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404
[ "[", "Preventive", "effect", "of", "low", "-", "dose", "carvedilol", "combined", "with", "candesartan", "on", "the", "cardiotoxicity", "of", "anthracycline", "drugs", "in", "the", "adjuvant", "chemotherapy", "of", "breast", "cancer", "]", ".", "To", "investigate", "the", "effect", "of", "low", "-", "dose", "carvedilol", "combined", "with", "candesartan", "in", "the", "prevention", "of", "acute", "and", "chronic", "cardiotoxicity", "of", "anthracycline", "drugs", "in", "adjuvant", "chemotherapy", "of", "breast", "cancer", ".", "Forty", "patients", "were", "randomly", "divided", "into", "two", "groups", ":", "the", "experimental", "group", "with", "chemotherapy", "plus", "low", "-", "dose", "carvedilol", "combined", "with", "candesartan", "(", "20", "cases", ")", "and", "control", "group", "with", "chemotherapy", "alone", "(", "20", "cases", ")", ".", "The", "same", "chemotherapy", "was", "given", "to", "the", "two", "groups", ".", "All", "the", "40", "patients", "had", "no", "contraindication", "for", "carvedilol", "and", "candesartan", ".", "Patients", "of", "the", "experimental", "group", "received", "low", "-", "dose", "carvedilol", "from", "2.5", "mg", "orally", "twice", "a", "day", "at", "first", "cycle", "to", "5", "mg", "twice", "a", "day", "gradually", "if", "no", "side", "reactions", ",", "and", "candesartan", "2.5", "mg", "orally", "once", "a", "day", ".", "Electrocardiogram", ",", "ultrasonic", "cardiogram", ",", "arrhythmia", ",", "troponin", "and", "non", "-", "hematologic", "toxicity", "were", "recorded", "and", "compared", "after", "the", "second", ",", "forth", "and", "sixth", "cycle", "of", "chemotherapy", ".", "Each", "cycle", "included", "21", "days", ".", "LVEF", "was", "decreased", "along", "with", "the", "prolongation", "of", "chemotherapy", "in", "the", "experimental", "group", "and", "control", "group", ".", "LVEDD", "and", "LVESD", "showed", "no", "significant", "changes", "in", "the", "experimental", "group", ",", "but", "gradually", "increased", "in", "the", "control", "group", ".", "After", "four", "and", "six", "cycles", "of", "chemotherapy", ",", "LVEF", "were", "(", "57.00", "±", "5.13", ")", "%", "and", "(", "45.95", "±", "3.68", ")", "%", ",", "respectively", ",", "in", "the", "control", "group", ",", "significantly", "lower", "than", "that", "of", "(", "67.00", "±", "5.13", ")", "%", "and", "(", "57.50", "±", "2.57", ")", "%", ",", "respectively", ",", "in", "the", "experimental", "group", "(", "P", "<", "0.05", ")", ".", "After", "six", "cycles", "of", "chemotherapy", ",", "LVEDD", "and", "LVESD", "were", "(", "50.00", "±", "10.48", ")", "mm", "and", "(", "35.01", "±", "2.99", ")", "mm", ",", "respectively", ",", "in", "the", "control", "group", ",", "significantly", "higher", "than", "those", "before", "chemotherapy", "(", "P", "<", "0.05", ")", "and", "experimental", "group", "(", "P", "<", "0.001", ")", ".", "The", "rate", "of", "ST", "segment", "and", "T", "wave", "abnormalities", "was", "80.0", "%", "in", "the", "control", "group", "after", "six", "cycles", "of", "chemotherapy", ",", "significantly", "higher", "than", "that", "of", "25.0", "%", "after", "four", "cycles", "of", "chemotherapy", "(", "P", "=", "0.001", ")", "and", "10.0", "%", "after", "two", "cycles", "of", "chemotherapy", "(", "P", "<", "0.001", ")", ".", "The", "reduction", "of", "QRS", "voltage", ",", "arrhythmia", "and", "abnormal", "troponin", "were", "55.0", "%", ",", "45.0", "%", "and", "45.0", "%", ",", "respectively", ",", "in", "the", "control", "group", ",", "significantly", "higher", "than", "those", "in", "the", "experimental", "group", "(", "20.0", "%", ",", "P", "<", "0.05", ")", ",", "(", "10.0", "%", ",", "P", "=", "0.010", ")", "and", "(", "10.0", "%", ",", "P", "<", "0.05", ")", ",", "respectively", ".", "The", "rate", "of", "abnormal", "expression", "of", "troponin", "was", "45.0", "%", "in", "the", "control", "group", ",", "significantly", "higher", "than", "the", "10.0", "%", "in", "the", "experimental", "group", "(", "P", "<", "0.05", ")", ".", "The", "use", "of", "low", "-", "dose", "carvedilol", "combined", "with", "candesartan", "can", "reduce", "the", "acute", "and", "chronic", "cardiotoxicity", "of", "anthracycline", "drugs", ",", "and", "with", "tolerable", "toxicities", ".", "This", "may", "provide", "a", "new", "approach", "to", "prevent", "cardiotoxicity", "of", "anthracycline", "drugs", "in", "adjuvant", "chemotherapy", "of", "breast", "cancer", "." ]
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405
[ "Preoperative", "dexamethasone", "reduces", "postoperative", "pain", ",", "nausea", "and", "vomiting", "following", "mastectomy", "for", "breast", "cancer", ".", "Dexamethasone", "has", "been", "reported", "to", "reduce", "postoperative", "symptoms", "after", "different", "surgical", "procedures", ".", "We", "evaluated", "the", "efficacy", "of", "preoperative", "dexamethasone", "in", "ameliorating", "postoperative", "nausea", "and", "vomiting", "(", "PONV", ")", ",", "and", "pain", "after", "mastectomy", ".", "In", "this", "prospective", ",", "double", "-", "blind", ",", "placebo", "-", "controlled", "study", ",", "70", "patients", "scheduled", "for", "mastectomy", "with", "axillary", "lymph", "node", "dissection", "were", "analyzed", "after", "randomization", "to", "treatment", "with", "8", "mg", "intravenous", "dexamethasone", "(", "n", "=", "35", ")", "or", "placebo", "(", "n", "=", "35", ")", ".", "All", "patients", "underwent", "standardized", "procedures", "for", "general", "anesthesia", "and", "surgery", ".", "Episodes", "of", "PONV", "and", "pain", "score", "were", "recorded", "on", "a", "visual", "analogue", "scale", ".", "Analgesic", "and", "antiemetic", "requirements", "were", "also", "recorded", ".", "Demographic", "and", "medical", "variables", "were", "similar", "between", "groups", ".", "The", "incidence", "of", "PONV", "was", "lower", "in", "the", "dexamethasone", "group", "at", "the", "early", "postoperative", "evaluation", "(", "28.6", "%", "vs.", "60", "%", ";", "p", "=", "0.02", ")", "and", "at", "6", "h", "(", "17.2", "%", "vs.", "45.8", "%", ";", "p", "=", "0.03", ")", ".", "More", "patients", "in", "the", "placebo", "group", "required", "additional", "antiemetic", "medication", "(", "21", "vs.", "8", ";", "p", "=", "0.01", ")", ".", "Dexamethasone", "treatment", "significantly", "reduced", "postoperative", "pain", "just", "after", "surgery", "(", "VAS", "score", ",", "4.54", "±", "1.55", "vs.", "5.83", "±", "2.00", ";", "p", "=", "0.004", ")", ",", "at", "6", "h", "(", "3.03", "±", "1.20", "vs.", "4.17", "±", "1.24", ";", "p", "<", "0.0005", ")", "and", "at", "12", "h", "(", "2.09", "±", "0.85", "vs.", "2.54", "±", "0.98", ";", "p", "=", "0.04", ")", ".", "Analgesics", "were", "required", "in", "more", "patients", "of", "the", "control", "group", "(", "21", "vs.", "10", ";", "p", "=", "0.008", ")", ".", "There", "were", "no", "adverse", "events", ",", "morbidity", "or", "mortality", ".", "Preoperative", "intravenous", "dexamethasone", "(", "8", "mg", ")", "can", "significantly", "reduce", "the", "incidence", "of", "PONV", "and", "pain", "in", "patients", "undergoing", "mastectomy", "with", "axillary", "dissection", "for", "breast", "cancer", ".", "NCT", "01116713", "." ]
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406
