Pub Date : 2018-10-15DOI: 10.4172/2324-9110.1000230
N. Levasicc, Lesnik La, M. Garbajs, R. Dezman, P. Popovič
Objective: Transarterial chemoembolization (TACE) is the most widely used therapeutic option in the treatment of intermediate hepatocellular carcinoma (HCC). Due to the heterogeneity of the intermediate stage patient population, survival rates are variable. The purpose of this retrospective study was to investigate prognostic factors in predicting overall survival in patients with HCC treated by transarterial chemoembolization using drug-eluting beads loaded with doxorubicin (DEBDOX TACE). Methods: 119 patients with intermediate stage HCC who had undergone DEBDOX TACE between February 2010 and January 2017 were studied. All procedures were performed under Cone Beam Computed Tomography (CBCT) control. Survival was calculated from the date of the first procedure. The survival rates and curves were calculated using the Kaplan-Meier method. Survival curves were compared using the log-rank test.Results: Overall, 362 procedures were performed (mean: 3.04 per patient). After a mean follow up of 24.5 ± 1.3 months, 83 patients had died and 36 survived. The average survival was 30.7 months ± 2.3 months (95% CI: 26.3-35.2 months). Median survival was 24.7 months. One-year, two-year and five-year survival rates were 84%, 47% and 3%, respectively. Independent survival prognostic factors were Child-Pugh class ,B (p=0.009), ascites (p=0.019), portal hypertension (p=0.024), bilirubin increase after procedure (p=0.002) and number of procedures (p=0.022).Conclusion: The presence of ascites, portal hypertension, Child-Pugh class B, Child-Pugh score, a higher increase in bilirubin levels after the procedure and a lower number of DEBDOX TACE procedures are significant prognostic factors in overall survival.
{"title":"Prognostic Factors for Survival in Patients with Hepatocellular Carcinoma Treated By Transarterial Chemoembolization Using Drug-Eluting Beads","authors":"N. Levasicc, Lesnik La, M. Garbajs, R. Dezman, P. Popovič","doi":"10.4172/2324-9110.1000230","DOIUrl":"https://doi.org/10.4172/2324-9110.1000230","url":null,"abstract":"Objective: Transarterial chemoembolization (TACE) is the most widely used therapeutic option in the treatment of intermediate hepatocellular carcinoma (HCC). Due to the heterogeneity of the intermediate stage patient population, survival rates are variable. The purpose of this retrospective study was to investigate prognostic factors in predicting overall survival in patients with HCC treated by transarterial chemoembolization using drug-eluting beads loaded with doxorubicin (DEBDOX TACE). \u0000Methods: 119 patients with intermediate stage HCC who had undergone DEBDOX TACE between February 2010 and January 2017 were studied. All procedures were performed under Cone Beam Computed Tomography (CBCT) control. Survival was calculated from the date of the first procedure. The survival rates and curves were calculated using the Kaplan-Meier method. Survival curves were compared using the log-rank test.Results: Overall, 362 procedures were performed (mean: 3.04 per patient). After a mean follow up of 24.5 ± 1.3 months, 83 patients had died and 36 survived. The average survival was 30.7 months ± 2.3 months (95% CI: 26.3-35.2 months). Median survival was 24.7 months. One-year, two-year and five-year survival rates were 84%, 47% and 3%, respectively. Independent survival prognostic factors were Child-Pugh class ,B (p=0.009), ascites (p=0.019), portal hypertension (p=0.024), bilirubin increase after procedure (p=0.002) and number of procedures (p=0.022).Conclusion: The presence of ascites, portal hypertension, Child-Pugh class B, Child-Pugh score, a higher increase in bilirubin levels after the procedure and a lower number of DEBDOX TACE procedures are significant prognostic factors in overall survival.","PeriodicalId":73658,"journal":{"name":"Journal of clinical & experimental oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47118650","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 : 2018-10-15DOI: 10.4172/2324-9110.1000228
F. Najjar, M. Alammar, G. Al-Massarani, Nissreen Almalla, A. Japawe, I. Banat, A. Ikhtiar
Objectives: Tumor angiogenesis is controlled by inhibitors and angiogenic factors. However, circulating endothelial cells (CECs) and microparticles (MPs) may be related to tumor angiogenesis in malignant tumors. We therefore investigated the significance of CECs and MPs variation for the prediction of treatment efficacy andprognosis in patients with extensive small-cell lung cancer (SCLC). Materials and methods: Isolation and quantification of CECs from the whole-blood was performed using immune magnetic separation (IMS) technique, while flow cytometry measurement (FCM) was used for enumerating MPs in plasma samples.Results: Twenty-six patients were included in this prospective study. The relative change in CEC and MP counts after treatment, correctly identified treatment response in 22/26 patients (84.6%) and 17/23 patients (73.9%) respectively. The difference in themedian duration of time to progression (TTP) between patient with high relative changes and those with low relative changes in CEC and MP values was not statistically significant (p=0.39 and p=0.2, respectively). By contrast, the increase in CEC and MP levels after chemotherapy tended to be inversely correlated with longer TTP duration (r²=0.111 and r²=0.171, respectively). However, onlym decreased MP values after chemotherapy have the trend to be correlated with longer TTP duration (r²=0.167).Conclusion: The relative change in CEC and MP values after treatment seems to be a useful biomarker for the evaluation of treatment response in patients with extensive SCLC. Moreover, this relative change in both biomarkers might be considered as a prognostic tool in SCLC.
