bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative percutaneous nephrostomy in recurrent cervical cancer: Retrospective analysis of 50 consecutive cases
Authors: Pinto C. S. , Small I. A. , Ferreira C. G. , Dienstmann R. 
Published: March 2020

19609 Background: Cervical cancer is a public health problem in Brazil, with annual incidence rates of 20 to 40 cases/ 100.000 women. Most patients with recurrent disease have local symptoms and develop renal failure. There are no clear guidelines to predict which patients in palliative care derive benefit from percutaneous nephrostomy (PN) in terms of survival and quality of life. This study aims to evaluate the outcome of patients with recurrent cervical cancer in palliative care submitted to PN and thereby identify those who can potentially benefit from this intervention. Methods: Retrospective chart review of all patients assisted in the Palliative Care Unit of Brazilian National Cancer Institute from January 2002 to October 2006 and submitted to PN. Results: Fifty patients received unilateral PN. Median age was 44 years (26 - 67). All patients were previously treated with radiotherapy with or without chemotherapy and brachytherapy. At relapse, 50 presented with locally advanced disease and 7 also had metastatic disease. Twenty-four patients (49%) had improvement of uremic symptoms and/ or lumbar pain after PN and seven (14%) in Performance Status (PS). Median creatinine levels before and after PN were 6.4 and 3.7 mg/dl, respectively (p < 0.05). Twenty-five patients (50%) had improvement in renal function. Until December 2006, 49 patients have died. Median overall survival after PN was 9.1 weeks (95% CI: 8.0 - 10.2). Median survival was 10 weeks (9.0 - 11.0) in 40 patients with baseline PS 1 - 3 and 1.7 weeks (0 - 3.7) in 10 patients with PS 4 (log rank, p = 0.04). Median survival in patients with and without improvement of renal function after PN was 10.7 weeks (8.6 - 12.8) and 8.1 weeks (4.8 - 11.5), respectively (log rank, p = 0.02). Twenty-nine patients (58%) died due to renal failure. Complications of PN were mainly urinary tract infection (n: 10), catheter loss (n: 9) and bleeding (n: 1). Conclusions: These data suggest that PN can be of clinical benefit for patients with recurrent cervical cancer and PS 1 to 3, but not PS 4. In fact, improvement of renal function after PN did prolong survival. Complications of PN are frequent and most patients still die in renal failure. However, our data indicate that carefully selected patients can derive benefit from this procedure. No significant financial relationships to disclose.
Docetaxel and fluid retention: Use of single-dose dexamethasone
Authors: Montoya M. E. , Markowitz A. B. , Klementich F. , Palacio D. 
Published: March 2020

19635 Background: Docetaxel (T) is generally well tolerated but fluid retention has been reported following therapy. This can be prevented with dexamethasone (D) but dexamethasone has its own side effects. Methods: Retrospective IRB-approved review of adult patients (pts) treated with T between March 2003 and February 2006 receiving single dose D prior to T. End point was development of fluid retention: edema, weight gain and/or pleural effusion (measured by Common Toxicity Criteria). Pts with congestive hearth failure, renal failure, chronic edema or on diuretics were excluded. Prostate cancer was excluded because chemotherapy included daily prednisone Results: 94 charts were reviewed; 64 pts included. Total T dose ranged from 80 to 1,350 mg/m2 and pretreatment D dose from 8 to 20 mg. See table 1 for demographics and reason for patient exclusion. Edema developed in 7 pts (10.9 %); arms and legs were affected equally. Only 2 pts with edema had weight gain (less than grade III). Including these 2 pts weight gain developed in 5 pts: 3 grade I and 2 grade II (3.1 %). New pleural effusions occurred in 3 pts. All were asymptomatic and none required management. Effusions were small or moderate as confirmed by radiology review. 4 pts had pretreatment pleural effusions. These either became smaller or resolved after T. Conclusions: The incidence of moderate fluid retention (measured by weight gain) with single dose D was lower (3.1 %) compared with published data (6% with 3 days of D). Development of pleural effusions was infrequent and not clinically significant. Single dose D prior to T is recommended to avoid hypersensitivity reactions. No significant financial relationships to disclose. [Table: see text]
Incidence of febrile neutropenia (FN) is not altered by the day of administration of pegfilgrastim (PEG)
Authors: Athar U. , Rajan A. , Gajra A. , Lynch T. P. 
Published: March 2020

