bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating if darbepoetin alfa efficacy and safety in patients with chemotherapy-induced anemia is affected by the disease stage of the patient
Authors: Schwartzberg L. S. , Glaspy J. , Tomita D. , Lillie T. 
Published: April 2020

18568 Background: Cancer patients (pts) often develop chemotherapy-induced anemia (CIA), resulting in increased transfusion incidence and fatigue. Darbepoetin alfa (DA) is an erythropoiesis-stimulating agent that can reduce the incidence of transfusions, increase hemoglobin (Hb) levels to a range of 11 to 13 g/dL (as recommended by evidence-based guidelines), and decrease fatigue in pts with CIA. The 74-hour half-life of DA allows it to be effectively administered weekly (QW), every 2 weeks (Q2W), or every 3 weeks (Q3W). DA treatment can also be synchronized with chemotherapy (Glaspy et al., 2005). Here we examined if the efficacy and safety of DA for treating CIA is affected by the disease stage of the pt. Methods: Eight clinical trials (including single-arm, active-controlled, and placebo-controlled studies) were analyzed that described the administration of DA QW (2 studies), Q2W (3 studies), or Q3W (3 studies) to pts with CIA. Tumor-Nodes-Metastases (TNM) classification was used to define disease stage of I, II, III, or IV. A clinically meaningful endpoint evaluated was the proportion of pts achieving a target Hb of ≥ 11 g/dL. Other endpoints included incidence of transfusions, change in FACT-F score at end of study from baseline, and incidence of adverse events. Results: A high percentage of pts in all disease stages achieved a target Hb of ≥ 11 g/dL in response to DA treatment (see Table ). Early stage pts were seen to benefit at least as much as later stage pts. A similar trend was seen for the other efficacy and safety endpoints (data will be presented). Conclusions: The present analysis suggests that DA administered QW, Q2W, or Q3W can effectively correct anemia when administered to pts in either early or late disease stages. The potential to synchronize DA treatment and chemotherapy regardless of disease stage may increase pt convenience by reducing the number of clinic visits. [Table: see text] [Table: see text]
Colorectal cancer patients’ informational needs about sexuality related issues
Authors: Karagiannis S. , Heras P. , Hatzopoulos A. , Georgopoulou A. , Kritikos K. 
Published: April 2020

18569 The aim of this study was to identify and describe the importance of information for patients about sexuality related issues during hospitalization. 112 patients (87 with colorectal cancer) completed the structural questionnaire. Most colorectal cancer patients (71%) reported that their disease or its treatment had affected their sexuality. Men reported slightly more adverse effects of disease or treatment on their sexuality than did women. Effects on sexuality were reported by 77% of men and 64% of women (p=0,041) having colorectal cancer. Among younger colorectal cancer patients reported more often effects of disease than did older colorectal cancer respondents. Over than half, 75% (n=84) of respondents under 40 and 67% (n= 75) of respondents over 50 years old complained effect on sexuality. Most colorectal cancer patients (72%) stated that it is necessary to discuss about the effect of the disease and of its treatment on sexuality during hospitalization. Most colorectal cancer patients (87%) wanted the health care personnel to take the initiative for the discussion of sexuality related issues. Only 12% expressed the wish that the initiative should come from the patient. It is important that health care professionals provide colorectal cancer patients with an opportunity to discuss sexuality related issues. The caring organization should develop, introduce and evaluate action models to facilitate especially opening discussion for these sensitive issues. No significant financial relationships to disclose.
Erectile dysfunction (ED) in successfully treated lymphoma patients
Authors: Aksoy S. , Dinçer M. , Kilickap S. , Harputluoglu H. , Dizdar Ö. , Akdogan B. , Özen H. , Erman M. , Celik I. 
Published: April 2020