{"title":"Changes of Circulating Endothelial Cells and Microparticles after Conventional Chemotherapy in Patients with Extensive Small-Cell Lung Cancer: Relevance to Prognosis and Treatment Response","authors":"F. Najjar, M. Alammar, G. Al-Massarani, Nissreen Almalla, A. Japawe, I. Banat, A. Ikhtiar","doi":"10.4172/2324-9110.1000228","DOIUrl":"https://doi.org/10.4172/2324-9110.1000228","url":null,"abstract":"Objectives: Tumor angiogenesis is controlled by inhibitors and angiogenic factors. However, circulating endothelial cells (CECs) and microparticles (MPs) may be related to tumor angiogenesis in malignant tumors. We therefore investigated the significance of CECs and MPs variation for the prediction of treatment efficacy andprognosis in patients with extensive small-cell lung cancer (SCLC). Materials and methods: Isolation and quantification of CECs from the whole-blood was performed using immune magnetic separation (IMS) technique, while flow cytometry measurement (FCM) was used for enumerating MPs in plasma samples.Results: Twenty-six patients were included in this prospective study. The relative change in CEC and MP counts after treatment, correctly identified treatment response in 22/26 patients (84.6%) and 17/23 patients (73.9%) respectively. The difference in themedian duration of time to progression (TTP) between patient with high relative changes and those with low relative changes in CEC and MP values was not statistically significant (p=0.39 and p=0.2, respectively). By contrast, the increase in CEC and MP levels after chemotherapy tended to be inversely correlated with longer TTP duration (r²=0.111 and r²=0.171, respectively). However, onlym decreased MP values after chemotherapy have the trend to be correlated with longer TTP duration (r²=0.167).Conclusion: The relative change in CEC and MP values after treatment seems to be a useful biomarker for the evaluation of treatment response in patients with extensive SCLC. Moreover, this relative change in both biomarkers might be considered as a prognostic tool in SCLC.","PeriodicalId":73658,"journal":{"name":"Journal of clinical & experimental oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49501550","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 : 2018-10-15DOI: 10.4172/2324-9110.1000226
M. SanjayKumar, M. Praveenkumar
We report a case of a young male with Carcinoma right lateral border of tongue, cT3N1Mx, post-surgery post adjuvant chemo-radiation. Following a Disease-free interval of 15 months, he developed pain in the left knee region for which he was evaluated with MRI and then biopsy which was conclusive of a Metastatic squamous cell carcinoma from the tongue primary. Workup for the Chest, Abdomen and Pelvis did not show any other metastatic disease. He further underwent palliative radiotherapy for pain at the local site and is being further planned for palliative chemotherapy. In this case report, we discuss the rarity of such presentations, possible high-risk factors, present and future implications in the follow-up of such high-risk cases of Head and Neck Squamous Cell Carcinomas, especially in the younger population.
