bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pegylated liposomal doxorubicin in ovarian cancer patients with renal compromise
Authors: Basu C. K. , Mukhopadhyay A. , Pandey R. , Dey S. 
Published: August 2020

e16569 Background: Ovarian cancer patients with renal compromise poses problem in choosing chemotherapy for them. Pegylated liposomal doxorubicin (PLD) can be used in such cases. However there is not much data regarding the efficacy and toxicity of PLD. We used PLD in a few renal compromised ovarian and peritoneal cancer patients. Methods: The clinical records of patients with recurrent ovarian and peritoneal cancer patients with high creatinine or low creatinine clearance level who were given PLD at the Netaji Subhas Chandra Bose Cancer Research institute) (NCRI) from July 2005 to July 2008 was reviewed retrospectively to study efficacy and toxicity. Results: Twenty-one patients were identified, which included 16 with epithelial ovarian cancer, 5 with peritoneal cancer. Renal compromise was diagnosed and graded according to creatinine clearance test (CCT) as severe when less than 28 mL/min/1.5 m2, moderate when CCT is 28–55 mL/min/1.5 m2, and mild when CCT is 55–84 mL/min/1.5 m2. Normal value was taken as 85 mL/min/1.5 m2. Patients had distribution as mild: 4 patients, moderate:7 patients, and severe:10 patients. The initial doses of PLD were classified into regular initial dose (40 mg/m2/4 weeks) and lower initial dose (20–30 mg/m2/4 weeks). The median cycle was 5 (range 1–12). We used lower dose for moderate and severe renal disease. The incidence of palmar-plantar erythrodysesthesia 5/21 (23.8%), stomatitis 6/21(28.5%), and hematologic toxicity 3/21(14.2 %). Dose reduction due to toxicities occurred in 19.04 % (4/21) patients. Amongst 21 cases no patient had deterioration of renal function while and after the treatment with PLD. However we had primary treatment with PLD in four cases (2 moderate and 2 severe) while others had platinum based initial treatment. We did not have any complete responder though we had 6 (28.5%) partial responders, 8 (38.1%) stable diseases and 7(33.3%) progressive diseases. Conclusions: Patients with renal compromise who received PLD therapy at an initial dose lower than 40 mg/m2/4 weeks tolerated their treatment well. They required subsequent dose reduction due to mucocutaneous and cardiological toxicities in 19% cases. Treatment response in this population with ovarian and peritoneal cancer was similar to that of patients with normal renal function. No significant financial relationships to disclose.
Retrospective analysis: Patients with ovarian cancer at National Cancer Institute of Mexico
Authors: Morales-Vasquez F. , Gallardo D. , Tirado L. , López-Basave H. N. , Cantú D. , Mendez C. 
Published: August 2020

e16573 Background: Ephitelial ovarian cancer (EOC) is the leading cause of death from gynecologic malignancies among women worldwide. Little is known about reproductive factors or lifestyle determinants and ovarian cancer prognosis. The purpose of this study was to analyze the pathologic, clinical and other characteristics. Methods: This study included all EOC seen at the Institute from 2000–2006. Epidemiological and clinical variables were collected from the patients’ medical records. Exposure data on prediagnostic factors were collected through questionnaires. The cases were followed-up until December 31, 2007. Cox proportional hazard regression model was used to estimate the prognostic effect of each factor in terms of hazard ratios (HR) and 95% confidence intervals (CI), following adjustment for age at diagnosis, FIGO tumor stage and WHO grade of tumor differentiation. Results: 571 cases of ovarian cancers. Median age was 51 years, (range 18–95). 20.30%, 4.4%, and 63.5% of patients had stage I, II and III, respectively. The histological types: 52.2% serous, 17.2% endometrioid, 12.8% of mucinous origin; 62.5% underwent radical surgery, 24% with optimal cytorreduction. The mean follow-up was 60 ± 22 months. The overall three-year survival was 97.4% and 98% for mucinous and serous tumors, respectively. The survival rate was 100%, 90%, and 71.8% in stages I, II and III, respectively. After adjustment for the tumor characteristics, no clear associations were detected between reproductive history, anthropometric characteristics, factors before diagnosis (alcohol consumption, smoking and physical activity over lifetime), nor family history of breast cancer or ovarian cancer and survival Conclusions: Our findings indicate that the tumor characteristics significantly influenced the risk of death from ovarian cancer and no clear associations were detected between others factors and the survival. In this cohort the median age for ovarian cancer were 51 years old, one decade before than other reports. No significant financial relationships to disclose.
Human papilloma virus (HPV): Burden of the disease in cervical cancer in the Extended Middle East and North Africa (EMENA). A comprehensive review
Authors: Seoud M. A. , Seoud K. M. , Lindely S. , Anis S. 
Published: August 2020

