bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient preferences for chemoradiation-related side effects
Authors: Sun C. C. , Ramondetta L. M. , Jhingran A. , Eifel P. J. , Crane C. , Phan A. T. , Frumovitz M. M. , Elting L. S. , Bodurka D. C. 
Published: August 2020

e20604 Background: Patients (pts) undergoing chemoradiation (CRT) face intense treatment (tx) schedules and adverse tx- related side-effects (SEs). We conducted this study to determine whether pts’ preferences (PREFs) for CRT-related SEs changed over tx duration. Methods: We used the visual analog scale (VAS) and modified time trade-off (TTO) to assess PREFs of newly diagnosed pts with gynecologic (GYN) and gastrointestinal (GI) cancers scheduled to receive CRT. Pts evaluated 16 SE health state scenarios during interviews conducted at 3 points in time: T1=prior to starting CRT; T2=2–3 weeks after starting CRT; and T3=4–6 weeks after completing CRT. Using the VAS, pts ranked SEs on a scale of 0=worst to 100=best. The TTO asked pts whether they would accept a hypothetical tx for a specified time with the SE in question or a tx for a shorter length of time that involved a worse SE profile. PREF scores were converted to 0.0=least preferred to 1.0=most preferred. Mann-Whitney and Kruskal-Wallis tests were used to analyze data. P- values were adjusted for multiple comparisons. Results: PREFs were collected from 93 pts (GYN=43; GI=50). 46/93 pts were female (3 women were GI pts). Median age was 53.7 yrs. Pts received a median of 5 chemo cycles (31/50 GI and all GYN pts received platinum) and 5.4 wks of external beam radiation. Median time between T1-T2 was 2.6 wks and T2-T3 was 9.1 wks. TTO PREFs were stable over time regardless of disease group or tx regimen. VAS scores for 7 SEs worsened significantly after initiation of CRT and remained low despite completion of CRT ( table ). Pts gave low baseline PREF scores for diarrhea, fatigue, and loss of appetite; these did not change significantly over time. Conclusions: Pts receiving CRT were willing to accept tx of longer duration with less severe SEs instead of shorter tx with more severe SEs. Relative to other SEs, pts rated GI-associated SEs lower after initiation of CRT. Ratings remained low 4–6 weeks after tx completion. Further studies are needed to determine whether pts’ experiences with and perceptions of SEs influence tx compliance. [Table: see text] [Table: see text]
Oxaliplatin for colorectal cancer: Prevalence of delayed nausea and/or vomiting
Authors: Fleishman S. B. , Gorospe V. E. , Rosenwald V. 
Published: August 2020

e20610 Background: Delayed nausea and vomiting (N&V) have been associated with cisplatin and carboplatin. Its prevalence with third-generation oxaliplatin was examined in patients (pts) receiving oxaliplatin-based regimens. Methods: 64 pts (53% male, 47% female) signed IRB-approved informed consent and were enrolled on day 1 of cycle 1. 53 (83%) pts had colon cancer, and received 85mg/kg of oxaliplatin, while 11 (17%) had rectal cancer, and received 65mg/kg. Age ranged from 29 to 84 years, with 65% between 50 and 69. Data was collected on the first chemotherapy cycle of 24 pts and the first and second cycles of 40 pts, for a total of 104 cycles. Baseline demographic data were collected by chart review and interview. Maximum grade of N&V for each cycle was assessed by the Functional Living Index - Emesis (FLIE). Pts also maintained a daily diary of nausea, vomiting, and anti-emetic usage for 7 days after each infusion. Results: 7 pts (11%) reported a history of motion sickness. History of morning sickness was reported by 13 (43%) of the 30 female pts. All pts received anti-emetics and steroids on day 1 of each cycle. 75% of pts received 5HT3 inhibitors only, 22% received 5HT3 + an oral NK-1 receptor antagonist, and 3% received an NK-1 receptor antagonist alone. Among 40 pts for whom data were collected on both first and second cycles, the occurrence of nausea was the same during cycle 1 and cycle 2: Grade 0 - 60% and 62% respectively; Grade 1 - 20% and 21%, Grade 2 - 20% and 21%. 41% of pts used rescue antiemetics (prochlorperazine, metoclopramide, or lorazepam) in cycle 1 and 43% in cycle 2. Men experienced no nausea 69% of the time, while women had no nausea in 41% of cycles. In 57% of cycles, no nausea was reported. In 88% of cycles there was no reported vomiting. Conclusions: Oxaliplatin-based regimens (65–85 mg/kg) caused minimal nausea and negligible vomiting, with a satisfactory response to 5HT3-inhibitor antiemetics and corticosteroids. [Table: see text] [Table: see text]
Evaluation of AMG 531 in chemotherapy-induced thrombocytopenia (CIT): Results of a phase I/II study
Authors: Vadhan-Raj S. , Trent J. , Araujo D. M. , Patel S. , Zhou X. , Benjamin R. S. 
Published: August 2020

