bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topotecan therapy as salvage in heavily pretreated ovarian cancer patients (hpocp)
Authors: Wcislo G. B. , Bodnar L. , Nasilowska A. , Szarlej-Wcislo K. , Szczylik C. 
Published: March 2020

15057 Background: Topotecan is utilized as to a second-line chemotherapy agent in ovarian cancer. The third or more line of chemotherapy is possibly to use against ovarian cancer which is chemosensitive even when this malignancy progressed. Methods: Prior chemotherapy with platinum compounds, paclitaxel, doxorubicin was used. Topotecan was given as 30-minute infusion at the dose of 1.5 mg/m2 through 5 consecutive days every 21 days. Toxicity profile was assessed according to NCI CTC and response was measured while met RECIST and CA-125 criteria described by Rustin et al. Results: Between 2001 and 2005, 22 hpocop were enrolled onto the study and received at least two cycles of topotecan salvage, median 6 (range 2–6). The patients were previously treated with chemotherapy and characterised 37% (8/22) as platinum-sensitive, 9% (2/22) as partial platinum- sensitive, 27% (6/22) as platinum-resistant and 27% (6/22) as platinum-refractory. Twenty hpocp of the total number of 22 were monitored after chemotherapy through fulfilling RECIST criteria: 7/20 (35%) -PR, 7/20 (35%)-NC, 8/20 (40%)-PD. The clinical response rate in 20 patients with assessable CA 125 levels was 30% (6/20) with 75% response, and 15% (3/20) with 50% response by Rustin et al. criteria. Time to progression of ovarian cancer was median 5,0 months, SD ± 2.0 (range from 2 to 7) and median survival 8 months, SD ± 21 (range from 2 to 39). Toxicity profile was recorded as following: neutropenia 3/4th grade in 8/22 (36%), anaemia 3/4th grade in 9/22 (41%), thrombocytopenia 4th grade in 6/22 (27%), and non-hematologic toxicity relied on alopecia 7/22 (32%). We have not observed fatal outcome after topo salvage therapy. Conclusions: Topotecan could be involved in therapy of patients with ovarian cancer previously heavily pretreated. It offers clinical benefits in ovarian cancer course as to be a stabilised disease despite prior chemotherapy but reliable management alleviates hematologic toxicity. No significant financial relationships to disclose.
Analysis of prognostic factors with cervical squamous cell carcinoma after neoadjuvant chemotherapy
Authors: Hayashi S. , Fujii T. , Nakamura M. , Hirao N. , Nakagawa H. , Fukuchi T. , Kubushiro K. , Tukazaki K. , Aoki D. 
Published: March 2020

15060 Background: The purpose of the study was to evaluate retrospectively the clinical effects of neoadjuvant chemotherapy (NAC) given to women with cervical squamous cell carcinoma using the response rates, prognostic parameters, and diagnostic imaging data (CT scan or MRI). Methods: Patients included in the study were 32 women with a mean age of 48.8 ± 10.6 who had stage Ib-IIIb cervical squamous cell carcinoma and was treated initially with platinum-based NAC prior to surgical intervention at our institution between 1994 and 2003. The response rates in these patients were assessed, and a statistical analysis was performed to evaluate the effects of NACT on survival rates and disease recurrence using the following 9 parameters: 1. clinical stage of cancer, 2. lymph node metastasis, 3. blood vessel invasion, 4. parametrial involvement, 5. depth of stromal invasion, 6. tumor diameter, 7. pre- and post-treatment serum levels of the squamous cell carcinoma antigen, 8. age, and 9. rates of response to NAC. CT scan or MRI obtained prior to and after NAC were compared and evaluated for any evidence of lymph node metastasis. Results: Five and 18 patients achieved complete response (CR) and partial response (PR), respectively, with a response rate of 71.8% for these CR and PR patients. A multivariate analysis revealed that lymph node metastasis was the only independent prognostic parameter for survival rates and disease recurrence. In 13 patients in whom lymph node metastasis was found by the was found by the CT scan or MRI prior to NAC, 8 (61.5%) still showed the evidence of metastasis after treatment. Among these, 7 (87.5%) actually had metastatic lymph nodes. In addition, the occurrence of lymph node metastasis was unrelated to rates of response to NAC. Conclusions: The rates of response to NAC dose not predict prognosis in patients with cervical squamous cell carcinoma. The occurrence of lymph node metastasis is unrelated to rates of response to NAC. If metastatic lymph nodes are suspected after NAC, appropriate treatment approaches should be well considered in such patients. No significant financial relationships to disclose.
Borderline ovarian tumors: A study of 100 cases
Authors: Taner C. E. , Oztekin M. , Mun S. , Sehirali S. , Büyüktosun C. , Basogul O. 
Published: March 2020

