bluuebunny/crossref_metadata_2025 huggingface dataset:
How Accurate Is Clinician Reporting of Chemotherapy Adverse Effects? A Comparison With Patient-Reported Symptoms From the Quality-of-Life Questionnaire C30
Authors: Fromme Erik K. , Eilers Kristine M. , Mori Motomi , Hsieh Yi-Ching , Beer Tomasz M.
Published: August 2004

Purpose

Adverse events in chemotherapy clinical trials are assessed and reported by clinicians, yet clinician accuracy in assessing symptoms has been questioned. We compared patient reporting of eight symptoms using a validated instrument, the European Organization for the Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (QLQ-C30 or QLQ) with physicians' reporting of the same symptoms in the study's adverse events log.

Patients and Methods

Thirty-seven men with metastatic, androgen-independent prostate cancer enrolled onto a phase II trial of weekly calcitriol and docetaxel completed the QLQ every 4 weeks for up to 28 weeks. A patient-reported symptom was defined as an increase in a QLQ symptom score by at least 10 points (0 to 100 scale), sustained for at least 4 weeks. A physician-reported symptom was considered present if it was ever documented in the adverse event log.

Results

Forty-nine (new or worsened) symptoms were detected by both physician and QLQ, 48 symptoms were detected by the physician alone, and 55 symptoms were detected by the QLQ alone. They agreed on the absence of a symptom in 102 instances of 254 possible opportunities. Their uncorrected agreement was 59.4%, but Cohen's κ, a coefficient of agreement that corrects for chance, was 0.15, indicating only slight agreement. Using the QLQ as the standard, overall physician sensitivity and specificity was 47% and 68%, respectively, although it varied considerably among symptoms.

Conclusion

Even in a tightly controlled clinical trial, physician reporting was neither sensitive nor specific in detecting common chemotherapy adverse effects. Tools for collecting patient-reported adverse event data in chemotherapy clinical trials should be developed.
Psychological, Behavioral, and Immune Changes After a Psychological Intervention: A Clinical Trial
Authors: Andersen Barbara L. , Farrar William B. , Golden-Kreutz Deanna M. , Glaser Ronald , Emery Charles F. , Crespin Timothy R. , Shapiro Charles L. , Carson William E.
Published: August 2004

Purpose

This randomized clinical trial tests the hypothesis that a psychological intervention can reduce emotional distress, improve health behaviors and dose-intensity, and enhance immune responses.

Patients and Methods

We studied 227 women who were surgically treated for regional breast cancer. Before adjuvant therapy, women completed interviews and questionnaires assessing emotional distress, social adjustment, and health behaviors. A 60-mL blood sample was drawn for immune assays. Patients were randomly assigned to either the intervention group or assessment only group. The intervention was conducted in small patient groups, with one session per week for 4 months. The sessions included strategies to reduce stress, improve mood, alter health behaviors, and maintain adherence to cancer treatment and care. Reassessment occurred after completion of the intervention.

Results

As predicted, patients receiving the intervention showed significant lowering of anxiety, improvements in perceived social support, improved dietary habits, and reduction in smoking (all P < .05). Analyses of adjuvant chemotherapy dose-intensity revealed significantly more variability (ie, more dispersion in the dose-intensity values) for the assessment arm (P < .05). Immune responses for the intervention patients paralleled their psychological and behavioral improvements. T-cell proliferation in response to phytohemagglutinin and concanavalin A remained stable or increased for the Intervention patients, whereas both responses declined for Assessment patients; this effect was replicated across three concentrations for each assay (all P < .01).

Conclusion

These data show a convergence of significant psychological, health behavior, and biologic effects after a psychological intervention for cancer patients.
Efficacy and Safety of Ibandronate in the Treatment of Opioid-Resistant Bone Pain Associated With Metastatic Bone Disease: A Pilot Study
Authors: Mancini Isabelle , Dumon Jean-Claude , Body Jean-Jacques
Published: August 2004

Purpose

Bone metastases are associated with severe and sometimes intractable pain, compromising patient quality of life (QOL). This open-label pilot study investigated the effects of short-term intensive treatment with intravenous (IV) ibandronate on opioid-resistant bone pain in patients with skeletal metastases.

Patients and Methods

Eighteen patients with advanced tumors and metastatic bone disease received nonstandard treatment with 4 mg of ibandronate administered IV (2-hour infusion) for 4 consecutive days (16-mg total dose). Baseline opioid analgesic use was equivalent to 400 mg/d of morphine. Patients were assessed for 6 weeks or until death. Changes from baseline were determined for bone pain, opioid consumption, patient functioning, QOL, performance status, and biochemical markers of calcium metabolism and bone turnover. Renal function was assessed by serum urea and creatinine measurement.

Results

Short-term, intensive ibandronate treatment significantly reduced bone pain scores within 7 days (P < .001). Pain reductions were sustained over the study period. Ibandronate significantly improved QOL, patient functioning, and performance status (P < .05). Mean values of the urinary cross-links pyridinoline and deoxypyridinoline tended to increase after day 21, returning close to baseline values by day 42. There was no correlation between the change in crosslinks values and the change in pain scores after ibandronate treatment. Ibandronate was well tolerated, with no evidence of renal toxicity.

Conclusion

Nonstandard, intensive treatment with IV ibandronate seems to have a marked analgesic effect in patients with opioid-resistant bone pain from metastatic bone disease. Further investigation is warranted.
Papillary and Follicular Thyroid Carcinomas Show Distinctly Different Microarray Expression Profiles and Can Be Distinguished by a Minimum of Five Genes
Authors: Aldred Micheala A. , Huang Ying , Liyanarachchi Sandya , Pellegata Natalia S. , Gimm Oliver , Jhiang Sissy , Davuluri Ramana V. , de La Chapelle Albert , Eng Charis
Published: August 2004

Purpose

We have previously conducted independent microarray expression analyses of the two most common types of nonmedullary thyroid carcinoma, namely papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC). In this study, we sought to combine our data sets to shed light on the similarities and differences between these tumor types.

