bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pananemia 2008 multicenter observational study on erythropoietin beta treatment in patients with cancer: Efficacy, patient satisfaction, and impact on psychological distress
Authors: Del Prete S. , Addeo R. , Leo L. , Cinieri S. , Lorusso V. , Vincenzi B. , Bianco M. , Savastano C. , Montesarchio V. , Filippelli G. ,   Pananemia Southern Italy Group GOIM
Published: August 2020

e20695 Background: Cancer-related anemia, results in both a need for transfusions and a decreased functional capacity and quality of life. Treating anemia associated with chemotherapy and many cancers is often necessary. However, patient satisfaction with anemia treatment, and the possible correlation between anemia and psychological distress frequently present in these patients is limited by the lack of validated instruments. Methods: Between January 2008 and December 2008, 591 cancer patients in treatment with erythropoietin beta for anemia were targeted to complete the Psychological Distress Inventory (PDI), a 13-item self-administered questionnaire, and the Patient Satisfaction Questionnaire ( PSQ) at 4 week intervals, a 10-item, self-administered questionnaire. Data from weeks 5 and 9 were analyzed. Patients were required to receive at least four weekly injections of Epo, expecting to receive ≥ 8 additional weeks of chemotherapy, and able to complete questionnaires. Results: Among patients fulfilling eligibility criteria and having received at least four Epo Beta administrations, most (57.5%) of them were female, with a median age of 66 (52.4 - 76.5), and a median KPS of 85 (range: 50–100). 399 patients had a stage IV cancers. Hemoglobin values increased from mean baseline levels of 9.55 g/dL, to attain levels 10.31 at week 5, and 11.05 after 8 weeks of therapy; 247 (42%) patients received iron supplementation. For PDI, the overall response rate was 93 % (548/591) at baseline, 100 % (517/517) at week 5, and 99% (491/492) at week 9. The percentage of patients with psychological difficulties decreased during the treatment. For PSQ, the overall response rate was 100% (517/517) at week 5, and 100 % (492/492) at week 9. The PSQ questionnaires showed that a conspicuous group of patients (124/517) marked troubles to accept the treatment. Conclusions: Our results suggest that in anemic cancer patients psychological distress and anemia were related. PSQ reflect the burden of injection anemia treatment on cancer patients. Final data analysis will be presented. No significant financial relationships to disclose.
Analysis of the patient-related barriers in cancer pain anagement in Turkish patients
Authors: Bagçivan G. , Tosun N. , Kömürcü S. , Özet A. , Akbayrak N. 
Published: August 2020

e20699 Background: The most important issue, which may be preventing effective cancer pain management, have generally been the barriers originating from misbelieve or misunderstandings, which lead patients to be reluctant to report pain and receive the appropriate analgesic. It is the first study about this issue in Turkey. Methods: This study was planned as a descriptive and cross-sectional. The sample was 170 patients with cancer, who used or is still using analgesic medication for pain related to cancer. Demographic Questionnaire, Brief Pain Inventory and BQ-II were used for data collection. The reliability coefficient for the total scale and subscales (Cronbach's α) were calculated. Test and retest results were compared to determine the scales validity for Turkish patients. All statistical analyses were performed with the SPSS 15.0.The value p≤0.05 was considered ‘statistically significant’. Results: As a result of the factor analysis made for BQ-II, seven factors that make up for 66.451% of the total variance were found. Cronbach's alpha value was 0.87 for the BQ-II. According to the points given by patients to the items in BQ-II, it was seen that they have beliefs that may be barriers to optimal pain management mostly in “addiction” and minimally in “physical side effects” subscale. It was ascertained that male, not married patients, patients with a chronic disease other than cancer, patients whose “average pain” level is >5 and who use inadequate analgesic have more beliefs that may be barriers to optimal pain management. Conclusions: BQ-II was a valid and reliable scale for Turkish defining patient related barriers in cancer pain management. Items suggested by patients such as “family related barriers” and “family members’ role and responsibilities” could be added to the BQ-II for future studies. No significant financial relationships to disclose.
Adverse events due to chemotherapy in emergency room
Authors: Serrano Solares S. , Vidal M. , Ferrer A. , Tobeña M. , Millastre E. , Ruiz Echarri M. , Pajares I. , Lopez D. , Tres A. , Lambea J. 
Published: August 2020