{"title":"Tibial Metastasis from Primary Carcinoma Tongue in a Young Male: A Case Report","authors":"M. SanjayKumar, M. Praveenkumar","doi":"10.4172/2324-9110.1000226","DOIUrl":"https://doi.org/10.4172/2324-9110.1000226","url":null,"abstract":"We report a case of a young male with Carcinoma right lateral border of tongue, cT3N1Mx, post-surgery post adjuvant chemo-radiation. Following a Disease-free interval of 15 months, he developed pain in the left knee region for which he was evaluated with MRI and then biopsy which was conclusive of a Metastatic squamous cell carcinoma from the tongue primary. Workup for the Chest, Abdomen and Pelvis did not show any other metastatic disease. He further underwent palliative radiotherapy for pain at the local site and is being further planned for palliative chemotherapy. In this case report, we discuss the rarity of such presentations, possible high-risk factors, present and future implications in the follow-up of such high-risk cases of Head and Neck Squamous Cell Carcinomas, especially in the younger population.","PeriodicalId":73658,"journal":{"name":"Journal of clinical & experimental oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47257177","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 : 2018-10-15DOI: 10.4172/2324-9110.1000231
F. Fortuna
This article is my prospective that can be proposed for patients diagnosed with serious organic diseases like cancer for the ways to overcome their fear of death and lead their remainingm life in a prosperous way. This was my study in a patient named Michela. Although I’ve been referring to Michela in this study, it can be implied to all the patients suffering with this pain.
{"title":"Ways for Happy Living for Patients Diagnosed with Cancer","authors":"F. Fortuna","doi":"10.4172/2324-9110.1000231","DOIUrl":"https://doi.org/10.4172/2324-9110.1000231","url":null,"abstract":"This article is my prospective that can be proposed for patients diagnosed with serious organic diseases like cancer for the ways to overcome their fear of death and lead their remainingm life in a prosperous way. This was my study in a patient named Michela. Although I’ve been referring to Michela in this study, it can be implied to all the patients suffering with this pain.","PeriodicalId":73658,"journal":{"name":"Journal of clinical & experimental oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44445403","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 : 2018-10-15DOI: 10.4172/2324-9110.1000229
F. Fortuna
Psychosomatic is the term used to refer to an orientation of the medical, psychological and psychoanalytic sciences, aimed at emphasizing the aspect of the psychophysical totality of individuals. The term "psychosomatic" was conceived in 1818 by J. C. Heinroth. Psychosomatic means both the set of morbid states that can create depressive situations in the subject, and the psychic implications in the etiogenesis of organic diseases.
{"title":"New Psychotherapeutic Method in Psychosomatic Diseases like Cancer","authors":"F. Fortuna","doi":"10.4172/2324-9110.1000229","DOIUrl":"https://doi.org/10.4172/2324-9110.1000229","url":null,"abstract":"Psychosomatic is the term used to refer to an orientation of the medical, psychological and psychoanalytic sciences, aimed at emphasizing the aspect of the psychophysical totality of individuals. The term \"psychosomatic\" was conceived in 1818 by J. C. Heinroth. Psychosomatic means both the set of morbid states that can create depressive situations in the subject, and the psychic implications in the etiogenesis of organic diseases.","PeriodicalId":73658,"journal":{"name":"Journal of clinical & experimental oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48312386","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 : 2018-10-09DOI: 10.4172/2324-9110.1000227
S. Uehara, Yuichi Fukuzawa, T. Matuyama, K. Gotoh
Objective: The aim of the study was to examine correlations of the plasma levels of soluble (s) CD44 standard (std), and a disintegrin and metalloproteinase (ADAM) 10, with those of the soluble Tyro3, Axl, and Mer receptors (sTAMRs) and their ligands (GAS6 and PROS1) in patients with hepatocellular carcinoma (HCC), and other liver diseases.Method: The subjects were 55 patients with HCC, 4 with fulminant hepatitis (FH), 18 with acute hepatitis (AH), 10 with chronic hepatitis (CH), 20 with liver cirrhosis (LC), and 20 healthy normal controls (NCs). Plasma levels of sCD44std, ADAM10, sTAMRs, GAS6, PROS1, des-γ-carboxy prothrombin (DCP), and des-γ-carboxy GAS6 were measured by enzyme-linked immunosorbent assay.Results: The levels of sCD44std, ADAM10, sTAMRs, and Gas6 were significantly