Pub Date : 2019-04-20DOI: 10.23937/2378-3419/1410111
J KubicekGregory, K. Rachel, J RossiMatthew, S. Christian, H. Alexander, P. Melvin, A. Stephen, Khrizman Polina
Background: Small cell lung cancer (SCLC) is an aggressive malignancy with a short median survival time. Because of the rapid growth rate there may be an advantage to emergently beginning chemotherapy as soon as SCLC diagnosis is made. Methods: All SCLC patients evaluated at Cooper University Hospital from January 2011 to September 2014 were reviewed. Multiple clinical factors were analyzed including timing between diagnosis and start of chemotherapy. Results: A total of 75 patients were analyzed. On univariate analysis there was a survival detriment to early initiation of chemotherapy. With multivariate analysis the difference in survival disappeared. With logistic regression, the only variable that was related to overall survival was stage (extensive versus limited). We did not find any subset that benefited from early initiation of chemotherapy. Conclusions: Mortality and cumulative survival time were not improved by early initiation of chemotherapy for any patient subset. Only stage at diagnosis was predictive for mortality and cumulative survival. Our data appears to show that urgency in starting chemotherapy has little bearing on survival in patients diagnosed with SCLC. The data suggest that there is no detriment to a non-urgent start time for chemotherapy. time, symptomatic disease, and early development of metastatic disease [1,2]. The cellular proliferation rate is much higher in comparison to other types of lung cancer, which has contributed tothe view of newly diagnosed SCLC as an “oncologic emergency”. Some oncologists will urge the start of chemotherapy as soon as possible (sometimes within 24 hours of diagnosis) given the potential for aggressive growth and metastasis. Similarly, some institutions will keep a patient with newly diagnosed lung cancer admitted to the hospital until final pathology is available so that in the event that the final diagnosis is SCLC chemotherapy can be initiated immediately as an in-patient. The theoretical rationale for emergent start of chemotherapy is based on the perceived rapid growth rate for SCLC. Since the tumor has such rapid growth potential, earlier chemotherapy start time may allow for an increase in cure rate for limited stage patients and provide improved disease control in extensive stage patients. While there may be a theoretical benefit to early initiation of chemotherapy, there is also a downside. Emergent initiation of therapy may overwhelm patients who haven’t had time to properly process their disease status (including potentially compromising the integrity of informed consent), strain hospital systems with the costs of inpatient chemotherapy and delayed discharge, and interfere with proper disease staging. Introduction Small Cell Lung Cancer (SCLC) is aparticularly aggressive lung malignancy characterized by a rapid doubling ISSN: 2378-3419 DOI: 10.23937/2378-3419/1410111 Kubicek et al. Int J Cancer Clin Res 2019, 6:111 • Page 2 of 5 • number of pack-years. Time from presentation w
背景:小细胞肺癌(SCLC)是一种侵袭性恶性肿瘤，中位生存时间短。由于生长速度快，一旦诊断为SCLC，紧急开始化疗可能有优势。方法:回顾性分析2011年1月至2014年9月在库珀大学医院接受评估的所有SCLC患者。分析了多种临床因素，包括诊断和化疗开始的时间。结果:共分析75例患者。单因素分析显示，早期开始化疗对生存率有不利影响。通过多变量分析，生存率的差异消失。通过逻辑回归，与总生存率相关的唯一变量是分期(广泛vs有限)。我们没有发现任何亚组从早期化疗中获益。结论:对于任何患者亚组，早期开始化疗均未改善死亡率和累积生存时间。只有诊断时的分期可预测死亡率和累积生存率。我们的数据似乎表明，紧急开始化疗对SCLC患者的生存几乎没有影响。数据表明，不紧急开始化疗没有损害。时间、症状性疾病和转移性疾病的早期发展[1,2]。与其他类型的肺癌相比，SCLC的细胞增殖率要高得多，这使得新诊断的SCLC被认为是一种“肿瘤急症”。一些肿瘤学家会敦促尽早开始化疗(有时在诊断后24小时内)，因为有可能出现侵袭性生长和转移。同样，一些机构会让新诊断的肺癌患者住院，直到最终病理结果出来，以便在最终诊断为SCLC的情况下，可以作为住院患者立即开始化疗。紧急开始化疗的理论依据是基于SCLC的快速增长速度。由于肿瘤具有如此快速的生长潜力，较早的化疗开始时间可能会提高有限期患者的治愈率，并改善广泛期患者的疾病控制。虽然从理论上讲，早期开始化疗可能有好处，但也有缺点。紧急开始治疗可能会使没有时间正确处理其疾病状态的患者不堪重负(包括可能损害知情同意的完整性)，使住院化疗和延迟出院的费用使医院系统紧张，并干扰适当的疾病分期。小细胞肺癌(SCLC)是一种特别具有侵袭性的肺部恶性肿瘤，其特征是快速翻倍ISSN: 2378-3419 DOI: 10.23937/2378-3419/1410111 Kubicek等。国际癌症临床杂志，2019,6:111•第2页5•包年数。从出现到实际诊断的时间定义为首次报告症状的时间。平均年龄为65岁。22例患者病情有限，47例患者病情广泛(表1)。从诊断到开始化疗的中位时间为23天(范围3至63天)。使用的化疗类型(一线化疗方案)包括卡铂、顺铂、依托泊苷、拓扑替康和紫杉醇。文献Karnofsky Performance Status (KPS)和Eastern Cooperative Oncology Group (ECOG)评分用于根据患者的身体状况和偏好来评估患者的表现状态。ECOG评分根据有效的统计评估量表转换为KPS评分。评估合并症(冠状动脉疾病、心肌梗死史、高血压、高脂血症、外周动脉疾病、慢性心力衰竭、糖尿病、肝炎、慢性阻塞性肺病、PE史、恶性肿瘤史、结核病史)，并将患者分为合并症小于或大于3的组。本研究仅分析了第一轮化疗(未检查进展后的化疗时间和二线化疗时间)。
{"title":"Importance of Time to Chemotherapy Initiation in Small Cell Lung Cancer","authors":"J KubicekGregory, K. Rachel, J RossiMatthew, S. Christian, H. Alexander, P. Melvin, A. Stephen, Khrizman Polina","doi":"10.23937/2378-3419/1410111","DOIUrl":"https://doi.org/10.23937/2378-3419/1410111","url":null,"abstract":"Background: Small cell lung cancer (SCLC) is an aggressive malignancy with a short median survival time. Because of the rapid growth rate there may be an advantage to emergently beginning chemotherapy as soon as SCLC diagnosis is made. Methods: All SCLC patients evaluated at Cooper University Hospital from January 2011 to September 2014 were reviewed. Multiple clinical factors were analyzed including timing between diagnosis and start of chemotherapy. Results: A total of 75 patients were analyzed. On univariate analysis there was a survival detriment to early initiation of chemotherapy. With multivariate analysis the difference in survival disappeared. With logistic regression, the only variable that was related to overall survival was stage (extensive versus limited). We did not find any subset that benefited from early initiation of chemotherapy. Conclusions: Mortality and cumulative survival time were not improved by early initiation of chemotherapy for any patient subset. Only