bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multicenter phase II study evaluating docetaxel (D) and cisplatin (C) as an induction regimen prior to surgery or radiochemotherapy (RCT) with D, followed by adjuvant D in chemonaive patients with NSCLC: TAX-AT1–203
Authors: Greil R. , Pfeifer W. , Vetter N. , Eckmayr J. , Burghuber O. , Hilbe W. , Schmid T. , Gastl G. , Mohn-Stauder A. 
Published: March 2020

7702 Background: This phase II study evaluated operable and unresectable patients (pts) treated with induction chemotherapy with DC to assess the response rate and conversion to resectability. Furthermore, the feasibility and efficacy of radiosensitizing with D was tested in unresectable pts undergoing RCT. The feasibility of adjuvant D was investigated in all patients. Study Design: Pts with stages II, IIIA and IIIB NSCLC were treated with 3 cycles of 3-wkly neoadjuvant D (75 mg/m2 d 1) and C (40 mg/m2 d1, 2). Within 4 wk after induction, pts were either resected or treated with RCT (2 Gy × 5d for 6 wk) and D 20 mg/m2 wkly × 6 cycles. Within 4–8 wk after definitive RCT or surgery, 3 cycles of adjuvant D 75 mg/m2 q3wk were initiated. Adjuvant RT was allowed in non-R0 resected cases. The primary endpoint was response rate to induction; secondary endpoints included resectability after induction, progression-free survival, overall survival, and safety. Results: 77 pts were included: age 60 yr [46–76 yr], males 78%, stages (II/IIIA/IIIB: 8%/39%/52%), primary resectability n=22 (29%), primary unresectability n=55 (71%). 59 patients were evaluable after induction chemotherapy, of whom 66% achieved a PR, 23% had stable disease, and 10% progressed. The PR rate was 73% in initially resectable and 63% in initially unresectable pts. 67 pts were evaluable for resectability. 28/39 (72%) of PR patients were resectable. As a result of induction therapy, 19 pts (25%) became resectable, 18 (24%) remained resectable, 27 (35%) remained unresectable, and 3 (4%) became unresectable. Treatment had to be stopped in 11 pts during induction. Three pts, primarily unresectable (4%) died of toxicity. 53% of patients had a grade 3 or 4 toxicity. In evaluable pts, the median PFS was 350 [80–1495] days vs 192 [21–989] days for resectable and unresectable pts after induction, respectively, and overall survival was 491 vs 303 days. Conclusions: DC induction chemotherapy resulted in a promising PR rate and rate of secondary resectability. The toxicity is substantial. Results of efficacy and toxicity of radiosensitizing and adjuvant D are pending. No significant financial relationships to disclose.
Percutaneous radiofrequency ablation of lung tumours: Results in first 100 consecutive patients
Authors: Zhu J. C. , Yan T. D. , Ng K. , Glenn D. , Morris D. L. 
Published: March 2020

7714 Background: Treatment modalities for patients with primary and secondary lung malignancies who are not surgical candidates are limited. Radiofrequency ablation is a minimally invasive, lung sparing therapeutic alternative that may provide local disease control for these patients. The study reported our experience with first 100 consecutive patients who underwent radiofrequency ablation of their lung tumours. Methods: From November 2000 to December 2006, the clinical and treatment-related information regarding the 100 consecutive patients (58 males, mean age of 65 years) with 240 lung tumours treated by radiofrequency ablation were collected prospectively. Radiofrequency ablation was performed percutaneously under CT guidance with local anaethesiologic assistance and conscious sedation using a RITA Starbust XL electrode. The patients were hospitalized overnight and followed at one week, one month and then every three months with CT to evaluate treatment outcome and complications. Results: Five patients had primary lung carcinoma while the remaining patients had pulmonary metastases from extra-thoracic malignancies, with colorectal cancer being the most common primary site (68%), followed by renal cell carcinoma (8%) and uterine leiomyosarcoma (5%). The mean number of pulmonary lesions ablated was 2.4 per patient; the mean size of lesion ablated was 2.2 cm in diameter. Fifteen patients had second-time RFA; 4 patients underwent third- or fourth-time RFA for pulmonary recurrence. There was no post-procedural mortality and the overall morbidity rate was 42%. The most common complication was pneumothorax, which occurred in of 31% of procedures (n=39/127) with 20 (16%) requiring chest tube placement. After a median follow-up of 24 months (range 1 to 70 months), 72% of RFA treated lesions did not progress. The overall median disease-free interval was 13 months, with 1-, 3- and 5- year disease-free survival of 55%, 22% and 7% respectively. The overall median survival was 34 months with 1-, 3- and 5-year- survival of 85%, 49% and 33% respectively. Conclusions: Percutaneous radiofrequency ablation is an emerging therapy with promising results when surgical resection of pulmonary malignancy cannot be performed. No significant financial relationships to disclose.
Positron emission tomography using 18-fluorodeoxyglucose in pre- and post-transplantation in lymphoma patients treated with autologous stem cell transplantation: Impact
Authors: Cuenca X. , Mounier N. , Deville G. L. , Brice P. , Larghero J. , Haddad A. , Ertault M. , Filmont J. , Moretti J. , Briere J. , De Kerviler E. , Hennequin C. , Gisselbrecht C. 
Published: March 2020

