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Evaluation of the Timed Up and Go test for screening vulnerability and frailty in older cancer patients 在老年癌症患者中筛查易感和虚弱的time Up and Go试验的评价
Q4 Medicine Pub Date : 2023-09-29 DOI: 10.5603/ocp.96855
Teodoro J. Oscanoa, Edwin Cieza-Macedo, Xavier Vidal, Roman Romero-Ortuno
Introduction. The need for comprehensive geriatric assessment (CGA) in older adults with cancer is increasing, which makes it necessary to have a screening instrument to identify those who would benefit from this evaluation. This study aimed to investigate diagnostic performance of the Timed Up and Go test (TUG) for identifying vulnerable or frail older adults with cancer who might benefit from CGA. Material and methods. This observational and retrospective study took place at the geriatric center of Almenara Hospital in Lima, Peru. We extracted CGA reports from electronic medical records of outpatients and inpatients aged 60 years and older with cancer, who were evaluated between November 2022 and July 2023. Patients were classified based on SIOG-2 (International Society of Geriatric Oncology) criteria as fit, vulnerable, or frail, based on scales including Activities of Daily Living (ADL), Instrumental ADL, Mini-Nutritional Assessment (MNA), Mini-Mental State Exam (MMSE), Geriatric Depression Scale, and Cumulative Illness Rating Scale-Geriatrics (CIRS-G). For the study, two groups were formed: fit patients and non-fit patients (vulnerable plus frail). We estimated sensitivity, specificity, and positive predictive values of the TUG test. The accuracy of the TUG test was analyzed using the area under the receiver operating characteristic curve (AUC). Results. Among the 283 included patients, 154 were men (54.4%) and 129 women (45.6%), and the mean age was 76.8 ± 15.8 years. The most common neoplasms were colorectal (19.4%), stomach (15.2%), prostate (9.9%), and bile duct cancers (8.1%). The percentage of fit and non-fit patients was 21.9% and 78.1%, respectively. When the TUG test was equal to or greater than 15.5 seconds, sensitivity, specificity, positive predictive value, and AUC were 68.5% (95% CI 61.9–74.5), 88.5% (77.8–95.3), 95.6% (91.1–98.2), and 84.8% (0.80–0.90), respectively. Conclusions. A TUG test result equal to or greater than 15.5 seconds demonstrated good screening properties for identifying older cancer patients who were vulnerable or frail and could benefit from CGA.
介绍。对患有癌症的老年人进行综合老年评估(CGA)的需求正在增加,这使得有必要有一种筛查工具来确定那些将从这种评估中受益的人。本研究旨在探讨time Up and Go测试(TUG)的诊断性能,以识别可能受益于CGA的脆弱或虚弱的老年癌症患者。材料和方法。这项观察性和回顾性研究在秘鲁利马Almenara医院的老年中心进行。我们从2022年11月至2023年7月期间评估的60岁及以上癌症门诊和住院患者的电子病历中提取了CGA报告。根据SIOG-2(国际老年肿瘤学会)标准,根据日常生活活动(ADL)、工具ADL、迷你营养评估(MNA)、迷你精神状态检查(MMSE)、老年抑郁量表和累积疾病评定量表-老年病学(CIRS-G)等量表,将患者分为健康、易受伤害或虚弱。在这项研究中,分为两组:健康患者和非健康患者(脆弱加虚弱)。我们估计了TUG试验的敏感性、特异性和阳性预测值。利用接收机工作特性曲线下面积(AUC)对TUG试验的精度进行了分析。结果。283例患者中,男性154例(54.4%),女性129例(45.6%),平均年龄76.8±15.8岁。最常见的肿瘤是结直肠癌(19.4%)、胃癌(15.2%)、前列腺癌(9.9%)和胆管癌(8.1%)。适合和不适合患者的比例分别为21.9%和78.1%。当TUG试验≥15.5秒时,灵敏度、特异度、阳性预测值和AUC分别为68.5% (95% CI 61.9 ~ 74.5)、88.5% (95% CI 77.8 ~ 95.3)、95.6% (95% CI 91.1 ~ 98.2)和84.8%(0.80 ~ 0.90)。结论。TUG测试结果等于或大于15.5秒,显示出良好的筛选特性,可以识别易受伤害或虚弱的老年癌症患者,并可能从CGA中受益。
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引用次数: 0
Pembrolizumab in combination with chemotherapy in patients with advanced squamous cell lung cancer — clinical trials and real-world data Pembrolizumab联合化疗治疗晚期鳞状细胞肺癌患者-临床试验和现实世界数据
Q4 Medicine Pub Date : 2023-09-22 DOI: 10.5603/ocp.2023.0047
Magdalena Knetki-Wróblewska, Dariusz M. Kowalski
Advanced squamous-cell lung carcinoma remains a disease with an unfavorable prognosis. Until recently, chemotherapy was used in systemic treatment, and its effectiveness was limited. Implementation of immune check-point inhibitors allowed for an improvement in treatment results. The KEYNOTE-407 study included patients with squamous-cell lung cancer who received 4 immunochemotherapy cycles followed by maintenance treatment with pembrolizumab. Median overall survival of 17.2 months versus 11.6 months for chemotherapy was obtained (risk of death reduction by 29%) while the percentage of patients remaining in follow-up was 18%. Analysis of patients with good performance status treated in clinical practice confirms the results from the registration study and emphasizes the importance of taking into consideration clinical factors while qualifying patients for treatment.