stage at diagnosis was predictive for mortality and cumulative survival. Our data appears to show that urgency in starting chemotherapy has little bearing on survival in patients diagnosed with SCLC. The data suggest that there is no detriment to a non-urgent start time for chemotherapy. time, symptomatic disease, and early development of metastatic disease [1,2]. The cellular proliferation rate is much higher in comparison to other types of lung cancer, which has contributed tothe view of newly diagnosed SCLC as an “oncologic emergency”. Some oncologists will urge the start of chemotherapy as soon as possible (sometimes within 24 hours of diagnosis) given the potential for aggressive growth and metastasis. Similarly, some institutions will keep a patient with newly diagnosed lung cancer admitted to the hospital until final pathology is available so that in the event that the final diagnosis is SCLC chemotherapy can be initiated immediately as an in-patient. The theoretical rationale for emergent start of chemotherapy is based on the perceived rapid growth rate for SCLC. Since the tumor has such rapid growth potential, earlier chemotherapy start time may allow for an increase in cure rate for limited stage patients and provide improved disease control in extensive stage patients. While there may be a theoretical benefit to early initiation of chemotherapy, there is also a downside. Emergent initiation of therapy may overwhelm patients who haven’t had time to properly process their disease status (including potentially compromising the integrity of informed consent), strain hospital systems with the costs of inpatient chemotherapy and delayed discharge, and interfere with proper disease staging. Introduction Small Cell Lung Cancer (SCLC) is aparticularly aggressive lung malignancy characterized by a rapid doubling ISSN: 2378-3419 DOI: 10.23937/2378-3419/1410111 Kubicek et al. Int J Cancer Clin Res 2019, 6:111 • Page 2 of 5 • number of pack-years. Time from presentation w","PeriodicalId":13873,"journal":{"name":"International journal of cancer and clinical research","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87859989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-18DOI: 10.23937/2378-3419/1410110
O ZarghamEmilia, A MasonChristian, Jr Lee
Over the past decade, there has been a rising interest in the use of carboranes as a potential pharmacophoric moiety in the development of new drugs for the treatment of various types of cancer. The unique physical and chemical properties of carboranes make their use attractive in drug development. In several instances, the inclusion of carboranes into a drug structure has increased the agent’s binding affinity, potency, or bioavailability. The purpose of this review is to highlight applications of carboranes to the medicinal chemistry of cancer. Citation: Mason EOZ, Mason CA, Lee Jr MW (2019) The Use of Carboranes in Cancer Drug Development. Med Chem (Los Angeles) 9: 044-055. doi: 10.4172/21610444.1000534 Med Chem (Los Angeles), an open access journal ISSN: 2161-0444 Volume 9(4): 044-055 (2019) 45 typically be used to synthesize any of the three carborane isomers, while in contrast the synthesis of the ortho, meta, and para isomers in aryl rings is much more challenging [5]. The closo-carboranes are both air and moisture stable and are known to possess “superhydrophobicity.” Their high partition coefficient values are known to surpass common bioisosteres such as aryl, cycloalkyl, and adamantyl groups [5]. Moreover, their high stability and low toxicity towards cells make them interesting compounds for therapeutic applications [2]. The interactions between carborane pharmacophores and the active sites of biological targets are often stronger than those of the aryl, cycloakyl, or adamantyl pharmacophore counterparts. Several studies have been performed in an attempt to elucidate the underlying mechanism behind these interactions. In addition to the three dimensional shape and hydrophobicity which results in more points of interaction with the active site, the carborane cage can form dihydrogen bonds. The formation and characteristics of the dihydrogen bonds were explored by Fanfrlik et al. through the use of molecular dynamic simulations between carboranes and various amino and nucleic acids [28]. Dihydrogen bonding, also named proton-hydride bonding, typically occurs between a positively charged hydrogen atom of a proton donor AH (A=N, O, S, C, halogen) and an MH proton acceptor (M=boron, alkali metal, or transition metal). In the case of carboranes and biological molecules these bonds form between NH--HB, CH--HB, and SH--HB. Such bonds are calculated to exhibit strong stabilization energies between 6.1 to 7.6 kcal mol-1, compared with 1 to 5 kcal mol-1 for typical biomolecular hydrogen bond strengths, and H--H distances between 1.7 to 2.2 Å [28]. These interactions can potentially be used to improve the binding of carboranes over the more conventional pharmacophores containing aromatic groups such as aryl, or cycloakyl, or adamantyl. The successful design and implementation of a pharmacophore requires a careful study of the drug candidate’s pharmacokinetics. In cancer therapy, the agent’s biodistribution is an especially important characteristic