higher in HCC and other liver diseases (except CH) compared to those in NCs, but PROS1 levels in these diseases were significantly lower than those in NCs. These were significant positive correlations of sCD44std levels with ADAM10, and sMer levels in HCC and other liver diseases. SAxl was lower in stage HCC than in stage HCC, but GAS6 increased with progression of HCC stages. There was a significant positive correlation between the levels of DCP and des-γ-carboxy GAS6 in HCC. The subjects were roughly classified into three groups of HCC, inflammatory diseases, and normal controls using ratios of TAMRs and their ligands.Conclusion: The measurement of these blood factors facilitates a unified view of HCC therapy
{"title":"Circulating Levels of ADAM-10 and Soluble Standard CD44 in Patients with Hepatocellular Carcinoma: Relationship with Soluble TAM Receptors and their Ligands","authors":"S. Uehara, Yuichi Fukuzawa, T. Matuyama, K. Gotoh","doi":"10.4172/2324-9110.1000227","DOIUrl":"https://doi.org/10.4172/2324-9110.1000227","url":null,"abstract":"Objective: The aim of the study was to examine correlations of the plasma levels of soluble (s) CD44 standard (std), and a disintegrin and metalloproteinase (ADAM) 10, with those of the soluble Tyro3, Axl, and Mer receptors (sTAMRs) and their ligands (GAS6 and PROS1) in patients with hepatocellular carcinoma (HCC), and other liver diseases.Method: The subjects were 55 patients with HCC, 4 with fulminant hepatitis (FH), 18 with acute hepatitis (AH), 10 with chronic hepatitis (CH), 20 with liver cirrhosis (LC), and 20 healthy normal controls (NCs). Plasma levels of sCD44std, ADAM10, sTAMRs, GAS6, PROS1, des-γ-carboxy prothrombin (DCP), and des-γ-carboxy GAS6 were measured by enzyme-linked immunosorbent assay.Results: The levels of sCD44std, ADAM10, sTAMRs, and Gas6 were significantly higher in HCC and other liver diseases (except CH) compared to those in NCs, but PROS1 levels in these diseases were significantly lower than those in NCs. These were significant positive correlations of sCD44std levels with ADAM10, and sMer levels in HCC and other liver diseases. SAxl was lower in stage HCC than in stage HCC, but GAS6 increased with progression of HCC stages. There was a significant positive correlation between the levels of DCP and des-γ-carboxy GAS6 in HCC. The subjects were roughly classified into three groups of HCC, inflammatory diseases, and normal controls using ratios of TAMRs and their ligands.Conclusion: The measurement of these blood factors facilitates a unified view of HCC therapy","PeriodicalId":73658,"journal":{"name":"Journal of clinical & experimental oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43525705","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 : 2018-08-16DOI: 10.4172/2324-9110.1000222
Max H. Cohen, A. Ketcham, R. Herberman
In a prospective randomized trial in patients with metastatic melanoma we compared two agents that had been used for metastatic melanoma intratumoral injections. Each patient had progressive metastatic disease no longer surgically controllable. Multiple metastases included satellitosis in the form of progressive nodules around the previously excised original melanoma site, and/or in-transit metastases in the form of observable tumor nodules progressing in a linear fashion toward a lymph node bearing area. As patients were receiving intratumoral injections, serially collected blood samples were tested for general immunologic reactivity and anti-melanoma reactivity. Specificity controls included breast cancer and lung cancer extracts. Additionally, as a measure of cell-mediated immunity, the patients were serially skin tested against antigens to measure general and melanoma-specific immunity. Depending on the patients’ clinical courses, we have divided the patients retrospectively into groups whose clinical courses were either better or worse than their cohorts, and determined the relationship between the immune testing and the clinical courses that the patients were experiencing as the serial testing was being conducted. Additionally, in a group of similar patients that were ‘cured for life’, we analyze their treatment in light of therapeutic attempts made by others to similarly haptenize melanoma antigens. We describe potential synergies between newly discovered melanoma therapies and intratumoral injection treatments and point out potential combination therapies that may offer the potential for enhancement of antitumor effects without increased systemic toxicity, a desirable goal now that combinations of recently acceptable immunotherapies have been associated with severe potential toxicities including death.
