Background: Hypofractionated radiotherapy delivered a lower total dose of radiation in larger dose per-fraction over 3 weeks.Many randomized trials supported the comparable efficacy and toxicities of conventional radiotherapy schedule to differenthypofractionated regimens. Patients and methods: One hundred female patients having breast cancer post-surgery randomized into two arms of acceleratedhypofractionation; 39 Gy/13 fractions (group A) and 42.4 Gy/16 fractions (group B) both regimens given as 5 fractions per week. Results: There was a significant increase of incidence of acute radiation dermatitis in patients receiving 39 Gy. Grade I and IIdermatitis reported in 82% and 46% for 39 Gy group and 42.4 Gy group respectively. In-addition, increased chronic subcutaneousfibrosis among patients with group A (28%) compared with (18%) to group B that was statistical significance. Breast conservativesurgery is the only factor that had significant effect on incidence of acute radiation dermatitis and chronic subcutaneous fibrosis. Conclusion: Thirty-nine Gy in 13 fractions has higher acute dermatitis and chronic subcutaneous fibrosis for patients underwentbreast conservative surgery. We need longer follow up to evaluate the efficacy of both regimens as regard of local control andsurvival.
{"title":"Acute and late adverse effects of breast cancer radiation: Two hypo-fractionation protocols","authors":"M. Aboziada, S. Shehata","doi":"10.5430/JST.V7N2P1","DOIUrl":"https://doi.org/10.5430/JST.V7N2P1","url":null,"abstract":"Background: Hypofractionated radiotherapy delivered a lower total dose of radiation in larger dose per-fraction over 3 weeks.Many randomized trials supported the comparable efficacy and toxicities of conventional radiotherapy schedule to differenthypofractionated regimens. Patients and methods: One hundred female patients having breast cancer post-surgery randomized into two arms of acceleratedhypofractionation; 39 Gy/13 fractions (group A) and 42.4 Gy/16 fractions (group B) both regimens given as 5 fractions per week. Results: There was a significant increase of incidence of acute radiation dermatitis in patients receiving 39 Gy. Grade I and IIdermatitis reported in 82% and 46% for 39 Gy group and 42.4 Gy group respectively. In-addition, increased chronic subcutaneousfibrosis among patients with group A (28%) compared with (18%) to group B that was statistical significance. Breast conservativesurgery is the only factor that had significant effect on incidence of acute radiation dermatitis and chronic subcutaneous fibrosis. Conclusion: Thirty-nine Gy in 13 fractions has higher acute dermatitis and chronic subcutaneous fibrosis for patients underwentbreast conservative surgery. We need longer follow up to evaluate the efficacy of both regimens as regard of local control andsurvival.","PeriodicalId":17174,"journal":{"name":"Journal of Solid Tumors","volume":" 1197","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2016-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91409273","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}
The most common sites of distant metastasis for breast are the lungs, liver, bones and brain. Here we report an extremely rarepresentation of isolated salivary gland metastasis from primary breast cancer, indicating advanced stage of breast disease and signof poor prognosis. The case emphasizes the need for a thorough workup for distant metastatic disease in patients diagnosed withinvasive breast cancer.
