bluuebunny/crossref_metadata_2025_split huggingface dataset:
Daily irinotecan and concomitant radiotherapy for locally advanced pancreatic cancer: Feasibility and MTD
Authors: Carrie C. , De La Fouchardière C. , Perol D. , Negrier S. , Desseigne F. , Meeus P. , Labrosse H. , Martel Lafay I. 
Published: March 2020

15124 Background: To determine the maximal tolerated dose (MTD) of daily irinotecan with radiotherapy (RT) in patients (pts) with locally advanced adenocarcinoma of the pancreas. Methods: Between 09/2000 and 05/2006, 30 pts with histologically proved adenocarcinoma of pancreas were included in this prospective phase I/II study. Irinotecan was administrated daily, 1 hour before RT session. Doses were escalated by increment of 2 mg/m2 every 3 patients for an initial dose of 6 mg/m2/day. RT was delivered at 2 Gy per session, 5 fractions per week to a total dose of 50 Gy to the doses tumor volume. Primary endpoint was toxicity; secondary endpoints were tumor objective response (OR) defined as complete or partial response, secondary operability and overall survival (OS). Inoperability was assessed by surgeon. All images were reviewed by a radiologist. OR rates were compared using the Fisher’s exact test. Results: 30 pts were entered over 6 years through 7 dose levels from 6 mg/m2/day. Sex ratio was 1:1, median age was 58 years (range 33–71), Karnofsky score was ≥ 90 in 93%. Current median follow-up is 45 months. No dose limiting toxicity was yet observed (last level 18 mg/m2/day). Three patients experienced grade 3 toxicity at level 1 (ulcer perforation), level 6 (nausea, vomiting and abdominal pain), and level 7 (nausea, vomiting and hypokaliemia), respectively. OR rates were 33% at 4 weeks. 3/13 pts (23%) included within the 3 first levels (= 10 mg/m2/day) experienced an OR at 4 weeks, versus 7/17 (41%) in the levels > 10 mg/m2/day (P = 0.44). 3 pts underwent surgery because of control tumor. Median OS was 13 months (95% CI 11–14) with 24 patient’s death. One patient is in complete remission since 21 months. Conclusions: Maximal tolerated dose is not yet reached. Despite response rate is not the main aim of the study, results suggest that RT combined with a higher daily level of irinotecan could be associated with a better tumor control. No significant financial relationships to disclose.
A retrospective study of surgical treatment for gastric cancer in our institute as a clinical hospital in Japan
Authors: Kishimoto T. , Imamura H. , Yamamoto K. , Miyazaki Y. , Furukawa H. 
Published: March 2020

15125 Background: Two European randomized controlled trials comparing D1 and D2 gastrectomy revealed a high operative mortality in the D2 group. Based on these reports, D1 gastrectomy is a standard treatment for western patients. In contrast, D2 gastrectomy is considered a standard and safe procedure in Japan. Moreover, the operative morbidity/mortality and the incidence of the major surgical complications were not different between D2and extended para-aortic lymphadenectomy in a prospective randomized controlled trial in Japan. We report a retrospective study of surgical treatment for gastric cancer in our institute as a clinical hospital in Japan. Methods: Patients who underwent gastrectomy between January 1998 and November 2006 in our institute were analyzed. Survival according to the staging by Japanese Classification of Gastric Cancer, the level of the dissection of lymph nodes, and all complications were studied. Results: A total 1342 patients underwent gastrectomy between January 1998 and November 2006 in our institute. The male/female ratio was 2.2 and the mean age was 64.7±11.4 years(range,27–94 years). The 5-year survival according to the staging by Japanese Classification of Gastric Cancer was 98.4%, 84.7%, 77.2%, 46.1%, 40.2% and 33.4% in the stage IA, IB, II, IIIA, IIIB, and IV, respectively. D0, D1, D2, and D3 or D4 gastrectomy was performed in 48, 200, 610, and 27 patients, respectively. Complications were identified in 295 patients(22%) involving 2 patients with treatment death(0.01%) and anastomotic leak, surgical site infection, pancreatic fistula, ileus, anastomotic stenosis, abdominal abcess, liver dysfunction, postoperative bleeding, pneumonia , DIC , peritonitis, and others were identified in 66, 51, 42, 28, 26, 23, 21, 14, 13, 4, 3, and 4 patients, respectively. We analyzed the D0/D1 and D2/D3/D4 dissection subgroups about complications. There was no significant difference in the incidence of complications between the two groups (p=0.093). Conclusions: Our data suggested that gastrectomy with D2 dissection has been a safe treatment with a good prognosis in our institute. D2 gastrectomy is considered a safe treatmemt without increasing surgical complications. No significant financial relationships to disclose.
Phase II trial of oxaliplatin, 5-FU, and leucovorin chemotherapy for the previously treated patients with advanced gastric cancer
Authors: Oh S. C. , Kim Y. , Kim J. , Choi I. , Sung H. , Seo H. , Shin S. 
Published: March 2020