e20616 Background: AMG 531 is a Fc-peptide fusion protein (peptibody) that increases platelet production by stimulating thrombopoietin (TPO) receptors. Prior studies have shown the importance of schedule of recombinant TPO to overcome cumulative thrombocytopenia (TCP) caused by high-dose chemotherapy with carboplatin (C), a late-nadir regimen, and doxorubicin and/or ifosfamide (AI), early-nadir regimen. Methods: The objectives of this study were to evaluate the safety and biologic activity of AMG 531 in CIT. Pts receiving high dose C (AUC=11) or AI received CT alone in the study cycle-1 and CT + AMG 531 in the study cycle-2 and subsequent cycles. At least 6 pts were enrolled at each dose level of AMG 531 (1, 3, and 10 mcg/kg). AMG 531 was administered SC as 2 doses given 2 days apart, starting from the day after CT (post-dosing schedule). An additional cohort of 6 pts received AMG 531 (10 mcg/kg) 2 doses administered as predose (day -5) and postdose given on day after CT (pre-/postdosing schedule). Results: Twenty-four of the 27 pts enrolled received the study drug and are evaluable. Treatment with AMG 531 was well tolerated; one pt experienced pulmonary embolism during cycle-6. In the 4 pts that received C with AMG 531 (1 mcg/kg) by post-dosing schedule, there was a reduction in duration of TCP (days < 100,000/mm3; 10 vs 7, p = 0.023, and days < 50,000mm3; 6 vs 2, p = 0.001, in cycles 1 and 2, respectively) and the PLT nadir count was stable (2 pts), increased < 2-fold (1 pt) or > 2-fold (1 pt) in C-2 as compared to C-1. In pts that received AI with AMG 531, there was a trend for increase in PLT nadir count with pre/post dosing schedule with a regimen known to cause cumulative thrombocytopenia from C-1 to C-2 ( Table ). Conclusions: AMG 531 is well tolerated and shows biologic activity in pts receiving CT. These findings suggest that postdosing may be effective with late-nadir regimen such as C. Ongoing study will determine if pre-/postdosing may be more effective with early-nadir regimens such as AI. [Table: see text] [Table: see text]
Caspofungin for invasive aspergillosis: A single-centre prospective study
Authors: Bonini A. , Tieghi A. , Gamberi B. , Imovilli A. , Carbonelli C. , Spaggiari L. , Gugliotta L. 
Published: August 2020

e20618 Background: Infections are the main complication for neutropenic patients (pts).Fungal infections represent a frequent cause of death. Caspofungin (Caspo) is the first drug able to inhibit the growth of the fungal cell wall. Methods: Since 2004 we began a prospective study with the administration of Caspo as first line therapy in 63 consecutive adult neutropenic pts. With persistent fever despite antibiotics,a chest CT-scan and galactomannan test were performed. In case of probable or proven infection Caspo was administered at the dose of 70 mg on the first day followed by 50 mg daily. They were 35 males and 28 females; the mean age was 56 yrs. The diagnoses were: leukemia 44, myeloma 3, lymphoma 16; the disease's phases were: new onset 24, remission 16, relapse 23. 12 pts received an allogeneic and 6 an autologous transplant; the others received conventional chemotherapy. Results: Fungal infections were proven in 12 and probable in 51 cases.The first site of infection was the lung in 62 pts. CT scan was positive(halo sign or air-crescent sign)in all the pts with a lung localization. BAL was performed in 37 pts.The mean time of treatment was 18 days. Caspo was well tolerated and not discontinued for adverse events. Among pts submitted to an allogeneic HSCT the concomitant therapy with Cyclosporin A was not influenced by Caspo. No adverse events during the infusion were seen, and it was not necessary to administer any premedication. The global (partial and complete) response was 50/63 (79%); 13 pts died for fungal infection. The responses were generally similar for probable and proven infections. No breakthrough infections were seen. All surviving patients, upon discharge from the hospital, received oral treatment with voriconazole. For all the cured pts, there was a concomitant recovery of neutrophils and this seems crucial for the resolution of the infection. Among the 50 responsive patients, 25 died later: 23 for hematologic disease and 2 for sepsis during recurrence of the malignant disease. In 2 pts there was the recurrence of the fungal infection. Conclusions: The resolution rate of the infections is very high; Caspo seems safe, it does not preclude any other treatment, it is well tolerated and the cost is lower than other antifungal treatments. No significant financial relationships to disclose.
Corrleation of health-related quality of life (HRQL) of cancer patients and the mental component parameters of their family members
Authors: Vrettos I. , Papadopoulos A. , Kamposioras K. , Charitos D. , Giannopoulos G. , Pectasides D. , Niakas D. , Economopoulos T. 
Published: August 2020

