bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuroendocrine tumors of uterine cervix in Mexican women.
Authors: Flores Lucia Edith , Green Dan , Morales-Espinosa Daniela , Cetina Lucely 
Published: March 2020

e15569 Background: Neuroendocrine tumors of the uterine cervix are rare, aggressive, and carry a poor prognosis. Most are small cell (SCNEC) and large cell (LCNEC). The limited knowledge of this neoplasm is based on small series due to the rarity of the diagnosis.There is a lack of information about NEC in Latin America. We describe both demographic and clinical characteristic of Mexican patients; and their multidisciplinary management in a reference center. Methods: We studied retrospectively clinical and histopathological variables of 33 women treated at the National Cancer Institute of Mexico from 1991 to 2010 with NEC. Patients were allocated into groups according to staging (Group 1 FIGO stages IB1 and IB2; Group 2 IIA-IVA, and Group 3 IVB). Results: Mean age at diagnosis was 50 y.o.; mean tumour size was 4.9 cm. There were 59.4% SCNEC and 40.6% LCNEC. Stage at diagnosis: IB1 15% (n=5), IB2 3% (n=1), IIA 18.2% (n=6), IIB 27.3% (n=9), IIIA 6% (n=2), IVB 27.3% (n=9). Common sites of metastases were lung and liver. The most common presenting symptom was transvaginal bleeding. In Group 1, 6/7 patients received multimodal management with surgery, chemoradiotherapy and induction or adjuvant chemotherapy. In Group 2, 12/17 patients received three modalities, 3/17 received only 2, due to comorbidty. In Group 3, 8/9 received 2 modalities. Patients with one treatment modality were those with disease progression. Cisplatin was used concurrently with radiotherapy; paclitaxel and carboplatin or etoposide and cisplatin were used for either induction or adjuvant settings. Disease free survival in months was: 50.3 (group 1); 23.1 (group 2), and 3.5 (group 3). Overall survival was: 68.5, 46.3, and 17.2 months, respectively. Main sites of recurrence were pelvis, mediastinum, lung, liver, central nervous system, pancreas, adrenal gland, bone and soft tissue. Conclusions: TheNational Cancer Institute of Mexico offers multidisciplinary treatment emphasizing local control after systemic therapy in both early and locally advanced disease; providing the most favourable disease-free survival and overall survival described. To our knowledge, this is the first report of NEC in the Mexican population, where carcinoma of uterine cervix represents yet an important public health issue.
Integration of neuropathy-sparing multimetronomic bevacizumab and multibiochemical modulation followed by regional consolidation and maintenance therapy for refractory ovarian cancer.
Authors: Bruckner Howard , Brandeis Alison Emily , Radjabi Amir Reza , Mull Ruslan , Stega Jeanetta , Hirschfeld Azriel 
Published: March 2020

e15576 Background: In vitro disease models predicted advantages for use of 1/2-1/4 standard cytotoxic doses and selection of drugs each of which simultaneously interact with multiple drugs. Methods: Treatment (rx) combined 10mg/kg bevacizumab (B) q 2 weeks, cyclophosphamide (Cy) 400mg/m2 modified AC (Garcia Gyn Onc 05) with low dose GFLIP (carboplatin=P) P -/+ docetaxel (D) (Bruckner, ASCO 08). Regional therapy followed: +/- intraperitoneal, target directed or D+cisplatin, +/- or empirical HIPEC. To prevent further neuropathy, present in 8 of 10 pts, D was reserved for late addition (as needed) to create less than 0.5cm or otherwise “eligible for reduction surgery” tumors. Results: Overall S is 8/10 and 4/6 @ 6 and 12 mos. Two lead pts S at 18+ mos. 10/10 tumor marker responses (R); 9/10 objective R all with benefit. Patients (pts) had failed a median of 3 prior regimens and all had large rapidly worsening tumors during prior rx; 6/10 were considered “entirely untreatable.” There were no grade 4 complicated AEs, other than anemia. Epistaxis and HTN were minor, easily controlled AEs. Three deaths due to disease: One pt, PS3, refused surgery for a preexisting bowel obstruction and one, PS3, required weekly paracentesis and had sb obstruction. She relapsed after four mos OR. The third, PS4, pt was paracentesis and thorocentesis dependent and had a 6 mos OR. Median PFS is not yet reached. The lead pt, a 33yo third line, twice operated achieved a pCR in 4 mos, now stoma reversed, unmaintained for 14+ mos, following vaccine rx. Seven had OR without D; brief addition of D; brief addition of D produced 3/3 OR, a pCR, CR and PR. IRB provided prospective oversight of consent. Conclusions: This is an active multi-drug, in theory, anti BRCA rx, for very high risk and some otherwise “untreatable” pts. Simultaneous modulation of multiple drugs, both metronomically, six ways, (Cy-GFIC-D) and biochemically, up to five ways "each," 15 ways (5+4+3+2+1), is safe. Algorithms can offer cost savings (for B) by selecting a finite, short, “best” period for rx and then definitive, B free, consolidation rx. B driven response can create new windows of opportunity for test worthy multidisciplinary rxs.
