Pub Date : 2019-10-23DOI: 10.1177/0300891619882491
M. Brunet, A. Cazeau, H. Ben Rejeb, V. Catena, T. Grellety
Purpose: Among breast cancer subgroups, Luminal A is the subgroup with the best prognosis. We report the case of a young woman presenting with a localized luminal A breast cancer with a suspicious liver lesion on initial positron emission tomography (PET)/computed tomography (CT) scan staging. Case description: A 31-year-old woman presented with localized breast cancer accessible to curative treatment. However, PET/CT staging revealed an increase of focal activity in the liver, suspicious of a secondary malignant localization, changing the care towards palliative intent. Discrepancy between breast cancer luminal A subtype and the liver lesion led to further investigations (contrast ultrasound, magnetic resonance imaging, and biopsy), excluding a malignant process, and were in favor of toxic hepatitis, probably secondary to herbal tea consumption. Conclusions: Questioning PET/CT findings in light of the cancer subtype enabled us to rectify the diagnosis and allow this patient to be treated with curative intent.
{"title":"From palliative to curative intent: PET/CT findings in the light of breast cancer intrinsic subgroup","authors":"M. Brunet, A. Cazeau, H. Ben Rejeb, V. Catena, T. Grellety","doi":"10.1177/0300891619882491","DOIUrl":"https://doi.org/10.1177/0300891619882491","url":null,"abstract":"Purpose: Among breast cancer subgroups, Luminal A is the subgroup with the best prognosis. We report the case of a young woman presenting with a localized luminal A breast cancer with a suspicious liver lesion on initial positron emission tomography (PET)/computed tomography (CT) scan staging. Case description: A 31-year-old woman presented with localized breast cancer accessible to curative treatment. However, PET/CT staging revealed an increase of focal activity in the liver, suspicious of a secondary malignant localization, changing the care towards palliative intent. Discrepancy between breast cancer luminal A subtype and the liver lesion led to further investigations (contrast ultrasound, magnetic resonance imaging, and biopsy), excluding a malignant process, and were in favor of toxic hepatitis, probably secondary to herbal tea consumption. Conclusions: Questioning PET/CT findings in light of the cancer subtype enabled us to rectify the diagnosis and allow this patient to be treated with curative intent.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"1 1","pages":"NP79 - NP82"},"PeriodicalIF":0.0,"publicationDate":"2019-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83039500","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 : 2019-10-10DOI: 10.1177/0300891619880603
M. Chisari, Raffaella Sensi, C. Clerici, F. Gariboldi, F. Spreafico, V. Biassoni, E. Schiavello, P. Gasparini, A. Caraceni, A. Ferrari, M. Massimino
This study reports a case series of patients with upper limb neuromotor deficits following pediatric central nervous system tumor and treated with rehabilitative therapy according to action observation therapy (AOT). AOT is based on the “mirror neurons” system and had positive results in various non-oncologic neurologic pathologies. This study is the first experience in the oncology field, and included 6 patients, 4 of whom were fully evaluated at 6-month follow-up. In all patients, therapy showed improvement in all assessment tests. These promising results lead to further studies to confirm their effectiveness.