e20701 Background: High rates of mortality due to cancer make necessary improve oncologic treatments. Relationship between adverse events and chemotherapy schedule and dose is well known thanks to large observational studies. Our study´s objective is to estimate the prevalence of chemotherapy adverse events in oncologic patients attended in Emergency room. Methods: From October 2007 to October 2008 560 patients were recollected. It was revised tumors location and stage, chemotherapy schedule and date of the last treatment, diagnosis and therapheutic in Emergency. Results: 87 of the 560 patients (15%) were attended in Emergency room because of chemotherapy toxicity. The most common cause of consultation was fever (27 patients, 31%) followed by diarrhea (18 patients, 20.7%) and nausea-vomiting (12 patients, 13.8%). Most of the patients were being treated with classic chemotherapy schedules (70.1%). Comparing as a whole all the chemotherapy schedules there were not statistically significant differences due to toxicity between them. Nevertheless analyzing by subgroups we found there was no difference between toxicity in patients treated with classic chemotherapy and chemotherapy plus target agents (33.8% vs 5.5%, p=0.30), but there was differences between chemotherapy and target agents in monotherapy (33.8% vs 13.2%, p<0.05). In 39 of the 87 patients (39%) admission was required with a good evolution in most of them. Conclusions: Adverse events due to chemotherapy is a common cause of consultation in Emergency room. In our sample new target agents did not add toxicity to classic chemotherapy and given as monotherapy they had really good tolerance. More randomized studies are necessary to do a better evaluation of adverse events due to new agents. No significant financial relationships to disclose.
Fever in cancer patients as a cause of attendance in emergency room
Authors: Vidal M. , Ferrer A. , Serrano S. , Tobeña M. , Pajares I. , Lopez D. , Millastre E. , Ruiz-Echarri M. , Lambea J. , Tres A. 
Published: August 2020

e20706 Background: Normal human body temperature displays a circadian rhythm, ranging from 36.1 C or lower in predawn hours to 37.4 C or higher in the afternoon. Abnormal elevation of temperature occurs as a result of hyperthermia or fever. Cancer patients frequently experience fever. Nearly two-thirds of the cases of fever in patients with prolonged neutropenia could be attributed to infection, a major cause of morbidity in cancer patients. Purpose: The aim of our study is to evaluate the prevalence of cancer patients who were attended in the emergency room for fever, the diagnosis and clinical management. Methods: From October 2007 to October 2008, 560 cancer patients were seen in the emergency department of the University Hospital of Zaragoza. The purpose of this paper is to describe the characteristics of patients who presented with fever. Results: A total of 560 patients were seen. Ninety-eight (17.5%) presented with fever. 63% of patients were stage IV. Cancer tumor type, 35 had lung cancer (35.7%), 14 had breast cancer (14.3%), 9 had colorectal cancer (9.2%), 9 had urothelial cancer (9.2%), 5 had head neck cancer (5.1%), 5 had pancreatic cancer (5.1%), 3 had esophageal cancer (3%), 2 had prostate cancer (2%), and 14,3% had other neoplasm. 18 patients (18.36%) had been received chemotherapy treatment in a period of 10 days before. they were attended in emergency room. By diagnosis: 23 patients (23,46%) were diagnosed of febrile neutropenia, and 19 of them (82,6%) required admission to the hospital. 30 were diagnosed of respiratory tract infection (30,6%), 12 were diagnosed of urinary infection (12.24%). Considering all the patients who presented with fever: 45 patients were sent home with new treatment (45,9%), 6 patients were observed for 24 hours in the emergency room (6.2%) and 47 patients required admission to the hospital (47.9%). Conclusions: Fever in cancer patients remains a challenge, and the differentiation between infectious and non-infectious causes at onset of fever is very difficult. Despite all the prophylactic measures, infection is still the principal cause. Infection in the immunocompromised host is a serious clinical situation due to high morbimortality and is one of the most frequent complications in the patient with cancer. No significant financial relationships to disclose.
A randomized controlled trial of the effect of intercessory prayer on the spiritual wellbeing and quality of life of patients with cancer
Authors: Olver I. N. , Whitford H. S. 
Published: August 2020