Materials and Methods

Microarray data from six PTCs, nine FTCs, and 13 normal thyroid samples were normalized to remove interlaboratory variability and then analyzed by unsupervised clustering, t test, and by comparison of absolute and change calls. Expression changes in four genes not previously implicated in thyroid carcinogenesis were verified by reverse transcriptase polymerase chain reaction on these same samples, together with eight additional FTC tumors.

Results

PTCs showed two distinct groups of genes that were either over- or underexpressed compared with normal thyroid, whereas the predominant changes in FTCs were of decreased expression. Five genes could collectively distinguish the two tumor types. PTCs showed overexpression of CITED1, claudin-10 (CLDN10), and insulin-like growth factor binding protein 6 (IGFBP6) but showed no change in expression of caveolin-1 (CAV1) or -2 (CAV2); conversely, FTCs did not express CLDN10 and had decreased expression of IGFBP6 and/or CAV1 and CAV2.

Conclusion

PTC and FTC show distinctive microarray expression profiles, suggesting that either they have different molecular origins or they diverge distinctly from a common origin. Furthermore, if verified in a larger series of tumors, these genes could, in combination with known tumor-specific chromosome translocations, form the basis of a valuable diagnostic tool.
Consolidation Treatment With Chimeric Anti-GD2-Antibody ch14.18 in Children Older Than 1 Year With Metastatic Neuroblastoma
Authors: Simon Thorsten , Hero Barbara , Faldum Andreas , Handgretinger Rupert , Schrappe Martin , Niethammer Dietrich , Berthold Frank
Published: August 2004

Purpose

Antibody treatment is considered tolerable and potentially effective in the therapy of neuroblastoma. We have analyzed stage 4 neuroblastoma patients older than 1 year who underwent consolidation treatment with the chimeric monoclonal anti-GD2-antibody ch14.18.

Patients and Methods

Stage 4 patients older than 1 year who completed initial treatment without event were eligible. ch14.18 was scheduled in a dose of 20 mg/m2/d during 5 days in six cycles every 2 months. Patients who did not receive ch14.18 served as controls.

Results

Of 334 assessable patients, 166 received ch14.18, 99 received a 12-month low-dose maintenance chemotherapy (MT) instead, and 69 had no additional treatment. During 695 ch14.18 cycles, fever (55% of cycles), abnormal C-reactive protein without infection (35%), cough (24%), rash (22%), and pain (16%) were the main side effects. Univariate analysis found similar event-free survival (EFS) for the three groups (3-year EFS, 46.5% ± 4.1%, 44.4% ± 4.9%, 37.1% ± 5.9% for patients treated with antibody ch14.18, MT, and no additional therapy, respectively; log-rank test, P = .314). For overall survival (OS), ch14.18 treatment (3-year OS, 68.5% ± 3.9%) was superior to MT (3-year OS, 56.6% ± 5.0%) or no additional therapy (3-year OS, 46.8% ± 6.2%; log-rank test, P = .018). Separate univariate analysis of patients with autologous stem-cell transplantation revealed no difference between patients with ch14.18 treatment and no additional consolidation. Multivariate analysis failed to demonstrate an advantage of antibody treatment for EFS and OS.

Conclusion

Consolidation treatment of stage 4 neuroblastoma with ch14.18 was associated with considerable but manageable side effects. Compared with oral maintenance chemotherapy and no consolidation treatment, ch14.18 had no clear impact on the outcome of patients.
Randomized, Placebo-Controlled Study of Oregovomab for Consolidation of Clinical Remission in Patients With Advanced Ovarian Cancer
Authors: Berek Jonathan S. , Taylor Peyton T. , Gordon Alan , Cunningham Mary J. , Finkler Neil , Orr James , Rivkin Saul , Schultes Birgit C. , Whiteside Theresa L. , Nicodemus Christopher F.
Published: August 2004

Purpose

To assess oregovomab as consolidation treatment of advanced ovarian cancer and refine the immunotherapeutic strategy for subsequent study.

Patients and Methods

Patients with stage III/IV ovarian cancer who had a complete clinical response to primary treatment were randomly assigned to oregovomab or placebo administered at weeks 0, 4, and 8, and every 12 weeks up to 2 years or until recurrence. The primary end-point was time to relapse (TTR).

Results

One hundred forty-five patients were treated with oregovomab (n = 73) or placebo (n = 72). For the population overall, median TTR was not different between treatments at 13.3 months for oregovomab and 10.3 months for placebo (P = .71). Immune responses were induced in most actively treated patients. This was associated with prolonged TTR. Quality of life was not adversely impacted by treatment. Adverse events were reported with similar frequency in oregovomab and placebo groups, indicating a benign safety profile. A long-term survival follow-up is ongoing. Cox analysis of relapse data identified significant factors: performance status, CA-125 before third cycle, and baseline CA-125. Further evaluation identified a subpopulation with favorable prognostic indicators designated as the successful front-line therapy (SFLT) population. For the SFLT population, TTR was 24.0 months in the oregovomab group compared with 10.8 months for placebo (unadjusted hazard ratio of 0.543 [95% CI, 0.287 to 1.025]), a hypothesis-generating observation.