{"title":"Action observation therapy in pediatric patients with neuromotor deficits of the upper limbs secondary to central nervous system tumors","authors":"M. Chisari, Raffaella Sensi, C. Clerici, F. Gariboldi, F. Spreafico, V. Biassoni, E. Schiavello, P. Gasparini, A. Caraceni, A. Ferrari, M. Massimino","doi":"10.1177/0300891619880603","DOIUrl":"https://doi.org/10.1177/0300891619880603","url":null,"abstract":"This study reports a case series of patients with upper limb neuromotor deficits following pediatric central nervous system tumor and treated with rehabilitative therapy according to action observation therapy (AOT). AOT is based on the “mirror neurons” system and had positive results in various non-oncologic neurologic pathologies. This study is the first experience in the oncology field, and included 6 patients, 4 of whom were fully evaluated at 6-month follow-up. In all patients, therapy showed improvement in all assessment tests. These promising results lead to further studies to confirm their effectiveness.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"33 4 1","pages":"NP75 - NP78"},"PeriodicalIF":0.0,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83588278","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 : 2019-09-30DOI: 10.1177/0300891619878898
R. Falcone, L. Strigari, L. Farina, P. Marchetti
Dear Editor: We appreciate the interest in our recent report1 and the comment.2 To solve the issue of overparameterization, as suggested by Weng et al.,2 we assumed a cutoff p value of 0.10 to include potential interest parameters, thus we excluded the sex variable from the multivariate analysis (MVA). The results of the MVA are shown in Table 1. Moreover, reducing the number of variables to 2 factors (stage and tumor site) (Table 2), the results, once again, are confirmed. Stage and tumor site remain independent predictors of overall survival (OS). To test the validity of the model and answer the second question by Wang et al.,2 considering the small sample of the population, we implemented the analysis including the cross-validation with bootstrapping. To quantify the discrimination performance of the model, Harrell’s C-index was measured. The model was subjected to bootstrapping validation (1000 bootstrap resamples) to calculate the optimistic corrected estimate of C-index. The C-index for OS models was 0.70 while the corrected C-index was 0.67. Despite the small sample, the conclusions of our model seem to be robust. The potential for significant bias has already been mentioned in our report1 and the results must be considered cautiously. Large-scale studies are warranted.
{"title":"Response to: Comment on “Impact of tumor site on the prognosis of small bowel adenocarcinoma”","authors":"R. Falcone, L. Strigari, L. Farina, P. Marchetti","doi":"10.1177/0300891619878898","DOIUrl":"https://doi.org/10.1177/0300891619878898","url":null,"abstract":"Dear Editor: We appreciate the interest in our recent report1 and the comment.2 To solve the issue of overparameterization, as suggested by Weng et al.,2 we assumed a cutoff p value of 0.10 to include potential interest parameters, thus we excluded the sex variable from the multivariate analysis (MVA). The results of the MVA are shown in Table 1. Moreover, reducing the number of variables to 2 factors (stage and tumor site) (Table 2), the results, once again, are confirmed. Stage and tumor site remain independent predictors of overall survival (OS). To test the validity of the model and answer the second question by Wang et al.,2 considering the small sample of the population, we implemented the analysis including the cross-validation with bootstrapping. To quantify the discrimination performance of the model, Harrell’s C-index was measured. The model was subjected to bootstrapping validation (1000 bootstrap resamples) to calculate the optimistic corrected estimate of C-index. The C-index for OS models was 0.70 while the corrected C-index was 0.67. Despite the small sample, the conclusions of our model seem to be robust. The potential for significant bias has already been mentioned in our report1 and the results must be considered cautiously. Large-scale studies are warranted.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"14 1","pages":"532 - 532"},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89104142","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 : 2019-09-09DOI: 10.1177/0300891619872264
J. Weng, Mengying Xie, Zhe Xu, Zhiyi Wang
We were interested to read the article “Impact of tumor site on the prognosis of small bowel adenocarcinoma” by Falcone and colleagues1 in Tumori Journal. The authors aimed to evaluate clinical outcome of patients diagnosed with small bowel adenocarcinoma. They drew the conclusion that disease stage and primary tumor site were independent predictors of overall survival. However, some statistical problems need to be resolved before drawing that conclusion. The author mentioned in the article that multivariate Cox regression was used to test independence of significant factors in univariate analysis. All the variables (including nonsignificance factors) in the univariate analysis were imported into the multivariate regression model, resulting in an inevitable problem with overparameterization.2,3 As we know, age is a factor closely related to tumor incidence and progression. In this multivariate Cox regression, age was presented as nonsignificant, maybe caused by overparameterization. Therefore, we suggest excluding the sex factor from multivariate Cox regression. Another important question, especially in studies with small sample size, is the validity of the prediction model. This seems to be the major limitation of the Rosa Falcone et al. study, and it can be solved with statistical methods such as cross-validation and bootstrapping.4 Otherwise, the authors could draw an incorrect conclusion.
