bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the NCI patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE) in women receiving treatment for metastatic breast cancer.
Authors: Mitchell Sandra A. , Lang Kathy , Nichols Christine , Clauser Steven B. , Federico Victoria , Lalla Deepa , Tripathy Debu , Hurvitz Sara A. , Castro Kathleen M. , Reeve Bryce B. , Rogak Lauren J. , Denicoff Andrea , Chen Alice , Piekarz Richard , Bennett Antonia V , Atkinson Thomas Michael , O'Mara Ann M. , Minasian Lori M. , Basch Ethan M. 
Published: March 2020

9144 Background: NCI PRO-CTCAE is designed to enhance adverse event reporting by integrating patients’ self-report of the frequency (F), severity (S) and interference (I) with usual activities of 78 symptomatic treatment toxicities. This study examined the construct validity of a subset of PRO-CTCAE items in women with metastatic breast cancer (MBC). Methods: 207 women (70% aged 45-59 years; 94% White;71% college-educated) with HER2+ MBC who had received treatment in the past month were recruited from 6 U.S. breast cancer support groups and completed a web survey that collected 18 PRO-CTCAE symptoms, and the Rotterdam Symptom Checklist (RSC). Pairwise concordance among PRO-CTCAE symptom dimensions was examined using weighted Kappa and Bowker’s test for symmetry. Results: Respondents were a median of 47 months since MBC diagnosis and 61% rated their health-related quality of life (HRQL) as good to excellent. Symptom prevalence was similar for PRO-CTCAE and RSC, with respondents more likely to endorse mood disturbance on PRO-CTCAE (Anxiety/Worry 90%; Sad/Unhappy Feelings 86%) vs. RSC (Anxiety 63%; Depressed Mood 61%). There was parallel rank-ordering of fatigue, anxiety, insomnia, depression, difficulty concentrating and neuropathy as the symptoms that were most severe, interfered most and caused the greatest bother. Within PRO-CTCAE, pairwise agreement among F, S and I was moderate for most symptoms (κw=.42 to .54). Agreement between F and S was highest for pain, nausea and arm/leg swelling (κw=.61 to .80), and lowest for anxiety/worry and sad/unhappy feelings (κw= .27-.37). Except for arm/leg swelling, endorsement patterns by the dimensions of F, S and I were distinct (Bowker’s p all <.002). Across PRO-CTCAE symptoms, S was consistently higher than I (mean differences .12 to .72, all p<.01]). Means for S were consistently and significantly higher for those with impaired versus preserved HRQL, providing evidence of construct validity. Conclusions: This study supports the construct validity of PRO-CTCAE, and suggests that F, S and I dimensions offer non-overlapping information relative to 17 /18 PRO-CTCAE symptomatic toxicities.
Health behaviors among testicular cancer survivors.
Authors: Palmer Steven C , Jacobs Linda A. , Coyne James C. , Vaughn David J. 
Published: March 2020

9145 Background: Testicular cancer survivors (TCS) experience elevated risk for cardiovascular issues including coronary artery disease that present a greater threat to their long-term health than recurrence of cancer. These risks may be moderated by health behaviors (HBs), yet little is known about HBs or their barriers in this population. This is unfortunate, as these barriers may serve as intervention targets. This study examined HBs and their barriers in a population-based sample of TCS. Methods: TCS were recruited through the PA Cancer Registry. Eligible individuals were diagnosed with testicular cancer between 1990 - 2007 and provided informed consent. Participants completed measures of tobacco use, alcohol use, dietary habits, physical activity, BMI, quality of life (QOL), and barriers to performing HBs, as well as self-reported disease and treatment information. Results: 189 participants provided data. Participants were middle-aged (M=44 yrs. R=19-59), predominately white (95%), married (72%), parents (69%), 6.8 years post-diagnosis (R=1-19), and at normative levels for physical and psychosocial QOL. A substantial minority (31%) was unaware of their disease stage or histopathological type (27%), although 89% reported surgery, 32% chemotherapy, and 53% XRT. Almost 25% reported current tobacco use, and 35% reported “risky” alcohol use. Adequate aerobic activity was reported by half, but only 28% reported adequate strength and flexibility activities. 84% reported above normal BMI, with 35% in the obese range. Barriers to HBs included cancer-related problems (e.g., neuropathy, pain, hernia risk) and competing demands (e.g., work responsibility, time constraints). Cancer-related barriers were related to worse physical QOL and higher BMI. Competing demands predicted worse psychosocial QOL, unhealthy eating, and inadequate physical activities. Conclusions: Given the negative HBs in this sample and their potential cardiovascular risk, interventions aimed at reducing tobacco and risky alcohol use, as well as improving dietary and physical activity levels are needed. These interventions will likely need to overcome perceived barriers to adoption of HBs in order to be successful.
Lifetime traumas and their influence on advanced cancer patients’ illness understanding and likelihood of end-of-life discussions.
Authors: Kacel Elizabeth L , Maciejewski Paul K , Prigerson Holly Gwen 
Published: March 2020

