bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of poor prognostic phenotype non-Hodgkin lymphoma treatment among HIV-positive patients compared with HIV-negative counterparts in the HAART era: Experience from Hurlingham Oncology Clinic, Nairobi
Authors: Othieno-Abinya N. A. , Abwao H. O. , Kiarie G. W. 
Published: March 2020

18535 Background: In human immunedeficiency virus (HIV) related non-Hodgkin’s lymphoma (HIV-NHL) two interrelated life- threatening diseases are considered for treatment decision. Before highly active antiretroviral therapy (HAART), chemotherapy associated toxicity made it difficult for HIV-NHL patients to tolerate treatment. This has remarkably changed in the HAART era. These patients are best treated with standard protocols including: cyclophosphamde, doxorubicin, vincristine and prednisone (CHOP); rituximab-CHOP (R-CHOP): methotrexate, doxorubicin, cyclophosphamide, vincrstine, prednisone and bleomycin (MACOP-B). Methods: We reviewed records of patients with aggressive and highly aggressive phenotype NHLs aged 13 years and above, treated from June 1994 to May 2006. Information included demographic details, pathologic subtype, extent of disease, treatment, outcome. Results: Seventy-five patients - 43 M; 32 F. Age range 13–78 years, median 44.5. Thirty-two (42.7%) were HIV+, 32 (42.7%) HIV- and 11 (14.7%) HIV status undetermined. All HIV+ patients took HAART. Twenty-four (32%) were diffuse large B-cell, 7 (9.3%) transformed follicular, 3 (4%) Burkitt’s 32 (42.7%) only referred to as aggressive/highly aggressive and 9 (12%) others. Thirty-eight (50.7%) were in the high risk International Prognostic Index (IPI) category and 27 (36%) had IPI undetermined. Nine of 21 (42.9%) HIV+ patients had CD4+ cell counts <100/ml. Treatments given upfront were: CHOP-35 patients (46.7%), MACOP-B-14 (18.7%), R-CHOP-11 (14.7%), and dropouts - 8 (10.7%). Seven of 32 (21.9%) HIV-NHL achieved complete remission (CR) vs 24 of 32 (75%) HIV-patients; highly significant (P<0.0001). Five (15.6%) of HIV+ patients had treatment related deaths vs none in HIV- group (P<0.00001). No significant correlation emerged between treatment outcome and IPI score (P= 0.22), or CD4+ cell counts (P = 0.15). HIV+ patients had a median follow-up of 5.5 months, mean of 9; those for HIV- patients were 17 and 30 months respectively; highly significant (P = 0.0036 and 0.0018 respectively). Conclusions: The outcome of treatment was significantly inferior among HIV+ patients. No significant financial relationships to disclose.
Cases of extranodal lymphoma in the head and neck region
Authors: Bilge S. , Mayadagli A. , Ozseker N. , Parlak C. , Oruc F. , Ozturk N. , Gumus M. 
Published: March 2020

18544 Background: Primary extranodal lymphomas of the head and neck region constitute 10–20% of all NHLs. Since they are frequently encountered as localised disease, radiotherapy accounts for the important part in the treatment although other modalities are also available. Cases with the diagnosis of primary extranodal lymphomas of the head and neck region, who administered to our clinic were evaluated retrospectively and presented here. Materials and Methods: Total 13 patients who administered to the Radiation Oncology Clinic of Kartal Education and Research Hospital between years 2000 and 2005, with the diagnosis of primary extranodal lymphoma of the head and neck region were enrolled into the study. All information was gathered from the patients‘ files and evaluated in the electronic environment. Results: Median age was 61 (36–80). Nine patients (69%) were female, and 4 patients (41%) were male. Primary site was found to be tonsil in 8 cases (61%), nasopharynx in 4 cases (30%), and thyroid in one case (7%). Of the 13 cases, 5 (38%) had stage 1, 4 (30%) stage II, 3 (23%) stage III, and 1 (9%) stage IV diseases. Histological type was diffuse large B-cell lymphoma in 8 patients (7 originating from tonsil, 1 from thyroid), T-cell lymphoma in 2 patients (originating from nasopharynx), poorly differentiated histiocytic lymphoma in 1 patient (originating from nasopharynx), and diffuse mixed large B-cell and small B-cell lymphoma in 1 patient. Therapeutic approach was CT+RT in 7 cases, CT+RT+surgery in 3 cases, CT+ surgery in 1 case, RT+ surgery in 1 case, and CT alone in 1 case. Total 44 Gy RT was performed in 22 fractions to involved fields and regional lymph nodes by using cobalt 60 machine. Median 4 cycles of CT that consisted of CHOP were performed to the patients. Of the 13 patients 10 are still under control with no medical problem. One patient with stage 4 disease was lost under treatment after 3 cycles of CT. One case with nasopharyngeal lymphoma was referred due to progression after 2 series of CT, and died 1 month after palliative RT. One case with stage IB tonsil lymphoma received 2 cycles of CT+ RT+ 2 cycles of CT, and died of other medical reason during her 12th month follow up period. Conclusion: Primary extranodal lymphomas of the head and neck region constitute a heterogeneous group of patients, and RT represents an important part of the treatment. No significant financial relationships to disclose.
Monitoring of NK cell activity and serum LDH in metastatic melanoma patients treated with DTIC and interferon-alpha2a, with or without retinoic acid
Authors: Konjevic G. , Jovic V. , Vuletic A. , Radulovic S. , Jelic S. , Spuzic I. 
Published: March 2020