{"title":"Comment on “Impact of tumor site on the prognosis of small bowel adenocarcinoma”","authors":"J. Weng, Mengying Xie, Zhe Xu, Zhiyi Wang","doi":"10.1177/0300891619872264","DOIUrl":"https://doi.org/10.1177/0300891619872264","url":null,"abstract":"We were interested to read the article “Impact of tumor site on the prognosis of small bowel adenocarcinoma” by Falcone and colleagues1 in Tumori Journal. The authors aimed to evaluate clinical outcome of patients diagnosed with small bowel adenocarcinoma. They drew the conclusion that disease stage and primary tumor site were independent predictors of overall survival. However, some statistical problems need to be resolved before drawing that conclusion. The author mentioned in the article that multivariate Cox regression was used to test independence of significant factors in univariate analysis. All the variables (including nonsignificance factors) in the univariate analysis were imported into the multivariate regression model, resulting in an inevitable problem with overparameterization.2,3 As we know, age is a factor closely related to tumor incidence and progression. In this multivariate Cox regression, age was presented as nonsignificant, maybe caused by overparameterization. Therefore, we suggest excluding the sex factor from multivariate Cox regression. Another important question, especially in studies with small sample size, is the validity of the prediction model. This seems to be the major limitation of the Rosa Falcone et al. study, and it can be solved with statistical methods such as cross-validation and bootstrapping.4 Otherwise, the authors could draw an incorrect conclusion.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"36 1","pages":"531 - 531"},"PeriodicalIF":0.0,"publicationDate":"2019-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77872529","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 : 2019-09-03DOI: 10.1177/0300891619871103
Y. Tong, Ying He, Luying Hu, Yu-jia Liu, Xiao-wei Zheng, Jiao Sun, Yu Song, Yiwen Zhang, L. Fang, Ping Huang
Background: An integral and well-functioning vascular system is essential for tumor progression and chemotherapy infusion. However, the lumen integrity of the microvessels and its significance in prognosis has not been studied. In this study, we found that the proportion of collapsed microvessels is suggested to be a novel biomarker for predicting prognosis in patients with non-small cell lung cancer (NSCLC). Methods: In this study, immunohistochemical CD31 staining was performed to identify the microvessels in tumor specimens. Proportions of collapsed vessels were estimated in CD31-stained tumor specimens from 100 patients with NSCLC. The correlation between collapsed microvessel proportion and survival time were evaluated by univariate and multivariate analysis. Results: Data from 99 patients were analyzed and a wide range of collapse–microvessel fraction was observed in 96 patients (1.4%–70%). Elevated collapse proportion (⩾6.5%) indicated poor overall survival in both univariate analysis (p = 0.042) and multivariate analysis (p = 0.014). Conclusions: Elevated proportion of collapsed microvessels indicted poor survival outcome in patients with NSCLC.