8060 Background: The pre-transplant evaluation of lymphoma with Positron Emission Tomography (PET) scanning using 18- FluoroDeoxyGlucose may ease a decision making. The impact on patient outcome of post-transplant assessment is unknown. Methods: Between July 04 and December 05, patients (pts) who achieved tumor response and received high-dose chemotherapy plus autologous stem cell transplantation (ASCT) were explored with PET, prior and 100 days after ASCT, without knowledge of conventional imaging nor clinical history. PET results (negative or positive) were related to event-free survival (EFS) and overall survival (OS). Results: 60 pts were included. 50 had Non-Hodgkin Lymphoma (26 aggressive) and 10 Hodgkins Lymphoma. Median age was 52 [19-68]. 22 pts received front-line ASCT mainly after ACVBP (n=14) or CHOP. Platinum-based salvage chemotherapy was the most used (n=38), and most of the pts received rituximab (n=40). Prior ASCT,by clinical staging, there were 31 complete remission (CR), 23 uncertain CR and 6 partial remission. Conditioning regimen was BEAM in 39 pts; Zevalin BEAM in 11, Total Body Irradiation in 10. 75% were pre-ASCT-PET negative and 80% post-ASCT-PET negative. 6 pts (10%) converted from pre-ASCT-PET positive to post-ASCT-PET negative and 2 pts from negative to post-ASCT-PET positive. Median follow-up was 1.25 years [0.5–2]. 12 pts died (OS 80%) and 19 relapsed (EFS 68%). OS and EFS was better in pre-ASCT-PET-negative pts than in PET-positive (92% vs 53% (p=0.0009), 77% vs 35%, (p=0.0002) respectively). OS was estimated to 90% in post-ASCT-PET-negative pts vs 50% in PET-positive (p<0.0001), EFS was 79% vs 25%, respectively (p<0.0001). In multivariate analysis,including analysis by histology subtypes, the only adverse prognostic factor was PET positive either pre-ASCT (Relative Risk(RR)=4) or post-ASCT (RR=12). Conclusions: A positive PET after induction chemotherapy indicates a high risk of ASCT failure which is increased by a positive PET after ASCT. In pre-ASCT-PET-positive pts, more experimental approaches are required. In pre-ASCT-PET-negative patients, post-ASCT-PET assessment may be omitted. No significant financial relationships to disclose.
Gamma knife radiosurgery for melanoma/renal cell carcinoma brain metastases 1 -10 lesions with optimized margin dose: Improved tumor control and survival
Authors: Fregene A. O. , Mobit P. , Zamorano L. , Diaz F. , Guthikonda M. , Syrian M. , Rakowski J. 
Published: March 2020

8581 Background: Radioresistant brain metastases melanoma/renal cell carcinoma cause significant morbidity and mortality: response to whole brain external beam radiotherapy (WBXRT) is minimal, chemotherapy role is investigative, and surgery has its indications and limitations. Reports of survival with Gamma Knife Radiosurgery (GK) is mixed. Reports indicate that 80 to 90% of tumor failure following GK is in the margin: recent multivariate analyses indicate tumor control dependence on margin dose. This study evaluates the impact of better control of brain lesions and consequent reduction of CNS death on overall survival. Methods: Between 10/2002 and 12/2005, 24 consecutive patients with melanoma and renal cell carcinoma male/female radio 14/10, 20 melanoma and 4 renal cell were treated by WBXRT followed by GK radiosurgery utilizing optimized margin dose. Dose was (16 - 20 Gy) to the 50% line with adequate margin to reduce systematic and other associated errors. This was achieved by combining the separate errors associated with the procedure; extent of tumor infiltration beyond gross tumor margin; GK/procedure mechanical precision limitations; MRI image transfer spatial limitations and beam profile margin dose sensitivity. Karnofsky Performance status was 70 - 90%. Follow-up period was 52 months. Results: The mean survival period for the 24 patients with 1 - 10 lesions was 14.11 months: median survival by Kaplan-Meier was 12.0 months. This result is a significant improvement on the 5.5 months reported earlier from this institution for 1 - 5 lesions treated with non-optimized GK dosage; and data by Lavin, et al, at 8 months for predominantly solitary lesions. Conclusions: Melanoma and renal cell carcinoma brain metastases respond very well to GK radiosurgery with optimized margin dose: mean survival for these patients with 1 -3 and 4 - 10 lesions is 14.11 months and comparable to the survival of patients with brain metastases from lung and breast patients: More studies along this line are called for. Patients with multiple metastatic brain lesions from melanoma and renal cell cancers stand to benefit. No significant financial relationships to disclose.
Increasing risk for venous thromboembolism among hospitalized cancer patients
Authors: Khorana A. A. , Francis C. W. , Culakova E. , Kuderer N. M. , Lyman G. H. 
Published: March 2020

