dose distribution was thus registered with the lung perfusion scan. The radiotherapy field (>20 Gy) was drawn as a region of interest (ROI) in the SPECT transversal images. The proportion of radioactive count within this ROI relative to total lung count in one slice was determined. Student's t

  14. Changes of arterial blood flow patterns by patients' posture during hepatic arterial infusion chemotherapy assessed by 99mTc-MAA perfusion scintigraphy

    International Nuclear Information System (INIS)

    Hepatic arterial perfusion scintigraphy (HAPS) with 99mTc-macroaggregated albumin (MAA) was performed to reveal the effect of patients' posture for the arterial blood flow patterns in hepatic arterial infusion (HAI) chemotherapy. Twenty patients with liver metastases having the percutaneously implanted catheter into the hepatic artery underwent HAPS following administration of 99mTc-MAA at the supine and the upright position under one week interval. Ten ml of the saline with radionuclide was injected at a rate of one ml per minute. Acquired two images at the different position of each patient were compared and grouped into three classes: similar, slightly different and different. Of 20 patients, 6 (30%) were judged as similar, 8 (40%) as slightly different, and 6 (30%) as different. These results suggest that the drug distribution can change by patients' posture in case of the slow rate HAI performed with continuous infusion pump. (author)

  15. Nursing Experience of Bladder Cancer after Chemotherapy Infusion%膀胱癌术后化疗灌注的体会

    Institute of Scientific and Technical Information of China (English)

    杨玉琴

    2012-01-01

    Objective: To investigate the nursing experience of Bladder cancer after chemotherapy infusion. Methods: After detailed communication with patients and health guidance on the importance of intravesical infusion therapy to prevent tumor recurrence, applied direct catheter injection or clamp needle perfusion method, bladder cancer patients start line of intravesical chemotherapy drugs. In the two weeks postoperative, 64 cases of clinical data were conducted retrospective analysis. Results- All 64 patients completed the chemotherapy treatment, including 4 cases of patients with bladder irritation, 2 cases of fever, 1 case of urethral stricture. Conclusion: Intravesical chemotherapy requires good communication between nurses and patients, method of scientific perfusion and skilled operation techniques.%目的:探讨膀胱癌术后膀胱内化疗灌注的护理。方法:回顾64例膀胱癌术后病人,于术后第2周开始行膀胱内灌注化疗药物,与患者进行详细的沟通和健康指导,讲解膀胱内灌注治疗对于预防肿瘤复发的重要性,然后运用直接经尿管注入或钳夹针头灌注法进行药物灌注。结果:64例患者均完成化疗疗程,其中4例患者出现膀胱刺激征,2例发热、1例尿道狭窄。结论:膀胱内灌注化疗需要护士与患者之间有良好的沟通、科学的灌注方法和熟练的操作技术。

  16. Chemotherapy-induced hyaluronan production: a novel chemoresistance mechanism in ovarian cancer

    International Nuclear Information System (INIS)

    Hyaluronan (HA) an important component of the extracellular matrix, has been linked to tumor progression and drug resistance in several malignancies. However, limited data is available for ovarian cancer. This study investigated the role of hyaluronan (HA) and a potential link between the HA-CD44 pathway and membrane ATP binding cassette (ABC) transporter proteins in ovarian cancer chemoresistance. We investigated the ability of HA to block the cytotoxic effects of the chemotherapy drug carboplatin, and to regulate the expression of ABC transporters in ovarian cancer cells. We also examined HA serum levels in ovarian cancer patients prior to and following chemotherapy and assessed its prognostic relevance. HA increased the survival of carboplatin treated ovarian cancer cells expressing the HA receptor, CD44 (OVCAR-5 and OV-90). Carboplatin significantly increased expression of HAS2, HAS3 and ABCC2 and HA secretion in ovarian cancer cell conditioned media. Serum HA levels were significantly increased in patients following platinum based chemotherapy and at both 1st and 2nd recurrence when compared with HA levels prior to treatment. High serum HA levels (>50 μg/ml) prior to chemotherapy treatment were associated with significantly reduced progression-free (P = 0.014) and overall survival (P = 0.036). HA production in ovarian cancer cells was increased in cancer tissues collected following chemotherapy treatment and at recurrence. Furthermore HA treatment significantly increased the expression of ABC drug transporters (ABCB3, ABCC1, ABCC2, and ABCC3), but only in ovarian cancer cells expressing CD44. The effects of HA and carboplatin on ABC transporter expression in ovarian cancer cells could be abrogated by HA oligomer treatment. Importantly, HA oligomers increased the sensitivity of chemoresistant SKOV3 cells to carboplatin. Our findings indicate that carboplatin chemotherapy induces HA production which can contribute to chemoresistance by regulating ABC

  17. Neoadjuvant chemotherapy in patients with locally advanced breast cancer: A pilot-observational study

    Directory of Open Access Journals (Sweden)

    Hardik G Dodiya

    2015-01-01

    Full Text Available Background: Locally advanced breast cancer (LABC remains major clinical issue with regard to selection and duration of therapy since many years. Neoadjuvant chemotherapy (NACT is multimodality program, established to treat LABC. Many research tasks are ongoing to develop specific neoadjuvant chemotherapy regimen with specific duration to improve long-term control of LABC. Patients and Methods: Forty-seven patients diagnosed with LABC were Included and analyzed to compare the outcomes [pathological complete response (pCR, clinical response, overall response rate (ORR, disease control rate, overall survival and progression-free survival]. These patients treated with either combination of anthracycline and taxane-based chemotherapy or anthracycline-based chemotherapy. Results: There was no any statistical significance with respect to demographic data treated of patients between two arms (P > 0.05. Patients underwent TAC chemotherapy had pCR 20.8% whereas FAC/FEC chemotherapy patients had pCR 13% (P = 0.48. Higher ORR was noted in TAC chemotherapy arm (75% when compared with FAC/FEC chemotherapy arm (60.9% (P = 0.29. The study also shows better disease control rate in TAC chemotherapy arm (95.8% as compared to FAC/FEC chemotherapy arm (82.6%. There was no statistical significance in overall survival (P = 0.31 and progression-free survival (P = 0.51 between two arms. Conclusion: Despite of the superiority of combination of anthracycline and taxane-based chemotherapy over the anthracycline-based chemotherapy in the present study, further pivotal studies should be conducted to confirm the combination of anthracycline and taxane-based chemotherapy as a better neoadjuvant regimen for treatment of LABC tumors.

  18. Quality of adjuvant CMF chemotherapy for node-positive primary breast cancer : a population-based study

    NARCIS (Netherlands)

    Schaapveld, M; de Vries, EGE; van der Graaf, WTA; Otter, R; Willemse, PHB

    2004-01-01

    Purpose: Adjuvant 'classical' oral cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) has long been the mainstay of adjuvant chemotherapy for premenopausal breast cancer patients. The Comprehensive Cancer Center North Netherlands (CCCN) breast cancer working group performed a retrospective aud

  19. Chemotherapy increases caspase-cleaved cytokeratin 18 in the serum of breast cancer patients

    International Nuclear Information System (INIS)

    Apoptosis is thought to be induced by chemotherapy in cancer patients. Therefore, the measurement of its amplitude may be a useful tool to predict the effectiveness of cancer treatment sooner than conventional methods do. In the study presented, apoptosis was assessed with an ELISA-based assay in which caspase-cleaved cytokeratin 18 (M30-antigen), a novel specific biomarker of apoptosis, is measured. Thirty seven patients with malignant (nonmetastatic and metastatic) breast cancer, 35 patients with benign breast disease, and 34 healthy subjects were studied. Cancer patients received neoadjuvant chemotherapy consisting of either fluorouracil, epirubicin, and cyclophosphamide (FEC) or epirubicin plus docetaxel (ED). Apoptosis was detected before chemotherapy, 24 and 48 h after chemotherapy in the malignant group. It was found that the baseline apoptosis level in either malignant but nonmetastatic group or benign group was not statistically different from that in the control group (p>0.05). However, it was statistically significantly higher in the metastatic group than that in the control group (p<0.05). Following the drug application, M30-antigen levels significantly increased at 24 h (p<0.05). The baseline M30-antigen levels increased about 3-times in patients showing tumor regression. M30-antigen level is increased after chemotherapy and its measurement may help clinicians to predict the effectiveness of chemotherapy sooner in breast cancer cases although confirmative larger trials are needed

  20. Relationship between BRCA1 Expression and Efifcacy of Platinum-based Chemotherapy in Colorectal Cancer

    Institute of Scientific and Technical Information of China (English)

    Xu Guanghui; Li Yu; Liu Yi

    2014-01-01

    Objective:To explore the expression of breast cancer susceptibility gene 1 (BRCA1) in human colorectal cancer and its correlation with efifcacy of platinum-based chemotherapy. Methods:A total of 78 samples from patients with colorectal cancer and receiving platinum-based chemotherapy were selected, and meanwhile 14 cases of normal colonic mucosa samples were selected as a normal control, 12 cases of non-cancerous tissue in colorectal cancer samples were selected as a pericarcinorma control. The expression of BRCA1 in these tissues was detected using immunohistochemical S-P method, and all patients treated with drugs were followed-up for survival time. Results: The positive rate of BRCA1 expression in colorectal cancer tissue was 52.6%, signiifcantly lower than that in the control groups. BRCA1 expression was closely associated with histological differentiation degrees (χ2=14.16,P=0.001), but not with the age, gender, local inifltration, lymph node metastasis and TNM staging. Comparing with those with positive BRCA1 expression, the patients with negative BRCA1 expression after oxaliplatin-based chemotherapy had signiifcantly longer disease-free survival (DFS) (P=0.032). Conclusion:Application of oxaliplatin-based chemotherapy in the patients with negative BRCA1 expression can obtain the survival beneift, and the level of BRCA1 expression can be useful in the selection of chemotherapy regimens and evaluation of prognosis for patients with colorectal cancer after surgery.

  1. Pilot study of bone mineral density in breast cancer patients treated with adjuvant chemotherapy

    Science.gov (United States)

    Headley, J. A.; Theriault, R. L.; LeBlanc, A. D.; Vassilopoulou-Sellin, R.; Hortobagyi, G. N.

    1998-01-01

    The objective of this cross-sectional study was to determine lumbar spine bone mineral density (BMD) in breast cancer patients previously treated with adjuvant chemotherapy. Sixteen of 27 patients who received adjuvant chemotherapy became permanently amenorrheic as a result of chemotherapy. BMD was measured at the lumbar spine using dual energy X-ray absorptiometry (DEXA). Chemotherapy drugs and dosages along with a history of risk factors for reduced bone density including activity level, tobacco and/or alcohol use, metabolic bone disease, family history, and hormone exposure were identified. Results showed that women who became permanently amenorrheic as a result of chemotherapy had BMD 14% lower than women who maintained menses after chemotherapy. Chemotherapy-treated women who maintained ovarian function had normal BMD. This study suggests that women who have premature menopause as a result of chemotherapy for breast cancer are at increased risk of bone loss and may be at risk for early development of osteoporosis. Women who maintain menses do not appear to be at risk for accelerated trabecular bone loss.

  2. Effects of KRAS, BRAF, NRAS, and PIK3CA mutations on the efficacy of cetuximab plus chemotherapy in chemotherapy-refractory metastatic colorectal cancer: a retrospective consortium analysis

    DEFF Research Database (Denmark)

    De Roock, Wendy; Claes, Bart; Bernasconi, David;

    2010-01-01

    with KRAS wild-type tumours still do not respond. We studied the effect of other downstream mutations on the efficacy of cetuximab in, to our knowledge, the largest cohort to date of patients with chemotherapy-refractory metastatic colorectal cancer treated with cetuximab plus chemotherapy in the pre...

  3. [Recent Status of Postoperative Adjuvant Chemotherapy after Completely Resected Lung Cancer].

    Science.gov (United States)

    Naito, Masahito; Tsuboi, Masahiro

    2016-02-01

    Several landmark study elucidated that adjuvant cisplatin-based chemotherapy for stage II-IIIA non-small cell lung cancer (NSCLC)patients after appropriate surgical resection can significantly improve 5-year survival rate. Meta-analysis of modern cisplatin based adjuvant chemotherapy trial confirmed this benefit. Furthermore, in Japan, large randomized trial and metaanalysis assessing the efficacy of uracil-tegafur(UFT)for stage I patients with completely resected NSCLC reported that UFT can significantly improve 5-year survival rate. Meta-analysis of subgroup assessed that effectiveness of UFT for stage I NSCLC patients with a tumor lager than 2 cm. According to these evidence, cisplatin-based adjuvant chemotherapy for stage II-III A NSCLC and UFT for stage I NSCLC patients with a tumor lager than 2 cm are used standard postoperative adjuvant chemotherapy in Japan. In recent year, it is presumed that personalized care will be necessary to re-evaluate strategies for postoperative adjuvant chemotherapy of lung cancer. Considering histological subtype of lung cancer, several randomize trial for postoperative adjuvant chemotherapy with non-squamous NSCLC or high neuroendocrine tumor of lung are ongoing. In addition, recent studies of biological research indicate that some tumor marker such as ERCC1 may had a predictive value for selecting patients who will derive the benefit from adjuvant chemotherapy. PMID:27067681

  4. Does Chemotherapy Really Affect the Quality of Life of Women with Breast Cancer?

    OpenAIRE

    Hwang, Sook Yeon; Chang, Sun Ju; Park, Byeong-Woo

    2013-01-01

    Purpose The aims of this cross-sectional study were to explore and evaluate the impact of adjuvant chemotherapy on quality of life in breast cancer patients according to the survival time from surgery. Methods Completed questionnaires were collected from 534 women with breast cancer. Clinical and sociodemographic characteristics were reviewed and Functional Assessment of Cancer Therapy-Breast cancer instrument, global quality of life, Beck Depression Inventory, and unmet sexuality needs were ...

  5. Neoadjuvant chemotherapy for locally advanced cervical cancer reduces surgical risks and lymph-vascular space involvement

    OpenAIRE

    Wang, Yue; Wang, Guang; Wei, Li-Hui; Huang, Ling-Hui; Wang, Jian-Liu; Wang, Shi-Jun; Li, Xiao-Ping; Shen, Dan-Hua; Bao, Dong-Mei; Gao, Jian

    2011-01-01

    Neoadjuvant chemotherapy (NACT), which can reduce the size and therefore increase the resectability of tumors, has recently evolved as a treatment for locally advanced cervical cancer. NACT has been reported to decrease the risk of pathologic factors related to prognosis of cervical cancer. To further assess the effects of NACT on surgery and the pathologic characteristics of cervical cancer, we reviewed 110 cases of locally advanced cervical cancer treated with radical hysterectomy with or w...

  6. IMPACT OF SEQUENTIAL NEOADJUVANT CHEMOTHERAPY IN LOCALLY ADVANCED BREAST CANCER: A SERIES OF 10 CASES

    OpenAIRE

    Gopa; Megha; Atul,; Bindu

    2014-01-01

    Breast cancer currently is a major health problem among women worldwide accounting for around 13.7% cancer deaths, nearly 1/3rd of it being due to Locally advanced breast cancer (LABC). Despite progress achieved in diagnosis & therapy of Breast cancer, LABC remains a major clinical challenge and in efforts to increase pCR, CCR & DFS in LABC, Neoadjuvant or primary chemotherapy followed by locoregional therapy and adjuvant systemic CT is well accepted treatment strategy sin...

  7. Referral pattern for neoadjuvant chemotherapy in the head and neck cancers in a tertiary care center

    OpenAIRE

    V M Patil; V Noronha; Joshi, A; V M Krishna; S Dhumal; Chaudhary, V.; Juvekar, S; P S Pai; C Pankaj; Chaukar, D.; A K Dcruz; Prabhash, K

    2014-01-01

    Background: Use of any treatment modality in cancer depends not only on the effectiveness of the modality, but also on other factors such as local expertise, tolerance of the modality, cost and prevalence of the disease. Oropharyngeal and laryngeal cancer are the major subsites in which majority of neoadjuvant chemotherapy (NACT) literature in the head and neck cancers is available. However, oral cancers form a major subsite in India. Materials And Methods: This is an analysis of a prospectiv...

  8. High-risk endometrial cancer may be benefit from adjuvant radiotherapy plus chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Jin-Wei Miao; Xiao-Hong Deng

    2012-01-01

    Objective:To present patterns of practice and outcomes in the adjuvant treatment of intermediate-and high-risk endometrial cancer.Methods:Retrospective data on 224 women with intermediate-risk and high-risk endometrial cancer from 1999 to 2006 were reviewed.All patients underwent surgical staging.Patterns of adjuvant treatment,consisting of pelvic radiotherapy,chemotherapy,and radiotherapy plus chemotherapy,were assessed.The 3-and 5-year disease-specific survival (DSS) rates were calculated using the Kaplan-Meier method.Results:The difference in 5-year DSS rate was statistically significant between adjuvant group and non-adjuvant group (80.65% vs.63.80%,P=0.040).In 110 high-risk patients who underwent adjuvant treatment,both 5-year DSS rate and recurrent rate were significantly different in combined radiotherapy and chemotherapy group compared with radiotherapy alone and chemotherapy alone groups (DSS rate,P=0.049; recurrent rate,P=0.047).In 83 intermediate-risk women who underwent adjuvant treatment,there was no significant difference in 5-year DSS rate and recurrence rate among the combined radiotherapy and chemotherapy,radiotherapy alone and chemotherapy alone groups (DSS rate,P=0.776; recurrent rate,P=0.937).Conclusions:Adjuvant radiotherapy plus chemotherapy is associated with a higher 5-year DSS rate and lower recurrence rate compared with radiotherapy alone and chemotherapy alone in high-risk endometrial cancer patients.Patients with intermediate-risk endometrial cancer may be not likely to benefit from adjuvant combined radiotherapy and chemotherapy.

  9. Experience in treatment of patients with locally advanced or recurrent breast cancer. Intraarterial infusion chemotherapy combined with radiotherapy

    International Nuclear Information System (INIS)

    For the purpose of local control and breast conservation, intraarterial infusion chemotherapy combined with radiotherapy has been indicated in patients with locally advanced breast cancer both in primary and recurrent cases. The present series, evaluated during the past 4 years, consisted of 15 patients 35-83 years of age, with invasive ductal carcinoma, including 10 with primary breast cancer (stage IIIb: 1, IV: 9) and 5 with postoperative recurrence (stage IIIb: 2, IV: 3). Intraarterial chemotherapy is started, basically infusing ADM 50 mg, MMC 10 mg and CDDP 50 mg into the internal thoracic and/or subclavian artery 1-3 times, followed by reduction surgery (quadrantectomy: 4, wide resection: 2) and radiotherapy to the breast, supraclavicular, parasternal and cervical regions according to tumor extent. Local response after arterial infusion was CR: 2, PR: 10, NC: 3 (response rate: 73% ). The response rate of distant metastases after arterial infusion was 73%. Of 10 patients with primary breast cancer, recurrence was noted in 1. Breast conservation was successful in 8 of 10 patients. One of them, in stage IIIb, has survived for 4.5 years with no evidence of disease and with breast conservation. Five patients with postoperative recurrence showed CR with no recurrence after intraarterial chemotherapy and radiotherapy. Acute skin reaction occurred in 6 patients, and was especially frequent in patients with postoperative recurrence (4 of 5). According to these results, combined therapy affords breast conservation even in patients with locally advanced breast cancer, and improves patient's QOL in stage IV. (author)

  10. Surgery and Adjuvant Chemotherapy Use Among Veterans With Colon Cancer: Insights From a California Study

    Science.gov (United States)

    Hynes, Denise M.; Tarlov, Elizabeth; Durazo-Arvizu, Ramon; Perrin, Ruth; Zhang, Qiuying; Weichle, Thomas; Ferreira, M. Rosario; Lee, Todd; Benson, Al B.; Bhoopalam, Nirmala; Bennett, Charles L.

    2010-01-01

    Purpose US veterans have been shown to be a vulnerable population with high cancer rates, and cancer care quality in Veterans Affairs (VA) hospitals is the focus of a congressionally mandated review. We examined rates of surgery and chemotherapy use among veterans with colon cancer at VA and non-VA facilities in California to gain insight into factors associated with quality of cancer care. Methods A retrospective cohort of incident colon cancer patients from the California Cancer Registry, who were ≥ 66 years old and eligible to use VA and Medicare between 1999 and 2001, were observed for 6 months after diagnosis. Results Among 601 veterans with colon cancer, 72% were initially diagnosed and treated in non-VA facilities. Among veterans with stage I to III cancer, those diagnosed and initially treated in VA facilities experienced similar colectomy rates as those at non-VA facilities. Stage III patients diagnosed and initially treated in VA versus non-VA facilities had similar odds of receiving adjuvant chemotherapy. In both settings, older patients had lower odds of receiving chemotherapy than their younger counterparts even when race and comorbidity were considered (age 76 to 85 years: odds ratio [OR] = 0.18; 95% CI, 0.07 to 0.46; age ≥ 86 years: OR = 0.17; 95% CI, 0.04 to 0.73). Conclusion In California, older veterans with colon cancer used both VA and non-VA facilities for cancer treatment, and odds of receiving cancer-directed surgery and chemotherapy were similar in both systems. Among stage III patients, older age lowered odds of receiving adjuvant chemotherapy in both systems. Further studies should continue to explore potential health system effects on quality of colon cancer care across the United States. PMID:20406940

  11. Factors Affecting Use and Delay (≥8 Weeks of Adjuvant Chemotherapy after Colorectal Cancer Surgery and the Impact of Chemotherapy-Use and Delay on Oncologic Outcomes.

    Directory of Open Access Journals (Sweden)

    Ik Yong Kim

    Full Text Available To evaluate factors affecting the use and delay ≥8 weeks of adjuvant chemotherapy and the impact of chemotherapy use and delay on survival.Between 2005 and 2012, consecutive patients with stage II and III colorectal cancer who were treated with major curative resection were enrolled.Among 750 patients with stage II (n = 318 and III (n = 432 disease, 153 (20.4% did not receive chemotherapy. Among 597 patients with adjuvant chemotherapy, 31 (5.2% began chemotherapy 8 weeks or more after surgery. Factors associated with not receiving chemotherapy were: age ≥80 years (hazard ratio [HR] = 5.2, American Society of Anesthesiologists score ≥3 (HR = 1.9, underlying cerebrovascular disease (HR = 1.7, stage II disease (HR = 2.0, presence of postoperative complications (HR = 2.2, or intensive care unit admission (HR = 2.4. Factors associated with chemotherapy delay ≥8 weeks were: male sex (HR = 4.2, rectal primary cancer (HR = 5.4, or presence of postoperative complications (HR = 2.5. Independent prognostic factors for overall survival included TNM III stage (HR = 2.04 and chemotherapy delay ≥8 weeks (HR = 0.39 or <8 weeks (HR = 0.22. Independent prognostic factors for recurrence-free survival were TNM III stage (HR = 2.26 and chemotherapy delay <8 weeks (HR = 0.35.Postoperative complications were associated with both lack of and delayed chemotherapy. Timely initiation of chemotherapy, defined as <8 weeks, was a favorable prognostic factor for overall and recurrence-free survival. To increase the proportion of patients receiving chemotherapy and timely initiation of chemotherapy, surgical complications should be minimized after curative resection.

  12. The effects of a six-week supervised multimodal exercise intervention during chemotherapy on cancer-related fatigue

    DEFF Research Database (Denmark)

    Andersen, Christina; Rørth, Mikael; Ejlertsen, Bent; Stage, Maria; Møller, Tom; Midtgaard, Julie; Quist, Morten; Bloomquist, Kira; Adamsen, Lis

    2013-01-01

    Cancer related fatigue (CRF) is a common problem for cancer patients across diagnoses during chemotherapy and is associated with physical inactivity, lower functional level and lack of energy. Few RCT exercise intervention studies have included cancer patients undergoing chemotherapy. The objective...... of this study is to evaluate whether a six-week supervised multimodal exercise intervention, adjunct to chemotherapy and standard care, can reduce the patient's CRF level....

  13. Effectiveness of immune therapy combined with chemotherapy on the immune function and recurrence rate of cervical cancer

    OpenAIRE

    Chen, Bin; Liu, Lifen; Xu, Haiyan; YANG, YIJIN; Zhang, Ling; Zhang, Fengchun

    2015-01-01

    The aim of this study was to compare the immune function of patients with cervical cancer and the cancer recurrence rate in patients treated with biological immune therapy combined with chemotherapy or with chemotherapy only. A total of 79 postoperative patients with cervical cancer participated in the present study. They were randomly divided into a control group and an experimental group. Patients in the control group were treated with cisplatin chemotherapy. Patients in the experimental gr...