e20708 Background: A number of scientific trials assessing the positive impact of intercessory prayer attest to centuries of anecdotal evidence, despite debate of its mechanism. However, little attention has been afforded to patients with cancer and the effect such intervention has on quality of life, including spiritual wellbeing. This study aimed to assess the effect of remote, Christian intercessory prayer on cancer patients’ quality of life, specifically their spiritual wellbeing, including their search for meaning, peace, and faith. Methods: New, consecutive patients with cancer attending an Australian cancer centre, aged 18 years or above, able to read English, and give consent were recruited. With Ethics Committee approval, this prospective, double blinded randomized controlled trial only partially divulged the nature of the study to patients who were informed of the measurements but not the inclusion of randomization to an intervention. Specifically, patients were blindly, randomly allocated to receive distant, intercessory prayer from an established Christian prayer chain (intervention) or not to receive prayer (control). All patients completed the Mental Adjustment to Cancer (MAC) scale and the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being (FACIT-Sp) at baseline. The FACIT-Sp was re-administered six months later to assess the primary endpoint, a change in spiritual wellbeing. It was anticipated that 1000 patients were needed (allowing for 20% drop out) to achieve 80% power to detect hypothesized small differences (Cohen's d .20-.50) between groups (alpha = .05). Results: A total of 1003 eligible, consenting patients were accrued between June 2003 and May 2008. Intervention (n = 509) and control (n = 494) groups will be compared across baseline characteristics to identify any pre-existing differences. Between-within subject analyses of covariance (ANCOVAs) will be used to assess whether any differences were evident between groups across measures of spiritual wellbeing and other facets of quality of life. Conclusions: The results of these analyses will be presented. It is hoped this research will provide further empirical support for the biopsychosocialspiritual model of health. No significant financial relationships to disclose.
History and organization of palliative care in Poland
Authors: Swietlik E. , Doboszynska A. 
Published: August 2020

e20749 Beginning of the hospice care in Poland is associated with democratic opposition in the eighties of the XX century and social movement Solidarity. In 1978, C. Saunders visited Gdansk, Warsaw, and Krakow, supporting an organization of palliative care in Poland. Polish hospice care, similarly to other countries,originated from the necessity of special care of terminally ill cancer patients. Palliative care societies, initially informal, then registered formally, emerged in Poland in 1981. Hospices, both institutional and house hospice care, came into being in all larger cities in Poland to the nineties of the XX century. In 1991, National Forum of the Hospice Movement was founded. This Forum, gathering the majority of hospices, is actually transformed into the association of societies: Forum of the Polish Hospices. In the nineties of the XX century, professional palliative care developed. Since 1998, specialization in the palliative care for both physicians and nurses is available. From the very beginning, hospice care based on the volunteers gathered at the Roman Catholic parish and several priests first organized palliative care. In 1991, The Sejm (lower chamber of the Polish Parliament) passed the law Health care institutions, enabling various societies and associations to establish health care institutions, whereas the law The Social Insurance Act (1997) gives an opportunity to get financial means for hospice care from the State. Actually, there are hospices acting on voluntary service (the number of such hospices decreases), partial voluntary service and also paid employees, and institutions which activities are based on full-time employment and financed by the National Health Fund. About 130 non-profit societies and hospice foundations both secular andchurch exist in Poland. Non-public health care institutions founded 99 hospices. About 70 hospices (both public and private) are stationary. No significant financial relationships to disclose.
Spectrum of KIT and PDGFRA mutations in primary gastrointestinal stromal tumors: Polish Clinical GIST Registry experience
Authors: Wozniak A. , Rutkowski P. , Debiec-Rychter M. , Siedlecki J. , Michej W. , Osuch C. , Matlok M. , Ruka W. , Limon J. ,   Polish Clinical GIST Registry
Published: August 2020