15069 Background: The purpose of the study was to evaluate the patients with borderline ovarian tumors. Methods: Clinical features, treatment and survival status of 100 patients with borderline ovarian tumors were retrospectively evaluated between 1998 and 2005. Results: Mean age was 37.75 (Range: 15–72) years. 22 cases were in postmenapausal status. Histopathological diagnosis was serous, musinous, endometrioid and clear cell in 54%, 41%, 2%, 3% of the patients, respectively. 19 cases underwent restaging laparotomy. In 52 cases fertility sparing surgery was performed. 70 patients had stage IA, 8 patients had stage IB, 16 cases had stage IC, 2 cases had stage IIIA, 3 cases cases had stage IIIB and a case had stage IIIC disease. 22 cases were administered chemotherapy because of advanced stage disease. All cases were alive. 5 year disease free survival of 51 cases was 100%. Conclusions: Borderline ovarian tumors have excellent prognosis and conservative surgery can be performed in young patients with early stage disease. No significant financial relationships to disclose.
Early necrosis following concurrent temozolomide and radiotherapy in adult patients with glioblastoma
Authors: Chamberlain M. C. , Glantz M. J. , Chalmers L. , Van Horn A. , Sloan A. E. 
Published: March 2020

1513 Background: Concurrent temozolomide (TMZ) and radiotherapy (RT) is the new standard of care for patients with newly diagnosed glioblastoma GBM). This report is a prospective observational study of surgically confirmed early necrosis in adult patients with GBM treated with concurrent TMZ and RT and post-RT TMZ. Methods: 52 consecutive patients (33 males; 19 females) ages 34 to 69 years (median 60), with newly diagnosed GBM were treated with surgery (complete resection in 40%, incomplete in 33%, biopsy in 27%) followed by concurrent TMZ and RT (median tumor dose 60Gy) followed by planned 6 cycles of monthly TMZ. TMZ was administered as 75mg/m2/day for 42 consecutive days with radiotherapy followed by 200mg/m2/day for 5 consecutive days every 28 days. Neurological evaluations were performed monthly and cranial MR bimonthly. Results: 26 patients (50%) manifested clinical and neuroradiographic evidence of tumor progression within 6 months of completing RT. 15 patients (28%) underwent reoperation with image verified complete resection. Histopathology was interpreted as necrosis without evidence of tumor in seven patients (13%). Conclusion: The patients in this study with early necrosis suggest a potential and perhaps significant chemo- radiosensitization effect in a subset of patients treated with this regimen of concurrent TMZ and radiotherapy that may predict for durable responses and contribute to the regimens observed benefit in patients with newly diagnosed GBM. Clearly, confirmation of this preliminary observation of unexpected and common early necrosis using concurrent TMZ and radiotherapy in a larger GBM population is required. [Table: see text]
Evidence-based review of intrathecal chemotherapy in outcome of patients with leptomeningeal metastasis
Authors: Rogers L. R. , Chamberlain M. , Glantz M. 
Published: March 2020

1529 Background: Intrathecal chemotherapy (ITC) is commonly employed to treat leptomeningeal metastasis (LM). An evidence-based literature review supporting this practice is lacking. We therefore searched the literature for evidence of efficacy of ITC on LM patient outcome in order to provide evidence-based treatment recommendations. Methods: Computer-assisted searches of the Medline and Cochrane Library databases were performed. Only prospective, randomized, controlled trials in which ITC chemotherapy was used to treat LM were selected. Study design, patient characteristics, interventions, and outcome measures were independently compiled by each of the authors using customized data extraction forms. Each article was assigned a class of evidence by each of the authors. Disagreements were resolved by consensus. Results: Five articles met the criteria. Four studies compared different ITC regimens. One compared ITC to controls who did not receive ITC. Study populations included solid tumors (3 [2 of these included lymphoma]), lymphoma only (1), breast cancer only (1). Positive CSF cytology was a requirement for study entry in three trials. In each trial patients were allowed to receive CNS radiation as needed and non-investigational chemotherapy to treat the underlying cancer. Outcome measures included neurological status (5), survival (5), toxicity (5), CSF cytology (4), cause of death (3), time to neurologic progression (3), and quality of life (2). All studies lacked masked outcome assessment, and some suffered from additional design flaws including insufficient size, inequalities in baseline characteristics, inadequate characterization of treatment arms, and poor choice or definition of primary endpoints. Consequently, all studies provided only Class III evidence. Conclusions: There is no Class I or II evidence that ITC improves outcome in patients with LM. Improved quality of life, survival, or time to neurologic progression in treatment responders vs. non-responders in some of these trials provides a weak suggestion that effective therapy improves clinical outcome. Well-designed, adequately powered studies are urgently needed to determine efficacy of ITC in LM. No significant financial relationships to disclose.
Superiority of bi-dimensional measurements compared to RECIST in measuring response of metastatic brain tumors
Authors: Kilpatrick M. R. , Linn N. U. , Smith J. K. , Winer E. P. , Bullitt E. , Carey L. A. , Ewend M. G. 
Published: March 2020