在过去的十年中，人们对使用碳硼烷作为治疗各种癌症的新药开发中潜在的药效成分的兴趣日益浓厚。碳硼烷独特的物理和化学性质使其在药物开发中的应用具有吸引力。在一些情况下，将碳硼烷包含到药物结构中增加了药物的结合亲和力、效力或生物利用度。本文综述了碳硼烷类化合物在癌症药物化学中的应用。引用本文:Mason EOZ, Mason CA, Lee Jr MW(2019)碳硼烷在癌症药物开发中的应用。医学化学(洛杉矶)9:044-055。Med Chem (Los Angeles)，开放获取期刊ISSN: 2161-0444卷9(4):044-055(2019)45通常用于合成三种碳硼烷异构体中的任何一种，而相反，芳基环中邻位异构体、间位异构体和对位异构体的合成更具挑战性[5]。近碳硼烷对空气和水分都是稳定的，并且已知具有“超疏水性”。已知它们的高分配系数值超过了常见的生物同分酯，如芳基、环烷基和金刚烷基[5]。此外，它们的高稳定性和对细胞的低毒性使它们成为治疗应用的有趣化合物[2]。碳烷类药效团与生物靶点活性位点之间的相互作用通常比芳基、环烷基或金刚烷基药效团的相互作用强。已经进行了几项研究，试图阐明这些相互作用背后的潜在机制。碳硼烷笼除了具有三维形状和疏水性使其与活性位点有更多的相互作用点外，还可以形成二氢键。Fanfrlik等人通过碳硼烷与各种氨基酸和核酸之间的分子动力学模拟，探索了二氢键的形成和特征[28]。二氢键，也称为质子-氢化物键，通常发生在质子供体AH (a =N, O, S, C，卤素)和MH质子受体(M=硼，碱金属或过渡金属)带正电的氢原子之间。在碳硼烷和生物分子的情况下，这些键在NH—HB、CH—HB和SH—HB之间形成。据计算，这种键的稳定能在6.1至7.6 kcal mol-1之间，而典型生物分子的氢键强度为1至5 kcal mol-1, H- H距离在1.7至2.2 Å[28]。这些相互作用可以潜在地用于改善碳硼烷与含有芳香族基团(如芳基、环烷基或金刚烷基)的更传统的药效团的结合。药效团的成功设计和实施需要仔细研究候选药物的药代动力学。在癌症治疗中，药物的生物分布是一个特别重要的特征。设计和使用含碳硼烷的药效团是一个相对较新的尝试[29-31]。过去文献中描述的研究工作探讨了各种碳硼烷类抗癌药效团的设计及其相对效力。然而，大部分初步工作仅限于体外进行的研究。尽管如此，在文献中有一些重要的例子，含碳硼烷的药效团被成功地转化为小动物模型。虽然这些实验与癌症无关，但有趣的是，Nampt酶与许多不同的癌症密切相关，包括最具侵袭性和最难治疗的癌症[32]。关于碳硼烷衍生物的给药、生物分布、肿瘤靶向和体内稳定性的许多已知信息都来自于碳硼烷用于开发BNCT富硼剂的研究[7-13]。有效BNCT所需的硼浓度比常规化疗期间通常施用的硼浓度高几个数量级。然而，在BNCT动物研究中所做的许多观察结果仍然与碳硼烷作为药效团在常规药物中的使用高度相关。碳硼烷和取代碳硼烷在体内具有很高的稳定性。例如，分子2,4-(α，β二羟乙基)去卟啉(BOPP)是一种卟啉，具有四个邻碳硼基基团，通过酯键连接[33]。使用该分子进行了几项动物研究，最常见的是使用浓度为10mg /ml的钾盐等渗盐水溶液[33]。含有bnct相关剂量的BOPP溶液，通常在5-50 mg/kg之间，已通过腹腔、静脉或尾静脉注射给小鼠和大鼠胶质瘤癌模型[34]。
{"title":"The Use of Carboranes in Cancer Drug Development","authors":"O ZarghamEmilia, A MasonChristian, Jr Lee","doi":"10.23937/2378-3419/1410110","DOIUrl":"https://doi.org/10.23937/2378-3419/1410110","url":null,"abstract":"Over the past decade, there has been a rising interest in the use of carboranes as a potential pharmacophoric moiety in the development of new drugs for the treatment of various types of cancer. The unique physical and chemical properties of carboranes make their use attractive in drug development. In several instances, the inclusion of carboranes into a drug structure has increased the agent’s binding affinity, potency, or bioavailability. The purpose of this review is to highlight applications of carboranes to the medicinal chemistry of cancer. Citation: Mason EOZ, Mason CA, Lee Jr MW (2019) The Use of Carboranes in Cancer Drug Development. Med Chem (Los Angeles) 9: 044-055. doi: 10.4172/21610444.1000534 Med Chem (Los Angeles), an open access journal ISSN: 2161-0444 Volume 9(4): 044-055 (2019) 45 typically be used to synthesize any of the three carborane isomers, while in contrast the synthesis of the ortho, meta, and para isomers in aryl rings is much more challenging [5]. The closo-carboranes are both air and moisture stable and are known to possess “superhydrophobicity.” Their high partition coefficient values are known to surpass common bioisosteres such as aryl, cycloalkyl, and adamantyl groups [5]. Moreover, their high stability and low toxicity towards cells make them interesting compounds for therapeutic applications [2]. The interactions between carborane pharmacophores and the active sites of biological targets are often stronger than those of the aryl, cycloakyl, or adamantyl pharmacophore counterparts. Several studies have been performed in an attempt to elucidate the underlying mechanism behind these interactions. In addition to the three dimensional shape and hydrophobicity which results in more points of interaction with the active site, the carborane cage can form dihydrogen bonds. The formation and characteristics of the dihydrogen bonds were explored by Fanfrlik et al. through the use of molecular dynamic simulations between carboranes and various amino and nucleic acids [28]. Dihydrogen bonding, also named proton-hydride bonding, typically occurs between a positively charged hydrogen atom of a proton donor AH (A=N, O, S, C, halogen) and an MH proton acceptor (M=boron, alkali metal, or transition metal). In the case of carboranes and biological molecules these bonds form between NH--HB, CH--HB, and SH--HB. Such bonds are calculated to exhibit strong stabilization energies between 6.1 to 7.6 kcal mol-1, compared with 1 to 5 kcal mol-1 for typical biomolecular hydrogen bond strengths, and H--H distances between 1.7 to 2.2 Å [28]. These interactions can potentially be used to improve the binding of carboranes over the more conventional pharmacophores containing aromatic groups such as aryl, or cycloakyl, or adamantyl. The successful design and implementation of a pharmacophore requires a careful study of the drug candidate’s pharmacokinetics. In cancer therapy, the agent’s biodistribution is an especially important characteristic","PeriodicalId":13873,"journal":{"name":"International journal of cancer and clinical research","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73828623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: To investigate whether the implementation of additional modern information tools about cosmetic outcome of breast-conserving treatment (BCT) could improve patient satisfaction. Methods: A comparative case study compared data of two cross-sectional studies. The historical group (HG) was treated in 2013, the implementation group (IG) in 2016. The HG received a questionnaire, which resulted in implementation of the following items in our practice, expansion of the BCT brochure and photo book, incorporation of the Harvard and Numeric Rating scale. The IG received the same questionnaire, with the addition of nine more questions concerning specific implementation aspects. Results: The HG contained 76 patients (age 41-86), versus 57 in the IG (age 40-84). Although additional information tools were implemented, no significant enhancement of IG patient satisfaction could be demonstrated. Nevertheless, the need for information appeared significantly greater (p < 0.001) in the IG. Conclusion: The need for information about cosmesis was greater in the IG, possibly due to increased attention paid by professionals. Furthermore, it is difficult to improve an information program concerning cosmetic consequences of BCT, despite the implementation of better tools. Professionals should focus on individual cosmetic outcome information during the entire treatment and follow up process of BCT.