{"title":"Elevated proportion of collapsed microvessels indicate poor survival outcome in patients with non-small cell lung cancer","authors":"Y. Tong, Ying He, Luying Hu, Yu-jia Liu, Xiao-wei Zheng, Jiao Sun, Yu Song, Yiwen Zhang, L. Fang, Ping Huang","doi":"10.1177/0300891619871103","DOIUrl":"https://doi.org/10.1177/0300891619871103","url":null,"abstract":"Background: An integral and well-functioning vascular system is essential for tumor progression and chemotherapy infusion. However, the lumen integrity of the microvessels and its significance in prognosis has not been studied. In this study, we found that the proportion of collapsed microvessels is suggested to be a novel biomarker for predicting prognosis in patients with non-small cell lung cancer (NSCLC). Methods: In this study, immunohistochemical CD31 staining was performed to identify the microvessels in tumor specimens. Proportions of collapsed vessels were estimated in CD31-stained tumor specimens from 100 patients with NSCLC. The correlation between collapsed microvessel proportion and survival time were evaluated by univariate and multivariate analysis. Results: Data from 99 patients were analyzed and a wide range of collapse–microvessel fraction was observed in 96 patients (1.4%–70%). Elevated collapse proportion (⩾6.5%) indicated poor overall survival in both univariate analysis (p = 0.042) and multivariate analysis (p = 0.014). Conclusions: Elevated proportion of collapsed microvessels indicted poor survival outcome in patients with NSCLC.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"107 1","pages":"494 - 500"},"PeriodicalIF":0.0,"publicationDate":"2019-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79378199","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 : 2019-08-28DOI: 10.1177/0300891619871104
F. Piccioni, D. Codazzi, M. Paleari, P. Previtali, G. Delconte, L. Fumagalli, R. Manzi, M. Faustini, L. Persiani, M. Rizzi, Federico Sodi, E. Masci
Introduction: Endobronchial ultrasound (EBUS) is an endoscopic diagnostic procedure combining flexible fibrobronchoscopy with ultrasound techniques; it allows transbronchial needle aspiration biopsy for the diagnosis and staging of mediastinal masses. We present our preliminary experience with the use of the i-gel O2 supraglottic airway device for management of EBUS procedures. Methods: An observational study on 39 patients who underwent EBUS under general anesthesia was performed. Airways were managed with i-gel O2 by anesthesiologists unfamiliar with it. Data collected included patient characteristics, i-gel O2 positioning, mechanical ventilation, procedure, and complications occurring during and after the EBUS. Results: The i-gel airway was successfully positioned during the first attempt in 34/39 cases (87.2%). No failed positioning was recorded. The EBUS scope easily passed through the i-gel in all patients and in 14 (35.6%) cases it was also inserted through the esophagus allowing the examination or fine needle aspiration of paraesophageal lymph nodes. In one case, during the EBUS procedure, the i-gel was dislocated but easily put in place again. During EBUS, air leakages were significant in 2 cases (5.1%) and minimal in 14 cases (35.9%). A brief self-solved laryngospasm and a bronchospasm during bronchoscopy were recorded. After recovery, no patients had dysphagia; mild odynophagia and pharyngodinia were referred by 2 (5.1%) and 12 (30.1%) patients, respectively. Conclusions: The i-gel O2 airway is easy to position and manage even for anesthesiologists unfamiliar with it. This supraglottic airway device is suitable for a complete endosonographic evaluation of the mediastinum.
{"title":"Endosonographic evaluation of the mediastinum through the i-gel O2 supraglottic airway device","authors":"F. Piccioni, D. Codazzi, M. Paleari, P. Previtali, G. Delconte, L. Fumagalli, R. Manzi, M. Faustini, L. Persiani, M. Rizzi, Federico Sodi, E. Masci","doi":"10.1177/0300891619871104","DOIUrl":"https://doi.org/10.1177/0300891619871104","url":null,"abstract":"Introduction: Endobronchial ultrasound (EBUS) is an endoscopic diagnostic procedure combining flexible fibrobronchoscopy with ultrasound techniques; it allows transbronchial needle aspiration biopsy for the diagnosis and staging of mediastinal masses. We present our preliminary experience with the use of the i-gel O2 supraglottic airway device for management of EBUS