19636 Background: Chemotherapy induced neutropenia can significantly increase patient morbidity and mortality and decrease the efficacy of treatment either due to a decrease in dose density and/or dose intensity of chemotherapy. Based on small studies in breast cancer and Non-Hodgkin's Lymphoma (NHL) there is concern regarding increased risk of FN if PEG is used on the same day as chemotherapy rather than 24 hours later. In our predominantly rural elderly patient population an extra visit to the infusion area can contribute to poor compliance. Hence we retrospectively analyzed patients treated at the Syracuse VA medical center who received PEG with chemotherapy to ascertain if differences existed in the incidence of FN. Methods: All patients who received PEG with cytotoxic chemotherapy between August 2002 and July 2006 were identified from hospital pharmacy records. We analyzed this population for cancer diagnosis, type and number of chemotherapy cycles, comorbidities (diabetes and COPD), use of prior or concurrent radiation, incidence of febrile neutropenia and the day of administration of PEG (Day 1 or Day >1 defined as administration of PEG 24 hours or more after chemotherapy). Results: A total of 64 patients were identified and PEG was administered with a total of 212 cycles. The mean age of our patients was 70 years and 66 (97%) were males. The most common diagnoses were NHL (42 %), small cell lung cancer (18%) and non-small cell lung cancer (14 %). Other diagnoses included Hodgkin's disease, carcinoma of unknown primary and multiple myeloma (4% each). Comorbidities included diabetes mellitus and COPD (31% each). A total of 17 patients (27%) received prior or concurrent radiation therapy. PEG was given on Day 1 with 112 cycles (53%) and on Day >1 with 100 cycles (47%) of chemotherapy. FN developed with 5 of 112 (4.5%) cycles when PEG was given on day 1 and 5 of 100 (5%) cycles when given on Day > 1. Conclusions: In this single institution, retrospective cohort of patients the timing of PEG administration (day 1 or > 1) did not affect the incidence of FN. If confirmed in larger prospective series, then current guidelines may be altered to include PEG administration on the day of chemotherapy as an acceptable standard. This would enhance patient comfort and may improve compliance with PEG therapy. No significant financial relationships to disclose.
Effect of melatonin on taxane-induced neuropathy in breast cancer patients
Authors: Sweany S. , Lafollette J. , Pruemer J. , Swango M. , Clark M. , Wainino A. , Nahleh Z. 
Published: March 2020

19640 Background: Neurotoxicity caused by taxane chemotherapies(CT) can be dose limiting and can cause a decrease in quality of life. Melatonin has been evaluated for its use in decreasing adverse reactions of CT. Preclinical data suggests that melatonin has neuroprotective capability. The objective of this study is to determine if melatonin will decrease the incidence and severity of taxane-related neuropathy. Methods: Fifty patients beginning CT for any stage of breast cancer with paclitaxel, albumin-bound paclitaxel, or docetaxel will be enrolled. Patients should have no underlying neuropathy. Melatonin is given at 21 mg at bedtime on Day 1 and continued for 28 days after the last taxane dose. Every 28 days, neuropathy is assessed using the NCI-CTC 3.0 scale and possible side effects of melatonin are evaluated. Quality of life (QOL) is analyzed using the FACT-Taxane QOL assessment. Outcomes analyzed included the incidence and severity of neuropathy, and changes in QOL. Results: Currently 17 patients have been enrolled with 12 having completed taxaneCT and melatonin. Five have withdrawn due to non-medical reasons and were evaluated for toxicities. The mean age is 49 years (range 36–67 years). The end of study FACT-Taxane score was available for 11 of the 12 patients, with an average score of 135 (range 106–168). The average baseline QOL score was 131 (range 99–148). The average change in QOL score was +4. Eleven have completed paclitaxel with an average dose of 862 mg/m2 (range 525–1620 mg/m2). One patient received docetaxel t 450 mg/m2. Five patients self- reported adverse effects including night-time sedation (2), hot flashes (1), headache (1), constipation (1), nail darkening (1), and fatigue (1). Neuropathy distribution was as follows : 50 % (6) of patients had grade 0, 33% (4) grade 1, and 16% (2) grade 2 neuropathy. The mean change in neuropathy score was +0.67. Conclusion: Melatonin appears promising as a neuroprotective agent in patients receiving taxane-based chemotherapy. No patient developed grade 3 or 4 neuropathy compared to historical controls of 22–33%. Fifty percent of patients treated with melatonin while on taxane CT developed no neuropathy, and those who did, had grade 1 or 2 neuropathy.QOL was maintained. Melatonin's neuroprotective effect should be further evaluated. No significant financial relationships to disclose.
Sexual dysfunction in patients with cancer
Authors: Colmano C. M. Bonini , Molnar S. , Salvano L. M. , Barrios G. Molina , Arevalo M. , Di Marco P. , Rizzi M. L. , Dubersarsky C. , Lavarda M. , Jarchum G. D. 
Published: March 2020