晚期鳞状细胞肺癌是一种预后不良的疾病。直到最近,化疗被用于全身治疗,其有效性是有限的。实施免疫检查点抑制剂可以改善治疗结果。KEYNOTE-407研究纳入了接受4个免疫化疗周期的鳞状细胞肺癌患者,随后接受派姆单抗维持治疗。中位总生存期为17.2个月,而化疗组为11.6个月(死亡风险降低29%),剩余随访患者比例为18%。对临床实践中表现良好的患者的分析证实了注册研究的结果,并强调了在对患者进行治疗时考虑临床因素的重要性。
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引用次数: 0
Vinorelbine plus platinum compared to vinorelbine plus capecitabine in treatment of patients with metastatic triple negative breast cancer previously treated with anthracycline and taxane: a prospective randomized study 长春瑞滨加铂与长春瑞滨加卡培他滨治疗转移性三阴性乳腺癌患者的比较:一项前瞻性随机研究
Q4 Medicine Pub Date : 2023-09-18 DOI: 10.5603/ocp.96278
Heba Mohamed El-Zawahry, Ayman Abd Al-Samie Gaber, Amany Abd-Elhameed Abou-Bakr, Marwa Nabil Abd-Elhafez, Ahmed Mohamed El-Debawy
Introduction. This study aims to investigate the efficacy and tolerability of the vinorelbine-based combination chemotherapy with either cisplatin or capecitabine in metastatic triple-negative breast cancer (mTNBC) pretreated with anthracycline and taxane. Material and methods. This is an open-labeled randomized prospective single-institute study, that included all patients who received chemotherapy for mTNBC in the period between 1st of July 2016 and 30th of June 2017 and were pretreated with anthracycline and taxane. Patients were randomized to either vinorelbine 25 mg/m2 I.V on days 1 and 8 plus oral capecitabine 1000 mg/m2 twice daily, on days 1–14 (NX); or vinorelbine 25 mg/m2 I.V on days 1 and 8 plus cisplatin 75 mg/m2 (NP), every 21 days. The primary endpoint was time to progression (TTP), whereas the secondary endpoints were objective response rate (ORR), safety, and overall survival (OS). Results. Median TTP was 9.9 months with NP vs. 8 months with NX, (p = 0.22). ORR was 40% with NP vs . 36% with NX, (p = 0.77). Median OS was 13 months with NP vs . 13.2 months with NX (p = 0.599). Both regimens demonstrated similar rates of grade ≥ 3 vomiting and neutropenia. A higher incidence of thrombocytopenia, tinnitus, and kidney function alteration were reported with NP. A higher incidence of anorexia, diarrhea, mucositis, and hand-foot syndrome were reported with NX. Conclusions. Vinorelbine-based combination chemotherapy regimens with either cisplatin or capecitabine are active in the treatment of mTNBC pretreated with anthracycline and taxane with manageable toxicity profiles. Both regimens have comparable TTP, ORR, OS, and safety profiles.
