bluuebunny/crossref_metadata_2025_split huggingface dataset:
3-D non-coplanar conformal radiotherapy compared to traditional beam arrangements for the adjuvant treatment of gastric cancer
Authors: Soyfer V. , Corn B. , Melamud A. , Alani S. , Tempelhof H. , Agai R. , Shmueli A. , Figer A. , Kovner F. 
Published: March 2020

15145 Background: The Current standard of adjuvant treatment for gastric cancer following curative resection is concurrent administration of radiation and 5FU-based chemotherapy (INT0116). Radiation fields are often arranged as AP-PA opposed parallel fields with general recommendations for sparing at least two thirds of one kidney. In the current trial we investigated whether a better radiation distribution is achievable with 3-D conformal approaches as opposed to classical AP-PA fields. Methods: Nineteen patients with adenocarcinoma of stomach were treated by adjuvant chemoradiotherapy using a non-coplanar four field arrangement. In each case parallel planning by AP-PA arrangement and four fields “box was carried out and the generated plans were subsequently compared with dose volume histograms (DVH). Adequate coverage of the CTV was the basis for a comparison between other planning parameters. Separate analysis was performed not for right and left kidney but rather for kidneys exposed to higher and lower doses in each patient (since kidney dose is mostly a function of tumor location inside the stomach and respective nodal drainage). Mean dose of irradiation (MD) and percentage of kidney volume receiving radiation over 20 Gy (V20) were registered. Statistical analysis was performed by 2-tailed T-test. Results: The clinical target volume was adequately covered in all three plannings. In the “higher dose” kidneys group all the differences were statistically significant with the benefit of 3-D plan. In the “lower dose” kidneys group MD differences didn’t reach the level of statistical significance, while V20 data showed statistically significant benefit for 3-D plan. These data indicate that even when the mean doses of radiation are similar, 3-D planning can result in better distribution within the organ - thereby reducing the percentage of organ receiving dose above 20 Gy. DVH of spine was significantly better in 3-D planning. The exposure of liver was minimal in AP-PA technique. Conclusion: Noncoplanar 3-D based conformal planning for postoperative radiation therapy of gastric cancer provides the best results regarding kidney and spinal cord exposure with adequate CTV coverage. No significant financial relationships to disclose.
Treatment with rAD001 improves the efficacy of siRNA mediated down-regulation of survivin/BIRC5 in pancreatic carcinoma cell lines
Authors: Maute L. , Glienke W. , Milz E. , Bauer N. , Bergmann L. 
Published: March 2020

15146 The rapamycin derived mTOR inhibitor RAD001 (everolimus) is cytotoxic to a number of cell lines. Because survivin, an important mediator of apoptosis and cell survival, is one of the targets down-regulated by RAD001, we tested the ability of a combination of RAD001 and siRNA mediated inhibition of survivin to enhance the cytotoxic effects. We have used four pancreatic cancer cell lines, MiaPaCa-2, BxPC-3, AsPC-1 and Panc-1. We found that the cytotoxic effect was enhanced in all cell lines after treatment with RAD001 and survivin siRNA. An efficient way of treatment was the initial down-regulation of survivin with RAD001 and a subsequent incubation with survivin siRNA. We conclude, that the transformation efficiency of siRNA, still a limiting factor in using this method, is more sufficiently combining both ways to down-regulate survivin. Our data indicate that a combination of mTOR inhibitors like RAD001 and survivin-targeted down-regulation with siRNA may improve the efficacy of therapy in pancreatic cancer. No significant financial relationships to disclose.
Phase II study of induction chemotherapy and concomitant chemoradiotherapy with cisplatin and continuous infusion 5-fluorouracil (PF) for anal carcinoma
Authors: Freire J. G. , Trindade M. C. , Barata A. M. , Venâncio J. , Claro I. , Fernandes A. H. 
Published: March 2020