Docetaxel, cisplatin, and 5-fluorouracil-based induction chemotherapy followed by concurrent chemoradiotherapy with cisplatin in locally advanced stage III and IV nasopharyngeal cancer.
Authors: Dane Faysal , Atasoy Beste Melek , Akgun Zuleyha , Yumuk Fulden , Cabuk Devrim , Teomete Mehmet , Basaran Gul , Turhal Serdar , Abacioglu Ufuk 
Published: March 2020

e16015 Background: Concomitant chemoradiatiotherapy (CRT) is the standard treatment in locally advanced nasopharyngeal cancer (LANPC). We studied the activity and tolerability of docetaxel, cisplatin and 5-fluorouracil-based induction chemotherapy (IC) followed by concurrent CRT with cisplatin in LANPC. Methods: Between 2004 and 2010 a total of 33 (15 stage III, 18 non-metastatic stage IV) patients were included into this retrospective analysis. Median age was 51 (range, 19 to 75) years. Twenty-five patients were male. IC was planned for three courses in all patients. IC was consisted of docetaxel and cisplatin (DC) in 11 patients and fluoropyrimidine, dosetaxel and cisplatin (DCF) in 22 patients. G-CSF and ciprofloxacin were given prophylactically to all patients received DCF. 3D conformal radiotherapy (RT) was administered in conventional fractionation (2Gy/fr, 5 fraction per week) using 6-18MV photon energy and appropriate electron energies. Therefore, nasopharynx, level I-V and supraclavicular lymph nodes received 46 Gy (phase I) whereas, nasopharynx and clinically positive or initially bulky lymph nodes received 70 Gy (phase II). Cisplatin (75 mg/m2/21days) was administered during RT concomitantly. Results: Median follow up for surviving patients was 48 months. There was no progression after IC. Complete (CR) and partial responses (PR) were achieved in 6 and 23 patients in nasopharynx, respectively. We observed CR and PR in 19 and 13 patients in neck, respectively. All patients were given 3 cycles of IC. The dose of chemotherapy was reduced in 8 patients during IC. Sixty-six percent of the planned cisplatin dose could be given in the concomitant setting. In 11 patients, cisplatin was either reduced or permanently stopped. Thirty-one patients completed RT as planned. Five years PFS and OS rates were 65.5% and 72.2% respectively. Conclusions: In our LANPC patients, induction DC(F) chemotherapy followed by concomitant CRT was promising. This strategy should be evaluated in prospective studies.
Palliative chemotherapy in head and neck cancers: A tertiary care center experience with weekly paclitaxel and cetuximab.
