bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cystatin C, an additional marker of ovarian cancer extent: A pilot study
Authors: Wcislo G. , Bodnar L. , Szarlej-Wcislo K. , Gasowska-Bodnar A. , Szczylik C. 
Published: March 2020

16080 Background: Cystatin C is a cysteine protease inhibitor which has been recommended as the marker of glomerular filtration rate (GFR). We investigated significance of cystatin C in relation to ovarian cancer extent and its feasibility in assessment of renal function in patient with ovarian cancer (OC) who underwent chemotherapy. Methods: We prospectively included consecutive patients with OC who underwent chemotherapy : cisplatin 75 mg/m2 plus 24-hour infusion of paclitaxel 135 mg/m2 every three week after surgery. Before chemotherapy serum renal markers were noted as: creatinine (Cr), cystatin C (Cys C), albumin, creatinine clearance (ClCr) calculated by using 24-hour urine collection per 1.73 m2, creatinine clearance estimated with formulas Cocroft- Gault (ClCG) and Modification of Renal Disease (MDRD1), respectively. Results: Between February 2003 and January 2006 37 patients were enrolled onto this study. Median age 54 year (range from 28 to 68). Cystatin C and CrCl weakly correlated (R Spearman= -0.36; p=0,03). There were no correlation between cystatin C and other markers of GFR (serum creatinine, ClCG, MDRD1). We showed correlation between cystatin C and tumor extent revealed by spiral CT- scan (> 1 cm diameter) after surgery (R Spearman= 0.4; p=0.01), and CA 125 (R Spearman= 0.4, p=0.03). Cut-off values were established as medians for both factors, and patients with high and low values had no statistical differences in overall survival (log- rank test, p=0.9). Conclusions: We believe that cystatin C could imply OC extent in patients.This factor weakly was correlated with CrCl, and no correlated with other GFR parameters. No significant financial relationships to disclose.
The correlation of the AKT/mTOR/p70S6K1 pathway and VEGF in human epithelial ovarian cancer
Authors: Trinh X. , Tjalma W. A. , Dirix L. Y. , Vermeulen P. B. , Van Den Eynden G. G. , Van Laere S. J. , Van Der Auwera I. , van Dam P. A. 
Published: March 2020

16081 Background: The Akt/mTOR/p70S6K1 (Amp) pathway is activated in a proportion of epithelial ovarian cancers. The ribosomal protein pS6 and p4EBP1 are downstream targets and presumed representative for the pathway's activity. VEGF and angiogenesis in ovarian cancer play an important role as bevacizumab induces high response rates and prolongs progression-free survival in women with relapsed ovarian cancer in two phase II trials. The Amp pathway has proven to be correlated with HIF1alfa and VEGF A expression in vitro. Material and Methods: Our primary objective was to evaluate correlation between this pathway in human subject tissues and angiogenesis using VEGF A and pVEGFR2. Our second objective was to evaluate if different metastatic abdominal (peritoneal and/or omental) lesions show the same pathway hyperactivity and/or angiogenesis as the primary tumour, because relapses usually involve metastatic abdominal lesions. Epithelial ovarian cancer paraffin imbedded material from 1999–2004 was collected. A tissue micro array was build with three samples per paraffin block. Immunohistochemical staining was performed using pS6, p4EBP1, pAKT, VEGF and pVEGFR2. Results: 89 patients were collected with a median age of 69.8y. Patients were FIGO stage I in 21%, stage II in 4%, stage III in 62% and 11% stage IV. Histological examination showed in 53% serous papillary tumours, 25.8% endometroid tumours, clear cell carcinoma in 11.2% and mucinous tumours in 4.5%. 65 patients had available tissue material of both primary tumour as well as other (multiple) metastatic abdominal disease tissue. The results of the immunohistochemical staining as well as the correlation analysis will be presented. Conclusion: Although anti-angiogenesis seems to be very active against human epithelial ovarian cancer, it is at present associated with unacceptable treatment induced toxicities. Inhibiting the Amp pathway with mTOR inhibitors could potentially also inhibit angiogenesis in ovarian cancer with the potential of more manageable side effects. This study will provide some evidence on the relationship between the Amp pathway and the VEGF pathway in human epithelial ovarian cancer. No significant financial relationships to disclose.
Beyond race: The impact of ethnicity on the treatment outcome of locally advanced head and neck cancer
Authors: Calfa C. J. , Escalon M. , Zafar S. , Lopez E. , Patel V. , Patel S. , Feun L. , Raez L. E. 
Published: March 2020