15148 Background: Chemoradiotherapy is the primary treatment for anal squamous cell carcinoma (ASCC). The aim of this trial was to assess activity and toxicity of induction chemotherapy and concomitant chemoradiotherapy with cisplatin (CDDP) and 5-fluorouracil (5- FU). Methods: Inclusion criteria: invasive, non-metastatic ASCC, age < 70 years, WHO performance status 0 - 2, adequate bone marrow and renal function and written informed consent. Treatment: Five courses of chemotherapy with PF: two induction courses (CDDP 100mg/m2 D1, 5-FU 1000mg/m2 D1–5 Q 21d); two concomitant (CDDP 20mg/m2 D1–4 and D28–31, 5-FU 225mg/m2 continuous infusion D1–31) with the first sequence of radiotherapy (45Gy in 25 fractions of 1.8Gy) and, after a five week gap, one concomitant (CDDP 20mg/m2 D1–4, 5-FU 800mg/m2 D1–4) with the radiation boost (15Gy in 6 fractions of 2.5Gy). The primary endpoints were response rate and toxicity. Results: 26 patients (pts) were included from March 2002 to August 2006 [21 women, 5 men; median age 53 years (29–69)]. Tumor location: anal canal 24 pts, anal margin 2 pts. Histology: squamous cell carcinoma 24 pts, basaloid carcinoma 2 pts. Stage: 35% tumors were T3–4 and 58% were N1–3. Nineteen pts (73%) completed the treatment. Failure to complete treatment were disease progression (1 pt), catheter related complications (2 pts), hematological toxicity (1pt), traumatic bone fracture (1pt); two pts died (one metastatic disease; one pulmonary thromboembolism). Twenty three pts were evaluable for response (1 pt too early). Nineteen pts (76%) had a complete remission (CR); four pts (16%) had local disease persistence. Grade 3 toxicities of 30, 22, 19, 16 and 5% were observed for stomatitis, radiation dermatitis, emesis, hematological toxicity and diarrhea. Grade 4 toxicity was 8% (3 pts: hematological, diarrhea, infection). Sixteen pts (62%) had a treatment delay or dose reduction. At a median follow up of 28 months, the overall survival was 73%. Six pts died, 5 of disease progression. Four pts required a colostomy. Conclusions: The results of this small single institution phase II trial, in line with those of RTOG 98–11, suggest that there is no role for CDDP/5-FU chemoradiotherapy for ASCC. No significant financial relationships to disclose.
Is African-America race (AAR) a risk factor for failure in prostate cancer (PCa)?
Authors: Mann M. J. , Benson M. C. , McKiernan J. M. 
Published: March 2020

1515 Background: There is much disagreement as to whether AAR is an independent negative risk factor in biochemical disease-free survival (BCDFS) of PCa. Much of the literature suggests that AAR is a negative risk factor of BCDFS. However, the past decade has seen improvements in treatments that may have affected outcomes in PCa. Thus, we sought to determine if AAR is an independent risk factor for BCDFS in a modern cohort of PCa patients. Methods: A retrospective review of The Columbia Urologic Oncology Database was performed. From ‘91-‘06, 2,747 patients underwent radical prostatectomy and did not receive adjunctive treatment. Of these, 252 (9%) patients were AAR, and 2495 were not of African-American Race (NAAR). Of the NAAR patients, 1,907 (69%) were Caucasian, and 588 (21%) were of other or unknown race. BCDFS was defined as time to first rise in PSA (>0.1ng/mL) or use of secondary therapy after surgery. Patients were stratified based on race (AAR vs NAAR) and year of surgery. BCDFS was evaluated using Kaplan-Meier (KM) analysis with log- rank test. Multivariate Cox regression models were fit and interaction terms were tested with Wall’s test to determine the significance of AAR on BCDFS over 3 time periods (91–95, 96–00, and 01–06). Results: The patients had a median age 61.9 yrs, pathological Gleason sum (GS) 7, and mean PSA 7.7. In KM analysis, AAR was a negative risk factor of BCDFS (p<0.01) over all time periods, had lower mean age at surgery (p<0.01), higher pre-operative PSA (p<0.01), and higher GS (p<0.01). Not surprisingly, once PSA, GS, and stage were controlled across time cohorts, AAR lost significance as a risk factor (p=0.46). When Wall’s test was used to compare the results of a multivariate analysis controlling for the same variables and stratified by time, it was found that outcomes improved over time in patients of AAR and NAAR (p<0.01), but there was no difference between the two groups (p=0.99). Conclusions: Despite previous reports that AAR is an independent negative predictor of outcome, it only appeared to be a negative risk factor in univariate analyses. Despite higher PSA, and GS, AAR was no longer a significant risk factor. Additionally, when stratified by time, patients in more contemporary cohorts had improved outcomes, with no differences between AAR and NAAR patients. No significant financial relationships to disclose.
Platelet-derived growth factor receptor alpha (PDGFRA) and C-Kit immunohistochemistry (IHC) in gastrointestinal stromal tumours (GISTs)
Authors: Skarlos D. , Kyrodimou E. , Papakonstantinou N. , Klouvas G. , Christodoulou C. , Papadimas G. , Koutselini H. 
Published: March 2020

