bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression, immunity, and survival in patients diagnosed with hepatobiliary carcinoma
Authors: Steel J. L. , Geller D. A. , Olek M. C. , Carr B. I. 
Published: April 2020

18525 Background: Depression has been found to be associated with increased morbidity and mortality in healthy adults. The prevalence of depression in patients diagnosed with cancer, and in particular hepatobiliary carcinoma (HBC), is significantly higher than the general population. The aims of the present study were to: (1) examine the prevalence of depressive symptoms in patients with HBC, (2) test the relationship between depressive symptoms and survival, and (3) begin to explore underlying mechanisms that explain the relationship between depression and survival in patients with HBC. Methods: 101 patients diagnosed with HBC were administered a battery of questionnaires which included the Center for Epidemiological Studies-Depression (CES-D) questionnaire. Disease-specific data was gathered from medical charts and survival was measured from the date of diagnosis to death. Immune markers (NK cell, IL-4 and 5, TNF, and IFN) were collected in 24 patients. Results: At diagnosis, 39% of the sample reported a score of 16 or greater (clinical range). Using Cox Regression, demographic (age, gender, ethnicity) and disease specific variables (diagnosis, treatment, hepatitis, cirrhosis, tumor location, tumor number, tumor size, vascularity of lesion, and portal vein invasion) variables, as well as CES-D score at diagnosis were analyzed. CES-D scores >16 [Wald = 4.0, p = 0.05] and portal vein invasion (PVI) [Wald = 9.0, p = 0.003] significantly predicted survival. Using Kaplan Meier Survival analysis (Breslow test) and stratifying for PVI, a trend was found [Chi-Square = 3.1, p = 0.08] in which patients with PVI and CES-D scores >16, survived 7.4 months whereas patients with CES-D scores <16 survival 13 months. Patients without PVI and CES-D scores >16 survived 18.2 months whereas those with CES-D scores <16 survived 24.7 months. In a sample of 24 patients, those who reported CES-D scores >16 had significantly lower Natural Killer cell numbers than patients with CES-D scores <16 while covarying age, gender, stress, social support, and coping style [F(1,21) = 9.39, p = 0.003]. Conclusions: Depression may be an important prognostic factor for patients diagnosed with HBC. No significant financial relationships to disclose.
The most troublesome aspects of quality of life for people with advanced cancer in a supportive care trial
Authors: Nowak A. K. 
Published: April 2020

18527 Background: ZEST is a placebo-controlled trial of sertraline for people with advanced cancer who feel depressed, anxious or tired but do not have a clear indication for antidepressants. We describe here the aspects of quality of life (QL) rated most troublesome at baseline by the first 150 subjects. Methods: Subjects completed a battery of QL questionnaires including the CES-D, HADS, FACT-G, FACT-Fatigue, and the Patient Disease and Treatment Assessment Form (Pt DATA Form). The Pt DATA Form assesses pertinent symptoms and concerns using 40 single items with a uniform response scale from 0 (no trouble at all) to 10 (worst I can imagine). Test-retest reliability was assessed with the intraclass correlation coefficient (ICC). Convergent validity was assessed by testing correlations between single items from the PT DATA Form and the corresponding, validated, multi-item scales. Results: The median age was 66 (IQR 59 to 73); median Karnofsky Perfomance Status was 80 (IQR 70 to 90); 63% were male; commonest primaries were colorectal (17%), lung (16%), prostate, (14%), breast (13%), and gynaecologic (10%). The aspects rated worst (mean score, proportion scoring >3) were: Fatigue (5.5, 90%), Problems with sex (4.1, 51%), Trouble sleeping (3.6, 49%), Drowsiness (3.5, 54%), Not feeling myself (3.5, 51%), Pain (3.4, 45%), Shortness of breath (3.4, 47%), Problems doing what I wanted (3.1, 45%), Anxiety (3.0, 40%), Depression (2.7, 36%), Dry mouth (2.7, 38%), Trouble concentrating (2.7, 30%), Irritability (2.6, 32%), Altered sense of taste (2.5, 34%), Difficulty walking (2.4, 32%), and Constipation (2.1, 24%). Mean scores were higher in men than women for Problems with sex (5.0 v 2.4, p < 0.001); and, in subjects aged 65 or younger for Hair loss (2.4 v 1.1, p = .01). There were no other significant differences by gender or age. Correlations supported the validity of the single item scales for depression, anxiety, fatigue; and for physical, emotional and overall well-being. The test-retest reliability of the Pt DATA Form was good (ICC >0.5 for 34 of 40 items). Conclusions: Pertinent aspects of QL were validly measured with single item scales. Insomnia, dry mouth, altered sense of taste and irritability were more troublesome than many other, better studied symptoms. No significant financial relationships to disclose.
Tumor-specific response rates to erythropoietin in chemotherapy-induced anemia in a community practice setting
Authors: Vasu S. , Seidler C. , Field T. , Emani S. 
Published: April 2020

