bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraperitoneal therapy for ovarian cancer: Impact on survival and recurrence—The result of multi-institutional studies
Authors: Takeuchi S. , Tsubamoto H. , Adachi S. , Ito K. , Itani Y. , Miyamoto T. , Terai Y. , Kigawa J. , Sugiyama T. 
Published: March 2020

16068 Background: For optimal debulked mullerian cancer (MC), the Intraperitoneal (IP) therapy has become the effective modality of chemotherapy to obtain better prognosis. We have reported KCOG9811study: IP CDDP + Paclitaxel (PTX) intravenous (IV) 2 cycles followed by 3 cycles of usual PTX-Carboplatin (abstr.1970, ASCO2002). And we have also reported the feasibility study and satisfactory response rate of the weekly IP-PTX with IV Carboplatin therapy (IP-PIVC, abstr. 5120, ASCO2005). Objectives: We have conducted two types of IP therapy for optimal debulked MC to improve the progression free survival (PFS) and overall survival (OS). Here are the prognosis and recurrent fashion after these IP therapies. Methods: Twenty patients (pts) with optimal debulked ovarian cancer were enrolled for KCOG9811, and eleven pts with optimal debulked MC newly/recurrent diagnosed disease were enrolled for IP-PIVC. The regimen of each therapy consisted of as follows: KCOG9811:50mg/ m2 of CDDP was administered via IP port at operation, after 2 weeks (wks) of operation, PTX was administered at a dose of 175mg/ m2IV for 3hrs on day 1, CDDP was administered at 75mg/ m2IP on day 2, every 3wks for 2 cycles, followed by PTX 175mg/ m2 IV and Carboplatin AUC5 IV on day1 every 3wks for 3 cycles. The IP-PIVC therapy consisted of IP-PTX, on days 1, 8, 15 at a dose of 45 mg/m2 (3pts) and 60 mg/m2(8pts). Carboplatin was administered monthly at a dose of AUC 5 on day 1 only. 2–6 cycles were performed. Results: The mean observation time was 72.6 months (m) and 32.6m for KCOG9811 and IP-PIVC, respectively. As for the median PFS was 1308+ days and 678+ days, and the median OS was 2180+ days and 978+ days, respectively. The five years survival rate showed 59.3% on KCOG9811, and the three years survival rate showed 75.8% on IP-PIVC. As for recurrent fashion, liver metastases and proximal lymphnodes metastases, and retroperitoneal metastases were detected. Few cases recurred Intraperitoneal lesion with small ascites Conclusions: There are some differences in the recurrent fashion of IP treatment from that of IV treatment. IP treatment prevented ascitic recurrence. Further improvement of chemotherapy is necessary for liver metastasis and proximal lymphnodes. [Table: see text]
Morbidity and survival of 32 recurrent ovarian cancer patients treated with aggressive cytoreductive surgery followed by intraperitoneal hyperthermic chemoperfusion
Authors: Richard S. D. , Gusani N. , Zeh H. J. , Colovos C. , Cho S. W. , Bartlett D. L. , Edwards R. P. 
Published: March 2020

16078 Background: Cytoreductive surgery followed by intraperitoneal hyperthermic chemoperfusion (CS/IPHC) has shown increased survival for patients with recurrent and persistent GI malignancies with peritoneal dissemination. We present our preliminary experience with CS/IPHC as palliative therapy for recurrent ovarian cancer treated at a single institution. Methods: A retrospective review of CS/IPHC for women with recurrent or persistent epithelial ovarian carcinoma previously treated with platinum/taxane chemotherapy at a single institution from 2002–2006 was performed. Each patient had an attempted optimal surgical debulking (volume of residual disease <1 cm) prior to chemoperfusion. IPHC was performed on all patients for 100 minutes at temperatures between 40–42°C with either mitomycin C (40 mg/m2) or cisplatin (100 mg/m2). Post-surgical complications were evaluated. End points analyzed included morbidity, progression free survival, and over all survival. Results: Thirty-two patients were identified, with optimal cytoreductive surgery obtained in 26 (81.3%). Procedures required for cytoreduction included omentectomy (n=16), splenectomy (n=14), colonic resection (n=14), small bowel resection (n=13), ileostomy (n=9), hepatic resection (n=5), partial gastrectomy (n=5), and diaphragmatic stripping (n=3). Over-all morbidity was 65.6%, with major morbidity of 9.4%. There were three mortalities within sixty days of operation. Common morbidities included neutropenia (n=5), ileus (n=5), pleural effusions (n=4), and sepsis (n=4). Median length of stay was 11 days (6 to 47). Nineteen patients had a documented recurrence with a median progression free survival of 8 months (1 to 22). Median survival was 13 months (1 to 54) for these patients with recurrent end stage ovarian cancer. Conclusions: CS/IPHC is associated with high morbidity, but acceptable mortality. In a subset of patients, survival is improved compared to historical controls for recurrent ovarian cancer. A randomized phase II study is planned based on this data. No significant financial relationships to disclose.
Neoadjuvant chemotherapy with docetaxel and cisplatin followed by concomitant chemoradiotherapy (CT-RT) in the management of locally advanced laryngeal carcinoma
Authors: Sayed F. S. , Karim A. , Hossain M. , Ahmed D. , Khan M. A. , Momin M. , Sobhan J. 
Published: March 2020