  14. Neoadjuvant or adjuvant chemotherapy: what is the best treatment of muscle invasive bladder cancer?

    Directory of Open Access Journals (Sweden)

    Nabil Ismaili

    2011-09-01

    Full Text Available Bladder cancer is the fourth most common cancer for men and the eighth most common cancer for women. Transitional cell carcinoma is the most predominant histological type. Bladder cancer is highly chemosensitive. In metastatic setting the treatment is based on cisplatin chemotherapy regimens type MVAC, MVAC-HD or gemcitabine plus cisplatin. The standard treatment of muscle invasive operable bladder cancer (T2–T4 used widely was radical cystectomy with pelvic lymph nodes dissection; the anatomical extent of pelvic lymphadenectomy has not accurately been defined so far. However, in the last decade, the treatment of tumors was improved by the introduction of chemotherapy as part of the management of the disease. Neoadjuvant chemotherapy should be considered at first, as standard treatment of choice, before local treatment for patients with good performance status (0–1 and good renal function–glomerular filtration rate (GFR >60 mL/min. For patients treated with primary surgery, adjuvant chemotherapy is a valuable option in the case of lymph nodes involvement. This brief review would provide the evidence of the role of neoadjuvant chemotherapy in the management of operable muscle invasive (T2–T4 bladder cancer.

  15. WISP1 Polymorphisms Contribute to Platinum-Based Chemotherapy Toxicity in Lung Cancer Patients

    Directory of Open Access Journals (Sweden)

    Juan Chen

    2014-11-01

    Full Text Available Platinum-based chemotherapy toxicity is always one of the serious problems from which lung cancer patients suffer. The genetic polymorphism of WISP1 was revealed to be associated with susceptibility and platinum-based chemotherapy response in our previous studies. In this study, we aimed to investigate the relationship of WISP1 genetic polymorphisms with platinum-based chemotherapy toxicity in lung cancer patients. A total of 412 lung cancer patients were enrolled in this study, and 28 polymorphisms of the WISP1 gene were genotyped by SequenomMassARRAY. We found that WISP1 polymorphisms (rs2929965, rs2929969, rs2929970, rs2929973 and rs754958 were related to the overall chemotherapy toxicity of lung cancer in subgroup analyses. Rs16904853, rs2929970, rs2977549 and rs2977551 (p = 0.021, 0.028, 0.024, 0.048, respectively polymorphisms were significantly associated with hematologic toxicity. Rs2929946, rs2929970, rs2977519, rs2977536, rs3739262 and rs754958 (p = 0.031, 0.046, 0.029, 0.016, 0.042, 0.035, respectively polymorphisms were significantly associated with the gastrointestinal toxicity of lung cancer. Genotypes of WISP1 may be novel and useful biomarkers for predicting platinum-based chemotherapy toxicity in lung cancer patients.

  16. WISP1 Polymorphisms Contribute to Platinum-Based Chemotherapy Toxicity in Lung Cancer Patients

    Science.gov (United States)

    Chen, Juan; Yin, Jiye; Li, Xiangping; Wang, Ying; Zheng, Yi; Qian, Chenyue; Xiao, Ling; Zou, Ting; Wang, Zhan; Liu, Junyan; Zhang, Wei; Zhou, Honghao; Liu, Zhaoqian

    2014-01-01

    Platinum-based chemotherapy toxicity is always one of the serious problems from which lung cancer patients suffer. The genetic polymorphism of WISP1 was revealed to be associated with susceptibility and platinum-based chemotherapy response in our previous studies. In this study, we aimed to investigate the relationship of WISP1 genetic polymorphisms with platinum-based chemotherapy toxicity in lung cancer patients. A total of 412 lung cancer patients were enrolled in this study, and 28 polymorphisms of the WISP1 gene were genotyped by SequenomMassARRAY. We found that WISP1 polymorphisms (rs2929965, rs2929969, rs2929970, rs2929973 and rs754958) were related to the overall chemotherapy toxicity of lung cancer in subgroup analyses. Rs16904853, rs2929970, rs2977549 and rs2977551 (p = 0.021, 0.028, 0.024, 0.048, respectively) polymorphisms were significantly associated with hematologic toxicity. Rs2929946, rs2929970, rs2977519, rs2977536, rs3739262 and rs754958 (p = 0.031, 0.046, 0.029, 0.016, 0.042, 0.035, respectively) polymorphisms were significantly associated with the gastrointestinal toxicity of lung cancer. Genotypes of WISP1 may be novel and useful biomarkers for predicting platinum-based chemotherapy toxicity in lung cancer patients. PMID:25405734

  17. Systemic chemotherapy induces microsatellite instability in the peripheral blood mononuclear cells of breast cancer patients

    International Nuclear Information System (INIS)

    Systemic chemotherapy is an important part of treatment for breast cancer. We conducted the present study to evaluate whether systemic chemotherapy could produce microsatellite instability (MSI) in the peripheral blood mononuclear cell fraction of breast cancer patients. We studied 119 sequential blood samples from 30 previously untreated breast cancer patients before, during and after chemotherapy. For comparison, we also evaluated 20 women who had no relevant medical history (control group). In 27 out of 30 patients we observed MSI in at least one sample, and six patients had loss of heterozygosity. We found a significant correlation between the number of MSI events per sample and chemotherapy with alkylating agents (P < 0.0001). We also observed an inverse correlation between the percentage of cells positive for hMSH2 and the number of MSI events per sample (P = 0.00019) and use of alkylating agents (P = 0.019). We conclude that systemic chemotherapy may induce MSI and loss of heterozygosity in peripheral blood mononuclear cells from breast cancer patients receiving alkylating agents, possibly mediated by a chemotherapy-induced decrease in the expression of hMSH2. These effects may be related to the generation of secondary leukaemia in some patients, and may also intensify the genetic instability of tumours and increase resistance to treatment

  18. Preoperative radio-chemotherapy for rectal cancer: Forecasting the next steps through ongoing and forthcoming studies

    International Nuclear Information System (INIS)

    Protracted preoperative radio-chemotherapy with a 5-FU-based scheme, or a short course of preoperative radiotherapy without chemotherapy, are the standard neo-adjuvant treatments for resectable stage II-III rectal cancer. Local failure rates are low and reproducible, between 6 and 15% when followed with a 'Total Meso-rectal Excision'. Nevertheless, the therapeutic strategy needs to be improved: distant metastatic recurrence rates remain stable around 30 to 35%, while both sphincter and sexual sequels are still significant. The aim of the present paper was to analyse the ongoing trials listed on the following search engines: the Institut National du Cancer in France, the National Cancer Institute and the National Institute of Health in the United States, and the major cooperative groups. Keywords for the search were: 'rectal cancer', 'preoperative radiotherapy', 'phase II-III', 'preoperative chemotherapy', 'adjuvant chemotherapy' and 'surgery'. Twenty-three trials were selected and classified in different groups, each of them addressing a question of strategy: (1) place of adjuvant chemotherapy; (2) optimization of preoperative radiotherapy; (3) evaluation of new radiosensitization protocols and/or neo-adjuvant chemotherapy; (4) optimization of techniques and timing of surgery; (5) place of radiotherapy for non resectable or metastatic tumors. (authors)

  19. Development of regional chemotherapies: feasibility, safety and efficacy in clinical use and preclinical studies.

    Science.gov (United States)

    Cai, Shuang; Bagby, Taryn R; Forrest, M Laird

    2011-11-01

    Conventional oral and intravenous chemotherapies permeate throughout the body, exposing healthy tissues to similar cytotoxic drug levels as tumors. This leads to significant dose-limiting toxicities that may prevent patients from receiving sufficient treatment to overcome cancers. Therefore, a number of locoregional drug-delivery strategies have been evaluated and implemented in preclinical studies, clinical trials and in practice, in the past decades to minimize systemic toxicities from chemotherapeutic agents and to improve treatment outcomes. Localized treatment is beneficial because many cancers, such as melanoma, peritoneal cancer and breast cancer, advance locally adjacent to the site of the primary tumors prior to their circulatory invasion. In this article, we will review the feasibility, safety and efficacy of multiple localized chemotherapies in clinical use and preclinical development. PMID:22229080

  20. Superselective intraarterial chemotherapy and concurrent radiotherapy in advanced tongue cancer

    International Nuclear Information System (INIS)

    We clarified the efficacy of superselective intraarterial concurrent chemoradiotherapy (IA-CRT) for preserving organs in locally advanced squamous cell tongue carcinoma. Subjects most of whom had subtotal glossectomy indications, numbered 20 with untreated T2 (4 pts) T3 (11 pts), or T4 (5 pts) carcinoma and undergoing 60 to 70 Gy of irradiation (median total dose: 66 Gy) concurrently with 2 cycles of 5FU chemotherapy in 1000 mg/m2, continuous 120-hour infusion, and 60 mg/m2 of cisplatin was delivered to the lingual artery using the Seldinger technique via the femoral artery. In acute toxicity exceeding than grade 3, mucositis (13 pts) was more serious than leucopenia (4 pts), anemia (1 pt), or diarrhea (1 pt) of the 20, 19 underwent scheduled treatment. Response was good at 95% for local regions and 79% for cervical lymphnodes. Three-year overall survival (OS) was 61% and progression-free survival (PFS) 49% in median follow-up at 35 months (range: 9 to 75 months). A statistically difference existed in three-year OS and PFS: 82-60% for T2-3 and 33% and 0% for T4. Two subjects (T3, T4) underwent received down staging surgery in which half of the tongue was removed with neck dissection, and 1 underwent selective neck dissection alone to preserve the primary site. One was found to have no residual tumor. One underwent postoperative contralateral neck dissection. These three subjects remain alive without recurrence postoperatively. Failure patterns occurred in two subjects with local recurrence and two with post-IA-CRT regional lymphnode recurrence without salvage surgery. All without post-IA-CRT recurrence with or without surgery maintained quality of life (QOL) in swallowing and articulation. IA-CRT can be thus an alternative in treating, T3 to T4 tongue in subjects refusing surgery. (author)

  1. Types of chemotherapy

    Science.gov (United States)

    Chemotherapy is the use of medicine to treat cancer. Chemotherapy kills cancer cells. It may be used to ... people are treated with a single type of chemotherapy. But often, people get more than one type ...

  2. The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review.

    Science.gov (United States)

    Bhatt, Aditi; Glehen, Olivier

    2016-06-01

    Ovarian cancer is one of the leading causes of cancer related deaths in women worldwide. It is usually diagnosed in an advanced stage (Stages III and IV) when peritoneal cancer spread has already occurred. The standard treatment comprises of surgery to remove all macroscopic disease followed by systemic chemotherapy. Despite all efforts, it recurs in over 75 % of the cases, most of these recurrences being confined to the peritoneal cavity. Recurrent ovarian cancer has a poor long term outcome and is generally treated with multiple lines of systemic chemotherapy and targeted therapy. The propensity of ovarian cancer to remain confined to the peritoneal cavity warrants an aggressive locoregional approach. The combined treatment comprising of cytoreductive surgery (CRS) that removes all macroscopic disease and HIPEC (Hyperthermic Intraperitoneal Chemotherapy) has been effective in providing long term survival in selected patients with peritoneal metastases of gastrointestinal origin. Intraperitoneal chemotherapy used as adjuvant therapy has shown a survival benefit in ovarian cancer. This has prompted the use of CRS and HIPEC in the management of ovarian cancer as a part of first line therapy and second line therapy for recurrent disease. This article reviews the current literature and evidence for the use of HIPEC in ovarian cancer. PMID:27065709

  3. Drug concentrations in axillary lymph nodes after lymphatic chemotherapy on patients with breast cancer

    International Nuclear Information System (INIS)

    Lymph node status is one of the decisive prognostic factors in breast cancer. Chemotherapy targeting regional lymphatic tissues has emerged as a promising therapy for the treatment of malignancies with a high tendency to disseminate lymphatically. The present study determined the drug concentrations in axillary lymph nodes after lymphatic chemotherapy (LC) in patients with breast cancer and compared the results with those receiving intravenous chemotherapy (VC) to investigate whether LC could improve the accumulation of anticancer drug in regional lymph nodes. Sixty patients with breast carcinoma confirmed by preoperative puncture-biopsy were divided into two groups at random. The LC group (n = 30) received a subcutaneous injection of 4 ml of carboplatin-activated carbon suspension, containing 20 mg of carboplatin, adjacent to the primary tumour. The VC group (n = 30) received an intravenous administration of an equal dose of aqueous carboplatin. At 1, 12, 24, 36 and 48 hours after administration, modified radical mammectomies were performed on 12 patients at each time point, with 6 from each group. Axillary lymph nodes were removed for pathological examination. The platinum concentrations in nodes were determined by Zeeman atomic absorption spectrometry. A total of 275 axillary lymph nodes were resected, with 154 in the LC group and 121 in the VC group. Of the 275 lymph nodes, 136 (49.5%) from 23 patients (38.3%) had histopathologically detected metastases. At 1, 12, 24, 36 and 48 hours after injection, the carboplatin concentrations in the LC group were 11.82 ± 3.50, 23.58 ± 7.34, 18.22 ± 4.93, 16.70 ± 5.15 and 14.62 ± 4.29 μg/g (means ± SD), respectively, whereas those in the VC group were 0.06 ± 0.02, 0.11 ± 0.05, 0.10 ± 0.02, 0.05 ± 0.02 and 0 μg/g, respectively. Significant differences were found in each corresponding comparison (P < 0.001). Lymph node metastasis was uncorrelated with drug concentration (P > 0.05). LC can effectively and

  4. [Survey on antiemetic therapy in ambulatory cancer chemotherapy and medical economics for standardization].

    Science.gov (United States)

    Sato, Junya; Terui, Kazufumi; Souma, Akemi; Fujita, Shoko; Hayakari, Makoto

    2007-10-01

    A cancer chemotherapy unit was established to support therapy for outpatients with cancer in Hirosaki University Hospital. It is essential to standardize antiemetic therapy, since a wide variety of the therapy provided to the unit from the diagnosis and treatment departments were conventional and empirical. We surveyed the use conditions and compatibility of the therapy based on reliable guidelines, and then considered the medical economics for standardization. In moderate-grade emetogenic chemotherapy, 5-HT(3) receptor antagonists tended to be used frequently instead of the recommended steroids. From this survey, the standardization of the cost of 5-HT(3) receptor antagonists and the relatively inexpensive steroids used in cancer chemotherapy might reduce either the nausea or vomiting suffered by patients with cancer and their economic burden as well. PMID:17940380

  5. Sequential chemoradiation in locally advanced head and neck cancer after induction chemotherapy: an induction chemotherapy schedule more suited to a limited resource setting

    OpenAIRE

    Gangopadhyay, Aparna; Nath, Partha; Biswas, Jaydip

    2015-01-01

    Background In our experience, induction docetaxel, platinum, and fluorouracil (TPF) chemotherapy and sequential chemoradiation in locally advanced head and neck cancer lowers compliance owing to their considerable toxicity. Most of our head and neck cancer patients have locally advanced disease at presentation. Physicians frequently prefer paclitaxel–cisplatin induction chemotherapy instead, because of better patient tolerance. Materials and methods A total of 207 locally advanced head and ne...

  6. Prevention and management of chemotherapy-induced diarrhea in patients with colorectal cancer: a consensus statement by the Canadian Working Group on Chemotherapy-Induced Diarrhea

    OpenAIRE

    Maroun, J A; Anthony, L.B.; Blais, N; Burkes, R.; Dowden, S.D.; Dranitsaris, G; Samson, B.; Shah, A.; Thirlwell, M.P.; Vincent, M D; Wong, R.

    2007-01-01

    Chemotherapy-induced diarrhea (cid) is a common side effect of cancer treatment and can cause significant morbidity and mortality. Diarrhea is frequently severe enough to require a dose reduction of, a delay in, or a discontinuation of chemotherapy. Diarrhea-associated mortality has been reported to be as high as 3.5% in clinical trials of irinotecan and bolus 5-fluorouracil in colorectal cancer. The frequency of cid and its impact on patient management are frequently under-recognized in clin...

  7. Regional distribution of ventilation-perfusion ratio in patients with interstitial pneumonia using Kr-81m

    International Nuclear Information System (INIS)

    In order to know the pathophysiological change of interstitial pneumonia, it is important to detect the morphological change of vascular and air way systems in the lung. The study group consisted of 12 patients of interstitial pneumonia including IIP, PSS, RA, sarcoidosis, and hypersensitive pneumonia. The Kr-81m bolus inhalation from 3 different lung volumes were analyzed to detect regional ventilation abnormalities. The regional distribution of ventilation-perfusion ratio (V/Q) in the lung was obtained from the continuous inhalation and infusion Kr-81 m. In 7 patients, regional distribution of V/Q was also measured at rest and during exercise. In advanced stage of interstitial pneumonia, radioactivity in lower lung fields was decreased in bolus inhalation from TLC-400 ml lung volume, and present in lower lung in bolus inhalation from RV level. These findings are representing air way rigidity especially in lower lung fields. However, in early stage or reversible cases, it is difficult to detect the abnormal distribution of radioactivity in lung, in spite of decreased PO2. So it seems impossible to screen early stage or reversible cases of interstitial pneumonia by bolus inhalation method alone. At rest for normal subjects in the upright position, the apical zone had a high V/Q, but in the lower parts two third of V/Q distribution was relatively homogeneous. During exercise at 50W, the distribution became more uniform. In most cases of the disease, weak exercise (less than 40W) produced the same uniform V/Q distribution. It should be noted that in the disease not only was perfusion in upper lung fields increased, but that perfusion of lower lung fields was reduced. So late in the cource of extension of the disease, pulmonary vascular bed in the lower lung fields is restricted.(J.P.N.)

  8. Comparison of acute toxicities of two chemotherapy schedules for head and neck cancers

    Directory of Open Access Journals (Sweden)

    Geeta S

    2006-01-01

    Full Text Available Background: Chemo-radiotherapy has become the standard of care for loco-regionally advanced head and neck cancers. Platinum based regimens are the most effective. Although benefits are proven with chemo-radiation, acute toxicities are markedly increased. The dose and delivery schedules of Cisplatin have ranged from intermittent higher dose [100 mg/m2] every 3 weeks to low dose [6 mg/m2] daily administration. At present there is no data indicating which regimen is superior. Purpose: To compare acute toxicities of two chemotherapy schedules for head and neck cancers. Materials and Methods: A total of 83 head and neck cancer patients treated with two schedules of concurrent chemo RT were analyzed, retrospectively, for treatment toxicity. In group A [51 patients], chemotherapy [CT] was administered on week 1, 4 and 7 [cisplatin 100 mg/m2] over a period of 2-3 days. In group B [32 patients], CT was delivered weekly [cisplatin 40 mg/m2]. Radiotherapy dose was 7000 cGy in 35 fractions for definitive concurrent chemo-radiation and 6600 cGy in 33 fractions for adjuvant treatment. Results: Group B patients had increased grade III skin and hematological toxicity, where as patients in group A had more pharyngeal toxicity. Treatment interruptions and percentage of weight loss were higher in group B. Weekly CT schedule had higher rate of severe mucositis, which was statistically significant on both univariate [ P =0.005] and multivariate [ P =0.007] analysis. Conclusions: Three weekly CT is less toxic than weekly. Weekly CT can be made more acceptable by reducing the dose and using feeding tubes for nutrition.

  9. Perception of Side Effects of Chemotherapy among Cancer Patients in B.P. Koirala Memorial Cancer Hospital Bharatpur, Nepal

    Directory of Open Access Journals (Sweden)

    Sharmila Gurung

    2016-01-01

    Full Text Available jdjBackground & Objectives: These side effects of chemotherapy affect the patients’ daily life and quality of life adversely. It affects the different body system resulting in physical and non physical (psychosocial side effects. Cancer patients demand information to understand chemotherapy-related adverse effects and actions to be taken. The aim of the study is to find out the perception of side effects of chemotherapy among cancer patients.Materials and methods: A descriptive cross-sectional study was conducted among 200 cancer patients, using purposive sampling technique and data was collected via face to face interview. Descriptive as well as inferential statistics (T-test was used to see the significant difference between dependent and independent variables.Results: The overall perceived side effects of chemotherapy include: affects work and home duties (non physical side effect, followed by anxiety, loss of appetite, affects family, affect partner, feel constantly tired (fatigue, affects social activities, feel irritable, nausea and constipation respectively. There is significant difference between perception of side effects of chemotherapy and gender of respondents.Conclusion: The perceptions of side effects of chemotherapy are different from individual to individual. Patient’s perception of side effects of chemotherapy is concerned with non physical side effects rather than physical side effects.Journal of College of Medical Sciences-Nepal, Vol.11(4 2015: 14-19

  10. Evaluation of pN factors in patients with primary lung cancer by using perfusion, inhalation and ventilation studies

    International Nuclear Information System (INIS)

    The interpretation of scintigraphic patterns and the role of pathophysiological mechanisms in patients with primary lung cancer were investigated. To determine the relative roles of perfusion, inhalation and ventilation scintigraphy, the relationship between the count ratio of the affected side to the healthy side and the post-surgical histological lymph nodes factors were observed in this study. These scintigraphic count ratio's in patients with primary lung cancer did not reflect the pN factors except in the perfusion study in patients with hilar primary lung cancer. (author)

  11. Chemotherapy-induced Fatigue among Jordanian Cancer Patients: What are the Contributing Factors?

    Directory of Open Access Journals (Sweden)

    Kholoud Abu Obead

    2014-03-01

    Full Text Available Background: The purposes of this study were to examine the impact of chemotherapy treatment on Jordanian cancer patients’ fatigue and to correlate their fatigue with selected sociodemographic variables at the beginning of treatment and after four weeks of treatment. Methods: This was a single group quasi-experimental correlational design study that enrolled 43 patients diagnosed with cancer who required chemotherapy treatment. Fatigue was measured according to the Piper Fatigue Scale (PFS before starting chemotherapy treatment and after four weeks of receiving the first dose of chemotherapy. Data were collected over a period of four weeks and analyzed with descriptive statistics, the paired-sample t-test, and Pearson product-moment correlation. Results: The study included 17 (39.5% males and 26 (60.5% females with a mean age of 45.98 years. Most (n=17 were diagnosed with breast cancer. Obesity was present in about 64.4% of patients. The majority (46% received an anthracycline-based regimen. There were statistically significant differences between respondents’ total mean scores of fatigue pre-treatment and four weeks following chemotherapy treatment (t= -2.31, df=42, P<0.05. In addition, significant differences were found in the scores for behavioral, affective, sensory, and cognitive dimensions subscales (t= -2.24, -2.19, - 2.4, -2.4, df=42, P<0.05 between pre-treatment and four weeks after receiving the first dose of chemotherapy treatment. We observed a significant negative relationship between fatigue scores and hemoglobin levels (r= -0.04, P<0.01. Conclusion: Cancer-related fatigue is common among cancer patients who received chemotherapy and result in substantial adverse physical, behavioral, cognitive and affective consequences for patient. Given the impact of fatigue, treatment options should be routinely considered in the care of patients with cancer.

  12. Regional pulmonary ventilation and perfusion studies with sup(81m)Kr after acetylcholine inhalation in bronchial asthma

    International Nuclear Information System (INIS)

    sup(81m)Kr is a radioactive noble gas with an ultrashort halflife of 13 seconds, and can be produced in gaseous form or in solution from its parent, 81Rb(T1/2=4.7hours). Using sup(81m)Kr both regional pulmonary ventilation and perfusion were studied simultaneously in 32 asthmatic patients during remission just before and after acetylcholine inhalation. Twenty-five patients were studied in the sitting position and 7 patients supine : the former were examined once, the latter repeatedly after acetylcholine inhalation. The results were as follows : 1. Changes in regional ventilation 1) Ventilatory abnormalities after acetylcholine inhalation appeared to be localized. Their appearances were related to the percentage decrease in FEVsub(1.0). 2) The lower zones were involved most frequently and the upper zones least frequently. 3) On serial examination, the time courses of regional ventilatory function showed the same patterns as those of percentage decrease in FEVsub(1.0). in hypoventilated areas. But regional ventilatory recovery times were different in each area. 2. Regional ventilation and perfusion relationships 1) Hypoventilated areas generally showed hypoperfusion (similar distribution), but ventilatory abnormalities were greater than those of perfusion (low regional ventilation /perfusion ratio). These findings indicate that perfusion abnormalities are secondary to the ventilatory abnormalities. 2) Abnormalities of regional ventilation/perfusion ratios were related to the ventilatory abnormalities but almost never to the percentage decrease in FEVsub(1.0). 3) In upper (middle) zones, there were some cases with increased perfusion in spite of decreased ventilation. 4) Hypoperfusion reached a maximum witnin 2-3 minutes after the start of the hypoventilated plateau. (author)

  13. Adjuvant chemotherapy, a valuable alternative option in selected patients with cervical cancer.

    Directory of Open Access Journals (Sweden)

    Shuang Li

    Full Text Available Radiotherapy is the standard treatment for cervical cancer, but causes radiotherapy-induced complications. Recently, chemotherapy has been more extensively utilized. Here, we perform a large-scale comparison of chemotherapy and radiotherapy. From 2002 to 2008, 2,268 patients were grouped according to adjuvant radiotherapy or chemotherapy before and/or after surgery, and we compared the 5-year overall survival (OS and disease-free survival (DFS rates, recurrence rates, side effects, quality of life (QoL, and sexual activity. There were no significant differences between the treatment groups for the 5-year OS and DFS rates (OS: p = 0.053, DFS: p = 0.095, although marginally improved outcomes were observed in the chemotherapy group (OS: 86.5% vs. 82.8%; DFS: 84.5% vs. 81.4%. However, patients with early-stage disease, clinical response, and younger age had increased 5-year OS and DFS rates following chemotherapy compared to radiotherapy (p<0.05. The chemotherapy group exhibited significantly lower 5-year recurrence and distant failure rates compared to the radiotherapy group (p<0.001 and p = 0.007, respectively. Nausea and vomiting were the most frequent short-term complications of chemotherapy, whereas bowel and urinary complications were more frequent in the radiotherapy group. Compared to the chemotherapy group, patients who received radiotherapy reported a lower QoL, less frequent sexual activity, and more severe menopausal symptoms (p<0.05. Cervical cancer patients treated with chemotherapy, especially those with early-stage disease, clinical responses, and younger ages, have more positive outcomes, fewer complications, better QoL and sexual activity, suggesting that chemotherapy may be a valuable alternative option for selected patients.