e20619 Background: It is widely experienced that health-related quality of life (HRQL) is greatly influenced in the family members of cancer patients. The aim of this study was to find the correlation of the HRQL parameters in cancer patients with the main mental component parameters of patients’ relatives. Methods: 122 cancer patients undergoing chemotherapy in our department (49 men and 73 women) of mean age 56.6 ±15.4 1SD and their 122 relatives that accompanied them (45 men and 77 women) of mean age 48.3 ±14.5 completed the validated SF-36 health survey by personal interview. The SF-36 health survey summarizes the functional health status and general health into eight scales with higher scores (0–100 range) reflecting better-perceived health. In this study, physical functioning (PF), role physical (RP), bodily pain (BP), general health perception (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH) of the patients were correlated with the SF, RE, MH of their family members using the Spearman's test. Data analysis was performed with SPSS version 13.0 and correlations were considered statistically significant when p<0.05. Results: Table 1 summarizes the results of our study. Social Functioning and Mental Health of family members are highly correlated with the HRQL parameters of cancer patients. The RE does not seem to be affected. Conclusions: HRQL of cancer patients undergoing chemotherapy is highly correlated with the SF and the MH of their relatives. This observation highlights the need to develop more oriented supportive programs for both the patients and their family memebers. Abbreviations: PF = Physical Functioning, RP = Role Physical, BP = Bodily Pain, GH = General Health, VT = Vitality, SF = Social Functioning, RE = Role Emotional, MH = Mental Health; NS=Not Significant. * = 0.05. ** = 0.01. [Table: see text] No significant financial relationships to disclose.
Chemotherapy in very elderly cancer patients (85 years and over): A retrospective study
Authors: Bascioni R. , Giorgi F. , Safi M. , Giustini L. , De Signoribus G. , Silva R. 
Published: August 2020

e20632 Background: Elderly cancer patients (pts) population is expanding due to demographic changes. Currently 2.4 % of Italian population is older than 85, with this group accounting ∼8 % of all cancer pts in our geographic area. Since very elderly (85 years and over) cancer pts are generally excluded from clinical trials, few data are available about tolerability of chemotherapy in this population. Methods: We conducted a retrospective analysis of cancer pts aged 85 years and over receiving chemotherapy for advanced disease in the years 2005–2007 in three Oncology Unit of the Regione Marche, Italy. Results: We identified 50 patients (26 males, 24 females) with a mean age of 86.4 (range 85–95), ECOG PS 0 (4 pts) 1 (25 pts) 2 (13 pts) 3 (8 pts). Type of cancer (pts): NSCLC (13), colorectal (11), breast (5), prostate (4), gastric (3), NHL (3), bladder (2), head-neck (2), ovarian (2), vulvar (1), skin (1), pancreas (1), GIST (1), UPT (1). Main co-morbidities included hypertension (18 pts), COPD (8 pts) and heart disease (6 pts). The median number of cycles in first line chemotherapy were 6 (1–44); 20 pts received 2 or more lines of chemotherapy (range 2–5). Dose reductions were planned in all pts: in 26 dose reduction was 30 %, in 22 was 50%, in 2 > 50 %. Most used drugs were: vinorelbine os or iv (14 pts), capecitabine (9 pts), gemcitabine (7 pts). Target agents were used in 7 pts (5 erlotinib, 2 gefitinib, 2 rituximab, 1 sunitinib). Ten partial responses were observed; main toxicities were: grade 3–4 neutropenia (10 %), grade 3 diarrhea (5 %), and 1 pts had grade 3 hand-foot syndrome. No treatment related deaths were observed. Conclusions: Very elderly cancer pts (85 years and over) in good PS and few co-morbid conditions receiving dose reduced chemotherapy experienced acceptable toxic effects; a partial response was documented in 10 out of 50 pts. The expanding use of chemotherapy and target therapy in this clinical setting has profound influence on health care management and costs. Prospective studies specifically designed for this pts population could clarify the benefit, in terms of quality of life and survival, of an interventionist instead of a supportive care only approach. No significant financial relationships to disclose.
Factors affecting type of surgical treatment in patients with breast cancer
Authors: Garip M. , Gumus M. , Dane F. , Seker M. , Bilici A. , Ustaalioglu B. O. , Salman T. , Sönmez B. , Salepci T. , Yaylaci M. 
Published: August 2020