{"title":"Does a New Information Structure about Cosmetic Outcome of Breast-Conserving Treatment Result in a Better Informed Patient? Outcome of a Comparative Case Study","authors":"Brands-Appeldoorn Atpm, Maaskant-Braat Ajg, Tjan-Heijnen Vcg, Roumen Rmh","doi":"10.23937/2378-3419/1410109","DOIUrl":"https://doi.org/10.23937/2378-3419/1410109","url":null,"abstract":"Background: To investigate whether the implementation of additional modern information tools about cosmetic outcome of breast-conserving treatment (BCT) could improve patient satisfaction. Methods: A comparative case study compared data of two cross-sectional studies. The historical group (HG) was treated in 2013, the implementation group (IG) in 2016. The HG received a questionnaire, which resulted in implementation of the following items in our practice, expansion of the BCT brochure and photo book, incorporation of the Harvard and Numeric Rating scale. The IG received the same questionnaire, with the addition of nine more questions concerning specific implementation aspects. Results: The HG contained 76 patients (age 41-86), versus 57 in the IG (age 40-84). Although additional information tools were implemented, no significant enhancement of IG patient satisfaction could be demonstrated. Nevertheless, the need for information appeared significantly greater (p < 0.001) in the IG. Conclusion: The need for information about cosmesis was greater in the IG, possibly due to increased attention paid by professionals. Furthermore, it is difficult to improve an information program concerning cosmetic consequences of BCT, despite the implementation of better tools. Professionals should focus on individual cosmetic outcome information during the entire treatment and follow up process of BCT.","PeriodicalId":13873,"journal":{"name":"International journal of cancer and clinical research","volume":"56 43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73267814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-11DOI: 10.23937/2378-3419/1410108
Strazzanti Angela, Trovato Claudio, Caponnetto Angelo, G. Santi, R VillariLoredana, G. Pietro, Basile Francesco
Neuroendocrine breast carcinomas (NEBC) are rarely malignant with a frequency of less than 0.1-0.3% of all breast tumors. The actual incidence of NEBC in BC (Breast Cancer) populations being still largely unknown due to the lack of a clear cut diagnostic criteria. In 2003, the World Health Organization (WHO) Classification of Tumors of the Breast and Female Genital Organs definitely established that the immunohistochemical expression of NE markers is the unique requirement for NEBC diagnosis [1] in more than 50% of the tumor cell population. In the 2012 WHO Classification of the Tumors of the Breast these entities were collected in another chapter, among the special subtypes: Carcinomas with neuroendocrine features, which encompass the categories of Neuroendocrine tumors which are well differentiated, Neuroendocrine carcinoma which is a poorly differentiated/small cell carcinoma and Invasive breast carcinoma with neuroendocrine differentiation. We would like to report the case of a 67-year-old woman with a rare neuroendocrine well differentiated breast cancer detected accidentally during a PET performed as a follow up in the treatment of a bone plasmacitoma. The result of histological examination was well differentiated primary neuroendocrine tumor of the breast with CKPan+, SYn+; CK7and CK5-; ER+, Pr+, HER2and ki67 < 5% [1]. The prognosis of NECB is not different from other invasive breast carcinomas and the most important prognostic factor is the tumor grade (G). However, there is no standard treatment and patients should be treated similarly to patients with invasive ductal carcinoma, NOS (Not Otherwise Specified), the choice of therapy depending on the size of the tumor, the degree of differentiation, the clinical stage, and the hormonal status. Abbreviations NEBC: Neuroendocrine Breast Carcinoma; BC: Breast Cancer; NOS: Not Otherwise Specified
{"title":"Well Differentiated Neuroendocrine Uncommon Primary Breast Carcinoma: A Case Report","authors":"Strazzanti Angela, Trovato Claudio, Caponnetto Angelo, G. Santi, R VillariLoredana, G. Pietro, Basile Francesco","doi":"10.23937/2378-3419/1410108","DOIUrl":"https://doi.org/10.23937/2378-3419/1410108","url":null,"abstract":"Neuroendocrine breast carcinomas (NEBC) are rarely malignant with a frequency of less than 0.1-0.3% of all breast tumors. The actual incidence of NEBC in BC (Breast Cancer) populations being still largely unknown due to the lack of a clear cut diagnostic criteria. In 2003, the World Health Organization (WHO) Classification of Tumors of the Breast and Female Genital Organs definitely established that the immunohistochemical expression of NE markers is the unique requirement for NEBC diagnosis [1] in more than 50% of the tumor cell population. In the 2012 WHO Classification of the Tumors of the Breast these entities were collected in another chapter, among the special subtypes: Carcinomas with neuroendocrine features, which encompass the categories of Neuroendocrine tumors which are well differentiated, Neuroendocrine carcinoma which is a poorly differentiated/small cell carcinoma and Invasive breast carcinoma with neuroendocrine differentiation. We would like to report the case of a 67-year-old woman with a rare neuroendocrine well differentiated breast cancer detected accidentally during a PET performed