{"title":"Synchronous isolated ipsilateral salivary gland metastasis from a primary breast cancer – A case report","authors":"Ashmitha Srinivasan","doi":"10.5430/JST.V7N1P16","DOIUrl":"https://doi.org/10.5430/JST.V7N1P16","url":null,"abstract":"The most common sites of distant metastasis for breast are the lungs, liver, bones and brain. Here we report an extremely rarepresentation of isolated salivary gland metastasis from primary breast cancer, indicating advanced stage of breast disease and signof poor prognosis. The case emphasizes the need for a thorough workup for distant metastatic disease in patients diagnosed withinvasive breast cancer.","PeriodicalId":17174,"journal":{"name":"Journal of Solid Tumors","volume":"228 4‐6","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2016-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91422137","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}
A. Buchali, L. Heiserich, P. Bauer, M. Tregel, D. Roggenbuck, A. Franzen
Purpose: Can double strand breaks in peripheral lymphocytes measured as baseline γH2AX and 53BP1 values be used as a signal for reduced DNA repair capacity and an increased late radiation morbidity? Methods and materials: Of 357 patients, homogenously treated with a definitive radio-chemotherapy, 11 patients without any relevant comorbidity concerning baseline DNA double strand breaks, a follow up of more than 3.5 years and different levels of late morbidity were selected. γH2AX and 53BP1 foci were analyzed, using the fully automated AKLIDES ® system (Medipan). For foci detection, images of different z-planes throughout the nucleus were obtained. For further evaluation mean focus number/cell as well as percentage of γH2AX/ 53BP1 focus-positive cells were used. Results: Patients with late toxicity levels 0°, I° and III° showed median numbers of γH2AX foci per peripheral mononuclear cell of 0.26, 0.34 and 0.73 respectively. The corresponding median values of 53BP1 foci per cell were 0.13, 0.06 and 0.40, respectively and concordant percentages of γH2AX positive cells for the 3 different late toxicity groups were 10.85, 14.30 and 30.67 as well as of 53BP1 positive cells 8.5, 5.7 and 25.37, respectively. Despite the wide interindividual range of all values, patients with severe late morbidity showed increased values for γH2AX as well as 53BP1 foci compared to the other groups, whereas no differences between groups with no or mild toxicity were seen. Conclusions: The determination of baseline γH2AX foci in peripheral blood mononuclear cells could be suited as a marker for late morbidity after definitive radio-chemotherapy of head and neck carcinoma. Blood sampling at the time of treatment i.e. moment of origin of the late effect should be more effective rather than a retrospective study. To address this question a prospective trial with a larger cohort of patients and a long term follow up is needed.
{"title":"Baseline γH2AX foci, 53BP1 values and late morbidity after definitive radio-chemotherapy in head and neck carcinoma patients","authors":"A. Buchali, L. Heiserich, P. Bauer, M. Tregel, D. Roggenbuck, A. Franzen","doi":"10.5430/JST.V7N1P11","DOIUrl":"https://doi.org/10.5430/JST.V7N1P11","url":null,"abstract":"Purpose: Can double strand breaks in peripheral lymphocytes measured as baseline γH2AX and 53BP1 values be used as a signal for reduced DNA repair capacity and an increased late radiation morbidity? Methods and materials: Of 357 patients, homogenously treated with a definitive radio-chemotherapy, 11 patients without any relevant comorbidity concerning baseline DNA double strand breaks, a follow up of more than 3.5 years and different levels of late morbidity were selected. γH2AX and 53BP1 foci were analyzed, using the fully automated AKLIDES ® system (Medipan). For foci detection, images of different z-planes throughout the nucleus were obtained. For further evaluation mean focus number/cell as well as percentage of γH2AX/ 53BP1 focus-positive cells were used. Results: Patients with late toxicity levels 0°, I° and III° showed median numbers of γH2AX foci per peripheral mononuclear cell of 0.26, 0.34 and 0.73 respectively. The corresponding median values of 53BP1 foci per cell were 0.13, 0.06 and 0.40, respectively and concordant percentages of γH2AX positive cells for the 3 different late toxicity groups were 10.85, 14.30 and 30.67 as well as of 53BP1 positive cells 8.5, 5.7 and 25.37, respectively. Despite the wide interindividual range of all values, patients with severe late morbidity showed increased values for γH2AX as well as 53BP1 foci compared to the other groups, whereas no differences between groups with no or mild toxicity were seen. Conclusions: The determination of baseline γH2AX foci in peripheral blood mononuclear cells could be suited as a marker for late morbidity after definitive radio-chemotherapy of head and neck carcinoma. Blood sampling at the time of treatment i.e. moment of origin of the late effect should be more effective rather than a retrospective study. To address this question a prospective trial with a larger cohort of patients and a long term follow up is needed.","PeriodicalId":17174,"journal":{"name":"Journal of Solid Tumors","volume":"134 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2016-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84709837","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}
Paraganglioma of the nasal and paranasal sinuses are quite rare neuroendocrine tumours, usually hormonally inactive, presentingas nasal polyps with or without epistaxis. We present a rare case of a 23 year old male, with Addison’s disease, who was referredfrom endocrinology department with a complaint of right nasal blockage associated with recurrent epistaxis. A provisionalclinical diagnosis of vascular tumour was made, Computed tomography and MRI suggested hemangioma /inverted papilloma.However, biopsy reported a highly vascular tissue mimicking angiofibroma, further immunostaining studies with Synaptophysinand S-100 confirmed the diagnosis of Paraganglioma. This rare tumour in the paranasal sinuses may mimic vascular tumour andcan only be confirmed with histopathological immunostains studies. According to our knowledge, this is first case reported to beassociated with Addison’s disease in the English literature.