e20633 Background: Many prospective randomized studies have shown that modified radical mastectomy (MRM) and breast conserving surgery (BCS) are equivalent in terms of overall survival. Patients’ social and cultural features and clinicopathological characteristics of the tumors generally influence the decision of selecting surgical type. Here, we aimed to evaluate the variables that affect the type of surgical resection in our patients’ population. Methods: One hundred patients undergone breast surgery with the diagnosis of breast cancer from December 2007 to March 2008 were included in the study. After detailed history taking and physical examination, all patients were given questionnaire evaluating sociodemographical data and parameters influencing their decision in choosing type of breast surgery. Results: Overall, 100 patients (80 MRM, 20 BCS) were evaluated in this study. Age was statistically significant predictive indicator in choosing BCS (p: 0.025). Nulliparous women were more likely to select BCS than multiparous (p:0,004). Patients who have the experience of breastfeeding less likely preferred BCS (p: 0.007). Having taken second opinion from a different breast surgeon about type of surgery during evaluation made patients select more BCS (p: 0.023). Although not statistically significant patients who had family history of breast cancer had selected MRM more than BCS (p: 0.088). Marital status, life assurance, age at first birth, and education status were not associated with the decision of selecting type of surgery. Conclusions: We concluded that cosmetic concern and risk of relapse affect the decision of surgical type in breast cancer patients. Broader efforts should be made to inform our patients about the results of BCS. No significant financial relationships to disclose.
A systematic review of the impact of comorbidity on chemotherapy utilization and outcomes in solid tumors
Authors: Lee L. M. , Cheung W. Y. , Krzyzanowska M. K. 
Published: August 2020

e20646 Background: The management of cancer patients (pts) with comorbidities can be challenging as these individuals are underrepresented in oncology clinical trials. We conducted a systematic literature review to determine the impact of comorbidity on utilization, tolerability, and efficacy of chemotherapy among pts with solid tumors. Methods: Using MEDLINE and EMBASE databases, all English-language articles published from 1990–2008 that explored the association between comorbidity and chemotherapy were identified. MeSH and keyword search terms included “comorbidity,” “chemotherapy” and “cancer.” All abstracts were manually reviewed for eligibility based on inclusion and exclusion criteria. Two reviewers independently abstracted data on the design and results of each eligible study, and rated the quality of the article using the STROBE checklist. Results: Of 1,031 citations retrieved by the search, 29 articles met inclusion criteria. Study designs were too heterogeneous to permit a quantitative summary and the overall quality of articles was poor. Comorbidity was investigated most frequently among pts with lung (41%), breast (17%), or colon cancers (17%). Most studies were retrospective (72%), based on cancer registry data (48%), and assessed the effect of cumulative comorbidity based on an index score (76%). Fourteen studies (41%) investigated access and 26 (90%) addressed survival. For pts with comorbidities, the majority reported decreased access (50%) and inferior survival (65%). Of the 12 articles that included both parameters, 6 showed that comorbidity was independently associated with worse survival while 4 demonstrated that impaired access to treatment, not comorbidity, was the stronger predictor of inferior outcomes. Few studies addressed toxicity (24%), ability to complete chemotherapy (7%) or response rates (7%). Among them, no differences based on comorbidity were noted. Conclusions: The evidence regarding the impact of comorbidity on chemotherapy utilization and outcomes among cancer pts is limited and of poor quality. Further better-designed studies are warranted to determine the relationship between decreased access and inferior outcomes and to better define the tolerability and efficacy of chemotherapy in pts with comorbidities. No significant financial relationships to disclose.
Effect of the response to first-line chemotherapy (chemo) in the chemotherapy-induced anemia control with the administration of Erithropoyetins (Epos) in metastatic non-small cell lung cancer (NSCLC) patients (pt)
Authors: Gasent Blesa J. , Giner Marco V. , Alberola Candel V. , Juan O. , Giner-Bosch V. , López A. , Provencio Pulla M. , Grande Pulido E. 
Published: August 2020