18528 Background: Erythropoietin [Epo] is widely used in the management of Chemotherapy-Induced Anemia [CIA] with reported response rates of 70% in the setting of clinical trials. To evaluate overall response rates and tumor specific response rates a retrospective study was performed. Methods: Chart reviews of 109 consecutive patients with chemotherapy-induced anemia were conducted from 2001–2004. Inclusion criteria were: age > 18 yrs, solid or non-myeloid hematological malignancy, receiving concurrent chemotherapy. Patients who received at least one dose of epo were also included, under the intention-to-treat principle. Hb, HCT and MCV during the course of chemotherapy and epo treatment were also collected. Transfusion requirements were also noted. Rise of 1gm Hb after receiving at least 8 weeks of epo was considered as evidence of responsiveness. Epoetin alpha was administered as 40,000 units weekly or darbepoietin at 200mcg q2 weeks and appropriate dose adjustments were made depending on responses. A PRBC transfusion after Day 29 was considered to be evidence of non-responsiveness. Results: Of 109 patients, 108 were considered eligible to be studied. The table shows the distribution of patients according to cancer type. Among the patients who received epo for 8 weeks, the epo response rate was 46%. 21 patients required transfusions after Day 29. Conclusions: Our data suggests that the community response rates to erythropoietin are lower than that reported in the literature. Tumor specific response rates were not statistically significantly (p > 0.05), although this may reflect the small number of patients in the study. A multivariate analysis is being performed to determine if there are predictive factors for response. [Table: see text] [Table: see text]
Ondansetron (O) with or without dexamethasone (D) for the prevention of chemotherapy (C)-induced nausea and vomiting (CINV)
Authors: Bonicatto S. , Mainella A. , Troncoso E. , Barbero A. , Lavezzaro M. , Zapata G. 
Published: April 2020

18558 Background: Adition of D to the standard antiemetic treatment for CINV prevention is frequent, despite the lack of benefit evidence in controlled clinical trials. In this study we compare the impact of O treatment with or without D on daily life, in patients (pts) under treatment with high or moderately emetogenic C. Methods: Longitudinal, randomized and prospective study. All pts who received anticancer treatment with high or moderately emetogenic C were included, and randomly assigned to group A (O 8 mg iv and D 8 mg iv) or group B (O 8 mg iv). Evaluable pts did not have to receive any medication which could modify the antiemetic effect of treatment within the 24 hours following the administration of CH and had to be able to answer an autoadministered questionnaire. After 24 hours, the Functional Living Index- Emesis (FLIE), a daily life index which consists of 18 questions divided into two domains: nausea and vomiting, had to be completed. Data were analyzed by independent mean sample t-test, and ANOVA One-Way, with a 0.05 significance level. Results: Between December/04 and November/05 233 patients (age average: 59.24; range 21–87) were randomly assigned to antiemetic treatment with (n = 125) or without D (n = 108). Both groups were well balanced as regards the type of chemotherapy, sex and age, and all patients were evaluable. No significant effects were observed between both groups when the global data were analyzed. However, when the sample was stratified by type of chemotherapy, a significantly lower impairment (55.1 vs 51.3; p < .05) was detected in the nausea domain in those patients who received moderately emetogenic chemotherapy. Conclusion: In our sample of patients we observed benefits in the impact on daily life, by the addition of D to the O as preventive treatment of CINV, in those patients that received moderately emetogenic chemotherapy. No significant financial relationships to disclose.
Health related quality of life (HRQoL) and demographic characteristics of long term head and neck cancer survivors submitted to concomitant chemoradiation in Brazil
Authors: Santos D. V. , Kiyota K. M. , Snitcovsky I. , Leitão G. M. , Federico M. H. 
Published: April 2020