  14. Administration of Concurrent Vaginal Brachytherapy During Chemotherapy for Treatment of Endometrial Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nagar, Himanshu; Boothe, Dustin; Parikh, Amar; Yondorf, Menachem; Parashar, Bhupesh [Department of Radiation Oncology, Weill Cornell Medical College of Cornell University, New York, New York (United States); Gupta, Divya; Holcomb, Kevin; Caputo, Thomas [Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Weill Cornell Medical College of Cornell University, New York, New York (United States); Chao, K. S. Clifford; Nori, Dattatreyudu [Department of Radiation Oncology, Weill Cornell Medical College of Cornell University, New York, New York (United States); Wernicke, A. Gabriella, E-mail: gaw9006@med.cornell.edu [Department of Radiation Oncology, Weill Cornell Medical College of Cornell University, New York, New York (United States)

    2013-11-15

    Purpose: To evaluate the tolerability and toxicity of administering vaginal brachytherapy (VB) concurrently during chemotherapy compared with the sequential approach for patients with endometrial cancer. Methods and Materials: A retrospective analysis of 372 surgically staged patients with endometrial cancer American Joint Committee on Cancer 2009 stages I to IV treated with adjuvant postoperative radiation therapy (RT) at our institution from 2001 to 2012 was conducted. All patients received VB + external beam RT (EBRT) + 6 cycles of adjuvant carboplatin- and paclitaxel-based chemotherapy. The VB mean dose was 15.08 Gy (range, 15-20 Gy), with 3 to 4 weekly applications, and the EBRT mean dose was 45 Gy delivered with 3-dimensional or intensity modulated RT techniques. Hematologic, gastrointestinal (GI), and genitourinary (GU) toxicities were assessed by Common Toxicity Criteria (CTC) and compared between sequential and concurrent chemotherapy and VB schedules. Results: Among patients who received RT and adjuvant chemotherapy, 180 of 372 patients (48%) received RT sandwiched between cycles 3 and 4 of chemotherapy. A separate group of 192 patients (52%) were treated with VB during the first 3 cycles of chemotherapy, with a weekly application on nonchemotherapy days, and received the EBRT portion in a sandwiched fashion. Patients treated with VB during chemotherapy had a decreased overall treatment time by 4 weeks (P<.001; 95% confidence interval: 3.99-4.02) and sustained no difference in CTC-graded acute hematologic, GI, or GU toxicities in comparison with the patients treated with VB and chemotherapy in a sequential manner (P>.05). CTC grade 3 or 4 hematologic, GI, and GU toxicities were zero. Conclusions: VB during chemotherapy is well tolerated, decreases overall treatment time, and does not render more toxicity than the sequential regimen.

  15. Clinical efficacy of local targeted chemotherapy for triple-negative breast cancer

    International Nuclear Information System (INIS)

    The aim of the study was to evaluate the clinical efficacy of superselective intra-arterial targeted neo-adjuvant chemotherapy in the treatment of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and human epidermal growth factor receptor 2 (HER2)-negative (triple-negative) breast cancer. A total of 47 triple-negative breast cancer patients (29 at stage II, 13 at stage III and 5 at stage IV) were randomly assigned to two groups: targeted chemotherapy group (n=24) and control group (n=23). Patients in the targeted chemotherapy group received preoperative superselective intra-arterial chemotherapy with CEF regimen (C: cyclophosphamide [600 mg/m2]; E: epirubicin [90 mg/m2]; F: 5-fluorouracil [600 mg/m2]), and those in the control group received routine neoadjuvant chemotherapy with CEF. The duration of the treatment, changes in lesions and the prognosis were determined. The average course of the treatment was 15 days in the targeted chemotherapy group which was significantly shorter than that in the control group (31 days) (P<0.01). The remission rate of lesions was 91.6% in the targeted chemotherapy group and 60.9% in the control group, respectively. Among these patients, 9 died within two years, including 2 (both at IV stage) in the targeted chemotherapy group and 7 (2 at stage II, 4 at stage III and 1 at stage IV) in the control group. As an neoadjuvant therapy, the superselective intra-arterial chemotherapy is effective for triple-negative breast cancer, with advantages of the short treatment course and favourable remission rates as well as prognoses

  16. PHASE Ⅱ STUDY OF GEMCITABINE COMBINED WITH PLATINUM CHEMOTHERAPY FOR RECURRENT EPITHELIAL OVARIAN CANCER

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To evaluate the anti-tumor effect and toxicity of gemcitabine combined with platinum chemotherapy on recurrent epithelial ovarian cancer.Methods Phase Ⅱ study of gemcitabine combined with platinum chemotherapy was carried out in 22 patients with recurrent epithelial ovarian cancer. Median age of patients was 50. 5 years old. Seven patients were platinum-sensitive and 15 patients were platinum-resistant or -refractor. All patients received gemcitabine combined with carboplatin or oxaliplatin chemotherapy. Patients' response rate (RR) and toxicity of gemcitabine combined with platinum chemotherapy were evaluated.Results A total of 98 gemcitabine-based chemotherapy cycles were performed. Total RR was 36.4%, RR of platinum-sensitive patients was 4/7 and platinum-resistant and -refractory patients was 4/15. The estimated median survival time was 10. 0 months (95% CI: 7.0-13.0) after initiation of gemcitabine combined with platinum chemotherapy.There was no significant difference in survival time between platinum-resistant/refractory group and platinum-sensitive group (P = 0. 061 ). Side effects of gemcitabine combined with platinum chemotherapy were observed in 81.8 % of patients. Grade Ⅱ/Ⅲ anemia (54.5%) and grade Ⅲ/Ⅳ neutropenia (54.5%) were most common toxicities. Ten (45.5%) patients had to delay their chemotherapy cycles or reduce the dose of chemotherapeutic drugs because of the severe side effects. Fourteen (63.6%) patients received granulocyte colony-stimulating factor to relieve neutropenia,and 8 (36. 4% ) patients received component blood transfusion to treat anemia or thrombocytopenia. There was no treatment-associated death.Conclusion Gemcitabine combined with platinum chemotherapy appears to be an effective and well-tolerant treatment for recurrent epithelial ovarian cancer, including platinum-resistant or -refractory diseases.

  17. Expression of sIL-2R before and after Chemotherapy in Patients with Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    FAN Yuan-ming; SUN Zhi-jun

    2008-01-01

    Objective:To investigate the difference of peripheral blood sIL-2R before and after chemotherapy in breast cancer patients,and evaluate the clinical value of the sIL-2R in breast cancer's diagnosis and therapy.Methods:The peripheral blood sIL-2R levels of the breast cancer patients with or without chemotherapy were detected by ELISA.The healthy persons were made as the control group.Results:The slL-2R levels of the breast cancer patients were higher than that of the control group(P<0.05);the slL-2R's levels in Ⅰ~Ⅱ stage breast cancer were lower than that in Ⅲ~Ⅳ stag e breast cancer (P<0.05);the sIL-2R levels of the patients before chemotherapy were higher than that of the patients undergone chemotherapy(P<0.05);The level of the patient with chemotherapy was still higher than that of the control group(P<0.05);the sIL-2R levels of the patients whose chemotherapies were noneffective were higher than that of the patients received effective chemotherapies(P<0.05).There was no significant difference between the group with ER(+)or PR(+)and the group with ER(-)or PR(-)(P>0.05).Conclusion:The breast cancer patients have the high slL-2R levels.There is a close relationship between the cancer incidence and the patients,immune situation.The level of slL-2R could be a clinical index which Can be used for evaluating the cancer degree,because the higher levels of slL-2R can indicate that the immune ability of patient is worse.There is a significant difference between the slL-2R levels of the patients before chemotherapy and that of the patients undergone chemotherapy.

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

    Directory of Open Access Journals (Sweden)

    Palesh O

    2012-12-01

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

  19. Radiofrequency Heat-Enhanced Chemotherapy for Breast Cancer: Towards Interventional Molecular Image-Guided Chemotherapy

    OpenAIRE

    Zhou, Yurong; Han, Guocan; Wang, Yue; Hu, Xi; Li, Zhiming; Chen, Lumin; Bai, Weixian; Luo, Jingfeng; Zhang, Yajing; Sun, Jihong; Yang, Xiaoming

    2014-01-01

    Breast cancer is the most common malignancy in women worldwide. Recent developments in minimally invasive interventional radiology techniques have significantly improved breast cancer treatment. This study aimed to develop a novel technique for the local management of breast cancers using radiofrequency heat (RFH). We performed both in vitro experiments using human breast cancer cells and in vivo validation in xenograft animal models with magnetic resonance imaging (MRI) and pathological corr...

  20. Studies on pulmonary ventilation-perfusion scintigraphy with Xe-133 in primary lung cancer, 2

    International Nuclear Information System (INIS)

    Regional lung ventilation-perfusion scintigraphy by Xe-133 was performed on 45 cases of primary lung cancer comparing with before and after irradiation. In the cases of complete obstruction of bronchial system (mainly segmental bronchus) by the tumor and in the cases of the tumor invasion in arteriovenous sysmen (near trunk), VQ disorder pattern changes to Pattern II (VQ matched defect) after radiation therapy, that is notremarking VQ improvement despite the improvement in chest X-ray. In the cases that recognized tumor oppresion, not obstruction, into bronchial system and arteriovenous system, VQ disorder pattern change to Pattern I (VQ normal) showing V or Q improvement and that the tumor decreased in the chest X-ray after irradiation. Observating radiation treatment effects from the view of morphological effects due to tumor decrease rate in chest X-ray and the view of functional effects due to Xe-133 methods, No Change (NC) Group and Progressive Disease (PD) Group showed a parallel relation among them and Complete Response (CR) Group and Partial Response (PR) Group did not always revealed parallel relation among them. The discrepancy between V improvement and Q improvement was 40% of entirety. V/Q in the abnormal range before irradiation and in the normal range after irradiation was more in CR, PR Groups and less in NC, PD Groups. V/Q in normal range before irradiation and in the abnormal range after irradiation was more in NC, PD Groups. MTT (t-bar) that delayed before irradiation was 71% of entirety. The cases that improved to the normal range after irradiation was tend to be more clearly in CR Group, on the contrary, the cases delayed more after irradiation was less in CR Group. VQ improved after radiotherapy was tend to back to the title of befor irradiation when radiation lung injury was occured. (author)

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

    International Nuclear Information System (INIS)

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

  2. Breakthrough therapy for peritoneal carcinomatosis of gastric cancer: Intraperitoneal chemotherapy with taxanes

    OpenAIRE

    Yamaguchi, Hironori; Kitayama, Joji; Ishigami, Hironori; Kazama, Shinsuke; Nozawa, Hiroaki; Kawai, Kazushige; Hata, Keisuke; Kiyomatsu, Tomomichi; Tanaka, Toshiaki; Tanaka, Junichiro; Nishikawa, Takeshi; Otani, Kensuke; Yasuda, Koji; Ishihara, Soichiro; SUNAMI, EIJI

    2015-01-01

    The effect of chemotherapy on peritoneal carcinomatosis (PC) of gastric cancer remains unclear. Recently, the intraperitoneal (IP) administration of taxanes [e.g., paclitaxel (PTX) and docetaxel (DOC)] during the perioperative period has shown promising results. Herein, we summarized the rationale and methodology for using IP chemotherapy with taxanes and reviewed the clinical results. IP administered taxanes remain in the IP space at an extremely high concentration for 48-72 h. The drug dire...

  3. Adjuvant chemotherapy in stage I breast cancer. More harm than benefit.

    OpenAIRE

    Mueller, C B

    1993-01-01

    Clinical trials of adjuvant chemotherapy for breast cancer have shown a prolonged disease-free interval but no improvement in survival. This review of the evidence indicates that adjuvant therapy induces an antineoplastic drug resistance that makes "salvage" therapy less effective. The benefit that is seen only in group statistics, not in an individual, must be weighed against the harm an individual incurs from the chemotherapy.

  4. A meta analysis of cetuximab plus oxaliplatin based chemotherapy regimen for metastatic colorectal cancer

    Directory of Open Access Journals (Sweden)

    Y L Zhu

    2014-01-01

    Full Text Available Background: Oxaliplatin based chemotherapy regimen was one of the most used chemotherapy modality for metastatic colorectal cancer. The purpose of this meta-analysis was to assess the clinical activity and toxicities of cetuximab plus oxaliplatin-based chemotherapy regimen for metastatic colorectal Cancer. Methods: We searched the clinical studies about the cetuximab plus oxaliplatin-based chemotherapy regimen versus oxaliplatin-based chemotherapy alone for metastatic colorectal cancer in the databases of PubMed, EMBASE, Cochran, and CNKI. The data of response and toxicities were extracted and pooled by random or fixed effects model. And publication bias was evaluated by begg′s funnel plot and egger′s regression test. Results: Seven papers were included in this study. Adding cetuximab to oxaliplatin-based chemotherapy regime can significant increase response rate in K-RAS mutation metastatic colorectal patients (odds ratio [OR]: 1.45, 95% confidence interval [CI]: 1.17-1.80, Z = 3.38, P = 0.001 and metastatic colorectal patients without knowing the K-RAS status (OR: 1.36, 95% CI: 1.11-1.65, Z = 1.89, P = 0.003. But for patients with mutated K-RAS, the improvement for objective response rate was not statistical significant (OR: 0.70, 95% CI: 0.49-1.01, Z = 3.00, P = 0.058 when adding cetuximab to oxaliplatin-based chemotherapy regime. The pooled results indicating the rash and diarrhea risk was significantly increased in the combined treatment group (P 0.05. Significant publication bias was found in toxicities evaluation. Conclusion: Cetuximab plus oxaliplatin-based chemotherapy regimen significant increase the response rate for metastatic colorectal cancer. But the some toxicities such rash and diarrhea risk was also increased.

  5. Herbal Medicines for the Treatment of Cancer Chemotherapy-Induced Side Effects

    OpenAIRE

    Shunsuke eOhnishi; Hiroshi eTakeda

    2015-01-01

    Accumulating evidence suggests that Japanese herbal medicines, called Kampo, have beneficial effects on cancer chemotherapy-induced side effects. Rikkunshito ameliorates cisplatin-induced anorexia through an antagonistic effect on the 5-HT receptors and by increasing the serum ghrelin levels. Hangeshashinto improves irinotecan-induced diarrhea and chemotherapy-induced mucositis by inhibiting the activity of β-glucuronidase as well as the synthesis of prostaglandin E2. Goshajinkigan prevents o...

  6. Herbal medicines for the treatment of cancer chemotherapy-induced side effects

    OpenAIRE

    Ohnishi, Shunsuke; TAKEDA, HIROSHI

    2015-01-01

    Accumulating evidence suggests that Japanese herbal medicines, called Kampo, have beneficial effects on cancer chemotherapy-induced side effects. Rikkunshito ameliorates cisplatin-induced anorexia through an antagonistic effect on the 5-HT receptors and by increasing the serum ghrelin levels. Hangeshashinto improves irinotecan-induced diarrhea and chemotherapy-induced mucositis by inhibiting the activity of β-glucuronidase as well as the synthesis of prostaglandin E2. Goshajinkigan prevents o...

  7. Neoadjuvant chemotherapy in advanced ovarian cancer: latest results and place in therapy

    OpenAIRE

    Sato, Seiya; Itamochi, Hiroaki

    2014-01-01

    Approximately 70% of women with epithelial ovarian cancer (EOC) are diagnosed with advanced stage disease, which is associated with high morbidity and mortality. The standard approach to treating patients with advanced EOC remains primary debulking surgery (PDS) followed by chemotherapy. EOC is one of the most sensitive of all solid tumors to cytotoxic drugs, with over 80% of women showing a response to standard chemotherapy combined with taxane and platinum. Furthermore, residual disease is ...

  8. The Utilization of the Immune System in Lung Cancer Treatment: Beyond Chemotherapy

    Directory of Open Access Journals (Sweden)

    Carmen W. H. Chan

    2016-02-01

    Full Text Available Lung cancer is ranked first worldwide as one of the main cancers in terms of prevalence and mortality rate. The development of effective treatment strategies against lung cancer is therefore of paramount importance. Traditionally, chemotherapy was employed in the treatment of various cancers. However, the non-specific nature of the actions of chemotherapeutic drugs and the potential for tumors to develop resistance to these drugs may render chemotherapy a less favorable option for cancer treatment. Immunotherapy provides an alternative strategy for this purpose. It involves the utilization of the immune system and the immune effector cells to elicit an immune response to the tumors, thereby eliminating them. Strategies include the administration of pro-inflammatory cytokines for immune stimulation, the removal of immunological checkpoints using monoclonal antibodies, and the use of cancer vaccines to enhance immunity against tumors. This article summarizes the above strategies, highlights the reasons why immunotherapy is superior to chemotherapy for the purpose of tumor removal, and reviews the recent clinical studies comparing the clinical outcomes of patients undergoing immunotherapy and chemotherapy. The article also describes advances in immunotherapeutic strategies for the treatment of lung cancer.

  9. Hypertension impairs myocardial blood perfusion reserve in subjects without regional myocardial ischemia

    International Nuclear Information System (INIS)

    Quantitative analysis of myocardial perfusion MRI can provide noninvasive assessments of myocardial perfusion reserve (MPR), which is associated with endothelial function. Endothelial function is influenced by various factors, including hypertension, diabetes, dyslipidemia, renal dysfunction and anemia. The purpose of this study was to evaluate which risk factor is the strongest effector of MPR in subjects without regional myocardial ischemia. We studied 110 patients (66 years ±10, male 68%, hypertension 76%, diabetes mellitus (DM) 40% and dyslipidemia 65%) without regional myocardial ischemia. Adenosine triphosphate (ATP) stress and rest first-pass perfusion magnetic resonance (MR) images were acquired with a 1.5-T MR system, and MPR was calculated as the ratio of stress to rest myocardial blood flow (MBF). Average rest MBF in 110 patients was 1.07±0.62 ml min-1 g-1, whereas stress MBF was 3.15±1.93 ml min-1 g-1 and the MPR was 3.33±1.82. Rest MBF correlated significantly with hematocrit, whereas stress MBF showed a strong correlation with estimated glomerular filtration rate (e-GFR). MPR was associated with hypertension, age, e-GFR, hematocrit and left ventricular mass index (LVMI). In multiple regression analysis, hypertension (P=0.003, β=-0.274) showed the strongest correlation with MPR among other risk factors, such as diabetes (P=ns), dyslipidemia (P=ns), e-GFR (P=ns), LVMI (P=0.007, β=-0.248) and hematocrit (P=ns) after adjusting age and gender. Hypertension is the most important effector of MPR in subjects without myocardial ischemia. (author)

  10. Paeonol Protects Rat Heart by Improving Regional Blood Perfusion during No-Reflow

    Science.gov (United States)

    Ma, Lina; Chuang, Chia-Chen; Weng, Weiliang; Zhao, Le; Zheng, Yongqiu; Zhang, Jinyan; Zuo, Li

    2016-01-01

    No-reflow phenomenon, defined as inadequate perfusion of myocardium without evident artery obstruction, occurs at a high incidence after coronary revascularization. The mechanisms underlying no-reflow is only partially understood. It is commonly caused by the swelling of endothelial cells, neutrophil accumulation, and vasoconstriction, which are all related to acute inflammation. Persistent no-reflow can lead to hospitalization and mortality. However, an effective preventive intervention has not yet been established. We have previously found that paeonol, an active extraction from the root of Paeonia suffruticosa, can benefit the heart function by inhibiting tissue damage after ischemia, reducing inflammation, and inducing vasodilatation. To further investigate the potential cardioprotective action of paeonol on no-reflow, healthy male Wistar rats were randomly divided into four groups: sham, ischemia-reperfusion (I/R) injury (left anterior descending coronary artery was ligated for 4 h followed by reperfusion for 8 h), and I/R injury pretreated with paeonol at two different doses. Real-time myocardial contrast echocardiography was used to monitor regional blood perfusion and cardiac functions. Our data indicated that paeonol treatment significantly reduces myocardial infarct area and no-reflow area (n = 8; p < 0.05). Regional myocardial perfusion (A·β) and cardiac functions such as ejection fraction, stroke volume, and fractional shortening were elevated by paeonol (n = 8; p < 0.05). Paeonol also lowered the serum levels of lactate dehydrogenase, creatine kinase, cardiac troponin T, and C-reactive protein, as indices of myocardial injury. Paeonol exerts beneficial effects on attenuating I/R-associated no-reflow injuries, and may be considered as a potential preventive treatment for cardiac diseases or post-coronary revascularization in which no-reflow often occurs. PMID:27493631

  11. Relative dose intensity of systemic chemotherapy in an outpatient cancer center

    Directory of Open Access Journals (Sweden)

    Christine Uptigrove

    2010-11-01

    Full Text Available Objective. This study was undertaken to determine the average relative dose intensity (RDI of chemotherapy administered to patients in a community-based outpatient cancer center. Methods. A retrospective review of medical records in an outpatient cancer center was conducted for patients initiating systemic chemotherapy in 2007 for a diagnosis of lymphoma, breast, lung, ovary, or colon cancer. Eighty-four records meeting the inclusion criteria were reviewed for demographic information, primary tumor type, chemotherapy regimen, staging at diagnosis, presence of disease progression, and mortality status. Regimen data included: chemotherapeutic agents used, dosages administered, dates of administration, treatment intent (adjuvant vs. metastatic, and granulocyte colony-stimulating factor (G-CSF usage per cycle. Mean summary statistics were calculated and average RDI was analyzed. Results. The overall RDI at our institution was 83% (n=65. The RDI for those receiving adjuvant chemotherapy was 85% (n=51, whereas for those receiving chemotherapy for metastatic disease the RDI was 76% (n=14. Fifty-four percent (n=35 of the regimens met or exceeded the recommended minimum goal RDI of > 85%. Conclusions. Overall the average RDI at our institution was 83%, slightly below the goal of ≥ 85%. Patients with potentially curable malignancies receiving adjuvant chemotherapy reached the threshold RDI; however, areas for quality improvement exist at our institution.

  12. Investigation of the Effect of Neoadjuvant Chemotherapy on Stage II Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Yanli Song; Dong Wang

    2007-01-01

    OBJECTIVE To investigate the effect of neoadjuvant chemotherapy in treatment of Stage II breast cancer.METHODS The data from 113 patients with breast cancer of the same pathologic type in Stage II, during the period of 1995 to 2001, were analyzed retrospectively. Among the patients, 47 were treated with neoadjuvant chemotherapy, and 66 received no adjuvant therapy before surgery (control group). After the patients of the neoadjuvant chemotherapy group had received 2 courses of chemotherapy with the CMF regimen, the surgical procedure was conducted.RESULTS Complete remission (CR) was attained in 9 of the 47 cases receiving neoadjuvant chemotherapy and partial remission (PR) was reached for 22 cases. The rate of breast-conserving surgery was enhanced from 22.73% to 46.81% (P<0.05) in the neoadjuvant treatment group. There was no difference in the 5-year overall survival (OS) and disease-free survival (DFS) rate between the two groups (P>0.05), but the 5-year OS and DFS of the cases with clinical tumor remission was higher compared to the control group (P<0.05).CONCLUSION Neoadjuvant chemotherapy can enhance the rate of breast conservation for Stage II breast cancer and may improve the prognosis of the cases with clinical remission.

