bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reproductive health assessment in women with cancer: A pilot study
Authors: Sreedevi M. , Sutaria R. , Schoenhage M. , Patel A. R. , Radeke E. K. , Zaren H. A. , Patel A. 
Published: March 2020

19660 Background: Many women in the reproductive age group are diagnosed with cancer. Reproductive health issues remain an important concern in caring for these women. Based on a case series in our institution and a review of the literature, we found a paucity of literature and clinical acumen regarding reproductive health issues. The purpose of this study was to pilot a survey instrument to develop descriptive data on the reproductive goals of reproductive aged women (15–44yrs) presenting with cancer. Methods: A cross- sectional pilot survey study of 20 selected women diagnosed with various types of cancers presenting to Hematology-Oncology clinic of John.H.Stroger Jr. Hospital of Cook County, Chicago, from January through July 2006. A survey instrument was developed and performed a reproductive health assessment. Patients were interviewed about their obstetric/menstrual history, contraceptive motivations and choices as well as future child bearing options. Results: Of the 20 patients with mean age of 36.6 years who were surveyed, 90 % had breast cancer. Child bearing was completed by 50%, 45% desired future childbearing, 5% were unsure. Contraception was used by 55 %( n=11) of patients out of which 55 %(n=6) were using abstinence, 45% denied the use of any contraception. Amongst the patients who received chemotherapy with radiation and chemotherapy without radiation, 75% and 72.7% respectively continued to menstruate. Ten percent would continue pregnancy, if they become pregnant while on treatment. Conclusions: The result of this pilot study demonstrates some insight into the reproductive health needs and concerns of women diagnosed with cancer. A reproductive health assessment should be performed on all cancer patients who are in the reproductive age group. We plan a large prospective study providing a larger database that may aid in developing treatment plan. No significant financial relationships to disclose.
Amifostine pretreatment for patients with advanced colorectal cancer receiving folfox chemotherapy
Authors: Arena F. , Kurzyna-Solinas A. , Stark R. F. , Ohri A. , Schiffer C. , Sulzbach H. , Jemison D. , Dolat J. 
Published: March 2020

19663 Background: Oxaliplatin plays a key role in the treatment of advanced colorectal cancer (CRC) but is associated with dose- limiting peripheral neuropathy (PN) in >20% of patients. We investigated the effects of amifostine, a cytoprotective agent, on the prevention of PN in patients receiving oxaliplatin in combination with 5-fluorouracil (5-FU) and leucovorin (LV) (FOLFOX) for the treatment of advanced (stage =III) CRC. Methods: In this ongoing prospective observational study, patients with stage =III CRC are assigned to receive FOLFOX alone (oxaliplatin 85 mg/m2, 5-FU 400 mg/m2 bolus, 5-FU 1.2 or 2.4 g/m2 continuous infusion over 46 h, LV 200 or 400 mg/m2) or FOLFOX plus 500 mg subcutaneous amifostine 30 minutes before chemotherapy. Some patients also receive bevacizumab and/or panitumumab. All patients receive Ca/Mg infusion (1 g each/100 mL normal saline) before and after oxaliplatin treatment. Incidence and degree of PN are assessed during biweekly patient interviews and graded using National Cancer Institute Common Toxicity Criteria Version 3. Results: Sixteen patients have enrolled to date (9 nonamifostine, 7 amifostine; mean age, 60.2 y [range, 33–81 y]; 81% men). Currently, data for 6 patients (3 per group) who have completed 12 cycles of therapy are available. Two of 3 patients in the nonamifostine group reported PN grade =2 during treatment; 1 of these patients required multiple treatment interruptions because of grade 3 PN. The third nonamifostine patient reported grade 1 PN on only 2 occasions during treatment but experienced grade 2 PN at 3-month follow-up. No patient in the amifostine group reported grade =2 PN during the treatment period. One amifostine patient required a reduction in oxaliplatin dose after 8 cycles because of neutropenia. At 3-month follow-up, 1 amifostine-treated patient reported grade 1 tingling in his hands and is currently receiving treatment with pregabalin. Conclusions: The use of amifostine for the prevention of oxaliplatin-induced PN is investigational. Patients with advanced CRC who received amifostine with FOLFOX chemotherapy had a decreased incidence and severity of PN compared with patients who did not receive amifostine. Updated data will be available at the time of presentation; study enrollment continues. No significant financial relationships to disclose.
Patterns of hospitalization and toxicity among patients undergoing cancer chemotherapy in community-based oncology practice in Brazil
Authors: Pizao P. E. , Katayama L. M. , Sagarra A. J. 
Published: March 2020