Conclusion

Consolidation therapy with oregovomab did not significantly improve TTR overall. A set of confirmatory phase III studies has been initiated to determine whether the SFLT population derives benefit from oregovomab treatment.
Neoadjuvant Chemotherapy Followed by Extrapleural Pneumonectomy in Malignant Pleural Mesothelioma
Authors: Weder Walter , Kestenholz Peter , Taverna Christian , Bodis Stefan , Lardinois Didier , Jerman Monika , Stahel Rolf A.
Published: August 2004

Purpose

To investigate neoadjuvant chemotherapy with cisplatin and gemcitabine followed by extrapleural pneumonectomy with or without radiation therapy in patients with potentially resectable malignant pleural mesothelioma (MPM).

Patients and Methods

Eligible patients had MPM with clinical stage T1-3, N0-2, M0 disease considered to be completely resectable and a WHO performance status of 0 to 2. Neoadjuvant chemotherapy consisted of three cycles of cisplatin 80 mg/m2 on day 1 and gemcitabine 1,000 mg/m2 on days 1, 8, and 15, given every 28 days. Surgery had to consist of a complete extrapleural pneumonectomy, including resection of pericardium and diaphragm. Postoperative radiotherapy was to be considered for all patients.

Results

Nineteen patients with MPM were included in this pilot study. According to the European Organization for Research and Treatment of Cancer prognostic score, two patients were in the good prognosis group, and 17 patients were in the poor prognosis group. The response rate to neoadjuvant chemotherapy was 32%. The major toxicity was thrombocytopenia. Extrapleural pneumonectomy was performed in 16 patients with no perioperative mortality. Major surgical complications occurred in six patients, and all were treated successfully. Thirteen patients received postoperative radiotherapy. The median survival time was 23 months. Two patients remain alive and free of disease 41 and 38 months after initiation of therapy.

Conclusion

For patients with potentially operable MPM, the availability of active and well-tolerated chemotherapy regimens, the fact that extrapleural pneumonectomy can be safely performed after neoadjuvant chemotherapy in an experienced center, and the promising results regarding survival in our pilot study warrant further investigation of the role of neoadjuvant chemotherapy in a multimodality strategy.
Radiation Therapy With or Without Concurrent Low-Dose Daily Chemotherapy in Locally Advanced, Nonmetastatic Squamous Cell Carcinoma of the Head and Neck
Authors: Jeremic Branislav , Milicic Biljana , Dagovic Aleksandar , Vaskovic Zeljko , Tadic Ljiljana
Published: August 2004

Purpose

To retrospectively investigate the difference between conventionally fractionated (CF) and hyperfractionated (Hfx) radiation therapy (RT), with and without either daily cisplatin (CDDP) or carboplatin (CBDCA), in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) enrolled onto two consecutive prospective randomized studies.

Patients and Methods

Treatment consisted of CF RT (70 Gy, group 1), CF RT and either daily CDDP (6 mg/m2) or daily CBDCA (25 mg/m2; group 2), Hfx RT (77 Gy, 1.1 Gy bid; group 3), or Hfx RT and daily CDDP (group 4).

Results

Hfx RT plus CDDP achieved better overall survival (OS) and local recurrence-free survival (LRFS) than any other group. There was an insignificant difference favoring Hfx RT over CF RT, either alone or in combination with CDDP or CBDCA, regarding both OS (P = .058 and P = .051, respectively) and LRFS (P = .088 and P = .091, respectively). No difference was seen between CF RT plus chemotherapy (CHT) and Hfx RT alone regarding either OS (P = .32) or LRFS (P = .48). Regional recurrence-free survival was similar in the four treatment groups. CF RT plus CHT and Hfx RT plus CDDP achieved better distant metastasis-free survival than CF RT and Hfx RT. High-grade toxicity was significantly more frequent in Hfx RT plus CDDP than in any other group, except in the Hfx RT group. Hfx RT led to significantly more acute toxicity and xerostomia than CF RT plus CHT. Hfx RT was more toxic than CF RT, either alone or with concurrent CHT.

Conclusion

Results of this study show that there may be a therapeutic benefit for CF RT plus CHT over Hfx RT plus CDDP in patients with SCCHN, but this cannot be firmly established without a larger and well-planned controlled trial.
Nuclear Expression of BCL10 or Nuclear Factor Kappa B Predicts Helicobacter pylori–Independent Status of Early-Stage, High-Grade Gastric Mucosa-Associated Lymphoid Tissue Lymphomas
Authors: Kuo Sung-Hsin , Chen Li-Tzong , Yeh Kun-Huei , Wu Ming-Shiang , Hsu Hui-Chen , Yeh Pei-Yen , Mao Tsui-Lien , Chen Chi-Long , Doong Shin-Lian , Lin Jaw-Town , Cheng Ann-Lii
Published: August 2004

Purpose

A high percentage of early-stage, high-grade gastric mucosa-associated lymphoid tissue (MALT) lymphomas remain Helicobacter pylori dependent. t(11;18)(q21;q21), a genetic aberration highly predictive of H pylori–independent status in low-grade gastric MALT lymphoma, is rarely detected in its high-grade counterpart. This study examined whether nuclear expression of BCL10 or nuclear factor kappa B (NF-κB) is useful in predicting H pylori–independent status in patients with stage IE high-grade gastric MALT lymphomas.

Patients and Methods

Twenty-two patients who had participated in a prospective study of H pylori eradication for stage IE high-grade gastric MALT lymphomas were studied. The expression of BCL10 and NF-κB in pretreatment paraffin-embedded lymphoma tissues was evaluated by immunohistochemistry and confocal immunofluorescence microscopy. The presence of t(11;18)(q21;q21) was identified by a multiplex reverse transcriptase polymerase chain reaction of the API2-MALT1 chimeric transcript.