  13. DNA damage in peripheral blood lymphocytes in patients during combined chemotherapy for breast cancer

    International Nuclear Information System (INIS)

    Combined chemotherapy is used for the treatment of a number of malignancies such as breast cancer. The target of these antineoplastic agents is nuclear DNA, although it is not restricted to malignant cells. The aim of the present study was to assess DNA damage in peripheral blood lymphocytes (PBLs) of breast cancer patients subjected to combined adjuvant chemotherapy (5-fluorouracil, epirubicin and cyclophosphamide, FEC), using a modified comet assay to detect DNA single-strand breaks (SSB) and double-strand breaks (DSB). Forty-one female patients with advanced breast cancer before and after chemotherapy and 60 healthy females participated in the study. Alkaline and neutral comet assays were performed in PBLs according to a standard protocol, and DNA tail moment was measured by a computer-based image analysis system. Breast cancer patients before treatment had higher increased background levels of SSB and DSB as compared to healthy women. During treatment, a significant increase in DNA damage was observed after the 2nd cycle, which persisted until the end of treatment. Eighty days after the end of treatment the percentage of PBLs with SSB and DSB remained elevated, but the magnitude of DNA damage (tail moment) returned to baseline levels. There was no correlation between PBL DNA damage and response to chemotherapy. DNA-SSB and DSB in PBLs are present in cancer patients before treatment and increase significantly after combined chemotherapy. No correlation with response to adjuvant chemotherapy was found. Biomonitoring DNA damage in PBLs of cancer patients could help prevent secondary effects and the potential risks of developing secondary cancers

  14. DNA damage in peripheral blood lymphocytes in patients during combined chemotherapy for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez-Suarez, Patricia [Oncological Research Unit, Oncology Hospital, National Medical Center S-XXI, Instituto Mexicano del Seguro Social (IMSS), Av. Cuauhtemoc 330, Col. Doctores, 06725 Mexico, D.F. (Mexico); Ostrosky-Wegman, Patricia [Biomedical Research Institute, Universidad Nacional Autonoma de Mexico (UNAM), Mexico City (Mexico); Gallegos-Hernandez, Francisco [Department of Clinical Oncology, Oncology Hospital, National Medical Center S-XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City (Mexico); Penarroja-Flores, Rubicelia; Toledo-Garcia, Jorge [Oncological Research Unit, Oncology Hospital, National Medical Center S-XXI, Instituto Mexicano del Seguro Social (IMSS), Av. Cuauhtemoc 330, Col. Doctores, 06725 Mexico, D.F. (Mexico); Bravo, Jose Luis [Atmospheric Sciences Institute, Universidad Nacional Autonoma de Mexico (UNAM), Mexico City (Mexico); Rojas del Castillo, Emilio [Biomedical Research Institute, Universidad Nacional Autonoma de Mexico (UNAM), Mexico City (Mexico); Benitez-Bribiesca, Luis [Oncological Research Unit, Oncology Hospital, National Medical Center S-XXI, Instituto Mexicano del Seguro Social (IMSS), Av. Cuauhtemoc 330, Col. Doctores, 06725 Mexico, D.F. (Mexico)], E-mail: luisbenbri@mexis.com

    2008-04-02

    Combined chemotherapy is used for the treatment of a number of malignancies such as breast cancer. The target of these antineoplastic agents is nuclear DNA, although it is not restricted to malignant cells. The aim of the present study was to assess DNA damage in peripheral blood lymphocytes (PBLs) of breast cancer patients subjected to combined adjuvant chemotherapy (5-fluorouracil, epirubicin and cyclophosphamide, FEC), using a modified comet assay to detect DNA single-strand breaks (SSB) and double-strand breaks (DSB). Forty-one female patients with advanced breast cancer before and after chemotherapy and 60 healthy females participated in the study. Alkaline and neutral comet assays were performed in PBLs according to a standard protocol, and DNA tail moment was measured by a computer-based image analysis system. Breast cancer patients before treatment had higher increased background levels of SSB and DSB as compared to healthy women. During treatment, a significant increase in DNA damage was observed after the 2nd cycle, which persisted until the end of treatment. Eighty days after the end of treatment the percentage of PBLs with SSB and DSB remained elevated, but the magnitude of DNA damage (tail moment) returned to baseline levels. There was no correlation between PBL DNA damage and response to chemotherapy. DNA-SSB and DSB in PBLs are present in cancer patients before treatment and increase significantly after combined chemotherapy. No correlation with response to adjuvant chemotherapy was found. Biomonitoring DNA damage in PBLs of cancer patients could help prevent secondary effects and the potential risks of developing secondary cancers.

  15. Lung perfusion SPECT in predicting postoperative pulmonary function in lung cancer

    International Nuclear Information System (INIS)

    The aim of this prospective study is to evaluate the availability of preoperative perfusion SPECT in predicting postoperative pulmonary function following resection. Twenty-three patients with lung cancer who were candidates for lobectomy were investigated preoperatively with spirometry, x-ray computed tomography and 99mTc-macroaggregated albumin SPECT. Their postoperative pulmonary functions were predicted with these examinations. The forced vital capacity and the forced expiratory volume in one second were selected as parameters for overall pulmonary function. The postoperative pulmonary function was predicted by the following formula: Predicted postoperative value=observed preoperative value x precent perfusion of the lung not to be resected. The patients were reinvestigated with spirometry at 3 months and 6 months after lobectomy, and the values obtained were statistically compared with the predicted values. Close relationships were found between predicted and observed forced vital capacity (r=0.87, p<0.001), and predicted and observed forced expiratory volume in one second (r=0.90, p<0.001). The accurate prediction of pulmonary function after lobectomy could be achieved by means of lung perfusion SPECT. (author)

  16. Estimation of the cost of treatment by chemotherapy for early breast cancer in Morocco

    Directory of Open Access Journals (Sweden)

    Boutayeb Saber

    2010-09-01

    Full Text Available Abstract Background Breast cancer is the first cancer in women both in incidence and mortality. The treatment of breast cancer benefited from the progress of chemotherapy and targeted therapies, but there was a parallel increase in treatment costs. Despite a relatively high incidence of many sites of cancer, so far, there is no national register for this disease in Morocco. The main goal of this paper is to estimate the total cost of chemotherapy in the early stages of breast cancer due to its frequency and the chances of patients being cured. This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of antimitotics and trastuzumab in Morocco. Method We start by evaluating the individual cost according to the therapeutic sub-groups, namely: 1. Patients needing chemotherapy with only anthracycline-based therapy. 2. Patients needing chemotherapy with both anthracycline and taxane but without trastuzumab. 3. Patients needing trastuzumab in addition to chemotherapy. For each sub-group, the protocol of treatment is described, and the individual costs per unit, and for the whole cycle, are evaluated. Then we estimate the number of women suffering from breast cancer on the basis of two data bases available in Morocco. Finally, we calculate the total annual cost of treatment of breast cancer in Morocco. Results The total cost of breast cancer in Morocco is given in Moroccan dirhams (MAD, the US dollar at the current exchange rate (MAD 10 = USD 1.30 and in international dollars or purchasing power parity (MAD 10 = PPP 1.95. The cost of a therapy with trastuzumab is 8.4 times the cost of a sequential chemotherapy combining anthracycline and taxane, and nearly 60 times the cost of chemotherapy based on anthracycline alone. Globally, between USD 13.3 million and USD 28.6 million need to be devoted every year by the Moroccan health authorities to treat

  17. A preliminary analysis of the reduction of chemotherapy waste in the treatment of cancer with centralization of drug preparation

    OpenAIRE

    Adriano Hyeda; Elide Sbardellotto Mariano da Costa

    2015-01-01

    SummaryIntroduction:chemotherapy is essential to treat most types of cancer. Often, there is chemotherapy waste in the preparation of drugs prescribed to the patient. Leftover doses result in toxic waste production.Objective:the aim of the study was to analyze chemotherapy waste reduction at a centralized drug preparation unit.Methods:the study was cross-sectional, observational and descriptive, conducted between 2010 and 2012. The data were obtained from chemotherapy prescriptions made by on...

  18. Exercise: a path to wellness during adjuvant chemotherapy for breast cancer?

    OpenAIRE

    Husebo, Anne Marie L.; Allan, Helen T; Karlsen, Bjørg; Soreide, Jon Arne; Bru, Edvin

    2014-01-01

    Background: Breast cancer treatment can represent a threat to a patient’s wellness. The role of exercise in perceived wellness in women with breast cancer merits further study. Objective: The objective of this study was to describe how exercise is perceived by women to influence their physical and psychosocial wellness at the time they were receiving chemotherapy. Methods: Five focus group interviews with a total of 27 women with early-stage breast cancer were conducted. Prior to...

  19. Nurses’ Knowledge and Education about Oral Care of Cancer Patients Undergoing Chemotherapy and Radiation Therapy

    OpenAIRE

    Pai, Radhika R; Ravikiran Ongole

    2015-01-01

    Context: Oral health awareness and oral care are crucial aspects of oncology nursing practice. However very few studies concentrate on the oral care of cancer patients undergoing cancer treatment and nursing practice in the Indian subcontinent. Most of the published studies have been conducted in the Western and European countries. Aim: This study aimed to determine the nurses′ knowledge and education about oral care in cancer patient undergoing chemotherapy and radiation therapy. Sett...

  20. NEO adjuvant chemotherapy in breast cancer: What have we learned so far?

    OpenAIRE

    Raut Nirmal; Chordiya Nilesh

    2010-01-01

    Neoadjuvant chemotherapy (NACT) in breast cancer has undergone continuous evolution over the last few decades to establish its role in the combined modality management of these tumors. The process of evolution is still far from over. Many questions are still lurking in the minds of oncologists treating breast cancer. This review analyzes the evidence from metaanlyses, major multiinstitutional prospective trials, retrospective institutional series and systematic reviews in breast cancer to det...

  1. A Serum Protein Profile Predictive of the Resistance to Neoadjuvant Chemotherapy in Advanced Breast Cancers*

    OpenAIRE

    Hyung, Seok-Won; Lee, Min Young; Yu, Jong-Han; Shin, Byunghee; Jung, Hee-Jung; Park, Jong-Moon; Han, Wonshik; Lee, Kyung-min; Moon, Hyeong-Gon; Zhang, Hui; Aebersold, Ruedi; Hwang, Daehee; Lee, Sang-Won; Yu, Myeong-Hee; Noh, Dong-Young

    2011-01-01

    Prediction of the responses to neoadjuvant chemotherapy (NACT) can improve the treatment of patients with advanced breast cancer. Genes and proteins predictive of chemoresistance have been extensively studied in breast cancer tissues. However, noninvasive serum biomarkers capable of such prediction have been rarely exploited. Here, we performed profiling of N-glycosylated proteins in serum from fifteen advanced breast cancer patients (ten patients sensitive to and five patients resistant to N...

  2. Clinical outcome of hyperthermo-radio-chemotherapy combined with surgery for patients with advanced breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Kokuriki; Fujimoto, Shigeru; Takahashi, Makoto; Nemoto, Kazuhisa; Mutou, Takaaki; Toyosawa, Tadashi [Social Insurance Funabashi Central Hospital, Chiba (Japan)

    2001-09-01

    For the patients with breast cancer that are locally advanced or metastatic, treatment to control not only local disease but also distant metastasis is desirable. Hyperthermo-radio-chemotherapy (HRC) combined with surgery was performed for 16 patients with stage III or stage IV breast cancer and the clinical outcomes of this multimodal treatment were analyzed. The size of the primary tumor was significantly reduced after preoperative HRC with the CR rate of 18.8% (3/16) and PR rate of 81.3% (13/16). Three- and 5-year overall survival rates for the stage III patients were 100% and 87.5%, respectively; their 3- and 5- year disease free rates were 78.8% and 52.5%, respectively. One- and 3-year survival rates for the stage IV patients were 80.0% and 20.0%, respectively. No loco-regional recurrence was observed. HRC combined with surgery for advanced breast cancer patients was effective for down-staging of the primary tumor and maintaining local control. (author)

  3. The effect of positive end-expiratory pressure on regional ventilation and perfusion in the normal and injured primate lung.

    Science.gov (United States)

    Hammon, J W; Wolfe, W G; Moran, J F; Jones, R H; Sabiston, D C

    1976-11-01

    Although positive end-expiratory pressure (PEEP) is being employed in the management of respiratory insufficiency, many of its physiological effects remain undetermined. The cardiopulmonary effects of PEEP as well as its effect on regional ventilation and perfusion were studied in 10 baboons before and after pulmonary injury with oleic acid. In the normal lung, there was significant improvement in oxygenation at a PEEP of 5 cm. of water secondary to improved ventilation and perfusion in all PEEP greater than 5 cm. of water produced increasing mismatch of ventilation and perfusion in all zones. After oleic acid was injected, hypoxemia was evident with a reversal of the normal ventilation-perfusion (V/Q) relationship between upper and lower lung zones. This mismatch of ventilation and perfusion was corrected at a PEEP of 15 cm. of water. It was reasonable to conclude that the use of PEEP in the injured lung exerts it beneficial effect by balancing regional ventilation and perfusion in addition to increasing functional residual capacity. PMID:824505

  4. Radiotherapy and chemotherapy in cancer treatment during pregnancy: a literature review

    International Nuclear Information System (INIS)

    The coexistence of pregnancy and cancer is a challenging situation for the physician. Chemotherapy and radiotherapy are often necessary, depending on the type and stage of cancer at diagnosis. When applying such treatment, several key points concerning the health of the fetus must be carefully monitored. Meanwhile, if the appropriate treatment is delayed until postpartum, the mother's life may be at risk. Historically, the mother's health was placed above that of the fetus. This concept has changed, and harmonization of maternal and fetal health is now considered ideal. Numerous reports have shown the safe use of chemotherapy especially during the second and third trimesters of pregnancy. In 2004 our department treated seven cases of simultaneous cancer and pregnancy, leading us to review the use of chemotherapy and radiotherapy during pregnancy and the repercussions on neonatal outcome. (author)

  5. Effect of intra-hepatic arterial infusion chemotherapy for patients with liver metastasis from breast cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of intra-hepatic arterial infusion chemotherapy for patients with liver metastasis from breast cancer. Methods: 1993-1998 years, Thirty four patients with liver metastasis from breast cancer had received epi-adriamycin, cisplatin, mitomycin and 5-fluorouracil by intrahepatic arterial infusion chemotherapy. Twelve patients had received embolization. Results: Six patients (17.65%) had a complete response, 12 patients (35.29%) had a partial response. The overall response rate was 52.94%. Cumulative survival rates at 1, 2, 3 and 4 years were 56.90%, 25.00%, 5.00% and 5.00% respectively (Kaplan-Meier method). The median overall survival time was 11.5 months. Conclusion: Intra-hepatic arterial infusion chemotherapy is safe and effective for liver metastasis from breast cancer and should be the first choice of treatment for these patients

  6. Breakthrough therapy for peritoneal carcinomatosis of gastric cancer: Intraperitoneal chemotherapy with taxanes.

    Science.gov (United States)

    Yamaguchi, Hironori; Kitayama, Joji; Ishigami, Hironori; Kazama, Shinsuke; Nozawa, Hiroaki; Kawai, Kazushige; Hata, Keisuke; Kiyomatsu, Tomomichi; Tanaka, Toshiaki; Tanaka, Junichiro; Nishikawa, Takeshi; Otani, Kensuke; Yasuda, Koji; Ishihara, Soichiro; Sunami, Eiji; Watanabe, Toshiaki

    2015-11-15

    The effect of chemotherapy on peritoneal carcinomatosis (PC) of gastric cancer remains unclear. Recently, the intraperitoneal (IP) administration of taxanes [e.g., paclitaxel (PTX) and docetaxel (DOC)] during the perioperative period has shown promising results. Herein, we summarized the rationale and methodology for using IP chemotherapy with taxanes and reviewed the clinical results. IP administered taxanes remain in the IP space at an extremely high concentration for 48-72 h. The drug directly infiltrates peritoneal metastatic nodules from the surface and then produces antitumor effects, making it ideal for IP chemotherapy. There are two types of perioperative IP chemotherapy with taxanes: neoadjuvant intraperitoneal and systemic chemotherapy and sequential perioperative intraperitoneal chemotherapy (SPIC). In SPIC, patients receive neoadjuvant IP chemotherapy and the same regimen of IP chemotherapy after cytoreductive surgery (CRS) until disease progression. Usually, a taxane dissolved in 500-1000 mL of saline at ordinary temperature is administered through an IP access port on an outpatient basis. According to phase I studies, the recommended doses (RD) are as follows: IP DOC, 45-60 mg/m(2); IP PTX [without intravenous (IV) PTX], 80 mg/m(2); and IP PTX (with IV PTX), 20 mg/m(2). Phase II studies have reported a median survival time of 14.4-24.6 mo with a 1-year overall survival of 67%-78%. A phase III study comparing S-1 in combination with IP and IV PTX to S-1 with IV cisplatin started in 2011. The prognosis of patients who underwent CRS was better than that of those who did not; however, this was partly due to selection bias. Although several phase II studies have shown promising results, a randomized controlled study is needed to validate the effectiveness of IP chemotherapy with taxanes for PC of gastric cancer. PMID:26600928

  7. Breakthrough therapy for peritoneal carcinomatosis of gastric cancer:Intraperitoneal chemotherapy with taxanes

    Institute of Scientific and Technical Information of China (English)

    Hironori; Yamaguchi; Joji; Kitayama; Hironori; Ishigami; Shinsuke; Kazama; Hiroaki; Nozawa; Kazushige; Kawai; Keisuke; Hata; Tomomichi; Kiyomatsu; Toshiaki; Tanaka; Junichiro; Tanaka; Takeshi; Nishikawa; Kensuke; Otani; Koji; Yasuda; Soichiro; Ishihara; Eiji; Sunami; Toshiaki; Watanabe

    2015-01-01

    The effect of chemotherapy on peritoneal carcinomatosis(PC) of gastric cancer remains unclear.Recently,the intraperitoneal(IP) administration of taxanes [e.g.,paclitaxel(PTX) and docetaxel(DOC)] during the perioperative period has shown promising results.Herein,we summarized the rationale and methodology for using IP chemotherapy with taxanes and reviewed the clinical results.IP administered taxanes remain in the IP space at an extremely high concentration for 48-72 h.The drug directly infiltrates peritoneal metastatic nodules from the surface and then produces antitumor effects,making it ideal for IP chemotherapy.There are two types of perioperative IP chemotherapy with taxanes: neoadjuvant intraperitoneal and systemic chemotherapy and sequential perioperative intraperitoneal chemotherapy(SPIC).In SPIC,patients receive neoadjuvant IP chemotherapy and the same regimen of IP chemotherapy after cytoreductive surgery(CRS) until disease progression.Usually,a taxane dissolved in 500-1000 m L of saline at ordinary temperature is administered through an IP access port on an outpatient basis.According to phase Ⅰ?studies,the recommended doses(RD) are as follows: IP DOC,45-60 mg/m2; IP PTX [without intravenous(IV) PTX],80 mg/m2; and IP PTX(with IV PTX),20 mg/m2.Phase Ⅱ studies have reported a median survival time of 14.4-24.6 mo with a 1-year overall survival of 67%-78%.A phase Ⅲ study comparing S-1 in combination with IP and IV PTX to S-1 with IV cisplatin started in 2011.The prognosis of patients who underwent CRS was better than that of those who did not; however,this was partly due to selection bias.Although several phase Ⅱ studies have shown promising results,a randomized controlled study is needed to validate the effectiveness of IP chemotherapy with taxanes for PC of gastric cancer.

  8. STOMATOLOGIC STATUS IN PATIENTS WITH MALIGNANT NEOPLASMS OF MAXILLOFACIAL REGION UNDERGOING CHEMOTHERAPY AND RADIOTHERAPY

    Directory of Open Access Journals (Sweden)

    Olga Shpulina

    2013-06-01

    Full Text Available The aim of this study was to evaluate the early acute side effects following radiation and chemotherapy in patients with head and neck cancer (HNC, namely: to ascertain main patient complaints; to investigate saliva properties and to determine the microecology of the oral cavity in patient with HNC before and after radiation and chemotherapy. Eighteen patients with HNC which were prescribed gamma therapy on two buccal submandibular fields combined with close-focus roentgenotherapy and methotrexate as a cytostatic were examined. It was established that 3 weeks after the radio- and chemotherapy 100 % of patients pointed at xerostomia, dysgeusia, disturbances during speech, burning, pricking and itching in oral cavity. After cancer treatment the speed of salivation decreased two times and pH was 15 % lower than before radio and chemotherapy. Anti-cancer treatment caused significant decrease of lysozyme level (34 % lower and secretory immunoglobulin A (1,5 times lower in patients with HNC. After radio and chemotherapy different fungi of Candida genus from oral cavity were inoculated in high concentrations (from 4,0 ± 0.07 to 6,9 ± 0.07 lg CFU/ml, such as С. Аlbicans, C. Kruzei, С. Tropicalis, C. Stellatoidea.Thus significant negative changes from the side of speed and character of salivation, decrease of saliva pH, depression of both non-specific and specific components of immune defense and high contamination of oral mucosa with fungi of Candida genus considerably worsenpost-cancer rehabilitation.

  9. Guide to intra-arterial infusion chemotherapy for pancreatic cancers (draft text)

    International Nuclear Information System (INIS)

    Pancreatic cancer is one of most malignant solid tumors. Trans-arterial infusion chemotherapy has been used for the inoperable pancreatic cancers. The local drug concentration in intra-arterial infusion chemotherapy is much higher than that in intravenous chemotherapy. Thus, a better therapeutic effect can be surely achieved, the disease-related symptoms can be well improved, the patient's survival time can be markedly prolonged, and the liver metastases can be effectively reduced. This paper aims to suggest a more detailed and standardized therapeutic scheme to perform intra-arterial infusion chemotherapy for inoperable pancreatic cancers, focusing on the relevant concept, contraindications, indications, preoperative preparation, methods of operation, postoperative treatment, the prevention and treatment of complications, etc. The scheme will help domestic interventional physicians to make reasonable decisions in their clinical practice. Of course, the scheme proposed here is not a mandatory standard, and it can not resolve all the problems which might be encountered in employing intra-arterial infusion chemotherapy for patients with inoperable pancreatic cancer. Therefore, the interventional physicians should fully understand the most useful medical evidence of a given patient and sincerely take the patient's own will into consideration before an individualized and reasonable therapeutic plan is able to be worked out. (authors)

  10. Patients’ perspectives on palliative chemotherapy of colorectal and non - colorectal cancer: a prospective study in a chemotherapy- experienced population

    International Nuclear Information System (INIS)

    A better understanding of patients’ views on the benefit and burden obtained from palliative chemotherapy would facilitate shared decision making. We evaluated palliative cancer patients’ reported outcomes (PROs) for toxicity and investigated the survival threshold for which they would repeat chemotherapy (CTx). Patients who had received a minimum of three months of palliative CTx for advanced colorectal (CRC) or non-colorectal (non-CRC: upper gastrointestinal, lung and head-and-neck) cancer were assessed by questionnaire. Patients were questioned about PROs for toxicity, subjective burden from side effects, and were asked for the survival threshold necessary for them to repeat CTx. Expected survival (sum of indicated survival threshold and median survival time with best supportive care) was compared to the patients’ actual survival. One hundred and thirty-four patients (CRC: 58; non-CRC: 76) were surveyed. The most frequent PRO- grade 3/4 toxicities were acne (12.8%), fatigue (9.0%), and diarrhea (8.5%). The symptom causing the highest subjective burden was fatigue and was worse than expected in 29.9% of the patients. The median survival threshold for which patients would repeat CTx was significantly longer in CRC than in non-CRC patients (p=0.01). Median expected survival was significantly longer than actual median survival (CRC: 44.0 months [22.0-65.9] compared with 30.0 months of actual survival [20.9-39.1]; non-CRC: 22.0 months [15.3-28.6] compared with 19.0 months of actual survival [15.1-22.9], p=0.03). Fatigue deserves more attention when toxicity of treatment and symptoms of disease are explained to patients. Patients’ survival expectations from palliative chemotherapy are higher than previously described, exceed the median survival time known from phase III trials, and are significantly longer than their actual survival

  11. Assessment of the Radiation-Equivalent of Chemotherapy Contributions in 1-Phase Radio-chemotherapy Treatment of Muscle-Invasive Bladder Cancer

    International Nuclear Information System (INIS)

    Purpose: To estimate the radiation equivalent of the chemotherapy contribution to observed complete response rates in published results of 1-phase radio-chemotherapy of muscle-invasive bladder cancer. Methods and Materials: A standard logistic dose–response curve was fitted to data from radiation therapy-alone trials and then used as the platform from which to quantify the chemotherapy contribution in 1-phase radio-chemotherapy trials. Two possible mechanisms of chemotherapy effect were assumed (1) a fixed radiation-independent contribution to local control; or (2) a fixed degree of chemotherapy-induced radiosensitization. A combination of both mechanisms was also considered. Results: The respective best-fit values of the independent chemotherapy-induced complete response (CCR) and radiosensitization (s) coefficients were 0.40 (95% confidence interval −0.07 to 0.87) and 1.30 (95% confidence interval 0.86-1.70). Independent chemotherapy effect was slightly favored by the analysis, and the derived CCR value was consistent with reports of pathologic complete response rates seen in neoadjuvant chemotherapy-alone treatments of muscle-invasive bladder cancer. The radiation equivalent of the CCR was 36.3 Gy. Conclusion: Although the data points in the analyzed radio-chemotherapy studies are widely dispersed (largely on account of the diverse range of chemotherapy schedules used), it is nonetheless possible to fit plausible-looking response curves. The methodology used here is based on a standard technique for analyzing dose-response in radiation therapy-alone studies and is capable of application to other mixed-modality treatment combinations involving radiation therapy

  12. Volumetric Cerebral Perfusion Imaging in Healthy Adults: Regional Distribution, Laterality, and Repeatability of Pulsed Continuous Arterial Spin Labeling (PCASL)

    OpenAIRE

    Pfefferbaum, Adolf; Chanraud, Sandra; Pitel, Anne-Lise; Shankaranarayanan, Ajit; Alsop, David C.; Rohlfing, Torsten; Edith V. Sullivan

    2010-01-01

    The regional distribution, laterality, and reliability of volumetric pulsed continuous arterial spin labeling (PCASL) measurements of cerebral blood flow (CBF) in cortical, subcortical, and cerebellar regions were determined in 10 normal volunteers studied on two occasions separated by 3 to 7 days. Regional CBF, normalized for global perfusion, was highly reliable when measured on separate days. Several regions showed significant lateral asymmetry; notably, in frontal regions CBF was greater ...