[ "Cost", "-", "benefit", "analysis", "of", "a", "follow", "-", "up", "program", "in", "patients", "with", "breast", "cancer", ":", "a", "randomized", "prospective", "study", ".", "Increasing", "the", "number", "of", "breast", "cancer", "patients", "in", "follow", "-", "up", "involves", "increased", "costs", "and", ",", "with", "limited", "health", "care", "resources", ",", "there", "is", "a", "need", "to", "evaluate", "the", "cost", "-", "benefit", "to", "the", "patient", "of", "follow", "-", "up", "regimens", ".", "We", "present", "a", "randomized", "prospective", "study", "to", "evaluate", "the", "cost", "-", "benefit", "of", "intensive", "follow", "-", "up", "in", "the", "early", "detection", "of", "relapses", "in", "patients", "with", "breast", "cancer", ".", "One", "hundred", "and", "twenty", "-", "one", "patients", "were", "randomized", "to", "standard", "clinical", "follow", "-", "up", "(", "n=", "63", ")", "or", "to", "an", "intensive", "follow", "-", "up", "(", "n=", "58", ")", "that", "included", "diagnostic", "laboratory", "tests", "and", "imaging", "designed", "to", "detect", "early", "relapse", "following", "curative", "treatment", ".", "All", "patients", "had", "annual", "mammography", ".", "The", "number", "of", "scheduled", "outpatient", "appointments", "kept", "were", "359", "in", "the", "standard", "clinical", "follow", "-", "up", "and", "355", "in", "the", "intensive", "follow", "-", "up", "group", ".", "After", "a", "median", "of", "3", "years", "of", "follow", "-", "up", ",", "there", "were", "28", "relapses", ",", "11", "in", "standard", "clinical", "follow", "-", "up", ",", "and", "13", "in", "the", "intensive", "follow", "-", "up", "group", ".", "The", "overall", "cost", "of", "follow", "-", "up", "was", "24", ",", "567", "euros", "in", "the", "standard", "clinical", "follow", "-", "up", "group", "and", "74", ",", "171", "euros", "in", "the", "intensive", "follow", "-", "up", "group", ".", "Performing", "complimentary", "investigations", "in", "breast", "cancer", "follow", "-", "up", "is", "associated", "with", "higher", "costs", "without", "difference", "in", "early", "detection", "of", "relapses", "." ]
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407
[ "Tamoxifen", "with", "or", "without", "breast", "irradiation", "in", "women", "50", "years", "of", "age", "or", "older", "with", "early", "breast", "cancer", ".", "We", "determined", "the", "effect", "of", "breast", "irradiation", "plus", "tamoxifen", "on", "disease", "-", "free", "survival", "and", "local", "relapse", "in", "women", "50", "years", "of", "age", "or", "older", "who", "had", "T", "1", "or", "T", "2", "node", "-", "negative", "breast", "cancer", ".", "Between", "December", "1992", "and", "June", "2000", ",", "769", "women", "with", "early", "breast", "cancer", "(", "tumor", "diameter", ",", "5", "cm", "or", "less", ")", "were", "randomly", "assigned", "to", "receive", "breast", "irradiation", "plus", "tamoxifen", "(", "386", "women", ")", "or", "tamoxifen", "alone", "(", "383", "women", ")", ".", "The", "median", "follow", "-", "up", "was", "5.6", "years", ".", "The", "rate", "of", "local", "relapse", "at", "five", "years", "was", "7.7", "percent", "in", "the", "tamoxifen", "group", "and", "0.6", "percent", "in", "the", "group", "given", "tamoxifen", "plus", "irradiation", "(", "hazard", "ratio", ",", "8.3", ";", "95", "percent", "confidence", "interval", ",", "3.3", "to", "21.2", ";", "P", "<", "0.001", ")", ",", "with", "corresponding", "five", "-", "year", "disease", "-", "free", "survival", "rates", "of", "84", "percent", "and", "91", "percent", "(", "P=", "0.004", ")", ".", "A", "planned", "subgroup", "analysis", "of", "611", "women", "with", "T", "1", ",", "receptor", "-", "positive", "tumors", "indicated", "a", "benefit", "from", "radiotherapy", "(", "five", "-", "year", "rates", "of", "local", "relapse", ",", "0.4", "percent", "with", "tamoxifen", "plus", "radiotherapy", "and", "5.9", "percent", "with", "tamoxifen", "alone", ";", "P", "<", "0.001", ")", ".", "Overall", ",", "there", "was", "a", "significant", "difference", "in", "the", "rate", "of", "axillary", "relapse", "at", "five", "years", "(", "2.5", "percent", "in", "the", "tamoxifen", "group", "and", "0.5", "percent", "in", "the", "group", "given", "tamoxifen", "plus", "irradiation", ",", "P=", "0.049", ")", ",", "but", "no", "significant", "difference", "in", "the", "rates", "of", "distant", "relapse", "or", "overall", "survival", ".", "As", "compared", "with", "tamoxifen", "alone", ",", "radiotherapy", "plus", "tamoxifen", "significantly", "reduces", "the", "risk", "of", "breast", "and", "axillary", "recurrence", "after", "lumpectomy", "in", "women", "with", "small", ",", "node", "-", "negative", ",", "hormone", "-", "receptor", "-", "positive", "breast", "cancers", "." ]