Authors: Prabhash Kumar , Noronha Vanita , Joshi Amit , Patil Vijay , Juvekar S , Muddu Vamshi 
Published: March 2020

e16028 Background: The concept of combination of paclitaxel and cetuximab is an intersesting prospect as both these agents have single agent acitivity, minimal toxicity and hold a biological rationale for combination. The aim of our study was to see the safety,efficacy and feasibility of administration of this combination in a outpatient setting. Methods: This was a retrospective analysis of the prospectively collected data, of patients offered weekly paclitaxel and cetuximab from May 2010-May 2011. The standard schedule of cetuximab along with 80 mg/m2 of weekly paclitaxel was administered till either disease progression or withdrawl of patient's consent. The toxicity profile was noted in accordance with CTCAE version 4.02 and response in accordance with RECIST criteria. SPSS version 16 has been utilized for analysis. Descriptive statistics are been presented and analyis of estimation of overall and progression free survival has been done with Kaplan-Meier survival method. Results: 42 patients with a median age of 52 years (35-81 years) were included. The KPS score was 60 in 1 (2.4%),70 in 11 (26.2%) and 80 in 30 patients(71.4%). Nearly half of our patients 22 (52.4%) had a primary in oral cavity. Except 3 (7.1%) patients rest all had received some form of previous treatment. The median event free period(EFP) from previous first line treatment was 231 days, it was below 180 days in 38.5% of patients. Best response observed was CR in 1 patient (2.4%), PR in 11 (26.2%), SD in 17 (40.5%) and PD in 13 (30.9%). Grade 3-4 skin changes were seen in 3 patients, grade 3-4 neuropathy was seen in 3 patients and there were no episodes of grade 3-4 gastrointestinal or haematological toxicity. The overall estimated median PFS and OS were 128 and 256 days. The median estimated PFS for patients with EFP less than 6 months versus more than 6 months was 115 and 165 days respectively (p = 0.132). Conclusions: The combination of paclitaxel and cetuximab was found to be safe, feasible and appears to be clinically beneficial.
Excellent long-term control in locoregionally recurrent radioactive iodine-refractory papillary thyroid cancer with the addition of external beam radiation therapy to maximal surgical resection.
Authors: Wilson William A. , Valentino Joseph , Gal Thomas , Sloan David , Ain Kenneth B. , Arnold Susanne M. , Brill Yolanda , Kudrimoti Mahesh R. 
Published: March 2020

e16035 Background: Locoregionally recurrent radioactive iodine (RAI) refractory papillary thyroid cancer represents a small percentage of papillary thyroid cancers but is an aggressive disease with significantly lower survival rates. This retrospective review is our experience with these cancers treated with maximal surgical resection followed by external beam radiotherapy. Methods: 26 patients treated from 2001-2011 were eligible for review. After obtaining IRB approval, medical records were reviewed for clinical outcome. All patients had histologically proven recurrences that were negative on I-131 scans. All patients were maximally resected. All patients received external radiotherapy to the thyroid bed, bilateral cervical lymph node levels II-IV, level VI, and superior mediastinal nodes. 15/26 patients received intensity modulated, 9/26 patients received 3-D conformal, and 2/26 patients received Tomotherapy radiation treatment. The mean dose was 5790 cGy (range 5280-6800 cGy). Results: All histologies were papillary thyroid cancer with 4/26 exhibiting tall cell features and 1/26 diffuse sclerosing features. All patients had locoregional relapse in the cervical nodes (16/26) or in the mediastinum (5/26) or both areas (5/26). The mean pre-treatment thyroglobulin was 5.2 (range <0.1 to 599.1). The mean post-treatment thyroglobulin was 1.0 (range <0.1-5.2). Median follow-up was 55 months (range 7-123 months). 0/26 patients failed locoregionally. 2/26 patients failed distantly (lungs). 20/26 patients (77%) of patients had undetectable thyroglobulin at last follow-up. 4/26 patients had detectable thyroglobulin (2.5-16.9), but had not recurred on imaging. 2/26 required PEG placement during treatment, but 0/26 patients were PEG-dependent on long-term follow-up. 1/26 patients experienced grade III osteoradionecrosis of the mandible. Conclusions: External beam radiotherapy provides excellent locoregional control for locoregionally recurrent radioactive iodine-refractory papillary thyroid cancers. Long-term grade III and IV toxicities are uncommon.
