bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glassy cell carcinoma of the uterine cervix
Authors: Restivo A. , Disilvestro P. , Moore R. , Weitzen S. , Kaufman S. , Puthawala Y. , Granai C. , Gordinier M. 
Published: March 2020

15050 Background: Glassy Cell Carcinoma of the uterine cervix is a rare, aggressive form of cervical cancer accounting for only 1–5% of all cervical carcinomas. To date, there is no consensus on treatment modalities, but most advocate for a more aggressive treatment strategy including both radical surgery and radiation therapy. The objective of this study was to analyze the clinical features, treatment, and outcome of patients with Glassy cell carcinoma diagnosed at our institution. We hypothesized that such aggressive therapies yield survival benefits which approximate those of the more common squamous cell carcinomas of the cervix. Methods: In collaboration with the Department of Radiation Oncology at Rhode Island Hospital, a retrospective comprehensive chart review of all patients diagnosed with Glassy cell carcinoma of the cervix between the years 1993 and 2005 was undertaken at Women and Infant’s Hospital, Providence, RI. All cases were assessed for clinicopathologic features, treatment strategies, and outcome, including progression free survival and overall survival rates. Results: Twenty-eight patients with biopsy proven Glassy Cell Carcinoma of the cervix were identified. Eleven (39%) were less than age 40, and five (18%) were less than age 30. Of these, 19 were either stage IB or IIA, and 15/19 (79%) received multimodality therapy, a combination of radiation, chemotherapy, and surgery, as initial treatment. When survival was broken down by mode of treatment, 25% of patients who received single modality treatment (either surgery or radiation) were DF at two and five years. In contrast, those patients who were treated with bimodal therapy had a DFS of 93% at 2 years and 84% at 5 years. Thus the survival of patients with glassy cell histology treated at our institution with multimodality therapy approximates the survival of similar stage patients with squamous and adenocarcinoma, with a mean follow-up of greater than 5 years. This represents a distinct improvement when compared to national survival statistics. Conclusions: The favorable survival results of this aggressively treated population, supports the belief that multimodality therapy is preferable in patients with glassy cell carcinoma of the cervix even in early stage disease. However, optimal treatment regimens have yet to be determined and is a field for further study. No significant financial relationships to disclose.
The clinical benefit of cisplatin-doxorubicin combination in heavily pretreated ovarian cancer patients
Authors: Steiner M. , Lavie O. , Leviov M. , Shklar Z. , Rabkin A. , Keren S. , Rubinov R. , Loven D. 
Published: March 2020

15052 Background: Cispatin-doxorubicin (Adriamycin) combination (50 mg/m2 each every 3 weeks) was used to treat ovarian cancer patients after failure of various chemotherapy lines. Methods: Eighteen patients were treated. Their mean age was 59 years (median 57.8, 41.3–70.3). They all had post operative first line carboplatin combination therapy (77% taxol containing) and all achieved NED status at end of therapy. They relapsed within 1–74 months from end of carboplatin therapy (median 9.5, mean 14.1). 3/13 patients (23%) were platinum resistant relapsing within less than six months. Second line therapy included carboplatin retreatment in 8/18 patients (44.5%) - (combined with taxol in 5 and as single agent in 3 patients). All patients received Topotecan therapy, 8 as second line, 6 as third line and 4 as forth line of therapy. Cis platin - Adriamycin combination was used as 3rd to 6th line of therapy (median 4th). All patients were in good general condition with normal renal function and had clinical evidence of recurrent disease confirmed by clinical examination and/or CT scan and CA125 level. 6/18 patients (33.3%) had severe symptoms of disease, 6/18 (33.3%) mild to moderate symptoms and 6/18 (33.3%) were asymptomatic. Results: 3–11 cycles of therapy were administered (median 7) using 60–100% of planned dose (median 100). Treatment was generally well tolerated with Grade III toxicity in 4/18 patients (22.2%) - (myelotoxicity in 2 and asthenia in 2 patients). 4/18 patients (22.2%) reported quality of life improvement, 4/18 (22.2%) reported quality of life deterioration and 10/18 (65.6%) stable quality of life during therapy. 13/18 patients (72.2%) benefited from therapy. 5/18 (27.7%) achieved complete response, 3/18 (16.8%) partial response and 5/18 (27.7%) minimal response or disease stabilization. All three platinum resistant patients responded: two achieved complete response and one minimal response. Mean time to progression in all responding patients was 9.4 months (median 8.6, 2.6–16.5). Conclusions: We concluded that Cis-Platin - Adriamycin combination is still effective in heavily pretreated ovarian cancer patients and clinical benefit can be achieved with reasonable toxicity. The combination can be considered an additional treatment option. No significant financial relationships to disclose.
Biologic behavior for patterns of recurrence and survival in ovarian versus uterine papillary serous carcinoma
Authors: de Souza B. 
Published: March 2020