18570 Background: Information on male potency in lymphoma survivors is insufficient. In this study, we assessed male sexual function in successfully treated lymphoma patients (pts). Methods: Fifty-nine pts treated for Hodgkin’s (HL) or non-Hodgkin’s lymphoma (NHL) with chemotherapy ± radiotherapy were recruited. Pts older than 55 years and those with a history of pelvic/inguinal radiotherapy or surgery were excluded. Study pts had to be disease-free and off-treatment for at least 6 months at the time of evaluation. Pts completed a survey questionnaire that consisted of demographic characteristics, risk factors for ED and the International Index of Erectile Function (IIEF) to assess their current level of sexual function. Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone levels were also determined. Results: The mean age of the 59 pts was 40.2 ± 11.0 (range, 18–55 years). Thirty-eight (64.4%) had HL and 21 (35.6%) NHL. The mean interval between the end of active treatment and study evaluation was 7.7 years (range: 10 mths to 20 yrs). According to the IIEF score, 61.0% had some degree of ED (IIEF score <26): 33.9% had mild ED (IIEF score 17–25), 15.2% moderate ED (IIEF score 11–16) and 11.9% severe ED (IIEF score 6–10). Mean total scores of sexual desire, sexual satisfaction, orgasm and overall satisfaction domains of IIEF were significantly lower in pts with ED than those with normal ED (26.0 ± 1.8 and 39.0 ± 0.8, respectively; p < 0.001). Nine (18.4%) of 49 pts had an elevated FSH, 7 (14.2%) had elevated LH, and 3 (6.1%) had decreased testosterone levels. These hormonal disturbances did not affect the presence of ED and its severity. Six (10.2%) pts had hypertension and 3 (5.1%) had diabetes mellitus. Forty (57.6%) pts were ever-smokers, 29 (49.2%) were overweight or obese (BMI >25), but none had coronary artery disease. These risk factors did not statistically affect the presence of ED or its severity in our pts. Conclusions: These findings suggest that diagnosis and treatment of lymphoma may be a risk factor per se for the development of ED. Therefore, the underlying pathology, either organic or psychological, remains to be defined. Clinicians should be aware of this problem in lymphoma survivors and offer these pts adequate treatment options. No significant financial relationships to disclose.
Pain on movement and pain at rest decrease after zoledronic acid infusion in patients with bone metastases due to breast or prostate cancer
Authors: Ripamonti C. , Fagnoni E. , Campa T. , Giardina V. , Brunelli C. , De Conno F. 
Published: April 2020

18582 Background: There is no study on bisphosphonates assessing separately pain at rest and incident pain. Aim of the study was to evaluate the reduction in pain at rest and incident pain after treatment (up to 6 infusions) with 4 mg zoledronic acid (ZA) I.V. every 28 days in patients with bone metastases. Methods: All consecutive patients with bone metastases from breast or prostate cancer starting ZA treatment (August 2002 - May 2004) at NCI of Milan were enrolled in this observational prospective longitudinal study. Pain at rest and incident pain referred to the prior week were measured by a six level verbal scale (0–5 score) at baseline and on each infusion as well as at follow-up visit (2 weeks after every infusion). The two main endpoints (estimated reduction in pain at rest and incident pain) were defined as the difference between the baseline score and the average of all the post-treatment scores for each patient, and are presented with their respective 95% Confidence Interval. Positive values indicate reduction. Because of the potential confounding effect of analgesics intake, patients without any increase in analgesic consumption while on study were also analyzed as a separate subgroup. Results: 48 patients (mean age 66 years, 33 female), with breast (34) or prostate cancer (14) were enrolled. 30 patients underwent 4 to 6 infusions while 7 dropped out before the first follow-up visit. The analysis was performed on the 41 patients with at least one follow-up evaluation (average number of evaluations = 8.1 range = 1–13). The estimated reduction in pain at rest and incident pain was 0.55 (0.19–0.91) and 0.73 (0.31–1.14) respectively. In the 13 patients who did not report increased analgesic consumption, the estimated reduction was still substantial: 0.61 (0.25–0.97) 1.12 (0.41–1.83) respectively. Conclusions: This is the first study showing that in patients with painful multiple bone metastases, ZA reduces both pain at rest and incident pain in patients with painful bone metastases. [Table: see text]
Synthetic TGF-ß antagonist promotes healing of injured epithelial surfaces
Authors: Johnson F. E. , Wang Y. , Ling T. , Chuang S. , Huang S. S. , Huang J. S. 
Published: April 2020