1542 Background: Criteria for measuring response rates of brain metastases are not well established. Unilateral (RECIST), and bilateral (WHO) criteria were developed to approximate tumor volume, which is the gold standard but difficult to measure. We compared WHO and RECIST criteria to volumetrics in patients with metastatic breast cancer lesions in the brain treated with lapatinib. Methods: MRI data from 20 patients enrolled in a prospective phase II study at UNC-Chapel Hill, the Dana-Farber/Harvard Cancer Center, and Georgetown were retrospectively analyzed. Post-gadolinium MRI images were analyzed at baseline and at 2 month intervals over a 7 month period. 196 lesions were analyzed for tumor size using one-dimensional (single greatest diameter), bidimensional (product of 2 longest diameters in perpendicular dimensions), and volume (calculated with an institutionally-derived software program) measurements. Tumor response was classified according to WHO and RECIST criteria. Progressive disease required a >20% increase, partial response >30% decrease, and stable disease for those in between. Similar definitions for volume measurements were used. Results: 3 of 20 patients were excluded as the diffuse metastatic nature of their tumors and small size prevented application of the RECIST or WHO measurement criteria. RECIST correctly predicted volumetric response or progression in 12/17 cases, but was delayed by either one or two scan cycles in reaching that conclusion in 3 of these 12 cases. WHO criteria correlated with volumetrics in 16/17 cases with a delay of one scan interval in a single case. The delay in correct identification of response category was particularly noticeable in identifying progressive disease with RECIST as compared to volumetrics. RECIST was only 50% specific for progressive disease at the time that progression was documented with volume. WHO was 90% specific. Both methods were sensitive to clinical benefit (SD + PR) (RECIST 86%; WHO 100%). Conclusions: For metastatic brain tumors that are large enough to be measured with linear criteria, WHO bidimensional criteria appear superior to unidimensional RECIST measurements in predicting volumetric response of tumors. Supported by EB000219-NIBIB and UNC Breast SPORE CA58223. No significant financial relationships to disclose.
Spinal myxopapillary ependymoma outcomes in patients treated with surgery and radiotherapy at M. D. Anderson Cancer Center
Authors: Akyurek S. , Chang E. L. , Yu T. , Little D. , Allen P. K. , McCutcheon I. , Mahajan A. , Maor M. H. , Woo S. Y. 
Published: March 2020

1547 Background: Myxopapillary ependymomas (MPEs) are a distinctive variant of ependymomas both clinicopathologically and genetically. These tumors usually occur in the lumbosacral/cauda equina region. Most spinal ependymoma series published in the literature included a few patients with MPEs. In this study, we report the outcomes from a single institutional experience with 35 spinal MPEs treated with either surgery alone or with adjuvant radiotherapy (RT). Methods: The medical records of 35 patients with MPE treated at The University of Texas M. D. Anderson Cancer Center between December 1968 and July 2002 were reviewed. The median age of patients in this series was 35 years (range, 14–63 years) and the male to female ratio was 2.5:1. Twenty-one patients (60%) underwent a gross total resection, 13 (37%) a subtotal resection, and 1 (3%) a biopsy only; 22 of these patients (63%) also received adjuvant RT. The endpoints analyzed were progression-free survival, overall survival, and local control. Results: The median follow-up was 10.7 years. The 10-year OS, PFS and LC rates for the entire group were 97%, 62%, and 72% respectively. Twelve patients (34%) had disease recurrence, all in the neural axis; 8 patients had treatment failure at the primary site only, 3 in the distant neural axis only, and 1 at the primary site and in the distant neural axis. Older patient age (≤35 vs. >35 years; p=0.002) and initial treatment modality (surgery vs. surgery + adjuvant RT; p=0.04) showed significant impact on PFS. Conclusions: The long-term patient survival duration for MPE managed with surgery and adjuvant RT is favorable. Regardless of the extent of resection adjuvant RT appears to significantly reduce the rate of tumor progression. Failures in this series occurred exclusively in the neural axis, mainly at the primary site. No significant financial relationships to disclose.
Concurrent chemoradiotherapy (crt) with weekly docetaxel (d) for advanced head and neck cancer
Authors: López-Argumedo G. , López-Vivanco G. , Fernández R. , Díaz de Corcuera I. , Sancho A. , Rubio I. , Martínez-Bueno A. , Mañé J. , Muñoz A. , Barceló R. 
Published: March 2020