as a follow up in the treatment of a bone plasmacitoma. The result of histological examination was well differentiated primary neuroendocrine tumor of the breast with CKPan+, SYn+; CK7and CK5-; ER+, Pr+, HER2and ki67 < 5% [1]. The prognosis of NECB is not different from other invasive breast carcinomas and the most important prognostic factor is the tumor grade (G). However, there is no standard treatment and patients should be treated similarly to patients with invasive ductal carcinoma, NOS (Not Otherwise Specified), the choice of therapy depending on the size of the tumor, the degree of differentiation, the clinical stage, and the hormonal status. Abbreviations NEBC: Neuroendocrine Breast Carcinoma; BC: Breast Cancer; NOS: Not Otherwise Specified","PeriodicalId":13873,"journal":{"name":"International journal of cancer and clinical research","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84218165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Sager, F. Dinçoğlan, S. Demiral, H. Gamsız, B. Uysal, Bahar, Dirican, M. Beyzadeoğlu
Aim: Acoustic neuromas, also known as vestibular schwannomas are benign and slow-growing tumors arising from neural crest-derived Schwann cells. Treatment of acoustic neuromas targets to achieve local control while preserving hearing without comprimising cranial nerve functionality. In this context, radiosurgery in the form of Stereotactic Radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) offer viable therapeutic options for effective management. Multimodality imaging has gained utmost priority for improved target defnition for radiosurgery. In this study, we assessed the utility of Magnetic Resonance Imaging (MRI) for target volume definition for acoustic neuroma radiosurgery. Methods and materials: Twenty patients treated with radiosurgery for acoustic neuroma at our institution were included. Radiosurgery target definition was performed by using CT simulation images only or by using fused T1 gadolinium-enhanced MR images acquired within 1 week before treatment day. A comparative evaluation was made including volumetric analysis of target volumes. Results: Target volume definition based on CT-only imaging and CT-MR fusion based imaging were comparatively evaluated for 20 patients receiving SRS for acoustic neuroma at our institution. Mean target volumes were 5.7 cc (range: 2.1-13.9 cc) and 6.2 cc (range: 2.3-14.1 cc) with CT-only imaging and CT-MR fusion based imaging, respectively. Conclusion: MRI may be used as a viable imaging modality for acoustic neuromas and may improve target definition for radiosurgery despite the need for further supporting evidence.
{"title":"Utility of Magnetic Resonance Imaging (Imaging) in Target Volume Definition for Radiosurgery of Acoustic Neuromas","authors":"O. Sager, F. Dinçoğlan, S. Demiral, H. Gamsız, B. Uysal, Bahar, Dirican, M. Beyzadeoğlu","doi":"10.23937/2378-3419/6/3","DOIUrl":"https://doi.org/10.23937/2378-3419/6/3","url":null,"abstract":"Aim: Acoustic neuromas, also known as vestibular schwannomas are benign and slow-growing tumors arising from neural crest-derived Schwann cells. Treatment of acoustic neuromas targets to achieve local control while preserving hearing without comprimising cranial nerve functionality. In this context, radiosurgery in the form of Stereotactic Radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) offer viable therapeutic options for effective management. Multimodality imaging has gained utmost priority for improved target defnition for radiosurgery. In this study, we assessed the utility of Magnetic Resonance Imaging (MRI) for target volume definition for acoustic neuroma radiosurgery. Methods and materials: Twenty patients treated with radiosurgery for acoustic neuroma at our institution were included. Radiosurgery target definition was performed by using CT simulation images only or by using fused T1 gadolinium-enhanced MR images acquired within 1 week before treatment day. A comparative evaluation was made including volumetric analysis of target volumes. Results: Target volume definition based on CT-only imaging and CT-MR fusion based imaging were comparatively evaluated for 20 patients receiving SRS for acoustic neuroma at our institution. Mean target volumes were 5.7 cc (range: 2.1-13.9 cc) and 6.2 cc (range: 2.3-14.1 cc) with CT-only imaging and CT-MR fusion based imaging, respectively. Conclusion: MRI may be used as a viable imaging modality for acoustic neuromas and may improve target definition for radiosurgery despite the need for further supporting evidence.","PeriodicalId":13873,"journal":{"name":"International journal of cancer and clinical research","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80446393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.23937/2378-3419/1410128
Sahinturk Kadriye, Abakay Candan Demiroz, Sahinturk Serdar, Sag Sebnem Ozemri, Atalay Fatma, Can Fatma E, Kurt Meral, Cetintas Sibel Kahraman
In this study, the relationship between MSI (microsatellite instability) and the parameters such as age, stage, histologic grade, recurrence, overall survival (OS), disease free survival (DFS) were investigated in 99 endometrioid adenocancer patients. Our aim is to find out the whether there is a prognostic value of MSI in endometrium adenocarcinoma. In MSI analysis, by employing the Promega MSI Analysis System. ‘IBM SPSS v.20’ was used for statistical analysis. MSI was identified in 19.1% of patients. There was no statistically significant effect of MSI on OS (p = 0.404) or on DFS (p = 0.407). MSI was found associated with younger age (p = 0.032), lymph node involvement (p = 0.012) and advanced stage (p = 0.014).