procedures. Methods: An observational study on 39 patients who underwent EBUS under general anesthesia was performed. Airways were managed with i-gel O2 by anesthesiologists unfamiliar with it. Data collected included patient characteristics, i-gel O2 positioning, mechanical ventilation, procedure, and complications occurring during and after the EBUS. Results: The i-gel airway was successfully positioned during the first attempt in 34/39 cases (87.2%). No failed positioning was recorded. The EBUS scope easily passed through the i-gel in all patients and in 14 (35.6%) cases it was also inserted through the esophagus allowing the examination or fine needle aspiration of paraesophageal lymph nodes. In one case, during the EBUS procedure, the i-gel was dislocated but easily put in place again. During EBUS, air leakages were significant in 2 cases (5.1%) and minimal in 14 cases (35.9%). A brief self-solved laryngospasm and a bronchospasm during bronchoscopy were recorded. After recovery, no patients had dysphagia; mild odynophagia and pharyngodinia were referred by 2 (5.1%) and 12 (30.1%) patients, respectively. Conclusions: The i-gel O2 airway is easy to position and manage even for anesthesiologists unfamiliar with it. This supraglottic airway device is suitable for a complete endosonographic evaluation of the mediastinum.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"23 1","pages":"86 - 90"},"PeriodicalIF":0.0,"publicationDate":"2019-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82428258","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 : 2019-08-28DOI: 10.1177/0300891619870247
Selin Narter, Seçil Hasdemir, Ş. Tolunay, S. Gokgoz
Introduction: Sclerosing adenosis is a form of adenosis characterized by lobulocentric architecture, glandular and stromal proliferation in which the stromal component compresses and distorts the glandular structures. Atypical epithelial proliferations such as atypical lobular hyperplasia, lobular carcinoma in situ, and ductal carcinoma in situ may accompany areas of sclerosing adenosis. We present a case of ductal carcinoma in situ and sclerosing adenosis with metastatic carcinoma on sentinel lymph node. Case description: A 40-year-old woman presented with a palpable mass in her left breast. Radiologic studies showed a lesion suggesting malignancy in the left breast and atypical lymph node in the left axillary region. Left lumpectomy and sentinel lymph node biopsy was performed. Histopathologic examination revealed lobulocentric lesions with glandular proliferation and hyalinizing stroma in between. Foci of high-grade cribriform and solid type ductal carcinoma in situ were observed. Sentinel lymph node biopsy showed micrometastasis in one lymph node section. Based on these findings, the patient was diagnosed with high-grade ductal carcinoma in situ with sclerosing adenosis. However, the presence of micrometastasis in the lymph node suggested occult invasion that we were not able to detect. Conclusion: Ductal carcinoma in situ with sclerosing adenosis can mimic invasive carcinoma both radiologically and histologically. It should be kept in mind that there may be occult invasive carcinoma in patients with ductal carcinoma in situ whether the lesion is accompanied by sclerosing adenosis or not. Multiple sections and immunohistochemical studies can be of help.
{"title":"A case of extensive ductal carcinoma in situ and sclerosing adenosis with metastasis on sentinel lymph node","authors":"Selin Narter, Seçil Hasdemir, Ş. Tolunay, S. Gokgoz","doi":"10.1177/0300891619870247","DOIUrl":"https://doi.org/10.1177/0300891619870247","url":null,"abstract":"Introduction: Sclerosing adenosis is a form of adenosis characterized by lobulocentric architecture, glandular and stromal proliferation in which the stromal component compresses and distorts the glandular structures. Atypical epithelial proliferations such as atypical lobular hyperplasia, lobular carcinoma in situ, and ductal carcinoma in situ may accompany areas of sclerosing adenosis. We present a case of ductal carcinoma in situ and sclerosing adenosis with metastatic carcinoma on sentinel lymph node. Case description: A 40-year-old woman presented with a palpable mass in her left breast. Radiologic studies showed a lesion suggesting malignancy in the left breast and atypical lymph node in the left axillary region. Left lumpectomy and sentinel lymph