Results

Aberrant nuclear expression of BCL10 was detected in seven (87.5%) of eight H pylori–independent and in none of 14 H pylori–dependent high-grade gastric MALT lymphomas (P < .001). All seven patients with nuclear BCL10 expression had nuclear expression of NF-κB, compared with only two of 15 patients without nuclear BCL10 expression (P = .002). As a single variable, the frequency of nuclear expression of NF-κB was also significantly higher in H pylori–independent tumors than in H pylori–dependent tumors (seven of eight [87.5%] v two of 15 [12.3%]; P = .002). The API2-MALT1 fusion transcript was detected in only one (12.5%) of eight H pylori–independent lymphomas.

Conclusion

Nuclear expression of BCL10 or NF-κB is highly predictive of H pylori–independent status in high-grade gastric MALT lymphoma, and coexpression of these two markers in the nuclei is frequent.
Estimating the Cost of Cancer: Results on the Basis of Claims Data Analyses for Cancer Patients Diagnosed With Seven Types of Cancer During 1999 to 2000
Authors: Chang Stella , Long Stacey R. , Kutikova Lucie , Bowman Lee , Finley Denise , Crown William H. , Bennett Charles L.
Published: August 2004

Purpose

Cancer accounts for $60.9 billion in direct medical costs and $15.5 billion for indirect morbidity costs. These estimates are derived primarily from national surveys or Federal databases. We derive estimates of the costs of cancer using administrative databases, which include claims and employment-related information on individuals insured by private or Medicare supplemental health plans.

Methods

A retrospective matched-cohort control analysis was performed using 1998 to 2000 databases with information on insurance claims, benefits, and health productivity for 3 million privately insured employees, their dependents, and early retirees. Study patients had new diagnoses of one of seven types of cancer (n = 12,709). Controls without cancer were matched at a 3:1 ratio by demographics. A variable follow-up length was used (maximum of 2 years). Direct costs included health care costs for patients and deductibles and copayments for caregivers. Indirect costs of work absence and short-term disability (STD) were calculated for a subgroup of cancer patients and caregivers.

Results

Mean monthly health care costs ranged from $2,187 for prostate cancer to $7,616 for pancreatic cancer, most often driven by hospitalization. Costs for controls were $329 per month. Indirect morbidity costs to employees with cancer averaged $945, a result of a mean monthly loss of 2.0 workdays and 5.0 STD days.

Conclusion

The economic burden of cancer is substantial. It is feasible to derive tumor-specific estimates of direct and indirect costs for large numbers of cancer patients using administrative databases. Policy makers charged with providing annual cost-of-cancer estimates should incorporate data obtained from a broad range of sources.
Receptor Imaging in Oncology by Means of Nuclear Medicine: Current Status
Authors: Van Den Bossche Bieke , Van de Wiele Christophe
Published: August 2004

To date, our understanding of the role of receptors and their cognate ligands in cancer is being successfully translated into the design and development of an arsenal of new, less toxic, and more specific anticancer drugs. Because most of these novel drugs are cytostatic, objective response as measured by morphologic imaging modalities (eg, computed tomography or magnetic resonance imaging) cannot be used as a surrogate marker for drug development or for clinical decision making. Positron emission tomography (PET) can be used to image and quantify the in vivo distribution of positron-emitting radioisotopes such as oxygen-15, carbon-11, and fluorine-18 that can be substituted or added into biologically relevant and specific receptor radioligands. Similarly, single-photon emission computed tomography (SPECT) can be used to image and quantify the in vivo distribution of receptor targeting compounds labeled with indium-111, technetium-99m, and iodine-123. By virtue of their whole-body imaging capacity and the absence of errors of sampling and tissue manipulation as well as preparation, both techniques have the potential to address locoregional receptor status noninvasively and repetitively. This article reviews available data on the in vivo evaluation of receptor systems by means of PET or SPECT for identifying and monitoring patients with sufficient receptor overexpression for tailored therapeutic interventions, and also for depicting tumor tissue and determining the currently largely unknown heterogeneity in receptor expression among different tumor lesions within and between patients.
Use of Surgery Among Elderly Patients With Stage IV Colorectal Cancer
Authors: Temple Larissa K.F. , Hsieh Lillian , Wong W. Douglas , Saltz Leonard , Schrag Deborah
Published: August 2004

Purpose

The role of surgery to remove the primary tumor among patients with stage IV colorectal cancer (CRC) is controversial. The purpose of this study was to evaluate surgical practice patterns for patients ≥ 65 years of age with stage IV CRC in a US population-based cohort.

Patients and Methods

We used the Surveillance, Epidemiology, and End Results-Medicare–linked database to evaluate the patterns of cancer treatment for 9,011 Medicare beneficiaries presenting with stage IV CRC from 1991 to 1999. Patients were categorized according to whether they had primary–cancer-directed surgery (CDS) or no CDS within 4 months of diagnosis. The use of other treatment modalities, including metastasectomy, chemotherapy, and radiation, was evaluated in relationship to whether patients belonged to the CDS or no CDS group.

Results

Seventy-two percent (6,469 of 9,011) of patients received CDS, and their 30-day postoperative mortality was 10%. Patients with left-sided or rectal lesions, patients older than age 75 years, blacks, and those of lower socioeconomic status were less likely to undergo CDS; but even among those older than age 75, the CDS rate was 69% (3,378 of 4,909). In contrast, chemotherapy use was less common (47% for patients who had CDS and 31% for those who did not). Metastasectomy was rare; only 3.9% of patients underwent these operations at any point from diagnosis to death.

Conclusion

Palliative resection of the primary tumor is often performed for elderly US patients with stage IV colorectal cancer. This practice pattern merits re-evaluation, given the improvement in the efficacy of systemic chemotherapy.
Clinicopathologic Significance and Prognostic Value of Chromosomal Imbalances in Diffuse Large B-Cell Lymphomas
Authors: Beà Sílvia , Colomo Lluís , López-Guillermo Armando , Salaverria Itziar , Puig Xavier , Pinyol Magda , Rives Susana , Montserrat Emili , Campo Elias
Published: August 2004

Purpose

To determine the clinicopathologic significance and prognostic value of chromosomal imbalances in diffuse large B-cell lymphomas (DLBCL).