9146 Background: Research on posttraumatic stress in cancer patients has focused on patient reactions to their cancer diagnosis. Few studies have examined the impact of lifetime traumatic events prior to diagnosis on how advanced cancer patients understand the life-threatening nature of their illness and how likely they are to discuss their end-of-life (EOL) wishes with their oncology providers. Methods: The Coping with Cancer (CwC) is an NCI-funded prospective, multi-institutional cohort study of advanced cancer patients and their caregivers. Participants were recruited from September 2002 to February 2008 from six comprehensive cancer centers across the United States. Lifetime traumas were captured by the number of events reported in response to the Structured Clinical Interview for the DSM-IV (SCID) Lifetime Posttraumatic Stress Disorder question that probed for “extremely upsetting” life events. Associations between patient characteristics and number of lifetime traumas were estimated as odds ratios using ordinal logistic regression. Associations between number of lifetime traumatic exposures, controlling for confounding patient characteristics, and patient Terminal Illness Acknowledgement (TIA) and reports of EOL discussions were estimated as odds ratios using multiple logistic regression. Results: After adjusting for race, education, and recruitment site, the number of lifetime traumas patients reported remained significantly associated with TIA (OR = 1.25, p = .034) and discussion of EOL wishes (OR = 1.29, p = .013). Conclusions: The greater the number of traumatic experiences reported by cancer patients the more likely they are to acknowledge that they are terminally ill and discuss their end-of-life wishes with their oncology providers. The impact of witnessing or experiencing serious or life-threatening events in the past appears to improve advanced cancer patients’ abilities to understand the seriousness of their condition and increases the likelihood that they will discuss their preferences for care at the end of life with their doctors.
Vincristine (V), dactinomycin (A), and lower doses of cyclophosphamide (C) with or without radiation therapy for patients with newly diagnosed low-risk embryonal rhabdomyosarcoma (ERMS): A report from the Children’s Oncology Group (COG).
Authors: Walterhouse David , Pappo Alberto S. , Meza Jane L , Breneman John C. , Hayes-Jordan Andrea Anita , Parham David , Cripe Timothy P , Meyer William H. , Hawkins Douglas S. 
Published: March 2020

9509 Background: Intergroup Rhabdomyosarcoma Study (IRS) trials showed improved survival with VAC compared with VA for patients with Stage 1 Group III (non-orbit) or Stage 3 Group I/II ERMS (see table). In COG ARST0331, we hypothesized that VA in combination with lower doses of C (total cumulative dose=4.8 g/m2) would produce the benefit of IRS-IV VAC with less toxicity for patients with Stage 1 Group III (non-orbit) or Stage 3 Group I/II low-risk ERMS. Methods: This single arm, non-inferiority, phase III study enrolled newly diagnosed patients with Stage 1 Group III (non-orbit) ERMS or Stage 3 Group I/II ERMS onto Subset 2. Therapy was 4 cycles of VAC followed by 12 cycles of VA over 46 weeks (total cumulative doses: V=54 mg/m2, A=21.6 mg/m2, C=4.8 g/m2). The radiation therapy dose was 36 Gy for Group IIA patients, 41.4 Gy for Group IIB/C patients, and 50.4 Gy for Group III patients. From 2004–2008 girls with Group III vaginal RMS did not receive radiotherapy if a complete response was achieved with chemotherapy with or without delayed resection. The primary endpoint was failure-free survival (FFS), and results were compared with a fixed expected outcome. Results: With a median follow-up of 3.0 yrs, we observed 16 failures vs. 7.8 expected failures. Estimated 3-yr FFS was 63% (95% CI: 46%, 75%) (n=60), and overall survival (OS) was 84% (95% CI: 68%, 93%). Estimated 3-yr FFS was 46% (95% CI: 23%, 67%) for girls with non-bladder genitourinary tract ERMS (n=21) and 75% (95% CI: 53%, 88%) for all other Subset 2 patients (n=39). Conclusions: We observed suboptimal FFS of patients with Subset 2 low-risk RMS using reduced total cyclophosphamide (4.8 g/m2). Results were complicated by the choice of no radiation therapy for girls with vaginal tumors. Future studies for low-risk RMS Subset 2 patients could investigate a dose of C between 4.8 and 26.4 g/m2 with VA and local radiotherapy. [Table: see text]
Effect of radiation on outcome of types II and III PPB: A report from the International Pleuropulmonary Blastoma Registry.
Authors: Williams Gretchen M , Priest John R. , Finkelstein Marsha J , Harris Anne , Doros Leslie Ann , Kratz Christian , Schultz Kris Ann Pinekenstein , Hill D Ashley , Dehner Louis P , Messinger Yoav H. 
Published: March 2020