node biopsy was performed. Histopathologic examination revealed lobulocentric lesions with glandular proliferation and hyalinizing stroma in between. Foci of high-grade cribriform and solid type ductal carcinoma in situ were observed. Sentinel lymph node biopsy showed micrometastasis in one lymph node section. Based on these findings, the patient was diagnosed with high-grade ductal carcinoma in situ with sclerosing adenosis. However, the presence of micrometastasis in the lymph node suggested occult invasion that we were not able to detect. Conclusion: Ductal carcinoma in situ with sclerosing adenosis can mimic invasive carcinoma both radiologically and histologically. It should be kept in mind that there may be occult invasive carcinoma in patients with ductal carcinoma in situ whether the lesion is accompanied by sclerosing adenosis or not. Multiple sections and immunohistochemical studies can be of help.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"56 1","pages":"NP63 - NP66"},"PeriodicalIF":0.0,"publicationDate":"2019-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77062313","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 : 2019-08-28DOI: 10.1177/0300891619872546
G. Galli, C. Proto, M. Cossa, B. Valeri, S. Sdao, D. Signorelli, M. Imbimbo, F. de Braud, M. Garassino, G. Lo Russo
Introduction: Immunotherapy has shown efficacy in the treatment of different malignancies. Nivolumab, an immune checkpoint inhibitor directed against programmed death-1, has been approved for non-small cell lung cancer (NSCLC) in pretreated patients. Although it is generally well-tolerated, immunotherapy may be complicated by a wide range of immune-mediated adverse events. We describe the case of an uncommon skin toxicity arising as alopecia universalis induced by nivolumab in a patient with NSCLC. Case description: A 58-year-old man received nivolumab for metastatic NSCLC after progression to 3 lines of chemotherapy. The treatment was prescribed in June 2016, and induced a rapid and significant disease response. Nivolumab was well-tolerated until May 2017, when partial alopecia at hair and eyelashes appeared. In the next months, alopecia became complete and extended to the whole body surface. The dermatologic picture was compatible with alopecia areata. A topical steroid therapy was attempted, without benefit. The patient refused systemic treatments and is still undergoing nivolumab without new toxicities and with persistent disease response. Conclusions: This case suggests that alopecia areata may be a rare immune-related adverse event of immune checkpoint agents. Its late onset in our patient is uncommon and unexpected, underlining that the risk of nivolumab-induced toxicity is not limited to the beginning of treatment. Despite its rarity, alopecia areata should be considered in the range of adverse events potentially induced by immune checkpoint inhibitors even in the long term. Potential association between toxicity and efficacy of immunotherapy in NSCLC warrants further investigation.
{"title":"Unusual skin toxicity associated with sustained disease response induced by nivolumab in a patient with non-small cell lung cancer","authors":"G. Galli, C. Proto, M. Cossa, B. Valeri, S. Sdao, D. Signorelli, M. Imbimbo, F. de Braud, M. Garassino, G. Lo Russo","doi":"10.1177/0300891619872546","DOIUrl":"https://doi.org/10.1177/0300891619872546","url":null,"abstract":"Introduction: Immunotherapy has shown efficacy in the treatment of different malignancies. Nivolumab, an immune checkpoint inhibitor directed against programmed death-1, has been approved for non-small cell lung cancer (NSCLC) in pretreated patients. Although it is generally well-tolerated, immunotherapy may be complicated by a wide range of immune-mediated adverse events. We describe the case of an uncommon skin toxicity arising as alopecia universalis induced by nivolumab in a patient with NSCLC. Case description: A 58-year-old man received nivolumab for metastatic NSCLC after progression to 3 lines of chemotherapy. The treatment was prescribed in June 2016, and induced a rapid and significant disease response. Nivolumab was well-tolerated until May 2017, when partial alopecia at hair and eyelashes appeared. In the next months, alopecia became complete and extended to the whole body surface. The dermatologic picture was compatible with alopecia areata. A topical steroid therapy