Patients and Methods

We have examined 64 tumors at diagnosis using comparative genomic hybridization and real-time quantitative polymerase chain reaction (PCR), single-stranded conformational polymorphism, and DNA sequencing for the analysis of several potential target genes.

Results

The most recurrent alterations were gains of 18q (20%), Xq (15%), 2p, 7q, and 12p (14%), and losses of 6q and 17p (14%). Frequent high-level DNA amplifications were detected at 2p13-p16 and 18q21 loci. Real-time quantitative PCR detected REL and BCL11A gene amplifications in the nine patients with gains at 2p13-p16 and only in one additional patient with normal chromosome 2. Similarly, the BCL-2 gene was amplified in the 12 tumors with gains of 18q21 but in none of 39 patients with normal 18q profile. p53 gene inactivation was detected in nine of 58 (16%) tumors and was commonly associated with 17p losses. Tumors with 18q gains were significantly associated with a high number of chromosomal imbalances, primary nodal presentation, high serum lactate dehydrogenase levels, high International Prognostic Index, shorter cause-specific survival, and a high risk of relapse. Losses of 17p and p53 gene alterations were associated with an absence of complete response achievement.

Conclusion

These results suggest that DLBCLs have a characteristic pattern of genomic alterations; 18q gains or amplifications and 17p losses are associated with particular clinicopathological features and aggressive clinical behavior. Additional studies are needed to confirm these observations in larger series of patients.
Survey on Use of Palliative Radiotherapy in Hospice Care
Authors: Lutz Stephen , Spence Carol , Chow Edward , Janjan Nora , Connor Stephen
Published: August 2004

Purpose

Radiation oncologists and hospice professionals both provide end-of-life care for oncology patients, and little has been written about the interface between these two groups of specialists. Hospice professionals were surveyed to assess the perceived need for palliative radiotherapy in the hospice setting, to investigate factors that limit the access of hospice patients to radiotherapy, and to suggest areas of future collaboration on education, research, and patient advocacy.

Patients and Methods

Members of the National Hospice and Palliative Care Organization (NHPCO) and American Society for Therapeutic Radiology and Oncology jointly authored a questionnaire to investigate the beliefs of hospice professionals toward the use of radiotherapy for oncology patients in hospice. The questionnaire was distributed to all NHPCO member institutions, and the results were compiled and statistically analyzed.

Results

Four hundred eighty of more than 1,800 surveyed facilities responded to the questionnaire. The findings suggest that the majority of hospice professionals feel that radiotherapy is important in palliative oncology and that radiotherapy is widely available in the United States. Yet less than 3% on average of hospice patients served by hospices responding to the survey actually received radiotherapy in 2002. The most common barriers to radiotherapy in hospice care include radiotherapy expense, transportation difficulties, short life expectancy, and educational deficiencies between the specialties.

Conclusion

Multiple barriers act to limit the use of palliative radiotherapy in hospice care. Finding ways to surmount these obstacles will provide opportunity for improvement in the end-of-life care of cancer patients.
Genetic Variation in the Leptin Receptor Gene and Obesity in Survivors of Childhood Acute Lymphoblastic Leukemia: A Report From the Childhood Cancer Survivor Study
Authors: Ross Julie A. , Oeffinger Kevin C. , Davies Stella M. , Mertens Ann C. , Langer Erica K. , Kiffmeyer William R. , Sklar Charles A. , Stovall Marilyn , Yasui Yutaka , Robison Leslie L.
Published: August 2004

Purpose

Overweight (body mass index [BMI] 25 to 29 kg/m2) and obesity (BMI ≥ 30 kg/m2) frequently follow treatment for childhood acute lymphoblastic leukemia (ALL). Recent studies suggest that risk is most apparent in females treated with cranial radiation at a younger age. Because radiation at a young age may affect the hypothalamus causing leptin receptor insensitivity, we hypothesized that a polymorphism in the leptin receptor (LEPR) gene, Gln223Arg, might influence susceptibility to obesity in survivors of childhood ALL.

Patients and Methods

We genotyped 600 non-Hispanic white adult ALL survivors enrolled onto the Childhood Cancer Survivor Study. BMI was compared between those with two copies of the Arg allele to those who had at least one copy of the Gln allele.

Results

Female survivors with BMI ≥ 25 kg/m2 were more likely Arg homozygous than those with BMI less than 25 kg/m2 (24% v 12%; P = .007). This difference was not observed in males. Moreover, among females treated with ≥ 20 Gy cranial radiation, Arg/Arg individuals had six times higher odds of having BMI ≥ 25 kg/m2 (95% CI, 2.1 to 22.0) than those with a Gln allele (P = .04 for interaction).

Conclusion

LEPR polymorphism may influence obesity in female survivors of childhood ALL, particularly those exposed to cranial radiation. Because obesity is associated with increased morbidity and mortality in later life, identification of children at high risk might allow for early targeted interventions.
The Activity of Taxanes in the Treatment of Sex Cord-Stromal Ovarian Tumors
Authors: Brown Jubilee , Shvartsman Hyun S. , Deavers Michael T. , Burke Thomas W. , Munsell Mark F. , Gershenson David M.
Published: August 2004

Purpose

To determine the efficacy and side effects of taxanes, with or without platinum, for the treatment of sex cord-stromal tumors of the ovary.

Patients and Methods

We conducted a retrospective review of all patients seen from 1985 to 2002 at The University of Texas M.D. Anderson Cancer Center with ovarian sex cord-stromal tumors. Eligible patients underwent pathology confirmation and clinical evaluation at M.D. Anderson and received a taxane for initial or recurrent disease.