9521 Background: Pleuropulmonary blastoma (PPB) is a rare dysembryonic lung neoplasm of early childhood with progression from a purely cystic (Type I) lesion to a solid high-grade sarcoma Type III (T-III), or a mixed solid/cystic stage Type II (T-II). Surgery and chemotherapy are required for T-II and T-III PPB, but the benefit of radiation therapy for T-II and T-III PPB is debated and is being evaluated in this study. Methods: This is a retrospective analysis of central pathology-reviewed Types II and III PPB from the IPPBR. Treatments were chosen by physician, were not randomized, and included surgery and chemotherapy. The outcome of patients treated with upfront radiation (before progression or relapse) was compared to patients who did not receive radiation. Event-free survival (EFS) and overall survival (OS) were determined to last follow-up, using the Kaplan-Meier analysis, with log-rank test. Results: Outcome for 212 patients (117 Type-II and 95 Type III) was significantly better for T-II than T-III: EFS for T-II was 68.1% vs. T-III 45.7% (P=0.002), and OS for T-II was 75.2% vs. T-III 57.9% (p=0.01). Excluding patients with incomplete therapy information, 174 were treated with surgery and chemotherapy. Of these 44 (25%) also received radiation therapy; 130 patients did not. The table below shows comparison of radiated vs. non-radiated. Radiation provided no additional survival benefit, overall or by tumor Type. Multivariate analysis showed that gender and extent of primary tumor resection (biopsy vs. gross total resection) had no effect on outcome, however T-II vs. T-III retained prognostic significance. Conclusions: For this collection of advanced-type PPB, outcome is significantly better for T-II than T-III. For patients treated initially with surgery and chemotherapy, adding radiation therapy offered no improvement in event-free or overall survival. Limitations of this study include its retrospective nature and non-uniform treatment regimens. [Table: see text]
Increase in the incidence of differentiated thyroid carcinoma in children, adolescents, and young adults (AYA): A population-based study.
Authors: Vergamini Lucas B. , Frazier A. Lindsay , Abrantes Fernanda L. , Ribeiro Karina Braga , Rodriguez-Galindo Carlos 
Published: March 2020

9523 Background: Studies have shown an increase in thyroid cancer incidence among adults since the 1990s. However, few studies have evaluated this occurrence among children and AYA. Increases resulting from enhanced detection are most likely to involve small tumors. The objective of this study is to investigate trends in incidence of differentiated thyroid carcinomas in children and AYA by size and sex. Methods: This is an ecological time-trend study. Cases of differentiated thyroid cancer (1984-2008) in patients younger than 30 years old were selected from SEER 9 cancer registries using International Classification of Diseases for Oncology 3rd edition (ICD-O-3) codes for papillary and follicular cancers (codes 8050/3, 8052/3, 8130/3, 8260/3, 8290/3, 8330-8332/3, 8335/3, 8340-8344/3, 8450/3 and 8452/3). Patients who had multiple primary tumors were excluded from the study. SEER*Stat software was used to calculate age-standardized rates (estimated per 1,000,000 persons; World Standard Population) and annual percentage changes (APC) were calculated using Joinpoint model. Results: Rates ranged from 2.77 (1990) to 7.45 (2002) for males and from 17.19 (1987) to 41.3 (2008) for females. Overall, a significant increasing trend in incidence was observed for females (APC=3.20, 95%CI 2.80, 3.60). When a stratified analysis based on tumor size was performed, significant increasing trends were noted for the following categories: 0.5-0.9 cm (Males: APC=3.50, 95%CI 1.50, 5.40; Females: APC=7.30, 95%CI 5.90, 8.80), 1.0-1.9 cm (Males: APC=3.20, 95%CI 1.00, 5.40; Females: APC=2.90, 95%CI 2.20, 3.70), and ≥ 2cm (Males: APC=1.30, 95%CI 0.30, 2.40; Females: APC=2.50, 95%CI 1.70, 3.20). However, no statistically significant trends were noted for tumors <0.5 cm (Males: APC=2.50, 95%CI -0.30, 5.40; Females: APC=2.0, 95%CI -6.90, 11.80). Conclusions: Incidence rates for differentiated thyroid carcinoma are also increasing among children and AYA in the United States. The absence of increasing trends for small tumors (< 0.5cm) rules out diagnostic scrutiny as the only explanation for the observed results. Environmental, dietary and genetic factors should be investigated.
Association of bone mineral density with incidental renal stone in long-term survivors of childhood acute lymphoblastic leukemia.
Authors: Gawade Prasad Laxman , Ness Kirsten K. , Sharma Shelly , Li Zhenghong , Srivastava Deo Kumar , Spunt Sheri L. , Nottage Kerri , Hudson Melissa M. , Kaste Sue 
Published: March 2020