{"title":"Paraganglioma of maxillary sinus associated with Addison’s disease mimicking a vascular tumour: A case report","authors":"Sami A Alkindy","doi":"10.5430/JST.V7N1P7","DOIUrl":"https://doi.org/10.5430/JST.V7N1P7","url":null,"abstract":"Paraganglioma of the nasal and paranasal sinuses are quite rare neuroendocrine tumours, usually hormonally inactive, presentingas nasal polyps with or without epistaxis. We present a rare case of a 23 year old male, with Addison’s disease, who was referredfrom endocrinology department with a complaint of right nasal blockage associated with recurrent epistaxis. A provisionalclinical diagnosis of vascular tumour was made, Computed tomography and MRI suggested hemangioma /inverted papilloma.However, biopsy reported a highly vascular tissue mimicking angiofibroma, further immunostaining studies with Synaptophysinand S-100 confirmed the diagnosis of Paraganglioma. This rare tumour in the paranasal sinuses may mimic vascular tumour andcan only be confirmed with histopathological immunostains studies. According to our knowledge, this is first case reported to beassociated with Addison’s disease in the English literature.","PeriodicalId":17174,"journal":{"name":"Journal of Solid Tumors","volume":"209 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2016-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88123708","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}
Introduction and aim: Laryngeal preservation with concurrent chemo-radiation is an effective, alternative management forcancer larynx. Three weekly cis-platinum concurrent with radiotherapy (RT) considered the standard. However, weekly cisplatinumhas proven very effective for advanced head and neck carcinoma. We review our data to prove the efficacy and safety ofweekly cis-platinum plus RT for laryngeal preservation. Patients and methods: Untreated 64 patients with advanced laryngeal carcinoma were retrospectively analyzed. Patients offeredfor 6 weeks of cis-platinum 40 mg/m 2 concurrent with conformal RT; 70 Gy delivered to gross primary and lymph nodes. Results: Forty-six (71.8%) patients had complete remission (CR). Early stages had better CR than late stages. Median follow upwas 40 months. Three years DFS and OS were 69% and 77% respectively. Larynx preservation survival at 3 years was 73%.Protocol of treatment was tolerable, grade 3 or 4 acute and late toxic effects were reported in 25% of the included cases. Conclusion: Weekly cis-platinum could be effective and safe. We need to evaluate this protocol prospectively and compare itwith three-weekly high dose cis-platinum with concomitant radiotherapy.