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408
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409
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411
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416
[ "Omega-", "3", "fatty", "acids", "are", "protective", "against", "paclitaxel", "-", "induced", "peripheral", "neuropathy", ":", "a", "randomized", "double", "-", "blind", "placebo", "controlled", "trial", ".", "Axonal", "sensory", "peripheral", "neuropathy", "is", "the", "major", "dose", "-", "limiting", "side", "effect", "of", "paclitaxel", ".", "Omega-", "3", "fatty", "acids", "have", "beneficial", "effects", "on", "neurological", "disorders", "from", "their", "effects", "on", "neurons", "cells", "and", "inhibition", "of", "the", "formation", "of", "proinflammatory", "cytokines", "involved", "in", "peripheral", "neuropathy", ".", "This", "study", "was", "a", "randomized", "double", "blind", "placebo", "controlled", "trial", "to", "investigate", "the", "efficacy", "of", "omega-", "3", "fatty", "acids", "in", "reducing", "incidence", "and", "severity", "of", "paclitaxel", "-", "induced", "peripheral", "neuropathy", "(", "PIPN", ")", ".", "Eligible", "patients", "with", "breast", "cancer", "randomly", "assigned", "to", "take", "omega-", "3", "fatty", "acid", "pearls", ",", "640", "mg", "t.i.d", "during", "chemotherapy", "with", "paclitaxel", "and", "one", "month", "after", "the", "end", "of", "the", "treatment", "or", "placebo", ".", "Clinical", "and", "electrophysiological", "studies", "were", "performed", "before", "the", "onset", "of", "chemotherapy", "and", "one", "month", "after", "cessation", "of", "therapy", "to", "evaluate", "PIPN", "based", "on", "\"", "reduced", "Total", "Neuropathy", "Score", "\"", ".", "Twenty", "one", "patients", "(", "70", "%", ")", "of", "the", "group", "taking", "omega-", "3", "fatty", "acid", "supplement", "(", "n", "=", "30", ")", "did", "not", "develop", "PN", "while", "it", "was", "40.7", "%", "(", "11", "patients", ")", "in", "the", "placebo", "group", "(", "n", "=", "27", ")", ".", "A", "significant", "difference", "was", "seen", "in", "PN", "incidence", "(", "OR", "=", "0.3", ",", ".", "95", "%", "CI", "=", "(", "0.10", "-", "0.88", ")", ",", "p", "=", "0.029", ")", ".", "There", "was", "a", "non", "-", "significant", "trend", "for", "differences", "of", "PIPN", "severity", "between", "the", "two", "study", "groups", "but", "the", "frequencies", "of", "PN", "in", "all", "scoring", "categories", "were", "higher", "in", "the", "placebo", "group", "(", "0.95", "%", "CI", "=", "(", "-", "2.06", "-", "0.02", ")", ",", "p", "=", "0.054", ")", ".", "Omega-", "3", "fatty", "acids", "may", "be", "an", "efficient", "neuroprotective", "agent", "for", "prophylaxis", "against", "PIPN", ".", "Patients", "with", "breast", "cancer", "have", "a", "longer", "disease", "free", "survival", "rate", "with", "the", "aid", "of", "therapeutical", "agents", ".", "Finding", "a", "way", "to", "solve", "the", "disabling", "effects", "of", "PIPN", "would", "significantly", "improve", "the", "patients", "'", "quality", "of", "life", ".", "This", "trial", "was", "registered", "at", "ClinicalTrials.gov", "(", "NCT", "01049295", ")", "." ]
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417