16507 Background: Neoadjuvant chemotherapy has been used effectively in the treatment of locally advanced head and neck cancers. We conducted a study to evaluate the efficacy and adverse events associated with neoadjuvant chemotherapy schedule comprising of docetaxel and cisplatin followed by concomitant CT-RT from July 2004 to June 2006. Methods: 25 patients with locally advanced supraglottic laryngeal cancer were enrolled to receive docetaxel 75 mg/m2 and cisplatin 75 mg/m2 every 3 weekly for 3 cycles followed by one cycle of concomitant external beam radiotherapy (6000 cGy) and docetaxel 75 mg/m2+cisplatin 75 mg/m2 on day 7 of radiotherapy. All patients after completion of neoadjuvant chemotherapy were evaluated by CT scan and direct laryngoscopy and biopsy from any residual disease. All patients were followed up every month up to disease progression. Follow-up was done by physical examination and indirect laryngoscopy and by 3 monthly CT scan. Adverse events were treated mostly on outpatient basis. Results: Out of 25 patients, 9 had residual disease after completion of treatment and 2 had a disease relapse within 5 months of disease completion. The remaining 14 patients were disease free from a duration of 6 to14 months follow-up period. Median progress free survival had not been reached. 9 (36%) patients had severe mucositis and neutropenia while receiving concomitant CT-RT. 6 (24%) patients had grade III mucositis and rest 3 (12%) patients had grade II mucositis and all the 9 (36%) patients had grade III neutropenia. All of them were treated with G-CSF and prophylactic antibiotics. All the rest had grade I and grade II mucositis and neutropenia Conclusions: In our experience, neoadjuvant chemotherapy with docetaxel and cisplatin (3 cycles) followed by 1 cycle of concomitant CT-RT may be a good choice in treating locally advanced supraglottic laryngeal cancer. The toxicity profile was also manageable. No significant financial relationships to disclose.
Impact of post-surgical residual tumor volume on local control in radiotherapy for maxillary sinus cancer
Authors: Elhag A. G. , Elsawy W. H. , Khalifa D. N. 
Published: March 2020

16518 Background: The aim was to study the influence of post-surgical gross residual tumor volume on local control of maxillary sinus cancer treated with radiotherapy combined with debulking surgery. Methods: Twenty-five patients with squamous cell carcinoma of the maxillary sinus treated by combined surgery and radiotherapy (50–65 Gy, median 60 Gy). Gross residual tumor volume (GRTV) after surgery was measured on computed tomograms obtained after surgery. Patients were classified according to GRTV as follows: group A, GRTV = 0 (microscopic residual, n = 5); group B, GRTV <10 cm3 (n = 11); group C, 10–40 cm3 (n = 5); and group D, =40 cm3 (n = 4). The relationship between local control and GRTV was analyzed using univariate and multivariate analysis. Results: The 2-year local control rate for all patients was 64%. The differences in local control rates between groups A, B and C were not significant (P > 0.05), but the rate was significantly lower in group D than in the other groups (65% at 2 years vs. 25% at 1 year, P < 0.001). Multivariate analysis showed that GRTV (P = 0.002) and histological differentiation (poorly differentiated histology was favorable, P = 0.035) were independent prognostic factors and that tumor stage and the sequence of treatment were not. Conclusions: Our data suggest that adequate, not complete, debulking associated with the proper dose of radiotherapy can provide satisfactory local control for patients with squamous cell carcinoma of the maxillary sinus. No significant financial relationships to disclose.
Squamous carcinoma of the skin responding to erlotinib: Three cases
Authors: Read W. L. 
Published: March 2020