e21504 Background: KIT or PDGFRA gene mutations are found in 80–90% of gastrointestinal stromal tumors (GIST). The prognostic value of those mutations for the outcome in primary tumors is controversial. Objective: To assess the spectrum, frequency and prognostic significance of the KIT and PDGFRA gene mutations in Polish group of surgically treated primary GISTs. Methods: DNA isolated from paraffin blocks from 300 patients (pts) with histologically diagnosed primary GISTs included in clinical registry database, were analyzed using denaturing high performance liquid chromatography (DHPLC) and direct sequencing for KIT (exons 9, 11, 13, 17) and PDGFRA (exons 12, 14, 18) mutations. For primary GIST risk assessment the Miettinen stratification was used. Results: KIT/PDGFRA genes mutations were found in 82% tumors: KIT was mutated in 69% and PDGFRA in 13% of tumors. KIT exon 11 and 9 mutations were found in 61.5% and 7.5% respectively. Among KIT exon 11 mutants the most frequent were deletions (32.7%) followed by point mutations (15.3%), duplications (8.4%) and complex rearrangements (5.1%). KIT exon 11 mutations were found at the similar rates in tumors with gastric and non-gastric localization (53.9% vs. 46.1% respectively) while KIT exon 9 duplications were more often observed in non-gastric GISTs (86.4%, p=0.00036) and PDGFRA mutations were more frequently found in tumors originated from the stomach (86.8%; p=0.00017). In high risk tumors KIT exon 11 deletions were more frequently found than point mutations (p=0.017). On the other hand mutations in PDGFRA were more often observed in very low-/low- than high risk GISTs as compared to KIT exon 11 (p=0.0026). There was no statistically significant correlation between disease-free survival and the spectrum or frequency of mutations. Conclusions: Spectrum and frequency of KIT and PDGFRA mutations in Polish GIST population are similar to the previously described groups. No significance of mutations for disease outcome after surgery of primary tumors was found. [Table: see text]
Evaluation of Ki-67 in gastrointestinal stromal tumor (GIST)
Authors: Saponara M. , Di Battista M. , Lolli C. , Derenzini E. , Pantaleo M. A. , Santini D. , Ceccarelli C. , Catena F. , Nannini M. , Maleddu A. , Biasco G. 
Published: August 2020

e21510 Background: GISTs show a wide spectrum of biological behaviors which translates in an even wider spectrum of possible clinical courses. The two canonical parameters used for the prediction of GISTs’ prognosis are tumor size and mitotic index. However, few but controversial data on Ki-67 are also available. The aim of our study was to clarify the role of Ki-67 expression as a new biological marker in GISTs. Methods: Forty-one cases of GIST were examined. Twenty-six cases arose from stomach and 15 from small bowel. Immunohistochemical analysis for Ki-67 was stained on tissue samples and a cut-off value of >10% immunoreactive cells was used to distinguish between low (<= 10%) and high (>10%) Ki-67 nuclear expression. The expression of this cell-cycle related protein was correlated with tumor site (stomach; any other site), dimensions (<5 cm; >=5cm), mitotic index (<=5/50 HPFs; >5/50 HPFs), standard risk groups (low; intermediate-high) and disease free survival (DFS). Results: Ki-67 over-expression was positively correlated with tumor size >=5cm (p= 0.035). Not significant but a positive trend was seen with intermediate and high risk groups (p = 0.114), mitotic index >5/50 HPFs (p = 0.615). Lower levels of Ki-67 expression have been observed in gastric GISTs compared to any other site (29 cases with Ki-67 <=10% of which 21 gastric and 8 in other sites), even if these values were not statistically significant (p = 0.527). Moreover, Ki-67 over-expression was found to be significantly associated with a shorter DFS interval (p = 0.0196, analysis performed on 32 cases). Conclusions: Our data demonstrate that Ki-67 over-expression is significantly correlated with larger GIST and with a shorter DFS, suggesting that Ki-67 evaluation can be a useful tool to predict biological behavior of GIST, even if further studies are needed. In a clinical perspective, such information could be used in association with standard risk factors to select patients who could benefit from adjuvant therapy. No significant financial relationships to disclose.
Clinical features and outcome in primary breast sarcomas (BS): Analysis of a single-institution experience
Authors: Ramon y Cajal T. , Mazarico J. , Lopez Pousa A. , Quintana M. , Sala N. , Altabas M. , Sebio A. , Robert L. , Alonso C. , Barnadas A. 
Published: August 2020