15056 Background: Papillary serous carcinoma of the ovary (OPSC) and uterus (UPSC) are relatively uncommon malignancies with similar histological features. Information for their comparative behavior is lacking, hence a review was done to compare patterns of recurrence, disease-free and overall survival between the 2 groups. Methods: A retrospective review of 352 consecutive patients (pts) at a single institution with ovarian and uterine malignancies from 1991 through 2004 was done. Of these, 48 patients were identified with OPSC (n = 32) and UPSC (n = 16). To control surgeon as a prognostic factor, only pts undergoing surgery by a single surgeon were included. Stages at diagnosis, patterns of recurrence and survival for FIGO stages I-III with a minimum follow-up of 8 months were obtained from tumor registry, hospital and office records. The median follow-up for UPSC was 25 months and for OPSC was 46 months. Stage IV pts were excluded. Results: The mean age for OPSC and UPSC was 64 and 63 years respectively. Of the 32 OPSC pts, 94% had optimal debulking. In the UPSC group 88% had proper staging with lymph node dissection. The pts with OPSC had a mean overall survival of 60 months and a mean disease-free survival of 38 months for all stages combined. The pts with UPSC had a mean overall survival of 51 months and a mean disease-free survival of 40 months for all stages combined. Ten (31%) pts with OPSC had no recurrence. The remaining 22 (69%) pts had a total of 36 recurrences, the most common (17%) being pelvic masses (mean interval of 24 months). In the UPSC group, 9 (56%) had no recurrences. The remaining 7 (44%) had a total of 10 recurrences, the most common (30%) being peritoneal implants (mean interval of 17 months). Conclusions: UPSC is detected at an earlier stage twice as often as OPSC and yet it has lower overall survival. The disease-free interval is comparable, which shows that even after recurrence, the survival for OPSC is longer. Although OPSC and UPSC share similar histological features UPSC behaves more aggressively. [Table: see text] No significant financial relationships to disclose.
MGMT methylation in newly-diagnosed glioblastoma multiforme (GBM): From the S0001 phase III study of radiation therapy (RT) and O6-benzylguanine, (O6BG) plus BCNU versus RT and BCNU alone for newly diagnosed GBM
Authors: Blumenthal D. T. , Wade M. , Rankin C. J. , Fitzpatrick F. , Stelzer K. , Sloan A. , Ackerley W. , Rushing E. J. 
Published: March 2020

1512 Background: Glioblastoma multiforme (GBM) is a high grade primary brain neoplasm associated with a median survival of less than a year. Historically, one-third of patients seem to benefit from treatment with alkylating chemotherapy. This minority may correspond to a population with decreased levels of active O6-methylguanine- methyltransferase enzyme (MGMT). MGMT repairs tumor DNA damaged by chemotherapy, allowing continued replication after exposure to treatment. Patients with low tumor MGMT activity may be more likely to respond to alkylating treatment. Hypermethylation of the MGMT promoter region leads to decreased transcription of the enzyme and is associated with improved outcome in GBM patients treated with radiation and alkylating chemotherapy. Methods: We studied a patient cohort with newly diagnosed GBM registered on Southwest Oncology Group protocol S0001, a phase III randomized, two arm clinical trial investigating an inhibitor of MGMT (O6-benzylguanine, O6BG). Both groups received standard radiation and BCNU (carmustine). The experimental group additionally received O6BG. We determined polymerase chain reaction (PCR) methylation status of the promoter region of MGMT in 88 patients with adequate tissue samples. In 41 cases, we were able to obtain successful PCR results. Results: 28 of 41 samples (68%) were found to be unmethylated and 13 of 41 (32%, 95% c. i. 18% to 50%) were methylated. Patients with methylated MGMT had a median survival of 12.6 months (95% c.i. of 7.8–15.8 months). Patients with unmethylated MGMT had a median survival of 10.6 months (95% c.i. of 8.7–12.0 months). Median progression-free survivals were 4.5 and 3.1 months respectively, for the methylated and unmethylated groups. Conclusions: This result is consistent with prior studies which showed that approximately two-thirds of patients express MGMT, and accordingly, are resistant to alkylating agents. The subgroup of patients without promoter methylation may be more likely to benefit from treatment with O6BG. Analysis of MGMT promoter methylation status per study treatment group, and correlation with median survival and progression-free survival will be presented. No significant financial relationships to disclose.
Impact of Karnovsky performance status (KPS) on outcome of elderly patients (pts) with glioblastoma (GBM) and activity of temozolomide (TMZ) as first line therapy: Retrospective analysis of a cohort
Authors: Chinot O. , Barrie M. , Calissi B. , Fuentes S. , Metellus P. , Honore S. , Boucard C. , Loundou A. , Figarella-Branger D. , Dufour H. 
Published: March 2020