16519 Background: Systemic therapies for squamous cell carcinoma of the skin (SCCS) include cytotoxic chemotherapy and immunotherapy with retinoids and interferon. Erlotinib is an orally available EGFR inhibitor which is generally well tolerated. This report describes three patients with SCCS in whom erlotinib treatment produced clinical benefit. Methods: Case report. Results: 1. A 40 year old lung transplant recipient with multifocal SCCS was diagnosed with lung metastases by CT scan and bronchoscopy. These lesions progressed during treatment with acitretin and interferon. He began erlotinib at 150 mg daily and one month later CT scan showed his lung metastases to have responded, with the largest lesion decreasing in size by 50%. He continued on erlotinib for his remaining 8 months of life, during which his lung lesions continued to regress. Unfortunately the SCCS on his face progressed while on erlotinib, and ultimately caused his death. 2. A 54 year old with SCCS of the face treated with orbital exenteration and neck dissection followed by chemoradiation for submental recurrence developed a new 2 cm submental mass. He began erlotinib at 150 mg daily with complete resolution of the mass over 1 month. PET scan was negative, and there was doubt as to whether the mass had actually been SCCS. Because of this the patient discontinued erlotinib, and 3 weeks later the mass recurred. It was biopsy confirmed to be SCCS, and erlotinib again produced a clinical CR. Two months later he stopped erlotinib prior to planned surgery, and the tumor again regrew. 3. A 41 year old developed SCCS of the left temple. This lesion repeatedly recurred despite irradiation and resection, ultimately involving the orbit and cranial nerves and causing significant pain. The lesion progressed during chemotherapy with cisplatin and capecitabine. The patient began erlotinib 150 mg daily and experienced a partial response, together with marked improvement in pain and quality of life. He has continued on erlotinib for three months to date. Conclusions: Erlotinib provided excellent palliation for these patients with SCCS who had failed other therapies. The sensitivity of these aggressive SCCS to erlotinib suggests that this drug might be used at earlier points in the treatment of such patients, possibly in combination with radiation. No significant financial relationships to disclose.
Weight loss during concomitant chemo-radiation therapy for squamous cell head and neck cancer: Possible role of transient hyperthyroidism
Authors: Mehrotra B. , Caramalis A. , Nissel-Horowitz S. , Radhakrishnan N. , Marsh J. , Limaye S. 
Published: March 2020

16531 Background: Concomitant Chemoradiotherapy (CRT) is a standard treatment modality for locally advanced squamous cell head and neck cancer (HNC). This treament is often associated with significant weight loss which is commonly attributed to nutritional depletion secondary to mucositis, pain and inadequate oral intake. We undertook an evaluation of thyroid function as measured by Thyroid Stimulating Hormone (TSH) levels during CRT to evaluate the possible role of a thyroid hormone flare during treatment that may account for part of this weight loss. Methods: Institutional Review Board approval was obtained to conduct this retrospective analyses. Patients treated at our institution during the past six months who were treated with CRT for HNC and had recorded TSH levels at baseline (when available), mid treatment (week 4 to 6 of CRT), and post CRT (6 to 9 weeks later), at least 5% weight loss during treatment, and feeding tube requirement data available were identified. Age, Gender, Stage and Primary site of disease, Radiation dose and fields, chemotherapy regimen, were recorded. Results: Twelve patients were identified. Mid treatment TSH levels were suppressed below normal reference range (0.49–4.67 mIU/L) in 7of 12 pts (58%). A decline in TSH levels was noted in all 8 of 8 pts (100%) that had recorded pre-CRT TSH levels and mid treatment levels. Improvement of TSH levels was noted in all 9 of 9 patients that had mid treatment and post treatment TSH levels recorded, although in three of these nine patients TSH levels remained below normal range. Four of twelve pts required PEG placements for nutritional support. Conclusions: Transient suppression of TSH levels suggesting a thyroid flare is frequently observed early during CRT for HNC and appears to improve by 6–9 weeks post treatment. This may contribute to weight loss in this nutritionally challanged population. Further studies evaluating more specialised thyroid function testing to exclude sick euthyroid states and other etiologies for suppressed TSH levels are warranted. In addtion, therapeutic methods to abbrogate this flare may reduce weight loss during aggressive CRT treatment protocols. No significant financial relationships to disclose.
Nasopharyngeal carcinoma: Comparison of concomitant chemoradiotherapy with neoadjuvant chemotherapy in the caucasian population
Authors: Sancho A. , Rubio I. , Diaz de Corcuera I. , Munoz A. , Martinez-Bueno A. , Mane J. M. , Ruiz de Lobera A. , Fernandez-Rodriguez R. , Gil-Negrete A. , Carrera S. 
Published: March 2020