介绍。本研究旨在探讨以长春瑞滨为基础的顺铂或卡培他滨联合化疗在蒽环类和紫杉烷预处理的转移性三阴性乳腺癌(mTNBC)中的疗效和耐受性。材料和方法。这是一项开放标签随机前瞻性单研究所研究,纳入了2016年7月1日至2017年6月30日期间接受化疗的mTNBC患者,并进行了蒽环类和紫杉烷预处理。患者随机接受静脉注射长春瑞滨25mg /m2,第1天和第8天加口服卡培他滨1000mg /m2,每天两次,第1 - 14天(NX);或长春瑞滨25mg /m2静脉注射,第1天和第8天加顺铂75mg /m2 (NP),每21天一次。主要终点是进展时间(TTP),次要终点是客观缓解率(ORR)、安全性和总生存期(OS)。结果。NP组的中位TTP为9.9个月,NX组为8个月,(p = 0.22)。与NP相比,ORR为40%。36%用NX, (p = 0.77)。NP组与NP组的中位OS为13个月。NX治疗13.2个月(p = 0.599)。两种方案均显示出相似的≥3级呕吐和中性粒细胞减少率。据报道,NP患者血小板减少、耳鸣和肾功能改变的发生率较高。据报道,NX患者厌食症、腹泻、黏膜炎和手足综合征的发生率较高。结论。以长春瑞滨为基础的联合化疗方案与顺铂或卡培他滨在蒽环类和紫杉烷预处理的mTNBC治疗中具有活性,毒性谱可控。两种方案在TTP、ORR、OS和安全性方面具有可比性。
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引用次数: 0
Potassium imbalances induced by systemic cancer therapy: pathophysiology and potential therapeutic strategies 全身癌症治疗引起的钾失衡:病理生理学和潜在的治疗策略
Q4 Medicine Pub Date : 2023-09-18 DOI: 10.5603/ocp.96314
Datis Kalali
Imbalances of serum potassium levels are common complications in patients receiving systemic antineoplastic therapy. These conditions can provoke further complications such as cardiac arrhythmia and paralysis due to the significant role of potassium in muscle physiology. Many cytotoxic drugs and novel targeted therapy agents have been found to induce hypokalemia and occasionally hyperkalemia. Therefore, they should be administered carefully and a broad understanding of the topic is necessary for medical oncologists. To this end, the present narrative review explores the pathophysiology of potassium disorders induced by systemic therapy and points out some therapeutic strategies for reversing them.
血清钾水平失衡是接受全身抗肿瘤治疗的患者常见的并发症。由于钾在肌肉生理中的重要作用,这些情况可引起进一步的并发症,如心律失常和瘫痪。许多细胞毒性药物和新的靶向治疗药物已被发现可引起低钾血症和偶尔高钾血症。因此,他们应该小心地管理和广泛的理解的主题是必要的医学肿瘤学家。为此,本文对全身治疗引起的钾障碍的病理生理进行了探讨,并指出了一些逆转钾障碍的治疗策略。
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引用次数: 0
Low-grade serous ovarian cancer with BRAFV600E mutation treated with metronomic chemotherapy — a case report and literature review 节拍化疗治疗BRAFV600E突变的低级别浆液性卵巢癌1例报告及文献复习
Q4 Medicine Pub Date : 2023-09-08 DOI: 10.5603/ocp.96964
Maria Rozpłoch-Sapa, Patrycja Mrowczyk, Łukasz Kwinta, Mateusz Łobacz, Paweł M. Potocki
Introduction. Ovarian cancer (OC) is the leading cause of cancer death worldwide. In Poland, it is the fourth leading cause of death from neoplasms in women. OC is a heterogeneous disease with low-grade cases characterized by a better prognosis, but poor chemosensitivity. Metronomic chemotherapy (MC) may be a beneficial approach. Case presentation. We present a patient with low-grade serous ovarian cancer (LGSOC) with long-term disease control achieved with MC despite being resistant to standard-dose chemotherapy with paclitaxel and carboplatin. Overall survival (OS) of the patient was 65 months. MC was administered most of the time. The patient was treated with two metronomic regimens: topotecan plus cyclophosphamide and vinorelbine plus methotrexate, both in combination with hormone therapy. The cancer was found to harbor the BRAF V600E mutation (v-raf murine sarcoma viral oncogene homolog B1, a valine-to-glutamic acid substitution at position 600), but that did not impact the treatment. Conclusions. LGSOC has distinct features from high-grade serous ovarian cancer (HGSOC). MC may be a valuable option in LGSOC despite being understudied. The BRAF V600E mutation occurs in 2–33% of low-grade serous ovarian tumors. It is a more common finding in LGSOC than in HGSOC. BRAF inhibition in OC may be a new therapeutic option. Some BRAF inhibitors have already been registered for solid tumors with this mutation.