{"title":"Retrospective analysis of the clinical efficacy of concurrent weekly cisplatinum - radiotherapy for patients with laryngeal carcinoma","authors":"M. Aboziada, Ashraf Elyamany","doi":"10.5430/JST.V7N1P1","DOIUrl":"https://doi.org/10.5430/JST.V7N1P1","url":null,"abstract":"Introduction and aim: Laryngeal preservation with concurrent chemo-radiation is an effective, alternative management forcancer larynx. Three weekly cis-platinum concurrent with radiotherapy (RT) considered the standard. However, weekly cisplatinumhas proven very effective for advanced head and neck carcinoma. We review our data to prove the efficacy and safety ofweekly cis-platinum plus RT for laryngeal preservation. Patients and methods: Untreated 64 patients with advanced laryngeal carcinoma were retrospectively analyzed. Patients offeredfor 6 weeks of cis-platinum 40 mg/m 2 concurrent with conformal RT; 70 Gy delivered to gross primary and lymph nodes. Results: Forty-six (71.8%) patients had complete remission (CR). Early stages had better CR than late stages. Median follow upwas 40 months. Three years DFS and OS were 69% and 77% respectively. Larynx preservation survival at 3 years was 73%.Protocol of treatment was tolerable, grade 3 or 4 acute and late toxic effects were reported in 25% of the included cases. Conclusion: Weekly cis-platinum could be effective and safe. We need to evaluate this protocol prospectively and compare itwith three-weekly high dose cis-platinum with concomitant radiotherapy.","PeriodicalId":17174,"journal":{"name":"Journal of Solid Tumors","volume":"23 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2016-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91483207","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}
Elnaz Agi, Z. Mosaferi, Sepideh Khatamsaz, P. Cheraghi, Nooshin Samadian, A. Bolhassani
Gene therapy is the gene transfer into host cells for treatment of acquired and genetic disorders. For this purpose, there are awide variety of gene delivery methods with special properties including viral and non-viral vectors. The non-viral methods usephysical forces or chemical compounds (natural or synthetic) to transfer DNA into a cell. The efficiency of the non-viral genetherapy depends on conquering four different intra- and extra-cellular barriers such as cellular uptake, endosomal escape, nuclearentry, and gene expression. Among various gene carriers, some viral vectors such as Adenovirus, Lentivirus, Vaccinia as well asgene gun and lipofection achieved to clinical trials. In this mini-review, we briefly describe different approaches for gene deliveryand their applications in various phases of clinical trials.
{"title":"Different strategies of gene delivery for treatment of cancer and other disorders","authors":"Elnaz Agi, Z. Mosaferi, Sepideh Khatamsaz, P. Cheraghi, Nooshin Samadian, A. Bolhassani","doi":"10.5430/JST.V6N2P76","DOIUrl":"https://doi.org/10.5430/JST.V6N2P76","url":null,"abstract":"Gene therapy is the gene transfer into host cells for treatment of acquired and genetic disorders. For this purpose, there are awide variety of gene delivery methods with special properties including viral and non-viral vectors. The non-viral methods usephysical forces or chemical compounds (natural or synthetic) to transfer DNA into a cell. The efficiency of the non-viral genetherapy depends on conquering four different intra- and extra-cellular barriers such as cellular uptake, endosomal escape, nuclearentry, and gene expression. Among various gene carriers, some viral vectors such as Adenovirus, Lentivirus, Vaccinia as well asgene gun and lipofection achieved to clinical trials. In this mini-review, we briefly describe different approaches for gene deliveryand their applications in various phases of clinical trials.","PeriodicalId":17174,"journal":{"name":"Journal of Solid Tumors","volume":"36 1","pages":"76"},"PeriodicalIF":0.0,"publicationDate":"2016-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82209497","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}
Melanomas with extensive metastasis can rarely regress on the appearance of a halo nevus (HN). This study explores the possiblefactors involved. The component melanocytes of HN, flatten, depigment and line vascular spaces to replace and result in theinvolution of the nevus. This simulates vasculogenesis in amelanotic melanomas, malignant melanocytes differentiating intoendothelial cells. The reverse is seen in pigmented tumors. Nestin positive endothelial cells lining angiogenic tubes, enter thetumor margins, show glial differentiation and form transient tumor vascular complexes (TVC) with stepwise neural differentiationand pigment laden cells, suggesting transdifferentiation of endothelial cells to melanocytes. During development, a range ofmolecular tools are used by blood vessels as well as nerves, including ephrins/Eph, NP-I and Notch signalling. This is vindicatedby morphologic evidence of melanocyte/endothelial transdifferentiation as shown in this study. These observations, suggesta common multipotent stem cell, differentiating into vascular and melanocyte/neural stem cell depending on the surroundingmicroenviroment. Concurrent tumor regression may involve a rapid transdifferentiation triggered by a molecular switch or shutdown of the common stem cell and/or presence of circulating antibodies to melanomas released on the appearance of HN.