9009 Background: Venous thromboembolism (VTE) contributes to morbidity and mortality in cancer patients and is a frequent complication of anti-cancer therapy. We examined the frequency, risk factors and trends associated with VTE among hospitalized US cancer patients. Methods: We conducted a retrospective cohort study using the discharge database of the University Health System Consortium. This included all 1,824,316 hospitalizations of cancer patients between 1995 and 2003 at 133 United States medical centers. To avoid overestimation, only a single randomly chosen hospitalization was included for patients with multiple admissions. Results: Among 1,015,598 individual cancer patients, 34,357 (3.4%) were diagnosed with deep venous thrombosis and 11,515 with pulmonary embolism (PE) (1.1%) for an overall VTE rate of 4.1%. Subgroups of cancer patients with highest rates included Black ethnicity (5.1% per hospitalization) and those on chemotherapy (4.9%). Sites of cancer with the highest rates of VTE included pancreas (8.2%), kidney (5.7%), ovary (5.6%), lung (5.1%) and stomach (4.9%). Amongst hematologic malignancies, myeloma (5%), non-Hodgkin’s lymphoma (4.8%) and Hodgkin’s disease (4.6%) had the highest rates of VTE. The rate of VTE rose from 3.6% per hospitalization in 1995–96 to 4.6% in 2002–03, an increase of 28%, including a near-doubling of PE rates from 0.8% to 1.5% (P<0.0001). Among patients receiving chemotherapy, rates of VTE rose from 3.9% per hospitalization to 5.7%, an increase of 47% (P<0.0001). In contrast, patients undergoing surgery for breast, head and neck, pancreatic or spinal cancers, experienced no significant change in the rate of VTE. Use of diagnostic procedures for VTE also did not increase over the study period. Conclusions: The rate of VTE, including PE, among hospitalized cancer patients has increased significantly in recent years. Black patients, those on chemotherapy and those with certain types of cancer are disproportionately at increased risk. The rise in VTE does not appear to be attributable to an increased utilization of diagnostic procedures. Further efforts to increase thromboprophylaxis compliance during hospitalization are needed. No significant financial relationships to disclose.
Co-morbidity is a better predictor of 5-fluorouracil pharmacokinetic than chronological age in older adults
Authors: Gusella M. , Stievano L. , Padrini R. , Ferrazzi E. , Bononi A. 
Published: March 2020

9038 Background: Fifty percent of all cancers occur in elderly people and the total cancer burden is expected to rise. Data are needed to ensure the safe administration of chemotherapy in the older patient population. Aging can affect the pharmacokinetics in a number of ways and the selection of chemotherapy in the elderly is frequently and empirically determined by degree of comorbidity and the patients’ functional status. The aim of our study was to determine whether high level of comorbidity, measured using a standardized instrument, can predict 5-fluorouracil (5FU) disposition in older adults. Methods: Geriatric outpatients affected by stage 2 or 3 colorectal cancer and treated with adjuvant MAYO Clinic regimen were the study population. The evaluation was conducted on men aged 70 years old or more, with varying levels of chronic illness. All of them had a good performance status (ECOG score= 0–1). Non neoplastic disease burden was measured using the Cumulative Illness Rating Scale (CIRS) and drug disposition using area under the curve (AUC) of the drug plasma levels during 30 min immediately after 2 minute bolus administration of 5FU 375–425 mg/mq. Results: Forty men were studied, aged between 70 and 80 years old (median = 72); their CIRS scores ranged between 0 and 12 (median=3). Pharmacokinetic analysis confirmed an elevated interpatient variability: 5FU plasma AUC after bolus administration ranged between 241 and 1,140 mg × min/L. There was no correlation between age and comorbidity burden or age and 5FU AUC in that population. On the contrary with increasing comorbidity (increase in CIRS score) there was a proportional increase in 5FU AUC: patients with CIRS score from 0 to 3 (n=22), between 4 and 7 (n=11) and greater than 7 (n=7) had mean AUC of 523.5± 139.6, 637.0±124.0 and 877.4±195.0 mg × min/L respectively (p<0.0001). Conclusions: This study shows that chronological age did nor correlate with CIRS score or 5FU disposition. In older adults with varying degrees of chronic illness, administrated with the same chemotherapy doses, the comorbidity level influenced the magnitude of 5FU exposition, suggesting that the CIRS score could be used to tailor treatment doses. Funded by AIRC-Veneto No significant financial relationships to disclose.
Identifying patient-reported anxiety and depression in older adults with cancer.
Authors: Jayani Reena , Sun Can-Lan , Charles Kemeberly , Soto Perez De Celis Enrique , Chien Leana , Roberts Elsa , Moreno Jeanine , Dale William , Mohile Supriya Gupta , Sedrak Mina S. , Koczywas Marianna , Chung Vincent , Fakih Marwan , Chao Joseph , Cristea Mihaela C. , Pal Sumanta K. , Katheria Vani , Hurria Arti , Li Daneng 
Published: March 2020