15138 Background: The effect of chemotherapy for advanced gastric cancer was disappointing. Most of patients have progressed after treatment of first line chemotherapy. So, many trials searching for effective combination chemotherapy to these patients are warranted. We conducted this study to ascertain the efficacy and toxicity of oxaliplatin, 5FU, and leucovorin combination chemotherapy for the previously treated patients with advanced gastric cancer. Methods: In all, 48 patients received course of oxaliplatin 100mg/m2 intravenously (i.v) for 2hour and leucovorin at 100mg/m2 intravenously (i.v) for 2hour on day 1, then 5FU 2.4 g/m2 i.v for 46 hour continuous infusion on day 1 and 2. This regimen was repeated every 2 weeks. Results: A total 220 courses were administered as second line (64.6%) and third line (29.2%), and median number of courses per patient was four. No complete response was reported and 7 partial responses (14.6%) were achieved, giving an overall disease stabilizing rate of 52.2% (95% Confidence interval, 37.85 % to 66.6%). The major toxicity was neutropenia, which reached grade 3/4 in 8 patients (16.7%). Median time to progression was 3 months (0.6 to 8 months), median survival duration was 8 months (0.5+ to 14.5 months), and median response duration was 3 months (1.6–4.3 months). Conclusions: We conclude that oxaliplatin, 5-FU, leucovorin combination chemotherapy for the treatment of previously treated advanced gastric cancer has a role for disease stabilizing and toxicity was tolerable to most of patients. No significant financial relationships to disclose.
Weekly paclitaxel, cisplatin, and 24-hour infusion of high-dose 5-fluorouracil plus leucovorin (weekly TP-HDFL) in patients with metastatic or recurrent esophageal cancer
Authors: Huang T. , Tsai Y. , Lin C. , Cheng A. , Yeh K. , Hsu C. 
Published: March 2020

15165 Background: Paclitaxel (T), cisplatin (P), and 5-fluorouracil (5-FU) are active chemotherapy drugs for esophageal cancer. The 3-drug combination using a conventional 3-weekly schedule was active in patients with advanced esophageal cancer with response rate of 46% (Ilson DH et al: J Clin Oncol 1998;16:1826). The toxicity was substantial, with 57% grade 3/4 hematologic toxicities and 18% grade 3/4 peripheral neuropathy. We reported a multifractionated schedule using twice-weekly TP and weekly 5-FU (Lin CC et al: Anticancer Drugs 2007;18: in press). The multifractionated schedule, while induced comparable antitumor activity, had similar hematologic toxicities, less neuropathy, but more diarrhea than conventional 3-weekly schedule. The optimal way of combining T, P, and 5-FU remains to be defined. Methods: Patients with metastatic or recurrent esophageal cancer treated with weekly T, P, high-dose 5-FU plus leucovorin (weekly TP- HDFL) were retrospectively analyzed. The regimen consisted of T 70–80 mg/m2 IV 1h D1, P 35 mg/m2 IV 3h D2, 5-FU 2000 mg/m2 plus leucovorin 300 mg/m2 IV 24h D2, for 2 or 3 weeks followed by 1 week off. Results: Between Dec 2004 and Sep 2006, a total of 15 patients (male 14, squamous cell carcinoma 12) with a median age of 54 (range 37–76) were included. Eleven patients had de novo metastatic disease and 4 had recurrent disease. The disease extent included local esophageal tumor, lymph nodes, lung, liver, and bone in 13, 13, 5, 4, and 5 patients, respectively. The patients received an average of 3 cycles (range 1–5). Grade 3/4 neutropenia, leukopenia, thrombocytopenia, and infection occurred in 4, 3, 1, and 5 patients, respectively. No grade 3/4 vomiting, mucositis, diarrhea, and peripheral neuropathy occurred. The overall response rate was 33% (95% CI 12–87) (PR 5, SD 6, PD 4). With a median follow-up of 5 months, the median progression-free and overall survival were 3 (range 2–7) and 12.5 months (range 3+-12.5), respectively. Conclusions: Weekly TP-HDFL has a comparable activity and a better toxicity profile in patients with advanced esophageal cancer compared to previously reported 3-weekly or multifractionated schedule. (The study was supported by the grant of DOH95-TD-B-111- 001) No significant financial relationships to disclose.
Combination of gemcite and cisplatin chemotherapy in unresectables gall bladder cancer
Authors: Gupta P. , Chitalkar P. , Sen A. , Sarkar S. , Mukhopadhyay S. , Sultania N. , Mukhopadhyay A. 
Published: March 2020