18572 Background: Head and neck cancer (HNC) is a stigmatizing disease. In order to identify special needs in these patients (pts), we evaluated HRQoL and the demographic characteristics of HNC pts who had survived at least one year after chemoradiation. Methods: Our survey, done in may 2005, identified 42 pts alive (from 527 admitted from May 2002 to May 2004 treated with either exclusive (n = 19) or adjuvant (n = 23) chemoradiation. These pts as well 16 normal controls, were interviewed and invited to complete EORTC-QLQ-C30 and HN35. These questionnaires had already been validated for Brazilian Portuguese. Primary site was 12 oral cavity, 14 pharynx, 13 larynx, 3 not determined. Age 60.3 ± 9.0 y, 36 male and 6 female; 39 were squamous cell carcinoma and 3 other type; 28 were stage III or IV; 40 had no evidence of disease and two had recurrent disease at the time of survey. Comparison between groups were done by using the Mann-Whitney test and differences of at least 10 points was considered of clinical significance. Simple correlations were conducted between HRQoL variables and clinical correlates and demographics. The level of significance was established at p < 0.05. This work was conducted according to Helsinki declaration and Brazilian law. Results: Scores relative to global QoL (p = 0.18) and emotional function (p = 0.59) did not differ in pts as compared to controls. Pts presented worse scores in swallowing, senses, speech, pain, dental problems, xerostomia and mouth opening (all p < 0.05). Emotional function (r = 0.316, p = 0.041) and financial worries (r = −0.509, p = 0.001) impacted on global QoL, what did not happen with marital status, income and level of education, age or previous surgery. Chronic pain was more prevalent in oral cavity tumors than in other sites such as pharynx or larynx tumors (p = 0.046 and p = 0.030, respectively). Pts with larynx tumors presented worse cough score as compared to those with pharynx tumors (p = 0.009). Conclusions: Providing continuous oral and dental care seems to be important to address survivors’ concerns. Financial distress could be ameliorated by a better social support system. Tumor site seem to affect differently some domains of HRQoL, in contrast to organ preservation. No significant financial relationships to disclose.
Assessment of nutritional status and prognosis in advanced metastatic cancer (AMC) of gastrointestine (GI)
Authors: Choi K. , Kim H. J. , Cho H. J. , Oh S. J. , Lee S. S. 
Published: April 2020

18573 Background: Depletion of nutritional reserves and significant weight loss can lead to an increased risk of morbidity, reduced chemotherapy response, and shorter survival in patients (pts) with cancer. Numerous methodologies are used for the assessment of nutritional status. However, it remains unclear which of these tools is the most appropriate in the setting of cancer chemotherapy. The PINI (prognostic inflammatory nutritional index) is a simple scoring system that has been used to evaluate nutritional status and prognosis in critically ill pts. The aim of this study was designed to investigate the relationship between nutritional status after the palliative chemotherapy and prognosis in AMC of GI. Methods: This study included 130 pts with ECOG PS 1∼3 in AMC of GI following the palliative chemotherapy. ECOG PS, body mass index (BMI), alpha 1-acid glycoprotein (AGP), C-reactive protein (CRP), albumin (ALB), prealbumin (PALB), transferrin, protein, lactate dehydrogenase (LDH), PINI ratio [PINI = (AGP × CRP)/(ALB × PALB)], and survival time were evaluated. Results: In 130 patients, the median age was 57 years. The ECOG PS was 1: 68 patients, 2: 43 patients, 3: 19 patients. The mean value of PINI was PS 1: 16.0 ± 47.8, PS 2: 55.6 ± 106.9, PS 3: 106.3 ± 141.6. The mean survival was PS 1: 144.0 ± 71.8, PS 2: 68.9 ± 41.2, PS 3: 32.0 ± 6.9 days. In the PS 3 group, the mean values of AGP, CRP, and LDH were significantly higher than in the PS 1 group. In the PS 3 group, the mean values of ALB, PALB, and transferrin were significantly lower than in the PS 1 group. The survival time was correlated with the ECOG PS (r = −0.602, p < 0.001,), PINI (r = −0.318, p < 0.001,), AGP (r = −0.265, p = 0.002), CRP (r = −0.345, p < 0.001), ALB (r = 0.324, p < 0.001), PALB (r = 0.260, p = 0.003) and transferrin (r = 0.377, p = 0.001). Conclusions: The PINI should be considered nutritional status and prediction of prognosis in AMC of GI following palliative chemotherapy. [Table: see text] No significant financial relationships to disclose.
Comparison of outpatient parenteral nutrition regimens of patients with GIT tumors with and without receiving simultaneous palliative systemic chemotherapy
Authors: Stuebs P. , Fahlke J. , Schmidt C. , Habermann P. , Hribaschek A. , Ridwelski K. , Lippert H. 
Published: April 2020