16532 Background: Nowadays, concomitant chemoradiotherapy (CT-RT) is the standard treatment for nasopharyngeal carcinoma (NPC). Neoadyuvant chemotherapy (CT) has been investigated without definitive conclusions. The aim of this study is to compare results of patients(pts) treated with neoadyuvant CT with those treated with concurrent CT-RT. Methods: 38 pts with histologically proven NPC stage II-IVb (PS 0–2) were treated. 27 pts (71.1%) (Group A) (June 1994-May 2000) received Cisplatin (P) 100 mg/m2, Epirrubicin (E) 70 mg/m2, Bleomicin (B) 15 mg D1 and B 12 mg/m2 continous infusion (c.i) for 5 days every 3 week with sequential RT. The other 11 pts (28.9%) (Group B) (June 2002-August 2006) received P 100 mg/m2 D1, D22 and D43 concurrent with RT followed by adyuvant CT P 80 mg/m2 and 5-Fluorouracil 1,000mg/m2/d D1-D4 c.i every 28 day for 3 cycles. Results: 38 pts: 30 male(79%), 8 female(21%). Median age: 53(range 15–75). Stages:II:7, III:11, IVA:12, IVB:8(AJCC 2002). Histology:WHO I-II:11, WHO III:27. Overall response rate: Group A: 25/27 (92.5%), Group B: 10/11 (90.9%) p=0.65. Group A: CR: 17/27 (62.9%); PR: 8/27 (29.6%); PD: 1/27( 3.7%). Group B: CR: 8/11(72.7%); RP: 2/11 (18.1%). 1 pts of each group was not evaluated. Median overall survival (OS) was 34 months (m) in Group A and has not been reached in Group B. Estimated 3 years OS was 48% in GroupA and 80% in GroupB. Median progression free survival (PFS) was 42 m in Group A and 45 m in Group B p=0.72. Estimated 3 years PFS was 50.6% and 66.7% respectively. In the multivariate analysis concurrent CT-RT (HR=5.94 p=0.03) and stage (HR=0.17 p=0.01) were associated with OS. There was 2 toxic death in Group A. The most common toxicities was; Group A: bone marrow suppresion, nausea; Group B: mucositis. Conclusions: These data suggest that P based concomitant CT-RT improves OS and PFS compared with neoadyuvant CT (BEC) followed by RT. No significant financial relationships to disclose.
Treatment outcomes in anaplastic thyroid carcinoma from 1966–2006: Failure of overall survival enhancement despite four decades of progress in surgery, radiotherapy and chemoradiation
Authors: Chan P. , Yau T. , Epstein R. , Lam K. , Liang R. , Lo C. 
Published: March 2020

16537 Introduction: Anaplastic thyroid carcinoma (ATC) is a notoriously aggressive malignancy associated with a highly lethal clinical course despite therapeutic intervention. To identify factors that could suggest improved therapeutic strategies, we have analysed the clinicopathological features, treatment and outcome of all patients with ATC treated over the past four decades in our institution. Methods: Fifty patients presenting with biopsy-proven ATC to our centre between 1966 and 2006 were studied. All patients were managed with surgery, radiotherapy, chemotherapy, and/or chemoradiation. Survival was calculated using the Kaplan-Meier method. Potential factors affecting survival were compared using the log-rank test. Results: Most patients (88%) presented with a neck mass, while 17 (34%) patients also had cervical lymphadenopathy. Distant metastases at diagnosis were present in 9 (18%) of patients. Median survival was 97 days, while the 1- and 3-year survival was 14 % and 8% respectively. On univariate analysis, patients aged ≤65 years (p=0.04), undergoing surgical resection (p<0.01), receiving RT to the neck (p<0.01) and without metastatic disease on presentation (p<0.01) enjoyed longer survival. Cytotoxic chemotherapy was not associated with survival enhancement (p = 0.4). Moreover, no change in survival was evident as a function of treatment era (p = 0.5). Conclusions: ATC remains a uniformly lethal disease despite numerous technical advances in surgery, radiotherapy and chemotherapy over the last forty years. Nonetheless, our results indicate that younger patients with localized ATC be treated aggressively in a multimodality manner. Identification of signalling pathways that can be medically blocked to reduce ATC metastatic/invasive potential and enhance apoptotic sensitivity should now be the main priority for multicentre collaborative clinical research. No significant financial relationships to disclose.
Endoscopic treatment for superficial squamous cell carcinoma in the head and neck region (HNSCC)
Authors: Omori T. , Kawakubo H. , Sato Y. , Yokoyama A. 
Published: March 2020

