bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dysgerminoma of the ovary: Review of 32 cases
Authors: Streltsova O. , Tjulandin S. , Jordaniya K. , Kuznetsov V. , Kedrova A. 
Published: March 2020

16072 Purpose: This study was undertaken to determine the frequency, characteristics, treatment and outcome of patients with dysgerminomas in single institution between 1990 and 2006. Methods: A total of 32 patients with pure dysgerminoma were retrospectively reviewed, among whom 23 patients had primary treatment in NNBRCRC during the period 1990–2006 and referred for follow-up (n=1) or salvage therapy after recurrence (n=9). Results: The median (range) age at presentation was 21 (14–42) years. 17 women (53%) presented with FIGO surgical stage I disease, 2 (6%) had pelvic metastases (stage II), and 9 (28%) had advanced (stage III/IV) disease. 4 patients had no comprehensive surgical staging. 2 women had evidence of dysgenetic gonads with a 46 XY karyotype. Primary surgery was done in all patients. 22 patients (69%) underwent fertility-sparing surgery. 4 (13%) patients received no adjuvant treatment after surgery due to stage Ia. All of them are alive without evidence of disease at a median (range) follow-up of 4,2 (2–6,4) years. Postoperative systemic chemotherapy was administered to 28 (87%) women. 16 of them received adjuvant chemotherapy and 12 received chemotherapy for metastatic disease. Among them 20 received platinum-based chemotherapy. Six patients had disease progression during first-line systemic treatment, all women received non-platinum-based chemotherapy. Three of them were salvage with second-line cisplatinum-based chemotherapy. Two deaths were associated with progressive disease, and one patient died of intercurrent disease. Overall, 29 women (90%) are alive without evidence of disease at a median follow-up of 68 months. Conclusions: Our date confirmed that the majority of patients can be managed with fertility sparing surgery and platinum-based adjuvant treatment without compromising survival. No significant financial relationships to disclose.
Weekly topotecan as a salvage therapy in heavily pre-treated patients with recurrent platinum-resistant epithelial ovarian cancer
Authors: Marinaccio M. , De Marino E. , Mele E. , Catacchio R. , Meo D. , Iezzoni C. , Conversano C. 
Published: March 2020

16076 Background: The prognosis of patients with recurrent epithelial ovarian cancer is extremely poor after several lines of chemotherapy; this situation becomes more and more difficult to manage in the presence of a platinum-resistance condition. Topotecan 1.5mg/m2 on days 1 through 5 of a 21-day cycle is often employed as a second-line chemotherapy also for platinum-resistant epithelial ovarian cancer. In this phase II study we investigated the safety as well response rate of weekly topotecan as a salvage therapy in heavily pretreated patients with recurrent platinum-resistant epithelial ovarian cancer (RprEOC). Methods: To be elegible for the study patients had to be considered resistant to platinum and paclitaxel pretreated. Eleven patients (median age 51 yrs, range 45 - 70) with performance status 0–2 affected by RprEOC with measurable disease, were planned to receive weekly topotecan. They had received at least 3 prior lines of chemotherapy. Topotecan was administered at the dose of 2.0 mg/m2 via a 30-minute i.v. infusion once every week until disease progression or unacceptable toxicity. Results: All patients were evaluable for toxicity and clinical response. All the 11 pts enrolled had stage III-IV disease. Median number of chemotherapy cycles was 5 (range 3 - 8). A total of 62 cycles were administered. Dose reduction was necessary for 12% of the cycles. Main toxicities included anemia (12%), leucopenia (18%), thrombocytopenia (15%) and asthenia (20%). No deaths were attributable to therapy. No one showed complete response, while two partial response (18.2%) and four stable disease (36.4%) were observed. Five pts (45.4%) progressed on therapy. The median progression-free interval was 13 weeks. Conclusion: Salvage therapy for patients with ovarian cancer who failed several platinum and paclitaxel treatments remains a therapeutic challenge. Topotecan administered at low weekly dosage (2.0 mg/m2) is an active option in the subset of heavily RprEOC and it seems also to be a more tolerable regimen compared to the classical 5-day schedule. No significant financial relationships to disclose.
Doxorubicin and concurrent radiotherapy for anaplastic thyroid cancer: We need to do better
Authors: Lim S. , Lee N. Y. , Fury M. G. , Ghossein R. A. , Shaha A. R. , Wolden S. L. , Pfister D. G. 
Published: March 2020