15166 Background: Adenocarcinoma of the gall bladder accounts for approximately 4% of all malignant neoplasm of the gastro- intestinal tract. Though surgical resection is the treatment of choice, majority of the cases are unresectable. Different chemotherapeutic agents including 5Flurouracil, Mytomycin C, Cisplatin, Methotrexate, Etoposide and Doxorubicin have been tried single or in combination. Partial response lasting from weeks to several months have been observed only in about 10% - 20 % of the cases and the median survival for patients with gall bladder cancer is approximately 4 months. Gemcitabine has shown strong anti tumour activity in a variety of solid tumours. Cisplatin has synergistic activity with Gemcitabine. The aim of our study was to determine the response rate of Gemcitabine and Cisplatin combination in unresectable gall bladder cancer and to see the tolerability in Indian-Asian pollution. Methods: During period from November 2002 to December 2006 we selected 84 consecutive patients with histologicaly proven unresectable measurable, gall bladder cancer. The inclusion criteria were performance status more than 60% (Kornofsky) and normal liver (bilirubin < 2) and kidney function ( creatinine <2) function . All patient received Gemcitabine (1000mg/m2 intravenously over 30 minute) on day 1 and day 8 and Cisplatin total (100mg/m2 divided D1 to D3) every 21days. Response assessment was done by CT Scan after 3 cycles of chemotherapy. All 84 patients are eligible for efficacy and toxicity analysis. Results: There were 15 (17.8%) complete responders, 27 (32%) partial responders, 22 (26.1%) with stable disease and 20 (23.8%) shows disease progression. The median time to progression was 22 weeks (range 12- 30 weeks). The median duration of response was 16 weeks (range 5.6 - 60 weeks). The median over all survival was 24 weeks (range 11–32 weeks) with 1year survival rate of 20.2%. WHO grade III or IV anaemia was seen in 23 (18.63%) patients respectively. Sixteen (13.44%) patients experienced grade III or IV neutropenia while grade III or IV thompocytopenia was seen in 8 patients (6.72%). Conclusions: The present study showed the Gemcitabin & Cisplatine combination was very useful in advanced unresectable gall bladder cancer. It was well tolerated by the patients. No significant financial relationships to disclose.
Deep electro-hyperthermia (EHY) with or without thermo-active agents in patients with advanced hepatic cell carcinoma: Phase II study
Authors: Ferrari V. D. , De Ponti S. , Valcamonico F. , Amoroso V. , Grisanti S. , Rangoni G. , Marpicati P. , Vassalli L. , Simoncini E. , Marini G. 
Published: March 2020

15168 Background: Advanced HCC has no standard chemotherapy , all pts would be valuabled in clinical trials. We evaluated effectiveness and toxicity of capacitatively coupled low-frequency 13.56 MHz deep hyperthermia (Oncotherm-EHY 2000) treatment on chemo- refractory malignant primary liver cancer which underwent all other possible treatment. Methods: From February 2005 to July 2006, we enrolled 22 pts with advanced HCC. ECOG PS was 1 or O. Viral hepatic infection status was 7 HBV+, 8 HCV+, 1 HCV/HBV+. Median age was 67,5 y (range 63 -78), male/female 20/2 . 15 pts were uneligible for liver surgery, 3 pts received TACE, 1 PEI, 1 a lot of therapy. 7 pts were pre-treated with surgery, 2 also received TACE, 1 PEI and 1 a lot of therapy. 75% of pts were in stage C of BCLC classification. 2 pts had also distant metastases, 70% of pts had portal vein thromboses. 8 pts underwent only to EHY without CT. Schedule : EHY was achieved by arrangements of capacitative electrodes with a radiofrequency field of 13.56 Mhz (RF-DHT) at 80- 130 W equivalent to 41 °- 47° C for 60 minutes, 2 times/w for 5 weeks in combination with thermo-active agents . EHY was applied over 2 time a week over 1 hour as mono - combined therapy . Concomitant chemotherapy was oxaliplatin 50 mgr at fixed dose on D 1and D 15 . One cycle is 10 treatments of EHY ; 4 pts underwent 2 cycles and 2 pts to 3 cycles and 1 pt to 4 cycles . Median number of cycles was 1,5 (range 1–4), total EHY applications were 365. Results: EHY plus thermo-active drug is beneficial on clinical conditions off treated pts with an excellent compliance on out- patients. We observed 1 CR ( pt has only one bone metastases after 6 months without liver relapse), no PR, 25% of SD. Median survival time was 20’5 weeks (5 - 81+) We noted that 11 pts (50%) presented evidence of increasing well-being. Toxicity : 4 pts had skin reaction after application of EHY. In 3 pts we observed cutaneous hyperemia on the area of treatment and mild burn on the skin ; all symptoms disappeared after local steroid therapy , treatment was interrupted until resolution . Conclusions: Low toxicity and clinical benefit will be confirmed in further clinical studies. Capacitively coupled low-frequency 13.56 deep-hyperthermia is feasible for chemo-refractory HCC. No significant financial relationships to disclose.
Clinical benefit of liver hanging maneuver for right-side major hepatectomy
Authors: Hayashi H. , Beppu T. , Nasu J. , Masuda T. , Mizumoto T. , Ishiko T. , Takamori H. , Kanemitsu K. , Hirota M. , Baba H. 
Published: March 2020