16542 Background: The HNSCC are usually diagnosed at advanced stage, therefore, the prognosis is dismal. Recently we can find the superficial HNSCC by using high-resolution and magnifying endoscopy. We expect to get a good prognosis by the endscopic treatment (EMRC: Endoscopic Mucosal Resection by Cap-method/ELPS: Endoscopic Laryngo-Pharyngeal Surgery) for the superficial HNSCC. The purpose of this study is to examine the usefulness and effectiveness of endoscopic treatment for the superficial HNSCC. Methods: The superficial HNSCC means that the depth of cancer invasion is within the subepithelial layer. When we diagnose superficial HNSCC with no lymphnode metastasis, the endoscopic treatment (EMRC/ELPS) becomes the first line treatment under general-anesthesia. For those treatment cases, We examine the method of treatment, complication, pathological diagnosis and prognsis. Result: We have 130 patients (201 lesions) of the superficial HNSCC from Jan 2000 to Jan 2007. The endoscopic treatment cases were 92 (142 lesions), 87 male and 5 female, ranging in age from 40 to 86 years. Of the 92 patients, 56 (60.9%) had been treated by EMRC, 36 (39.1%) had been treated by ELPS. EMRC is good for small lesion (less than 10 mm in diameter). ELPS is suitable for large lesion. In EMRC case, a wound pain was often slight after the operation, and patient could leave the hospital in 4–5POD. In ELPS case, a wound pain was stronger than EMRC, and needed more hospital days. Major complication was not recognized both in EMRC and ELPS. Of 142 lesions which clinical assessments of the depth of cancer invasion were ep (epithelial layer) or sep (subepithlial layer), 140 lesions (98.6%) were histopathologically ep or sep. Two lesions (1.4%) were mp (proper muscular layer). Of the 92 patients, 83 are alive, 9 had been dead. There was no lymphnode metastasis, distant metastasis and local recurrent case. Forty patients of 3 years observation were accrued from Jan 2000 to Dec 2003. Of the 40 patients, 33 were alive, 7 were dead. No HNSCC patients died. The cause specific 3 years survival rate is 100%. Conclusion: The result of our trial indicated the usefulness of endoscopic treatment for superficial HNSCC and the effectiveness for improving the prognosis of HNSCC No significant financial relationships to disclose.
Cost effectiveness of whole breast IMRT for reduction of moist desquamation
Authors: Strauss J. B. , Chen S. S. , Dickler A. T. , Griem K. L. 
Published: March 2020

17004 Background: Cost minimization studies have compared conventional whole breast radiation therapy (C-WBRT) to whole breast intensity modulated radiation therapy (IMRT). Consistently, IMRT has proved to be far more expensive. The weakness of cost minimization studies is that they assume the outcomes and toxicities of the treatment modalities in question are identical. Data from a case- control trial and a recent randomized controlled trial show that IMRT reduces the incidence of moist desquamation. We performed an analysis to estimate the cost effectiveness of breast IMRT to prevent moist desquamation. Methods: The direct medical costs of C-WBRT and IMRT were estimated using the 2006 Medicare Fee Schedule. We assumed rates of moist desquamation of 48 to 31% in accordance with Pignol, et al., ASTRO 2006. The cost effectiveness ratio (additional dollars spent per case of desquamation avoided) was calculated under two circumstances: 1) every patient received IMRT, or 2) only those patients destined to desquamate were treated with IMRT. Results: The direct medical costs of C-WBRT are $7,948 vs. $29,790 for IMRT. Thus, the marginal cost of IMRT is $22,142. In circumstance 1, the marginal cost to avoid one case of desquamation is $130,247. In circumstance 2, this cost is $62,518. Conclusions: The two circumstances described above are extremes that bound the range of cost estimates. Patient risk factors for desquamation, such as large breast size, can be used to identify high risk patients, obviating the need to treat all patients with IMRT. However, perfect prospective identification of all patients destined to desquamate is unlikely. Instead, the true marginal cost to avoid one case of moist desquamation will lie between $62,518 and $130,247. This cost may be too high to justify the benefit of reduced acute skin toxicity, but it is likely that the benefits of IMRT have been underestimated. IMRT may shorten the duration of moist desquamation. Late effects such as breast fibrosis and color variegation of the skin caused by desquamation as well as dose to the heart and lungs may be decreased by IMRT. If new data support these benefits, then IMRT may become a more cost effective option. No significant financial relationships to disclose.