[ "Plasma", "TNF", "-", "α", "and", "Soluble", "TNF", "Receptor", "Levels", "after", "Doxorubicin", "with", "or", "without", "Co", "-", "Administration", "of", "Mesna", "-", "A", "Randomized", ",", "Cross", "-", "Over", "Clinical", "Study", ".", "Chemotherapy", "-", "induced", "cognitive", "impairment", "(", "CICI", ")", "is", "a", "common", "sequelae", "of", "cancer", "therapy", ".", "Recent", "preclinical", "observations", "have", "suggested", "that", "CICI", "can", "be", "mediated", "by", "chemotherapy", "-", "induced", "plasma", "protein", "oxidation", ",", "which", "triggers", "TNF", "-", "α", "mediated", "CNS", "damage", ".", "This", "study", "evaluated", "sodium-", "2", "-", "mercaptoethane", "sulfonate", "(", "Mesna", ")", "co", "-", "administration", "with", "doxorubicin", "to", "reduce", "doxorubicin", "-", "induced", "plasma", "protein", "oxidation", "and", "resultant", "cascade", "of", "TNF", "-", "α", ",", "soluble", "TNF", "receptor", "levels", "and", "related", "cytokines", ".", "Thirty", "-", "two", "evaluable", "patients", "were", "randomized", "using", "a", "crossover", "design", "to", "receive", "mesna", "or", "saline", "in", "either", "the", "first", "or", "second", "cycle", "of", "doxorubicin", "in", "the", "context", "of", "a", "standard", "chemotherapy", "regimen", "for", "either", "non", "-", "Hodgkin", "lymphoma", "or", "breast", "cancer", ".", "Mesna", "(", "360", "mg", "/", "m", "2", ")", "or", "saline", "administration", "occurred", "15", "minutes", "prior", "and", "three", "hours", "post", "doxorubicin", ".", "Pre", "-", "treatment", "and", "post", "-", "treatment", "measurements", "of", "oxidative", "stress", ",", "TNF", "-", "α", "and", "related", "cytokines", "were", "evaluated", "during", "the", "two", "experimental", "cycles", "of", "chemotherapy", ".", "Co", "-", "administration", "of", "mesna", "with", "chemotherapy", "reduced", "post", "-", "treatment", "levels", "of", "TNF", "-", "related", "cytokines", "and", "TNF", "-", "receptor", "1", "(", "TNFR", "1", ")", "and", "TNF", "-", "receptor", "2", "(", "TNFR", "2", ")", "(", "p", "=", "0.05", "and", "p", "=", "0.002", ",", "respectively", ")", ".", "Patients", "with", "the", "highest", "pre", "-", "treatment", "levels", "of", "each", "cytokine", "and", "its", "receptors", "were", "the", "most", "likely", "to", "benefit", "from", "mesna", "co", "-", "administration", ".", "The", "extracellular", "anti", "-", "oxidant", "mesna", ",", "when", "co", "-", "administered", "during", "a", "single", "cycle", "of", "doxorubicin", ",", "reduced", "levels", "of", "TNF", "-", "α", "and", "its", "receptors", "after", "that", "cycle", "of", "therapy", ",", "demonstrating", "for", "the", "first", "time", "a", "clinical", "interaction", "between", "mesna", "and", "doxorubicin", ",", "drugs", "often", "coincidentally", "co", "-", "administered", "in", "multi", "-", "agent", "regimens", ".", "These", "findings", "support", "further", "investigation", "to", "determine", "whether", "rationally", "-", "timed", "mesna", "co", "-", "administration", "with", "redox", "active", "chemotherapy", "may", "prevent", "or", "reduce", "the", "cascade", "of", "events", "that", "lead", "to", "CICI", ".", "clinicaltrials.gov", "NCT", "01205503", "." ]
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435
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436
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454
