Indian journal of cancer最新文献

Background: Several studies have indicated the benefits and safety of Endostar in combination with chemotherapy, but the exact real-life safety of Endostar is poorly known. This study aimed to assess the safety of Endostar in combination with chemotherapy in a real-life setting in China.

Materials and methods: This was a retrospective study of patients treated with Endostar combined with chemotherapy from January 1, 2006, to December 31, 2017. Data were obtained from the Hospital Information System (HIS). Laboratory abnormalities were evaluated according to Common Terminology Criteria for Adverse Events, Version 4.0. Bleeding events and wound complications after surgery associated with Endostar were evaluated.

Results: Finally, 825 patients were included. No patients used Endostar alone. Anemia occurred in 74.5% of the patients, thrombocytopenia in 29.0%, abnormal white blood cell counts in 54.5%, abnormal liver function in 13.8%, and increased creatinine in 1.2%. No definite bleeding events and wound complications associated with Endostar were found. Most laboratory adverse effects (AEs) were found in Grades 1 and 2. Lung cancer, osteosarcoma, and doxorubicin-based chemotherapy were associated with an increased risk of Grade ≥3 abnormal white blood cell counts. The total dose of Endostar was not associated with severe (Grade ≥3) thrombocytopenia and abnormal white blood cell counts.

Conclusion: The occurrence of AEs during Endostar and chemotherapy treatment differed across different tumor types and chemotherapy regimens. No new unexpected Endostar-related AEs were observed. The total dose of Endostar was not associated with an increased risk of severe (Grade ≥3) thrombocytopenia and abnormal white blood cell counts when used in combination with chemotherapy in the real-life setting.

Background: Staging of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs) is considered as the most important prognostic indicator, but salivary proteins such as interleukins (ILs) can serve as potential biomarkers. The aim of this study was to assess the presence of salivary IL-10 and IL-17 in OSCC and OPMD (oral submucous fibrosis and oral leukoplakia).

Materials and methods: This was a hospital-based, in vivo, cross-sectional, comparative study. A total of 90 patients (N = 90) were included in the study. Whole unstimulated saliva was collected and subjected to enzyme-linked immunosorbent assay (ELISA): 30 from histopathologically confirmed OSCC (Group 1, n = 30), 15 from clinically diagnosed OSMF (Group 2, n = 15), 15 from clinically diagnosed OL (Group 3, n = 15), 15 from patients who had tobacco habits but no clinical lesions of OSCC/OL/OSMF (Group 4, n = 15), and 15 from healthy controls (Group 5, n = 15).

Results: Statistical analysis was performed by SPSS®25.0 (analysis of variance [ANOVA], Tukey's post hoc test, and Mann-Whitney U test). Both IL-10 and IL-17 were found in saliva. One-way ANOVA between groups showed IL-10 did not vary significantly within groups (P = 0.853), but IL-17 varied significantly between groups (P = 0.000). Mann-Whitney U test used to compare IL-10 and IL-17 between stage III and IV of OSCC showed that they did not vary significantly.

Conclusion: IL-17 can indicate the presence of ongoing inflammation toward developing OPMD/OSCC, proving it as a potent diagnostic biomarker. An increase in IL-17 with successive stages of OSCC proves it as a prognostic biomarker for OSCC.

Background: Duodenal neuroendocrine tumors (D-NETs) are rare but clinically significant tumors that can occur in various parts of the duodenum, including the duodenal papilla. Endoscopic submucosal dissection (ESD) has emerged as a minimally invasive treatment option for D-NETs, offering potential advantages in terms of tumor removal and postoperative recovery. We aimed to retrospectively analyze the clinical characteristics and prognosis of ESD for D-NETs.

Methods: A total of 26 cases of duodenal neuroendocrine tumors (27 lesions), including duodenal papillary neuroendocrine tumors, were studied retrospectively.