e16577 Background: Cervical cancer is less common in the EMENA than in the rest of the world. The purpose of this paper is to review the prevalence of HPV in the general population (GP), in cervical intraepithelial neoplasia (CIN) and in cervical cancer (CCA) in the EMENA. Methods: We performed an extensive literature search (English and French literature). Data extracted included information on the method of HPV detection and HPV type-specific data, age, and the histology of the CCA when available. Results: In North Africa (Algeria, Morocco, and Egypt): The prevalence of HPV varied from 5%-12% in the low-risk GP and to 20%-49% in the high-risk GP such as prostitutes. In CIN it varied from 25%-90% (HPV 16 in 40%-100%). In CCA HPV was present in 61%-98% of cases (HPV 16 in 50%-73%). In the Middle East (Jordan, Lebanon, and Israel): The prevalence of HPV was 1.8%-13% in the low-risk GP, in CIN it was 32%-88% (HPV 16 in 10%-30%), and in CCA it varied from 45%-78% (HPV 16 in 31–67%). In the gulf countries (UAE): HPV was found in 4%-11% of the low-risk GP and 20%-30% in the high GP. HPV was present in 37% in LSIL and 67% in HSIL. In CCA, High-risk HPV was present in 87% of specimen in one study. In Turkey, Iran, and Pakistan: HPV was present in 1.5%-13% in the low-risk GP, and up to 42.9% in patients with abnormal smears. In CIN HPV was found in 50% to 100% (HPV 16 in up to 76%). In CCA, HPV was detected in 60%-100% (HPV 16 in 27%-95%). In the GP the age range was 30–50 years, while in CIN it was 30–60 years, and in CCA it was 30–70 years. The studies were varied with small number of patients and varied detection methods that are difficult to compare. Most were PCR, few were Hybrid Capture (I or II). Conclusions: Although the studies on the prevalence of HPV in the EMENA region are not abundant, but there is enough data to suggest that the prevalence of HPV is around 5%-12% in the GP, 30%-80% in CIN and 60%-90% in cervical cancer with HPV 16 as the most predominant type. [Table: see text]
Common head and neck cancer treatment pathways and associated costs in the U.S. commercial managed care population
Authors: Camacho F. , Mullins C. D. , Joish V. , Choi J. 
Published: August 2020

e17001 Background: For the treatment of head and neck cancer (HNC), different modalities (chemotherapy, radiation, surgery, or chemoradiotherapy) can be used either independently or in combination with others. Information regarding real-world treatment pattern is limited. The purpose of this study was to identify common treatment pathways and associated costs. Methods: The study was performed using data from a large U.S. commercial managed care claims database. Adult subjects (≥18) diagnosed with HNC between January 1, 2006, to December 31, 2006, (index-period) were identified based on a pre-selected ICD-9-CM codes. All subjects were HNC diagnosis-naïve 12 months prior to their index dates (first date of HNC diagnosis) and followed for 12 months post index date. Treatment modalities were identified based on the Healthcare Common Procedure Coding System used in the U.S. Pathways were constructed by reflecting time of and between modality administration claims. Results: 6,570 subjects were identified. The average age was 61 years (±14.9) and 44% (n = 2869) were female. Midwest (31%) and east (31%) region had a higher (p < 0.01) representation, compared to south (20%) and west (18%). Only 2,257 subjects (34%) received some type of treatment modality and were categorized into 20 mutually exclusive treatment pathways. Of these, 82% (n = 1,843) received single modality, 18% (n = 398) received a combination of 2, and 0.7% (n = 16) received a combination of 3 modalities. Among single modality pathways, radiation (34%; n = 619) was most common, however, cheomoradiotherapy (26%; n = 485) had the highest average patient cost ($98,440). Within double modalities, radiation followed by chemotherapy (24%; n = 95) was most common, however, chemoradiotherapy followed by surgery (4%; n = 16) had the highest average cost ($146,374). Within triple modalities, surgery followed by radiation then chemotherapy (50%; n = 8) was most common and costly ($95,868). Conclusions: The most common treatment pathways one year post HNC diagnosis used a single modality; however, the average patient costs within multiple modalities were higher. Further study is required to investigate if these patterns are comparable to current guideline recommendation. [Table: see text]
EZH2 expression and correlation with Ki-67 and p53 in head and neck squamous cell carcinoma
Authors: Choi J. , Ahn M. , Park Y. , Oh Y. , Park K. , Jeong H. , Son Y. , Baek C. , Ahn Y. 
Published: August 2020