16500 Background: Self identified racial groups share an unequal burden of head and neck cancer . Recent evidence suggests that outcome among races is different and the causes are multifactorial. Nonetheless, differences among ethnic groups have not been reported. Herein, we decided to analyze differences in treatment response and outcome among our white and Hispanic patient population treated for locally advanced head and neck cancer. Methods: Patients were identified using the tumor registry. We reviewed retrospectively the data from medical records. 100 white Hispanics (WH) and 50 white non-Hispanics (WNH) diagnosed with locally advanced head and neck cancer and treated at our institution from 2004 to 2005, were eligible for the study. Standard statistical analysis, including Kaplan-Meier survival curve and Cox proportional hazard models were used. P value of <0.05 was considered for statistical significance. Results: Preliminary results reveal that, in our study population, median age at diagnosis, gender, performance status (ECOG 0–2) and squamous cell histology did not differ significantly between the two groups. Stage 4 at diagnosis was more commonly observed in Hispanics as opposed to WNH (85.7% vs 68.6%) (P = 0.1). Surgery was more commonly used as an initial treatment option in Hispanics than WNH (42.8% vs 28.6%) (P = 0.18) while chemotherapy was less likely to be used (78.6% vs. 91.4%) (P = 0.15). Hispanics were more likely to smoke than WNH (P = 0.0003) and were equally exposed to chronic alcohol use. Patients from the Hispanic group were more likely to respond to therapy than whites by Chi-squared analysis but this difference was not statistically significant (P = 0.09). No differences were seen in disease free survival. Kaplan-Meier estimate of median overall survival was 16 months for Hispanics vs. 25 months for whites but this difference did not reach statistical significance (P = 0.26). Final analysis will be available at the time of the annual meeting. Conclusion: In our experience, a trend for decrease overall survival was noted in the Hispanic ethnic group. This may be in part due to more advanced stage at presentation. Nonetheless, in order to definitively answer this question, further research is warranted. No significant financial relationships to disclose.
Elevated thyroglobulin levels and negative I-131 whole body scans: Six-year experience in United Arab Emirate
Authors: Uttamchandani A. , Maarraoui A. M. , Attia N. M. , Latif H. A. , Bakir M. A. , Hanif R. M. , Siddiqui Z. J. , Ashruth A. C. , Zachariyah Y. , Morris L. A. 
Published: March 2020

16508 Purpose: This is a retrospective study of thyroid cancer patients seen at Oncology Department at Mafraq Hospital/UAE from 1/1999 to 12/2005. Clinical data, prognostic factors and treatment outcomes were studied, special emphasis was put on patients with elevated Serum Thyroglobulin (TG) and negative I-131 whole body scans. Patients and Methods: Total of 144 patients were fully evaluated, intent to treat analysis was used. All patients were treated surgically and post-op thyroid technician 99 scan were performed. I-131 ablation was given if the tumor size was =1 cm or if =1 cm (micropapillary) and multi-focal. Post ablation scan was done on day 10 and thyroxin was given in suppressive doses. Periodic evaluations were done with TG level, I-131 whole body scan, neck US and CXR. Plain CT scans and PET scans were done in selected cases. Results: Male to female ratio 1:2.42, non-smokers were 90%, non-alcoholics were 99%, Diabetes and Hypertension were associated in 28% of cases, family history of thyroid cancer was noted in 8%, papillary carcinoma was seen in 85.8%, follicular cancer in 11.6%, hurthel cell cancer in 0.83% and medullary cancer in 0.17%. Vascular and lymphatic invasion was noted in 29% of all cases. Interesting all patients with vascular or lymphatic invasion relapsed locally or distantly. Post-operative thyroid scan showed residual thyroid tissue in 96% of cases. During follow up TG levels (cut off 5.0 ng/ml) were elevated in 52 patients (37% cohort). Diagnostic I-131 scans were done in 36 patients and were positive in 24 patients (67%) and negative in 12 patients (33%). In the 12 patient group of research interest with elevated TG and negative I-131 whole body scans, 9 received high dose I-131 therapy. Of these patients 8 (88%) showed positive post therapy scan and 1 (12%) showed negative post therapy scan. Conclusion: 1. TG is more sensitive marker than diagnostic I-131 scan in making treatment decisions. 2. Lympho vascular invasion has adverse prognostic value. No significant financial relationships to disclose.
Acute and late effects of radical radiotherapy in elderly head and neck cancer patients
Authors: Turaka A. , Mohanti B. K. , Chander S. , Jena R. , Deo S. V. 
Published: March 2020

