bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiographic and clinical factors associated with improved outcomes in cancer patients with bowel obstruction
Authors: Contreras C. M. , Badgwell B. D. , Askew R. L. , Feig B. W. , Cormier J. N. 
Published: August 2020

e20564 Background: The purpose of this study was to identify clinical and radiographic factors relevant to treatment outcomes in cancer patients presenting with bowel obstruction. Methods: Clinical and radiographic factors were retrospectively abstracted from records of inpatients referred for surgical consultation for suspected bowel obstruction (2000–2006). Patients were stratified by treatment: surgical treatment (ST), minimally invasive (percutaneous/endoscopic) procedures (MIP), or bowel rest (BR). Clinical outcomes such as status at discharge and median overall survival (OS) were examined. Results: Of 194 patients, 25% had a primary diagnosis of colorectal cancer. Computed tomography, plain radiographs, enteral contrast studies, and other modalities were used for diagnosis in 59%, 26%, 12%, and 3% of patients, respectively. 62% of obstructions were located in the small bowel, with the remaining 23% and 12% identified as gastric outlet and colon, respectively. Over 90% of patients treated with ST (n = 60) were discharged home and tolerated enteral feeding. In contrast, for patients treated with MIP and BR, 48% and 68% were discharged home, and 70% and 72% were able to tolerate enteral feeding, respectively. OS was similar for patients treated with ST (6.3 months) and for those whose bowel obstruction resolved with BR (6.4 months). For patients treated with MIP, however, OS was 1.4 months. Though significant differences in OS for patients treated with ST and MIP were observed (p<0.0001), 30-day readmission rates were similar across treatment groups. Radiographic images demonstrating low grade obstruction, absence of ascites, and the absence of peritoneal carcinomatosis were associated with improved OS. Additional relevant clinical factors affecting OS included serum albumin level; however, no association was observed for age, tumor type, site of obstruction, previous bowel obstruction, or abdominal exploration. Conclusions: Clinical and radiographic factors affect treatment outcomes for cancer patients with bowel obstruction. Given that factors such as ascites, peritoneal carcinomatosis and low serum albumin result in poor OS, non-invasive procedures should be considered. No significant financial relationships to disclose.
Triticum vulgare mouthwashes (TVM) for patients (pts) with oral mucositis (OM) induced by chemotherapy and chemoradiotherapy (ONCOLGroup study)
Authors: Carrasco-Chaumel E. , Cardona A. F. , Ospina E. G. , Montaño L. M. , Noemí R. , Bleda M. , Carranza H. , Vargas C. , Otero J. M. , Castro C. 
Published: August 2020

e20570 Background: OM is a frequent complication of cancer therapy in Colombia. Triticum vulgare has been reported to effectively treat mucosal and skin disturbances. Methods: To evaluate the safety and efficacy of TVM for the control of OM induced by chemoradiotherapy in pts with head and neck cancer (HNC) and by chemotherapy in pts with haematological malignancies (HM). Thirty-one pts received TVM delivered in a spray four times daily to the whole oral cavity until the OM being resolved. The primary endpoint was the OM grade evaluated daily using the Nebraska scale (NS). Secondary endpoints were OM duration, weight loss, pain and TVM tolerance; the latter two were evaluated using a visual analogue scale (VAS). Results were compared with data from 42 pts with OM treated with saline mouthwashes (SM) in a previous clinical trial. Results: Nineteen pts had HM and 12 had HNC; those with HM developed OM on day 9 of chemotherapy (range, 7–14), whilst those having HNC did so towards day 17 of chemoradiation (range, 13–26). Using NS 38% of pts developed GI OM, 46% GII OM and 16% GIII OM. Moderate and severe OM occurred more frequently amongst HNC pts (8 vs 1, p = 0.047), mean OM duration in HNC pts was 12±4.5 days, whilst it was 7 ±3 days (p = 0.047) in pts with HM. Median OM duration in pts treated with TVM was 5.4 days (range, 2–9) vs 7 days (range 1–17) for pts treated with SM (p = 0.048). TVM appears to reduce weight loss, especially in pts with HNC (p = 0.058); however, no changes were documented regarding saliva characteristics and production, mucosal bleeding and voice properties. Evaluation of pain did not reveal differences between the groups (VAS 5.5 for the TV compared to VAS 6.2 for SM; p = 0.27) but the proportion of pts suffering from pain VAS≥7 differed between both populations (8% TV vs 23% SM; p = 0.043). There are no significant adverse events with TVM. Conclusions: TVM is safe and has therapeutic activity against OM. Further phase III study is needed to confirm these results. No significant financial relationships to disclose.
Cognitive functioning in breast cancer patients during and following chemotherapy
Authors: Janelsins M. C. , Roscoe J. A. , Jean-Pierre P. , Morrow G. R. 
Published: August 2020