15516 Background: Concomitant CRT has become a standard treatment for advanced head and neck cancer. The aim of this study was to evaluate the efficacy and toxicity of concurrent CRT with D in patients (pts) with advanced squamous cell carcinoma of head and neck (SCCHN). Methods: Patients with untreated and unresectable stage III or IV (M0) squamous cell carcinoma of head and neck were included. Treatment consisted of D 20 mg/m2 weekly with concomitant radiotherapy 70 Gy (2 Gy per day, 7 weeks). Results: From September 03 to October 05, sixty-four pts with advanced SCCHN, were recruited. Gender: 61 male, 3 female. Mean age: 56.5 years old (range 42–77). ECOG PS 0/1/2: 0/57/7. Primary sites of disease: oral cavity 8, oropharynx 26, hypopharynx 15 and larynx 15. Stage III 16 pts and stage IV 48 pts. Compliance: 393 administrations of D were given, median 6, mean 6 (range 1–8). Fifty-five pts (86%) completed the radiotherapy dose planned (mean dose of RT was 66 Gy). One refused more treatment with D after first administration. Nineteen pts required supportive percutaneous gastrostomy or nasogastric tubes previously or during therapy. Grade 2/3/4 toxicity per patient: anemia 4/2/0, mucositis 21/24/0, dermatitis 21/20/0. Neither thrombopenia nor neutropenia were observed. Four pts died of aspiration pneumonia during treatment, one of gastric perforation and two of unknown causes. Fifty-six pts were evaluable for response: CR 28 (44%), PR 23 (36%), SD 2 (3%), PD 3 (5%), with an overall response rate of 80%. Median overall survival was 74.86 weeks (95% CI: 40.40–109.32) and median progression free survival was 48 weeks (95% CI: 18.80–77.20). With a median follow up of 40 weeks 34 pts (53%) were alive and 21 of them (33%) remained free of disease. Conclusions: Concurrent weekly D with conventional radiotherapy showed a high response rate. Toxicity was manageable and allowed maintaining radiotherapy administration. Taking into account poor prognostic factors of our series, survival results seem promising. No significant financial relationships to disclose.
A phase II trial of stereotactic radiosurgery boost following surgical resection for solitary brain metastases
Authors: Narayana A. , Chan K. , Brennan C. , Chang J. , Higgins V. , Lymberis S. , Yamada J. , Gutin P. H. 
Published: March 2020

1552 Background: At present there is no standard of care for adjuvant therapy following resection of solitary brain metastases. The objective of this study was to determine the local control, survival, patterns of relapse and the incidence of brain injury following a surgery-stereotactic radiosurgery (SRS) combined therapy approach while avoiding upfront whole brain radiation therapy (WBRT). Methods: The eligibility criteria included radiologically proven solitary brain metastases, KPS≥70 and a neurologic function score of 0–2. Following the surgical resection, SRS was delivered to the surgical cavity 4–8 weeks later to a dose of 15–22 Gy in a single fraction using the BrainLAB linear accelerator system. Patients were followed with neurological examination and serial MRI images done every 3 months following the procedure. Results: 25 out of 50 patients needed for the study have been accrued since it opened in August 2004. Four patients have failed locally, with a median time to local failure of 9.5 months. The one year local control at the site of original disease was 35%. Two of the four patients who had local recurrence at the time of relapse also had evidence of leptomeningeal disease. Six additional patients developed new brain metastases, resulting in a 1 year brain relapse free survival of 38% following the combined approach. The median overall survival was 12 months. One patient (4%) developed radiation necrosis that required surgical intervention 6 months following the procedure. Six patients (24%) needed WBRT, two patients (8%) needed further SRS and one patient (4%) needed surgery as salvage following development of new brain lesions with this approach. Conclusions: The preliminary results of surgery-SRS approach appear inferior to surgery-WBRT data for solitary brain metastases in terms of local control and development of new brain metastases. However, relapses can be subsequently managed with WBRT without adversely affecting the overall survival and the morbidity. No significant financial relationships to disclose.
Phase I/II trial of induction chemotherapy in locally advanced head and neck carcinoma (LAHNC) and recurrent disease (RD) after surgery/radiotherapy with weekly docetaxel (D), tomudex (T) and cisplatin (P)—DTP
Authors: Johnson-Buarque E. J. 
Published: March 2020