16515 Background: To evaluate the difference between acute and late effects of radical radiotherapy in elderly(above 60 years,Group A) head and neck cancer patients with young patients (below 50 years of age, Group B). Methods: The study was conducted on histologically proven head and neck cancer patients receiving radical radiotherapy (RT),49 patients were in group A and 40 in group B.The acute and late radiation morbidity was assessed using RTOG (phases I,II,&III- Pre RT, During RT & 1 month post RT respectively) and LENT-SOMA scoring systems (phases IV &V-3 & 6 months post RT). Results: In phase II, grade I dermatitis was commonly seen (83.7% in group A,72.5% in group B) and grade II dermatitis was 12.2 % vs 25% of patients.The difference in distribution over age was not significant (p= 0.12 & 0.18 in phase II and III).There was no significant difference in the incidence of late effects between two groups (p=0.91 in phase IV and p=0.99 in phase V).Grade II mucositits was seen in majority of patients in both groups,71.4% vs 72.5% in phase II.The late mucosal changes with worrisome subjective (pain) experiences were observed in 69.4% vs 75% of patients in group A and B, respectively.The difference in distribution over the age was significant (p<0.051) only in phase II.Dryness of mouth was the most common acute and late sequel of RT.The acute salivary gland morbidity was mostly moderate to complete dryness (grade II),seen in phases II and III in 24.5% & 73.5% of patients but the late sequel was seen in 83.37% of patients in group A and 85% in group B and the difference in late effects in both groups was statistically significant except in phase V (p= 0.02). Moderate dysphagia of grade II morbidity was seen in 75.5% vs. 65% in phase II. Grade III dysphagia was seen only 5 patients in group A and one in group B. In phase IV,66.7% patients in group A,72.5% in group B had persistent difficulty in swallowing. Conclusions: Grade I and II mucositis and dermatitis during the course of treatment led to increased morbidity, decreased nutritional intake and pain. Xerostomia is the most common and inevitable acute and late squeal of radical radiotherapy to head and neck cancer region resulting in difficulty in mastication and swallowing. There was no difference in the occurrence of acute and late effects between younger and elderly patients. No significant financial relationships to disclose.
Feasibility study of capecitabine (cap) and cisplatin (cis) with radiation therapy (RT) in the management of patients with locally advanced unresectable squamous cell carcinoma of the head and neck (HNSCC)
Authors: Allen J. W. , Vasireddy S. , Kaufman J. , Hughes J. M. , Sebelik M. , Salazar J. E. , Niell H. B. 
Published: March 2020

16520 Background: Concurrent chemoradiation has become the standard of care for locally advanced unresectable HNSCC. The most commonly used chemotherapy is cis and 5-fluorouracil (5-FU). We evaluated the feasibility of using cap and cis during RT in this population. Cap is an oral pro-drug of 5-FU that can be given daily with RT in order to enhance the activity of RT. Methods: Between Oct, 2003 and Sept, 2005, 12 male patients aged 46–83 were treated at the VA Medical Center. Patients received cis 100 mg/m2 on days 1 and 29 and cap 450 mg/m2 bid (2 hours prior to RT and 12 hours later) for 5 days of each week concurrent with RT to a total dose of 70 Gy in 35 fractions over 7 weeks. Primary endpoint of the study was toxicity. Results: All 12 patients were able to complete therapy. Treatment delays and/or dose modifications were needed in 7 patients. Treatment related toxicities included 6 patients with grade 3 mucositis and 5 patients with grade 3 dysphagia. Other grade 3 toxicities included 3 patients with dehydration and 1 patient each with leucopenia, constipation, nausea and vomiting, and odynophagia. Percutaneous gastrostomy (PEG) tubes were required in 5 patients. Complete response to chemoradiation was seen in 9 patients, 2 patients obtained partial response, and 1 patient progressed. Median progression free and overall survivals have not been reached with a median follow-up of 21 months. Conclusions: Cis and cap administered concurrently with RT has manageable toxicities and is active in patients with locally advanced unresectable HNSCC. No significant financial relationships to disclose.
Functional morbidities in patients ≥ 65 years compared with younger patients undergoing organ preservation therapy (OPT) for squamous cell carcinoma (SCC) of larynx (L) or propharynx (OP)
Authors: Ramanarayanan J. , Burstein M. , Brodzik F. A. , Jackson A. I. , Mehdi S. 
Published: March 2020