16506 Background: Anaplastic thyroid cancer (ATC) is a rare, aggressive malignancy. The potential for pathologic misclassification complicates the interpretation of published data. One treatment option for locoregionally (LR) advanced disease is weekly low-dose doxorubicin (D) with concurrent radiation therapy (RT), based on reported 2-year local control rates of 68% (ATC)/77% (other TC histologic subtypes) (Cancer 1987;60:2372). We looked to evaluate our experience with this general approach, but in a larger series which included pathologic confirmation of all ATC cases. Methods: Patients (pts) were identified through the Memorial Sloan-Kettering Cancer Center (MSKCC) Radiation Oncology and Pathology Databases. Inclusion criteria: diagnosis of ATC between 1984–2006, with pathology review at MSKCC; LR disease only, able to be encompassed within a RT portal; treatment at MSKCC with planned weekly D (10 mg/m2) and concurrent radiation. Prior surgery was allowed. Documentation of failure was based on clinical/radiographic assessment. Principal outcomes assessed: LR control (LRC: no failure at the primary site, in the neck, or the mediastinum), progression-free survival (PFS), and overall survival (OS). The Kaplan-Meier method was applied. Results: Thirty-seven patients were included in our analysis (median age 64; 54% female, 46% male). Median RT dose 5760 cGy, >4500 cGy in 32 (87%), administered through hyperfractionated or once-daily schedules. Median number of D treatments received 5.5, >4 in 24 (65%). 2-year outcomes: LRC 25%; PFS 8%; OS 18%. 6 patients remain alive at the time of last follow-up with survival durations of 4.1, 11.4, 11.7, 57.3, 58.5, and 140.7 months, respectively. A subset analysis was performed limited to the 24 patients (65%) who completed >4,500 cGy of radiation and >4 doses of D. 2-year outcomes were improved in this latter group, but remained disappointing, even among these more highly selected pts (LRC 30%; PFS 11%; OS 27%). Conclusions: Better therapy is needed for this poor prognostic disease. Future analyses will evaluate the impact of histologic subtype of ATC, radiation technique/dose, and surgical resection on outcome. No significant financial relationships to disclose.
Evaluation of epidermal growth factor receptor (EGFR) in nasopharyngeal carcinoma and lymph node metastases: Implications for EGFR targeted therapy
Authors: Huang Y. , Lin T. Y. , Lu T. X. , Luo R. Z. , Niraula S. , He J. H. 
Published: March 2020

16510 Background: Epidermal growth factor receptor (EGFR) overexpression is proved to be an independent predictor of poor clinical outcome in Nasopharyngeal Carcinoma (NPC). Expression level of EGFR is also important for EGFR-Targeted therapy but yet unexplored in the primary NPC tumors and lymph node metastases. Aim of this study was to correlate EGFR expression levels in primary tumors and lymph node metastases in NPC to find out whether assessing EGFR status on primary cancer is an effective tool for planning EGFR targeted therapy. Methods: Archived tissue samples of primary tumor and corresponding lymph node metastases of 86 NPC patients (67 males, 19 females; median age = 52 years) diagnosed between 1997 and 2006 were collected from Sun Yat-sen University Cancer Center. Immunohistochemical evaluation of EGFR expression in primary tumors and related lymph node metastasis was performed. According to the UICC 2002 staging system for nasopharyngeal carcinoma, stages Iib, III, IVa, IVb and IVc included 43, 11, 3, 27 and 2 cases respectively. Cervical and supraclavicular lymph nodes were taken in 66 (76.7%) and 20 patients (23.3%) respectively. EGFR status was defined as positive if the percentage of malignant cells stained were =1%. The SPSS 10.0 system was used for statistical analysis and Chi- square test was used to assess the correlation between the EGFR expression in the primary and metastatic tumors. Results: EGFR status was positive in 63 primary tumors (73.2%) and 52 metastatic lymph nodes(60.5%). In 18 EGFR expressing primary tumors (28.6%), the corresponding metastatic lymph node site was negative whereas it was found positive in 7 metastic lymph node (13.5%) of EGFR-negative primary tumors. The difference between these two groups (ie, EGFR-positive to EGFR-negative vs. EGFR-negative to EGFR-positive) was statistically significant (P=0.001). Conclusions: High levels of EGFR protein are frequently observed in NPC and represent potential therapeutic target. However, equivalent expression is not displayed by metastatic nodes, which may limit the effectiveness of anti- EGFR treatment in advanced diseases. These findings have to be considered in future prospective studies. No significant financial relationships to disclose.
A proposal of pathological classification (pTNM) of patients with head and neck cancer according to capsular rupture (pN- RC)
Authors: Gallego O. , Leon X. , Lopez Pousa A. , Farre N. , Vega M. , Lopez M. , Carreras G. , Carreras G. , Marse R. , Quer M. , Barnadas A. 
Published: March 2020