Results

Of 222 patients identified, 44 were eligible for analysis. For nine patients treated in the first-line adjuvant setting, median progression-free survival (PFS) was not reached at 51 months. Of two patients treated for measurable disease in the first-line setting, one had a complete response. Median PFS was 34.3 months; median overall survival (OS) was not reached. Median follow-up was 90.3 months (range, 39.4 to 140.5 months). Response rate for 30 patients treated with a taxane ± platinum for recurrent, measurable disease was 42%. Median PFS was 19.6 months; median OS was not reached. Median follow-up was 100.7 months (range, 8.1 to 361.3 months). The presence of platinum correlated with response in the recurrent, measurable disease setting. The number of patients was insufficient to detect relative efficacy of paclitaxel and docetaxel. Adverse effects of paclitaxel included neutropenia (n = 6), anemia (n = 1), thrombocytopenia (n = 1), myelodysplasia (n = 1), and hypersensitivity (n = 1).

Conclusion

Taxanes seem to be active agents in the treatment of patients with sex cord-stromal tumors of the ovary. The combination of taxanes with platinum in the treatment of this disease deserves additional investigation.
Ligand Influences in Heme–Copper O2-Chemistry as Synthetic Models for Cytochrome c Oxidase
Authors: Karlin Kenneth D , Kim Eunsuk
Published: August 2004

Prominent recent advances in synthetic modeling chemistry of cytochrome c oxidase include the generation and characterization of high-spin heme–peroxo–copper species derived from FeII/CuI/O2 reactions. Comparison of spectroscopic properties of a series of related complexes leads to a finding that the coordination nature of the peroxo bridging group binding between heme and copper can be dramatically altered by copper ligand environment. Intrinsic copper/O2 interactions seem to be applicable to the chemistry of heme/Cu/O2 systems.
Morphological Development and Etching of Gold Thin Film under UV-exposure in Chlorine-based Liquids
Authors: An Ilsin , Seong Deokkyeong
Published: August 2004

Gold thin film is found to be soluble in chlorine-containing liquid such as 1,2-dichloroethane, NaCl, or HCl solution under illumination, especially UV shorter than 310 nm. We attribute this to the formation of gold chloride and its desorption from the surface. Atomic force microscopy study shows that the grain-like surface morphology evolves during the etch process.
Determination of the Field Strengths of Weak Neutral Ligands Having Oxygen as Coordination Atom
Authors: Hoshino Akito , Nakamura Mikio
Published: August 2004

Weakness of various neutral ligands having oxygen as coordination atom was ranked on the basis of the pyrrole proton chemical shifts of planar [Fe(TPP)L2]+. Furthermore, weakness of the ligands, which is difficult to determine from the NMR data of planar [Fe(TPP)L2]+, was successfully differentiated by the use of highly ruffled [Fe(TiPrP)L2]+. Among the 10 ligands examined, THF turned out to be the weakest ligand.
Self-organized Wire-like Aggregates of Palladium Nanoparticles with Poly(amidoamine)dendrimer
Authors: Naka Kensuke , Itoh Hideaki , Chujo Yoshiki
Published: August 2004

Wire-like aggregates of palladium nanoparticles with a length up to several micrometer were produced by stirring palladium(II) acetate with the G1.0 poly(amidoamine) (PAMAM) dendrimer in methanol at room temperature via self-organized wire-like templates of palladium ions and the PAMAM dendrimer.
Highly Active and Selective Pd–Cu–TiO2 Catalyst for the Direct Synthesis of Benzyl Acetate by Gas Phase Acetoxylation of Toluene
Authors: Benhmid A , Narayana K V , Martin A , Lücke B , Pohl M-M
Published: August 2004

Extremely high benzyl acetate selectivity (ca. 94%) at a toluene conversion of ca. 60% was achieved over Pd–Cu–TiO2 catalyst for the first time by gas phase acetoxylation of toluene with good long-term stability.
Cobalt-catalyzed Cross-coupling Reaction of Chloropyridines with Grignard Reagents
Authors: Ohmiya Hirohisa , Yorimitsu Hideki , Oshima Koichiro
Published: August 2004

Treatment of 2-chloropyridine with benzylmagnesium chloride in the presence of a catalytic amount of cobalt(II) acetylacetonate in dioxane afforded the corresponding cross-coupling product in excellent yield. Trimethylsilylmethyl and phenyl Grignard reagents also participated in similar cross-coupling reactions.
VUV Photocatalytic Degradation of Toluene in the Gas Phase
Authors: Zhang Pengyi , Liu Juan , Zhang Zhongliang
Published: August 2004

The photocatalytic degradation rate of gaseous toluene under irradiation of vacuum ultraviolet (185 nm) was 2–3 times faster than that under irradiation of 254 nm. The 185-nm VUV photolysis was greatly improved by the presence of TiO2 photocatalyst.
High Electron Drift Mobility in an Amorphous Film of 2,4,6,-Tris[4-(1-naphthyl)phenyl]-1,3,5-triazine
Authors: Ishi-i Tsutomu , Yaguma Kentaro , Thiemann Thies , Yashima Masataka , Ueno Kazunori , Mataka Shuntaro
Published: August 2004

2,4,6-Tris[4-(1-naphthyl)phenyl]-1,3,5-triazine exhibited a high electron drift mobility of 8.0 × 10−4 cm2 V−1 s−1.
Boron Trifluoride Etherate Mediated Dehydrogenative Nucleophilic Addition Reaction of Aliphatic Ethers in the Presence of Acetal Affording α,β-Unsaturated Carbonyl Compounds
Authors: Jobashi Takashi , Takano Masaomi , Hino Tetsuo , Maeyama Katsuya , Fugami Keigo , Ozaki Hiroyuki , Ogino Kenji , Yonezawa Noriyuki
Published: August 2004