{"title":"Melanocyte-endothelial melanomas: Plasticity and transdifferentiation in melanomas","authors":"B. Iyengar","doi":"10.5430/JST.V6N2P66","DOIUrl":"https://doi.org/10.5430/JST.V6N2P66","url":null,"abstract":"Melanomas with extensive metastasis can rarely regress on the appearance of a halo nevus (HN). This study explores the possiblefactors involved. The component melanocytes of HN, flatten, depigment and line vascular spaces to replace and result in theinvolution of the nevus. This simulates vasculogenesis in amelanotic melanomas, malignant melanocytes differentiating intoendothelial cells. The reverse is seen in pigmented tumors. Nestin positive endothelial cells lining angiogenic tubes, enter thetumor margins, show glial differentiation and form transient tumor vascular complexes (TVC) with stepwise neural differentiationand pigment laden cells, suggesting transdifferentiation of endothelial cells to melanocytes. During development, a range ofmolecular tools are used by blood vessels as well as nerves, including ephrins/Eph, NP-I and Notch signalling. This is vindicatedby morphologic evidence of melanocyte/endothelial transdifferentiation as shown in this study. These observations, suggesta common multipotent stem cell, differentiating into vascular and melanocyte/neural stem cell depending on the surroundingmicroenviroment. Concurrent tumor regression may involve a rapid transdifferentiation triggered by a molecular switch or shutdown of the common stem cell and/or presence of circulating antibodies to melanomas released on the appearance of HN.","PeriodicalId":17174,"journal":{"name":"Journal of Solid Tumors","volume":"5 1","pages":"66"},"PeriodicalIF":0.0,"publicationDate":"2016-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87361946","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}
Primary cardiac tumors are extremely rare, although only 20% are malignant. Of the malignant tumors, sarcomas are the mostcommon type and usually present with signs and symptoms of pericardial effusion or tamponade, including dyspnea, chestpain, or syncope. We present the case of a woman with nausea, vomiting, and epigastric pain who eventually received thediagnosis of a large cardiac angiosarcoma. To our knowledge, no case reports have described patients with primary cardiac tumorspresenting with nausea and vomiting without cardiac symptoms. Our patient was treated with open heart resection of the tumorand reconstruction of the right atrium with bovine pericardium. This case highlights an atypical presentation of this rare conditionand shows the current optimal management.
{"title":"Nausea and vomiting masquerading heart cancer","authors":"J. Shapiro, V. Vasile, K. Klarich, H. Schaff","doi":"10.5430/JST.V6N2P62","DOIUrl":"https://doi.org/10.5430/JST.V6N2P62","url":null,"abstract":"Primary cardiac tumors are extremely rare, although only 20% are malignant. Of the malignant tumors, sarcomas are the mostcommon type and usually present with signs and symptoms of pericardial effusion or tamponade, including dyspnea, chestpain, or syncope. We present the case of a woman with nausea, vomiting, and epigastric pain who eventually received thediagnosis of a large cardiac angiosarcoma. To our knowledge, no case reports have described patients with primary cardiac tumorspresenting with nausea and vomiting without cardiac symptoms. Our patient was treated with open heart resection of the tumorand reconstruction of the right atrium with bovine pericardium. This case highlights an atypical presentation of this rare conditionand shows the current optimal management.","PeriodicalId":17174,"journal":{"name":"Journal of Solid Tumors","volume":"201 1","pages":"62"},"PeriodicalIF":0.0,"publicationDate":"2016-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75430194","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}