16525 Background: Lymph node metastasis remains one of the most significant prognostic factors of head and neck squamous cell carcinoma survival. Several studies have demonstrated that capsular rupture (CR) significantly decreases survival in patients with a positive neck dissection. We proposed to investigate whether inclusion of CR in the pTNM improves the prognostic capacity of the classification. Methods: We reviewed 841 patients (p) who underwent neck dissection and had a minimum follow-up of two years. The Kaplan-Meier method was used to analyce survival according to presence of neck nodes with CR and number of nodes with CR. Results: We analyzed 841p (151 oral cavity, 97 oropharynx, 136 hypopharynx, 258 supraglotis, 151 glotis and 48 only node; T1, 208 T2, 336 T3, 164 T4; 349 N0, 174 N1, 242 T2 and 78 N3). Treatment was surgery in 220 p and surgery plus radiotherapy in 621p. We treated 465 p with induction chemotherapy. Five-year survival was: 87% for pN0 (n=34), 67.2% for pN1RC-negative (n=118), 74.6% for pN1RC-positive (n=24), 51.7% for pN2RC-negative (n=127), 39.8% for pN2RC-positive only one node (n=58), 17.4% for pN2RC-positive more than one node (n=93) and 21.7% for pN3 (n=72). Conclusions: These results indicate that including CR information in the pTNM improves prognostic capacity of the classification. We propose four pTNM categories: Category 0: pN0; category 1: pN1RC-negative or -positive; category 2: pN2RC-negative or pN2RC-positive only one node; category 3: pN2RC-positive more than one node or pN3. No significant financial relationships to disclose.
Moving from 2D to 3D conformal radiotherapy (3DCRT) in locally advanced head and neck cancer: A dosimetric comparison
Authors: Billan S. G. , Bakouche V. , Nevelsky A. , Abdah-Bortnyak R. , Uziel R. , Rawashdeh F. , Gez E. , Epelbaum R. , Kuten A. 
Published: March 2020

16530 Background: The aim of this study is to evaluate the dosimetric parameters of 3D CRT in head and neck tumors, to compare with hypothetical 2D plans, and to evaluate the acute toxicity. Methods: A total of 33 patients with median age of 62 years (range: 23–87 ) and with histologically proven head and neck cancer were consecutively treated with 3D CRT using a 6-field photon beam technique. 9 patients had supraglottic carcinoma, 5 - glottic carcinoma, 4- nasopharyngeal carcinoma, 4 - thyroid carcinoma, 2- oropharyngeal cancer, 3 - carcinoma of oral cavity, 1- carcinoma of hypopharynx, 1- maxillary sinus carcinoma, 3- unknown primary, 1- recurrent laryngeal carcinoma. 28 patients received concomitant chemotherapy and 13 were treated with neoadjuvant chemotherapy, 5 patients received postoperative radiotherapy and 28 received definitive radiotherapy. A comparative analysis of dose distributions and dose-volume histograms (DVH) between 2D and 3D plans for 11 patients with glottic and supraglottic carcinoma for the initial 50 Gy (since the 20 Gy boost was given almost identical in both technique) was carried out. Toxicity analysis was determined according to RTOG/EORTC toxicity criteria. Results: The mean dose coverage V45 (%) of the primary planning target volume for 2D and 3D plans was 89.6% and 94.8%, respectively (p=0.005). The mean volumes of the hot spots ( 110% of prescribed dose) for primary target volumes for 2D and 3D plans were: 61cc (range: 8.7–130.2 cc) and 26.2 cc (range: 0–49.8 cc), respectively (p=0.005). The mean dose to the parotid glands was significantly lower with 3D CRT (22.1 Gy and 24.7 Gy) compared to 2D technique (45.2 Gy and 46.4 Gy) for right and left parotids, respectively (p=0.003). The maximal spinal cord dose was: mean 45.3 Gy and 41.6 Gy for 2D and 3D CRT, respectively (p=0.003). Gr3 acute toxicity was observed in 3 patients (9%) , and Gr 4 toxicity in 6 patients ( 18%). Treatment was interrupted in 3 patients only. Conclusions: 3DCRT in head and neck cancer permits good coverage of the PTV .The low rate of acute toxicity can be explained by improving the dosimetric parameters of organs of risk and reducing the volume of hot spots in the target. Using 3D CRT for laryngeal carcinoma allows parotid sparing with a mean parotic dose of less than 26 Gy No significant financial relationships to disclose.
Effectiveness of concurrent radiation therapy combined with peroral chemotherapy (UFT or TS-1 ) for T2N0 glottic cancer in Japanese population
Authors: Niibe Y. , Hayakawa K. , Nakayama M. , Matsubayashi T. , Takahashi H. , Okamoto M. 
Published: March 2020