1515 Background: Due to increasing incidence of GBM in the elderly, prognostic factors and therapeutic strategies need to be considered in this population. Recently radiotherapy has shown survival improvement in patients with KPS ≥ 70 (ANOCEF, EANO 2005), while chemotherapy with TMZ may be considered as a therapeutic option (Chinot at al, Cancer 2003). Methods: We analyzed retrospectively all pts above 70 years old with GBM, who were referred to our institution from May 1998 to October 2004; all responses to TMZ were reviewed. Results: We identified 136 pts registered. Median age was 74 (range 70–87), and 43% had a KPS < 70. Surgery consisted of stereotactic biopsy (SB), 29% ; partial surgery (PS), 12%; and gross total removal (GTR), 29% of pts. Diagnosis was strongly suggested by neuroradiology in 30% of cases. Treatment consisted of TMZ (5 days standard schedule) (group A) as first-line treatment in 89 pts (65%), radiotherapy and/or nitroso-urea based regimens in 40 pts (30%) (group B) and best supportive care in 7 (5%) pts. For the all cohort, median of overall survival (OS) was 7 months (m), strongly impacted by KPS (3.9 vs 8.7 m, p<0.0001 for KPS < 70 and ≥70 respectively) and age (8.2 vs 6.0 m, p<0.007 for age < 75 years vs. ≥ 75). OS was 6.6, 7.3, and 8.4 mos in the case of SB, PS, and GTR respectively and was 5.2 for neuroradiologic diagnosis. In group A, median time to tumour progression (TTP) and OS were 4.7 & 7.3 m. KPS impacted TTP (2.9 vs. 5.1 m, p=0.0002) and OS (4.9 vs. 8.7 m, p<0.0001) for KPS < and ≥ 70 respectively. Response rates (RR) were for 71 pts evaluable 28%; SD 35%; PD 37% associated with an OS of 11.7, 7 and 3.2 m respectively. RR was 34% for histologically proven GBM, vs 22% in cases of neuroradiologic diagnosis. In group B, TTP and OS were 4.3 & 6.7 m respectively. Conclusions: KPS appeared to have a major impact on outcomes in elderly patients with GBM. Future trials designs should take this impact into consideration. TMZ appeared to be effective in elderly patients with newly diagnosed GBM. This alternative approach is currently being tested against RT alone in international trials. Impact of MGMT status in the TMZ population will be presented. No significant financial relationships to disclose.
11C-Methionine PET to predict survival of glioma patients treated by radiotherapy
Authors: Zhang H. , Tian M. , Zhao C. , Ye X. , Zhan H. 
Published: March 2020

1523 Background: The early prediction of glioma prognosis is very important. Amino acid metabolism of glioma is associated with numerous catabolic processes favoring tumor growth. As an essential amino acid, L-methionine plays a central role in the altered metabolism of cancer cells. The aim of this study was to evaluate the prognostic value of PET imaging using 11C-methionine (MET) in patients with gliomas treated by radiotherapy. Methods: MET PET was prospectively performed in 36 patients with gliomas before and within one month after radiotherapy. Tumor MET uptake was measured with the semiquantitative tumor-to-nontumor ratio (T/N ratio). The MET uptake in the tumor and relevant clinical parameters were entered into univariate and multivariate survival analysis. Results: All tumors were identified in the baseline MET PET study. Patients with a baseline T/N ratio of < 4.0 had a significant better survival than patients with a baseline T/N ratio > 4.0 (2-year survival rate: 50.8% versus 0%, P=0.026). Patients with a post radiotherapy ratio of <4.0 had a better survival than that with a post radiotherapy ratio > 4.0 (2-year survival rate: 50.4% versus 0%, P=0.0012). The univariate analysis showed that both baseline and postradiotherapy T/N ratio were statistically significant predictors of patient survival, and postradiotherapy T/N ratio was a significant independent survival predictor in multivariate analysis. Tumors with larger T/N ratio had a significantly poorer prognosis. Conclusions: Baseline MET uptake was a potential survival indicator and postradiotherapy MET uptake was a significant independent predicator in glioma patients treated by radiotherapy. MET PET is a valuable tool in the predication of survival in patients with gliomas treated by radiotherapy. No significant financial relationships to disclose.
Prognostic model for primary CNS lymphoma (PCNSL): Recursive partitioning analysis (RPA) of the MSKCC PCNSL population
Authors: Abrey L. E. , Benporat L. , Panageas K. S. , Yahalom J. , Deangelis L. M. 
Published: March 2020