18586 Background: Cancer treatment often results in injury to epithelial surfaces. These injuries are often symptomatic and can delay or prevent further treatment. Since transforming growth factor-1 (TGF-ß) mediates inflammation, fibrosis, and epithelial mitogenesis, agents modulating TGF-ß may be useful in treating such wounds. We synthesized a dodecapeptide containing the active site of human TGF-ß. It is a TGF-ß antagonist in vitro. We investigated whether application to cutaneous wounds might promote epithelialization and decrease scarring by directly blocking local TGF-ß activity. Methods: We applied synthetic TGF-ß antagonist (1.5 mM in gel carrier, topically), with gel-only and no-treatment controls, to 6 standardized thermal burn wounds in each of 4 pigs. Wounds were measured and photographed for 41 d., then excised. Wound dimensions and percent epithelialization were calculated from photographs. Scar volume was estimated as surface area (photographs) x depth (microscopy). Statistical analysis employed student’s t-test. Additional experiments utilized skin excision wounds in rabbits and pigs. Recombinant TGF-ß and platelet-derived growth factor (PDGF) were applied to identical wounds in other pigs and rabbits in parallel experiments as additional controls. Results: In TGF-ß antagonist-treated pig burn wounds, epithelialization was complete on d. 26 ± 2 (mean ± SD); control wounds were 70 ± 10% re-epithelialized by d. 26 (p < 0.001). Contraction rate, collagen and fibronectin content, and scar volume were all significantly less in treated wounds. TGF- ß and PDGF each retarded wound epithelialization. Conclusions: Treatment of standard skin wounds with a synthetic TGF-ß antagonist promotes epithelialization in a whole-animal model. This agent may be useful in human epithelial injuries due to chemotherapy or radiation. No significant financial relationships to disclose.
Topiramate (Top) in the treatment of neuropathic pain (Np) in cancer patients (pts)
Authors: Bendaly E. A. , Jordan C. A. , Staehler S. A. , Rushing D. A. 
Published: April 2020

18589 Background: Top relieves Np by four direct and one indirect method, compared to most other anti-epileptics that relieve Np by one. Methods: Seventeen cancer pts treated with Top for Np were found on retrospective chart review of Palliative Care Clinics at Indiana University Hospital and Roudebush VA. Pain was assessed by physician serial follow-up. Results: Mean age was 53.8 years; 53.8 % were males. Four pts were not included in statistical analysis for efficacy, one for incomplete follow’up, and 3 had their pain decrease in frequency by 25 to 75 % but not in severity. Of the remaining 13 pts, 69% had previous gabapentin use, 85% had previous tricyclic use, and all were on opioids. Most common Np sites were extremity (53.8%), trunk (30.8%), and face (15.4%). Most common Np characteristics included burning (61.5%), pins and needles (30.8%), and sharp (15.4%). Np was related directly to active tumor in 38.5%, previous surgery in 43.8%, and chemotherapy in 11.7%. Mean duration of Top therapy was 6 months; mean total daily dose was 173 mg. 61.5% were current users. Pts had Np for 27.3 months on average prior to starting Top. All 13 pts were using Top as second-line therapy; 69.2% had tried another anticonvulsant, and 92.3% used antidepressants. 53.8% experienced Top-related adverse effects (AEs). These included change of taste (15.4%), dose-dependent, transient, memory loss (23.1%), depression (15.4%), nausea (7.7%), chest pain (7.7%), and fatigue (7.7%). 29.4% discontinued Top due to AEs. Using two-tailed paired testing, mean decrease in worst pain was from 8.7 to 5.6 (p < .001), in average pain from 6.4 to 2.4 (p = .0004), and in least pain from 4.4 to 1.5 (p < .03). Conclusions: Top was associated with improvements in Np in a high proportion of pts with refractory Np. Pts tolerated Top therapy well as indicated by the average duration of therapy. Further studies of Top in cancer-related Np are indicated, particularly as first-line therapy. No significant financial relationships to disclose.
Information to cancer patients: A questionnaire survey in three different geographical areas in Italy
Authors: Piga A. , Zanon E. , Bracci R. , Barbieri V. , Puglisi F. , Aprile G. , Gesuita R. , Carle F. , Venuta S. , Cellerino R. 
Published: April 2020