e17018 Background: Polycomb group proteins are transcriptional repressors that silence specific sets of genes through chromatin modification. The enhancer of zeste homolog 2 (EZH2), considered a member of the polycomb group proteins, is overexpressed in aggressive forms of several malignancies. However, the role of EZH2 expression in head and neck cancer has not yet been fully determined. This study was conducted to investigate the clinical value of EZH2 expression in head and neck cancer and its correlation with Ki-67 and p53 expression. Methods: Expression of EZH2, Ki-67, and p53 was determined by immunohistochemical staining of tissue microarrays from specimens of 138 cases of head and neck squamous cell carcinoma. Results: High EZH2 expression was observed in 51.5%. 44.2% were positive for p53. The percentage of Ki-67 staining was significantly greater in the EZH2 positive group (12.37 ± 8.51) than in the EZH2 negative group (4.73 ± 6.06, p < 0.001). EZH2 expression was significantly correlated with p53 expression (p = 0.003) and smoking history (p = 0.021). However, we found no significant differences in other clinicopathological parameters (age, sex, primary tumor size, and lymph node metastasis) and survival between the EZH2 positive and negative groups. Conclusions: These results suggest that high EZH2 expression may be associated with tumor cell proliferation and cell cycle regulation in head and neck cancer. No significant financial relationships to disclose.
Daily concurrent chemoradiotherapy with docetaxel (DOC) and cisplatin (CDDP) using superselective intra-arterial infusion via superficial temporal artery for T3 and T4 head and neck cancer: Possibility of organ preservation in advanced head and neck cancer
Authors: Mitsudo K. , Shigetomi T. , Nishiguchi H. , Fukui T. , Yamamoto N. , Furue H. , Ueda M. , Ohhara Y. , Iwai T. , Tohnai I. 
Published: August 2020

e17020 Background: Superselective intra-arterial chemotherapy via a superficial temporal artery (HFT method) has become feasible for daily concurrent radiotherapy and chemotherapy for head and neck cancer. We used this novel method for head and neck cancer, and evaluated its efficacy. Treatment consisted of superselective intra-arterial infusions (docetaxel total 60 mg/m2, cisplatin total 100 mg/m2) and concurrent radiotherapy (total 40 Gy) for 4 weeks as preoperative therapy. Thirty-five patients with stage III and IV oral cancer underwent surgery after this treatment, of whom pathological complete response (CR) was obtained in 31 (88.6%). In this study, the possibility of organ preservation in cases of advanced head and neck cancer was evaluated based on this result. Methods: Eligibility included T3 or T4 squamous cell carcinoma of head and neck. Treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m2, cisplatin, total 150 mg/m2) and concurrent radiotherapy (total 60 Gy) for 6 weeks. Organ preservation was demonstrated in cases when the biopsy specimen of the primary lesion showed grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) after the completion of all treatments. Results: Thirty two patients (21 male and 11 female) were eligible for evaluation. A relapse was detected in 11 cases (34.4%): primary sites, 7 cases (21.9%); cervical lymph node and distant metastasis, 2 cases (6.3%); primary site and distant metastasis, 1 case (3.1%); cervical lymph node, 1 case (3.1%). Seven patients (21.9%) died. The Kaplan-Meier method was used to estimate the 3-year and 5-year survival rates, which were 81.3% and 78.1%, respectively, and the 3-year and 5-year locoregional control rates, which were 68.8% and 64.5%, respectively. No major complications such as cerebral infarctions or other neurological complications developed in any patient. Conclusions: These results of the present study demonstrate that this is a promising new treatment strategy for advanced head and neck cancer, thus contributing to patients’ QOL. No significant financial relationships to disclose.
Impact of human papillomavirus (HPV) E6/E7 gene silencing on the expression of biomarkers that distinguish HPV+ versus HPV16- head and neck squamous cell carcinomas (HNSCC)
Authors: Gouveris P. , Rampias T. , Sasaki C. , Psyrri A. 
Published: August 2020