{"title":"Research of Prognostic Role of MSI in Endometrioid Adenocarcinoma Cases That Received Postoperative Radiotherapy","authors":"Sahinturk Kadriye, Abakay Candan Demiroz, Sahinturk Serdar, Sag Sebnem Ozemri, Atalay Fatma, Can Fatma E, Kurt Meral, Cetintas Sibel Kahraman","doi":"10.23937/2378-3419/1410128","DOIUrl":"https://doi.org/10.23937/2378-3419/1410128","url":null,"abstract":"In this study, the relationship between MSI (microsatellite instability) and the parameters such as age, stage, histologic grade, recurrence, overall survival (OS), disease free survival (DFS) were investigated in 99 endometrioid adenocancer patients. Our aim is to find out the whether there is a prognostic value of MSI in endometrium adenocarcinoma. In MSI analysis, by employing the Promega MSI Analysis System. ‘IBM SPSS v.20’ was used for statistical analysis. MSI was identified in 19.1% of patients. There was no statistically significant effect of MSI on OS (p = 0.404) or on DFS (p = 0.407). MSI was found associated with younger age (p = 0.032), lymph node involvement (p = 0.012) and advanced stage (p = 0.014).","PeriodicalId":13873,"journal":{"name":"International journal of cancer and clinical research","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89466483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01Epub Date: 2019-02-25DOI: 10.23937/2378-3419/1410107
Sarah Colonna, Karen Curtin, Eric Johnson, Wendy Kohlmann, Jennifer Wright, Anne Kirchhoff, Sean Tavtigian, Joshua Schiffman
Introduction: Advances in treatments for Hodgkin Lymphoma (HL) have significantly increased survival of childhood and adult patients; however, the leading cause of death in HL survivors is due to secondary malignancy following HL treatment [1,2]. Among women treated for HL, breast cancer (BC) is the most common secondary malignancy [3]. We explored if an association exists between HL and BC exists within families.
Methods: Utilizing the Utah Population Database and the Utah Cancer Registry, we identified 988 women with HL, and no history of BC prior to HL, diagnosed in Utah from 1966-2014. We examined if women with HL were at greater risk of developing BC based on the presence or absence of family history of BC. We also examined the familial recurrence risk of BC among female FDRs of women with HL and BC using Cox regression methods.
Result: Among 988 female HL patients, 42 (4.3%) were diagnosed with subsequent BC while among 9,876 matched controls, 280 controls (2.8%) were diagnosed with BC from 1966-2014 (P < 0.05). We observed a significant 3-fold increased risk of BC in the first-degree relatives (parent, full sibling, or child of patient) of female HL patients with subsequent BC, compared to FDR in controls (HR = 2.8, 95%CI 1.4-5.6; P = 0.005). Female HL patients who had a family history of BC were significantly more likely to develop BC, compared to HL patients with no history of BC among relatives (HR = 3.3, 95%CI 1.6-7.1; P = 0.002).
Conclusion: Women with HL and a family history of BC are at even higher than anticipated risk of BC, as are their female relatives. Obtaining a thorough family history for a woman preparing to undergo therapy for HL is important for treatment decisions for HL and maintaining an up to date family history over time is also important for the management of a woman's ongoing cancer risks and her surveillance strategy following survival of HL.
{"title":"Family History of Breast Cancer Associated with Breast Cancer in Survivors of Hodgkin Lymphoma.","authors":"Sarah Colonna, Karen Curtin, Eric Johnson, Wendy Kohlmann, Jennifer Wright, Anne Kirchhoff, Sean Tavtigian, Joshua Schiffman","doi":"10.23937/2378-3419/1410107","DOIUrl":"https://doi.org/10.23937/2378-3419/1410107","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in treatments for Hodgkin Lymphoma (HL) have significantly increased survival of childhood and adult patients; however, the leading cause of death in HL survivors is due to secondary malignancy following HL treatment [1,2]. Among women treated for HL, breast cancer (BC) is the most common secondary malignancy [3]. We explored if an association exists between HL and BC exists within families.</p><p><strong>Methods: </strong>Utilizing the Utah Population Database and the Utah Cancer Registry, we identified 988 women with HL, and no history of BC prior to HL, diagnosed in Utah from 1966-2014. We examined if women with HL were at greater risk of developing BC based on the presence or absence of family history of BC. We also examined the familial recurrence risk of BC among female FDRs of women with HL and BC using Cox regression methods.</p><p><strong>Result: </strong>Among 988 female HL patients, 42 (4.3%) were diagnosed with subsequent BC while among 9,876 matched controls, 280 controls (2.8%) were diagnosed with BC from 1966-2014 (<i>P</i> < 0.05). We observed a significant 3-fold increased risk of BC in the first-degree relatives (parent, full sibling, or child of patient) of female HL patients with subsequent BC, compared to FDR in controls (HR = 2.8, 95%CI 1.4-5.6; <i>P</i> = 0.005). Female HL patients who had a family history of BC were significantly more likely to develop BC, compared to HL patients with no history of BC among relatives (HR = 3.3, 95%CI 1.6-7.1; <i>P</i> = 0.002).</p><p><strong>Conclusion: </strong>Women with HL and a family history of BC are at even higher than anticipated risk of BC, as are their female relatives. Obtaining a thorough family history for a woman preparing to undergo therapy for HL is important for treatment decisions for HL and maintaining an up to date family history over time is also important for the management of a woman's ongoing cancer risks and her surveillance strategy following survival of HL.</p>","PeriodicalId":13873,"journal":{"name":"International journal of cancer and clinical research","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37321366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-31DOI: 10.23937/2378-3419/1410100