介绍。卵巢癌(OC)是全球癌症死亡的主要原因。在波兰,它是妇女因肿瘤死亡的第四大原因。OC是一种异质性疾病,低级别病例的特点是预后较好,但化疗敏感性差。节律化疗(MC)可能是一种有益的方法。案例演示。我们报告了一例低级别浆液性卵巢癌(LGSOC)患者,尽管对紫杉醇和卡铂的标准剂量化疗有耐药性,但通过MC获得了长期的疾病控制。总生存期(OS)为65个月。大部分时间都进行了MC。患者接受两种节律治疗方案:拓扑替康加环磷酰胺和长春瑞滨加甲氨蝶呤,两者均与激素治疗联合使用。该癌症被发现含有BRAF V600E突变(v-raf鼠肉瘤病毒癌基因同源物B1,在600位缬氨酸到谷氨酸的替代),但这并不影响治疗。结论。LGSOC与高级别浆液性卵巢癌(HGSOC)具有不同的特征。MC可能是LGSOC的一个有价值的选择,尽管还没有得到充分的研究。BRAF V600E突变发生在2-33%的低级别浆液性卵巢肿瘤中。这在LGSOC中比在HGSOC中更常见。抑制BRAF可能是一种新的治疗选择。一些BRAF抑制剂已经被注册用于这种突变的实体瘤。
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引用次数: 0
A rare case report on bilateral scrotal lipoma — the largest tumor in Vietnam 双阴囊脂肪瘤是越南最大的肿瘤,报告一罕见病例
Q4 Medicine Pub Date : 2023-08-31 DOI: 10.5603/ocp.96055
Chi Truong Nguyen, Ngoc Hieu Nguyen, Van Nguyen Huong, Ngoc Tran Pham, Thai Chan Nguyen
Scrotal lipoma is benign and still, one of the rarest cancers, with very few cases previously reported in the world. The exact pathogenesis of lipomas remains unknown. Scrotal lipomas can be classified into three categories based on their origins: scrotal lipoma, spermatic cord and tunica vaginalis tumor, and primary scrotal lipoma. The disease may be misdiagnosed or diagnosed inaccurately. We present a case of a 46-year-old male with a giant bilateral scrotal lipoma presenting as scrotal swelling and discomfort, which was first diagnosed as an inguinal hernia. Computed tomography, ultrasound, and fine needle aspiration were performed and aroused a suspicion of lipoma. An operation was performed, and the tumor was completely excised and histologically confirmed as a lipoma. To our knowledge, this is the largest scrotal tumor reported in Vietnam, which led to not only diagnostic but also treatment challenges. Therefore, it is significant to report similar cases that can help clinicians diagnose and handle such tumors in a timely manner.