R. Hurle, R. Peschechera, N. Buffi, G. Lughezzani, E. Morenghi, A. Saita, L. Pasini, P. Casale, M. Seveso, Silvia Zandegiacomo, G. Taverna, A. Benetti, I. Vavassori, P. Colombo, M. Lazzeri, G. Guazzoni
Objective: To test the hypothesis that a teaching program improves the quality of transurethral resection of bladder tumor(TURBT) and decreases the risk of early recurrence. Material and methods: This is an observational retrospective cohort study of prospectively recorded data of patients withfirst clinical diagnosis of non-muscle-invasive bladder cancer (NMIBC), scheduled for TURBT. In 2005 a systematic TURBTteaching program was introduced in our Department. We reviewed the charts of patients who underwent TURBT in the years1998-2004, when no tutoring was applied, and those who underwent TURBT in the years 2005-2010. The outcomes of interestwere: presence/absence of detrusor muscle (DM), carcinoma in situ (CIS) detection, complication rate and recurrence rate at thefirst follow-up cystoscopy (RRFF-C). Results: Complete data from 427 patients were available: 199 before and 228 after the introduction of the teaching program.Multivariable logistic analysis showed that the training program was an independent prognostic factor for DM (presence) rate(OR = 3.92, 95%CI = 2.42-6.33), CIS detection rate (OR = 4.36, 95%CI = 1.92-9.86), and complication rate (OR = 0.28, 95%CI= 0.15-0.55), but not for RRFF-C (OR = 0.79, 95%CI = 0.52-1.20). Between 1998-2004, RRFF-C was correlated with tumornumber, pathological stage, DM presence, presence of complication, CIS detection and surgeon experience. After the introductionof the teaching program, only tumor number, DM presence and surgeon experience influenced the RRFF-C. Conclusion: Our findings suggest the hypothesis that the teaching program might have an impact of quality of TURBT, but itfailed to improve the RRFF-C.
{"title":"Impact of a teaching program on outcome quality of white light transurethral resection for bladder tumor: A cohort study","authors":"R. Hurle, R. Peschechera, N. Buffi, G. Lughezzani, E. Morenghi, A. Saita, L. Pasini, P. Casale, M. Seveso, Silvia Zandegiacomo, G. Taverna, A. Benetti, I. Vavassori, P. Colombo, M. Lazzeri, G. Guazzoni","doi":"10.5430/JST.V6N2P56","DOIUrl":"https://doi.org/10.5430/JST.V6N2P56","url":null,"abstract":"Objective: To test the hypothesis that a teaching program improves the quality of transurethral resection of bladder tumor(TURBT) and decreases the risk of early recurrence. Material and methods: This is an observational retrospective cohort study of prospectively recorded data of patients withfirst clinical diagnosis of non-muscle-invasive bladder cancer (NMIBC), scheduled for TURBT. In 2005 a systematic TURBTteaching program was introduced in our Department. We reviewed the charts of patients who underwent TURBT in the years1998-2004, when no tutoring was applied, and those who underwent TURBT in the years 2005-2010. The outcomes of interestwere: presence/absence of detrusor muscle (DM), carcinoma in situ (CIS) detection, complication rate and recurrence rate at thefirst follow-up cystoscopy (RRFF-C). Results: Complete data from 427 patients were available: 199 before and 228 after the introduction of the teaching program.Multivariable logistic analysis showed that the training program was an independent prognostic factor for DM (presence) rate(OR = 3.92, 95%CI = 2.42-6.33), CIS