1531 Background: Increasingly there is a need to develop a simple prognostic score that can be used in the analysis and design of PCNSL studies as well as for clinical management. Recently the IELSG published a 3 group prognostic model incorporating patient age, performance status, serum LDH, location of brain lesions and CSF total protein; however, only 105 of their 378 patients had all of the variables available to develop this score. Methods: We analyzed 338 patients (median age 60; median KPS 70) seen and treated for PCNSL at MSKCC between 1983 and 2003. The median survival was 37 months and median follow up of surviving patients is 35 months. Univariate analysis of potential prognostic factors was performed using the Kaplan Meier product limit method. Significant univariate variables were included in a multivariate analysis using the Cox proportional hazards regression model. Patients were separately analyzed using the IELSG prognostic score. Finally, RPA was employed as an independent method of developing specific prognostic categories. Results: In the univariate analysis, age, hemiparesis, mental status changes, creatinine clearance and KPS were significant predictors of overall survival; in the multivariate model only age and KPS remained as significant predictors. 113 patients had adequate information (all 5 variables) to be analyzed using the IELSG prognostic score; while this correlated significantly with overall survival, the comparison between groups 2 and 3 was not statistically significant (p = 0.10). RPA of all 338 patients identified 3 subgroups: age ≤ 50 (median OS 9.2 y), age > 50 and KPS ≥ 70 (median OS 3.2 y) and age > 50 and KPS < 70 (median OS 1 y) that significantly separated our entire PCNSL population (p < 0.001). Conclusions: The use of RPA allows for easy discrimination of 3 prognostic groups of patients with PCNSL. In contrast to the IELSG score the MSK RPA classification includes information that is readily available on all patients and can be easily incorporated into the analysis or design of clinical research. No significant financial relationships to disclose.
Although substantial (qol) quality of life problems may occur due to acute and delayed complications of therapy for advanced head & neck squamous cancer, overall long term qol is good/acceptable
Authors: Taneja C. , Somasundar P. , Stager S. , Carroll E. , Wanebo H. J. , Radie-Keane K. , Nadeem O. 
Published: March 2020

15510 Background: Patients with locally advanced head and neck squamous cell cancer (HNSCCA) have traditionally been treated with aggressive regimens of concurrent chemo-radiation, or more recently, induction chemotherapy followed by concurrent chemo-radiation, to achieve high rates of tumor control at our institution. Objectives: We initiated a QOL study in patients who were free of tumor and available for long term follow up with a focus on acute & delayed complications and long term QOL observation. Methods: The study included 75 patients with stage III-IV HNSCCA treated with either concurrent chemo-radiation or induction chemotherapy followed by concurrent chemo-radiation at our institution. All patients had completed therapy and were considered free of disease at the time of survey. We were unable to complete the survey in 43 pts largely due to patient access problems or unavailability at time of survey. In the remaining 32 patients, the University of Washington QOL survey could be completed over the telephone. Two pts were excluded due to recent demonstration of recurrence. Additional information regarding acute toxicity during treatment was also recorded. Results: There were 11 women and 19 men with a median duration of follow up of 36 months (range 3–120 months) after completion of treatment. Early complications were associated with gastrostomy tube placement (5 leaks & 6 infections,12/31 patients, 38.7%) and portacath placements (2 deep vein thrombosis requiring port removal and anticoagulation, 6.45%). No patients in this group were still dependent on their gastrostomy tube for nutrition at the time of follow up. Of note, 9% of patients were still smoking and drinking on a regular basis. The composite scores for 9 QOL domains ranged from 370–875, with a median score of 615/900. Major problem issues regarding QOL were associated saliva 11/31 (35.5%), swallowing 10/31 (32.2%), followed by mood 6/31 (19.3%), pain 5/31 (16.12%), chewing 4/31 (12.9%), local pain 5/31 (16.12%) and shoulder problems 5/31 (16.12%). Conclusion: Initial QOL problems in advanced HNSCCA appear related to surgical/chemo therapy related problems, whereas late QOL issues appear primarily related to radiation. Most patients however had a good or acceptable quality of life after treatment for advanced HNSCCA. No significant financial relationships to disclose.
Activity of irofulven (IROF) combined with capecitabine (CAPE) in patients (pts) with advanced thyroid carcinoma: Phase II international multicenter study (preliminary results)
Authors: Droz J. , Baudin E. , Medvedev V. , Delord J. , Kane M. , Kloos R. , Ringel M. , Kahatt C. , Weems G. , Shah M. 
Published: March 2020