e20571 Background: The development of cognitive difficulties, including memory loss, confusion, and difficulty concentrating following cancer treatment is a significant concern in patients receiving chemotherapy. Methods: This secondary analysis of a study assessing the effects of a RCT of paroxetine on fatigue in cancer patients investigated changes in self-report cognitive functioning over four cycles of chemotherapy and then approximately two years later. Approximately half of the patients were chemotherapy naïve. Questions on 5 point scales anchored by 1 = “absence of” and 5 = “a great deal” evaluating whether patients experienced heavy headedness, muddled thoughts, difficulty thinking, trouble concentrating, and forgetfulness. Each was answered seven days after each treatment and scores from each cycle were summed. Results: Fifty-eight of 84 patients completed questionnaires for all four cycles and are included herein. Paired t-tests showed cognitive difficulties were highest following the 1st on-study chemotherapy cycle (mean=7.9) and were significantly improved at the 3rd (mean=6.9) and 4th (mean=6.6) on-study cycles (both, p<0.005). Independent sample t-tests revealed that paroxetine had no effect on cognitive functioning when compared to placebo at all 4 cycles (all, p>0.54). Fifteen participants were reassessed two years after completing treatement. There was an increase in reported cognitive difficulties from the last cycle (mean=5.9) to the follow-up time-point (mean=7.8) that was not significant (p=0.18). Patients with ≥2 point change in score from the last on-study cycle to follow-up were categorized as “better” or “worse”. Those with <2 point change in score were classified as “no change”. Four (27 %) patients got worse (mean change=9.0), 2 (13 %) got better (mean change=-3.5), and 9 (60%) did not change. Conclusions: These data suggest that self-report cognitive difficulties related to cancer treatment are most pronounced following initial cycles of chemotherapy treatment and improve during the treatment course. Further studies need to include objective neuropsychological examinations and biological correlates of cognitive functioning to understand the extent of cognitive decline due to chemotherapy. Funding: DOD DA17–96-C-6106, NCI R25CA10618. No significant financial relationships to disclose.
Effect of 25 hydroxy vitamin D status on serological response to influenza vaccine in cancer patients
Authors: Chadha M. K. , Fakih M. G. , Tian L. , Mashtare T. , Nesline M. , Davis W. , Silliman C. , Trump D. L. 
Published: August 2020