19653 Background: Malignant diseases have a strong influence in quality of life, being sexuality one of the most affected variables. The objetive is to determine the prevalence of sexual dysfunction in a cohort of patients with cancer and its relationship with the following: pain, fatigue, nausea, vomiting, mechanisms of adaptation to stress, anxiety and depression. Methods: Anonymous questionnaires were used, including: treatment, adverse events, Zimong and Snaith depression and anxiety scale, sexual dysfunction questionnaire, coping strategies of Tobin David, Hopwood body image scale and the analogical visual test for pain evaluation. Results: Between January and August 2006, sixty four patients were evaluated; 72% were women; median age: 50 years old. Libido was absent in 50%; this was associated with gender (better in men; p=0,05) and the presence of pain (p=0,05) and fatigue (p=0,05) but not with age. All patients who had intact libido also had arousal and orgasms; this was more prevalent in men than in women and in subjects younger than 60 years. Arousal was absent in 47% of cases. Forty four percent of men had erectile dysfunction; this was present in all patients older than 60 years. Frequency of intercourses was decreased in 75%. Fifty eight percent of patients said that their sexuality was better before the diagnosis of their disease. Interestingly, 85% didn’t talk to their doctors about their sexual problems. Conclusions: One out of 2 patients had sexual dysfunction, predominantly women. Sexuality was affected mainly by pain and fatigue. Although normal libido was present in all ages, subjects older than 60 years had less arousal and orgasms. No significant financial relationships to disclose.
SF-36 quality of life questionaire evaluation in a large cohort of women with breast cancer treated with hormonotherapy
Authors: Morgenfeld E. L. , Rolnik B. , Cassab L. , Gercovich D. , Negro F. , Calarame J. C. , Tognelli F. , Rivarola E. , Deza E. Gil , Gercovich F. G. 
Published: March 2020

19657 Background: Hormonotherapy (H) is the most widely used treatment against breast cancer (BC). The aim of this study is a prospective evaluation with an enriched the SF-36 questionnaire, of the QOL of BC patients (pt) treated with H at the IOHM. Specific questions regarding menopausal symptoms and body weight were added. Methods: Between Aug 2005 and Nov 2006, all pt that were undergoing H, were requested to fill out a SF-36 self-evaluation form. The SF-36 is a multi-purpose, short-form health survey, with 36 questions about functional health and well-being. The answers were tabulated. The pre-treatment and post-treatment body weight of each pt was registered. Results: Three Hundred and Twenty-six pt were invited to participate, and all of them accepted, and signed a consent form. Characteristics of the population: Diagnosis: DCIS: 36 pt; LCIS: 5 pt; IDC 250 pt; ILC: 35 pt. All cases expressed hormonal receptors. The H was adjuvant in 254 pt (78%) mostly treated with T and palliative in 72 pt (22%) mostly treated with AI. Median age was 62 years, however 63 pt (19%) were pre-menopausal. The median time under treatment was 33 months (range 1–71 m). The pt reported: General evaluation of Quality of life: Very good or excellent: 154 pt (47%) , Good: 134 pt (41%), Poor: 34 pt (11%). Severe limitations for demanding physical activities: 43 pt (13 %). A reduction of time spent on the job: 66 pt (22%). Severe pain during the last four weeks prior to answering the questionnaire: 24 pt (8 %). Weight increase perception: 153 pt (47%). Actual increase of weight: 192 pt (60%) (Median: 4 kg). Menopausal symptoms: Daily Hot Flushes: 132 pt (40%). Vaginal discharge 110 pt (33%) Decrease of libido: 98 pt (30%), Vaginal dryness 76 pt (23%), Nightly sweats: 40 pt (12%). Sixty pt (18%) suffered from and received treatment for menopausal symptoms. Conclusions: 1) The SF-36 is a useful tool to measure the BC patients’ quality of life 2) Although in our cohort most of the patients (88,3%) rated their general QOL as “good to very good”, a third of the pt presented severe menopausal symptoms, and 18% received non hormonal medication for symptoms relief 3) Sixty percent of the pt had a median body weight gain of 4 Kg. No significant financial relationships to disclose.
Ulcerative keratitis in gatrointestinal stromal tumor patients treated with perifosine
Authors: Esmaeli B. , Trent J. , Espandar L. , Hatef E. , Kim S. K. , Song D. 
Published: March 2020