e17024 Background: Three studies (Pyeon et al, Slebos et al, and Schlecht et al) have identified biomarkers that distinguish HPV+ versus HPV- HNSCC using cDNA microarrays. We sought to determine whether the identified biomarker differences are a direct consequence of HPV16 E6 andE7 oncogene expression. Methods: We selected genes that were found to have altered expression in HPV16+ HNSCC compared to HPV16-. Short hairpin RNAs targeting HPV type 16 E6 and E7 genes were delivered by retrovirus infection to HPV16+ oropharyngeal cancer cell lines 147T and 090. cDNA microarray analysis was performed (slides represented approximately 35000 genes) to determine the transcriptional profile before and after E6/E7 silencing. Results: E6/E7 gene silencing affected the expression of the following genes: RFC4, CDKN2A, MCM6, NASP, EP300, E2F2, PCNA, KLK6, ANGPT1, DNAJCI, PRKCG (Table). Conclusions: Expression of several biomarkers that distinguish HPV16+ from HPV16- HNSCC is regulated by E6/E7 gene expression. Targeting E6/E7 will be an effective therapeutic strategy in HPV16+ HNSCC since alteration of key molecules that increase the malignant potential of these tumors is controlled by E6/E7 expression. [Table: see text] No significant financial relationships to disclose.
Prognostic impact of radiology response and tumor volume among patients with locally advanced squamous cell carcinoma of the head and neck (LASCHNC) treated with concomitant chemoradiation
Authors: Herchenhorn D. , Souza A. L. , Souza A. M. , Boasquevisque E. T. , Boasquevisque E. M. , Dias F. L. , Small I. , Knust R. 
Published: August 2020

e17035 Background: There are no validated prognostic factors to predict response of chemo/RT in LASCHNC. Tumor volume as well as post-treatment CT radiology response have been studied in small retrospective series. An analysis of tumor volume and CT radiology response-score to endoscopic and pathologic responses as well as disease free survival was performed. Methods: In a single institution phase I-II study LASCHNC of oropharynx, hypopharynx and larynx were treated with concurrent radiation, cisplatin and erlotinib. 34 patients (pts) underwent a base line and post treatment CT (after 6 weeks), endoscopic evaluation and biopsy. Tumor volume was measured by multiplying the longest diameter by 0,523. (Cancer Res Clin Oncol. 2005), CT post-treatment changes score used as proposed by Pamejier et al., using a 3-point CT-score: 1 = expected post-treatment changes; 2 = focal mass with a maximal diameter of < 1 cm and/or asymmetric obliteration of laryngeal tissue planes; 3 = focal mass with a diameter of > 1 cm, or < 50% estimated tumor volume reduction. Results: Median tumor volume (mTV) was 21cm3 (0.3 to 178), median disease free survival (mDFS) in pts with tumor volume greater than mTV was 20.4 months and not reached in patients with tumor volume lower than mTV, log-rank 5.9, p = 0.015. The median tumor volume reduction by CT was 84% (-62 a 100%), 8pts were classified as score 1 (23.5%), 1pt score 2 (2.9%), 25pts score 3 (73%). There was a tendency for shorter DFS for those with a score 3, log-rank 3.05, p = 0.08. With a median follow-up of 24 months, 88% of score 1.2 are alive, versus 56% of score 3. Conclusions: There is a great variability in TV in LASCHNC, small tumor volumes were related to longer DFS and there is no correlation between tumor reduction and post-treatment CT score. No significant financial relationships to disclose.
Evaluation of speech outcomes in oral and oropharyngeal cancers
Authors: Dwivedi R. C. 
Published: August 2020

e17039 Background: The aim of the study was to review the literature on oral and oropharyngeal cancers for speech outcomes over the last 8 years. Study design: Systematic review of published studies between 2000 and 2008. Methods: A comprehensive literature search for speech outcomes was performed on PUBMED/MEDLINE, EMBASE, CINAHL, and Science citation index from 2000 to 2008 using the key words- speech, voice, articulation, acoustic analysis etc in oral and oropharyngeal cancers. The reference lists from the selected relevant articles were also inspected and any other pertinent publications were added to the final review. Articles published in all languages on human subjects, and all types of studies were included. Sixty eight articles satisfied the inclusion criterion and their findings were tabulated, analysed and evaluate based on the modality used for evaluation - questionnaire evaluation (QE), perceptual evaluation (PE) and acoustic analysis (AE). Results: 39/68 studies used questionnaires; 30/68 used PE and 2/68 used acoustic analysis. Questionnaires with PE were used in 5 studies. Thirty three/ 68 were retrospective, 28/68 prospective and 7/68 were cross-sectional studies. The finds suggest that the Frequency and quality of abnormal phonation depends on postoperative deficits. Oral (vs. oropharyngeal) cancers, advanced (vs. early), associated comorbidities (vs. without comorbidities), flap reconstruction (vs. primary closure), irradiated (vs. non-irradiated) and Mandibulotomy (vs. without mandibulotomy) have poor speech outcome. Preservation of Tip of tongue and FOM, lateral type excision, smaller excision, greater tongue mobility, primary closure and younger patients have better speech outcome. Conclusions: No validated scoring system for PE has been used; QE needs to be done with speech/ dysarthria specific questionnaires. Most studies suffered because of their retrospective nature, single modality evaluation, small sample size and short duration of follow-up. There is a clear paucity of acoustic analysis studies in oral and oropharyngeal literature and further longitudinal studies are needed. No significant financial relationships to disclose.
Towards adaptive radiation therapy: Image-based tumor shrinkage modeling in head and neck cancer
Authors: Chao M. , Xie Y. , Le Q. , Xing L. 
Published: August 2020