19678 Background: In Brazil, most cancer patients receive treatment outside the controlled clinical trial setting and at community- based clinics. In this scenario, data on treatment-related toxicity and its complications are seldom reported. Chemotherapy is frequently referred to as an excessively toxic treatment modality and this perception may have a negative impact on treatment decision-making. Methods: This is a single institution, prospective study. Eligible population consisted of all patients with solid tumors undergoing chemotherapy, between January/2005 and November/2006, at this community-based private oncology clinic with a multidisciplinary staff (physicians, nurses, pharmacists, nutrition and psycology experts). Treatment-related hospitalization (TRH) was defined as any hospitalization starting within 4 weeks after a chemotherapy session. Data concerning tumor-related symptoms and chemotherapy-induced toxicity were prospectively collected by a single physician. Results: A total of 59 patients were hospitalized during the study period. Median hospitalized patients′ age was 61 years and 58% were female. Most frequent tumor types were breast (36%), colorectal (14%), pancreatic (14%) and ovarian (9%) cancers. 34 (57%) of the 59 hospitalizations were classified as TRH. Febrile neutropenia (27%) and gastrointestinal complications (26%) were the main reasons for TRH. The median length of TRH was 4 days. 6/34 (17%) patients died during TRH: 5 died as a result of complications caused by disease progression (not chemotoxicity); 1 patient died as a consequence of chemotherapy-induced neutropenia and sepsis. TRH′s were associated to only 2% (34) of the 2203 chemotherapy sessions performed. Conclusions: Current evidence-based, consensus-guideline-oriented, cancer chemotherapy, administered by a multidisciplinary team of specialists, was associated to a low rate of treatment-related hospitalizations. Generally, chemotherapy-induced toxicity was reversible and manageable in the outpatient setting. The permanent monitoring and reporting of treatment-related toxicities is feasible in community-based clinical practice as part of a quality-assurance program. No significant financial relationships to disclose.
Pediatric salivary gland neoplasms: The M. D. Anderson Cancer Center experience
Authors: Huh W. W. , Bosworth C. , Hessel A. C. , Mahajan A. , Hughes D. P. , Herzog C. E. 
Published: March 2020

20006 Background: Epithelial salivary gland neoplasms (ESGN) are uncommon tumors that mainly occur in adults, only 5 percent of ESGNs occur in children. Data regarding differences in clinical presentation and biologic behavior of these tumors between adult and pediatric patients remain unclear. There is less data concerning the role of radiation therapy in the treatment of ESGNs in pediatric patients. Methods: Retrospective review of medical records of patients presenting under age 18 years from January 1988 to August 2006. Results: 45 patients were evaluable. 26 patients were female. Median age at diagnosis was 14.7 years. Mucoepidermoid carcinoma (MEC) was seen in 22 cases (49%), acinic cell carcinoma 10 cases (22%), adenocystic carcinoma (ACC) 8 cases, and pleomorphic adenoma (PA) 5 cases. The parotid area was the most common involved site (25/45; 56%) with MEC and acinic cell noted in 80% of parotid cases. 76% of MEC cases (16/21) were grade 2 or 3 tumors. Initial complete resection was achieved in 20 ESGN cases, while the remaining cases required re-excision or adjuvant therapy. Thirteen patients received postoperative radiation. Median age was 15.8 years. Radiation therapy was used in 6 ACC cases, 4 MEC and 3 adenoid cystic. Primary site and first echelon nodes dose range was 54–64 Gy, and supraclavicular dose was 50 Gy in those in whom regional nodes were treated. Positive margin status and local invasion (perineural, lymphatic, or nodal) were the most common indications. Mean follow-up for 35 patients was 60.3 months (2–175 months). Nine patients were lost to follow- up, and one patient received therapy at another institution. Two patients died from progressive disease, and both had received radiation therapy. Conclusions: MEC is the most common ESGN in pediatrics, and the parotid is the most common involved site. Complete surgical resection remains the treatment of choice. Radiation therapy may be used as adjuvant therapy, but more study is required. No significant financial relationships to disclose.
The incidence of pseudo-progression in a cohort of malignant glioma patients treated with chemo-radiation with temozolomide
Authors: Taal W. , Brandsma D. , de Bruin H. G. , Bromberg J. E. , Swaak-Kragten A. T. , Eijkenboom W. M. , van den Bent M. J. 
Published: March 2020