11556 Background: Anxiety and depression are associated with decreased quality of life, treatment adherence, and survival in patients with cancer. Mental Health Inventory (MHI-17) is a validated screening tool for psychological well-being, but cut points for older adults with cancer are unknown. The goal of this study is to identify cut points on MHI-17 Anxiety (MHI-A) and Depression (MHI-D) subscales which correlate with patient-reported anxiety and depression in older adults with cancer. Methods: This is a secondary analysis of baseline data from a randomized controlled trial in adults aged 65+ with solid tumors starting chemotherapy. At baseline, patients completed MHI-17. MHI-A and MHI-D were calculated (range 0-100; higher scores represent better mental health). Self-reported anxiety was obtained from single-item Linear Analog Scale Assessment (0-5 = low, 6-10 = high). Self-reported depression was obtained from Yale Depression Screen, “Do you often feel sad or depressed?” The association of MHI-A and MHI-D with the patient-reported outcomes was analyzed using logistic regression. Youden’s index was used to determine the optimal cut points for MHI-A and MHI-D for identifying patients with high anxiety and depression. Results: 458 patients (median age 71 (range 65-91), 57% female, 55% non-Hispanic white) were included in this analysis. The most common cancer types were: GI (31%), breast (19%), GU (18%), and pulmonary (16%); 75% had stage IV cancer. Twenty-four percent (N = 110) reported high anxiety and 21% (N = 97) depression. Median scores for MHI-A and MHI-D were 75 (range 0-100) and 80 (range 0-100). The optimal cut point for high anxiety on MHI-A was 65; this had an accuracy of 76.1%, a sensitivity of 71.8%, and a specificity of 77.5%. The optimal cut point for depression on MHI-D was 70; this had an accuracy of 80.1%, a sensitivity of 80.4%, and a specificity of 79.8%. Conclusions: The current study identified optimal cut points for MHI-Anxiety and MHI-Depression subscales to identify older adults with cancer starting chemotherapy with self-reported anxiety and depression. In the absence of patient-reported anxiety and depression, these cut points could be used to identify older patients with cancer at risk for poor mental health.
Treatment of Patients With Late-Stage Colorectal Cancer: ASCO Resource-Stratified Guideline
Authors: Chiorean E. Gabriela , Nandakumar Govind , Fadelu Temidayo , Temin Sarah , Alarcon-Rozas Ashley Efrain , Bejarano Suyapa , Croitoru Adina-Emilia , Grover Surbhi , Lohar Pritesh V. , Odhiambo Andrew , Park Se Hoon , Garcia Erika Ruiz , Teh Catherine , Rose Azmina , Zaki Bassem , Chamberlin Mary D. 
Published: March 2020

PURPOSETo provide expert guidance to clinicians and policymakers in resource-constrained settings on the management of patients with late-stage colorectal cancer.METHODSASCO convened a multidisciplinary, multinational Expert Panel that reviewed existing guidelines, conducted a modified ADAPTE process, and used a formal consensus process with additional experts for two rounds of formal ratings.RESULTSExisting sets of guidelines from four guideline developers were identified and reviewed; adapted recommendations from five guidelines form the evidence base and provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75% on all recommendations.RECOMMENDATIONSCommon elements of symptom management include addressing clinically acute situations. Diagnosis should involve the primary tumor and, in some cases, endoscopy, and staging should involve digital rectal exam and/or imaging, depending on resources available. Most patients receive treatment with chemotherapy, where chemotherapy is available. If, after a period of chemotherapy, patients become candidates for surgical resection with curative intent of both primary tumor and liver or lung metastatic lesions on the basis of evaluation in multidisciplinary tumor boards, the guidelines recommend patients undergo surgery in centers of expertise if possible. On-treatment surveillance includes a combination of taking medical history, performing physical examinations, blood work, and imaging; specifics, including frequency, depend on resource-based setting. Additional information is available at www.asco.org/resource-stratified-guidelines .
Mary Wroth, Ovid, and the Metamorphosis of Petrarch
Authors: Sokolov Danila 
Published: March 2020

