Onkologie最新文献

Background: Fatigue is a frequent symptom in cancer patients. In Europe and Northern America fatigue questionnaires were developed and tested, but their generalizability to other cultural contexts is largely unknown. The aim of this study is to provide normative values for the Multidimensional Fatigue Inventory (MFI-20) based on a representative sample of the general population in Colombia and to test psychometric properties.

Methods: 1,500 individuals completed a questionnaire that contained the MFI-20, as well as other questionnaires, and questions on sociodemographic variables and chronic diseases.

Results: The mean values of the scales were marginally higher than those for 2 European samples. The mean value of the total score was 44.3 ± 14.1. Women were affected by fatigue more than men, and there was an almost linear age trend, with higher mean scores for older subjects. People with chronic diseases were affected by fatigue more than people without chronic conditions. The best psychometric properties were obtained for the total scale (sum score) of the MFI-20.

Conclusion: The normative values presented here can help us to assess the individual burden of fatigue in a Latin American context. Psychometric properties of the MFI-20 in Colombia are similar to those obtained in Europe.

Background: Extrapulmonary small cell carcinoma is a distinct clinicopathological entity accounting for only 2.5-4% of small cell carcinomas. Here we present a case of primary intracranial small cell carcinoma.

Case report: A 69-year-old woman with an isolated brain lesion presented with progressive headaches, confusion, nausea, and vomiting. A magnetic resonance imaging scan of the brain revealed a 4 × 3 × 5-cm solitary cystic tumor in the right frontoparietal lobe, accompanied by a midline shift. The mass was resected and pathologically proven to be a small cell carcinoma. The patient was given adjuvant radiotherapy but refused any chemotherapy. At the 12-month follow-up the patient was alive and well.

Conclusion: Primary intracranial small cell carcinoma presenting as an isolated lesion is extremely rare. While there are no standard treatment guidelines for these patients, the authors believe multimodality treatment including tumorectomy and postoperative radiotherapy should be recommended.

Unlabelled: Several studies have described mental distress and anxiety in patients with melanoma. The findings of these studies varied from patients with a quality of life similar to the general population and those with increased mental distress. In the present study, we investigated anxiety, posttraumatic stress, and fear of cancer progression to gain a detailed picture of the burdens of these patients.

Patients and methods: 70 patients with malignant melanoma who attended cancer aftercare were surveyed using the psychometric instruments Hospital Anxiety and Depression Scale (HADS), Posttraumatic Symptom Scale (PTSS-10), and Fear of Progression Questionnaire (FoP-Q). The questionnaires were evaluated and an analysis of the single items carried out.

Results: The scores for the three anxiety parameters were low, but 7% of the patients presented an increased HADS score, and 17% an increased PTSS-10 value. An analysis of the items showed that patients feared physical disabilities more than mental distress or lack of social support.

Conclusion: Most of the patients perceived themselves as stable, and relied on the assistance of their families. However, a small group of patients suffered from clinically relevant anxiety; these patients should be given the support indicated for their specific distress.

Background: The aim of this study was to investigate the role of far upstream element-binding protein 1 (FUBP1) in gastric cancer development.

Patients and methods: Using immunohistochemistry, we detected FUBP1 expression in 18 chronic superficial gastritis patients, 33 chronic atrophic gastritis patients, 21 moderate and severe gastric dysplasia patients, and 31 gastric cancer patients. FUBP1 mRNA expression in gastric cancer tissue and paraneoplastic tissue was measured with fluorescent quantitative reverse transcription polymerase chain reaction.

Results: The FUBP1 expression rates in the chronic atrophic gastritis, moderate and severe dysplasia, and gastric cancer patients were 51.51% (17/33), 76.19% (16/21), and 90.32% (28/31), respectively; these were higher than the expression rate of the chronic superficial gastritis patients (11.11%, 2/18). FUBP1 expression in the gastric cancer patients was significantly higher than that in the chronic atrophic gastritis patients. The relative amount (0.2593 ± 0.1209) of FUBP1 mRNA in the gastric cancer tissue was higher than that in paraneoplastic tissue (0.1969 ± 0.0211) (p < 0.05). There was a statistically significant correlation between overall survival rates and age, sex, lymph node metastasis, and distant metastasis (p < 0.05).

Conclusion: FUBP1 expression differs among gastric tissues. There is a correlation between overall survival rates and age, sex, lymph node metastasis, and distant metastasis.

Clinical trials connect basic science with patient care. They form the backbone of evidence-based medicine and clinical guidelines. The unprecedented implementation of new methods in oncology over the past 40 years has only been possible on the basis of multiple well-organized clinical study groups. The continued existence of these study groups in their current multitude is in danger. Far-reaching changes in the legal framework, underfunding, new definitions of patient-related outcome and shifts in the organization of cancer patient care ask for critical reappraisal and new concepts.

Before the start of a clinical trial, approval by the responsible institutional ethical review board (IRB) is required. In Germany, nearly 50 independent IRBs may be responsible for the different participating sites of a multicenter study. In trials for rare diseases, the participation of many centers is required. Therefore, the application procedure for academic multicenter trials in malignant hematologic diseases is often a bureaucratic nightmare. Different aspects of IRB application and possible approaches for improvement are presented.

Clinical studies have been situated very well in Germany during the last 10 years; oncologists in practices and clinics are highly motivated. However, the financing of clinical trials is desolate so that disillusionment spreads in many centers. This paper would like to give some impetus to the discussion on better and more adequate financing. Facts and backgrounds concerning unsatisfactory financing of clinical trials are demonstrated; costs are analyzed in a detailed way. It seems to be very important to establish tools for a better calculation of costs. First approaches have been defined.

Everolimus is an orally administered inhibitor of the mammalian target of rapamycin (mTOR), an intracellular protein kinase downstream of the phosphatidylinositol 3-kinase/AKT pathway involved in key components of tumorigenesis, including cell growth, proliferation, and angiogenesis. In the advanced cancer setting, based on favorable results from phase III trials, everolimus is indicated for the treatment of advanced renal cell carcinoma, advanced neuroendocrine tumors of pancreatic origin, and advanced hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer. Additional oncology indications for everolimus include renal angiomyolipoma with tuberous sclerosis complex and subependymal giant-cell astrocytoma. Although it is generally well tolerated, with most adverse events of mild to moderate severity and manageable, everolimus exhibits a distinct adverse event profile that warrants guidance for proper diagnostic and medical management. This guidance is particularly important given the potential for widespread long-term use of everolimus. This review will focus on the most relevant toxicities associated with mTOR inhibitors and on their management. Practical treatment recommendations are presented for stomatitis, noninfectious pneumonitis, rash, selected metabolic abnormalities, and infections. Provided these events are rapidly identified and treated, the vast majority should resolve with minimal effect on treatment outcomes and patients' quality of life.