{"title":"Intratumoral Therapy II: In Vitro and In Vivo Immunologic Testing and Therapy Options","authors":"Max H. Cohen, A. Ketcham, R. Herberman","doi":"10.4172/2324-9110.1000222","DOIUrl":"https://doi.org/10.4172/2324-9110.1000222","url":null,"abstract":"In a prospective randomized trial in patients with metastatic melanoma we compared two agents that had been used for metastatic melanoma intratumoral injections. Each patient had progressive metastatic disease no longer surgically controllable. Multiple metastases included satellitosis in the form of progressive nodules around the previously excised original melanoma site, and/or in-transit metastases in the form of observable tumor nodules progressing in a linear fashion toward a lymph node bearing area. As patients were receiving intratumoral injections, serially collected blood samples were tested for general immunologic reactivity and anti-melanoma reactivity. Specificity controls included breast cancer and lung cancer extracts. \u0000Additionally, as a measure of cell-mediated immunity, the patients were serially skin tested against antigens to measure general and melanoma-specific immunity. Depending on the patients’ clinical courses, we have divided the patients retrospectively into groups whose clinical courses were either better or worse than their cohorts, and determined the relationship between the immune testing and the clinical courses that the patients were experiencing as the serial testing was being conducted. Additionally, in a group of similar patients that were ‘cured for life’, we analyze their treatment in light of therapeutic attempts made by others to similarly haptenize melanoma antigens. We describe potential synergies between newly discovered melanoma therapies and intratumoral injection treatments and point out potential combination therapies that may offer the potential for enhancement of antitumor effects without increased systemic toxicity, a desirable goal now that combinations of recently acceptable immunotherapies have been associated with severe potential toxicities including death.","PeriodicalId":73658,"journal":{"name":"Journal of clinical & experimental oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42598814","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 : 2018-08-16DOI: 10.4172/2324-9110.1000221
Max H. Cohen, A. Ketcham, R. Herberman
We have demonstrated in a randomized prospective study the superiority of intratumoral (intralesional) dinitrochlorobenzene (DNCB) compared to intratumoral (intralesional) bacillus Calmette-Guerin (BCG) in the treatment of progressive metastatic melanoma. The metastatic melanoma was in the form of satellitosis and/or in-transit metastases. We now demonstrate the ability of intralesional DNCB to permanently cure a selected group of patients with the same clinical criteria, and describe their clinical characteristics and treatment regimens. The described cured patients were followed for their remaining lifetimes, for up to 30 years, after being immunotherapeutically rendered free of metastatic cancer. They were each female, between the ages of 51 and 56 when intratumoral treatments were begun. Treatment was for progressive cutaneous and subcutaneous metastatic disease in the leg in two cases and for rapidly spreading scalp and forehead metastases in another. In each case the disease was not surgically controllable. Treatments were continued for 6 to 26 months. Subsequently the patients survived tumor free for either 18 years, dying at age 83; or for 24 years, dying at age 89; or for 30 years, dying at age 97. There has been a significant interest in recent years in immunotherapy for advanced cancer. The absence of systemic toxicity in the cured patients reported herein provides a basis for consideration of combining intratumoral treatments with current effective but systemically more toxic immunotherapeutic approaches to some metastatic cancers. Intratumoral treatments may be particularly applicable in cases of uncontrollable melanoma with cutaneous metastases, without evidence of distant spread, as in the current report.