15171 Background: Liver hanging maneuver is a new technique in anterior approach of major hepatectomy. However, the impact of the maneuver has never been fully investigated in patients with liver tumors. To evaluate the surgical benefits of liver hanging maneuver, we set up a comparative study in right-side major hepatectomy. Methods: From 2000 to 2006, 326 hepatectomy were performed in our institution. Fifty-eight patients with liver tumor (hepatocellularcarcinoma in 36, metastatic liver tumor in 13, and the others in 9) considered for right-side major hepatectomy were prospectively analyzed. Right-side hepatectomy included 26 right hepatectomy, 24 extended right hepatectomy, and 8 tri-segmentectomy. The patients were devided into a group with conventional approach (n = 21), a group with anterior approach without hanging maneuver (n = 19), and a group with approach with liver hanging maneuver (n = 18). In the three groups, age, body mass index, child-pugh classification, type of liver tumor, staging in hepatocellularcarcinoma, tumor size, resected liver weights, intraoperative blood loss, frequency of transfusion and surgical time were analyzed. Results: In conventional approach, anterior approach without hanging maneuver, and approach with liver hanging maneuver, mean age was 55, 59, and 65 years, and mean tumor size was 65, 75, and 108mm, respectively. Patients with liver hanging maneuver were significantly elder (p<0.05) and have larger tumor size (p<0.01). There were no significant differences in body mass index, child-pugh classification, type of liver tumor, staging in hepatocellularcarcinoma, and resected liver weights. Mean intraoperative blood loss was 1771, 805, and 704g, and mean surgical time was 562, 483, and 435minutes, and the frequency of red blood cell transfusion was 33, 21, and 17%, respectively. Patients with liver hanging maneuver had significantly less intraoperative blood loss (P=0.0001) and surgical time (P=0.002). The frequency of red blood cell transfusion in the liver hanging maneuver group was significantly lower than that of the conventional group (p<0.05). Postoperative morbidity rate were 33.3, 15.8, and 16.7%, respectively. Conclusions: Liver hanging maneuver is less invasive and a quite useful method for right-side major hepatectomy. No significant financial relationships to disclose.
GEMOX as first-line chemotherapy in advanced pancreatic cancer (APC): A monoinstitutional experience
Authors: Di Marco M. , Nobili E. , Di Cicilia R. , Brandi G. , Bertolini S. , Derenzini E. , Dell’Arte S. , Casadei R. , Calculli L. , Biasco G. 
Published: March 2020

15179 Background: To date, gemcitabine (GEM) remains the cornerstone of chemotherapy (CHT) for APC. According to GERCOR and GISCAD phase III trials the combination of GEM and oxaliplatin (GEMOX) has proven superior to GEM alone in terms of response rate (RR), time to progression (TTP) and clinical benefit rate (CBR). Methods: We conducted a retrospective analysis on 19 patients (pts) affected with histologically-confirmed APC, in order to determine the impact of GEMOX as first-line chemotherapy in terms of objective responses (OR) and TTP, using the Kaplan-Meier method. Among the 19 pts considered there were 15 males and 4 females (median age at diagnosis of 60.84 yrs; ECOG 0–2). The staging, according to AJCC criteria, was: IIB in 1 case, III in 5 cases and IV in the 13 remaning cases. The only metastatic site was the liver (in 13/19 pts). Ten of the 19 pts underwent surgical treatment prior to CHT: 2 radically resected (R0) subsequently treated with GEMOX after recurrence, 4 with positive margins (R1) and 4 surgically palliated. All pts received GEM 1000 mg/m2/d1 + oxaliplatin 100 mg/m2/d2 every 2 weeks. The median number of cycles was 5.89. Results: Among the 19 pts, 3 had a partial response (PR, 15.69%), 6 had stable disease (SD, 31.57%); no complete response was observed and 10 pts had progressive disease (PD, 52.63%). The overall disease control rate (DCR: PR + SD) was 47.37% while the OR were 15.69%. The median survival observed was 9.03 months (95% C.I. 5.15–12.91) and the median TTP was 6.13 months (95% C.I. 2.81–9.46). The main toxicities were: leucopenia, piastrinopenia, diarrhoea, nausea, fever and peripheral neuropathy; 3 pts discontinued the treatment due to grade 3–4 neurotoxicity. Conclusions: In our experience GEMOX gives an improved control of APC in terms of OR and TTP, with acceptable toxicity. The OS is in accordance to literature as well as the other data. No significant financial relationships to disclose.
Efficacy of oxaliplatin, 5 FU and gemcitabine in advanced pancreato-biliary cancer
Authors: Aggarwal S. , Negi A. , Banerjee N. , Buxi T. , Kumar M. , Singhal M. , Tageja N. , Nundy S. 
Published: March 2020