Farrag Ashraf, ArifShaukat, A. Muhammad, MagdyKandil
Background: Pretreatment Neutrophil-to-lymphocyte ratio (NLR) has been correlated with survival outcome in different types of cancers. In this study we evaluated the prognostic significance of pretreatment NLR in patients with oral squamous cell carcinoma (OSCC). Methods: We retrospectively collected the clinical and epidemiological data of all biopsy proven, non-metastatic OSCC treated in our center between 2009-2015. Pretreatment absolute neutrophils and lymphocytes counts used to obtain NLR. The impact of NLR on overall (OS) and progression free survivals (PFS) was investigated in both uniand multivariate analyses. Results: We identified a total of 68 patients of OSCC with a median pretreatment NLR ratio of 1.79. Patients were classified into two groups; high NLR and low NLR based on median NLR as a cut-off. Elevated NLR was significantly associated with male gender (p = 0.003) and with the presence lymph node metastases (p = 0.029). The 3-years OS and PFS for low and high NLR groups were (69.5% vs. 54.7%, p = 0.037) and (51% vs. 29.5%, p = 0.028), respectively. In multivariate analysis NLR was significant for both OS (p = 0.005) and PFS (p = 0.008). Conclusions: Pretreatment NLR has been shown to be an independent prognostic factor for our patients with OSCC. This provides a simple and easily measurable indicator of outcome. Larger and prospective studies are required to determine the optimal cut-off values to accurately identify NLR related risk groups.
背景:预处理中性粒细胞与淋巴细胞比率(NLR)与不同类型癌症的生存结局相关。在这项研究中，我们评估了预处理NLR对口腔鳞状细胞癌(OSCC)患者预后的意义。方法:回顾性收集本中心2009-2015年间所有活检证实的非转移性OSCC的临床和流行病学资料。预处理绝对中性粒细胞和淋巴细胞计数用于获得NLR。在单因素和多因素分析中，研究了NLR对总生存率(OS)和无进展生存率(PFS)的影响。结果:我们共确定了68例OSCC患者，预处理NLR比中位数为1.79。患者分为两组;高NLR和低NLR基于中位NLR作为截止值。NLR升高与男性(p = 0.003)和存在淋巴结转移(p = 0.029)显著相关。低NLR组和高NLR组3年OS和PFS分别为(69.5% vs. 54.7%， p = 0.037)和(51% vs. 29.5%， p = 0.028)。在多变量分析中，NLR对OS (p = 0.005)和PFS (p = 0.008)均有显著性意义。结论:预处理NLR已被证明是我们的OSCC患者的独立预后因素。这提供了一个简单而容易衡量的结果指标。需要更大规模的前瞻性研究来确定最佳临界值，以准确识别NLR相关的风险群体。
{"title":"Pretreatment Neutrophil-To-Lymphocyte Ratio (NLR) as a Prognostic Factor of Outcome for Patients with Oral Cavity Squamous Cell Carcinoma: A Single Institution Experience","authors":"Farrag Ashraf, ArifShaukat, A. Muhammad, MagdyKandil","doi":"10.23937/2378-3419/1410100","DOIUrl":"https://doi.org/10.23937/2378-3419/1410100","url":null,"abstract":"Background: Pretreatment Neutrophil-to-lymphocyte ratio (NLR) has been correlated with survival outcome in different types of cancers. In this study we evaluated the prognostic significance of pretreatment NLR in patients with oral squamous cell carcinoma (OSCC). Methods: We retrospectively collected the clinical and epidemiological data of all biopsy proven, non-metastatic OSCC treated in our center between 2009-2015. Pretreatment absolute neutrophils and lymphocytes counts used to obtain NLR. The impact of NLR on overall (OS) and progression free survivals (PFS) was investigated in both uniand multivariate analyses. Results: We identified a total of 68 patients of OSCC with a median pretreatment NLR ratio of 1.79. Patients were classified into two groups; high NLR and low NLR based on median NLR as a cut-off. Elevated NLR was significantly associated with male gender (p = 0.003) and with the presence lymph node metastases (p = 0.029). The 3-years OS and PFS for low and high NLR groups were (69.5% vs. 54.7%, p = 0.037) and (51% vs. 29.5%, p = 0.028), respectively. In multivariate analysis NLR was significant for both OS (p = 0.005) and PFS (p = 0.008). Conclusions: Pretreatment NLR has been shown to be an independent prognostic factor for our patients with OSCC. This provides a simple and easily measurable indicator of outcome. Larger and prospective studies are required to determine the optimal cut-off values to accurately identify NLR related risk groups.","PeriodicalId":13873,"journal":{"name":"International journal of cancer and clinical research","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87009436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-31DOI: 10.23937/2378-3419/1410096
S. GoodmanJohn, R. SandersHoward, J. MitchellBrian, D. BunnJeffrey, A. CallJason, K. FairbanksRobert, T. LamoreauxWayne, E. WagnerAaron, J. PeressiniBen, Strauss Casey, M. LeeChristopher
Purpose: The effect of surgical resection (SR) and/or adjuvant radiotherapy (RT) on overall survival (OS) for patients with non-metastatic adenoid cystic carcinoma (ACC) of the head and neck has not been clearly established. Methods and materials: The primary endpoint was overall survival (OS). Univariate and multivariate analyses were performed on pretreatment clinical variables. Results: The records for 1,595 patients with non-metastatic ACC of the head and neck were obtained from the SEER database. Multivariate analysis revealed that younger age at diagnosis, surgery performed, gross resection type, no lymph node involvement, smaller tumor size, and major salivary gland and palate primary tumor sites to be prognostic for a statistically improved OS (p < 0.001). The addition of adjuvant RT was not associated with an improvement in OS for patients. Conclusions: This study reveals that age of diagnosis, absence of lymph node involvement, smaller tumor size, and extent of surgery were positive predictors for statistically significant improvements in OS in patients with ACC of the head and neck. Further clinical studies will be needed to further elucidate the impact of surgical resection type and adjuvant RT techniques on local regional control and risk of distant metastases.