Results: A total of 26 patients with D-NETs (27 lesions) were pathologically diagnosed, and 27 lesions were found by chance during endoscopy. The lesions included duodenal bulbar, descending part, and duodenal papilla. Nineteen tumors were <1 cm (70.4%) in diameter, and eight tumors were 1-2 cm (29.6%) in diameter. There were five cases of duodenal papilla NETs. G1: 24 (88.8%) and G2: 3 (11.1%). Endoscopic ultrasonography showed that 27 lesions were confined to the submucosa. One case was a neuroendocrine tumor 2 mm inside a tubular adenoma at the papilla. All operations were performed by senior doctors in the department. The total resection rate was 100%, and the incidence of intraoperative bleeding and perforation was 0. Delayed bleeding and perforation were 0. The shortest operation time was 25 min, and the longest was 70 min. Burning tumor cells at the basal resection margin were noted in 11 lesions, necessitating careful pathological assessment. There were 24 cases of G1 type and 3 cases of G2 type. All 26 patients underwent abdominal CT before operation to confirm the absence of lymph node and distal metastasis. One patient with papillary lesion had positive lesion base resection and was treated with additional operation. Temporary biliary and pancreatic duct stents were placed before or after ESD in all five cases of duodenal papillary lesions, and no biliary and pancreatic complications occurred after surgery. Postoperative follow-up gastroscopy and abdominal CT confirmed no recurrence or metastasis during a follow-up period of 3 months to 4.5 years. There was no recurrence or metastasis during a follow-up period of 3 months to 4 ½ years.

Conclusion: ESD may be an effective and safe intervention for D-NETs ≤20 mm confined to the mucosa or submucosa of the duodenum, including the papilla. Clinicians should remain vigilant about potential complications during and after surgery. Duodenal ESD treatment NET has high requirements in terms of treatment technology, and clinicians should pay attention to the potential complications of ESD during operation.

Abstract: Chronic myeloid leukemia is a myeloproliferative neoplasm which can present in chronic phase, accelerated phase, or blast crisis. Most of the children present in chronic phase. Tyrosine kinase inhibitors are used as a targeted therapy. Few children progress to blast crisis on therapy. The blast crisis occurs in the marrow. Very few cases are reported in adults with isolated central nervous system (CNS) blast crisis. Here we are reporting a rare case of isolated CNS relapse in a child.

Background: Cancer susceptibility candidate 2 (CASC2) was found underexpressed in multiple types of human malignancies. However, the specific role of CASC2 in AML remains uncertain. The purpose of this study is to explore the expression of CASC2 in patients with AML and healthy donors and its prognostic significance in AML.

Methods: Total RNA was isolated from bone marrow samples or peripheral blood samples of 87 patients with AML and 26 healthy adult donors. The expression of long noncoding RNA CASC2 was detected by quantitative real-time polymerase chain reaction. The association between CASC2 expression and other clinicopathological factors as well as its prognosis significance were analyzed.

Results: The peripheral blood mononuclear cell (PBMC) expression level of CASC2 in AML was significantly lower than that in the healthy control cohort (P = 0.0048), and in the bone marrow samples, CASC2 was significantly upregulated in patients with AML after the achievement of CR (median value: 0.041, range: 0.015-0.064) compared with that at newly diagnosis (median value: 0.017, range: 0.008-0.041) (P = 0.002). The expression of CASC2 had a significant relationship with complete remission (P = 0.019). Survival data assessed by Kaplan-Meier curves showed that patients with lower CASC2 expression had shorter overall survival and disease-free survival than patients with higher CASC2 expression. Finally, Cox proportional hazards analysis demonstrated that CASC2 was an independent prognostic indicator for both OS (P = 0.013) and DFS (P = 0.001) of AML.

Conclusions: LncRNA CASC2 may serve as a new molecular biomarker for the early diagnosis and of AML, and may be an independent prognostic factor affecting the survival of patients with AML.

Abstract: Giant basal cell carcinomas (GBCCs) represent only 0.5-1% of all basal carcinomas and are known to occur and behave differently than other basal cell carcinomas. We report a 93-year-old gentleman with GBCC of the back of superficial spreading histological type who we treated with radical radiotherapy with excellent local control. Nonaggressive histological subtypes of GBCC particularly the superficial type can be well managed with radiotherapy, especially in the elderly, and should be adequately utilized in carefully selected patients.