15511 Background: IROF, the first compound of the acylfulvene class to enter clinical trials, has demonstrated antitumor activity in a variety of chemoresistant tumors. Currently available chemotherapy offers limited benefit to pts with advanced thyroid cancer. A phase I trial of an IROF/CAPE combination showed confirmed partial responses in 2/4 pts (Alexandre, ASCO 2003). An international multicenter 2-stage, phase II trial was initiated to evaluate the objective response rate (RECIST) in pts with advanced thyroid cancer. Methods: Eligibility criteria included advanced Differentiated, Medullary or Anaplastic (D/M/A) thyroid cancer, ECOG PS 0–2, no benefit from prior I131 and ≤1 prior chemotherapy regimen. Pts received IROF 0.4 mg/kg (30 min IV infusion), days 1 and 15 and CAPE orally 2000 mg/m2 day 1 to 15 every 28 days. Results: As of Dec-05, 23 pts (D/M/A: 14/5/4) have been treated. Pt characteristics are (D/M/A); median age: 60/55/61 years (range 34–74), median PS: 1/1/1; prior chemotherapy in 4/1/2 pts; all had metastatic disease predominantly lung, bone and lymph nodes, with a median of 2/1/3 sites of metastasis. Median number of cycles given was 5/4/1. Efficacy: All pts are evaluable. No objective responses observed to date, SD was observed in 11 (79%)/ 3 (60%)/0 pts with median duration 4.8/5.2/0 months; 2/11 (D) pts with SD had 14% and 19% decreases in tumor size. Safety: Main adverse events were thrombocytopenia (grade [G] 1–2: 24% pts), neutropenia (G1–2: 17%; G3: 4%), nausea (G1–2: 41%), asthenia (G1–2: 41%); 1 pt had G3 asthenia. No pts discontinued due to toxicity. Conclusions: No objective responses were observed in pts with differentiated thyroid cancer treated with IROF/CAPE every 2 weeks, with 79% SD. Tolerance was acceptable and accrual is ongoing in the anaplastic cohort. [Table: see text]
Interstitial high dose rate brachytherapy and cervical dissection the management of recurrent head and neck cancers
Authors: Pellizzon A. C. , Novaes P. , Salvajoli J. , Fogaroli R. , Maia M. , Ferrigno R. 
Published: March 2020

15529 Background: The literature is scarce regarding the use of interstitial high dose rate brachytherapy (I-HDR) in this setting, most reports are focused on primary tumors. We performed a retrospective analysis of a single institutional polity of treatment using salvage surgery associated to I-HDR at the Radiation Oncology Departments, Hospital do Cancer A.C. Camargo, São Paulo, Brazil. Methods: All patients with recurrent cervical cancer treated with combination of surgery and I-HDR, with or without the addition a new second course of EBRT, biopsy proven squamous cell carcinoma (SCC), Karnofsky performance status up to 60 and, no evidence of distant metastasis. Patients treated from October, 1994 to June, 2004, were retrospectively selected. Results: Twenty-one patients with median age of 53.5 years (range 31–73) were included in the study. The ratio male to female was 3.2:1 and the follow up time ranged from 6 months to 82 months (median - 36 months). Thirteen (61.9%) had a previous course of irradiation, in whom the median total I-HDR dose was 25.8 Gy, inferior when compared to the median dose of 40.7 Gy given to patients without a previous course of EBRT (p = 0.011), but with no influence in OS (p = 0.9436). The only predictive factor for an improved LFRS and OS was margin status, p = 0.0007 and p = 0.0002, respectively Conclusions: Recurrent HNC should have aggressive salvage procedures as they they are life threatening. Although the number of patients is small, our preliminary results are inspiring, leading to a relative high local control rate with acceptable morbidity, No significant financial relationships to disclose.