e20575 Background: Increasing epidemiologic data suggest association of vitamin D deficiency with influenza epidemic. Vitamin D acts as an immune modulator and stimulates the expression of protective anti-microbial peptides. We conducted a prospective influenza vaccination study to determine the influence of vitamin D status on serological response to flu vaccine in cancer patients. Methods: Cancer patients at Roswell Park Cancer Institute were offered trivalent (H1N1, H3N2, B/Malaysia) Flu vaccine (Fluzone, 2006–7) and sera collected for hemagglutination inhibition (HI) assay titers. Response to vaccination was defined as ≥ 1:40 titer ratio or a 4 fold increase in HI titer at 3 months post vaccination, against any of the 3 strains. Chi-square tests were performed to compare serological response between the groups with lowest and highest quartiles of baseline 25 (OH) vitamin D (D) level. Logistic regression model was used using other covariates such as age, gender, cancer type, and chemotherapy (CT) as controls. Results: 85 patients with colorectal, 35 with prostate, 1 with anal and 1 with gastric adenocarcinoma participated in the study. Median age was 62 years (range: 24–87 years), 85 (70%) were males. Overall serological response was 59%. Median baseline D level was 42.9 ng/mL (range: 4.0–92.8 ng/mL); lowest and highest quartiles were 26.9 and 53.4 ng/mL. There was no association between serological response and baseline D level (p=0.42) or the lowest and highest quartiles of D level (p=0.6). The odds of response did not vary by sex (p=0.95). CRC patients (OR-0.051; 95% CI-0.013 to 0.209; p<0.0001) were less likely to respond. Few patients (n=20; 16%) were D deficient (<20ng/mL), 43 had D < 32ng/mL .70 patients (54.7%) were on vitamin D supplements. Among those in whom the dose of supplement was known (46),the median daily vitamin D supplement dose was 2000 IU (800–9000 IU).There was no association between serological response and dose (p=0.09). There was no difference in the response rates among patients on D supplement 44/70 (62.9%) versus those not on any D supplement 28/52 (53.8%)(p=0.32). Conclusions: Vitamin D status, in a population in which vitamin D supplementation was commonly used, did not affect serological response to influenza vaccine. No significant financial relationships to disclose.
Health-related quality of life indicators and overall quality of life: Results from a cluster analysis on baseline EORTC QLQ-C30 data from 6,739 cancer patients
Authors: Coens C. , Martinelli F. , Quinten C. , Cleeland C. S. , Greimel E. , King M. , Ringash J. , Schmucker-Von Koch J. , Shi Q. , Bottomley A. 
Published: August 2020

e20576 Background: Increasingly randomized controlled trials in cancer research include Health-related Quality of Life (HRQoL) alongside traditional biomedical outcome measures. The majority of these trials focus on a general cancer HRQoL measure. The objective of this meta-analysis was to identify which HRQoL indicators influence a patient's overall quality of life, in order to better understand the changes in such a generic scale. Methods: Retrospective pooling of 29 European Organisation for Research and Treatment of Cancer (EORTC) clinical trials, among 10 cancer sites, yielded baseline EORTC QLQ-C30 data for a total of 6,739 patients. A cluster analysis, using Ward's method, was performed to determine how the 15 HRQoL indicators, and the Global Health scale (GH) in particular, cluster overall and by cancer characteristics. Cronbach's alpha coefficient (α) was used to measure internal consistency. Dendrograms of the HRQoL indicators were plotted for each cancer type. Results: Three main clusters emerged: a physical function related cluster (physical functioning, role functioning, fatigue and pain, α = 0.83), a psychological function related cluster (emotional functioning, cognitive functioning and insomnia, α = 0.64) and a gastrointestinal cluster (nausea and vomiting and appetite loss, α = 0.68). The GH scale was found to be part of the physical function cluster in the overall dataset (α = 0.85). This result was reproduced for both metastatic and non-metastatic patients. When looking across the 10 different cancer sites, the GH scale was mainly linked with a physical component in brain, head and neck, lung, melanoma, ovarian, pancreatic and prostate cancer. However, in breast and testicular cancer, GH was more strongly associated with the emotional scales. Conclusions: This study shows that the GH scale of the EORTC QLQ-C30 is most strongly linked with a patient's physical status. This result is consistent across stage of disease and most cancer sites. The different results seen in patients with breast and testicular cancer deserve additional investigation. No significant financial relationships to disclose.
Prevalence and management of oropharyngeal candidiasis in cancer patients: Results of a prospective French multicentric survey
Authors: Azria D. , Gligorov J. 
Published: August 2020