e17050 Background: Understanding the kinetics of tumor growth/shrinkage represents a critical step in quantitative assessment of therapeutics and realization of adaptive radiation therapy. We established a novel framework for image-based modeling of tumor change and demonstrate its performance with a number of synthetic images and clinical cases. Methods: Due to the nonconservation of tissue, similarity-based deformable models are not suitable for describing the tumor growth/shrinkage process. Under the hypothesis that the tissue features in the tumor volume or the boundary region are partially preserved, we model the tumor kinetics by a two-step procedure: (1) auto-detection of homologous tissue features shared by the planning CT and subsequent on-treatment CBCT images using the Scale Invariance Feature Transformation (SIFT) method; (2) establishment of voxel-to-voxel correspondence between two input images for the remaining spatial points by a basis spline interpolation. The correctness of the tissue feature correspondence is doubly assured by a bi-directional association procedure, in which the SIFT features are mapped from planning CT to CBCT and reversely. Only the associations common to both mappings are used in Thin Plate Spline (TPS) interpolation. A synthetic digital phantom experiment and five clinical head and neck cases are used to assess the performance of the proposed technique. Results: Image contents of the digital phantoms are modified in various ways. It is found the proposed technique can identify any of the changes faithfully. The subsequent feature-guided TPS interpolation reproduces the “ground truth” with an accuracy better than 1.3mm. For the clinical cases, the new algorithm works reliably for a volume change less than 30%, suggesting the time span between two consequent imaging sessions should not be unreasonably far away in order for the model to function properly. Conclusions: An image-based tumor kinetic model has been developed to better understand the tumor response to radiation therapy. The technique provides a solid foundation for future head-and-neck adaptive radiation therapy. No significant financial relationships to disclose.
The impact of time of medical oncologist visit on survival among elderly patients with stage IV prostate cancer: An analysis using SEER-Medicare data
Authors: Mullins C. D. , Onukwugha E. , Seal B. , Hussain A. , Hussain A. 
Published: August 2020

e17509 Background: The association between physician referrals and treatment receipt has been established in other disease settings. The impact of time to a medical oncologist or hematologist/oncologist (MOH) visit on survival has not been examined in patients (pts) with advanced prostate cancer (A-PC). The objective of this study is to determine whether the time to a MOH visit is associated with survival. Methods: The SEER-Medicare database was used for the analysis. Pts aged >65 diagnosed with A-PC between 1994 and 2002 and who visited a urologist post-diagnosis were included. Pts who saw a MOH before the urologist visit were excluded. For pts who saw a MOH, time to a MOH visit was identified using the diagnosis date and the urologist visit as starting points. Survival models were used to examine the effect of the time (in months) to MOH visit on survival, controlling for demographic, clinical, continuity-of-care, and ecological measures. Results: There were 6,498 pts in the sample (mean age 76 years, 82% White race). PC-specific mortality was 38%. Two-thirds (67%) of patients did not visit a MOH after visiting a urologist. Among those with a visit to a MOH, an additional month from diagnosis till the MOH visit was positively associated with PC mortality (HR: 1.03; p < 0.001) - i.e. a shorter time to a MOH visit was associated with PC survival. Similar results were obtained using the month of the urologist visit as the starting point (HR: 1.02; p < 0.001). Conclusions: Among A-PC patients who are referred to an oncologist, each additional month between diagnosis/urologist visit and the oncologist visit is associated with an increased relative risk of mortality. [Table: see text]