In the presence of boron trifluoride etherate, some kinds of aliphatic ethers have been found to react with benzaldehyde dimethyl acetal yielding α,β-unsaturated carbonyl compounds with evolution of H2. In this reaction, dehydrogenation of the ether undergoes in cooperation with the acetal and BF3, which enables the ether molecule to behave as enol ether equivalent affording crossed aldol adduct via nucleophilic attack to oxycarbenium ion electrophile formed from the acetal.
Fabrication of Calcium Carbonate with Exquisite Morphologies and Colors through a New Controlled Precipitation Approach
Authors: Shan Wei , Wang Bo , Zhang Ya-Hong , Wu Bi-Yun , Tang Yi
Published: August 2004

A new approach involving the in situ hydrolysis of diethyl carbonate in calcium-containing solution was proposed for the controlled precipitation of CaCO3. CaCO3 crystals with exquisite morphologies and colors have been fabricated through this approach in the presence of organic molecules.
Direct Observation of Polytungstate Cluster and Monolayer Tungstate on Zirconium Oxide by High-resolution TEM
Authors: Satsuma Atsushi , Yokoi Hitoshi , Nishiyama Hiroyuki , Kakimoto Shiro , Sugaya Satoshi , Oshima Takafumi , Hattori Tadashi
Published: August 2004

Direct observation of WO3/ZrO2 by using high-resolution TEM images revealed the formation of polytungstate cluster with a narrow size distribution ranging in 0.4–0.7 nm, and the agglomeration into monolayer tungstate after the aging at 1073 K for 100 h.
Novel Anion Exchange Resin-based Catalyst for Liquid-phase Methanol Synthesis at 373–393 K
Authors: Aika Ken-ichi , Kobayashi Hidenobu , Harada Kenji , Inazu Koji
Published: August 2004

A thermo-stable anion exchange resin–Raney Cu system was found as the most effective solid catalyst for low-temperature liquid-phase methanol synthesis at 373 to 393 K under 5.0 MPa of syngas (2H2/CO). With the catalyst (20 mL of the resin and 2.0 g of Cu) suspended in methanol solution 72% of CO was converted to methanol (70%) and methyl formate (HCOOCH3) (30%) in 4 h.
The Effect of the Si/Al Ratio on the Photoluminescence Properties of Cu(I)SAPO-5 Catalysts
Authors: Chen Haijun , Matsuoka Masaya , Zhang Jinlong , Anpo Masakazu
Published: August 2004

Cu(I)SAPO-5 catalysts prepared by a combination of ion-exchange and an evacuation treatment at high temperatures were found to exhibit a fairly high photocatalytic activity for the decomposition of N2O into N2 and O2 under UV-light irradiation at 298 K. In contrast to other Cu(I) catalysts, such as Cu(I)ZSM-5, the coexistence of H2O in the reaction system of the Cu(I)SAPO-5 scarcely affected the photocatalytic activity. The relationship between the photoluminescence behavior due to the presence of Cu(I) species and the photocatalytic activity of Cu(I)SAPO-5 have been investigated as a function of the Si/Al ratio, showing that the excited state of the Cu(I) species plays a significant role in the photocatalytic reaction as an active site for the reaction.
Cyclin B-Cdk Activity Stimulates Meiotic Rereplication in Budding Yeast
Authors: Strich Randy , Mallory Michael J , Jarnik Michal , Cooper Katrina F
Published: September 2004

Haploidization of gametes during meiosis requires a single round of premeiotic DNA replication (meiS) followed by two successive nuclear divisions. This study demonstrates that ectopic activation of cyclin B/cyclin-dependent kinase in budding yeast recruits up to 30% of meiotic cells to execute one to three additional rounds of meiS. Rereplication occurs prior to the meiotic nuclear divisions, indicating that this process is different from the postmeiotic mitoses observed in other fungi. The cells with overreplicated DNA produced asci containing up to 20 spores that were viable and haploid and demonstrated Mendelian marker segregation. Genetic tests indicated that these cells executed the meiosis I reductional division and possessed a spindle checkpoint. Finally, interfering with normal synaptonemal complex formation or recombination increased the efficiency of rereplication. These studies indicate that the block to rereplication is very different in meiotic and mitotic cells and suggest a negative role for the recombination machinery in allowing rereplication. Moreover, the production of haploids, regardless of the genome content, suggests that the cell counts replication cycles, not chromosomes, in determining the number of nuclear divisions to execute.
MUTANTS OBTAINED BY CHRONIC GAMMA IRRADIATION FROM A CARPATHIAN-UKRAINIAN LOCAL SOYBEAN [Glycine max (L.) Merrill] VARIETY: I. M3 AND M4 GENERATIONS
Authors: Hajós-Novák M. , Kőrösi F.
Published: September 2004

Mutant soybean germplasm was developed from a Carpathian-Ukrainian local variety, using 100–300 Gy chronic gamma irradiation to obtain lines with improved oil and/or protein content. The mutant germplasm was developed by the pedigree method. Selection for high oil and protein content started in the M3 generation. Plants with 24.1 and 23.6% oil content in the seeds were detected in the M4 generation. There were negative, moderate (r = –0.4) and significant (P<0.1 and P<0.01) correlations between the oil content and the 1000-seed weight in both the M3 and M4 generations. The fatty acid composition in the seeds of plants with high oil content was favourable. It is suggested that selection for oil content in the seeds should be started in the M4 generation. Due to the limited genetic variation for protein content no mutant genotypes with higher protein content than that of the control could be identified.
EXPERIMENTAL IMPROVEMENT AND EVALUATION OF VERTICAL INTENSIVE CROWN FORMS
Authors: Brunner T. , Páldi E. , Juhász L. , Tóth F. , Iváncsics J.
Published: September 2004