9527 Background: With 5-year survival of childhood acute lymphoblastic leukemia (ALL) now exceeding 90%, long term morbidities are of growing concern. Both low bone mineral density (BMD) and renal dysfunction have been reported in ALL survivors. Our objective was to evaluate the association between low BMD and incidental renal stones, a known predictor of renal dysfunction. Methods: Adult participants who were 10+ year survivors of childhood ALL and members of St. Jude Lifetime Cohort study were recruited between 12/2007 and 3/2011. During their risk-based medical evaluations they underwent quantitative computed tomography (QCT) to evaluate BMD. Incidental renal stones were identified by radiologists’ review of axial QCT source images. Demographic information was abstracted from responses to health surveys and dietary intake from a Block food frequency questionnaire. Association between BMD and renal stones was evaluated in a multivariable logistic regression model. Confounding variables were selected using directed acyclic graphs and change in effect estimates strategy. Results: At a median of 26.1 years from diagnosis, BMD Z score of > 1 standard deviation (SD) was detected in 77/662 (11.6%) and renal stones in 73/662 (11%) participants. In a multivariable model adjusted for age, dietary vitamin D and renal radiation, when compared to BMD Z score > 1 SD, the risk of renal stones increased with a decrease in BMD Z-score; 1 to 0 SD (Odds Ratio (OR), 1.93; 95% confidence interval (CI), 0.69 to 5.41), 0 to -1 SD (OR, 1.46; 95% CI, 0.52 to 4.05), -1 to -2 SD (OR, 2.72; 95% CI, 0.81 to 6.41), and ≤ -2 SD (OR, 4.96; 95% CI, 1.43 to 17.13). Older age (45-54 vs.18-24 y; OR, 3.66; 95% CI, 1.10 to 12.15), renal radiation (OR, 1.97; 95% CI, 0.59 to 6.50) and > 141.5 IU intake of vitamin D (OR, 1.65; 95% CI, 0.98 to 2.77) were also associated with renal stone formation. Conclusions: Our results not only help us recognize survivors at risk, but also informs radiologists to be vigilant of incidental renal stones among older ALL survivors with low BMD.
A longitudinal study of anthracycline cardiotoxicity in pediatric Ewing sarcoma.
Authors: Brown Tanya Renae , Vijarnsorn Chodchanok , Potts James , Milner Ruth , Sandor George , Fryer Christopher 
Published: March 2020

9529 Background: Trends in cardiac function over time have not been previously described in Ewing sarcoma. Our cohort is unique as all the cardiac evaluations occurred systematically in one tertiary cardiology unit during a 28 year period. Objectives: 1.To evaluate the cardiac functional trends in the cohort at baseline, during treatment and in surveillance. 2.To evaluate the risk factors associated with cardiac toxicity. Design: Received ethics approval for a retrospective chart review of all patients less than 17 years, diagnosed with Ewing sarcoma from 1978-2006, treated initially at British Columbia Children’s Hospital . Methods: There was complete data on 71/79 eligible patients. Echocardiograms were recorded at 5 time points: pre treatment, worst function during treatment, on therapy completion, worst function during surveillance and the most recent echocardiogram. Cardiac toxicity was graded using CTCAE v 4.0. The statistical analysis with SAS software v 9.2 calculated the chi square and odds ratios to explore a possible association between exposure and outcome. Results: Median age at diagnosis 11.1 yrs (2.2-16.1 yrs), 52% female, metastatic in 17, overall survival 74% at 10yrs. A total of 397 echocardiograms were performed with 244 (61%) being normal and 153 (39%) being abnormal. The median cumulative dose of anthracyclines was 365mg/m2. Grade 1-5 cardiomyopathy occurred in 42 (59%) patients. Grade 3-5 toxicity occurred in 11 (15%) patients on chemotherapy completion increasing to 23 (32%) 120 months post diagnosis. The median time to the worst cardiac function was 51months (2-183). Four of 19 (20%) deaths were cardiac related including 2/3 cardiac transplants. Conclusions: Symptomatic cardiac toxicity increased from 20% noted in our earlier Ewings cohort (Kakader et al. 1997) to 32% with longitudinal evaluation assessments. Significant and progressive cardiac toxicity occurred after completion of chemotherapy.
Parent-reported cognition and its clinical applications in pediatric oncology.
Authors: Lai Jin-Shei , Krull Kevin R. , Zelko Frank , Wagner Lynne I. , Cella David , Goldman Stewart 
Published: March 2020