阴囊脂肪瘤是一种良性肿瘤,目前仍是最罕见的癌症之一,在世界上报道的病例很少。脂肪瘤的确切发病机制尚不清楚。阴囊脂肪瘤根据其来源可分为三类:阴囊脂肪瘤、精索及阴道膜瘤和原发性阴囊脂肪瘤。该病可能被误诊或诊断不准确。我们提出一个46岁的男性与一个巨大的双阴囊脂肪瘤表现为阴囊肿胀和不适,这是第一次被诊断为腹股沟疝。经电脑断层扫描、超音波及细针抽吸,怀疑为脂肪瘤。手术后,肿瘤被完全切除,组织学证实为脂肪瘤。据我们所知,这是越南报道的最大的阴囊肿瘤,这不仅导致了诊断,也带来了治疗挑战。因此,报告类似病例有助于临床医生及时诊断和处理此类肿瘤具有重要意义。
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引用次数: 0
Do solitary pancreatic metastases of renal-cell carcinoma indicate an indolent disease with a strong indication for aggressive local treatment? A case report with literature review 肾细胞癌的孤立性胰腺转移是否表明一种需要积极局部治疗的惰性疾病?1例报告并文献复习
Q4 Medicine Pub Date : 2023-08-31 DOI: 10.5603/ocp.96762
Jolanta Dobrzańska, Paweł Potocki, Piotr J. Wysocki
Renal-cell carcinoma (RCC) most often metastasizes to the lungs, liver, and brain. Metastases of RCC to the pancreas are very rare. In the last decade, only a few cases of metachronous metastasis of kidney cancer to the pancreas have been reported in the literature. This article presents a case report of a 75-year-old female patient with a 16-year history of treatment of clear-cell carcinoma of the kidney, in whom pancreatic metastases were detected twice. Renal-cell carcinoma may have an indolent course with late relapse or may show dissemination. It is important to establish new recommendations for long-term follow-up in patients after radical treatment.
肾细胞癌(RCC)最常转移到肺、肝和脑。肾细胞癌转移到胰腺是非常罕见的。在过去的十年中,文献中仅报道了少数肾癌异时性转移到胰腺的病例。本文报告一位75岁女性患者,有16年的肾透明细胞癌治疗史,其中两次发现胰腺转移。肾细胞癌病程缓慢,晚期复发或有播散。为根治后患者的长期随访建立新的建议是很重要的。
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引用次数: 1
Pulmonary tuberculosis as a differential diagnosis of a pulmonary nodule: the great masquerader 肺结核作为肺结节的鉴别诊断:伟大的假面舞者
IF 0.5 Q4 Medicine Pub Date : 2023-08-28 DOI: 10.5603/ocp.2023.0045
Kenneth G. Vargas Ponce, Claudia Claudia Meléndez Dávila, Juan A. Salas Lopez, Felix Llanos Tejada
{"title":"Pulmonary tuberculosis as a differential diagnosis of a pulmonary nodule: the great masquerader","authors":"Kenneth G. Vargas Ponce, Claudia Claudia Meléndez Dávila, Juan A. Salas Lopez, Felix Llanos Tejada","doi":"10.5603/ocp.2023.0045","DOIUrl":"https://doi.org/10.5603/ocp.2023.0045","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84890692","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}
引用次数: 0
Is the biology of breast cancer different in patients ≥ 80 years old? ≥80岁患者的乳腺癌生物学是否不同?
IF 0.5 Q4 Medicine Pub Date : 2023-08-23 DOI: 10.5603/ocp.2023.0046
J. Hudała-Klecha, Patryk Zając, Agnieszka Siedlaczek, B. Radecka
{"title":"Is the biology of breast cancer different in patients ≥ 80 years old?","authors":"J. Hudała-Klecha, Patryk Zając, Agnieszka Siedlaczek, B. Radecka","doi":"10.5603/ocp.2023.0046","DOIUrl":"https://doi.org/10.5603/ocp.2023.0046","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88425873","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}
引用次数: 0
Clinical and economic benefits of using next-generation sequencing (NGS) in the diagnostics of patients with non-small cell lung cancer with rare mutations 使用新一代测序(NGS)诊断罕见突变非小细胞肺癌患者的临床和经济效益
IF 0.5 Q4 Medicine Pub Date : 2023-08-17 DOI: 10.5603/ocp.2023.0044
Katarzyna Stencel, B. Wasąg, C. Pruszko, K. Dąbrowska, Paweł Książek, Karolina Dziadek, M. Bryl, Maciej Krzakowski
{"title":"Clinical and economic benefits of using next-generation sequencing (NGS) in the diagnostics of patients with non-small cell lung cancer with rare mutations","authors":"Katarzyna Stencel, B. Wasąg, C. Pruszko, K. Dąbrowska, Paweł Książek, Karolina Dziadek, M. Bryl, Maciej Krzakowski","doi":"10.5603/ocp.2023.0044","DOIUrl":"https://doi.org/10.5603/ocp.2023.0044","url":null,"abstract":"","PeriodicalId":42942,"journal":{"name":"Oncology in Clinical Practice","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77512773","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}
引用次数: 0
期刊
Oncology in Clinical Practice
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