19000 Background: The activity of NK cells, expression of CD69, and serum LDH were evaluated in terms of response to therapy in metastatic melanoma patients. Methods: In phase II clinical study metastatic melanoma (MM) patients were treated with DTIC (800 mg/m2, d1) and IFN-alpha 2a (5×106 IU/m2 s.c., d2–6 (group A, n=25) and 28 patients received the same therapy supplemented with RA, 60 mg/d, d1–10 (group B). Before and after each therapy cycle NK cell activity, CD69+NKcells and LDH were monitored in patients and 39 healthy controls. Results: There is no significant difference in OR (group A 32%, B 21%), in time to progression between groups. NK cell activity was significantly decreased pretherapy in both groups, with a significant increase in the 1st cycle in both groups. NK cell activity did not show significant correlation with OS in group A compared to group B (p=0.445). 20% of patients in group A with pretherapy NK cell cytotoxicity above 30% had better survival from month 3 to 12 of follow-up and a longer maximal survival (1.2 vs. 1.0 year, respectively). In comparison to pre-therapy values, all responding MM patients had a significantly higher increase of CD69 expression on CD56+ NK cells, while the increase was only significantly higher in responders in group B. Analyses of serum LDH level show a significantly higher time and therapy cycle-dependent decrease in group A compared to group B (50% vs. 25%, respectively). However, it is shown that responders in group B had a significantly greater decrease in serum LDH level compared to responders in group B (70% vs. 20%, respectively), if the level after a cycle was evaluated in terms of pretherapy values, as well as a greater decrease if the evaluation in each cycle was done compared to each pretherapy value (35% vs. 20%, respectively). Conclusions: Even though there is no significance in clinical response between patients in group A and B, in agreement with a steady-state pattern of NK cell activity, the fact that only responders in group B had a significant increase in CD69 expression on CD56+ NK cells, as well as the finding that the decrease in serum LDH was significantly greater in patients in group B, implicates favorable imunopotentiating and antitumor effect of RA in the therapy of metastatic melanoma. No significant financial relationships to disclose.
Impact of surgical treatment on survival in patients with primary rectal melanoma
Authors: Yap J. C. , Yang G. 
Published: March 2020

19001 Background: Reports of melanoma of the lower GI tract, especially in the rectal area, were often grouped with diseases from the anal canal region. Outcome and pattern of care regarding primary melanoma of the rectum only were not well described in the literature. This review examined the utilization of surgery, radiotherapy (RT), and the potential impact on survival outcome in this subgroup of patients. Methods: The Surveillance, Epidemiology, and End Results (SEER) database (1973 to 2003) was searched. Only patients with primary melanoma of the rectum (excluding anal lesions) with recordable pathology reports were included. 79 patients were identified. 61 of them had melanoma of the rectum as the sole primary disease, and these patients were the focus of this study. Kaplan Meier estimation and Cox-Mantel test were used to calculate and compare survival rates. Results: Among the 61 patients, 20 patients did not have further surgery after biopsy. Another 20 patients had surgery, but the types of procedure were unknown. Of the remaining 21 patients eligible for analysis, eight patients had abdominoperineal resection (APR), and one of them received postoperative RT. Thirteen patients had partial proctectomy (PP), and none had RT. In univariate analysis, the 5-year overall survival rates for APR and PP groups were 12.5% and 7.7% respectively (p=0.63). There were one survivor in each group at the last follow up period with crude survival time of 15 years and 13.5 years respectively. More patients in APR group had locoregional disease (extramural and nodal) than in PP group (63% versus 0% respectively) at diagnosis. Comparing the time intervals by decade between 1973 to 1982, 1983 to 1992, and 1993 to 2003 in all 61 patients, use of postoperative RT was relatively limited at 1 in 14 cases, 1 in 19 cases, 2 in 28 cases respectively. RT was used mostly in patients who were not candidate for surgery and in patients with metastatic disease at diagnosis presumably for palliation. Conclusions: Primary melanoma of the rectum is a rare disease. Data for analysis were limited. There was no significant difference in overall survival between patients who had APR versus PP although APR group had higher tumor burden at diagnosis than PP group. Use of adjuvant RT is rare, and its role has yet to be further defined. No significant financial relationships to disclose.
Peg-filgrastim (Peg-F) on day 4 of (R-)CHOP-14 chemotherapy compared to day 2 in elderly patients with diffuse large B-cell lymphoma (DLBCL): Results of a randomized trial of the German high-grade non-Hodgkin’s lymphoma study group (DSHNHL)
Authors: Hartmann F. , Zeynalova S. , Nickenig C. , Reiser M. , Lengfelder E. , Duerk H. , de Witt M. , Schubert J. , Loeffler M. , Pfreundschuh M. G. 
Published: March 2020