[ "Open", "-", "label", "randomized", "clinical", "trial", "of", "standard", "neoadjuvant", "chemotherapy", "with", "paclitaxel", "followed", "by", "FEC", "versus", "the", "combination", "of", "paclitaxel", "and", "everolimus", "followed", "by", "FEC", "in", "women", "with", "triple", "receptor", "-", "negative", "breast", "cancer†", ".", "Everolimus", "synergistically", "enhances", "taxane", "-", "induced", "cytotoxicity", "in", "breast", "cancer", "cells", "in", "vitro", "and", "in", "vivo", "in", "addition", "to", "demonstrating", "a", "direct", "antiproliferative", "activity", ".", "We", "aim", "to", "determine", "pharmacodynamics", "changes", "and", "response", "of", "adding", "everolimus", "to", "standard", "neoadjuvant", "chemotherapy", "in", "triple", "-", "negative", "breast", "cancer", "(", "TNBC", ")", ".", "Phase", "II", "study", "in", "patients", "with", "primary", "TNBC", "randomized", "to", "T", "-", "FEC", "(", "paclitaxel", "80", "mg", "/", "m", "(", "2", ")", "i.v", ".", "weekly", "for", "12", "weeks", ",", "followed", "by", "5", "-fluorouracil", "500", "mg", "/", "m", "(", "2", ")", ",", "epirubicin", "100", "mg", "/", "m", "(", "2", ")", ",", "and", "cyclophosphamide", "500", "mg", "/", "m", "(", "2", ")", "every", "3", "weeks", "for", "four", "cycles", ")", "versus", "TR", "-", "FEC", "(", "paclitaxel", "80", "mg", "/", "m", "(", "2", ")", "i.v", ".", "and", "everolimus", "30", "mg", "PO", "weekly", "for", "12", "weeks", ",", "followed", "by", "FEC", ")", ".", "Tumor", "samples", "were", "collected", "to", "assess", "molecular", "changes", "in", "the", "PI", "3", "K", "/", "AKT", "/", "mTOR", "pathway", ",", "at", "baseline", ",", "48", "h", ",", "12", "weeks", ",", "and", "at", "surgery", "by", "reverse", "phase", "protein", "arrays", "(", "RPPA", ")", ".", "Clinical", "end", "points", "included", "12", "-week", "clinical", "response", "rate", "(", "12", "-week", "RR", ")", ",", "pathological", "complete", "response", "(", "pCR", ")", ",", "and", "toxicity", ".", "Sixty", "-", "two", "patients", "were", "registered", ",", "and", "50", "were", "randomized", ",", "27", "received", "T", "-", "FEC", ",", "and", "23", "received", "TR", "-", "FEC", ".", "Median", "age", "was", "48", "(", "range", "31", "-", "75", ")", ".", "There", "was", "downregulation", "of", "the", "mTOR", "pathway", "at", "48", "h", "in", "the", "TR", "-", "FEC", "arm", ".", "Twelve", "-", "week", "RR", "by", "ultrasound", "were", "29.6", "%", "versus", "47.8", "%", ",", "(", "P", "=", "0.075", ")", ",", "and", "pCR", "were", "25.9", "%", "versus", "30.4", "%", "(", "P", "=", "0.76", ")", "for", "T", "-", "FEC", "and", "TR", "-", "FEC", ",", "respectively", ".", "mTOR", "downregulation", "at", "48", "h", "did", "not", "correlate", "with", "12", "-week", "RR", "in", "the", "TR", "-", "FEC", "group", "(", "P", "=", "0.58", ")", ".", "Main", "NCI", "grade", "3", "/", "4", "toxicities", "included", "anemia", ",", "neutropenia", ",", "rash", "/", "desquamation", ",", "and", "vomiting", "in", "both", "arms", ".", "There", "was", "one", "case", "of", "grade", "3", "pneumonitis", "in", "the", "TR", "-", "FEC", "arm", ".", "No", "grade", "3", "/", "4", "stomatitis", "occurred", ".", "The", "addition", "of", "everolimus", "to", "paclitaxel", "was", "well", "tolerated", ".", "Everolimus", "downregulated", "mTOR", "signaling", "but", "downregulation", "of", "mTOR", "at", "48", "h", "did", "not", "correlate", "with", "12", "-week", "RR", "in", "the", "TR", "-", "FEC", "group", ".", "NCT", "00499603", "." ]
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455
[ "Pamidronate", "in", "the", "prevention", "of", "chemotherapy", "-", "induced", "bone", "loss", "in", "premenopausal", "women", "with", "breast", "cancer", ":", "a", "randomized", "controlled", "trial", ".", "Mortality", "from", "breast", "cancer", "has", "decreased", "in", "large", "part", "because", "of", "adjuvant", "chemotherapy", ".", "Sequelae", "of", "therapy", "include", "ovarian", "failure", "and", "bone", "loss", ",", "loss", "that", "would", "increase", "these", "patients", "'", "risk", "of", "fracture", "with", "aging", ".", "In", "this", "study", ",", "we", "assessed", "the", "efficacy", "of", "pamidronate", "in", "preventing", "such", "loss", ".", "The", "study", "was", "a", "1", "-yr", "randomized", ",", "double", "-", "blind", ",", "placebo", "-", "controlled", "trial", "comparing", "pamidronate", "60", "mg", "iv", "every", "3", "months", "with