  13. Role of Postmastectomy Radiation After Neoadjuvant Chemotherapy in Stage II-III Breast Cancer

    International Nuclear Information System (INIS)

    Purpose: To identify a cohort of women treated with neoadjuvant chemotherapy and mastectomy for whom postmastectomy radiation therapy (PMRT) may be omitted according to the projected risk of local-regional failure (LRF). Methods and Materials: Seven breast cancer physicians from University of California cancer centers created 14 hypothetical clinical case scenarios, identified, reviewed, and abstracted the available literature (MEDLINE and Cochrane databases), and formulated evidence tables with endpoints of LRF, disease-free survival, and overall survival. Using the American College of Radiology appropriateness criteria methodology, appropriateness ratings for postmastectomy radiation were assigned for each scenario. Finally, an overall summary risk assessment table was developed. Results: Of 24 sources identified, 23 were retrospective studies from single institutions. Consensus on the appropriateness rating, defined as 80% agreement in a category, was achieved for 86% of the cases. Distinct LRF risk categories emerged. Clinical stage II (T1-2N0-1) patients, aged >40 years, estrogen receptor-positive subtype, with pathologic complete response or 0-3 positive nodes without lymphovascular invasion or extracapsular extension, were identified as having ≤10% risk of LRF without radiation. Limited data support stage IIIA patients with pathologic complete response as being low risk. Conclusions: In the absence of randomized trial results, existing data can be used to guide the use of PMRT in the neoadjuvant chemotherapy setting. Using available studies to inform appropriateness ratings for clinical scenarios, we found a high concordance of treatment recommendations for PMRT and were able to identify a cohort of women with a low risk of LRF without radiation. These low-risk patients will form the basis for future planned studies within University of California Athena Breast Health Network.

  14. Impact of group psychotherapy in chemotherapy induced vomiting for treatment of advanced breast and lungs cancer

    International Nuclear Information System (INIS)

    To assess the effect of group psychotherapy in the management of the side effects of chemotherapy treatment in advanced breast and lung cancer. One hundred patients treated with chemotherapy for advanced stage (IIIB and IV) breast and lung cancer were selected with ECOG performance status of 0 or 1. All patients received anti-emetic medications half an hour before chemotherapy. All those patients in this category who completed fist line chemotherapy with 6 cycles were included. Fifty were subjected to group discussions with other patients, family members and medical staff. This was labeled group A. The other 50 were not included in group discussion and were labeled group B. Both the group received similar standard chemotherapy and pre-medication for vomiting as per their disease and chemotherapy schedule. Breast and lung cancer patients were 29 and 21 in each arm respectively. At the end of the discharge, grade 2 and above of vomiting, according to common terminology criteria for adverse events (CTCAE) was counted for all patients in both the arms A and B, over full length of treatment for 6 cycles, and then were compared statistically. Mean with standard deviation for adverse event (vomiting) in group A and B was 6.2 + 2.6 and 13.4 + 3.8 respectively per cycle of treatment. It was observed that group psychotherapy had statistically significant effect (p-value <0.05) on the management of vomiting. Group psychotherapy can be used to reduce the incidence of vomiting in advanced breast and lung cancer patients treated with chemotherapy. (author)

  15. SEOM clinical guidelines for the treatment of antiemetic prophylaxis in cancer patients receiving chemotherapy.

    Science.gov (United States)

    García Gómez, Jesús; Pérez López, M Eva; García Mata, Jesús; Isla Casado, Dolores

    2010-11-01

    Chemotherapy-induced emesis is one of the most frequent side effects that affect the quality of life of cancer patients undergoing chemotherapy. In recent years, clinical research has allowed us to increase our therapeutic arsenal with new drugs that have increased efficiency in the control of nausea and vomiting associated with chemo. This guide provides and update of the earlier published by our society and represents the continued commitment of SEOM to move forward and improve in the supportive care of cancer patients. PMID:20974571

  16. Is it possible to define an optimal time for chemotherapy after surgery for ovarian cancer?

    DEFF Research Database (Denmark)

    Lydiksen, L; Christensen, Lisbeth Lydiksen; Jensen-Fangel, S;

    2014-01-01

    OBJECTIVE: The aims of this study are to investigate the actual time from primary surgery for epithelial ovarian cancer (OC) to initiation of chemotherapy (TI) amongst Danish women in 2005-2006, and to compare the survival for groups with early initiation (≤median TI) and late initiation of...... adjuvant chemotherapy (>median TI). METHODS: All Danish women who underwent surgery for OC in the period 1 January 2005 to 31 December 2006 and recorded in the Danish Gynaecological Cancer Database (DGCD) were included. The five-year survival was estimated overall and by TI exposure. The Cox proportional...

  17. Improved survival with early adjuvant chemotherapy after colonic resection for stage III colonic cancer

    DEFF Research Database (Denmark)

    Klein, Mads; Azaquoun, Najah; Jensen, Benny Vittrup;

    2015-01-01

    BACKGROUND AND OBJECTIVES: In stage III colonic cancer, time from surgery to start of adjuvant chemotherapy may influence survival. In this study, we evaluated the effect of timing of adjuvant therapy on survival. METHODS: Database study from the Danish Colorectal Cancer Group's national database....... RESULTS: The final population included 1,827 patients scheduled for adjuvant chemotherapy. Adjuvant therapy started within 4 and 8 weeks improved survival when compared to start later than 8 weeks (HR [95%CI]: 1.7 [1.1-2.6]; P = 0.024 and 1.4 [1.07-1.8]; P = 0.013, respectively), whereas there was no...

  18. Chemotherapy and Targeted Therapy for Gall Bladder Cancer

    OpenAIRE

    Sirohi, Bhawna; Singh, Ashish; Jagannath, P.; Shrikhande, Shailesh V.

    2014-01-01

    Gall bladder cancer is a common cancer in the Ganges belt of North-eastern India. In view of incidental diagnosis of gall bladder cancer by physicians and surgeons, the treatment is not optimised. Most patients present in advanced stages and surgery remains the only option to cure. This review highlights the current evidence in advances in systemic therapy of gall bladder cancer.

  19. The role of neoadjuvant chemotherapy in the management of locally advanced cervix cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Mohammed Osman

    2014-09-01

    Full Text Available Cervical cancer is the second most common cancer in women. Neoadjuvant chemotherapy for patients with locally advanced cervix cancer has comparable benefits to concurrent chemoradiotherapy (CCRT, but with fewer side effects. This systematic review aims to provide a comprehensive summary of the benefits of neoadjuvant chemotherapy for the management of locally advanced cervix cancer from stage IB2 (tumor >4.0 cm to IIIB (tumor extending to the pelvic wall and/or hydronephrosis. Our primary objective was to assess benefits in terms of survival. The data source included the USA national library of medicine, Medline search, and the National Cancer Institute PDQ Clinical Protocols. Inclusion criteria for consideration in the current systematic review included studies published between January 1997 and December 2012. In terms of histology, they had to be focused on squamous cell carcinoma, adenosquamous carcinoma, and/or adenocarcinoma. Patients should be either chemotherapy naïve or cervix cancer chemotherapy naïve, and have a performance status ≤2. The search in the above-mentioned scientific websites led to identify 49 publications, 19 of which were excluded, as they did not meet the inclusion criteria of this systematic review. Therefore only 30 studies were deemed eligible. Data was collected from 1760 patients enrolled in the current systematic review study. The mean age was 45.2 years. The mean tumor size was 4.7 cm. The most commonly used chemotherapies were cisplatin doublets. Paclitaxel was the most commonly used chemotherapeutic agent in the doublets. The mean chemotherapy cycles were 2.7. After chemotherapy, patients underwent surgery after a mean time of 2.5 weeks. The standard operation was radical hysterectomy with pelvic lymphadenectomy. Chemotherapy achieved an objective response rate of 84%. The 5-year progression-free survival and overall survival were 61.9% and 72.8% respectively. The treatment protocol was associated

  20. Phytochemicals that counteract the cardiotoxic side effects of cancer chemotherapy

    Directory of Open Access Journals (Sweden)

    Anita Piasek

    2009-04-01

    Full Text Available Almost all clinically used antitumor drugs exhibit toxic side effects affecting heart function. Because of cardiotoxicity during anticancer chemotherapy, effective doses of cytostatics have to be limited, which may worsen antitumor efficacy. The cardiotoxicity induced by cytostatics of the anthracycline group in particular results, among others, from massive stimulation of ROS. It has therefore been suggested that some phytochemicals with high antioxidant potential, when administered together with antitumor agents, could decrease the toxic side effects of chemotherapy and reduce the risk of heart failure. This review summarizes findings of studies undertaken to identify edible plants or phytochemicals isolated from them displaying cardioprotective properties during chemotherapy. Such properties have been shown for such foods as grapes, garlic, tomato, spinach, and beetroot. A protective role on the heart is also displayed by melatonin (a hormone synthesized by the pineal gland, but also present in many edible plants, chalcones (precursors of all known flavonoids, some herbal dietary supplements, vitamins A, C, and E, selenium, and semisynthetic flavonoid 7-monohydroxyethylrutoside (monoHER. Although to date only a limited number of investigations have been carried out, their results suggest that dietary intervention with antioxidants found in edible plants may be a safe and effective way of alleviating the toxicity of anticancer chemotherapy and preventing heart failure.

  1. In vivo intratumor angiogenic treatment effects during taxane-based neoadjuvant chemotherapy of ovarian cancer

    International Nuclear Information System (INIS)

    The aim of our study was to analyze the effect of taxane-based chemotherapy on tumor angiogenesis in patients with advanced epithelial ovarian cancer. Within a prospective phase II trial, 32 patients with stage IIIC and IV ovarian cancer were treated with either two or three cycles of neoadjuvant chemotherapy prior to cytoreductive surgery. Carboplatin (AUC5) and docetaxel (75 mg/m2) were administered intravenously in a 3-weekly schedule. Changes in intratumor microvessel density (MVD) were assessed with immunohistochemistry by staining pre- and posttreatment surgical tumor specimens with panendothelial, neovascular and lymphatic vessel markers. Mean values of MVD defined by CD31, CD34, CD105 and D2-40 antibodies showed 12.3, 21.0, 2.7 and 3.1 vessels per high power field (HPF) before chemotherapy and increased after treatment to 15.3, 21.8, 4.8 and 3.6 per HPF, respectively. These changes were significant for CD31 (p = 0.04) and for CD105 (p = 0.02). Taxane-based chemotherapy appears to promote tumor vascularization when administered every 3 weeks. A possible explanation is the secondary recovery of MVD in response to immediate cytotoxic and antiangiogenic effects of the chemotherapy. If confirmed prospectively, these findings favor shorter treatment intervals of taxane-based chemotherapy to counteract proangiogenic recovery

  2. New Treatment on Bone Marrow Suppress after Chemotherapy of Female Genitalia Cancer

    Institute of Scientific and Technical Information of China (English)

    WU Yuepeng; MEI Zhuoxian; HE Ke; CHEN Wei

    2002-01-01

    Objective This study is to find valid medication to improve the condition of bone marrow suppress in a short period of time after chemotherapy of female genitalia cancer and to create a condition for second - time chemotherapy. Method Thirty- five cases using rhG- CSF were included in the experiment group while cases without rhG - CSF were set as control group. The wbc level in two groups are compared. Result The comparison shows that wbc resumes normal within 22 days in the experiment group while 35 days in the control group. The duration is 13 days less in the experiment group than the control group. From the 21st day after chemotherapy, patients in the experiment group need 2.5 days before another chemotherapy while 12 days for the control group. The average account of wbc in the experiment group is 9.5 × 109/L while 6.2 × 109/L in the control group. The variation in the comparison of 3 groups of data is statistically significant (P < 0.05). Conclusion The above results show that rhG - CSF has positive efficacy on the treatment of bone marrow suppress after chemotherapy of female genitalia cancer and helps the regular chemotherapy proceed smoothly.

  3. Cytotoxic chemotherapy in the contemporary management of metastatic castration-resistant prostate cancer (mCRPC).

    Science.gov (United States)

    Sonpavde, Guru; Wang, Christopher G; Galsky, Matthew D; Oh, William K; Armstrong, Andrew J

    2015-07-01

    For several years, docetaxel was the only treatment shown to improve survival of patients with metastatic castration-resistant prostate cancer (mCRPC). There are now several novel agents available, although chemotherapy with docetaxel and cabazitaxel continues to play an important role. However, the increasing number of available agents will inevitably affect the timing of chemotherapy and therefore it may be important to offer this approach before declining performance status renders patients ineligible for chemotherapy. Patient selection is also important to optimise treatment benefit. The role of predictive biomarkers has assumed greater importance due to the development of multiple agents and resistance to available agents. In addition, the optimal sequence of treatments remains undefined and requires further study in order to maximize long-term outcomes. We provide an overview of the clinical data supporting the role of chemotherapy in the treatment of mCRPC and the emerging role in metastatic castration-sensitive prostate cancer. We review the key issues in the management of patients including selection of patients for chemotherapy, when to start chemotherapy, and how best to sequence treatments to maximise outcomes. In addition, we briefly summarise the promising new chemotherapeutic agents in development in the context of emerging therapies. PMID:25046451

  4. Factors that affect response to chemotherapy and survival of patients with advanced head and neck cancer.

    Science.gov (United States)

    Amer, M H; Al-Sarraf, M; Vaitkevicius, V K

    1979-06-01

    A review of 164 patients with far advanced head and neck cancer, treated by a cytotoxic chemotherapy over a ten year period, at WAyne State University, Detroit, Michigan, was done in an attempt to determine factors that may influence the response to chemotherapy and subsequent survival. Response rate to methotrexate was 28%, 5-FU 31%, and porfiromycin 13%. Improved responses were noted with combination chemotherapy. Patients who failed to first line therapy rarely responded to other single agent or combination chemotherapy. Those who did not have prior surgery and/or radiotherapy had better results from drug therapy. Patients with good performance status at the time of initial chemotherapy, had better response to treatment (32% vs. 13% PR & CR) and longer survival (28 weeks vs. 9 weeks, p = 0.01) when compared to those with poor status. Patients who responded to chemotherapy have better survival compared to nonresponders (29 weeks vs. 16 weeks, p = 0.002). This information may prove helpful in future planning of multidisciplinary approach in the treatment of patients with head and neck cancer. PMID:455217

  5. Tolerability of chemotherapy in HIV-infected women with breast cancer: are there prognostic implications?

    Science.gov (United States)

    Parameswaran, Lalitha; Taur, Ying; Shah, Monika K; Traina, Tiffany A; Seo, Susan K

    2014-07-01

    Breast cancer is the most commonly diagnosed malignancy in women, but little is known about therapeutic outcomes in patients with both breast cancer and HIV. We performed a retrospective cohort study of women with or without HIV undergoing treatment for breast cancer from 1996 to 2011. Cases with HIV were 1:2 matched to non-HIV controls based on age, sex, race, and date of cancer diagnosis. Dose reduction and/or delay during chemotherapy, overall survival, and development of metastatic disease were studied outcomes. 156 (52 HIV, 104 non-HIV) subjects were analyzed. The majority of breast cancers in both groups were clinical stages 0, I, II, and III (73%). HIV infection preceded cancer diagnosis by a median of 13 years. Median CD4 count at time of cancer diagnosis was 417 cells/mcL. Approximately 87% (45/52) were on HAART, mostly protease inhibitor-based (57%) therapy. HIV-infected women needed more dose reductions and/or delays to chemotherapy due to toxicity (56% vs. 30%; p=0.03). Stage at diagnosis, triple negative receptor status, and dose reduction and/or delay were predictors of metastatic disease and death. HIV-infected women experienced more adverse events during breast cancer treatment, and a potential causative factor could be drug-drug interactions between HAART and chemotherapy. PMID:24839993

  6. 晚期胃癌姑息性术后血管介入性灌注化疗联合静脉化疗与单纯静脉化疗效果分析%The Analysis of Vascular Interventional Perfusion Chemotherapy Combined with Intravenous Chemotherapy and Pure Intravenous Chemotherapy after Palliative Operation of Patients with Advanced Gastric Carcinoma

    Institute of Scientific and Technical Information of China (English)

    李永标

    2011-01-01

    目的:探讨晚期胃癌姑息性术后血管介入性灌注化疗联合静脉化疗的临床疗效.方法:回顾性分析37例胃癌姑息性术后血管介入性灌注化疗联合静脉化疗(观察组)和26例单纯静脉化疗(对照组)的临床病理资料,比较两组之间的临床疗效.结果:观察组化疗有效率为81.1% (30/37),对照组化疗有效率为53.8% (14/26),两组之间疗效比较具有统计学意义(P<0.05).两组之间化疗反应比较没有显著性差异(P>0.05).观察组1年及3年生存率分别为86.5%和35.1%;对照组1年及3年生存率分别为57.7%和19.2%,两组之间比较差异具有统计学意义(P<0.0l).结论:晚期胃癌姑息性术后血管介入性灌注化疗联合静脉化疗的临床疗效显著优于单纯静脉化疗,值得在临床上推广应用.%Objective: Discuss the clinical effect of vascular interventional perfusion chemotherapy combined with intravenous chemotherapy after palliative operation for patients with advanced gastric carcinoma. Method: 37 cases treated with vascular interventional perfusion chemotherapy combined with intravenous chemotherapy after palliative operation for patients with advanced gastric carcinoma were taken as the group of observation. And 26 cases treated with pure intravenous chemotherapy were taken as the group of control. The two groups were analyzed through review and compared in their clinical effects. Result: Effectiveness ratio of chemotherapy for the group of observation reached 81.1 % ( 30/37) and that of the group of control reached 53. 8 % ( 14/26). Comparison in curative effects of the two groups was of statistical significance (P <0. 05). No significant difference was found in the chemotherapy reaction between the two groups (P>0. 05). One-year and three-year survival rates for the group of observation were 86. 5% and 35. 1% respectively, and those for the group of control were 57. 7% and 19. 2% respectively. The comparison between the

  7. Peri-operative chemotherapy in the management of resectable colorectal cancer pulmonary metastases

    International Nuclear Information System (INIS)

    Surgery is often advocated in patients with resectable pulmonary metastases from colorectal cancer (CRC). Our study aims to evaluate peri-operative chemotherapy in patients with metastastic CRC undergoing pulmonary metastasectomy. Patients treated for CRC who underwent pulmonary metastasectomy by a single surgeon were identified. Outcome measures included survival, peri-operative complications, radiological and histological evidence of chemotherapy-induced lung toxicities. Between 1997 and 2009, 51 eligible patients were identified undergoing a total of 72 pulmonary resections. Thirty-eight patients received peri-operative chemotherapy, of whom 9 received an additional biological agent. Five-year overall survival rate was 72% in the whole cohort - 74% and 68% in those who received peri-operative chemotherapy (CS) and those who underwent surgery alone (S) respectively. Five-year relapse free survival rate was 31% in the whole cohort - 38% and ≤18% in CS and S groups respectively. Only 8% had disease progression during neoadjuvant chemotherapy. There were no post-operative deaths. Surgical complications occurred in only 4% of patients who received pre-operative chemotherapy. There was neither radiological nor histological evidence of lung toxicity in resected surgical specimens. Peri-operative chemotherapy can be safely delivered to CRC patients undergoing pulmonary metastasectomy. Survival in this selected group of patients was favourable

  8. Peri-operative chemotherapy in the management of resectable colorectal cancer pulmonary metastases

    Directory of Open Access Journals (Sweden)

    Hawkes Eliza A

    2012-08-01

    Full Text Available Abstract Background Surgery is often advocated in patients with resectable pulmonary metastases from colorectal cancer (CRC. Our study aims to evaluate peri-operative chemotherapy in patients with metastastic CRC undergoing pulmonary metastasectomy. Methods Patients treated for CRC who underwent pulmonary metastasectomy by a single surgeon were identified. Outcome measures included survival, peri-operative complications, radiological and histological evidence of chemotherapy-induced lung toxicities. Results Between 1997 and 2009, 51 eligible patients were identified undergoing a total of 72 pulmonary resections. Thirty-eight patients received peri-operative chemotherapy, of whom 9 received an additional biological agent. Five-year overall survival rate was 72% in the whole cohort - 74% and 68% in those who received peri-operative chemotherapy (CS and those who underwent surgery alone (S respectively. Five-year relapse free survival rate was 31% in the whole cohort - 38% and ≤18% in CS and S groups respectively. Only 8% had disease progression during neoadjuvant chemotherapy. There were no post-operative deaths. Surgical complications occurred in only 4% of patients who received pre-operative chemotherapy. There was neither radiological nor histological evidence of lung toxicity in resected surgical specimens. Conclusions Peri-operative chemotherapy can be safely delivered to CRC patients undergoing pulmonary metastasectomy. Survival in this selected group of patients was favourable.

  9. Paeonol Protects Rat Heart by Improving Regional Blood Perfusion during No-Reflow.

    Science.gov (United States)

    Ma, Lina; Chuang, Chia-Chen; Weng, Weiliang; Zhao, Le; Zheng, Yongqiu; Zhang, Jinyan; Zuo, Li

    2016-01-01

    No-reflow phenomenon, defined as inadequate perfusion of myocardium without evident artery obstruction, occurs at a high incidence after coronary revascularization. The mechanisms underlying no-reflow is only partially understood. It is commonly caused by the swelling of endothelial cells, neutrophil accumulation, and vasoconstriction, which are all related to acute inflammation. Persistent no-reflow can lead to hospitalization and mortality. However, an effective preventive intervention has not yet been established. We have previously found that paeonol, an active extraction from the root of Paeonia suffruticosa, can benefit the heart function by inhibiting tissue damage after ischemia, reducing inflammation, and inducing vasodilatation. To further investigate the potential cardioprotective action of paeonol on no-reflow, healthy male Wistar rats were randomly divided into four groups: sham, ischemia-reperfusion (I/R) injury (left anterior descending coronary artery was ligated for 4 h followed by reperfusion for 8 h), and I/R injury pretreated with paeonol at two different doses. Real-time myocardial contrast echocardiography was used to monitor regional blood perfusion and cardiac functions. Our data indicated that paeonol treatment significantly reduces myocardial infarct area and no-reflow area (n = 8; p lactate dehydrogenase, creatine kinase, cardiac troponin T, and C-reactive protein, as indices of myocardial injury. Paeonol exerts beneficial effects on attenuating I/R-associated no-reflow injuries, and may be considered as a potential preventive treatment for cardiac diseases or post-coronary revascularization in which no-reflow often occurs. PMID:27493631

  10. Change in bone mineral density during adjuvant chemotherapy for early-stage breast cancer

    DEFF Research Database (Denmark)

    Christensen, Carina Ørts; Cronin-Fenton, Deirdre; Frøslev, Trine;

    2016-01-01

    PURPOSE: Adjuvant chemotherapy has been associated with loss of bone mineral density (BMD) either as a direct effect or due to glucocorticoids used as supportive care medication. A prospective cohort study was conducted to evaluate changes in BMD from baseline to right after completion of...... chemotherapy, i.e., 4 months. METHODS: Dual-imaging X-ray absorptiometry (DXA) was performed at baseline and after completing anthracycline- and taxane-based chemotherapy to measure BMD in the spine, hip, and forearm in early-stage breast cancer patients. High-dose prednisolone was used at three weekly...... % CI -3.3; -0.1, p = 0.04) compared to never/former smokers. CONCLUSIONS: Adjuvant chemotherapy supplemented with prednisolone was not associated with loss of BMD. Postmenopausal women gained bone mass, whereas current smokers lost bone mass....

  11. Induction Chemotherapy in Locally Advanced Pharyngolaryngeal Cancers with Stridor: Is It Feasible and Safe?

    Directory of Open Access Journals (Sweden)

    Vijay Maruti Patil

    2012-01-01

    Full Text Available Background. The standard initial management of patients with locally advanced pharyngolaryngeal presenting with stridor is tracheostomy. Tracheostomy has been shown to negatively impact cancer-related outcomes. Methods. Retrospective analysis of prospectively collected data of 9 patients, who underwent induction chemotherapy with the aim of prevention of tracheostomy. Presenting features, time to resolution of stridor, and further management are reported. Results. Eight out of 9 patient received chemotherapy within 12 hours of presentation with stridor. There were 4 patients each with primary hypopharynx and larynx. The stage was IVA in 6 patients and IVB in 2 patients. In all patients receiving immediate chemotherapy, clinical stridor resolved within 48 hours. The radiological response rate was 62.5%. The median reduction in size of tumor was 37%. Conclusion. Immediate neoadjuvant chemotherapy is a feasible and safe option for patients presenting with early stridor and helps in resolution of stridor and avoiding tracheostomy.