18593 Background: The way information to cancer patients is delivered widely varies among different countries. In Italy, as in other Mediterranean countries, the traditional approach has been of partial disclosure of the truth. Methods: We asked 200 cancer patients in 3 different Centres form Northern, Central and Southern Italy (Udine, Ancona, Catanzaro) to answer a 26-item questionnaire on communication aspects, in order to verify if information received was correct and adequate, and dependent on geographical variations. Statistics included univariate and multiple correspondence analysis, which studies relations between all variables, and provides a graphical representation in which associated variables tend to aggregate spatially. Results: Questionnaires were completed by 587 patients, of median age 60 yrs, 57% females, mainly with gastrointestinal (32%) or breast cancer (30%); 63% had active disease at time of interview. 77% of patients interviewed had a correct knowledge of their diagnosis, with no difference between different Centres. More informed were patients of female gender (p = 0.004), young age, better education, and with breast cancer (all p < 0.001). Patients appropriately informed on prognosis were 41%. More informed were those with good prognosis, breast cancer, and not receiving treatment; less informed patients from Southern Italy and those with advanced disease. Degree of information was not directly related to desire for information, which was more pronounced for patients from Central and Southern Italy. Satisfaction for information received was higher for patients from Northern Italy, not on treatment, with limited disease. Multiple correspondence analysis identified clusters of patients such as those of old age, lower education, male sex, advanced disease, preferred paternalistic approach, characterized by poor level of information; and young age, female sex, high scholarity, breast cancer, patient-centered relationship with their doctor, characterized by high level of information. Conclusions: The cultural attitude towards communication aspects in oncology is changing in Italy. There are still significant differences at different latitudes, but there is a general trend to improving awareness about cancer. No significant financial relationships to disclose.
Necessity for including quality of life diagnostics and therapy in routine oncological care: Evaluation by methods of clinical guideline implementation
Authors: Klinkhammer-Schalke M. , Koller M. , Ehret C. , Steinger B. , Ernst B. , Hofstädter F. , Lorenz W. 
Published: April 2020

18594 Background: Application of quality of life assessment has become an important topic in oncology. Current approaches, however, have focused on technical issues within single center settings overlooking the requirements of routine care. We report on implementing of structural elements of a quality of life diagnostics and therapy system (QoL system). It was designed as integral part of the health care program for breast cancer patients in a regional tumor center. Methods: The QoL system was implemented by a systematic approach (Med. Care, 39, Suppl.2, 2(2001). Its elements comprised (a) coordinating practitioners (CPs) who functioned as gate keepers for QoL related therapies, (b) experts in the QoL unit who provided QoL reports and specific therapeutic recommendations based on patients’ responses to the EORTC questionnaire, (c) professional health care providers in psychotherapy, pain therapy, social support, physiotherapy/lymph drainage, and fitness (nutrition, sports), (d) clinicians (gynecologists) for patient recruitment and (e) opinion leaders for educational influence on the CPs to keep the QoL system in daily practice. Success of implementation (as indicated by CPs’ QoL-related changes in knowledge, attitude and behavior) was evaluated in a prospective study with breast cancer patients. Results: The QoL system was applicable in all of 170 patients recruited between Dec. 2002-June 2004 (age 34–86yrs, UICC 0–4, breast conserving surgery 67%). From 75 CPs (mostly gynecologists) in the area only 39 fulfilled criteria for the QoL system, 1 refused to participate. 38 CPs showed knowledge about QoL following educational outreach visits. Concerning attitudes and behavior, 64% of CPs found the experts’ reports comprehensible, 56% followed their recommendations, 20% made additional actions. Follow-up 4 months after first QoL measurement revealed improvements in pain, body image and social life (p < .05). Conclusion: The study—in combining doctor’s approach and patient’s demands—showed success using methods of guideline implementation by improving QoL deficits within a routine oncological care. Effectiveness will be analyzed in an ongoing randomized trial. No significant financial relationships to disclose.
The changing face of cancer in the elderly—Only a demographic change?
Authors: Rottenberg Y. , Peretz T. 
Published: April 2020