", "placebo", "in", "40", "premenopausal", "women", "with", "newly", "diagnosed", "breast", "cancer", ".", "Bone", "mineral", "density", "(", "BMD", ")", "of", "the", "spine", "and", "hip", "and", "remodeling", "markers", "were", "monitored", "over", "1", "yr", ".", "Over", "half", "of", "the", "subjects", "became", "amenorrheic", ",", "and", "those", "who", "did", "were", "4", "yr", "older", "than", "those", "who", "did", "not", "(", "P", "=", "0.02", ")", ".", "The", "mean", "difference", "in", "percent", "change", "in", "BMD", "at", "12", "months", "between", "the", "two", "treatment", "groups", "was", "5.1", "%", "at", "the", "lumbar", "spine", "(", "P", "=", "0.002", ")", "in", "the", "overall", "study", "group", "and", "5", "%", "at", "the", "lumbar", "spine", "and", "5.2", "%", "at", "the", "total", "hip", "in", "the", "amenorrheic", "subgroup", "(", "P", "<", "0.03", ")", ".", "Biochemical", "markers", "of", "bone", "remodeling", "did", "not", "differ", "between", "the", "two", "treatment", "groups", ",", "and", "treatment", "was", "well", "tolerated", ".", "Chemotherapy", "-", "induced", "amenorrhea", "is", "common", "with", "ensuing", "bone", "loss", "at", "the", "spine", "and", "hip", ".", "Pamidronate", "prevented", "bone", "loss", "at", "the", "spine", "and", "hip", "and", "was", "well", "tolerated", "." ]
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456
[ "Circulating", "hormones", "and", "breast", "cancer", "risk", "in", "premenopausal", "women", ":", "a", "randomized", "trial", "of", "low", "-", "dose", "tamoxifen", "and", "fenretinide", ".", "Tamoxifen", "and", "fenretinide", "have", "been", "extensively", "studied", "and", "exhibit", "breast", "cancer", "-", "preventing", "activity", ".", "We", "aimed", "to", "assess", "their", "effect", "on", "sex", "hormones", ",", "sex", "hormone", "binding", "globulin", "(", "SHBG", ")", "and", "retinol", ",", "and", "their", "association", "with", "mammographic", "density", "(", "MD", ")", "and", "breast", "cancer", "events", ".", "In", "a", "double", "-", "blind", ",", "placebo", "-", "controlled", "trial", ",", "premenopausal", "women", "at", "risk", "for", "breast", "cancer", "were", "randomized", "to", "tamoxifen", "5", "mg", "/", "day", ",", "fenretinide", ",", "both", "agents", ",", "or", "placebo", "for", "2", "years", ".", "We", "measured", "MD", "and", "circulating", "concentrations", "of", "follicle", "-", "stimulating", "hormone", ",", "luteinizing", "hormone", "(", "LH", ")", ",", "estradiol", ",", "progesterone", ",", "testosterone", ",", "androstenedione", ",", "dehydro", "-", "epiandrosteronesulfate", ",", "prolactin", ",", "SHBG", ",", "and", "retinol", "at", "baseline", "and", "on", "yearly", "intervals", ".", "The", "associations", "with", "breast", "cancer", "events", "were", "evaluated", "through", "competing", "risk", "and", "Cox", "regression", "survival", "models", ".", "Low", "-", "dose", "tamoxifen", "markedly", "and", "enduringly", "increased", "SHBG", ",", "whereas", "the", "increases", "in", "testosterone", ",", "estradiol", ",", "and", "prolactin", "and", "reduction", "in", "LH", "weakened", "after", "1", "year", ".", "Fenretinide", "increased", "testosterone", "and", "androstenedione", "and", "decreased", "retinol", ".", "MD", "correlated", "directly", "with", "SHBG", "and", "inversely", "with", "retinol", ".", "After", "a", "median", "follow", "-", "up", "of", "12", "years", ",", "the", "10", "-year", "cumulative", "incidence", "of", "breast", "cancer", "events", "was", "37", "%", "in", "women", "with", "SHBG", "≤", "59.3", "nmol", "/", "L", ",", "22", "%", "in", "women", "with", "SHBG", "between", "59.3", "and", "101", "nmol", "/", "L", ",", "and", "19", "%", "in", "women", "with", "SHBG", ">", "101", "nmol", "/", "L", "(", "P", "=", "0.018", ")", ".", "The", "difference", "among", "SHBG", "tertiles", "remained", "statistically", "significant", "at", "multivariable", "analysis", ":", "HR", "=", "2.26", "(", "95", "%", "CI", "1.04", ",", "4.89", ")", "for", "the", "lowest", "versus", "the", "highest", "tertile", ".", "We", "conclude", "that", "low", "-", "dose", "tamoxifen", "or", "fenretinide", "exhibits", "favorable", "hormonal", "profiles", "as", "single", "agents", ",", "further", "supporting", "their", "administration", "for", "prevention", "of", "breast", "cancer", "in", "premenopause", ".", "Notably", ",", "SHBG", "levels", "were", "inversely", "associated", "with", "breast", "neoplastic", "events", "." ]
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471
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472
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473
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[ "Cyanoacrylate", "Adhesive", "Reduces", "Seroma", "Production", "After", "Modified", "Radical", "Mastectomy", "or", "Quadrantectomy", "With", "Lymph", "Node", "Dissection", "-", "A", "Prospective", "Randomized", "Clinical", "Trial", ".", "The", "accumulation", "of", "fluid", ",", "a", "seroma", ",", "is", "a", "frequent", "complication", "after", "modified", "radical", "mastectomy", "or", "quadrantectomy", "with", "lymph", "node", "dissection", ".", "The", "aim", "of", "the", "present", "study", "was", "to", "examine", "whether", "a", "new", "adhesive", "material", "made", "of", "cyanoacrylate", "can", "effectively", "provide", "a", "sealing", "coat", "to", "tissues", "and", "thus", "reduce", "the", "incidence", "of", "seroma", "significantly", ".", "The", "present", "prospective", ",", "randomized", "case", "-", "control", "study", "included", "128", "women", "with", "a", "breast", "cancer", "diagnosis", "and", "scheduled", "for", "modified", "radical", "mastectomy", "or", "quadrantectomy", "with", "lymph", "node", "dissection", "in", "Thessaloniki", ",", "Greece", ".", "In", "64", "patients", "(", "cases", ")", ",", "a", "cyanoacrylate", "adhesive", "was", "applied", "at", "the", "operative", "field", "after", "removal", "of", "the", "tumor", "and", "lymph", "nodes", ";", "the", "remaining", "64", "patients", "served", "as", "the", "controls", ".", "Seroma", "production", "(", "P", "=", ".", "001", ")", ",", "drainage", "duration", "(", "P", "=", ".", "001", ")", ",", "and", "drainage", "amount", "(", "P", "=", ".", "001", ")", "were", "all", "significantly", "less", "for", "cases", "than", "for", "controls", ".", "The", "results", "from", "a", "stepwise", "multiple", "regression", "model", "incorporating", "the", "use", "of", "adhesive", ",", "body", "mass", "index", ",", "tumor", "size", ",", "and", "number", "of", "infiltrated", "lymph", "nodes", "were", "significant", "and", "able", "to", "explain", "51.6", "%", "of", "the", "variability", "in", "seroma", "amount", ".", "The", "results", "of", "our", "study", "have", "demonstrated", "that", "the", "cyanoacrylate", "adhesive", "can", "contribute", "to", "the", "reduction", "of", "seromas", "produced", "after", "mastectomy", "and", "subsequently", "decrease", "the", "duration", "of", "postoperative", "drainage", "and", "the", "frequency", "of", "seroma", "aspirations", ".", "However", ",", "because", "the", "pathogenesis", "of", "seroma", "formation", "is", "multifaceted", "and", "complex", ",", "further", "research", "of", "larger", "sample", "sizes", "is", "required", "to", "confirm", "the", "results", "of", "our", "study", "." ]
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479
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480
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485
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486
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487
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496
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497
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