e20647 Background: The aim of this retrospective study, is to measure the influence of the tumor control with chemo on the results of the chemo-induced anemia treatment with epos in pts with nsclc, that were non-anemic before chemo, and in whom the only recorded cause of anemia was chemotherapy treatment. cycle. Methods: We analyzed 57 stage IV nsclc pt (21 Squamous, 26 Adenocarcioma, 4 Lare cell, 6 non specified), 41 male, 16 female, 30 with tumor progression (progression) and 27 with partial response (responders). Average age was 60.3 years (CI 95%: 57.2; 63.4). Pt were treated between April 2004 and May 2008. Any patient with disease stabilization was included. 52 pt were treated with platin-gemcitabine, and 5 with cisplatin-paclitaxel. 17 pt received Erithropoyetin-α and 40 darbepoetin. Pt who received radiotherapy as part of their treatment, were excluded of the analysis. Pt began treatment of epos when hemoglobin (hgb) was <12gr/dl. Epos treatment was discontinued if the hgb level increased over 13gr/dl. No patient received epos with the first chemo cycle. Results: Pt with progression began the epos significantly before ( 100% before 4th chemo, 50% in the 2nd cycle) than responders ( 100% before 5th cycle, 7,4% at 2nd cycle) (p<0.001). Pt with progression, had a lower value of hgb at the beginning of the epos (median 9.82 in responders; 8.89 in progression; p=0.009). Recovery of the anemia was observed in 25.9% of the responders front to 3.3% of the pt with progression (p=0.014). No significant differences appeared in the requirements for red-cells transfusion (14.8% responders vs 30% progression; p=0.172). The mean hgb increase by each chemo cycle with epos was of 0.74gr/dl in responders and of 0.25gr/dl in pt with progression (p<0.001 CI 95%: 0.232–0.748 for the odds ratio). The mean absolute hgb increase in responders was singnificanly greater than in pt with progression (1.49 gr/dl vs 0.7 gr/dl p=0.008CI 95% 0.21–1.368 for the difference of the means). Conclusions: From the obtained data, we can conclude that the tumor response can have a direct impact on the efficacy of chemo-induced anemia treatment with epos; and that anemia control may reflect beneath disease control. No significant financial relationships to disclose.
Doctor, how long?
Authors: Fêde A. B. , da Costa Miranda V. , Martins F. D. , Magalhães N. P. , Schaffhausser H. L. , Riechelmann R. P. , Del Giglio A. 
Published: August 2020

e20653 Background: In practice it is common to start terminal sedation for patients with advanced cancer who develop physical discomfort not amenable to be treated by other means. We aimed at quantifying the average survival time of terminal cancer patients once sedation was started until death and identify potential variables that may influence their survival time on sedation. Methods: This is a retrospective cohort analysis of all consecutive terminal cancer patients who died after starting terminal sedation at public tertiary brazilian Hospital during 2 years (January 2005 to January 2007). Results: 532 cancer patients died in Hospital Estadual Mário Covas during this period and 181 out of them who received terminal sedation were included in this analysis. The median survival was 27 hours. By multivariate analysis, increase in the dose of sedative drug during sedation (Odds Ratio 1.576, 95% CI 1.113–2.232); use of opioids alone for sedation (Odds Ratio 1.438, 95% CI 1.046–1.977); and dyspnea as cause of sedation (Odds Ratio 1.564 95% CI 1.045–2.341) were independent risk factors for a shorter survival time after starting terminal sedation. Conclusions: Sedated, terminal cancer patients usually live about one day. We identified risk factors for a shorter sedation period. This study is limited by its retrospective design and by the frequent use of opioids as the main sedative medications. Prospective studies must be carried out in order to validate these data in settings in which non-opiods are the main sedative medications. No significant financial relationships to disclose.