  12. Neoadjuvant chemotherapy in patients with stages Ⅱ and Ⅲ breast cancer

    Institute of Scientific and Technical Information of China (English)

    YUAN Zhu; QU Xiang; ZHANG Zhong-tao; WANG Yu

    2009-01-01

    Background Neoadjuvant chemotherapy has been used as a primary treatment for locally advanced or inflammatory breast cancer, and recently extended to operable breast cancer. However, only a few studies have published data concerning the outcomes of patients with stages Ⅱ and Ⅲ breast cancer after neoadjuvant chemotherapy. Methods This study retrospectively investigated the clinical value of neoadjuvant chemotherapy for patients with stages Ⅱ and Ⅲ breast cancer. The patients in Group 1 (n=54) were treated with neoadjuvant chemotherapy, followed by definitive surgery and adjuvant therapy. The patients in Group 2 (n=43) initially received definitive surgery, followed by adjuvant chemotherapy and other therapies. The operability rates for breast conservation and dermatoplasty were observed in Group 1 after neoadjuvant chemotherapy. After follow-up, the recurrence and overall and disease-free survival rates of the two groups were analyzed.Results Neoadjuvant chemotherapy increased the operability rates for breast conservation from 17.1% to 40.0% in stage Ⅱ (P=0.034) and 0% to 12.6% in stage Ⅲ (P=0.016), and decreased the dermatoplasty rates from 17.1% to 2.8% in stage Ⅱ (P=0.046) and 28.1% to 8.1% in stage Ⅲ (P=0.026). After a median follow-up of 46.8 months, there were 11 deaths and 13 recurrences in Group 1, and 15 deaths and 19 recurrences in Group 2. The overall and disease-free survival rates of stage Ⅲ disease were significantly higher in Group 1 than in Group 2 (68.4% vs 31.2%, P=0.028, and 63.2% vs 25.0%, P=0.024, respectively). There were no significant differences in the overall and disease-free survival rates of stage Ⅱ disease for Group 1 compared with Group 2 (85.7% vs 85.2%, P=0.953, and 80.6% vs 74.1%, P=0.400, respectively).Conclusions Neoadjuvant chemotherapy resulted in increased operability for breast conservation and decreased dermatoplasty. Neoadjuvant chemotherapy exhibited better recurrence control, and overall and disease

  13. Relationship between Chemotherapy and Tamoxifen with Incidence of Fatty Liver in Women with Breast Cancer

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    Sh Keyhanian

    2013-08-01

    Full Text Available Introduction: Fatty liver disease is characterized by deposition of fat droplets in the liver of patients. According to some epidemiological studies; BMI, amount of fat intake from foods and high central fat are risk factors of breast cancer. This issue is one of the factors that cause high incidence of fatty liver in patients with breast cancer. Methods: In this cross-sectional descriptive study, all patients with breast cancer were evaluated who referred to Imam Sajjad hospital of Ramsar during 2008 - 2011. After initial review, 100 patients were enrolled. Those who were treated by chemotherapy underwent abdominal Sonography for evaluation of fatty liver. Also, those patients who also received tamoxifen in addition to chemotherapy, underwent abdominal ultrasonography 6 months after taking tamoxifen. After that, relationship between treatment of breast cancer and fatty liver in studied patients was evaluated based on obtained information. Results: The study results revealed that after chemotherapy, 30 (30% patients were reported to have fatty liver. Out of 70 people that after chemotherapy did not have fatty liver, 62 patients received tamoxifen; and after taking tamoxifen, 45.2% developed fatty liver. Using Chi Square test, there was a significant relationship between fatty liver after receiving tamoxifen, hyperlipidemia (p=0.011 and getting overweight (P =0.017. Conclusion: As the findings indicated, treatment of breast cancer especially with tamoxifen is associated with increased risk of fatty liver, especially in women who have hyperlipidemia and are overweight.

  14. Chemotherapy in heterogeneous cultures of cancer cells with interconversion

    International Nuclear Information System (INIS)

    Recently, the interconversion between differentiated and stem-like cancer cells has been observed. Here, we model the in vitro growth of heterogeneous cell cultures in the presence of interconversion from differentiated cancer cells to cancer stem cells (CSCs), showing that, by targeting only CSC with cytotoxic agents, it is not always possible to eradicate cancer. We have determined the kinetic conditions under which cytotoxic agents in in vitro heterogeneous cultures of cancer cells eradicate cancer. In particular, we have shown that the chemotherapeutic elimination of in vitro cultures of heterogeneous cancer cells is effective only if it targets all cancer cell types, and if the induced death rates for the different subpopulations of cancer cell types are large enough. The quantitative results of the model are compared and validated with experimental data. (paper)

  15. A target based approach identifies genomic predictors of breast cancer patient response to chemotherapy

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    Hallett Robin M

    2012-05-01

    Full Text Available Abstract Background The efficacy of chemotherapy regimens in breast cancer patients is variable and unpredictable. Whether individual patients either achieve long-term remission or suffer recurrence after therapy may be dictated by intrinsic properties of their breast tumors including genetic lesions and consequent aberrant transcriptional programs. Global gene expression profiling provides a powerful tool to identify such tumor-intrinsic transcriptional programs, whose analyses provide insight into the underlying biology of individual patient tumors. For example, multi-gene expression signatures have been identified that can predict the likelihood of disease reccurrence, and thus guide patient prognosis. Whereas such prognostic signatures are being introduced in the clinical setting, similar signatures that predict sensitivity or resistance to chemotherapy are not currently clinically available. Methods We used gene expression profiling to identify genes that were co-expressed with genes whose transcripts encode the protein targets of commonly used chemotherapeutic agents. Results Here, we present target based expression indices that predict breast tumor response to anthracycline and taxane based chemotherapy. Indeed, these signatures were independently predictive of chemotherapy response after adjusting for standard clinic-pathological variables such as age, grade, and estrogen receptor status in a cohort of 488 breast cancer patients treated with adriamycin and taxotere/taxol. Conclusions Importantly, our findings suggest the practicality of developing target based indices that predict response to therapeutics, as well as highlight the possibility of using gene signatures to guide the use of chemotherapy during treatment of breast cancer patients.

  16. Isolated lung perfusion as an adjuvant treatment of colorectal cancer lung metastases: a preclinical study in a pig model.

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    Pierre-Benoit Pagès

    Full Text Available BACKGROUND: The lung is a frequent site of colorectal cancer (CRC metastases. After surgical resection, lung metastases recurrences have been related to the presence of micrometastases, potentially accessible to a high dose chemotherapy administered via adjuvant isolated lung perfusion (ILP. We sought to determine in vitro the most efficient drug when administered to CRC cell lines during a short exposure and in vivo its immediate and delayed tolerance when administered via ILP. METHODS: First, efficacy of various cytotoxic molecules against a panel of human CRC cell lines was tested in vitro using cytotoxic assay after a 30-minute exposure. Then, early (operative and delayed (1 month tolerance of two concentrations of the molecule administered via ILP was tested on 19 adult pigs using hemodynamic, biological and histological criteria. RESULTS: In vitro, gemcitabine (GEM was the most efficient drug against selected CRC cell lines. In vivo, GEM was administered via ILP at regular (20 µg/ml or high (100 µg/ml concentrations. GEM administration was associated with transient and dose-dependant pulmonary vasoconstriction, leading to a voluntary decrease in pump inflow in order to maintain a stable pulmonary artery pressure. After this modulation, ILP using GEM was not associated with any systemic leak, systemic damage, and acute or delayed histological pulmonary toxicity. Pharmacokinetics studies revealed dose-dependant uptake associated with heterogenous distribution of the molecule into the lung parenchyma, and persistent cytotoxicity of venous effluent. CONCLUSIONS: GEM is effective against CRC cells even after a short exposure. ILP with GEM is a safe and reproducible technique.

  17. Effect of PEEP on regional ventilation and perfusion in the mechanically ventilated preterm lamb

    International Nuclear Information System (INIS)

    Improvement of gas exchange through closer matching of regional ventilation (V) and lung perfusion (Q) with the application of positive end-expiratory pressure (PEEP) was evaluated in vivo in six mechanically ventilated preterm lambs (107-126 days/145 days gestation). Changes in V and Q were determined from in vivo scintigraphic measurements in four lung regions with inhaled radioactive 81mKr, and infused 81mKr/dextrose and/or [99mTc]MAA as PEEP was applied at 2, 4, and 6 cm H2O in each animal. Dynamic compliance varied between 0.02 and 0.40 ml/cm H2O, which was consistent with surfactant deficiency. As PEEP was increased, the regional distribution of Q shifted from the rostral to the caudal lung regions (p less than 0.02 to less than 0.05), while that of V remained unchanged. Regional V/Q matching improved together with a trend towards improvement of arterial blood gases as PEEP was increased from 2 to 4 cm H2O. Pulmonary scintigraphy offers a noninvasive methodology for the quantitative assessment of regional V and Q matching in preterm lambs and may be clinically applicable to ventilated neonates

  18. Effect of PEEP on regional ventilation and perfusion in the mechanically ventilated preterm lamb

    Energy Technology Data Exchange (ETDEWEB)

    Schlessel, J.S.; Susskind, H.; Joel, D.D.; Bossuyt, A.; Harrold, W.H.; Zanzi, I.; Chanana, A.D. (Cornell Univ. Medical College, Manhasset, NY (USA))

    1989-08-01

    Improvement of gas exchange through closer matching of regional ventilation (V) and lung perfusion (Q) with the application of positive end-expiratory pressure (PEEP) was evaluated in vivo in six mechanically ventilated preterm lambs (107-126 days/145 days gestation). Changes in V and Q were determined from in vivo scintigraphic measurements in four lung regions with inhaled radioactive 81mKr, and infused {sup 81m}Kr/dextrose and/or ({sup 99m}Tc)MAA as PEEP was applied at 2, 4, and 6 cm H{sub 2}O in each animal. Dynamic compliance varied between 0.02 and 0.40 ml/cm H{sub 2}O, which was consistent with surfactant deficiency. As PEEP was increased, the regional distribution of Q shifted from the rostral to the caudal lung regions (p less than 0.02 to less than 0.05), while that of V remained unchanged. Regional V/Q matching improved together with a trend towards improvement of arterial blood gases as PEEP was increased from 2 to 4 cm H{sub 2}O. Pulmonary scintigraphy offers a noninvasive methodology for the quantitative assessment of regional V and Q matching in preterm lambs and may be clinically applicable to ventilated neonates.

  19. Therapeutic effect analysis of different neoadjuvant chemotherapy on the locally cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Mei-Ju Li

    2015-01-01

    Objective:To explore the therapeutic effect of different neoadjuvant chemotherapy on the locally cervical cancer.Methods:A total of 85 patients with cervical cancer for the initial treatment who were admitted in our hospital from January, 2011 to January, 2013 were included in the study and divided into the observation group and the control group according to different chemotherapy regimens. The way of drug administration is by transcatheter arterial chemoembolization (TACE). The patients in the observation group were given Taxol in combined with carboplatin for neoadjuvant chemotherapy, while the patients in the control group were given irinotecan in combined with carboplatin. The remission degree of clinical symptoms, chemotherapeutic effect, toxic and side effect, and operation evaluation 14 and 20 days after chemotherapy were evaluated.Results:The comparison of clinical symptom remission between the two groups was not statistically significant. The occurrence rate of myelosuppression in III-IV degree in the observation was significantly higher than that in the control group, but the occurrence rate of diarrhea was significantly lower than that in the control group. The comparisons of operation time and intraoperative amount of bleeding after chemotherapy between the two groups were not statistically significant. The comparisons of the occurrence rates of parametrial infiltration and lymphatic metastasis and the muscular layer invasion depth were not statistically significant.Conclusions:Arterial embolism neoadjuvant chemotherapy can obviously shorten the tumor volume in patients with local cervical cancer, relieve the clinical symptoms, and enhance the living qualities, but in the clinical application, appropriate chemotherapy regimen should be chosen according to the specific condition.

  20. Gene expression profile of residual breast cancer after doxorubicin and cyclophosphamide neoadjuvant chemotherapy.

    Science.gov (United States)

    Koike Folgueira, Maria Aparecida Azevedo; Brentani, Helena; Carraro, Dirce Maria; De Camargo Barros Filho, Mateus; Hirata Katayama, Maria Lucia; Santana de Abreu, Ana Paula; Mantovani Barbosa, Edson; De Oliveira, Célia Tosello; Patrão, Diogo F C; Mota, Louise D; Netto, Mario Mourão; Caldeira, José Roberto Figaro; Brentani, Maria Mitzi

    2009-10-01

    In breast cancer patients, primary chemotherapy is associated with the same survival benefits as adjuvant chemotherapy. Residual tumors represent a clinical challenge, as they may be resistant to additional cycles of the same drugs. Our aim was to identify differential transcripts expressed in residual tumors, after neoadjuvant chemotherapy, that might be related with tumor resistance. Hence, 16 patients with paired tumor samples, collected before and after treatment (4 cycles doxorubicin/cyclophosphamide, AC) had their gene expression evaluated on cDNA microarray slides containing 4,608 genes. Three hundred and eighty-nine genes were differentially expressed (paired Student's t-test, pFDR<0.01) between pre- and post-chemotherapy samples and among the regulated functions were the JNK cascade and cell death. Unsupervised hierarchical clustering identified one branch comprising exclusively, eight pre-chemotherapy samples and another branch, including the former correspondent eight post-chemotherapy samples and other 16 paired pre/post-chemotherapy samples. No differences in clinical and tumor parameters could explain this clustering. Another group of 11 patients with paired samples had expression of selected genes determined by real-time RT-PCR and CTGF and DUSP1 were confirmed more expressed in post- as compared to pre-chemotherapy samples. After neoadjuvant chemotherapy some residual samples may retain their molecular signature while others present significant changes in their gene expression, probably induced by the treatment. CTGF and DUSP1 overexpression in residual samples may be a reflection of resistance to further administration of AC regimen. PMID:19724859

  1. CEST-MRI detects metabolite levels altered by breast cancer cell aggressiveness and chemotherapy response.

    Science.gov (United States)

    Chan, Kannie W Y; Jiang, Lu; Cheng, Menglin; Wijnen, Jannie P; Liu, Guanshu; Huang, Peng; van Zijl, Peter C M; McMahon, Michael T; Glunde, Kristine

    2016-06-01

    Chemical exchange saturation transfer (CEST) is an MRI contrast mechanism that detects the exchange of protons from distinct hydroxyl, amine, and amide groups to tissue water through the transfer of signal loss, with repeated exchange enhancing their effective signal. We applied CEST to detect systematically 15 common cellular metabolites in a panel of differentially aggressive human breast cancer cell lines. The highest CEST contrast was generated by creatine, myo-inositol, glutamate, and glycerophosphocholine, whose cellular concentrations decreased with increasing breast cancer aggressiveness. These decreased metabolite concentrations resulted in turn in a decreased CEST profile with increasing breast cancer aggressiveness in water-soluble extracts of breast cell lines. Treatment of both breast cancer cell lines with the chemotherapy drug doxorubicin resulted in increased metabolic CEST profiles, which correlated with significant increases in creatine, phosphocreatine, and glycerophosphocholine. CEST can detect breast cancer aggressiveness and response to chemotherapy in water-soluble extracts of breast cell lines. The presented results help shed light on possible contributions from CEST-active metabolites to the CEST contrast produced by breast cancers. The metabolic CEST profile may improve detection sensitivity over conventional MRS, and may have the potential to assess breast cancer aggressiveness and response to chemotherapy non-invasively using MRI if specialized metabolic CEST profile detection can be realized in vivo. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27100284

  2. Induction chemotherapy and radiotherapy in loco-regionally advanced epidermoid carcinoma of the anal canal

    International Nuclear Information System (INIS)

    OBJECTIVE: To evaluate the treatment results of induction chemotherapy (IC) with carboplatin + 5-FU in combination with curatively intended external beam radiotherapy (RT). MATERIALS AND METHODS: Thirty-two patients diagnosed during the period 1989 - 1994 with loco-regionally advanced cancer of the anal (PHI Tmax≥4 cm or T4 or N+) were treated with IC consisting of one to three courses of carboplatin (300 - 375 mg/m2 i.v.) and 5-fluorouracil [5,000 mg/(m2x120 h) i.v.] followed by RT ± surgery. Treatment results have been analyzed and retrospectively compared to those for 17 patients fulfilling the same disease criteria but treated according to the Swedish National Care Program for Anal Carcinoma during the period 1985 - 1991. Differences in proportions were tested with Fisher's exact test. Kaplan-Meier life table analysis and the Wilcoxon-Peto test statistic were used in the univariate analyses of longitudinal follow-up data. Cox regression analysis was used for the multivariate analyses. RESULTS: The IC regimen is well tolerated. The most common side effects are oral mucositis, gastro-intestinal symptoms with diarrhoea, haematological toxicity, and general fatigue. The treatment results appear promising. A greater proportion of the patients in the IC + RT group were tumor free at conclusion of the primary therapy ((30(32)) vs (10(17)); P = .02). Statistically significant differences in favor of the induction therapy regimen were also found in the Kaplan-Meier analyses for preservation of sphincter (65% vs 46% at 5 years; P = .02), for probability of survival with a preserved sphincter (52 % vs 33 % at 5 years, P = .02), and freedom from recurrence (76 % vs 35 % at 5 years; P = .003). No difference was found with respect to overall survival (66 % vs 59 % at 5 years, P = .8) and tumor specific survival (80 % vs 63 % at 5 years, P = .3). The multivariate Cox regression analyses yielded a significant result in favor of the new regimen with respect to risk for

  3. l-Cystine-Crosslinked Polypeptide Nanogel as a Reduction-Responsive Excipient for Prostate Cancer Chemotherapy

    Directory of Open Access Journals (Sweden)

    Liang He

    2016-01-01

    Full Text Available Smart polymer nanogel-assisted drug delivery systems have attracted more and more attention in cancer chemotherapy because of their well-defined morphologies and pleiotropic functions in recent years. In this work, an l-cystine-crosslinked reduction-responsive polypeptide nanogel of methoxy poly(ethylene glycol-poly(l-phenylalanine-co-l-cystine (mPEG-P(LP-co-LC was employed as a smart excipient for RM-1 prostate cancer (PCa chemotherapy. Doxorubicin (DOX, as a regular chemotherapy drug, was embedded in the nanogel. The loading nanogel marked as NG/DOX was shown to exhibit glutathione (GSH-induced swelling and GSH-accelerated DOX release. Subsequently, NG/DOX showed efficient cellular uptake and proliferation inhibition. Furthermore, NG/DOX presented enhanced antitumor efficacy and security in an RM-1 PCa-grafted mouse model in vivo, indicating its great potential for clinical treatment.

  4. Chemotherapy principles of managing stage IV breast cancer in the United States.

    Science.gov (United States)

    Hernandez-Aya, Leonel F; Ma, Cynthia X

    2016-06-01

    The therapeutic landscape for metastatic breast cancer (MBC) has expanded greatly over the last three decades with an increasing availability of targeted therapies for specific breast cancer subtypes. However, cytotoxic chemotherapy remains an essential component for the management of endocrine refractory or triple negative MBC. Multiple chemotherapy agents have demonstrated activity in MBC as single agents and in combination. While taxanes are frequently recommended as the initial treatment of metastatic disease, capecitabine is a convenient oral therapy with well received toxicity profile. Eribulin is the only agent that demonstrated overall survival (OS) benefit in a phase III clinical trial when compared to treatment of physician choice in heavily pre-treated patients. Ixabepilone, gemcitabine, vinorelbine and platinum agents have demonstrated activity and, therefore, constitute additional therapeutic options. In this review, we will discuss the data supporting the use of different cytotoxic agents and the general principles in guiding the use of chemotherapy. PMID:27164855

  5. Chemotherapy or Liver Transplantation for Nonresectable Liver Metastases From Colorectal Cancer?

    DEFF Research Database (Denmark)

    Dueland, Svein; Guren, Tormod K; Hagness, Morten;

    2015-01-01

    OBJECTIVE:: The primary objective was to compare overall survival (OS) in patients with colorectal cancer (CRC) with nonresectable liver-only metastases treated by liver transplantation or chemotherapy. BACKGROUND:: CRC is the third most common cancer worldwide. About 50% of patients will develop...... metastatic disease primarily to the liver and the lung. The majority of patients with liver metastases receive palliative chemotherapy, with a median OS of trial patients of about 2 years, and less than 10% are alive at 5 years. METHODS:: Patients with nonresectable liver-only CRC metastases underwent liver...... transplantation in the SECA study (n = 21). Disease-free survival (DFS) and OS of patients included in the SECA study were compared with progression-free survival (PFS) and OS in a similar cohort of CRC patients with liver-only disease included in a first-line chemotherapy study, the NORDIC VII study (n = 47...

  6. Effect of neoadjuvant chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion

    Institute of Scientific and Technical Information of China (English)

    Chen; Aiping; Ding; Zhaoxia; Xu; Bing; Zhao; Shuping; Dai; Shuzhen

    2007-01-01

    Objective:To evaluate the effect of preoperative chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion.Methods:Sixty two patients with bulky or locally advanced cervical cancer from 1999 to 2004 were underwent internal iliac arterial infusion chemotherapy by using Seldinger technique.Combined regimens were applied including cisplatin as the major drug.Two weeks later,all patients received radical hysterectomy.Results:The local tumor regression rate was 93.55%.Postoperative pathologic examination showed that no cervical tumor residue in stumps were found in 61 of 62 patients who underwent radical hysterectomy.Large quantity of necrotic tissue appeared on primary tumor.In 16 patients with positive lymph nodes,15 demonstrated necrotic lymph nodes.Conclusion:Internal iliac arterial infusion chemotherapy could effectively reduce tumor volume,increase surgical success rate and decrease lymph nodes and subclinical metastasis rates.

  7. A good molecular target for prostate cancer chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Sidney R Grimes

    2011-01-01

    @@ An exciting new basic medical research study shows that inhibition of the activity of the kinesin spindle protein Eg5 effectively blocks cell division and induces cell death in prostate cancer cells.1 The potent anticancer drug S-(methoxytrityl)-L-cysteine(S(MeO)TLC)spe-cifically blocks activity of Eg5 in prostate cancer cells, arrests cell division, induces cell death during mitosis and inhibits prostate cancer cells in a mouse model of prostate cancer.

  8. Phytochemicals that counteract the cardiotoxic side effects of cancer chemotherapy

    OpenAIRE

    Anita Piasek; Agnieszka Bartoszek; Jacek Namieśnik

    2009-01-01

    Almost all clinically used antitumor drugs exhibit toxic side effects affecting heart function. Because of cardiotoxicity during anticancer chemotherapy, effective doses of cytostatics have to be limited, which may worsen antitumor efficacy. The cardiotoxicity induced by cytostatics of the anthracycline group in particular results, among others, from massive stimulation of ROS. It has therefore been suggested that some phytochemicals with high antioxidant potential, when administered together...

  9. Quality of Life and Neutropenia in Patients with Early Stage Breast Cancer: A Randomized Pilot Study Comparing Additional Treatment with Mistletoe Extract to Chemotherapy Alone

    OpenAIRE

    Tröger, Wilfried; Jezdić, Svetlana; Ždrale, Zdravko; Tišma, Nevena; Hamre, Harald J; Matijašević, Miodrag

    2009-01-01

    Background: Chemotherapy for breast cancer often deteriorates quality of life, augments fatigue, and induces neutropenia. Mistletoe preparations are frequently used by cancer patients in Central Europe. Physicians have reported better quality of life in breast cancer patients additionally treated with mistletoe preparations during chemotherapy. Mistletoe preparations also have immunostimulant properties and might therefore have protective effects against chemotherapy-induced neutropenia. Pati...

  10. Quality of Life and Neutropenia in Patients with Early Stage Breast Cancer: A Randomized Pilot Study Comparing Additional Treatment with Mistletoe Extract to Chemotherapy Alone

    OpenAIRE

    Wilfried Tröger; Svetlana Jezdić; Zdravko Ždrale; Nevena Tišma; Hamre, Harald J; Miodrag Matijašević

    2009-01-01

    Background: Chemotherapy for breast cancer often deteriorates quality of life, augments fatigue, and induces neutropenia. Mistletoe preparations are frequently used by cancer patients in Central Europe. Physicians have reported better quality of life in breast cancer patients additionally treated with mistletoe preparations during chemotherapy. Mistletoe preparations also have immunostimulant properties and might therefore have protective effects against chemotherapy-induced neutropenia.Patie...

  11. The Utility of Proton Beam Therapy with Concurrent Chemotherapy for the Treatment of Esophageal Cancers

    Directory of Open Access Journals (Sweden)

    Steven H. Lin

    2011-10-01

    Full Text Available The standard of care for the management of locally advanced esophageal cancers in the United States is chemotherapy combined with radiation, either definitively, or for those who could tolerate surgery, preoperatively before esophagectomy. Although the appropriate radiation dose remains somewhat controversial, the quality of the radiation delivery is critical for the treatment of esophageal cancer since the esophagus is positioned close to vital structures, such as the heart and lung. The volume and relative doses to these normal tissues affect acute and late term complications. Advances in radiation delivery from 2D to 3D conformal radiation therapy, to Intensity Modulated Radiation Therapy (IMRT or charged particle therapy (carbon ion or proton beam therapy (PBT, allow incremental improvements in the therapeutic ratio. This could have implications in non-cancer related morbidity for long term survivors. This article reviews the evolution in radiation technologies and the use of PBT with chemotherapy in the management of esophageal cancer.