A prospective phase II study of induction chemotherapy and nimotuzumab for resectable locally advanced head and neck squamous cell carcinoma.
Authors: Zhao Xiaoying , Guo Ye , Zhu Yongxue , Wang Yu , Zhu Guopei , Hu Chaosu , Ji Qinghai 
Published: March 2020

e16039 Background: We incorporated nimotuzumab, a humanized monoclonal antibody against the epidermal growth factor receptor (EGFR), into the induction chemotherapy for resectable locally advanced head and neck squamous cell carcinoma (LAHNSCC), aiming to evaluate the efficacy and toxicity of this novel combination. Methods: In this single-institute, prospective phase II study, patients with histologically confirmed and potentially resectable (T2-4, N0-3, M0) LAHNSCC were treated with induction therapy of nimotuzumab (400 mg day 1, cisplatin 75 mg/m² day 1, and 5-FU 750 mg/m² days 1-5) for 2 cycles. Radical surgery or radiotherapy/chemoradiotherapy was used as subsequent local therapy. The primary endpoints were overall response rate and pathological complete response (pCR). Results: Of 40 enrolled patients, 25 had stage IV disease and 20 had N2-3 node involvement. The most common tumor primary was hypopharynx (40%) and 9 patients had an oropharyngeal carcinoma. After induction therapy, the overall response rate was 87.2% and 24 patients got a T or N downstage. Twenty-seven patients underwent radical surgery and pCR was found in 4 patients (14.8%). After surgery, 25 patients received adjuvant radiotherapy or chemoradiatherapy depending on the risk factors. For responding patients after induction, radiotherapy, usually concurrently combined with high-dose cisplatin was given to 12 patients as local therapy with a median dose of 60 Gy. One patient with stable disease after induction refused surgery and was treated with second-line chemotherapy in an attempt to pursue organ-preservation. There were no more than 10% of grade 3/4 toxicities induced by induction therapy. Only one patient experienced with mild rash. One patients developed grade 2 renal dysfunction after first cycle and chose immediate surgery. With a median follow-up time of 13.9 months (3.8-29.9), 1-year progression-free and overall survival rate were 80% and 83.3%, respectively. Conclusions: For resectable LAHNSCC, nimotuzumab plus chemotherapy as an induction therapy is highly effective with tolerable toxicities.
Base of tongue squamous cell carcinoma susceptibility: Novel candidate genetic polymorphisms identified in genome-wide association study.
Authors: Lima Carmen Silvia Passos , Carvalho Benilton , Pellegrino Renata , Khater Leticia , Chone Carlos Takahiro , Costa Fernando Ferreira , Lourenco Gustavo Jacob 
Published: March 2020

e16041 Background: Inherited genetic alterations, such as single nucleotide polymorphisms (SNPs), were described in association with oropharyngeal cancer risk in few reports with restrict number of SNPs analyzed. Base of tongue (BT) squamous cell carcinoma (SCC) is a common tumor of oropharynx; however, the association of SNPs and BTSCC risk is not clarified and, therefore, this was the aim of this study. Methods: DNA from 49 BTSCC patients and 49 controls was extracted using the QIamp kit (Qiagen). Each sample was genotyped individually using DNA high-resolution microarrays containing 500.568 SNPs (SNP array 5.0, Affymetrix). Further sample processing, including digestion, adaptor ligation, amplification, fragmentation, labeling, hybridization, washing and scanning was assayed according to the standard protocol. Genotype data were acquired by genotyping calling of samples using crlmm algorithm provided by Bioconductor software. The differences between groups were analyzed by the logistic regression model. The SNPs localized in genes of interest were selected by data base analysis in DAVID and NCBI websites. The validation of selected SNPs was performed by RT-PCR, using TaqMan SNP Genotyping Assays (Applied Biosystems) in all samples studied. Results: We observed 6.609 SNPs with distinct frequencies between BTSCC patients and controls. Fifty-two SNPs (0.8%) were located in coding sequence (CDS), 51 (0.8%) in 3’ and 5’- untranslated regions (UTR), 3.461 (52.4%) in up or downstream regions (DWS) and 3.045 (46.0%) in introns. Ten SNPs were selected and validated in study, including those localized in genes related to cell cycle (3’-UTR: ERP29, rs7114; MCC, rs7033; DWS: LEF1, rs2107028 and rs4245926; PTCH1, rs16909856 and rs16909859), transcription process (CDS: IKBKAP, rs3204145; 3’-UTR: ZNF415, rs3814), and cell adhesion (CDS: COL22A1, rs2292927; DWS: LY6K, rs1995467). Conclusions: Our preliminary results suggest that SNPs in genes involved in tumor development may predispose individuals to BTSCC. However, these results should be confirmed by functional protein studies and validated in larger epidemiological studies. Financial support: FAPESP and FINEP.