16538 Background: The current study retrospectively reviewed 147 T2N0 glottic cancer patients treated at Kitasato University Hospital to compare concurrent radiation therapy combined with chemotherapy (most of them: UFT or TS-1, peroral anti-cancer drugs), with conventional radiation therapy. Methods: One-hundred and forty-seven patients with T2N0 glottic cancer treated with radiation therapy alone or radiation therapy combined with peroral (UFT or TS-1)or intravenous chemotherapy between 1974 and 2005 at Kitasato University Hospital. The median age of all patients was 64 years (range; 45–86 years). As for gender, 145 were males and the others were females. As for radiation therapy protocol, all except one were treated with 2 Gy per fraction, 5 fractions per week and a total of 60 Gy. Only one patient was treated with 1.8 Gy per fraction, 5 fractions per week and a total of 61.2 Gy. As for chemotherapy protocol, 83 patients were concurrently given UFT, (UFT group). 24 patients given TS-1, (TS-1 group) and 23 patients underwent intravenous chemotherapy using mainly cisplatin (Pt. group). The other 23 patients underwent no chemotherapy. Results: The median follow-up time was 61 months (range; 3–372 months). The 5-year local control rates of all patients was 83.4 %. Stratified by radiation therapy alone group (RT group) and concurrent chemoradiation therapy (CCRT group), The 5-year local control rates of RT group and CCRT group were 82.7%, 83.4%, respectively (p=NS). Stratified by chemotherapy regimens of CCRT group, 3-year local control rates of UFT group, TS-1 group and Pt. group were 90.1%, 100.0% and 73.4%, respectively, which indicated the peroral chemotherapy was not inferior to intravenous chemotherapy. As for morbidity, 2 patients of UFT group experienced severe enteritis . Conclusion: Concurrent radiation therapy combined with UFT or TS-1 for T2N0 glottic cancer might be the one of standard treatments in Japanese Population. Furthermore, concurrent use of TS-1 might perform break-through for T2N0 glottic cancer in terms of local control rate, overall survival and burdens of treatment on patients. No significant financial relationships to disclose.
Weekly chemotherapy with platinum as radio-sensitizer during concomitant chemoradiotherapy for squamous cell head and neck cancer
Authors: Caramalis A. , Nissel-Horowitz S. , Iqbal U. , Roy R. , Radhakrishnan N. , Thomas A. , Pollack J. , Lebowicz Y. , Mehrotra B. 
Published: March 2020

16541 Background: CRT protocols for locally advanced HNC commonly utilize single agent cisplatinum as the radiation- sensitizing chemotherpy. This is typically administered in q 3 weekly doses of 100 mg/sq m concomitantly with XRT. However, many pts are not candidates for this dose and schedule of cisplatinum delivery due to co-morbidities. Limited data are available regarding the efficacy of alternate dosing of platinum analogues.We therefore analysed our experience with alternate dosing of cisplatin or carboplatin administered concomitantly with XRT. Methods: IRB approval was obtained for this retrospective analysis. Tumor registry and pharmacy data were reviewed to identify eligible pts. between 2004–2006 who were treated with alternate dosing of platinum with XRT. Pt characteristics recorded included: age, gender, stage, site of disease, type of chemotherpeutic agent used carboplatin or cisplatinum, number of doses administered, local disease free survival and overall survival. Results: Eleven pts were identified. Median age: 64 years (44–75); Gender: M:F::8:3; Sites: Oral cavity: n=2; Pharynx: n=11; Stage III: n=3; Stage IVa &b: n=8. Cisplatin weekly (doses 30–40mg/sqm): n=8; Carboplatin weekly AUC=2: n=3; Cisplatin weekly, changed to carboplatin: n=1. Nine of 11 pts achieved a local CR (82%); one pt has achieved a near CR and one pt achieved a PR and required salvage laryngectomy. At a median follow up of 14 mos (range: 4–34), all pts remain alive. In addition to the pt that achieved a PR after initial treatment, one other pt has required surgical salvage at 23 mos post CRT. No treatment related mortality occurred in this series. Conclusions: Weekly administration of cisplatin and carboplatin appears to be a feasible alternative to standard dose and schedule of cisplatin with acceptable efficacy. Future studies should compare targetted therapies such as cetuximab with or in combination with weekly platinum regimens during CRT for pts not eligible for standard dose cisplatinum. No significant financial relationships to disclose.
Geriatrics, oncology, and palliative care for patient-tailored treatment: A Brookdale experience.
Authors: Naik S. G. , Dumlao T. L. , Kalavar M. , Steier W. 
Published: March 2020