  12. The Utility of Proton Beam Therapy with Concurrent Chemotherapy for the Treatment of Esophageal Cancers

    International Nuclear Information System (INIS)

    The standard of care for the management of locally advanced esophageal cancers in the United States is chemotherapy combined with radiation, either definitively, or for those who could tolerate surgery, preoperatively before esophagectomy. Although the appropriate radiation dose remains somewhat controversial, the quality of the radiation delivery is critical for the treatment of esophageal cancer since the esophagus is positioned close to vital structures, such as the heart and lung. The volume and relative doses to these normal tissues affect acute and late term complications. Advances in radiation delivery from 2D to 3D conformal radiation therapy, to Intensity Modulated Radiation Therapy (IMRT) or charged particle therapy (carbon ion or proton beam therapy (PBT)), allow incremental improvements in the therapeutic ratio. This could have implications in non-cancer related morbidity for long term survivors. This article reviews the evolution in radiation technologies and the use of PBT with chemotherapy in the management of esophageal cancer

  13. Integrating Chemotherapy in the Management of Cervical Cancer: A Critical Appraisal.

    Science.gov (United States)

    Kumar, Lalit; Gupta, Sudeep

    2016-01-01

    The management of locally advanced cervix cancer has undergone a paradigm shift during the last decade. Concurrent chemoradiation (CCRT) (with cisplatin alone or in combination) is currently the standard treatment approach. CCRT results in a 5-year overall survival rate of 66% and a disease-free survival of 58%. About 30-40% of patients with locally advanced cervical cancer fail to achieve complete response to CCRT; alternative approaches are needed to improve the outcome for such patients. Weekly paclitaxel and carboplatin for 4-6 weeks as dose-dense chemotherapy prior to CCRT could be one such potential approach. The role of adjuvant chemotherapy after CCRT in patients with positive lymph nodes, larger tumor volume and stage III-IVA disease needs further exploration. Adjuvant chemotherapy is also being investigated for early-stage (stages IA2, IB1 or IIA) cervical cancer with presence of risk factors such as lymph node metastasis, lymphovascular space invasion and invasion depth of more than 10 mm, microscopic parametrial invasion, non-squamous histology and positive surgical margins. For patients with early-stage disease (IA2-IIA), short-course chemotherapy prior to surgery is associated with an improved outcome in many studies. Neo-adjuvant chemotherapy followed by fertility preservation surgery is feasible in carefully selected young patients with bulky stage IB1 disease. Recently, a number of molecular pathways have been identified as potential therapeutic targets. Bevacizumab - an inhibitor of vascular endothelial growth factor - is associated with improved survival in patients with recurrent/metastatic cervical cancer. Whether bevacizumab and other similar novel agents targeting molecular pathways could be used in front-line treatment along with cytotoxic chemotherapy is likely to be an area of research in future studies. PMID:27464068

  14. Locally advanced cervix cancer: chemotherapy prior to definitive surgery or radiotherapy. A single institutional experience

    International Nuclear Information System (INIS)

    Primary or neoadjuvant chemotherapy prior to definitive local therapy has potential advantages for locally advanced cervix cancer. It can down stage a cancer and allow definitive local therapy to be technically possible (surgery), or potentially more effective (radiotherapy). It can also eradicate subclinical systemic metastases. This report reviews a single institution's experience of neoadjuvant chemotherapy prior to definitive local therapy for cervix cancer over a 13-year period. One hundred and six patients were treated with this intent. The patients were analysed for their response to chemotherapy, treatment received, survival, relapse and toxicity. The chemotherapy was feasible and the majority of patients had a complete or partial response (58.5%). Eight patients did not proceed to local treatment. Forty-six patients had definitive surgery and 52 had definitive radiotherapy. The 5-year overall survival was 27% and the majority of patients died with disease. The first site of relapse was usually in the pelvis (46.2%). Late complications that required ongoing medical therapy (n = 6) or surgical intervention (n = 2) were recorded in eight patients (7.5%). On univariate analysis stage (P= 0.04), tumour size (P = 0.01), lymph node status (P=0.003), response to chemotherapy (P = 0.045) and treatment (P = 0.003) were all significant predictors of survival. On multivariate analysis, tumour size (P < 0.0001) and nodal status (P = 0.02) were significant predictors of survival. Despite the impressive responses to chemotherapy of advanced cervix cancer, there is evidence from randomized trials that it does not improve or compromise survival prior to radiotherapy. As its role prior to surgery remains unclear, it should not be used in this setting outside a prospective randomized trial. Copyright (2001) Blackwell Science Pty Ltd

  15. Paradox of wellness and nonadherence among Nigerian women on breast cancer chemotherapy

    Directory of Open Access Journals (Sweden)

    Adisa Adewale

    2008-01-01

    Full Text Available Context: Intentional nonadherence among cancer patients is rare and may occur only when the benefits of treatment are not obvious to the patient. Aims: To highlight a group of women on chemotherapy for breast cancer who defaulted from their medications because they were improving. Settings and Design: A study was carried out of the reasons for nonadherence to medications among women receiving chemotherapy for breast cancer at a Nigerian teaching hospital between January 1993 and December 2002. Materials and Methods: A retrospective review of patients′ records was done. Results: Of the 188 women who received chemotherapy during the study period, 152 (80.9% defaulted from treatment at one point or another. The reasons for nonadherence were available in 101 patients. Among these, 18 (18.0% reported nonadherence because they felt better after commencing chemotherapy. They were aged 31-50 years (Mean = 35.6 (SD3.2. Six (33.3% of them presented in AJCC Stage I, and 10 (55.6% in stage II. Age and disease stage at presentation were found to have significant influence on their reason for nonadherence. Of the nine women on neo-adjuvant chemotherapy, six (66.7% had complete response but defaulted and five (55.6% re-presented within a year with metastatic disease. Three of the patients receiving systemic post-surgery chemotherapy presented within a year with local recurrence. Most of the other patients were subsequently lost to follow-up. Conclusions: Nonadherence due to wellness among breast cancer patients is associated with poor outcome. We propose a detailed prospective study to establish factors that may influence such behavior.

  16. Regional comparison of cancer incidence

    International Nuclear Information System (INIS)

    Background. Due to specific war and post-war situation in Balkan region, differences in the number, type, development, biological course, treatment of malignant tumours and its outcome are possible. In order to perceive the situation realistically, it is necessary to gather continuously exact data about malignant tumours and compare them with the data from other European and world countries.The aim of the study was to collect and analyse the data on cancer incidence in the region of Sarajevo city, which represents a symbol of difficult times in the recent past, and to compare it to the incidence in the neighbouring countries. Patients and methods. Data on all newly diagnosed cancer cases, permanent residents of Sarajevo Canton, in the years 1999 and 2000 were collected. Crude incidence rate has been calculated according to the years observed, gender and localizations of the disease The data were compared to the cancer registries of Slovenia and Croatia and were observed in the light of specific local situation. Results. The crude cancer incidence of all sites but skin was the highest in both years and by both genders in Croatia. The incidence of the most common tumours (lung and breast cancer) was similar in all three countries. The differences in the incidence between both genders in the Sarajevo canton were registered in laryngeal and urinary bladder cancer, as well as in bone and cartilage sarcoma. Cervical cancer had extremely high incidence and was high up on the incidence list in the Sarajevo canton, which correlates with the data in developing countries. The incidence of other tumours in the post-war period is reaching expected numbers. Conclusions. It is difficult to identify whether the war and post-war stress, irregular and insufficient nutrition during and after the siege of the city of Sarajevo or some other factor influenced the cancer incidence among exposed population. The prevalence of smoking in the whole region is extremely high, in Bosnia and

  17. Combinational strategies of metformin and chemotherapy in cancers.

    Science.gov (United States)

    Zhang, Hui-Hui; Guo, Xiu-Li

    2016-07-01

    Chemotherapeutic regimens are the most common treatment to inhibit tumor growth, but there is great variability in clinical responses of cancer patients; cancer cells often develop resistance to chemotherapeutics which results in tumor recurrence and further progression. Metformin, an extensively prescribed and well-tolerated first-line therapeutic drug for type 2 diabetes mellitus, has recently been identified as a potential and attractive anticancer adjuvant drug combined with chemotherapeutic drugs to improve treatment efficacy and lower doses. In this review, we summarized the molecular mechanisms underlying anticancer effects of metformin, which included insulin- and AMPK-dependent effects, selectively targeting cancer stem cells, reversing multidrug resistance, inhibition of the tumor metastasis and described the antineoplastic effects of metformin combined with chemotherapeutic agents in digestive system cancers (colorectal, gastric, hepatic and pancreatic cancer), reproductive system cancers (ovarian and endometrial cancer), prostate cancer, breast cancer, lung cancer, etc. Moreover, the clinical trials regarding metformin in combination of chemotherapeutic drugs were presented and the clinical obstacle or limitation related to the potential role of metformin in cancer treatment was also discussed in this review. PMID:27118574

  18. 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...

  19. Dealing with chemotherapy-related symptoms at home: a qualitative study in adult patients with cancer.

    Science.gov (United States)

    Coolbrandt, A; Dierckx de Casterlé, B; Wildiers, H; Aertgeerts, B; Van der Elst, E; van Achterberg, T; Milisen, K

    2016-01-01

    Given that chemotherapy treatments are done mostly in an outpatient setting, patients with cancer must deal with treatment-related symptoms mainly at home. Evidence suggests that they often feel left alone or unprepared to do so. This qualitative study explores how patients deal with chemotherapy-related symptoms in their home, which factors and ideas influence their self-management and what role professional caregivers play. One-off, semi-structured interviews were held with 28 adult patients with cancer being treated with chemotherapy. Using a Grounded Theory approach, we cyclically collected and analysed data to come to a thorough understanding of the major conceptual themes and their interconnections. Dealing with chemotherapy-related symptoms involves a process of experiencing and learning how side effects unfold over time and how to deal with them. Patients express very personal symptom experiences and symptom-management styles, which are shaped by personal factors (e.g. coping with cancer and cancer treatment, perceived level of control) and environmental factors (e.g. professionals' attitude, information resources). Improving symptom self-management support requires active exploration of the personal symptom experience and symptom-management style. Professional care should be tailored to the patient's perspective and should address personal and environmental determinants of their behaviour. PMID:25752741

  20. The Use of Complementary and Alternative Medicine Supplements of Potential Concern during Breast Cancer Chemotherapy

    Directory of Open Access Journals (Sweden)

    Erin Sweet

    2016-01-01

    Full Text Available Objective. While many Complementary and Alternative Medicines (CAM are unlikely to interact negatively with conventional oncology treatment, some ingestible CAM substances have biological activities that may reduce the effectiveness of chemotherapy or radiation. This study surveyed women with breast cancer in order to document the extent to which women with breast cancer use these CAM substances of concern concurrently with conventional treatments. Methods. A total of 398 women completed a survey describing their use of CAM at various time points in their cancer treatment. This report focuses on a subsample of 250 women receiving chemotherapy or radiation who reported using specific one or more of several chemotherapies. Results. Of those participating, 104 (43.7% of those receiving chemotherapy (n=238 and 45 (32.3% of those receiving radiation (139; 58.4% of all patients reported using one or more CAM substances that could be cause for concern when taken concurrently. Conclusion. Research is needed to understand the real risks associated with CAM and conventional polypharmacy. If risks associated with CAM conventional polypharmacy use prove to be substantial then improved systems to assure all women get advice regarding herb and supplement use during breast cancer treatment appear to be needed.

  1. The Use of Complementary and Alternative Medicine Supplements of Potential Concern during Breast Cancer Chemotherapy.

    Science.gov (United States)

    Sweet, Erin; Dowd, Fred; Zhou, May; Standish, Leanna J; Andersen, M Robyn

    2016-01-01

    Objective. While many Complementary and Alternative Medicines (CAM) are unlikely to interact negatively with conventional oncology treatment, some ingestible CAM substances have biological activities that may reduce the effectiveness of chemotherapy or radiation. This study surveyed women with breast cancer in order to document the extent to which women with breast cancer use these CAM substances of concern concurrently with conventional treatments. Methods. A total of 398 women completed a survey describing their use of CAM at various time points in their cancer treatment. This report focuses on a subsample of 250 women receiving chemotherapy or radiation who reported using specific one or more of several chemotherapies. Results. Of those participating, 104 (43.7%) of those receiving chemotherapy (n = 238) and 45 (32.3%) of those receiving radiation (139; 58.4% of all patients) reported using one or more CAM substances that could be cause for concern when taken concurrently. Conclusion. Research is needed to understand the real risks associated with CAM and conventional polypharmacy. If risks associated with CAM conventional polypharmacy use prove to be substantial then improved systems to assure all women get advice regarding herb and supplement use during breast cancer treatment appear to be needed. PMID:27528880

  2. Trastuzumab after Chemotherapy Is Effective in HER2-Positive Breast Cancer

    Science.gov (United States)

    Treatment with trastuzumab for 1 year following standard chemotherapy improved disease-free survival in women with HER2-positive early breast cancer, according to 4-year follow-up results of the Herceptin Adjuvant (HERA) trial reported February 25, 2011,

  3. Chemotherapy and its evolving role in the management of advanced prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Michael T Schweizer; Emmanuel S Antonarakis

    2014-01-01

    prostate cancer has been recognized as being responsive to androgen deprivation since the 1940s when Charles Huggins ifrst described the role of surgical castration in managing these patients. However, androgen deprivation only results in transient disease control for the vast majority of men, with those progressing in spite of castrate testosterone levels labeled as having castrate-resistant prostate cancer (CRPC). Until 2004, the therapeutic arena for these patients had remained stagnant, with no agent having shown a survival gain in the CRPC setting. Two landmark publications changed the prostate cancer treatment landscape by providing‘level-1 evidence’ that docetaxel-based chemotherapy led to prolongation in overall survival (OS). This was followed by the approval of cabazitaxel in 2010 on the basis of Phase III data demonstrating its efifcacy in patients pretreated with docetaxel. More recently, a number of next-generation androgen-directed agents (e.g. abiraterone and enzalutamide) have also been shown to lead to a survival beneift in men with CRPC. With so many new treatment options available, a number of questions remain. These include:how to best sequence chemotherapy with these newer hormonal agents, the clinical implication of cross-resistance between taxanes and androgen-directed agents and which subsets of patients may beneift most from early use of chemotherapy. This review will provide an overview of the evolving role of chemotherapy in the management of advanced prostate cancer in the current era.

  4. 76 FR 21368 - Evaluation of the Potential Developmental Effects of Cancer Chemotherapy During Pregnancy: Call...

    Science.gov (United States)

    2011-04-15

    ...., lymphoma, leukemia, and cancers of the breast, ovary, skin, and cervix. This review will evaluate a large... submitted to Dr. Kembra Howdeshell, CERHR, NTP, NIEHS, P.O. Box 12233, MD K2-04, Research Triangle Park, NC... chemotherapy on June 21, 2010 (75 FR 21003). BSC meeting minutes are available at...

  5. Genetically modified vaccines augment the efficacy of cancer surgery and chemotherapy

    Czech Academy of Sciences Publication Activity Database

    Bubeník, Jan

    2009-01-01

    Roč. 55, č. 6 (2009), s. 199-200. ISSN 0015-5500 Institutional research plan: CEZ:AV0Z50520514 Keywords : genetically modified vaccines * cancer surgery and chemotherapy Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 0.924, year: 2009

  6. Plasma HER2 amplification in cell-free DNA during neoadjuvant chemotherapy in breast cancer

    DEFF Research Database (Denmark)

    Bechmann, Troels; Andersen, Rikke Fredslund; Pallisgaard, Niels;

    2013-01-01

    Measurement of human epidermal growth factor receptor 2 (HER2) gene amplification in cell-free DNA (cfDNA) is an evolving technique in breast cancer, enabling liquid biopsies and treatment monitoring. The present study investigated the dynamics of plasma HER2 gene copy number and amplification in...... cfDNA during neoadjuvant chemotherapy....

  7. Chemotherapy using new superselective intra-arterial infusion for advanced oral cancer

    Institute of Scientific and Technical Information of China (English)

    Iwai Tohnai; Kenji Mitsudo; Takefumi Fukui; Toshinori Iwai; Kei Watanuki; Yoshiro Matsui

    2008-01-01

    @@ Purpose: We developed a new method of superselective intra-arterial infusion via the superficial temporal artery (HFT method: Hattori, Fuwa and Tohnai reported) and preoperatively performed daily concurrent radiotherapy and chemotherapy with docetaxel (DOC) and cisplatin (CDDP) using this method for 46 patients with stage Ⅲ, Ⅳ oral cancer.

  8. Prediction of response to chemotherapy by ERCC1 immunohistochemistry and ERCC1 polymorphism in ovarian cancer

    DEFF Research Database (Denmark)

    Dahl Steffensen, Karina; Waldstrøm, M.; Jeppesen, Ulla;

    2007-01-01

    118 polymorphism in epithelial ovarian cancer (EOC) and their possible predictive value in patients treated with platinum-based chemotherapy. Formalin-fixed, paraffin-embedded tissue sections from 159 patients with advanced EOC were used for immunohistochemistry. Ercc1 codon 118 SNP genotyping was...

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

    OpenAIRE

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

    2013-01-01

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

  10. 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…

  11. Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7)

    DEFF Research Database (Denmark)

    Oza, Amit M; Cook, Adrian D; Pfisterer, Jacobus;

    2015-01-01

    BACKGROUND: The ICON7 trial previously reported improved progression-free survival in women with ovarian cancer with the addition of bevacizumab to standard chemotherapy, with the greatest effect in patients at high risk of disease progression. We report the final overall survival results of the ...

  12. Concomitant radiotherapy and chemotherapy in head and neck cancer - theoretical rationale and clinical experience

    International Nuclear Information System (INIS)

    Concomitant radiotherapy and chemotherapy in head and neck cancer aims at an interaction between the two modalities which results in improved therapeutic index. Several mechanisms by which this benefit can be achieved are presented. Reviewed are also conclusive randomized trials in which this option has been compared with radiotherapy alone as well as the reasons for difficulties in interpretation of clinical results. (author)

  13. Influences of combination of chemotherapy and autophagy inhibitor on the calreticulin expression in colon cancer cells

    OpenAIRE

    Peng, Rui-Qing; Dan-dan LI; Ding, Ya; Zhang, Xing; Zhang, Xiao-Shi; Wu, Xiao-jun

    2016-01-01

    Objective  To investigate the influence of chemotherapy combined with autophagy inhibitor on apoptosis and calreticulin (CRT) expression on colonic cancer cells. Methods  The colon cancer cells HCT116 were taken as the target in the present study. The inhibition rates (IC50) of chemotherapeutics oxaliplatin, 5-Fu and SN-38 were assessed by MTT assay. The changes in CRT expression on the membrane of HCT116 and apoptosis were determined with flow cytometry before and after treatment with chemot...

  14. Tubulin-Targeting Chemotherapy Impairs Androgen Receptor Activity in Prostate Cancer

    OpenAIRE

    Zhu, Meng-Lei; Horbinski, Craig; Garzotto, Mark; Qian, David Z.; Beer, Tomasz M.; Kyprianou, Natasha

    2010-01-01

    Recent insights into the regulation of the androgen receptor (AR) activity led to novel therapeutic targeting of AR function in prostate cancer patients. Docetaxel is an approved chemotherapy for treatment of castration-resistant-prostate cancer (CRPC), but the mechanism underlying the action of this tubulin-targeting drug is not fully understood. This study investigates the contribution of microtubules and the cytoskeleton to androgen-mediated signaling, and the consequences of their inhibit...

  15. Bevacizumab plus chemotherapy in elderly patients with previously untreated metastatic colorectal cancer: single center experience

    OpenAIRE

    Ocvirk Janja; Moltara Maja Ebert; Mesti Tanja; Boc Marko; Rebersek Martina; Volk Neva; Benedik Jernej; Hlebanja Zvezdana

    2016-01-01

    Metastatic colorectal cancer (mCRC) is mainly a disease of elderly, however, geriatric population is underrepresented in clinical trials. Patient registries represent a tool to assess and follow treatment outcomes in this patient population. The aim of the study was with the help of the patients’ register to determine the safety and efficacy of bevacizumab plus chemotherapy in elderly patients who had previously untreated metastatic colorectal cancer.

  16. Combination of retrograde superselective intra-arterial chemotherapy and Seldinger method in locally advanced oral cancer

    OpenAIRE

    Masataka Uehara; Ryouichi Ohya; Masaaki Kodama; Takeshi Shiraishi; Izumi Asahina; Kazuhiro Tominaga

    2015-01-01

    The nonsurgical strategies for locally advanced oral cancer are desirable. Superselective intra-arterial infusion with radiotherapy was utilized for this purpose, and there are two types of superselective intra-arterial infusion methods: The Seldinger method and the retrograde superselective intra-arterial chemotherapy (HFT method). In one case, the HFT method was applied to locally advanced tongue cancer, and the Seldinger method was used for additional administration of cisplatin (CDDP) to ...

  17. Phosphodiesterase 5 Inhibitors Enhance Chemotherapy Killing in Gastrointestinal/Genitourinary Cancer Cells

    OpenAIRE

    Booth, Laurence; ROBERTS, JANE L.; Cruickshanks, Nichola; Conley, Adam; Durrant, David E.; Das, Anindita; Fisher, Paul B.; Kukreja, Rakesh C.; Grant, Steven; Poklepovic, Andrew; Dent, Paul

    2014-01-01

    The present studies determined whether clinically relevant phosphodiesterase 5 (PDE5) inhibitors interacted with clinically relevant chemotherapies to kill gastrointestinal/genitourinary cancer cells. In bladder cancer cells, regardless of H-RAS mutational status, at clinically achievable doses, PDE5 inhibitors interacted in a greater than additive fashion with doxorubicin/mitomycin C/gemcitabine/cisplatin/paclitaxel to cause cell death. In pancreatic tumor cells expressing mutant active K-RA...

  18. Chemotherapy for advanced non-small-cell lung cancer: Role of paclitaxel and gemcitabine

    OpenAIRE

    Lam, WK; Tsang, KWT; Ip, MSM

    1999-01-01

    Objective. To review the role of chemotherapy in advanced non-small-cell lung cancer, focusing on cisplatin-based regimens and two new drugs: paclitaxel and gemcitabine. Data sources. Medline search of the relevant English literature. Study selection. Open and randomised comparative (phases II and III) studies, and meta-analyses of cytotoxic drugs/regimens used to treat advanced non-small-cell lung cancer. Data extraction. The following factors were studied and compared: symptomatic response ...

  19. Research Progress of Nutrition Support for Patients with Lung Cancer 
During Chemotherapy

    OpenAIRE

    Yiqiao LUO; Zhu, Jiang

    2014-01-01

    Primary lung cancer is one of the most common malignancies. Nowadays, both its morbidity and mortality rank first, patients with lung cancer are often goes with some affiliating symptoms such as malnutrition and weight loss. The side effects of cytotoxicity during chemotherapy may lead to further deteriorate of the nutritional status and worsen the anti-tumor therapy’s efficacy and the patients’ quality of life. With the development of palliative treatment and the higher request of patients f...

  20. Early Prediction and Evaluation of Breast Cancer Response to Neoadjuvant Chemotherapy Using Quantitative DCE-MRI

    OpenAIRE

    Alina Tudorica; Oh, Karen Y.; Stephen Y-C Chui; Nicole Roy; Troxell, Megan L.; Arpana Naik; Kathleen A Kemmer; Yiyi Chen; Megan L Holtorf; Aneela Afzal; Charles S Springer Jr.; Xin Li; Wei Huang

    2016-01-01

    The purpose is to compare quantitative dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) metrics with imaging tumor size for early prediction of breast cancer response to neoadjuvant chemotherapy (NACT) and evaluation of residual cancer burden (RCB). Twenty-eight patients with 29 primary breast tumors underwent DCE-MRI exams before, after one cycle of, at midpoint of, and after NACT. MRI tumor size in the longest diameter (LD) was measured according to the RECIST (Response Eval...

  1. Correlation of clinico-pathologic and radiologic parameters of response to neoadjuvant chemotherapy in breast cancer

    OpenAIRE

    Mukherjee, P.; Sharma, S.; Z A Sheikh; Vijaykumar, D. K.

    2014-01-01

    Context: As of today, there is no validated standard method to assess clinical response of breast cancer to neo- adjuvant chemotherapy (NACT). Some centers use clinical dimensions while others use radiological measurements to evaluate response according to RECIST criteria. Aims: The aim was to correlate and compare the clinical, radiological, and pathological parameters for assessing the tumor response in patients of breast cancer receiving NACT. Settings and Design: Single institution, prosp...