was attempted, without benefit. The patient refused systemic treatments and is still undergoing nivolumab without new toxicities and with persistent disease response. Conclusions: This case suggests that alopecia areata may be a rare immune-related adverse event of immune checkpoint agents. Its late onset in our patient is uncommon and unexpected, underlining that the risk of nivolumab-induced toxicity is not limited to the beginning of treatment. Despite its rarity, alopecia areata should be considered in the range of adverse events potentially induced by immune checkpoint inhibitors even in the long term. Potential association between toxicity and efficacy of immunotherapy in NSCLC warrants further investigation.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"17 1","pages":"NP57 - NP62"},"PeriodicalIF":0.0,"publicationDate":"2019-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85257130","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 : 2019-08-27DOI: 10.1177/0300891619867815
{"title":"WITHDRAWAL - Administrative Duplicate Publication: The essential role of prevention in reducing the cancer burden in Europe: a commentary from Cancer Prevention Europe","authors":"","doi":"10.1177/0300891619867815","DOIUrl":"https://doi.org/10.1177/0300891619867815","url":null,"abstract":"","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"1 1","pages":"433 - 433"},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82450970","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 : 2019-08-26DOI: 10.1177/0300891619868014
R. Ricotti, E. Miglietta, M. Leonardi, F. Cattani, S. Dicuonzo, D. P. Rojas, G. Marvaso, R. Orecchia, B. Jereczek-Fossa
Objective: To report treatment times (door to door) of adjuvant treatments of breast cancer (BC) with intensity-modulated radiotherapy (IMRT). Methods: Treatment times of 62 patients with BC on the TomoTherapy Hi-Art System were collected for the analysis. Patients underwent either locoregional radiotherapy (postmastectomy radiotherapy [PMRT]) with helical modality (TomoHelical) or whole breast radiotherapy (RT) with simultaneous integrated boost (WBRT-SIB) with direct modality (TomoDirect). Door-to-door time was broken down into different steps, which were crucial to RT session. Results: A total of 594 treatment fractions were monitored. Median treatment time was 22.4 minutes (17.2–30.8) for PMRT and 14.4 minutes (10.9–23.5) for WBRT-SIB. The mean beam-on time accounted for 61.36% of the overall treatment time for PMRT compared to 57% for WBRT-SIB. The beam-on time was a much more time-consuming process. Conclusion: This treatment times analysis on the use of IMRT for BC might be useful to organize and improve the workflow efficiency in RT facilities.
{"title":"Workload of breast image-guided intensity-modulated radiotherapy delivered with TomoTherapy","authors":"R. Ricotti, E. Miglietta, M. Leonardi, F. Cattani, S. Dicuonzo, D. P. Rojas, G. Marvaso, R. Orecchia, B. Jereczek-Fossa","doi":"10.1177/0300891619868014","DOIUrl":"https://doi.org/10.1177/0300891619868014","url":null,"abstract":"Objective: To report treatment times (door to door) of adjuvant treatments of breast cancer (BC) with intensity-modulated radiotherapy (IMRT). Methods: Treatment times of 62 patients with BC on the TomoTherapy Hi-Art System were collected for the analysis. Patients underwent either locoregional radiotherapy (postmastectomy radiotherapy [PMRT]) with helical modality (TomoHelical) or whole breast radiotherapy (RT) with simultaneous integrated boost (WBRT-SIB) with direct modality (TomoDirect). Door-to-door time was broken down into different steps, which were crucial to RT session. Results: A total of 594 treatment fractions were monitored. Median treatment time was 22.4 minutes (17.2–30.8) for PMRT and 14.4 minutes (10.9–23.5) for WBRT-SIB. The mean beam-on time accounted for 61.36% of the overall treatment time for PMRT compared to 57% for WBRT-SIB. The beam-on time was a much more time-consuming process. Conclusion: This treatment times analysis on the use of IMRT for BC might be useful to organize and improve the workflow efficiency in RT facilities.","PeriodicalId":23450,"journal":{"name":"Tumori Journal","volume":"56 1","pages":"518 - 523"},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87012053","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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