Background: Distress is an unpleasant emotional feeling of uneasiness, sadness, worry, anger, helplessness, or guilt and is considered as the sixth vital sign of cancer. Understanding and managing distress at an early stage helps the patient to deal with cancer in a better way. The objective of the study is to estimate the pattern of distress among cancer patients assessed during new patient counseling and its association with demographic factors.

Methods: This is a cross-sectional retrospective study conducted by reviewing the case record forms of patients for a period of 4 months. The study included cancer patients between the age of 18 and 75 who attended new patient counseling and reported a score on the NCCN distress thermometer. Those with incomplete information and history of known psychiatric or neurological disorders were excluded.

Results: Among the 348 patients, 39.9% had a distress score of 4 or above, which is clinically significant distress. Nearly 75% of them reported that their distress has a psycho-social reason, and 25% reported that distress is due to physical reasons. Analysis of the association of gender and age with clinically significant distress revealed that women and younger age groups had higher distress. In our study, Christians had a higher association with clinically significant distress.

Conclusion: More than one-third of the patients reported to have clinically significant distress. This emphasizes the key role of distress screening and new patient counseling in an oncology setting. This also stresses the need for a psychotherapeutic approach in managing psycho-social concerns of cancer patients.

Introduction: Afatinib, a second-generation EGFR TKI, was approved in 2015 for the treatment of metastatic NSCLC in India. We aimed to evaluate the clinical outcomes of Afatinib therapy in a real-world setting.

Patients and methods: Electronic medical records of 43 patients who received Afatinib for advanced EGFR-mutant advanced NSCLC were retrospectively reviewed. In total, 43 patients were analyzed of whom 31 received Afatinib in first-line therapy.

Results: The patient population was younger than Lux-Lung 3. Median PFS was 15.03 months with 95% CI (7.8-18.3 months). At 14% maturity OS was not reached. However, 95% CI lower limit was 34.9 months. The most common adverse reactions were skin rash and diarrhea which were managed with dose alteration without compromising efficacy.

Conclusion: Currently, there are multiple first-line strategies to manage advanced NSCLC in India including EGFR TKIs. To the best of our knowledge, this is the first real-world study published from India which looks into the efficacy of Afatinib in advanced NSCLC. Afatinib showed a manageable safety profile and comparable efficacy in real-world practice compared with those described in previous studies.

Background: We aimed to investigate the relationship between sarcopenia, which is defined by using psoas muscle index (PMI), and survival outcomes in patients with metastatic renal cell carcinoma (mRCC).

Methods: This is a retrospective descriptive study of mRCC treated with first-line anti-vascular endothelial growth factor (anti-VEGF) therapy. The prognostic significance of PMI for progression-free survival (PFS) and overall survival (OS) was evaluated by univariate and multivariate analyses. Additionally, the skeletal muscle index (SMI) was calculated and correlation analysis was performed between PMI and SMI.

Results: Eighty-eight patients with a median age of 60 years (interquartile range [IQR], 51-66) were included. Median PFS with first-line treatment was 6 (95% confidence interval [CI]: 2.9-9.03) months and median OS was 17 (95% CI: 10.6-23.03) months in all patients. Mean PMI was 5.71 (standard deviation [SD]: ±1.41) in women and 8.30 (SD: ±2.04) in men. Forty-seven (53.4%) patients according to PMI and 49 (55.6%) patients according to SMI were accepted as sarcopenic. The overall correlation between SMI and PMI was strong (rs = 0.73). PFS was numerically shorter in the low-PMI and low-SMI groups than the high-PMI and high-SMI groups, but it did not reach statistical significance. In univariate analyses, International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk score, anti-VEGF agent option, PMI, and SMI were significant prognostic factors for OS (P < 0.05 each). In multivariate analyses for OS, while IMDC score (P < 0.001) and PMI (P = 0.04) were significant independent prognostic factors according to multivariate analysis-1, IMDC score (P < 0.001) and SMI (P = 0.01) were significant independent prognostic factors according to multivariate analysis-2.

Conclusions: Pretreatment PMI has a strong correlation with SMI and is an independent prognostic factor for OS in patients with mRCC.