The physiologically-based pruning methods elaborated by the authors were found to increase intensity in various ways, including early fruiting, improved yield and quality, and a reduction in the height of the cropping area, allowing at least 80% of the fruit to be picked from the ground. Compared with the Lespinasse control, crowns with a valve-like central leader on a sectorial spindle gave a surplus yield of 8.5 t/ha/year over the average of 3 years, including an increase of 2.3 t/ha/year in the yield of extra quality and grade I fruit.
DISCOURSE INTERFERENCE IN TRANSLATION
Authors: Zauberga Ieva
Published: September 2004

This article focuses on three major factors that may enhance the degree of hybridity of target texts: first, the ideological background, i.e., the prestige accorded to the source culture in relation to the target culture; second, translator's competence, i.e., the translator's ability to rationalise translation process and choose an adequate translation strategy; third, the skopos of translation, i.e., hybrid features may be deliberately imposed upon the translation to enable the text to serve a given function. Each of these factors is analysed within a framework of a concrete text. The conclusion of this analysis is that due to the functionalist approach, the concept of translation has become diffused and refers to texts whose relation with the original ranges from a faithful copy to free rewrites. Therefore there may be target texts which bear no obvious imprint of the source text. However, all translations by and large are transfers of one text into another language/culture system and therefore qualify as hybrids.
Towards Perfect Catalytic Asymmetric Synthesis: Dual Activation of the Electrophile and the Nucleophile
Authors: Ma Jun‐An , Cahard Dominique
Published: September 2004

The design and development of new high‐performance catalysts for applications in asymmetric catalytic reactions is of ongoing interest in organic chemistry. The combination of a Lewis acid and a Lewis base working in concert is now considered state of the art in stereoselective syntheses. The synergistic activation by two or more reactive centers allows high reaction rates and excellent transfer of stereochemical information. Despite the self‐quenching reaction between Lewis acids and Lewis bases that might lead to an inactive catalyst, considerable effort has been directed towards the development of the dual‐activation concept. The ultimate goal is to mimic nature by the discovery of catalytic systems analogous to enzymatic processes that involve metal‐ion cocatalysts. With this aim, the dual activation concept greatly broadens the range of artificial catalysts. The most efficient catalytic systems are reviewed, and the mechanisms of action are discussed.
Evolution of Carbonylation Catalysis: No Need for Carbon Monoxide
Authors: Morimoto Tsumoru , Kakiuchi Kiyomi
Published: September 2004

Progress in organometallic catalysis began with the discovery of the Roelen reaction (hydroformylation with carbon monoxide and hydrogen) in 1938 and the Reppe reaction (hydrocarboxylation with carbon monoxide and water) in 1939. Since then, carbonylation chemistry by using carbon monoxide has occupied a central position in organometallic chemistry, as it relates to organic synthesis. There is, however, the problem of using gaseous carbon monoxide (a toxic greenhouse gas) in this chemistry. Recently, some strategies that address this issue have appeared. This minireview describes carbonylation reactions that can be conducted without the direct use of carbon monoxide. These carbonylation reactions provide reliable and accessible tools for synthetic organic chemists.
Assessing the impact of cancer on work outcomes
Authors: Steiner John F. , Cavender Tia A. , Main Deborah S. , Bradley Cathy J.
Published: September 2004

Cancer may have a major impact on the capacity of survivors to work, with important economic, personal, and social implications. In this commentary, the authors identify six methodologic criteria for evaluating the return‐to‐work literature for cancer survivors, and they propose a conceptual model to guide future research.
Prognostic value of p53 and MIB‐1 in transitional cell carcinoma of the urinary bladder with regional lymph node involvement
Authors: Frank Igor , Cheville John C. , Blute Michael L. , Lohse Christine M. , Karnes R. Jeffrey , Weaver Amy L. , Sebo Thomas J. , Nehra Ajay , Zincke Horst
Published: September 2004

BACKGROUND

The effect of p53 protein expression and MIB‐1 proliferative activity on survival and chemotherapeutic response in patients with lymph node (LN)‐positive transitional cell carcinoma (TCC) of the urinary bladder remains unclear. The objective of this study was to assess the ability of these markers to predict disease‐associated outcomes and response to chemotherapy in a cohort of patients with LN‐positive TCC.

METHODS

The authors examined the expression of p53 and MIB‐1 in the LN metastases from 139 patients who underwent cystectomy for TCC at their institution. P53 and MIB‐1 nuclear staining were quantified using an image‐analysis system. Cox proportional hazards regression models were used to test associations of these markers with death from TCC, distant metastases, and local recurrence for all patients and in the subset of patients who were treated with adjuvant chemotherapy.

RESULTS

The median p53 and MIB‐1 indices were 45.2% and 30.3%, respectively. The median follow‐up was 4.5 years (range, 0.1–10 years). There were no statistically significant associations noted between the p53 and MIB‐1 indices and the outcomes studied. When the analysis was limited to patients who were treated with adjuvant chemotherapy (n = 37 patients), the p53 index was found to have no prognostic value; however, there was a significant association between MIB‐1 and distant metastases (P = 0.049). When disease‐specific survival rates were stratified according to p53 index and chemotherapy, patients exhibited a response to chemotherapy regardless of p53 index.

CONCLUSIONS

p53 and MIB‐1 were not found to be associated significantly with disease‐related outcomes in patients with LN‐positive TCC. Adjuvant chemotherapy appeared to be effective regardless of p53 status. MIB‐1 may prove useful in predicting response to chemotherapy. Cancer 2004. © 2004 American Cancer Society.