16533 Background: Advanced age is shown to be associated with increased late toxicity and minimal clinical benefit in head and neck cancer patients receiving aggressive or combined modality therapies. Elderly may also have delayed functional recovery after OPT. We conducted a retrospective study in patients = 65 years with L or O SCC undergoing OPT to compare functional outcome/ recovery with younger patients undergoing similar treatment. Methods: Patients with L or O SCC from January 1996-January 2006 who underwent OPT were retrospectively studied and stratified into 2 groups: = 65 or < 65 years based on age at diagnosis. Dysphagia, gastrostomy (g) tube dependence, speech quality and weight loss at diagnosis, 3 and 9 months post therapy were compared. Swallowing and speech were evaluated by 2 specially trained therapists based on the Swallowing Performance Scale and GBRAS Scale (perceptual impression of voice quality) respectively. Student z-test and t-test were used in statistical analysis for comparison between patient proportion and mean values. Results: One hundred and twenty patients (L 74 and OP 46) received OPT, of which 43 were excluded (recurrence/inadequate records). Of the 77 (L 54 and O 23) patients analyzed (KPS 80–100), 44 (57%) were = 65 and 33 (43%) <65; more patients aged <65 had advanced stage; 14 patients (31%) = 65 and 16 (48%) <65 received CRT or altered fractionation RT, rest of the patients received standard RT. Elderly group had greater proportion of patients with continued weight loss and higher incidence of dysphonia (70% vs 43% z-score 2.97, p=0.003) at 3 and 9 months than younger patients. Of 19 patients in the elderly group with g-tube, 13 were g-tube dependant at 3 months (68%) vs 12/23 (52%) in the younger population. Conclusions: Elderly may have persistent functional morbidity compared to younger patients receiving similar OPT. As the goal of OPT is to improve functional outcome, careful assessment of risk benefit ratio in the elderly is warranted before administering aggressive therapies. No significant financial relationships to disclose.
Intra-arterial chemotherapy using docetaxel and cisplatin + RT with radiomodification in combined treatment of patients with locally advanced SCC of the oral cavity
Authors: Adilbay D. G. , Adilbayev G. B. , Ahmetov D. N. , Kydirbaeva G. Z. 
Published: March 2020

16543 Background: Our previous studies of using intra-arterial induction chemotherapy in locally advanced SCCHN have showed a low level of toxicities, we haven't experienced any III grade toxicity, there was only 18,8% of grade I and II leucopenia. So this method allows intensify chemoradiotherapy. The addition of radiomodificant agent to standard RT increases its response rate. In our study we have used radiomodification with Arglabin, which showed a good results in different studies performed in Kazakhstan and Russia. To elevate the effect of intra-arterial induction chemotherapy + RT we have studied intensified preoperative chemoradiotherapy. Methods: 15 patients with previously untreated oral cancer (T3–4N0–2M0) received chemoradiotherapy by followed scheme: 1st day intra-arterial chemotherapy by catheterization of the feeding arteries of tumor through the superficial temporal artery: docetaxel - 80 mg/m2, cysplatin - 100 mg/m2, from 2nd to 21st day RT with intra-arterial radiomodification arglabin-70 mg/m2 (28 Gy by 4 Gy - 3 times week), 22nd day second course of intra-arterial chemotherapy and after RT (total dose- 60 Gy by 2 Gy 5 times week), depending on the results surgical treatment in necessary volumes. Results: The clinical effects were CR in 12 (80.0%) patients, PR in 3 (20,0%) patients. The following main toxicities of chemoradiotherapy were observed: only 1 case of grade III neutropenia, Non-hemathologic toxicity: 13% grade III mucosal events, alopecia 66,7%. All results have been confirmed by cytomorphology. All patients have being followed up. Conclusions: Using intra-arterial path of delivery allows intensify chemoradiotherapy. And adding radiomodification increases the results of combined treatment. Therefore this method needs further investigations. No significant financial relationships to disclose.
Temporal trends in first-line chemotherapy treatment among elderly stage IIIB/IV non-small cell lung cancer (NSCLC) patients in the United States: Evidence from SEER-Medicare data
Authors: Lang K. , Marciniak M. D. , Faries D. , Stokes M. , Buesching D. , Earle C. , Treat J. , Thompson D. 
Published: March 2020