19511 Background: Application of peg-f is recommended on day 2 of chemotherapy, but later application has not been studied. Objective: To compare the effects of peg-f given on day 4 instead of day 2 on the endpoints feasibility, leukocyte counts, rate of infections and therapy-associated deaths after CHOP-14 with and without rituximab (R). Methods: Intention-to-treat-analysis of 109 elderly patients (median 69 years) with DLBCL receiving CHOP-14 or R-CHOP-14 randomized to peg-f on day 2 or day 4 (D4). Results: Of 103 evaluable pats., 51 received peg-f on day 2 (D2) and 52 on day 4 (D4). D2 and D4 populations were well balanced for known risk factors, and there was no difference between pats. receiving CHOP-14 and R-CHOP-14 with respect to the above mentioned endpoints. Both D2 and D4 allowed for an excellent adherence to (R)-CHOP-14 protocol, with a median relative dose of myelosuppressive drugs of 98% (D2) and 99% (D4), respectively. Leukocytopenia <2,000/mm3lasted for 3 (day 8 to 10) after D2 and 1 day (day 9) after D4. Grade 4 leukocytopenia (<1,000/mm3) occurred in 47% of all cycles after D2 and in 20.5% after D4 (p<0.001). Grade 3 and 4 infections occurred in 9.4% of D2 and 6.0% of D4 cycles (p=0.118). There were 4 therapy-associated deaths (all infection-associated) in the D2 and 1 (none infection-associated) in the D4 group (p=0.205 for all and p=0.057 for infection-associated deaths). Conclusions: Peg-f allows for excellent adherence of elderly patients to (R)-CHOP-14. Peg-f should be given on day 4 instead of day 2, because D4 results in less leukocytopenia, less infections and less therapy-associated deaths. No significant financial relationships to disclose.
Functioning profile changes in cancer patients participating in comprehensive cancer rehabilitation
Authors: Dennehy C. A. 
Published: March 2020

19518 Background: Recommendations for inclusion of cancer rehabilitation as part of cancer care are notable. Treatment impact on patients’ functional status suggests integrating supportive and therapeutic care would be appropriate for most patients. Methods: Data were from two outpatient cancer rehabilitation centers (N=515) on referred patients receiving or completing treatment. Patients performed an initial assessment for cardiopulmonary (CP), physical therapy (PT), quality of life (QOL), and nutritional status evaluations. Qualifying patients completed 8 weeks of supportive and rehabilitative therapies specifically prescribed for side effect and presenting symptoms. Data were collected pre and post intervention. Measurements included descriptives with crosstabulations for all variables, acuity (A), stress (S), pain (P), energy (E), resting, target and highest heart rates (RHR) (TRH) (HHR), blood pressure (BP), treadmill speed and grade (S) (G) and QOL (total (T), health/function (HF), social/economic (SE), psychological/spiritual (PS) and family (F). Descriptive statistics are determined using means and frequencies. Pre and post intervention differences were determined using paired T-tests. Subsequent factor analyses were performed using principle component analysis with varimax rotation. Results: Descriptive statistics yielded characteristics on 53 different cancer types. Factor analysis produced 7 factors: heart rate (HR p=0.279), blood pressure (p=0.060), pulmonary (p=0.721), O2 saturation (p=0.387), intensity (p=0.598), SPE (p=0.000), AS (p=0.002). Differences were not expected for pulmonary function and O2 saturation. QOL differences were (T: p=0.000), (HF: p=0.000), (SE: p=0.022), (PS: p=0.001), (F: p=0.099). Conclusions: While many studies have noted a significant decline in functioning during and following treatments, patients participating in therapeutic cancer rehabilitation maintained or improved functional status and quality of life. Comprehensive cancer rehabilitation can be utilized for a number of cancer types and should be strongly considered as part of the continuum of care. No significant financial relationships to disclose.
Does self-reported functional limitation attributed to symptoms persist 1 year after initial treatment for early breast cancer?
Authors: Sehl M. , Satariano W. A. , Ragland D. R. , Reuben D. B. , Sawhney R. , Naeim A. 
Published: March 2020