15182 Background: The treatment of advanced pancreato-biliary cancer remains an unmet need. The drugs known to be effective are oxaliplatin, gemcitabine. Method: The records of twenty patients suffering with cancers of advanced gall bladder (10), common bile duct (3), ampulle of vater (3) and pancreas (4) were analysed. Twenty patients were treated in the year 2006. Median age was 52 years. The common sites of metastatis were liver (12), lymphnodes (10), peritoneum (4), lungs (1). The patients with normal bilirubin & LFT (< 3 times upper limit of normal) were included. The chemotherapy protocol was given as: oxaliplatin 50 mg, leucovorin 30 mg, and 5FU 500 mg/m2 on day 1, 2, & 3. Gemcitabine was given 800 mg/m2 on day 2, 9, and 16. The cycle was repeated every 4 weeks. Response: The regimen was well tolerated. Pancytopenia requiring G-CSF, delays in drug administration occurred in 70% cases. The response was as follows-partial response 6/20 (30%), stable disease 5/20 (25%), progressive disease 9/20 (45%). The median survival was 5.5 months, four patients completed six cycles of chemotherapy and survival for at least 12 months. Conclusion: Oxaliplatin, 5 FU, gemcitabine and leucovorin is an effective chemo-protocol in advanced pancreato-biliary cancer. However, there is a need to improve upon the existing results. No significant financial relationships to disclose.
Physician initiated cancer screening discussions and patient intention to engage in screening behavior
Authors: Gray S. W. , Wong N. , Kelly B. , Romantan A. , Ramirez S. , Fraze T. , Smith-McLallen A. , Armstrong K. , Schwartz J. , Hornik R. 
Published: March 2020

1528 Background: Cancer screening for colon, breast, and prostate cancer remains underutilized. Physician (MD)-patient discussions of screening are common but the impact of these discussions is unknown. Methods: 2489 40–70 year old subjects completed a national survey of cancer prevention information acquisition and decision making (median age 53, 49% male, 77% white, 59% married, 61% some college). Subjects reported whether their MD initiated discussions (MDID) about colonoscopy, mammography, & PSA within the past year. Age eligible subjects were “non-routine screeners” (NRS: never screened or colonoscopy >10 yrs, mammography >2 yrs or PSA>2 yrs prior) or “routine screeners” (RS).The endpoint was intention to screen when next eligible. Results: 46%, 75% and 60% of subjects reported intentions to obtain colonoscopy, mammography and/or PSA. Logistic regression was used to determine the association between MDID and intentions to screen controlling for sociodemographics and recency of screening. For colonoscopy and mammography, MDID was significantly associated with intention to screen for NRS but not RS groups; the opposite was true for PSA. For the NRS group: comparing those saying no versus yes to MDID, intentions were 15% vs. 43% for colonoscopy, 29% to 61% for mammography (RS: 85% vs. 91% and 82% vs. 85%). For PSA, NRS: 46% vs.52% but RS group 65% vs. 85%. All interactions (screening by MDID) were significant, p<.001. Conclusions: Given high intentions to undergo colon and breast cancer screening among patients who have been screened routinely, physician discussion preferentially increases intentions for colon and breast cancer screening among patients who are not routinely undergoing the screening test. Conversely, physician discussion preferentially influences prostate cancer screening intentions among patients who have been screened in the past two years- perhaps because men who have not undergone screening are more resolved in their decision not to screen. These results define subgroups of patients where physician attention may have the greatest impact on screening adherence. No significant financial relationships to disclose.