17002 Background: Data regarding first-line chemotherapy treatment among advanced-staged NSCLC patients is lacking. The purpose of this analysis was to assess first-line treatment patterns over time among elderly patients with Stage IIIB/IV NSCLC. Methods: Patients aged 65 years and older diagnosed with Stage IIIB/IV NSCLC between 1997 and 2002 were identified and followed over time using the SEER-Medicare database to evaluate temporal trends in first-line chemotherapy treatment. Results: Chemotherapy use increased from approximately 28% of Stage IIIB/IV patients diagnosed in 1997 to 36% of patients diagnosed in 2002. Among identifiable first-line treatments, cisplatin or carboplatin and taxane (C/CT) doublet therapy was the most common treatment in all years (approximately 50% or greater). The use of single-agent taxanes and gemcitabine increased over time (taxane use increased from 3.3% in 1997 to 7.6% in 2002; gemcitabine use increased from 0.6% in 1997 to 5.1% in 2002), while use of single agent cisplatin or carboplatin (C/C) declined (from 10.0% in 1997 to 3.1% in 2002). Use of doublet therapy with C/C and either a taxane or gemcitabine also increased over time (with the largest increase for the gemcitabine combination from 0.3% in 1997 to 11.8% in 2002). Correspondingly, use of doublet C/C and any other therapy declined markedly (from 18.9% in 1997 to 3.7% in 2002). Use of 3 or more agents as first-line treatment was infrequent across study years (<1.0%). Treatment discontinuation was substantial (>60% for all regimens). Conclusions: Our findings indicate relatively low but increasing use of first-line chemotherapy treatment among elderly Stage IIIB/IV NSCLC patients. [Table: see text]
Use of colony stimulating factors (CSF) for primary prophylaxis of chemotherapy-induced neutropenia in community oncology practices to reduce risk of febrile neutropenia (FN)
Authors: Wong M. D. , Hershman D. , Morrison V. A. , Ding B. , Malin J. L. 
Published: March 2020

17013 Background: In addition to proof of efficacy from randomized controlled trials (RCTs), health care decision makers need data on therapy effectiveness, specifically how well an intervention performs in routine practice. While the efficacy of filgrastim and pegfilgrastim in preventing FN has been established in RCTs, their effectiveness in community practice has not been studied. Methods: Data were obtained from medical records of patients treated with chemotherapy for a variety of malignancies in a random sample of 99 US community oncology practices in 2001 and 2003 (before and after FDA approval of pegfilgrastim in 2002). Patients receiving filgrastim or pegfilgrastim and, in 2003, every third patient not treated with a CSF, were consecutively sampled(n=6148). Only those receiving chemotherapy on 3–4 wk cycles were included in this analysis (n=3,744). Primary prophylaxis was defined as receipt of CSF within 3 days of the 1st cycle of chemotherapy. Multivariable logistic regression, adjusted for patient and treatment characteristics and weighted for patient sampling was used to estimate the odds of FN in patients who received primary prophylaxis versus those who were managed expectantly, i.e. patients who received CSF later during chemotherapy or not at all. Results: Of 3744 patients in the study population, 2966 (79%) received a CSF some time during their chemotherapy treatment. In 2003, approximately 18% of patients received CSF primary prophylaxis. Among patients who did not receive primary prophylaxis but received a CSF later during the treatment, 38% initiated CSF in the 1st cycle after day 3. In a multivariate model, increased risk of FN was associated with receiving myelosuppressive chemotherapy (OR 2.19; 95% CI 1.05–4.56) and having 3 or more drugs (vs. 1) in the regimen (OR 2.13; 95% CI 1.09–4.17). Adjusting for patient and treatment characteristics, the relative odds of FN in patients who received CSF primary prophylaxis was 0.70 (95% CI 0.50–0.98) compared with patients who either received CSF later or not at all. Conclusions: In this community practice setting, patients who received CSF primary prophylaxis had significantly lower odds of developing FN than patients managed expectantly. No significant financial relationships to disclose.