JNCI Journal of the National Cancer Institute最新文献

Although reduced mortality associated with moderate-to-vigorous physical activity has been reported among cancer survivors, the benefits of a concentrated physical activity pattern remain unclear. This prospective cohort study included 6075 cancer survivors from the UK Biobank accelerometry dataset: 2390 (39.3%) were inactive (<150 minutes/week), 1295 (21.3%) were active concentrated (≥150 minutes/week and achieved ≥50% total moderate-to-vigorous physical activity within 1-2 days), and 2390 (39.3%) were active regular (≥150 minutes/week but other than concentrated). After a median follow-up of 8 years (interquartile range [IQR] = 7.5 to 8.5 years), 634 deaths occurred. Active concentrated and regular patterns were associated with similar reduced all-cause mortality (hazard ratio [HR] = 0.72, 95% CI = 0.60 to 0.86; HR = 0.71, 95% CI = 0.56 to 0.89) and noncancer mortality (HR = 0.66, 95% CI = 0.47 to 0.92; HR = 0.56, 95% CI = 0.35 to 0.89). These findings highlight the concentrated physical activity pattern as a lifestyle intervention for cancer survivors.

Background: The cornerstone of the treatment of malignant peripheral nerve sheath tumors (MPNST) is surgical resection. Radiation and chemotherapy are variably employed. The optimal treatment remains uncertain, particularly for unresectable or metastatic disease and patients with neurofibromatosis type-1 (NF-1).

Methods: We present data for fifty-eight patients with newly diagnosed MPNST enrolled on the Children's Oncology Group study ARST0332. Patients were treated with risk-adapted therapy including surgery with or without radiotherapy and ifosfamide and doxorubicin chemotherapy.

Results: Most patients had primary tumors that were greater than 5 cm (86%), deep (95%), and invasive (74%), and 10% had distant metastases. Thirty-two (55%) patients had germline NF-1 and 26 (45%) did not. Thirty-one patients received neoadjuvant therapy and 22 were evaluable for response with 5 (23%) attaining an objective response, 10 (45%) stable disease, and 7 (32%) progressive disease. Estimated 5-year event-free survival (EFS) was 87%, 52% and 0% for the low- (n = 8), intermediate- (n = 44) and high-risk (n = 6) patients, respectively. In univariate analysis, EFS and overall survival (OS) differed by sex, presence or absence of metastatic disease, risk group, and achievement of upfront or delayed R0/R1. There was no difference in EFS or OS based on germline NF-1 status.

Conclusion: The treatment strategy in ARST0332 achieved excellent outcomes for low-risk MPNST. Patients with high risk (metastatic) MPNST have poor outcomes and novel treatments are needed. (NCT00346164).

Background: Drinking water can be an important source of exposure to nitrate and disinfection by-products, including trihalomethanes (THMs) and haloacetic acids (HAAs). N-nitroso compounds formed endogenously after nitrate ingestion are animal carcinogens, and THM and HAA exposures increase the risk of some cancers. Our objectives were to evaluate associations of drinking water nitrate and disinfection byproducts with total and aggressive (distant stage, poorly differentiated grade, fatal, or Gleason score ≥7) prostate cancer in the Agricultural Health Study cohort.

Methods: Male participants who were cancer free and used private wells or public water supplies (PWS) for drinking water at enrollment (1993-1997, n = 40 403) were followed through 2021 (mean = 21.9 years). Average nitrate-nitrogen (nitrate-N) concentrations were estimated for private well users based on state-specific geologic and meteorologic factors. We used monitoring data to compute average nitrate-N, THMs, and HAAs for PWS users. We estimated hazard ratios (HRs, 95% CIs) per doubling and categories of exposure for total (n = 3625) and aggressive (n = 2200) prostate cancer using Cox proportional hazards regression.

Results: Median (interquartile range) average water nitrate-N was 1.49 (0.76-3.01) mg L-1; 6% >10 mg L-1 (PWS maximum contaminant level). Compared to nitrate-N ≤ 1 mg L-1, exposures >10 mg L-1 were significantly positively associated with total (1.16, 1.01-1.35; P = .10 for trend) and aggressive disease (1.22, 1.02-1.47; P = .03 for trend). We observed weak associations between higher nitrate-N (Q4 vs Q1) and total (1.05, 0.95-1.16) and aggressive (1.13, 0.99-1.27) disease. We did not observe associations with total THMs or HAAs.

Conclusions: These findings suggest that drinking water nitrate-N exposure, at average levels > 10 mg L-1, is a risk factor for prostate cancer, particularly aggressive disease.