e21520 Background: BS are characterised by local spread and recurrence. Controversy remains about local and adjuvant treatment. The objective of this retrospective study was to analyze clinical and pathological prognostic factors influencing the outcome of BS patients. Methods: We analyzed clinicopathological variables, treatment and outcome of 33 BS patients treated at our institution from 1966 to 2007. A single pathologist reviewed pathologic diagnoses. Kaplan Meier method was used to evaluate outcome. Mean age: 44 years (20–82y. Tumor size 57 (0–230) mm. Pathology: 17 cistosarcoma phylodes (CPh), 9 angiosarcoma, 2 extraesqueletical osteosarcoma, 2 fibrosarcomas, 1 liposarcoma, 1 leiomiosarcoma, 1 malignant fibrous histiocitoma (2.9%). Low-grade in 12, high-grade in 15 pts. Mastectomy in all but 8 patients. Adjuvant chemotherapy and radiotherapy in 9 and 7 patients. Pathological stage I- 12%, II- 65%, III- 9%, IV-3% Results: Median follow-up 71 (5–239) months. Median survival 160 months. Survival was 83%, 74% and 59% at 5, 10 and 15 year. 5/8 (62.5%) local excision patients needed rescue surgery due to local progression. 8/25 (32%) mastectomy patients progressed Local recurrence in 9 pts, distant 4 pts (radical rescue surgery in 10 pts). 7 pts death only 1 phyllodes. Mean 15-year survival for CPh was 169 vs 124 months for other histologies (p 0.06). In the univariate analysis we didn't found statistical differences according to clinical & pathological factors, stage and recurrence, on OS or PFS. Conclusions: CPh have better prognosis than other BS although its stage or size tends to be higher. Radical surgery in BS should be always considered as first treatment option. High-grade non-phylodes BS types may be considered for adjuvant chemotherapy although there were non-statistical differences in OS. No significant financial relationships to disclose.
Activity of lenalidomide in metastatic hepatic epithelioid hemangioendothelioma (HEH): A case report
Authors: Schilling G. , Schuch G. , Panse J. P. , Sterneck M. , Bokemeyer C. 
Published: August 2020

e21527 Background: HEH is a rare tumor of the liver with an unpredictable malignant potential. Surgical resection or liver transplantation is recommended in locally advanced disease and has been successfully performed in selected cases with extrahepatic manifestations. Systemic therapy, however, is not standardized. Small cohorts have been treated with interferon, chemotherapy and angiogenesis inhibitors such as thalidomide with various results. Case report: A 33-year old caucasian previously healthy male was admitted to hospital with newly diagnosed suspicious lesions in liver and spleen. Further analyses showed additional pulmonal nodules. Biopsy revealed a tumor with predominant epithelioid cells, positive for CD31 and CD34 and negative for CD117, HHV8, AFP and CEA, classified as a HEH. Disease progressed during first line treatment with adriamycin and ifosfamide (2 cycles given). Based on a case report with encouraging results with thalidomide we treated our patient with lenalidomide, which is known to have less side effects while being more effective in the myeloma setting. After 6 courses of lenalidomide 25mg daily (21/28), regression of the splenic lesions was detected. Retrospective analysis after 9 cycles demonstrated stable disease in comparison to the recent investigation, but an overall progression of 22% according to RECIST criteria in the liver was observed. Due to the excellent tolerance we increased the daily dose to 30 mg (21/28) and 6 months later a slight regression in the lung and overall stable disease in the liver was observed. The splenic lesion disappeared completely. The patient was listed for liver transplantation and after another 4 months on lenalidomide 30 mg, he was successfully transplanted recently. Because of the remaining extrahepatic lesions it is planned to continue lenalidomide therapy in combination with the immunosuppressant rapamycine. Conclusions: We report the first case of successful therapy with lenalidomide in HEH. Higher doses than 25mg seem to be more effective. We grateful thank Celgene for offering us lenalidomide for this off label use. No significant financial relationships to disclose.