17028 Background: Patients over 75 years of age are particularly underrepresented in clinical trials. Measures have been used to help characterize the functional age of a patient, to optimize treatment decisions and stratify outcomes, based on factors other than chronological age. The purpose of this study was to evaluate if palliative and social issues influence decision-making in this older population. Methods: The geriatrics oncology patients’ consults from July 2005 to December 2006 were reviewed. In addition to geriatric and oncology tools, palliative measures such as advanced directives, DNR status and social support were incorporated. Results: 89 pts with mean age 80.3 years (range 72–91) and AJCC Stages I (3.3%), II (16.8%), III (28%), and IV (46%) across various malignancies were included. Of the study population, 86% of patients were > 75 years of age, 55% were women, and 75% were widowed; 64% were African- American and 20% were Hispanic. Interestingly, 14 patients (15.7%) had diagnosis of previous cancer (6 breast, 6 prostate). Performance status (KPS and ECOG), activities of daily living (ADL) and instrumental activities of daily living (IADL) scales were assessed. 38.2% had KPS>70, and 31.5% had KPS<40. 22.4% were also independent for instrumental activities of daily living. 33% patients had advanced directives (including DNR status) at diagnosis. Consent was signed by patients themselves in 56% of cases. Social issues included: 22.4% were in NH, 10.11% without social support, 21.3% with falls, and 41.6% with depression in the GDS. Co-morbidities included HTN in 50%, dementia in 19.1%, and multiple medical problems in 21.3% patients. 30.33% pts received aggressive treatment, while19.1% were referred to hospice, with 50% requiring palliation. Pain was the main symptom that needed palliation in 48.3% patients. Supportive care included use of growth factors 24.7% and erythropoietin 48.3%. Conclusions: Social support, advanced directives, consent were the main issues even in patients with good performance status and absence of major co morbidities. Strategies to increase participation of good performance status elderly patients in geriatric clinical trials should include pain and palliative care issues. No significant financial relationships to disclose.
Truth telling to cancer patients: Views of Myanmar primary care physicians
Authors: Mon S. , Pe A. 
Published: March 2020

17030 Background: Due to cultural and social concern, non oncology physicians are still practicing nondisclosure in Myanmar. The views of Myanmar primary care physicians about truth telling to cancer patients were studied. Methods: A Questionnaire about revealing diagnosis and prognosis to cancer patients was prepared and given to 150 qualified Primary care physicians attending the oncology related lecture in CME course for General Practitioners in 2006, Yangon, Myanmar. Results: A total of 145 completed forms (96.66%) were returned. Age of primary care physicians range from 23 yrs to 52 yrs. 90 doctors (62.06%) were under age of 35 yrs (mean 29.94 yrs) and practicing experience ranged from 1 to 10 yrs. The remaining 55 (37.93%) were over 35 yrs of age (mean 44.52 yrs) with practicing duration of 10 to 28 yrs. The common cancer patients they have seen in daily practice were breast cancer (40%), lung cancer (28.96%), GI cancer (15.17%), cervical cancer (8.96%), ovarian cancer (3.4%), head and neck cancer ( 2.06%) and hematological malignancies (1.37%).A total of 73 doctors (50.34%) answered that they let the patient know they were suffering from a serious disease (not mentioning the word cancer) that needs further specialized treatment. Interestingly, 69.09% of physicians over 35 yrs of age agree with this approach, whereas only 38.88% of young physicians prefer it. Besides, 56.6% of senior primary care physicians prefer to reveal the diagnosis and prognosis to one or more family members first. Although all doctors are aware of the psychological distress on patients by painful truth telling, 58.8% of younger generation prefer to practice full disclosure to patients. Altogether, 105 physicians (72.41%) agree that disclosure of diagnosis and prognosis depends on education status of the individual patient. Conclusions: In this study, there were variations in physicians’ attitude and practice of truth telling. Full disclosure was preferred more by young physicians in Myanmar. Further studies on patients’ preference of telling the truth will help to better understand doctor-patient communication in Myanmar. No significant financial relationships to disclose.