{"title":"Effect of Surgery and Adjuvant Radiotherapy on Overall Survival for Non-Metastatic Adenoid Cystic Carcinoma of the Head and Neck: A SEER Population Analysis","authors":"S. GoodmanJohn, R. SandersHoward, J. MitchellBrian, D. BunnJeffrey, A. CallJason, K. FairbanksRobert, T. LamoreauxWayne, E. WagnerAaron, J. PeressiniBen, Strauss Casey, M. LeeChristopher","doi":"10.23937/2378-3419/1410096","DOIUrl":"https://doi.org/10.23937/2378-3419/1410096","url":null,"abstract":"Purpose: The effect of surgical resection (SR) and/or adjuvant radiotherapy (RT) on overall survival (OS) for patients with non-metastatic adenoid cystic carcinoma (ACC) of the head and neck has not been clearly established. Methods and materials: The primary endpoint was overall survival (OS). Univariate and multivariate analyses were performed on pretreatment clinical variables. Results: The records for 1,595 patients with non-metastatic ACC of the head and neck were obtained from the SEER database. Multivariate analysis revealed that younger age at diagnosis, surgery performed, gross resection type, no lymph node involvement, smaller tumor size, and major salivary gland and palate primary tumor sites to be prognostic for a statistically improved OS (p < 0.001). The addition of adjuvant RT was not associated with an improvement in OS for patients. Conclusions: This study reveals that age of diagnosis, absence of lymph node involvement, smaller tumor size, and extent of surgery were positive predictors for statistically significant improvements in OS in patients with ACC of the head and neck. Further clinical studies will be needed to further elucidate the impact of surgical resection type and adjuvant RT techniques on local regional control and risk of distant metastases.","PeriodicalId":13873,"journal":{"name":"International journal of cancer and clinical research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82973045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-31DOI: 10.23937/2378-3419/1410098
Levy Michal, M. Joseph, Boaz Mona, Wandel Ayelet, Mizrachi Yossi, Levy Tally
Introduction: Neoajuvant Chemotherapy (NACT) followed by Interval Debulking Surgery (IDS) is an acceptable therapeutic approach for selected patients with advanced stage Ovarian Carcinoma (OvC) and Primary Peritoneal Carcinoma (PPC) patients. Our aim was to assess whether the combined presence of reduction of the diameter of the largest tumor mass and of the CA125 level predict response to Neoadjuvant Chemotherapy (NACT). Material and methods: Clinicopathological data were abstracted from medical records of consecutive OvC and PPC patients who received paclitaxel + carboplatin NACT and underwent IDS. Computed tomography (CT) images before NACT and prior to IDS where compared. Response to NACT prior to IDS was determined according to the combined presence of two parameters: 1. Reduction in the greatest diameter of the largest CT tumor mass by 50% and 2. Reduction of the CA 125 level to ≤ 75 U/ml. No response was determined when both of these parameters where not observed. Results: Of 50 study group patients 10 (20.0%) had a response and 40 (80.0%) had no response to NACT. Optimal debulking (< 1 cm) was achieved in all responders and in 92.5% of nonresponders. The median progression free survival was similar in responders and nonresponders. The Overall Survival (OS) was 62.2% in responders and 22.6% in nonresponders (p = 0.40). The median OS was 51 months in the nonresponders and was not reached by responders. Conclusion: The proposed method of response prediction to NACT is simple and seems to identify patients who have a poor outcome after IDS.
{"title":"Response Prediction to Neoadjuvant Chemotherapy Prior to Interval Debulking Surgery and the Outcome of Responders Compared to Nonresponders","authors":"Levy Michal, M. Joseph, Boaz Mona, Wandel Ayelet, Mizrachi Yossi, Levy Tally","doi":"10.23937/2378-3419/1410098","DOIUrl":"https://doi.org/10.23937/2378-3419/1410098","url":null,"abstract":"Introduction: Neoajuvant Chemotherapy (NACT) followed by Interval Debulking Surgery (IDS) is an acceptable therapeutic approach for selected patients with advanced stage Ovarian Carcinoma (OvC) and Primary Peritoneal Carcinoma (PPC) patients. Our aim was to assess whether the combined presence of reduction of the diameter of the largest tumor mass and of the CA125 level predict response to Neoadjuvant Chemotherapy (NACT). Material and methods: Clinicopathological data were abstracted from medical records of consecutive OvC and PPC patients who received paclitaxel + carboplatin NACT and underwent IDS. Computed tomography (CT) images before NACT and prior to IDS where compared. Response to NACT prior to IDS was determined according to the combined presence of two parameters: 1. Reduction in the greatest diameter of the largest CT tumor mass by 50% and 2. Reduction of the CA 125 level to ≤ 75 U/ml. No response was determined when both of these parameters where not observed. Results: Of 50 study group patients 10 (20.0%) had a response and 40 (80.0%) had no response to NACT. Optimal debulking (< 1 cm) was achieved in all responders and in 92.5% of nonresponders. The median progression free survival was similar in responders and nonresponders. The Overall Survival (OS) was 62.2% in responders and 22.6% in nonresponders (p = 0.40). The median OS was 51 months in the nonresponders and was not reached by responders. Conclusion: The proposed method of response prediction to NACT is simple and seems to identify patients who have a poor outcome after IDS.","PeriodicalId":13873,"journal":{"name":"International journal of cancer and clinical research","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81893649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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