2009 Background: Radiotherapy (RT) plus concomitant and adjuvant temozolomide (TMZ) is now the standard of care for newly diagnosed glioblastoma. The occurrence of pseudo-progression at the end of RT is an often-mentioned phenomenon, but the actual incidence is unknown. It is also unclear if this is only a radiological phenomenon or is accompanied by clinical signs and symptoms. We retrospectively assessed this phenomenon in a cohort of patients treated with chemo-irradiation with temozolomide (RT/TMZ). Methods: The pre- and post-chemo-radiotherapy brain CT’s and MRI’s from all patients treated with RT/TMZ for a malignant glioma in the Daniel den Hoed Cancer Center between 2000 and 2005 were reviewed. Treatment consisted of 60 Gy RT in 6 weeks combined with daily TMZ (75mg/m2/day), followed after 4 weeks by 6 cycles of TMZ (150–200 mg/m2/day 1–5 every 4 weeks). Scans were made prior to the start of RT, four weeks after the end of RT and thereafter every three months. Macdonald’s criteria were used to assess the response. In addition information was collected on clinical signs and symptoms, dexamethasone dose, histology, and survival. Results: Sixty-five patients were identified; 54 had been diagnosed with a GBM. Mean age was 48 years and 42 were male. In 23 patients the first follow-up scan 4 weeks after the end of RT showed progression as compared to the pre-RT imaging. This was accompanied by clinical deterioration in12 patients. All patients continued with adjuvant TMZ. In 12 of these 23 patients the MRI and clinical signs and symptoms stabilized or improved in the months thereafter. In 8 of these 12 patients a response was observed without additional treatment other than TMZ. In none of these cases changes in dexamethasone dose could explain the observed MRI changes. Conclusions: In up to 50% of high grade glioma patients treated with chemo-irradiation with TMZ and a progressive MRI lesion immediately after RT suffer from pseudo-progression; this was observed in 12 out of 65 patients. These data support the notion to continue TMZ in case of progressive lesions immediately after RT/TMZ. Studies on recurrent gliomas that accept patients with progressive lesions directly after chemo-radiation will lead to an overestimation of the results. No significant financial relationships to disclose.
Dendritic cell vaccination in combination with TLR-7 agonist, imiquimod, following radio-chemotherapy for newly diagnosed glioblastoma
Authors: Liau L. M. , Prins R. M. , Odesa S. K. , Yang M. Y. , Lin M. S. , Khan-Farooqi H. , Soto H. , Lai A. , Bosch M. , Boynton A. , Cloughesy T. F. 
Published: March 2020