9532 Background: Parent-reported cognitive function (PCF) of their child's cognitive abilities is often used to trigger referral for comprehensive neuropsychological evaluation. The purpose of this study was to evaluate the clinical utility of PCF to predict impairment as measured by neuropsychological assessment and to identify factors associated with PCF. Methods: 565 patients (53% brain tumor, BT; 47% other types of cancer, non-BT) aged 7-21 (mean=14 yrs; 56% males) and their parents were recruited. 34% received radiation therapy, 72% chemotherapy and 71% surgery. Mean years since diagnosis= 5.7 yrs. PCF was measured using a 43-item pediatric perceived cognitive function item bank (pedsPCF). Parents completed the pedsPCF and a single item to rate their child's quality of life (QOL). Patients completed NINDS-NeuroQOL Depression, PedsQL Fatigue scales and neuropsychological tests (NPT) of psychomotor function, attention, learning and working memory using the CogState. K-Means clustering was used to group patients based on scores of depression, fatigue and pedsPCF. Results: PedsPCF significantly differentiated BT from non-BT, t=5.65, p<.01. Correlations between pedsPCF and NPT ranged from 0-0.66 (BT, < 1 yr diagnosis, psychomotor), depending on BT (vs non-BT), yrs since diagnosis and treatment, and NPT. Three clusters were identified with its own unique characteristics. Specifically, pedsPCF was significantly correlated w/ depression & fatigue for cluster 1; correlated w/ NPT scores for non-BT for cluster 2; and correlated w/ NPT for BT for cluster 3. Cluster membership of patients were significantly differentiated by Karnofsky rating, surgery (yes/no), QOL, parent education, child age, and child gender, but not types of treatment, and grade repetition (yes/no). Conclusions: This is one of the first studies to report an association between perceived cognitive function, using parent ratings, and neuropsychological performance. PedsPCF demonstrated clinical utility in differentiating between children with a brain tumor from children with other cancer types. PedsPCF has the potential to serve as a screening tool to facilitate efficient referral for comprehensive neurocognitive assessment.
Conservative treatment of intraocular retinoblastoma: A prospective phase II randomized trial of neoadjuvant chemotherapy followed by local treatments and chemothermotherapy.
Authors: Aerts Isabelle , Lumbroso-Le Rouic Livia , Hajage David , Levy-Gabriel Christine , Savignoni Alexia , Algret Nathalie , Doz Francois P. , Desjardins Laurence 
Published: March 2020

9538 Background: intraocular retinoblastoma treatments often associate chemotherapy and focal treatments. The protocols vary and may combine two or three drugs, and different number of cycles associated to the local adjuvant treatments. A first prospective protocol of conservative treatments in our institution showed the efficacy of the use of two courses of chemoreduction with etoposide and carboplatin, followed by chemothermotherapy using carboplatin, as a single agent. In order to decrease the possible long term toxicity of chemotherapy due to etoposide, a prospective randomized phase II chemo reduction protocol was conducted, using vincristine and carboplatin vs. etoposide carboplatin. Methods: the study was proposed when initial tumour size or location did not allow the use of front-line local treatments. The phase II randomized study of reduction chemotherapy used vincristin carboplatin or etoposide carboplatin, followed by local treatment including chemothermotherapy using the combination carboplatin and laser diode hyperthermia. Primary endpoint was the need for secondary enucleation or EBRT not exceeding 40% at 2 years. The new treatment was considered sufficiently effective if 10 events or less were observed among 33 eyes. Results: 55 children, 65 eyes were included in the study (May 2004- August 2009).32 eyes (27 children) were treated conservatively in the arm etoposide-carboplatin and 33 (28 children) eyes in the arm vincristin carboplatin.At two years after treatment 23/33 (69.7%) eyes were treated and salvaged without EBRT or enucleation in the arm vincristin-carboplatin and 26/32 (81.3%) in the arm etoposide and carboplatin. Conclusions: neoadjuvant chemotherapy by two cycles of vincristine and carboplatin followed by chemothermotherapy (using the combination carboplatin, as a single drug, and laser diode hyperthermia) does not seem to offer an optimal local control.