15536 Background: The role of neoadjuvant chemotherapy in LAHNC and treatment for RD have not been established yet. Infusional 5-FU combination with DP is one of the most active regimens for patients (pts) with LAHNC, at the same time is very toxic (hematological, gastrointestinal (GI) and cardiovascular). In order to reduce its toxicity we designed a novel weekly triple-drug scheme trying to reduce toxicity and mantain the high response rate. Methods: LAHNC and RD pts received D 35/mg/m2, T 1 mg/m2 and P 25 mg/m2 on days 1, 8 and 15. with one week rest. Some pts received only days 1 and 8 due to hematological toxicity (grade 2, 3 or 4). Planned treatment included 3 through 6 cycles (50% pts received 3 cycles). After neoadjuvant chemotherapy, pts with LAHNC were sent to their doctors to continue the treatment according to their own preference (surgery, RXT or RXT/QT). Results: Between november 2001 and may 2004, 24 pts (M = 17 F = 7) median age 61 (range 45–72) have been enrolled. 17 was LAHNC and 7 RD; tumor sites were: oral cavity 18 and oropharinx/larinx 6 pts. Response rate (RECIST) and toxicity (NCI) were avaible to all pts. 37.5% pts had grade 3/4 toxicity (hematological or GI) and these pts had a dose reduction. There was one febrile neutropenia and no deaths. The overall rate response was 91.6% (3 CR and 19 PR) in all sites of disease including lymphonodes. Conclusions: This scheme DTP has a high respose rate with low and manageable toxicity. It will be necessary to compare it with concurrent radiotherapy + dose reduction chemotherapy with or without cetuximab. No significant financial relationships to disclose.
Recurrent/progressive oligodendroglial tumors: A phase II study with temozolomide as first line chemotherapy
Authors: Soffietti R. , Rudà R. , Guarneri D. , Laguzzi E. , Trevisan E. 
Published: March 2020

1561 Background: There are few data regarding the efficacy of first line temozolomide in recurrent oligodendroglial tumors, and responses range from 17% to 54%. The objective of this phase II study was to investigate the efficacy and toxicity of temozolomide in the “standard schedule” in patients with oligodendroglial tumors at first relapse after surgery alone or surgery plus radiotherapy. Methods: The main inclusion criteria were as follows: age ≥ 18 yrs, Karnofsky ≥ 70; diagnosis of oligodendroglioma or oligoastrocytoma (grade II or III) according to WHO. Temozolomide was administered in the standard regimen up to 24 cycles in responding or stable patients or to unacceptable toxicity. Primary endpoint was response basing on Macdonald’s criteria, whereas secondary end-points were time to tumor progression and progression-free survival at 6 and 12 months. Results: Fifty patients are evaluable, with a median age of 50 (range 19–72). A median of 12 cycles (range 1–24) were administered. Responses were as follows: CR 8/50 (16%); PR 13/50 (26%); mR (minor response, a tumor volume reduction of 20–40%) 7/50 (14%); SD 18/50 (36%); PD 4/50 (8%). The overall response rate (CR+PR+mR) was 56%. The maximum tumor response was observed after 3 cycles in 9/28, 6 cycles in 10/28, 9 cycles in 6/28, 12 cycles in 1/28, 15 cycles in 2/28. Fourteen of 28 responding (CR+PR+mR) patients (50%) and 8 of stable patients (44%) displayed a reduction of seizures. Eighteen of 35 (51%) oligodendrogliomas responded, including 7 patients with CR (5 grade III tumors and 2 grade II), compared to 10/15 (67%) oligoastrocytomas. Twenty of 35 enhancing tumors responded (57%) compared to 8/15 non-enhancing tumors (53%) and 57% of grade III responded compared to 55% of grade II. Median TTP was 17 months (range 2–37), with a PFS at 6 months of 40% and at 12 months of 29%. Grade III-IV myelotoxicity accounted for 22%. Conclusions: Temozolomide shows activity as first line treatment in oligodendroglial tumors at first relapse. A long term treatment with temozolomide is well tolerated. No significant financial relationships to disclose.