{"title":"Intratumoral Therapy I: Association of Immunotherapy with Permanent Long Term Cure of Metastatic Cancer","authors":"Max H. Cohen, A. Ketcham, R. Herberman","doi":"10.4172/2324-9110.1000221","DOIUrl":"https://doi.org/10.4172/2324-9110.1000221","url":null,"abstract":"We have demonstrated in a randomized prospective study the superiority of intratumoral (intralesional) dinitrochlorobenzene (DNCB) compared to intratumoral (intralesional) bacillus Calmette-Guerin (BCG) in the treatment of progressive metastatic melanoma. The metastatic melanoma was in the form of satellitosis and/or in-transit metastases. We now demonstrate the ability of intralesional DNCB to permanently cure a selected group of patients with the same clinical criteria, and describe their clinical characteristics and treatment regimens. The described cured patients were followed for their remaining lifetimes, for up to 30 years, after being immunotherapeutically rendered free of metastatic cancer. They were each female, between the ages of 51 and 56 when intratumoral treatments were begun. Treatment was for progressive cutaneous and subcutaneous metastatic disease in the leg in two cases and for rapidly spreading scalp and forehead metastases in another. In each case the disease was not surgically controllable. Treatments were continued for 6 to 26 months. Subsequently the patients survived tumor free for either 18 years, dying at age 83; or for 24 years, dying at age 89; or for 30 years, dying at age 97. \u0000There has been a significant interest in recent years in immunotherapy for advanced cancer. The absence of systemic toxicity in the cured patients reported herein provides a basis for consideration of combining intratumoral treatments with current effective but systemically more toxic immunotherapeutic approaches to some metastatic cancers. Intratumoral treatments may be particularly applicable in cases of uncontrollable melanoma with cutaneous metastases, without evidence of distant spread, as in the current report.","PeriodicalId":73658,"journal":{"name":"Journal of clinical & experimental oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44113570","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 : 2018-08-16DOI: 10.4172/2324-9110.100E114
M. Retsky
Let’s think ahead. Where might this discussion lead? Is it just an intellectual exercise or can it leads to clinically useful results. My thought is that in a year or so we will have a number (hopefully large) of papers that discuss where and when early detection of cancer works well and where and when it does not work well. Perhaps this will lead to new ideas or at least properly document problems that need to be solved. Then perhaps some smart young scientists will be motivated to work on solutions to important real problems. There is a major need for such work. I will provide one “good” example of a screening process that when done properly is excellent but when done less than properly is far less valuable. The typical patient does not know if he or she got a good colonoscopy or a less than good colonoscopy. You have to know what question to ask and what acceptable answers are. It is not obvious.
{"title":"Early Detection of Cancer -The Good, the Bad, and the Ugly","authors":"M. Retsky","doi":"10.4172/2324-9110.100E114","DOIUrl":"https://doi.org/10.4172/2324-9110.100E114","url":null,"abstract":"Let’s think ahead. Where might this discussion lead? Is it just an intellectual exercise or can it leads to clinically useful results. My thought is that in a year or so we will have a number (hopefully large) of papers that discuss where and when early detection of cancer works well and where and when it does not work well. Perhaps this will lead to new ideas or at least properly document problems that need to be solved. Then perhaps some smart young scientists will be motivated to work on solutions to important real problems. There is a major need for such work. I will provide one “good” example of a screening process that when done properly is excellent but when done less than properly is far less valuable. The typical patient does not know if he or she got a good colonoscopy or a less than good colonoscopy. You have to know what question to ask and what acceptable answers are. It is not obvious.","PeriodicalId":73658,"journal":{"name":"Journal of clinical & experimental oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48599686","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 : 2018-08-08DOI: 10.4172/2324-9110.1000219
Nancy E Cisneros
The current evolution in Health Care Policy and emerging reimbursement models related to implementation of the Affordable Care Act has resulted in significant changes to care delivery practices. Patient-and family-centered care for the pediatric cancer patient in the home setting is expected to grow exponentially within the next decade. There is urgent need to develop models of care that insure optimal care delivery for this patient population with emphasis on care coordination, patient and family-centered care, and evidence-based practice in home-based care. Additionally, a pediatric case management model designed to incorporate standardized assessments, interventions and evaluation utilizing team-based care approaches offers opportunity to realize optimal patient outcomes.
{"title":"Improving Pediatric Case Management in Home Health","authors":"Nancy E Cisneros","doi":"10.4172/2324-9110.1000219","DOIUrl":"https://doi.org/10.4172/2324-9110.1000219","url":null,"abstract":"The current evolution in Health Care Policy and emerging reimbursement models related to implementation of the Affordable Care Act has resulted in significant changes to care delivery practices. Patient-and family-centered care for the pediatric cancer patient in the home setting is expected to grow exponentially within the next decade. There is urgent need to develop models of care that insure optimal care delivery for this patient population with emphasis on care coordination, patient and family-centered care, and evidence-based practice in home-based care. Additionally, a pediatric case management model designed to incorporate standardized assessments, interventions and evaluation utilizing team-based care approaches offers opportunity to realize optimal patient outcomes.","PeriodicalId":73658,"journal":{"name":"Journal of clinical & experimental oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44814405","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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