AbstractThe language of arboreal metamorphosis in Lady Mary Wroth’s pastoral song “The Spring Now Come att Last” from Pamphilia to Amphilanthus (1621) may invoke the myth of Apollo and Daphne. However, the Ovidian narrative so central to Petrarchan poetics celebrates the male poet by erasing the female voice. This essay instead explores parallels between Wroth’s poem and the metamorphosis of the Heliades, who turn into poplars while mourning their brother Phaeton in book 2 of the Metamorphoses. Their transformation is predicated on an act of female speech, however precarious and evanescent. This alternative Ovidian scenario offers a model of lyric that capitalizes on the brief resonance that the female voice acquires at the point of vanishing. By deploying it in her song, Wroth not only rewrites Petrarch through Ovid in order to articulate a gendered lyric voice but shows herself a poet attuned to the crucial developments in English lyric of the sixteenth and seventeenth centuries, in particular the complex relationship between the Petrarchan and the Ovidian legacies.
Addressing complex societal challenges in health education – A physiotherapy-led initiative embedding inclusion health in an undergraduate curriculum
Authors: Broderick Julie , Waugh Alice , Mc Govern Mark , Alpine Lucy , Kiernan Sinead , Murphy Niamh , Hodalova Sofia , Feehan Sorcha , Ní Cheallaigh Clíona 
Published: March 2020

People who are socially excluded experience vastly poorer health outcomes compared to the general population. Inclusion Health seeks to directly address this health inequity. Despite the increased requirement for health care and the increased prevalence of complex health and social needs in socially excluded people, Inclusion Health features very little in health education curricula. This letter has been written by a group of clinicians, academics, clinical education specialists and students with a common interest in Inclusion Health. In the absence of established guidance on how best to incorporate the broad topic of inclusion health in undergraduate education, we have developed a two-pronged approach within Physiotherapy. We are writing to highlight the following initiatives; firstly, the provision of a dedicated undergraduate clinical placement devoted to the area of Inclusion Health. Secondly, we have also initiated a step-wise process of introducing the topic of Inclusion Health into the formal undergraduate curriculum. This letter demonstrates the need to implement strategies to incorporate Inclusion Health into the curriculum and the approaches described are applicable to diverse health professions and settings.
<p><strong>New rearing method, life cycle, tunneling behavior and ecological notes on the splendid ghost moth <em>Aenetus djernaesae</em> Simonsen, 2018 from Western Australia (Lepidoptera: Hepialidae)</strong></p>
Authors: KAY PAUL , HUTCHINSON PAUL M , GREHAN JOHN A 
Published: March 2020

This study successfully documents, for the first time, the entire life cycle of Aenetus djernaesae Simonsen, 2018 and confirms the efficacy of using supplemental sources of fungi to feed the early instar larvae. Fresh cut pieces of the commercial mushroom Agaricus bisporus (J.E. Lange) and sections of Eucalyptus L’Her. bark were placed around the base of potted host plants –Myoporum insulare R.Br. (Scrophulariaceae) and the potential host plant Dodonea hackettiana W.Fitz. (Sapindaceae). First instar larvae were added to this matrix where they fed on the mushroom and bark. The life cycle comprised egg development of 20 days, fungal feeding of ~36 days, and host plant development (including pupal) of ~300 days. Adult emergence of reared and field collected samples occurred within a 22 day period. Larvae transferring from fungi to host plants transitioned during the night by constructing a web of silk and plant tissues within two hours and proceeding to excavate a tunnel from within. The mature larval tunnel is relatively short, up to 220 mm in length and usually extending below the entrance around which the larvae grazes on callus tissue forming after bark removal. Most adults emerged within an hour of dusk with the pupa protruding from the top of the vestibule. The rearing method described here demonstrates the feasibility of laboratory based studies of larval development in Aenetus Herrrich-Schäffer and other callus-feeding stem boring Hepialidae. Key words: Hepialidae, Aenetus, life cycle, artificial diet, Myoporum, Dodonea, larval foodplant