Induction chemotherapy with docetaxel, cisplatin, and 5FU (TPF) in unresectable advanced head and neck squamous cell carcinoma: Retrospective analysis of 300 cases and proposal for a prognostic index.
Authors: Bozec Alexandre , Fakhry Nicolas , Dupuis Charlotte , Lallemant Benjamin , Alfonsi Marc , Benezery Karen , Righini Christian , Guelfucci Bruno , Beltran Michel , Borchiellini Delphine , Poissonnet Gilles , Dassonville Olivier , Schori Clara , Giovanni Antoine , Peyrade Frederic 
Published: March 2020

e16055 Background: Phase III studies have demonstrated that induction chemotherapy with TPF followed by cisplatin-based chemoradiation (CRT) is a valid option for the treatment of advanced unresectable head and neck squamous cell carcinoma. These studies have been done in highly selected patients. The aim of our study is to confirm these data in unselected patients and to identify prognostic factors of tolerance and survival. Methods: Between October 2005 and June 2010, 300 patients from 5 institutions with locally advanced neck and head cancer received at least one induction cycle, followed by locoregional radiotherapy (R) associated or not with platinum (P) or cetuximab (C)-based chemotherapy. Results: Mean age was 56 years old (range 31-76). Performance status was 0 or 1 in 97% of patients and 50 % of them presented current alcohol intoxication. 69% (n=208) received 3 cycles of TPF, and 91% (n=268) underwent R associated or not with P (n=167) or C (n=51). 52% of patients (n=156) received the conform treatment (ie 3TPF + RP or RC). Grade 3-4 toxicities have been reported in 19% (n= 57), including 3% febrile neutropenia (n=9) and 7% kidney failure (n=22). Grade 3-4 toxicity, during TPF induction, led systematically to permanently discontinuation of the chemotherapy. Overall response rate after TPF induction was of 88% with 23% of complete response. After a median follow-up of 21 months, median progression-free survival and cause-specific survival (SS) were not reached. Median overall survival (OS) was 49 months (95% CI 31.2-66.8). SS and OS were significantly improved (p<0.0001) in patients who received the conform treatment. In multivariate analysis the probability of death related to cancer or to toxicities induced by treatment was increased for hemoglobin level ≤ 12.6g/dl or GGT level ≥ 77U/I [HR = 3.45 (95% CI: 1.50-7.93) p=0.0029]. Conclusions: We propose to use a biological index based on baseline hemoglobin and GGT levels to select patient for induction therapy in SCCHN. This simple index, predictive of treatment conformity and specific survival, needs further prospectives investigations.
Induction chemotherapy with weekly cetuximab, carboplatin, and paclitaxel in the treatment of locally advanced head and neck cancer: The University of Pennsylvania experience.