15156 Background: The vast majority of GISTs show activating mutations of the genes coding for c-kit (CD 117) and PDGFRA, two receptor tyrosine kinases (RTKs). The exact role of PDGFRA as this expressed immunohistochemically (IHC), has not been fully elucidated in the diagnosis and treatment of GISTs. The aim of this study was (1) to try to correlate the pathological features of patients (pts) with GISTs, with c-kit and PDGFRA as these expressed by IHC and 2) to correlate the c-kit and PDGFRA with the clinical outcome of the pts. We report here the first part of the study. Materials and Methods: Twenty one (21) pts with GISTs were studied 14 located in the stomach, 3 in small bowel, 3 in colon and 1 in the mesenterium. Criteria for positivity of c-kit were strong membranus, cytoplasmic and paranuclear staining and for PDGFRA dot-like or Golgi pattern of staining. Median age was 61 years while there was a male predominance. Results: C-kit was detected in 95% of cases while PDGFRA in 90.5%. All the GISTs that were positive for PDGFRA were also positive for c-kit. Conclusions: Preliminary results of the first part of the study show that an accurate diagnosis of GISTs can be achieved based on the conventional histological and IHC criteria without the need for mutational analysis. No significant financial relationships to disclose.
Impact of breast cancer risk assessment in primary care: Modeling clinical outcomes and effectiveness
Authors: Meadows E. , Mershon J. L. , Johnston J. , Iskander R. , DeLong K. , Taylor D. , Kerlikowske K. , Weinstein M. 
Published: March 2020

1516 Background: Breast cancer risk assessment (RA) is rarely performed in the primary care setting due to uncertainty regarding the balance of harms and benefits in high risk women subsequently offered chemoprevention. We used a decision model to assess the potential clinical impact of several strategies involving use of routine RA in primary care. Methods: We developed a decision analytic model to compare routine breast cancer RA in primary care to usual care. The RA method was the Gail model, with a 5-year risk of >1.67% being designated as high risk (varied in sensitivity analyses). We assumed that high risk women would be offered 5 years of tamoxifen and that acceptance (70%) and compliance (68%) rates would be incomplete. For women receiving tamoxifen, the relative risk (RR) of incident estrogen-receptor positive invasive breast cancer was 0.31 over the 5 years of treatment, diminishing over the next 5 years after cessation of treatment. RR’s for the other health effects associated with tamoxifen were: vertebral fracture (0.74), endometrial cancer (2.41), stroke (1.6), pulmonary embolism (PE, 3.01), and deep vein thrombosis (DVT, 1.60). The non-breast cancer health effects of tamoxifen were assumed to pertain only to the 5 years of active therapy. All RR’s were applied to age-dependent population-based incidence rates; data sources included published epidemiologic and clinical trial data; model duration was 40 years. Results: In agreement with recommended clinical use of tamoxifen, the results were sensitive to age and the Gail threshold above which chemoprevention was recommended ( Table ). The number of women needed to screen (NNS) to prevent 1 case of breast cancer is 7-fold higher among women aged 50 compared to 65 with a Gail risk of 1.67% (719 vs. 104). Conclusions: The number of women offered treatment, as well as the clinical outcomes and NNS, resulting from routine breast cancer risk assessment varies with the age at RA and treatment threshold selected. [Table: see text] No significant financial relationships to disclose.
Second-line chemotherapy in advanced gastric cancer: A retrospective, single-center analysis
Authors: Herrmann C. , Jaeger D. , Herrmann T. 
Published: March 2020