  2. Mechanisms of Nuclear Export in Cancer and Resistance to Chemotherapy

    Science.gov (United States)

    El-Tanani, Mohamed; Dakir, El-Habib; Raynor, Bethany; Morgan, Richard

    2016-01-01

    Tumour suppressor proteins, such as p53, BRCA1, and ABC, play key roles in preventing the development of a malignant phenotype, but those that function as transcriptional regulators need to enter the nucleus in order to function. The export of proteins between the nucleus and cytoplasm is complex. It occurs through nuclear pores and exported proteins need a nuclear export signal (NES) to bind to nuclear exportin proteins, including CRM1 (Chromosomal Region Maintenance protein 1), and the energy for this process is provided by the RanGTP/RanGDP gradient. Due to the loss of DNA repair and cell cycle checkpoints, drug resistance is a major problem in cancer treatment, and often an initially successful treatment will fail due to the development of resistance. An important mechanism underlying resistance is nuclear export, and a number of strategies that can prevent nuclear export may reverse resistance. Examples include inhibitors of CRM1, antibodies to the nuclear export signal, and alteration of nuclear pore structure. Each of these are considered in this review. PMID:26985906

  3. Importance of metabolic changes induced by chemotherapy on prognosis of early-stage breast cancer patients: a review of potential mechanisms.

    Science.gov (United States)

    Gadéa, E; Thivat, E; Planchat, E; Morio, B; Durando, X

    2012-04-01

    Weight variation has been reported as a side effect of chemotherapy treatment in early breast cancer patients and has been identified as a factor of poor prognosis. Causes of weight variation during chemotherapy and mechanisms involved in the poor prognosis have been little studied. Here is reviewed the current knowledge about the main causes and mechanisms involved in body weight change. Special emphasis is placed on factors associated with weight variation which could potentially be involved in the risk of relapse in breast cancer survivors. In recent decades, some studies have investigated the causes of weight variation by studying energy balance of breast cancer patients during chemotherapy. Weight gain or loss may be the consequence of energy imbalance through different factors linked with chemotherapy, such as poor treatment tolerance, decreased muscle mass and function, or hormonal alterations. This results in body composition modifications in favour of fat gain and/or lean body mass loss. Increased adipose tissue, especially in the abdominal region, could induce metabolic disturbances such as insulin resistance, through various pathways involving adipokines. These molecules have growth properties and could therefore play a role in cancer relapse. Understanding such mechanisms is key to developing preventive strategies for improving the prognosis of early-stage breast cancer patients. PMID:22133030

  4. MR-perfusion (MRP) and diffusion-weighted imaging (DWI) in prostate cancer: Quantitative and model-based gadobenate dimeglumine MRP parameters in detection of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Scherr, M.K., E-mail: michael.scherr@med.uni-muenchen.de [Institute of Clinical Radiology, University of Munich, Munich (Germany); Seitz, M. [Department of Urology, University of Munich, Munich (Germany); Mueller-Lisse, U.G. [Institute of Clinical Radiology, University of Munich, Munich (Germany); Ingrisch, M. [Josef Lissner Laboratory for Biomedical Imaging, Institute of Clinical Radiology, University of Munich, Munich (Germany); Reiser, M.F. [Institute of Clinical Radiology, University of Munich, Munich (Germany); Mueller-Lisse, U.L. [Department of Urology, University of Munich, Munich (Germany)

    2010-12-15

    Background: Various MR methods, including MR-spectroscopy (MRS), dynamic, contrast-enhanced MRI (DCE-MRI), and diffusion-weighted imaging (DWI) have been applied to improve test quality of standard MRI of the prostate. Purpose: To determine if quantitative, model-based MR-perfusion (MRP) with gadobenate dimeglumine (Gd-BOPTA) discriminates between prostate cancer, benign tissue, and transitional zone (TZ) tissue. Material and methods: 27 patients (age, 65 {+-} 4 years; PSA 11.0 {+-} 6.1 ng/ml) with clinical suspicion of prostate cancer underwent standard MRI, 3D MR-spectroscopy (MRS), and MRP with Gd-BOPTA. Based on results of combined MRI/MRS and subsequent guided prostate biopsy alone (17/27), biopsy and radical prostatectomy (9/27), or sufficient negative follow-up (7/27), maps of model-free, deconvolution-based mean transit time (dMTT) were generated for 29 benign regions (bROIs), 14 cancer regions (cROIs), and 18 regions of transitional zone (tzROIs). Applying a 2-compartment exchange model, quantitative perfusion analysis was performed including as parameters: plasma flow (PF), plasma volume (PV), plasma mean transit time (PMTT), extraction flow (EFL), extraction fraction (EFR), interstitial volume (IV) and interstitial mean transit time (IMTT). Two-sided T-tests (significance level p < 0.05) discriminated bROIs vs. cROIs and cROIs vs. tzROIs, respectively. Results: PMTT discriminated best between bROIs (11.8 {+-} 3.0 s) and cROIs (24.3 {+-} 9.6 s) (p < 0.0001), while PF, PV, PS, EFR, IV, IMTT also differed significantly (p 0.00002-0.0136). Discrimination between cROIs and tzROIs was insignificant for all parameters except PV (14.3 {+-} 2.5 ml vs. 17.6 {+-} 2.6 ml, p < 0.05). Conclusions: Besides MRI, MRS and DWI quantitative, 2-compartment MRP with Gd-BOPTA discriminates between prostate cancer and benign tissue with several parameters. However, distinction of prostate cancer and TZ does not appear to be reliable.

  5. MR-perfusion (MRP) and diffusion-weighted imaging (DWI) in prostate cancer: Quantitative and model-based gadobenate dimeglumine MRP parameters in detection of prostate cancer

    International Nuclear Information System (INIS)

    Background: Various MR methods, including MR-spectroscopy (MRS), dynamic, contrast-enhanced MRI (DCE-MRI), and diffusion-weighted imaging (DWI) have been applied to improve test quality of standard MRI of the prostate. Purpose: To determine if quantitative, model-based MR-perfusion (MRP) with gadobenate dimeglumine (Gd-BOPTA) discriminates between prostate cancer, benign tissue, and transitional zone (TZ) tissue. Material and methods: 27 patients (age, 65 ± 4 years; PSA 11.0 ± 6.1 ng/ml) with clinical suspicion of prostate cancer underwent standard MRI, 3D MR-spectroscopy (MRS), and MRP with Gd-BOPTA. Based on results of combined MRI/MRS and subsequent guided prostate biopsy alone (17/27), biopsy and radical prostatectomy (9/27), or sufficient negative follow-up (7/27), maps of model-free, deconvolution-based mean transit time (dMTT) were generated for 29 benign regions (bROIs), 14 cancer regions (cROIs), and 18 regions of transitional zone (tzROIs). Applying a 2-compartment exchange model, quantitative perfusion analysis was performed including as parameters: plasma flow (PF), plasma volume (PV), plasma mean transit time (PMTT), extraction flow (EFL), extraction fraction (EFR), interstitial volume (IV) and interstitial mean transit time (IMTT). Two-sided T-tests (significance level p < 0.05) discriminated bROIs vs. cROIs and cROIs vs. tzROIs, respectively. Results: PMTT discriminated best between bROIs (11.8 ± 3.0 s) and cROIs (24.3 ± 9.6 s) (p < 0.0001), while PF, PV, PS, EFR, IV, IMTT also differed significantly (p 0.00002-0.0136). Discrimination between cROIs and tzROIs was insignificant for all parameters except PV (14.3 ± 2.5 ml vs. 17.6 ± 2.6 ml, p < 0.05). Conclusions: Besides MRI, MRS and DWI quantitative, 2-compartment MRP with Gd-BOPTA discriminates between prostate cancer and benign tissue with several parameters. However, distinction of prostate cancer and TZ does not appear to be reliable.

  6. The effect of irradiation on lung function and perfusion in patients with lung cancer

    International Nuclear Information System (INIS)

    Purpose: To prospectively study the changes in lung function in patients with lung carcinoma treated with relatively high doses of irradiation. Methods and Materials: Lung function was assessed prior to and at 6 and 12 months following radiation therapy by a clinical dyspnea score, formal pulmonary function tests (lung volume spirometry and diffusion capacity) as well as an ipsilateral hemithorax lung perfusion scan. Changes in dyspnea score were evaluated by the chi-square and the Fishers exact test. Changes in formal lung function tests were compared with the t-test for dependent data and correlations with the t-test for independent data. Fifty-one patients were entered into the study. There were 42 evaluable patients at 6 months after irradiation and 22 evaluable patients at 12 months after irradiation. Results: A worsening of dyspnea score from 1 to 2, which is clinically acceptable, occurred in 50% or more of patients. However, a dyspnea score of 3, which is a serious complication, developed in only 5% of patients. The diffusion capacity (DLCO) decreased by 14% at 6 months and 12% at 12 months) (p < 0.0001). The forced vital capacity and total lung capacity decreased between 6% and 8% at 6 month and 12 months, which was statistically significant. The forced expiratory volume in 1 s decreased between 2 and 3% at 6 month and 12 months, which was not statistically significant. The ipsilateral hemithorax perfusion decreased by 17 and 20% at 6 and 12 months (p < 0.0001). There was no correlation between the initial hemithorax perfusion, or its decrease at follow up and the decrease in DLCO. Conclusion: Lung irradiation results in some loss of lung function in patients with lung cancer with a projected survival of 6 months or more. The pretreatment DLCO assessment should be useful in predicting clinical tolerance to irradiation

  7. Newly diagnosed lung cancer patients' preferences for and beliefs about physical activity prior to chemotherapy.

    Science.gov (United States)

    Karvinen, Kristina H; Vallance, Jeff; Walker, Paul R

    2016-07-01

    Physical activity has been found to have a number of benefits for lung cancer patients yet very little information is available concerning physical activity beliefs and preferences for this population. The purpose of the study was to explore physical activity programming and counseling preferences and beliefs about physical activity in newly diagnosed lung cancer patients scheduled to receive chemotherapy. A total of 43 new diagnosed lung cancer patients completed a researcher-administered survey prior to commencing chemotherapy. Results indicated that only 7 participants (17%) reported meeting public health recommendations for physical activity yet the majority of participants (n = 28) indicated interest or possible interest in physical activity counseling. Many participants also indicated interest or possible interest in an exercise program (n = 29) for lung cancer survivors, preferring it to start during chemotherapy (n = 20), for it to be home based (n = 21), and moderate in intensity (n = 22). The most common behavioral belief (advantage) of physical activity was to build/maintain strength (n = 26) and the most common control belief (barrier) was fatigue (n = 11). These data suggest that physical activity counseling and programming may be well received by newly diagnosed lung cancer patients. Information about physical activity and programming preferences and beliefs from this study may be useful for the design of optimal physical activity interventions for lung cancer patients. PMID:26813963

  8. The facilitating role of chemotherapy in the palliative phase of cancer: qualitative interviews with advanced cancer patients.

    Directory of Open Access Journals (Sweden)

    Hilde M Buiting

    Full Text Available OBJECTIVE: To explore the extent to which patients have a directing role in decisions about chemotherapy in the palliative phase of cancer and (want to anticipate on the last stage of life. DESIGN: Qualitative interview study. METHODS: In depth-interviews with 15 patients with advanced colorectal or breast cancer at the medical oncology department in a Dutch teaching hospital; interviews were analysed following the principles of thematic content-analysis. RESULTS: All patients reported to know that the chemotherapy they received was with palliative intent. Most of them did not express the wish for information about (other treatment options and put great trust in their physicians' treatment advice. The more patients were aware of the severity of their disease, the more they seemed to 'live their life' in the present and enjoy things besides having cancer. Such living in the present seemed to be facilitated by the use of chemotherapy. Patients often considered the 'chemotherapy-free period' more stressful than periods when receiving chemotherapy despite their generally improved physical condition. Chemotherapy (regardless of side-effects seemed to shift patients' attention away from the approaching last stage of life. Interestingly, although patients often discussed advance care planning, they were reluctant to bring on end-of-life issues that bothered them at that specific moment. Expressing real interest in people 'as a person' was considered an important element of appropriate care. CONCLUSIONS: Fearing their approaching death, patients deliberately focus on living in the present. Active (chemotherapy treatment facilitates this focus, regardless of the perceived side-effects. However, if anxiety for what lies ahead is the underlying reason for treatment, efforts should be made in assisting patients to find other ways to cope with this fear. Simultaneously, such an approach may reduce the use of burdensome and sometimes costly treatment in the

  9. Effect of steroid on brain tumors and surround edemas : observation with regional cerebral blood volume (rCBV) maps of perfusion MRI

    International Nuclear Information System (INIS)

    To observe the hemodynamic change in brain tumors and peritumoral edemas after steroid treatment, and then investigate the clinical usefulness of perfusion MRI. We acquired conventional and perfusion MR images in 15 patients with various intracranial tumors (4 glioblastoma multiformes, 4 meningiomas, 3 metastatic tumors, 1 anaplastic ependymoma, 1 anaplastic astrocytoma, 1 hemangioblastoma, and 1 pilocytic astrocytoma). For perfusion MR imaging, a 1.5T unit employing the gradient-echo EPI technique was used, and further perfusion MR images were obtained 2-10 days after intravenous steroid therapy. After processing of the raw data, regional cerebral blood volume (rCBV) maps were reconstructed. The maps were visually evaluated by comparing relative perfusion in brain tumors and peritumoral edemas with that in contralateral white matter. Objective evaluations were performed by comparing the perfusion ratios of brain tumors and peritumoral edemas. Visual evaluations of rCBV maps, showed that in most brain tumors (67%, 10/15), perfusion was high before steroid treatment and showed in (80%, 12/15) decreased afterwards. Objective evaluation, showed that in all brain tumors, perfusion decreased. Visual evaluation of perfusion change in peritumoral edemas revealed change in only one case, but objective evaluation indicated that perfusion decreased significantly in all seven cases. rCBV maps acquired by perfusion MR imaging can provide hemodynamic information about brain tumors and peritumoral edemas. Such maps could prove helpful in the preoperative planning of brain tumor surgery and the monitoring of steroid effects during conservative treatment. (author)

  10. Effect of steroid on brain tumors and surround edemas : observation with regional cerebral blood volume (rCBV) maps of perfusion MRI

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ju Youl; Sun, Joo Sung; Kim, Sun Yong; Kim, Ji Hyung; Suh, Jung Ho; Cho, Kyung Gi; Kim, Jang Sung [Ajou University, School of Medicine, Su won (Korea, Republic of)

    2000-01-01

    To observe the hemodynamic change in brain tumors and peritumoral edemas after steroid treatment, and then investigate the clinical usefulness of perfusion MRI. We acquired conventional and perfusion MR images in 15 patients with various intracranial tumors (4 glioblastoma multiformes, 4 meningiomas, 3 metastatic tumors, 1 anaplastic ependymoma, 1 anaplastic astrocytoma, 1 hemangioblastoma, and 1 pilocytic astrocytoma). For perfusion MR imaging, a 1.5T unit employing the gradient-echo EPI technique was used, and further perfusion MR images were obtained 2-10 days after intravenous steroid therapy. After processing of the raw data, regional cerebral blood volume (rCBV) maps were reconstructed. The maps were visually evaluated by comparing relative perfusion in brain tumors and peritumoral edemas with that in contralateral white matter. Objective evaluations were performed by comparing the perfusion ratios of brain tumors and peritumoral edemas. Visual evaluations of rCBV maps, showed that in most brain tumors (67%, 10/15), perfusion was high before steroid treatment and showed in (80%, 12/15) decreased afterwards. Objective evaluation, showed that in all brain tumors, perfusion decreased. Visual evaluation of perfusion change in peritumoral edemas revealed change in only one case, but objective evaluation indicated that perfusion decreased significantly in all seven cases. rCBV maps acquired by perfusion MR imaging can provide hemodynamic information about brain tumors and peritumoral edemas. Such maps could prove helpful in the preoperative planning of brain tumor surgery and the monitoring of steroid effects during conservative treatment. (author)

  11. Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer

    Energy Technology Data Exchange (ETDEWEB)

    Selle, F.; Gligorov, J. [Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris (France); Pierre & Marie Curie University (UPMC Paris VI), Paris (France); Richard, S.; Khalil, A. [Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris (France); Alexandre, I. [Medical Oncology Department, Hospital Centre of Bligny, Briis-sous-Forges (France); Avenin, D.; Provent, S.; Soares, D.G. [Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris (France); Lotz, J.P. [Medical Oncology and Cellular Therapy Department, Hospital Tenon, Public Assistance Hospitals of Paris, Alliance for Cancer Research (APREC), Paris (France); Pierre & Marie Curie University (UPMC Paris VI), Paris (France)

    2014-11-04

    Germ cell tumors present contrasting biological and molecular features compared to many solid tumors, which may partially explain their unusual sensitivity to chemotherapy. Reduced DNA repair capacity and enhanced induction of apoptosis appear to be key factors in the sensitivity of germ cell tumors to cisplatin. Despite substantial cure rates, some patients relapse and subsequently die of their disease. Intensive doses of chemotherapy are used to counter mechanisms of drug resistance. So far, high-dose chemotherapy with hematopoietic stem cell support for solid tumors is used only in the setting of testicular germ cell tumors. In that indication, high-dose chemotherapy is given as the first or late salvage treatment for patients with either relapsed or progressive tumors after initial conventional salvage chemotherapy. High-dose chemotherapy is usually given as two or three sequential cycles using carboplatin and etoposide with or without ifosfamide. The administration of intensive therapy carries significant side effects and can only be efficiently and safely conducted in specialized referral centers to assure optimum patient care outcomes. In breast and ovarian cancer, most studies have demonstrated improvement in progression-free survival (PFS), but overall survival remained unchanged. Therefore, most of these approaches have been dropped. In germ cell tumors, clinical trials are currently investigating novel therapeutic combinations and active treatments. In particular, the integration of targeted therapies constitutes an important area of research for patients with a poor prognosis.

  12. Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer

    International Nuclear Information System (INIS)

    Germ cell tumors present contrasting biological and molecular features compared to many solid tumors, which may partially explain their unusual sensitivity to chemotherapy. Reduced DNA repair capacity and enhanced induction of apoptosis appear to be key factors in the sensitivity of germ cell tumors to cisplatin. Despite substantial cure rates, some patients relapse and subsequently die of their disease. Intensive doses of chemotherapy are used to counter mechanisms of drug resistance. So far, high-dose chemotherapy with hematopoietic stem cell support for solid tumors is used only in the setting of testicular germ cell tumors. In that indication, high-dose chemotherapy is given as the first or late salvage treatment for patients with either relapsed or progressive tumors after initial conventional salvage chemotherapy. High-dose chemotherapy is usually given as two or three sequential cycles using carboplatin and etoposide with or without ifosfamide. The administration of intensive therapy carries significant side effects and can only be efficiently and safely conducted in specialized referral centers to assure optimum patient care outcomes. In breast and ovarian cancer, most studies have demonstrated improvement in progression-free survival (PFS), but overall survival remained unchanged. Therefore, most of these approaches have been dropped. In germ cell tumors, clinical trials are currently investigating novel therapeutic combinations and active treatments. In particular, the integration of targeted therapies constitutes an important area of research for patients with a poor prognosis

  13. Chemotherapy options for the elderly patient with advanced non-small cell lung cancer.

    LENUS (Irish Health Repository)

    Hennessy, B T

    2012-02-03

    Combination chemotherapy has been shown to improve overall survival compared with best supportive care in patients with advanced non-small cell lung cancer (NSCLC). The survival advantage is modest and was initially demonstrated with cisplatin-containing regimens in a large meta-analysis of randomized trials reported in 1995. Newer chemotherapy combinations have been shown to be better tolerated than older cisplatin-based combinations, and some trials have also shown greater efficacy and survival benefits with these newer combinations. Combination chemotherapy is, therefore, the currently accepted standard of care for patients with good performance statuses aged less than 70 years with advanced NSCLC. However, there are limited data from clinical trials to support the use of combination chemotherapy in elderly patients over 70 years of age with advanced NSCLC. Subgroup analyses of large randomized phase III trials suggest that elderly patients with good performance statuses do as well as younger patients treated with combination chemotherapy. There are few randomized trials reported that evaluate chemotherapy in patients aged greater than 70 years only. Based on data from trials performed by an Italian group, single-agent vinorelbine has been shown to have significant activity in elderly patients with advanced NSCLC and to be well tolerated by those patients with Eastern Cooperative Oncology Group performance statuses of two or less, with associated improvements in measures of global health.

  14. Influence of rmhTNF on the Chemotherapy Treatment of Small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The efficacy and safety of the recombinant mutant human tumor necrosis factor (rmhTNF) combined with chemotherapy vs chemotherapy alone in the treatment of patients with small cell lung cancer (SCLC) were evaluated in this study. The selected 37 patients with SCLC were divided into experimental group (n = 18) and control group (n = 19). Bothgroups were subjected to EP regimen. While in the experimental group, a regimen of 4 × 106 U/m2 rmhTNF intramuscular injection was given once a day from the 1st to 7th day and 11th to 17th day on the chemotherapy cycle.Twenty-one days were as a chemotherapy cycle and all patients received treatment with 2 cycles.The response rate was 83.3 % (15/18) in the experimental group and 63.2 % (12/19) in the control group respectively (P<0.05). The KPS score after treatment was 78.4±9.6 in the experimental group and 71.2±9.7 in the control group with the difference being significant (P<0.05).No severe adverse effects occurred in the two groups. It was concluded that the curative effectiveness of the rmhTNF combined with chemotherapy in the treatment of SCLC was more satisfactory than chemotherapy alone. The former could obviously improve the quality of life of the patients with SCLC.

  15. Perfusion and diffusion characteristics of cervical cancer based on intravoxel incoherent motion MR imaging-a pilot study

    International Nuclear Information System (INIS)

    To investigate the tissue characteristics of cervical cancer based on the intravoxel incoherent motion (IVIM) model and to assess the IVIM parameters in tissue differentiation in the female pelvis. Sixteen treatment-naive cervical cancer and 17 age-matched healthy subjects were prospectively recruited for diffusion-weighted (b = 0-1,000 s/mm2) and standard pelvic MRI. Bi-exponential analysis was performed to derive the perfusion parameters f (perfusion fraction) and D* (pseudodiffusion coefficient) as well as the diffusion parameter D (true molecular diffusion coefficient) in cervical cancer (n = 16), normal cervix (n = 17), myometrium (n = 33) and leiomyoma (n = 14). Apparent diffusion coefficient (ADC) was calculated. Kruskal-Wallis test and receiver operating characteristics (ROC) curves were used. Cervical cancer had the lowest f (14.9 ± 2.6 %) and was significantly different from normal cervix and leiomyoma (p -3 mm2/s) was lowest in cervical cancer and was significantly different from normal cervix and myometrium (p -3 mm2/s and ADC -3 mm2/s could differentiate cervical cancer from non-malignant tissues (AUC 0.773-0.908). Cervical cancer has low perfusion and diffusion IVIM characteristics with promising potential for tissue differentiation. (orig.)

  16. Primary malignant melanoma in the pineal region treated without chemotherapy

    OpenAIRE

    SHINSATO, Yoshinari; Hanada, Tomoko; Kisanuki, Takao; Yonezawa, Hajime; Yunoue, Shunji; Yoshioka, Takako; Hanaya, Ryosuke; Tokimura, Hiroshi; Hirano, Hirofumi; ARITA, Kazunori

    2012-01-01

    Background: Primary pineal malignant melanomas are uncommon intracranial tumor. Here we discuss and review a case of primary pineal malignant melanoma over its feature of imaging studies, pathological findings, and management. Case Description: A 49-year-old woman receiving renal dialysis underwent computed tomography due to a 4-month history of tinnitus and hearing disturbance. A high-density 35-mm diameter tumor was detected in the pineal region; there was obstructive hydrocephalus. The tum...

  17. Selective pulmonary artery perfusion for the treatment of primary lung cancer : Improved drug exposure of the lung

    NARCIS (Netherlands)

    van Putte, Bart P.; Grootenboers, Marco; van Boven, Wim-Jan; van Oosterhout, M.; Pasterkamp, Gerard; Folkerts, Gert; Schramel, Franz

    2009-01-01

    Introduction: Selective pulmonary artery perfusion (SPAP) is an experimental drug infusion method for the treatment of lung cancer that aims to achieve more effective T(umour) and lymph N(ode) down-staging. The aim of this experiment was to compare drug uptake of gemcitabine and carboplatin during S

  18. Regional ventilation/perfusion mismatch pattern in patient with Swyer James (MacLeod's) syndrome

    OpenAIRE

    Sait Sager; Sertac Asa; Reşit Akyel; Ersan Atahan; Bedii Kanmaz

    2014-01-01

    Swyer James (McLeod′s) syndrome (SJMS) is an uncommon disease, which occurs as a result of childhood bronchiolitis obliterans. Patients may not be diagnosed until later in their life. A 46-year-old man underwent ventilation/perfusion scintigraphy for acute onset of dyspnea. The scan showed markedly diminished ventilation and perfusion unilaterally on the right middle and inferior lobes. However, mismatched ventilation-perfusion pattern was shown on the upper right lobe, which was consistent w...