Authors: Bauman Jessica R , Langer Corey J. , Quon Harry , Algazy Kenneth M. , Desai Arati Suvas , Mutale Faith , Lin Alexander , Weiss Jared 
Published: March 2020

e16062 Background: Although Tax 324 demonstrated superior survival for induction docetaxel, cisplatin, and 5-fluorouracil (TPF) compared to PF in the management of locally advanced head and neck cancer, TPF is associated with serious toxicities and logistical challenges leading many institutions to seek alternative regimens. One promising regimen, piloted by Kies and Wanebo, combines weekly cetuximab with carboplatin and paclitaxel, which the University of Pennsylvania adopted in 2008. Methods: We retrospectively evaluated all LA-SCCHN patients treated with this regimen from May 2008 to December 2011, during which time it was the only one used. Most commonly, cetuximab was dosed at 400mg/m2 IV alone week one, followed by 250mg/m2 weekly in combination with weekly carboplatin AUC 2 and paclitaxel 90 mg/m2 over eight weeks. Our primary endpoint was feasibility. Results: Thirty patients were included. Median follow-up was 13.7 months (range, 5.0-38.7). Median age was 58.3 (range, 37.4-83.6). All but one had Stage IV SCCHN. 77% had oropharyngeal carcinoma. 70% were smokers. p16 staining as a surrogate for HPV positivity was available on 13 patients, of whom 10 were positive. For induction, high tolerability was observed based on 90% of patients receiving all planned cycles or missing only one cycle. Grade 3-4 toxicities included rash (7%), neutropenia (7%), and infusion reaction (3%). Only 10% were hospitalized at some point during induction therapy. All patients subsequently received definitive chemoradiotherapy (29) or surgery (1). All completed their full treatment course. At the time of post-treatment imaging, 19 (63%) had a complete response and 11 (37%) had a partial response. Of p16 positive patients, 8/10 (80%) had a CR. Of p16 negative patients, 1/3 (33%) had a CR. At the time of last follow-up, 30% of patients had recurrent disease. Median overall survival and progression free survival have not yet been reached; Kaplan-Meir curves will be shown. Conclusions: Induction chemotherapy with weekly, outpatient, cetuximab, carboplatin, and paclitaxel is feasible and well tolerated in LA-SCCHN. Preliminary efficacy results are promising.
Interventions to reduce racial and ethnic disparities in colorectal cancer care: A systematic review.
Authors: Ward James Edward , Naylor Keith , Polite Blase N. 
Published: March 2020

e16509 Background: Disparities in colorectal cancer (CRC) outcomes among underrepresented racial and ethnic minority patients continue to widen. We performed, and present here, the results of a systematic review of the literature evaluating interventions to reduce racial and ethnic disparities in CRC care. Methods: The MEDLINE, PsycINFO, CINAHL, and Cochrane databases were searched for articles that focused on interventions to reduce disparities in CRC screening, treatment, survivorship and end-of-life care from 1950 to 2010. Studies included were those that evaluated interventions in US populations that were composed of ≥50% racial/ethnic minorities (or that included a specific sub-analysis by race/ethnicity). Results: Following the electronic search, abstract and full text review, and reference reviews; a total of thirty-three studies were included in our final analysis. All of these were related to CRC screening; no studies evaluating the rest of the cancer care continuum were found. Nineteen studies (58%) were randomized controlled trials, nine (27%) were pre-test/post-test analyses, and five (15%) were cohort studies. Thirteen studies (39%) targeted African-American populations, eight (24%) targeted Hispanics, two (6%) targeted Asian populations, seven (21%) included a mixed population of ethnic minorities, and three (9%) were listed as “non-white” or included a subgroup analysis. The main results related to the magnitude of the effect of these patient-directed, patient navigator, and provider-directed interventions on CRC screening is outlined in the table below. Conclusions: Patient education involving personal contact, patient navigation services, and provider-directed education and reminder systems can modestly improve adherence to CRC screening among minority patients. Further studies targeting the rest of the colon cancer care continuum are needed. [Table: see text]