2021 Background: Standard therapy for glioblastoma, which includes surgery followed by radiation and concurrent chemotherapy, creates a low tumor burden environment that could be ideal for immunotherapeutic approaches. We conducted a Phase I study to assess the safety and immunologic responses of tumor lysate-pulsed dendritic cell (DC) therapy plus topical imiquimod, in combination with standard radio-chemotherapy. Methods: Thirteen patients with newly diagnosed glioblastoma were immunized using autologous tumor lysate-pulsed DC. Each patient initially received 3 immunizations at 2-week intervals, following completion of a 6-week course of radio- chemotherapy. Four patients received 1 million DC, 4 received 5 million, and 5 received 10 million DC per immunization. Patients without tumor progression subsequently received booster vaccinations combined with topical administration of the TLR-7 agonist imiquimod. Immunologic responses to tumor antigens were monitored by HLA-restricted tetramer staining, CTL assays, and quantitation of T-regulatory cells. Clinical tumor growth was monitored by brain MRI scans every 2 months, and the primary clinical endpoint was 2-year survival. Results: All immunizations were well tolerated, with only mild side effects attributable to the DC vaccination and imiquimod adjuvant. Increased levels of CD8+ T cells reactive against tumor antigens, (e.g., gp100, TRP-2, her-2, survivin, and CMV antigens), were detected in 5 patients. Median PFS and OS have not been reached in this trial. To date, 6 of the 13 patients have progressed, and 4 of those have died. The median PFS to date is 18.1 mos. and median OS is 33.8 mos. This compares favorably with controls from the published literature, with a median PFS of 6.9 mos and OS of 14.6 mos. Conclusions: This study demonstrates the safety and clinical/immunologic effects of an autologous tumor lysate-pulsed DC vaccine for patients with newly diagnosed glioblastoma. The adjunctive use of the TLR-7 agonist imiquimod with DC vaccination appears to be non-toxic, and deserves further study. We demonstrate that this active immunotherapy strategy can generate antigen-specific immunologic responses in brain tumor patients following standard radio-chemotherapy. No significant financial relationships to disclose.
Comparing cerebral blood volume and vascular permeability measurements with tumor volume measurements following anti-angiogenesis therapy in recurrent gliomas
Authors: Narayana A. , Chheang S. , Knopp E. , Peccerelli N. , Babb J. , Johnson G. , Gruber M. , Allen J. , Zagzag D. , Law M. 
Published: March 2020

2030 Background: Dynamic susceptibility contrast-enhanced MRI (DSC MRI) is emerging as an important adjunctive biomarker to assess the effectiveness of anti-angiogenic therapies in the treatment of brain tumors. The purpose of our study is to compare changes in relative cerebral blood volume (rCBV) and in perfusion-permeability index (KTrans) with those of tumor volume measurements (T1c, T2/Flair) in predicting tumor therapeutic response in recurrent high-grade gliomas treated with bevacizumab, an anti-VEGF monoclonal antibody. Methods: 11 patients were treated with one to four cycles of bevacizumab and CPT-11. Their histological diagnoses were: glioblastoma multiforme (n=7), anaplastic astrocytoma (n=2), anaplastic oligodendroglioma (n=1), and diffuse pontine glioma (n=1). All patients had baseline DSC MRI scans prior to the administration of bevacizumab and were followed clinically and radiographically with both conventional and DSC MRI. Mixed model regression was used to compare the pre-treatment and post-treatment levels of each response measure. Results: There were statistically significant reductions in both actual rCBV measurements and T1c enhancement following treatment with bevacizumab and CPT-11. The pretreatment rCBV and T1c rates of change (as determined per 100 days) correlated significantly with time (p values are 0.0229 and 0.0014, respectively), while only the post treatment rCBV demonstrated significant rate of change (p value = 0.0001), suggesting that rCBV may reflect the effects of bevacizumab better than tumor volume. However, when the changes in rate from pre- to post-treatment status were considered, both rCBV and T1c demonstrated significance (p= 0.0001, 0.0157, respectively). There was a trend towards females having higher mean levels of KTrans than males at the same time point relative to treatment onset, but the result was not statistically significant (p=0.072). Conclusions: rCBV as measured from DSC MRI can be used as a surrogate biomarker to determine therapeutic response to bevacizumab. This may influence the neurosurgical risk/benefit equation as well as alter the aggressiveness of the post-operative adjuvant therapy in patients with recurrent gliomas. No significant financial relationships to disclose.
Treatment of gliomatosis cerebri with temozolomide: A retrospective study of the AINO (Italian Association for Neuro- Oncology)
Authors: Soffietti R. , Rudà R. , Laguzzi E. , Buttolo L. , Pace A. , Carapella C. , Riva M. , Salvati M. , Silvani A. , Caroli M. 
Published: March 2020