18597 Background: In industrial countries, the cancer burden of the elderly is high and is increased. One reason is longer life expectancy. Increasing age standardized rates of cancer in this age group compared to younger groups may also explain this phenomenon. Methods: Two age groups were examined, above and below 65 years. Each age group was further divided into men and women. The age standardized rates for all cancers combined among the Jewish population in Israel were identified through the Israel Cancer Registry during the years 1973–2002. In addition, lung and colorectal cancers according to sexes, prostate cancer in men and breast cancer in women were examined. Results: Between the first 5 years of the study (1973–1977) and the last 5 years (1998–2002) the age standardized rates for all cancers combined were raised by about one third in the two age groups. In males, the overall change was higher in the older group (42% in men aged 65 years and older compared to 31% in men younger than 65). However, the rise in the younger group was more prominent in females (42% in women younger than 65 years compared to 33 % in women aged 65 and older). The most outstanding increase was in prostate cancer in men, but mainly in the younger group (176% in the older group and 368% in the younger group) followed by breast cancer in women, more prominent in the older group (64% in the older group and 50% in the younger group). In both sexes, more noticeable increases were noted in the older groups in colorectal cancer and in lung cancer. Between the years 1993–1997 and 1998–2002 shifts towards stabilization and even a decrease was noted in some of the cancers that were examined. In men aged 65 years and older rates for all cancers combined were decreased by 2.5%, among the specific tumors and a decrease was noted in lung cancer (6.7%) and prostate cancer (5.8%). The rates for all cancers combined among the older women were slightly decreasing (2.0%). No decrease was noted in the specific tumors in this group. Among the younger groups in both sexes, no decrease (defined >0.5%) was noted. Conclusions: These data argue against the hypothesis that the overall change in the cancer burden in the aged could be also explained by differences changes in the risk of developing cancer between these two age groups. No significant financial relationships to disclose.
Evaluation for cardiac toxicity with MRI in young adult survivors of acute lymphoblastic leukemia (ALL)
Authors: Wright J. A. , Reimold S. C. , Winick N. J. , Turoff A. , Brooks S. , Eshelman D. , Oeffinger K. C. 
Published: April 2020

18604 Background: Long-term survivors of childhood cancer treated with a moderate to high cumulative dose (≥300mg/m2) an anthracycline are known to be at risk for cardiac toxicity. It remains unclear what cardiac risk exists for survivors who received a low cumulative dose (<300mg/m2) of an anthracycline. Methods: We are conducting an NIH sponsored trial in 120 young adult survivors of ALL to determine the prevalence of cardiovascular risk factors and to determine the effectiveness of an exercise intervention. As part of their cardiovascular risk assessment, participants undergo cardiac MRI, a tool with excellent reproducibility in assessing left ventricular (LV) size and function. The aim of this component of the study is to determine the prevalence of cardiac toxicity in survivors treated with low dose anthracycline in comparison to those who did not receive any anthracycline. Descriptive statistics, chi-square analysis, and spearman correlation coefficients were used to examine the relationship between anthracycline dose and measures of cardiac function. Results: This study represents a work in progress. Preliminary results from the first 22 participants who have had a cardiac MRI do not show a significant difference in ejection fraction, LV mass, cardiac output, or mass to volume ratio between those treated with low cumulative dose anthracycline versus no anthracycline. Available cardiac MRI data for all participants will be presented at the meeting. Conclusions: With the continued use of an anthracycline at cumulative low doses, particularly in upcoming ALL standard risk trials, it is particularly important to determine if there is a risk of cardiac toxicity after low doses with aging. No significant financial relationships to disclose.