18578 Background: The nutritional status of oncology patients significantly impacts the success of tumor-specific therapy.This study was designed to objectify the benefit of parenteral nutrition therapy (PN) administered in the ambulatory care setting and at home by evaluation of nutritional parameters in patients simultaneously undergoing palliative systemic chemotherapy. Methods: From 2003 through 2005 56 patients diagnosed with metastatic GIT tumors were included in the survey.43 patients received PN at home (hPN n=16) or in the ambulatory clinic (aPN n= 27) over a period of 8 weeks because of their poor nutritional status.Of 36 patients who underwent palliative systemic chemotherapy, 25 received PN (13 hPN/12 aPN).In aPN 600kcl were administered, while 1500 kcal where given in hPN.The therapy was administered 5 times a week.In all patients albumin and total protein were measured weekly along with body composition via bioelectric impedance analysis (BIA). Results: Over the course of 8 weeks a continuous decrease of albumin and total protein was found in patients not receiving PN.In aPN laboratory values decreased during the first 4 weeks and later stabilized at low levels.In hPN continuous increases in albumin and total protein were observed.BIA results were comparable.In patients receiving chemotherapy without PN there was an initial improvement of relevant BIA parameters followed by a noticeable decline, while in patients receiving chemotherapy and simultaneous PN a stabilization of values occurred after a slight initial decrease.Evaluation of the corresponding laboratory values showed no decline in the group receiving PN but a significant decline in patients receiving chemotherapy only. Conclusions: The nutritional status of patients with GIT tumors shows a continuous decline during chemotherapy without the addition of PN.This study’s data indicate an advantage of PN for patients with GIT tumors, when started early enough. When chemotherapy and PN are administered, there are limitations the use of BIA as a method of measurement.Verification of laboratory parameters specific to nutrition in the process of treatment is both adequate and necessary for assessment of nutritional status. No significant financial relationships to disclose.
Early and late arrhythmogenic effects of doxorubicin
Authors: Kilickap S. , Barista I. , Akgul E. , Aytemir K. , Aksoy S. , Tekuzman G. 
Published: April 2020

18587 Background: To determine the early and late arrhythmogenic effects of doxorubicin-containing chemotherapy regimens, and to identify associated risk. Methods: A prospective study including 29 patients who were treated with doxorubicin-containing regimens between September 2002 and September 2003. Cardiac evaluation was based on 24-hour electrocardiographic monitorization (Holter), which was performed during the first cycle of doxorubicin-containing regimens as well as after the last cycle of chemotherapy. Results: The mean age of the patients was 45.8 ± 15.1 (range 18–69) and the average dose of doxorubicin was 280.03 ± 113.50 mg/m2 (range 50–480). Holter records obtained during the first cycle of treatment revealed varying arrhythmias in 19 patients (65.5%). The most common arrhythmia was supraventricular extrasystole (n = 11, 37%). Holter records obtained after completion of therapy revealed a variety of rhythm abnormalities in 18 (62.1%) patients, with supraventricular extrasystole again being the most common arrhythmia (n = 13, 44.8%). Only 13 (44.8%) patients had arrhythmias documented in both Holter records. One patient presented with syncope during the first course of doxorubicin therapy and Mobitz type 2 atrioventricular block along with complete atrioventricular block lasting for 12 seconds were demonstrated after examination of Holter records. The patient subsequently underwent permanent pacemaker implantation. There was no correlation between the development of arrhythmia in the early and late period and sex, diagnosis, age, and previous radiotherapy history. Conclusion: Doxorubicin may result in arrhythmias both in early and late periods of treatment. These arrhythmias are rarely life threatening. No significant financial relationships to disclose.
Outcomes and health status of patients undergoing usual care for highly emetogenic chemotherapy
Authors: Lewis C. R. , Olver I. N. , Walpole E. , Shannon C. , Pavlakis N. , Dalley D. , Van Hazel G. , Lybrand S. 
Published: April 2020