19519 Background and Significance: Comorbidity, disability and compromised functional status increase with age. It is unclear to what extent the symptoms related to the diagnosis and treatment of cancer play a role in activity limitation in older adults. We examined the prevalence of self-reported functional limitation in a breast cancer population, whether this limitation is attributed to various symptoms, and how this attribution changes over time from early in treatment to 9-months later. Methods: 1,011 patients with breast cancer were surveyed 3 months after diagnosis (baseline) and 933 of those patients were surveyed at 12 months after diagnosis (9 month follow up). In each survey, participants were asked whether or not they had each of 21 symptoms and whether or not each symptom caused significant activity limitation. Results: Of the 933 patients (mean age 62.7 years) who completed baseline and follow up evaluations, 420 were aged 65 years and older. At baseline, 47% of patients 65 years and older reported functional limitation compared with 44% of patients younger than 65 years (p=0.29). Activity limitation at baseline was attributed to nausea in 4% of older patients, (O) and 8% of younger patients (Y) (p=0.016), to pains in the chest area in 11% (O) and 9% (Y) (p=0.21), to joint or muscle aches in 20% (O) and 16% (Y) (p=0.13), to tiring easily in 31% (O and Y), and to depression in 9% (O) and 13% (Y) (p=0.19). At follow up 47% of patients 65 years and older reported functional limitation compared with 40% of patients younger than 65 years (p=0.02). Activity limitation at follow up was attributed to nausea in 3% (O) and 7% (Y) (p=0.003), to pains in the chest area in 11% (O) and 9% (Y) (p=0.21), to joint or muscle aches in 23% (O) and 17% (Y) (p=0.01), to tiring easily in 26% (O) and 24% (Y) (p=0.60), and to depression in 8% (O and Y). Conclusion: Self-reported functional limitation is prevalent 3 months and 1 year after breast cancer diagnosis. Self reported activity limitation in older and younger patients is not significantly different at baseline, and is significantly higher in older patients at follow up, with older patients having significantly less nausea and significantly more joint and muscle aches. No significant financial relationships to disclose.
A pilot international survey of oncologists’ opinions and self-reported practice patterns on complementary and alternative medicine
Authors: Lee R. T. , Hlubocky F. J. , Hu J. J. , Stafford R. , Daugherty C. K. 
Published: March 2020

19526 Background: Prior research has indicated that the prevalence of complementary and alternative medicine (CAM) use among cancer patients often exceeds 80%. Information about the prevalence of CAM use is important because many biologically-based therapies or alternative medical systems can potentially interfere with chemotherapy efficacy and increase the risk for treatment related toxicity and other complications. Methods: In 2004–2005, oncologists from the United States, mainland China, and Taiwan were surveyed regarding their perceptions and self-reported practice patterns regarding CAM. Results: A total 95 oncologists returned surveys providing a 38.2% response rate. Four out of five respondents (78%) felt unprepared to integrate CAM modalities into their practice. However, 71% reported they would allow CAM use during active cancer treatment, even in the setting of curable disease. Surveyed Chinese/Taiwanese oncologists were more likely than their US colleagues to inquire about their patients use of CAM (ask >10% of patients) - 80.6% vs. 52.4% (p<0.05). The same was true for individuals who felt their previous training had prepared them for CAM use, as compared to those who felt unprepared (80.9% vs. 57.0% (p<0.01). Chinese/Taiwanese respondents felt no more prepared for CAM use than US respondents (25.8.1% vs. 20.6%, p=0.57), were less likely to report integrating CAM with curable disease (48.3% vs. 69.8%, p<0.05), and were more likely to report concern about patients’ motivations for CAM use (83.9% vs. 46.8%, p<0.01). Conclusions: Despite a stated lack of preparedness, the majority of surveyed oncologists would allow cancer patients with curable disease to integrate CAM therapies. Although routinely exposed to CAM modalities, such as traditional Chinese medicine, responding Chinese/Taiwanese oncologists felt just as unprepared as their US colleagues. In addition, increased concern about patients’ motivations was associated with decreased integration of CAM. Continued education is needed to improve oncologists’ knowledge about patients’ use of CAM. No significant financial relationships to disclose.
Time to symptomatic progression: An emerging clinical trial endpoint in oncology
Authors: Aronson N. , Melilli L. , Cella D. , Gondek K. 
Published: March 2020

19529 Background: One of the critical challenges in oncology today is assessment of clinical trial results to inform clinical decision making. Because trials typically focus on overall survival, it is often difficult to determine individual patient benefits early on treatment. Surrogate endpoints such as time to disease progression and progression-free survival may not correlate with survival. Based on a growing body of evidence, cancer symptom assessment has been shown to provide immediate treatment responses and to predict long-term outcomes_including tumor response, disease progression and survival. Methods: Results from a comprehensive literature review of oncology clinical trials and observational studies with symptom endpoints to date are provided. Analyses methods are described including potential biases. To illustrate the potential clinical value of time to symptomatic progression (TTSP) in longitudinal clinical trials, a retrospective analysis of data from a three-arm (cisplatin/etoposide versus two dosage regimens of cisplatin/paclitaxel arms) randomized cooperative-group clinical trial in non-small-cell lung cancer (NSCLC) was conducted. Results: In a three-arm randomized cooperative group clinical trial of NSCLC, TTSP was significantly associated with best clinical response (p<0.01) and survival (p<0.05). Conclusion: The utility of cancer symptom response for comparing cancer treatments has been well documented. This endpoint has been shown to act as an early signal of disease progression and death. Opportunities for refinement include methods for more accurate assessment, reduction in the number of symptoms evaluated, and refined statistical methods for reducing bias due to missing data. Given the success demonstrated in clinical trials, clinicians may consider ongoing cancer symptom evaluation in clinical practice. No significant financial relationships to disclose.
Validation of a new questionnaire to assess the patient perception of cancer-related fatigue (CRF): The Perform Questionnaire (PQ)
Authors: Rodríguez C. , Gascón P. , García-Mata J. , Colomer R. , Cassinello J. , Carulla J. , Valentín V. , Baró E. , Gasquet J. A. , Sánchez J. 
Published: March 2020

19533 Background: CRF is a frequently reported complaint in cancer patients and survivors. There are scales available to measure the intensity, frequency and duration of CRF but there are few scales to assess patient perceptions and beliefs about CRF. The recently developed PQ attempts to fill this need. This study aims to validate the new measure. Methods: An observational and longitudinal multi- centre study was carried out on a sample of cancer patients with CRF. Data were collected at inclusion and 3 months later. The PQ was administered, as well as the FACT-F and Nottingham Health Profile (NHP) health measures, at both visits. Sociodemographic data, key clinical indicators, fatigue intensity (by means of a visual analogue scale) and self-rated stability for patient health status were also collected. Viability, reliability (internal consistency and test-retest) and validity were assessed for the PQ. Results: 431 patients were included in the study: 60.2% women, mean age 58.9 years, mean time since diagnosis 2.21 years 31.0% with breast cancer, 54.9% with metastatic disease, Karnofsky mean score 80.9, 28.8% with anaemia. Answering the PQ was considered moderately easy to very easy for 80.7% of patients. Answering the questionnaire took less than 10 minutes for 76.3% of the sample. Overall and dimension internal consistency were high (Cronbach alpha = 0.93 range 0.80–0.89). Test-retest reliability for overall score (intra-class correlation coefficient (ICC) = 0.81) and dimension scores (range 0.59–0.77) were also good in patients without changes in health status. The PQ had a stronger correlation with FACT (r=0.82) than with NHP (r=0.71), a moderate correlation with fatigue intensity (r=0.43), and low correlation with Karnofsky (r=0.26). Patients requiring third party care had a worse overall score for the PQ than patients who did not (30 vs. 37; p<0.0001), while patients with anaemia showed a worse health- related quality of life than patients without anaemia (31.7 vs. 36.4; p<0.0001). Conclusions: The PQ has demonstrated good reliability and validity for assessing patient perception of CRF in the study sample. Additional research is needed to obtain further insight into how the PQ performs with specific cancer populations. No significant financial relationships to disclose.