15170 Background: The role of second-line chemotherapy in advanced gastric cancer is not yet established. We analyzed patients with advanced gastric cancer treated at our department between 2002 and 2005 comparing the outcome of patients with first-line chemotherapy only and those who received second-line chemotherapy. Patients and Methods: 51 patients with metastatic or recurrent histologically confirmed gastric cancer were analyzed in this retrospective study. The choice of chemotherapy depended on the attending physician. Results: Altogether, 17 patients (33.3 %) were treated with only one chemotherapy regimen, whereas 34 patients (66.6 %) received at least two different chemotherapy regimens. During the last years, the preference for certain chemotherapy regimens changed. At the time of analysis, 9 patients were still alive. Median overall survival was 11 months (range: 1–41). Patients who received only one chemotherapy regimen were older (median age 70, range: 47–81), had a shorter TTP (3.5 months, range: 1–15) and a shorter overall survival (6 months, range: 2–25) than patients receiving sequential chemotherapies (median age 61.5 (range: 33–79) p = 0,009, TTP under first-line therapy 5 months (1–17), p = 0,45, overall survival 14.5 months (2–41), p = 0,001). Response to second-line chemotherapy was assessed in 32 patients: Partial remission was detected in 4 patients (12.5 %), stable disease for = 3 months in 15 patients (46.8 %), whereas disease progression occurred in 12 patients (37.5 %). 10 of 51 patients (19.6 %) received more than two different treatments: 4 patients had third-line chemotherapy, 6 patients had more than 3 different therapies. Overall survival was 13 months (11–22) for patients with third-line chemotherapy and 29 months (16–41) for patients receiving more than three different treatment regimens. Conclusion: Although a number of active antineoplastic drugs are available for the treatment of advanced gastric cancer, the prognosis is still poor. Selected patients may benefit from salvage chemotherapy after failure of first-line chemotherapy. No significant financial relationships to disclose.
Tailored combined treatment with radiofrequency ablation plus octreotide in advanced hepatocellular carcinoma
Authors: del Prete S. , Addeo R. , Caraglia M. , Faiola V. , Guarrasi R. , Palmeri A. , Capasso E. , Nocera V. , Tarantino L. 
Published: March 2020

15173 Background: Local therapies represent a valuable choice in small hepatocellular carcinoma (HCC), however, radiofrequency ablation (RFA) is increasingly used in advanced tumors. Medical treatments generally gave frustrating results in advanced hepatocellular carcinoma. Several biological non chemotherapeutic drugs are currently tested in HCC. Based on the expression of somatostatin receptor subtypes by HCC and the tolerability profile, octreotide was evaluated in single cases and small series of HCC patients and conflicting results are reported. Methods: 35 advanced HCC (26 males, 9 females; age range 55–85 years, median 73 years) were treated with RFA and octreotide with the aim to evaluate safety and determine the effect on disease control and survival. Testing regular and increasing doses of long-acting octreotide (from 20 to 30 mg monthly) were planned in the treatment schedule. Child A and Child B patients were 60% and about 34% of the cases, respectively. Only two patients with Child C compensated cirrhosis were included. All patients have multiple liver HCC nodules and one had bone metastases. Treatment with octreotide was maintained until disease progression or unacceptable toxicity. RFA was performed before or during treatment with octreotide according to medical evaluation. Results: In the majority of patients (65,7%) stable disease was obtained. In 3 patients (8,5%) progression of disease was documented. Clinical progression of underlying cirrhosis was identified in four patients and appear to condition the outcome, independently from HCC. Both medical and local treatments were well tolerated. Statistical evaluation was presented at ASCO 2007. Conclusions: The combined treatment with RFA and octreotide can be feasible in advanced HCC patients. No significant financial relationships to disclose.
The effects of gemcitabine on cell apoptosis and cycle of gastric cancer
Authors: Wang L. 
Published: March 2020

15181 Background: To study the effects of gemcitabine on cell apoptosis and cell cycle of gastric cancer Methods: Gastric cancer cells were cultured with different concentrations of gemcitabine (0.001, 0.01 and 0.1μM). MTT test was performed to evaluate the cell proliferation. The cells were divided into three groups: control group (cultured in RPMI-1640) and 5-FU group ( cultured in RPMI-1640 with 5- FU) and gemcitabine group ( cultured in RPMI-1640 with Gemcitabine). Flow cytometry was performed to determine the apoptotic rate and the cell cycle phases. Morphological changes were observed by phasecontrast microscope. Results: The cell proliferation was inhibited in experiment groups treated with gemcitabine and 5-FU, compared with control groups(P<0.01). Gemcitabine can induce cell apoptosis. 0.01μM and 0.1μM gemcitabine were much more effective than 0.001μM. On the third day, S phase cells accounted for 24.5% and G2-M phase cells 0.08% in the control group, while 24.6% and 0.06%, respectively in the gemcitabine group. However, on the seventh day, those came to 20.8% and 0.41% in the control group, and 18.2% and 1. 55% in the gemcitabine group, indicating a significant change in the cell cycle ( P<0.01). Conclusions: Gemcitabine can inhibit the cell proliferation, and it maybe related to cell apoptosis. No significant financial relationships to disclose.
Phase II study of S-1 as a first-line, S-1 plus cisplatin as a second-line, and weekly paclitaxel as a third-line therapy in patients with advanced gastric carcinoma
Authors: Yamada T. , Rino Y. , Kanari M. , Saeki H. , Yukawa N. , Wada N. , Ooshima T. , Yamada R. , Haruhiko C. , Masuda M. , Imada T. 
Published: March 2020