18591 Background: Chemotherapy-induced nausea and vomiting (CINV) remains a significant issue for patients, especially management of delayed symptoms. The Perugia 2004 antiemetic guidelines recommended that anthracycline/cyclophosphamide (A/C) combination regimens be considered as high risk emetogenic potential. The aim of our study was to determine the extent of CINV, and effect on quality of life for chemotherapy-naïve patients in a practice-based environment. Methods: Eligible patients were receiving their 1st cycle of high risk emetogenic or carboplatin chemotherapy, administered with “standard care” (5HT3 antagonist + dexamethasone) antiemetics (use of NK1 antagonists excluded). Patients completed a daily diary for 5 days post chemotherapy, capturing data on CINV activity and rescue medications usage. Emesis and nausea-specific health status was measured by the Functional Living Index - Emesis (FLIE); general health status was assessed using a 100mm VAS (EQVAS). Results: Of 74 patients, 42 received an A/C regimen, 16 cisplatin and 16 carboplatin. Overall complete response (no vomiting, no use of rescue antiemetics during the study period) was 60% in patients receiving carboplatin, 24% A/C and 21% cisplatin. During the delayed phase, mean total emesis episodes for carboplatin was 0.6, A/C 2.21 and cisplatin 4.08. Patients receiving carboplatin reported less delayed nausea, and better outcomes for FLIE and EQVAS scores. Treatment with either A/C or cisplatin was associated with similar deterioration in nausea control across the study period, and similar impact on FLIE scores (see table ). Conclusions: Our results are consistent with the recommendation that A/C regimens be considered highly emetogenic, with similar impact on patient symptoms and quality of life compared with cisplatin. Delayed CINV remains a target for antiemetic intervention. Similar studies need to be repeated in patients receiving additional NK1 antagonists to assess their impact on CINV outside clinical trials. [Table: see text] [Table: see text]
A randomized phase II trial of gemcitabine plus treosulfan versus treosulfan alone in patients with metastatic uveal melanoma
Authors: Schmittel A. H. , Schmidt-Hieber M. , Bechrakis N. E. , Schuster R. , Siehl J. M. , Foerster M. H. , Thiel E. , Keilholz U. 
Published: April 2020

8018 Background: In-vitro studies have suggested synergy of gemcitabine and treosulfan against uveal melanoma cells, and the combination of both drugs in the GeT regimen has shown activity in metastatic uveal melanoma patients. This first randomized phase II trial in this rare disease compared the efficacy of the gemcitabine/treosulfan (GeT) combination versus treosulfan alone. Methods: Chemotherapy-naïve patients with proven metastatic uveal melanoma were randomly assigned to receive 1000mg/m2 gemcitabine plus 3500mg/m2 of treosulfan (GeT) or 3500mg/m2 of treosulfan (T) alone. Chemotherapy was administered on days 1 and 8 in both arms, cycles were repeated on day 29. In the absence of disease progression a maximum of 6 cycles were administered. Results: Forty-eight patients were randomized. Seven confirmed stable diseases and one partial remission were observed in 24 patients (PR+SD=33%) treated with the GeT regimen, whereas no PR and only 3 SD (13%) were observed in the treosulfan alone arm (p=0.08). Median progression free survival was 3 months (95% CI 1.1–4.9) in the GeT arm and 2 months (95% CI interval 1.7–2.3) in the treosulfan arm (p=0.008, log-rank). Six and 12 months progression free survival was 34.8% and 17.9% and 16.7% and 0% always favouring the GeT arm. Conclusions: This first prospectively randomized trial in metastatic uveal melanoma showed a superior PFS and a trend for a higher response/stabilization rate of the GeT combination over treosulfan alone. Therefore GeT will further be investigated in randomized trials. No significant financial relationships to disclose.