19664 Background: Perifosine is a novel, oral, alkylphospholipid with antiproliferative properties attributed to Akt inhibition. We describe the ocular findings in 5 patients enrolled in phase I/phase II trials of perifosine in combination with imatinib for treatment of advanced GIST. Methods: The medical records of 5 patients who developed peripheral ulcerative keratitis while receiving perifosine and imatinib were retrospectively reviewed. Results: 1 man and 4 women ranged in age from 43 to 72 (median, 57 years). The ocular symptoms included redness, irritation, tearing, photophobia and a gradual decrease in vision. Slit lamp biomicroscopy in each case revealed a peripheral, paralimbal, ring-shaped, superficial stromal infiltration and ulcerative keratitis (UK), reminiscent of the autoimmune keratitis in conditions such as rheumatoid arthritis. The best corrected visual acuity in the affected eye(s) ranged from 20/25 to 20/300 (median 20/70). The UK was unilateral in 3 and bilateral in 2 patients; it was NCI grade II in all. All 6 patients had imatinib-resistant metastatic GIST and had continued on the highest dose of imatinib tolerated and initiated therapy with perifosine 100 mg daily or 900 mg weekly. Time from start of perifosine therapy to diagnosis of UK ranged from 1 to 3 months (median, 2). A combination of topical steroids, topical antibiotics and lubricating drops were used to manage UK. In the first 3 patients, UK was initially treated with topical antibiotics without improvement, but subsequently improved significantly once topical steroids were added. In 5 of 6 patients, the visual acuity improved with this regimen. Conclusions: UK may occur as a side effect of perifosine and shares features of autoimmune forms of keratitis. It is possible that imatinib in combination with perifosine is contributing to this toxicity. Topical steroids improve the signs and symptoms of UK and early treatment with topical steroids may lessen the potential risk of permanent corneal scarring and visual loss. The visual loss associated with perifosine can be reversible with close monitoring and judicious use of topical steroids, topical antibiotic coverage, and lubrication. No significant financial relationships to disclose.
Use of biological drugs in elderly cancer patients: A sustainable reality? A mono-institutional experience
Authors: Fratino L. , Crivellari D. , Spina M. , Bearz A. , Simonelli C. , Berretta M. , Michieli M. G. , Maso L. Dal , Trovò M. G. , Tirelli U. 
Published: March 2020