15186 Background: We conducted a pilot phase II study to evaluate the efficacy and safety of S-1 as a First-line, S-1 plus cisplatin as a second-line, and weekly paclitaxel as a third-line therapy for advanced gastric cancer. Patients and Methods: Between 2002 and 2005, 19 patients were enrolled into this study. Chemotherapy consisted of 60 mg/m2 of S-1 for 4 weeks at 6 weeks interval, 60 mg/m2 of S-1 for 3 weeks and 60mg/m2 Cisplatin on day 8 at 5 weeks interval, and paclitaxel 60 mg/m2 day 1, 8, 15 at 4 weeks interval. Results: The response rate was 15.8%, 7.7%, and 0% in the first-, second-, and third-line, respectively. The time to progression was 314 days. The mean survival time was 994 days. The median survival time was not calculated because 12 patients are still alive. With respect to hematological toxicity, the major adverse effect was leukopenia, which reached grades 3–4 in all line. And non-hematological toxicities, the major adverse effect was anorexia, which reached grade 3–4 in the Second line, and no deaths were attributable to the adverse effects of the drugs. Conclusion: This sequential therapy was very effective treatment for advanced gastric cancer with acceptable toxic side-effects. No significant financial relationships to disclose.
Reduction therapy of ALT levels and prevention of HCC development in patients with HCV-associated cirrhosis
Authors: Rino Y. , Yukawa N. , Yamada T. , Imada T. , Morinaga S. , Ohkawa S. , Miyakawa K. , Ueno M. , Tarao K. 
Published: March 2020

1529 Background: Approximately 30 million people worldwide are estimated to have liver cirrhosis (LC) associated with hepatitis C virus (HCV). In addition, patients with HCV-associated liver cirrhosis (HCV-LC) have a high risk of developing hepatocellular carcinoma (HCC). Namely, 60–80% of the patients may develop HCC in 10 years. So, preventing these patients from developing HCC is an urgent problem to be solved. To find a way to prevent the development of hepatocellular carcinoma (HCC) from hepatitis C-virus associated liver cirrhosis (HCV-LC), an analysis of the HCV-LC patients who had reduction therapy of ALT levels was performed. Patients and Methods: Seventy-four consecutive HCV-LC patients of Child Stage A were followed for > 10 years for the development of HCC. They were divided into two groups: In group A, the reduction therapy for ALT levels is aggressively performed and in group B, the reduction therapy was not performed aggressively. Results: Initial ALT was higher in group A than in group B, but there was no significance. After reduction therapy, ALT level was significantly high in group A in the first year. However, there were no significant differences between ALT levels in groups A and B of after the second year. In total, 39 patients out of 74 (52.7%) developed HCC within 13 years from the beginning of the study and 35 patients did not developed HCC in the same observation period. The incidence of HCC development in group B [65.7% (23/35)] was significantly higher than in group A [41.0% (16/39)] (p=0.039). The median HCC developing time in group A (12.8 years) was significantly longer than in group B (3.8 years) (p=0.0013). Multivariate analysis demonstrated that reduction therapy and ALT levels were the significant factors affecting HCC development. The incidence of HCC development in group B was 5.8 times higher than in group A. The high and unclassified ALT groups were 4.6 times and 2.2 times higher than in the low ALT group. Conclusion: The chances of surviving for more than 10 years without developing HCC in the HCV-LC patients of Child Stage A were far more favorable in group A than in group B. These results suggest that aggressive reduction therapy for ALT levels in HCV-LC patients could significantly prevent HCC development. No significant financial relationships to disclose.