detection rate (OR = 4.36, 95%CI = 1.92-9.86), and complication rate (OR = 0.28, 95%CI= 0.15-0.55), but not for RRFF-C (OR = 0.79, 95%CI = 0.52-1.20). Between 1998-2004, RRFF-C was correlated with tumornumber, pathological stage, DM presence, presence of complication, CIS detection and surgeon experience. After the introductionof the teaching program, only tumor number, DM presence and surgeon experience influenced the RRFF-C. Conclusion: Our findings suggest the hypothesis that the teaching program might have an impact of quality of TURBT, but itfailed to improve the RRFF-C.","PeriodicalId":17174,"journal":{"name":"Journal of Solid Tumors","volume":"59 1","pages":"56-61"},"PeriodicalIF":0.0,"publicationDate":"2016-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86781597","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}
Janine Pettiford, Sharon Felts, Edna Wischkaemper, Debbie Miller, S. Crawford, R. Rahman
Background: Given the 3.1 million breast cancer survivors in America, quality of life (QoL) is a vital issue. Bio-psychosocialmilieu of survivorship is increasingly important. This study assesses the impact of bio-psychosocial intervention (BPSI) on theQoL of breast cancer survivors utilizing Functional Assessment of Cancer Therapy – Breast (FACT-B) instrument. Methods: A prospective randomized trial was designed; intervention arm included a 4-hour BPSI coping skills class; control armreceived standard of cancer (SOC) and follow up care. Women diagnosed within 2 years of study initiation were eligible. Samplesize was based on 8-point difference in FACT-B score, 90% power, 5% type I error, and 20% attrition. FACT-B questionnaire wasadministered to all patients at baseline and at 6-month intervals. SAS 9.3 software was used to analyze data using Chi-square testfor categorical and Wilcoxon rank sum for ordinal data; linear mixed modeling was used for longitudinal analysis. Results: One hundred and three of 120 (86%) patients were available for analysis. Forty-seven patients were in BSPI arm, and 56received SOC. For BPSI arm vs. SOC arm, the median (interquartile) age [60 (52, 68) vs. 58 (52, 68)yrs. P = .9135], cancer-stage(0: 1: 2: 3 = 11%: 41%: 35%: 13% vs. 18%: 46%: 22%: 15%, P = .4645), and biology (triple-negative: HER2+ : ER+ =9%: 74%: 17% vs. 8%: 72%: 20%, P = .8454), respectively, was similar. Mean (SE) FACT-B scores in BPSI vs. SOC arms at6 months and 1 year were 115.1 (2.2) vs. 114.6 (2.0) ( P = .8731) and 124.7(2.8) vs. 101.4 (2.4) ( P = .0001). The inter-groupdifference significantly expanded at 1 year ( P = .0001). The 12-month difference persisted when confounding baseline variableswere adjusted for in in multivariate modeling. Conclusion: BPSI coping skills class significantly improved the QoL of breast cancer survivors by one year post-interventiontime point.
背景:鉴于美国有310万乳腺癌幸存者，生活质量(QoL)是一个至关重要的问题。生存的生物-心理-社会环境越来越重要。本研究利用肿瘤治疗功能评估-乳腺(FACT-B)仪器评估生物-社会心理干预(BPSI)对乳腺癌幸存者生活质量的影响。方法:设计前瞻性随机试验;干预组包括4小时的BPSI应对技能课程;对照组接受肿瘤标准(SOC)及随访护理。在研究开始的2年内确诊的女性是符合条件的。样本量基于FACT-B得分8分的差异，90%的功率，5%的I型误差和20%的损耗率。在基线和6个月的间隔对所有患者进行FACT-B问卷调查。采用SAS 9.3软件进行数据分析，分类资料采用卡方检验，有序资料采用Wilcoxon秩和检验;纵向分析采用线性混合模型。结果:120例患者中有103例(86%)可用于分析。BSPI组47例，SOC组56例。对于BPSI组和SOC组，中位(四分位数)年龄[60(52,68)对58(52,68)岁]。P = .9135]、癌症分期(0:1:2:3 = 11%:41%:35%:13% vs. 18%: 46%: 22%: 15%， P = .4645)和生物学(三阴性:HER2+: ER+ =9%: 74%: 17% vs. 8%: 72%: 20%， P = .8454)分别相似。BPSI组与SOC组在6个月和1年时的平均(SE) FACT-B评分分别为115.1(2.2)对114.6 (2.0)(P = 0.8731)和124.7(2.8)对101.4 (2.4)(P = 0.0001)。组间差异在1年时显著扩大(P = 0.0001)。在多变量模型中调整混杂基线变量后，12个月的差异仍然存在。结论:干预后1年，BPSI应对技能课程显著改善了乳腺癌幸存者的生活质量。
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