19665 Background: Several new biological anti-cancer drugs have been recently licensed, and some of them have shown impressive positive results particularly in tumors that express the targets for these agents (e.g., ERBB2 receptor in breast cancer, KIT mutations in gastrointestinal tumors, and the CD20 expression in NHL). However, the use of these drugs in elderly cancer patients is a matter of debate. The aim of this study was to quantify the use of biological drugs according to age and type of cancer. Methods: We analyzed data regarding patients diagnosed with metastatic breast cancer, NSCLC or colo-rectal cancer and NHL treated with biological drugs (i.e., bevacizumab, cetuximab, rituximab, trastuzumab, erlotinib, geftinib) at the National Cancer Institute of Aviano, North-east Italy, between 2002 and 2006. Patients were stratified according to age (i.e., <=69 years or >=70 years) and type of biological agent used. Results: Overall, 687 patients were treated with biological agents (360 with rituximab, 149 with trastuzumab, 114 with geftinib, 23 with bevacizumab, 21 with erlotinib and 20 with cetuximab). Older patients (n=103) had a median age of 74 years (range: 70–86 years): they represented 17.5% of those treated with rituximab, 7.4% of those treated with trastuzumab, 20.2% of those treated with geftinib. Moreover, one elderly cancer patient in each of the three groups of drugs less frequently used (i.e., bevacizumab, erlotinib and cetuximab) was treated with biological agents. Conclusions: In our Institute, nearly 20% of cancer patients is aged 70 years or older. Our findings suggest that elderly cancer patients are not denied biological therapies because of their age. This is particularly true for NHL patients treated with rituximab (17.5%) and for patients with NSCLC treated with geftinib. The low percentage of elderly women treated with trastuzumab is likely to depend from the biological (e.g. hormonal receptors) and clinical characteristics (e.g., pre-existing cardiovascular conditions and life expectancy) of breast cancer in elderly women. The increasing number of cancer in the elderly, asks for a proper selection of patients who should have access to biological agents according to clinical studies and cost-effectiveness evaluation. No significant financial relationships to disclose.
Renal safety of zoledronic acid administration beyond 24 months in breast cancer patients with bone metastases
Authors: Altundag M. K. , Dincer M. , Harputluoglu H. , Aksoy S. , Ozisik Y. , Guler N. , Tekuzman G. 
Published: March 2020

19669 Background: Zoledronic acid (ZA) delays the onset or reduces the incidence of skeletal complications in breast cancer patients with bone metastases. However there are few data on the long-term renal safety of ZA. Methods: We retrospectively evaluated 43 breast cancer patients with bone metastases who received ZA more than 24 months. The following parameters measured prior to first ZA use and after the last dose of ZA administration were compared: serum creatinine (SCr), blood urea nitrogen (BUN), alkaline phosphatase (ALP), calcium (Ca), and phosphorous (P). Results: Forty-three breast cancer patients with documented bone metastases were evaluated. Median age at the start of treatment was 53 years (range, 37 to 77). Median overall duration of ZA administration was 36 months (25 to 62). There were no statistically significant differences in the pre- and post-treatment levels of SCr, BUN, Ca and P. However, ALP levels after long-term ZA administration were decreased significantly (P <0.05). Conclusion: More than 24 months of ZA administration did not adversely affect the renal function. ZA can be used safely in breast cancer patients with bone metastases beyond 2 years. [Table: see text] No significant financial relationships to disclose.
Abnormality of growth hormone and insulin-like growth factor I axis in advanced cancer patients
Authors: Takahata T. , Munakata M. , Sakata Y. , Nakagawa K. , Mukaiyama T. , Ishitani K. , Tamura K. 
Published: March 2020

19671 Background: Pituitary and thyroid hormones are known to be altered in anorexia nervosa, but few hormonal studies have been performed in cancer anorexia-cachexia syndrome. This study focused on growth hormone (GH) and Insulin-like Growth Factor (IGF)-I axis in cancer patients. Methods: To investigate the relationship among performance status (PS), nutritional and hormonal status, blood sampling was performed to measure GH, IGF-I, IGF-binding protein 3(IGFBP-3), T3, T4, complete blood counts and blood chemistry profiles for 15 cancer patients in each of PS0–1, PS2, PS3 and PS4 after the informed consent was obtained. Results: A total of 58 patients were evaluated including 15 patients in PS0–1, PS2 and PS3 and 13 in PS4. Hemoglobin and albumin levels went down along with progression of PS. GH level was high and T3 was low in poor PS. T4 and IGFBP-3 were lower in PS4 than those of other PS. There is a tendency of low IGF-I and thyroid hormones and high GH levels in poor PS as compared with those of good PS (p=0.0064 for IGF-I, p<0.001 for T3, and T4, not significant for GH analyzed by ANOVA). Conclusions: Abnormal GH - IGF-I axis was more pronounced in poor PS. It is conceivable that normalization of this abnormality can improve cancer anorexia-cachexia syndrome and new drug development for such normalizing agents is warranted. No significant financial relationships to disclose.