e20590 Background: Oropharyngeal candidiasis (OPC) is usually considered as a frequent and manageable complication of cancer treatments. International guidelines recommend the use of broad spectrum local antifungal agents as first line treatment using old published data. In 2008, we elaborated a prospective pharmaco- epidemiological survey (Candidoscope) to update the prevalence and the management of OPC in France. Methods: Candidoscope concerned patients suffering from solid tumors or non-Hodgkin's lymphoma (NHL) and still under treatments. Thirty-five French centres participated in this survey. Patients were screened during a consecutive period of 15 days and were included in a registry to estimate OPC prevalence. Exclusion criteria was the use of antifungal agents within the last 15 days before the beginning of the the present study. OPC was defined clinically. Patients diagnosed for OPC were selected to the second part of the study detailing OPC treatments. Results: Overall, 2,027 patients were registered. OPC prevalence was 9.6% (n=195). Breast cancer population was the most frequent disease presenting untreated OPC (n= 47, 24%). The prevalence of OPC in head and neck, digestive cancer, and NHL patients was 30%, 20%, and 20%, respectively. Patients with combined treatments presented the highest OPC prevalence (nearly 22%). The most common clinical presentation for OPC was the erythematous form (62%). Main OPC symptoms were dry mouth (63%), altered taste (60%), pain (43%), dysphagia (42%), and appetite disorders (31%) with an average weight loss of 4kg. Local antifungal agents (amphotericin B, nystatin, and miconazole muco-adhesive buccal tablet (MBT)) were given in 75% of patients (41%, 12%, and 22%, respectively). Compliance to treatment was respectively 19%, 40%, and 88% for nystatin, amphotericin B with mouthwashes, and MBT. Conclusions: The prevalence of OPC in treated cancer patients is frequent with important clinical consequences. Systemic treatment compliance delivered according to the international guidelines is often poor and are strongly improved by the use of daily MBT. No significant financial relationships to disclose.
Expressed emotion, depression, and survival in patients diagnosed with hepatobiliary carcinoma
Authors: Steel J. L. , Hammond J. , Carr B. I. , Gamblin T. C. 
Published: August 2020

e20597 Background: The aims of the present study were to (1) investigate the association between expressed emotion, health related quality of life, and depression, and (2) explore the association between expressed emotion and survival in patients diagnosed with hepatobiliary carcinoma. Methods: The study was prospective in design. Ninety-six patients diagnosed with hepatobiliary carcinoma were administered a battery of questionnaires that measured depression, health-related quality of life, and expressed emotion. Medical chart review was used to gather disease specific information. Mann Whitney U and Kruskal Wallis tests were performed to test differences between groups and Cox regression analyses were performed to test predictors of survival. Results: At diagnosis, 54% of the patients reported a CES-D score ≥ 16 (clinical range). Patients who reported CES-D scores in the clinical range were found to have significantly lower overall health related quality of life (Mann Whitney U= 506, p = 0.003) and in particular lower emotional (Mann Whitney U=551, = 0.009) and functional well being (Mann Whitney U=507.5, p = 0.003). Patients who reported CES-D scores in the clinical range also reported a higher frequency of cancer-related symptoms (Mann Whitney U=503.5, p= 0.002) at diagnosis using the FACT-Hepatobiliary module. Patients who reported lower levels of emotional expression were found to have higher levels of depression (Mann Whitney U-6.6, p=0.04) and lower social and family well-being (Mann Whitney U=6.4, p=0.04). Using Cox regression, sociodemographic and disease-specific characteristics, depression, and expressed emotion were entered into a model. Significant predictors of survival included greater number of lesions (p=0.04), larger size of tumor (p=0.02), and lower levels of emotional expression (p=0.03). Conclusions: Preliminary findings suggest that patients with low levels of emotional expression reported higher rates of depression, poorer quality of life, and shorter survival. Interventions should be developed to treat symptoms of depression to improve quality of life. Expression of both positive and negative emotions should be encouraged by health care professionals. No significant financial relationships to disclose.
Level of fatigue in colorectal cancer patients (ccp) receiving adjuvant chemotherapy
Authors: Heras P. , Hatzopoulos A. , Kritikos K. , Karagiannis S. 
Published: August 2020

e20612 The aim of the study was to assess the level of fatigue during and after adjuvant chemotherapy in ccp. Methods: 52 patients (age 30–73 years) with colorectal cancer were recruited between May 2005 and November 2008. Fatigue intensity was measured according to 10-score visual analog scale (VAS, 0-no fatigue, 10-fatigue as bad as it could possibly be) before the start of adjuvant chemotherapy, once weekly during chemotherapy, 20 days and 6 months after. Results: Over half of the patients (56%) demonstrated no fatigue before the start of adjuvant chemotherapy. Fatigue intensity increased gradιιally during chemotherapy. It highest in the last week of treatment 20 days after the end of chemotherapy, fatigue intensity was still higher than before treatment, but 6 months after it was lower than the pretreatment level (mean fatigue-VAS was 1.17, 2.41, 1.45 and 0.61, respectively). However, 17% of the patients defined their fatigue as 2 or more in VAS six months after chemotherapy had ended. About 1/4 of the patients reported nο fatigue during chemotherapy. Increased level of fatigue was associated with an increased need of rest. Patients with pain (pain-VAS 1 or more) manifested higher fatigue level in comparison with individuals without pain (mean fatigue-VAS 3.20 vs 1.02 in the last week of treatment). Older patients (>65 years) estimated their fatique in the last week of treatment on lower level than younger patients (fatigue-VAS 1.79 vs. 2.83 No significant financial relationships to disclose.
Biological profile of oestrogen receptor alpha positive (ERalpha+) primary breast cancers in the elderly and their response to primary endocrine therapy
Authors: Okunade G. , Green A. R. , Ying M. , Agrawal A. , Paish E. C. , Winterbottom L. , Hassell K. , Morgan D. A. , Ellis I. O. , Cheung K. 
Published: August 2020