2033 Background: The optimal management for patients with primary gliomatosis cerebri is unknown, and some recent studies suggest that temozolomide could be useful as an upfront treatment. Methods: Between 1999 and 2005, 46 patients with biopsy proven gliomatosis cerebri were treated with temozolomide either upfront or at progression after prior radiotherapy/chemotherapy. Histological diagnoses were as follows: glioblastoma in 3 patients, malignant glioma in 8, anaplastic astrocytoma in 8, gemistocytic astrocytoma in 2, astrocytoma in 13, anaplastic oligodendroglioma in 1, anaplastic oligoastrocytoma in 1, oligoastrocytoma in 1, oligodendroglioma in 4, glial proliferation consistent with GC in 5. Median age was 49 years (range 14–70), with 20 males and 26 females and a median KPS at diagnosis of 80 (range 50–90). Twenty-three out of 46 (50%) pre-treatment MRI demonstrated some degree of contrast enhancement. Twenty-three of 46 patients were treated upfront, while 23 had received prior radiation therapy or nitrosourea-based chemotherapy. All patients received temozolomide 200 mg/m2 die for 5 days every 4 weeks until progression or unacceptable toxicity. Response was evaluated, according to Macdonald criteria, on T1-weighted with Gadolinium and FLAIR images. Results: Two patients (4%) showed a CR of the contrast enhancing area, 2 patients (4%) a PR, 5 (11%) a minor response, 18 (39%) a SD and 19 (42%) a PD. Overall response rate (CR + PR + “minor response”) was 19%, while a clinical benefit was observed in 13/46 patients (28%). Median TTP was 9 months (range 1–27), and median survival 14 months (range 3–123). PFS at 6 months was 57%, at 12 months 35%. Oligodendroglial tumours showed a 38% response rate and a TTP of 11 months. Response rate was higher among patients treated at progression compared to those treated upfront (13% versus 26%). Grade III-IV haematological toxicity was mild. Conclusions: Temozolomide has some activity in primary GC (19% response rate), and is well tolerated. A significant neurological improvement can be observed in patients with either response or stable disease on MRI. To improve the efficacy of temozolomide in the upfront setting (in order to delay a large field RT), a phase II study with a dose-dense regimen is ongoing. No significant financial relationships to disclose.
Single fraction radiosurgery of epidural spinal cord compression: Tumor control and neurologic outcome
Authors: Ryu S. , Rock J. , Jain R. , Ellika S. , Jin J. , Anderson J. 
Published: March 2020

2041 Purpose: Spine radiosurgery improves the pain and quality of life in spine metastasis. Phase II study was performed to determine the clinical efficacy of radiosurgery for malignant epidural spinal cord compression. Method: Total 67 patients with 93 lesions of epidural spinal cord compression at the solitary spine level were accrued. All patients had pathology-proven malignancy and had epidural tumor seen on MRI or CT scan. For radiosurgery, grossly visible tumor including the involved spine was treated with single fraction radiosurgery dose of 14–20 Gy. Spinal cord dose constraint was 10 Gy to 10% partial volume of the cord. Followup included neurological exam and imaging studies every 2 months. Endpoints were radiographic tumor control and neurological outcome. Median followup time was 8 months (2–30 months). Results: Objective radiographic tumor response was seen in 82% of patients. At 2 months, complete response was in seen 27%, partial response in 30%, and minimal response in 23%, Epidural tumor progressed in 6% at or the adjacent spine level. Thecal sac patency (= decompression effect) seen on T2-weighted MR image was improved in 82% of the lesions. There was average 68% volumetric reduction of tumor at the level of most severe cord compression. This tumor reduction opened the thecal sac patency to average 75% following radiosurgery, compared to 45% before radisourgery (p<0.05). Majority of patients with neurological deficit prior to radiosurgery were ambulatory with an improved neurological function or remained clinically stable. There was one case of likely long-term radiation-induced myelopathy 13 months after radiosurgery. Conclusion: Single fraction radiosurgery achieves significant tumor response and decompressive effect of spinal cord compression. Even minimal tumor response relieves the spinal cord compression and potential neurologic improvement. Spine radiosurgery can be a viable treatment option for spinal cord compression. No significant financial relationships to disclose.