e20622 Background: Aromatase inhibitors (AIs) have been shown to be superior to tamoxifen in several settings. However, it is unclear whether this superiority extends to its use as primary endocrine therapy in elderly patients with early operable primary breast cancer. Biological characteristics of the tumours may aid in selecting the most suitable agent. Methods: Primary endocrine therapy with one of the AIs (anastrozole) in 64 women >70 years with ERα+ breast cancer was compared to that in 84 treated with tamoxifen during the same period. Their selection was entirely based on contraindications e.g. thromboembolic risks. Needle core biopsies were assessed, by immunohistochemistry, for expression of biomarkers as described below. Results: There was no significant difference between the two groups (anastrozole vs tamoxifen) in terms of response at 6 months (clinical benefit (objective response + stable disease) rates = 97 vs 100%, p=0.099) or progression free survival (median = 16.5 vs 22.5 months, p=0.376). There were no withdrawals due to side effects from anastrozole, compared to four with tamoxifen. For all patients progesterone receptor (PgR), ERβ2, human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR) and Ki-67 were over-expressed in 48%, 99%, 8%, 4% and 64% respectively. HER2 (18 vs 21 months, p=0.003) and Ki-67 (17.5 vs 23 months, p=0.042) over-expression were significantly associated with shorter progression free survival. Conclusions: These results thus far show that primary endocrine therapy with anastrozole in elderly patients with early operable ERα+ breast cancer is similar to tamoxifen in terms of efficacy, but may be better tolerated. In this population, ERα+ breast cancer also appears to have a less aggressive biological profile favouring better hormone sensitivity. [Table: see text]
Pediatric sibling donor bone marrow transplant: Assessing distress in donors and family members
Authors: Hinds P. S. , Pelletier W. , Alderfer M. A. , Davies S. , Pentz R. D. 
Published: August 2020

e20625 Background: When a child is diagnosed with cancer, the entire family is affected. In qualitative studies, 28–81% of siblings of children with cancer display behavioral maladjustment. Quantitative studies show similar findings, documenting up to a three-fold increase in clinically significant behavioral problems among siblings of children with cancer. Methods: In order to better understand sibling distress we conducted 3–4 interviews using grounded theory methodology (a qualitative strategy to explore common themes and develop theory) with each family member over 9 years old of 7 families with a child undergoing a sibling donor bone marrow transplant for cancer or sickle cell anemia. Participants also completed standardized scales related to coping. Results: Of the 29 subjects interviewed, 6 were African American, 4 Hispanic and 19 white. Six parents had at least a college degree and income was evenly distributed from $5,000 to >$80,000 a year. Children, including 4 patients, 6 donor siblings and 5 other siblings, ranged in age from 9 to 18. Based on the grounded theory analysis of each interview, we theorize that siblings experience less distress if the parents share the patient care giving. Our data support this hypothesis, with analysis of interviews indicating improved coping in families that shared care giving for the transplant recipient, and increased distress in families in which all the patient care giving was performed by the mother, a commonly used strategy. Conclusion: In order to potentially facilitate increased family functioning and decrease caregiver burden, parents should be encouraged to share care giving when feasible. Our study shows that systematic interviews can explore the family experience of pediatric transplantation and allow development of improved support systems for families of children undergoing sibling donor bone marrow transplantation. No significant financial relationships to disclose.