bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience of low-intensity LED radiation (LILEDR) in combination treatment of radiation-induced rectal injuries.
Authors: Rodionova Olga G. , Voshedskiy Vitaliy I. , Sakun Pavel G. , Sheiko Elena A. , Gusareva Marina A. , Chalabova Tatiana G. , Pustovalova Alla V. , Solntseva Anna A. , Dontsov Vladimir A. , Vasilieva Ekaterina O. , Kabanov Sergey N. , Karnaukhova Elena A. , Krokhmal Yulia N. , Vlasov Stanislav G. 
Published: June 2021

e17514 Background: Malignant pelvic tumors account for more than 25% of cancer incidence in Russia. Radiation therapy is the most common treatment for such patients; however, 10-15% of patients develop radiation-induced complications of the pelvic organs, and more effective treatments are required to manage these complications. Methods: The study included 30 patients with cervical cancer T3NхM0 after combination treatment. 7-10 months after combined radiation treatment (total radiation dose to the primary focus 80 Gy), patients developed erosive ulcerative radiation rectitis (RTOG grade 1 and 2). Patients were divided into 2 groups: main group (n = 15) – conservative treatment combined with LILEDR. Each course included 10 LILEDR sessions, the red spectrum λ = 640 nm on the cubital vein projection (exposure time 5 minutes, dose 6.86 J/cm2) and locally on the ulcerated zones (exposure time 3 minutes, dose 3.96 J/cm2). Patients received 2 LILEDR courses with a 1-month interval. The control group received only conservative therapy. Results: Main clinical manifestations of rectitis (tenesmus, bloody mucous discharge) disappeared in the main group already on the 3-4th day of the first course, epithelialization of ulcerative defects occurred in a shorter period of 7-10 days. Soft superficial scars not causing rectal stenosis formed at the site of the ulcer by the end of LILEDR courses. The control group showed long periods of the ulcer epithelialization up to 30 days, late remission and a lingering recurrent character of the disease. Conclusions: LILEDR in combination with the main conservative therapy allows rapid managing with the clinical symptoms of radiation rectitis and regression of disorders developed after the complex treatment, which improves the quality of life of patients and shortens the rehabilitation period.
Levels of some cytokines in tumors of ovarian cancer patients with different responses to platinum-containing chemotherapy.
Authors: Sagakyants Aleksandr B. , Shulgina Oksana G. , Yakubova Darya Yu. , Ulianova Elena P. , Zhukova Galina V. , Menshenina Anna P. , Novikova Inna A. , Verenikina Ekaterina V. , Chalabova Tatiana G. 
Published: June 2021

e17528 Background: Resistance to chemotherapy is a complex problem in the treatment of patients with ovarian cancer (OC). Various intercellular intermediates are involved in the phenomenon, and cytokines are the most important of them; however, the involvement of individual representatives in the processes is poorly understood. Our purpose was to analyze levels of some cytokines in tumors of OC patients with different responses to chemotherapy they receive. Methods: Samples of ovarian tumors were obtained from 100 patients (aged 29-79 years) with advanced ovarian cancer stage IIIC-IV with/without ascites. All patients recruited in 2016-2020 received standard combination treatment with surgery and platinum-containing polychemotherapy (Pt CT). Based on the results of neoadjuvant Pt CT, patients were divided into groups: patients with stabilization or progression–group 1 “without effect”; patients with complete/partial regression–group 2 with positive effect. All patients gave their informed consent for the study. Levels of IL-6, IL-8 and IL-10 were measured in cytosolic fractions of tissue samples using standard ELISA test systems (Vektor-Best, Russia). Results were presented as Me (LQ; UQ). The significance of differences between the samples was assessed using the Mann-Whitney test (the differences were considered significant at p<0.05). Results: Levels of the anti-inflammatory cytokine IL-10 in tumors of patients did not differ significantly between groups 1 and 2. The local levels of IL-6 in tumors of patients sensitive to Pt CT were 5.5 times higher than in resistant patients–2.41 (1.71;4.55) vs. 0.44 (0.26;1.04), p≤0.05, and IL-8 13 was 13 times higher–27.23 (4.01; 30) vs. 2.1 (1.72; 2.5), p≤0.05. Conclusions: Local levels of anti-inflammatory cytokines IL-6 and IL-8 were significantly higher in patients with sensitivity to platinum-containing chemotherapy, which may reflect characteristics of the microenvironment in OC tumor tissues, while IL-10 levels were similar in all patients. The revealed features of the cytokine profile may be one of the factors determining the treatment outcomes.
Early efficacy prediction of nasopharyngeal carcinoma based on 3D-ADC value acquired during radiotherapy: A phase II prospective study.
Authors: Yan Lu , Wang He , Du Xiaoli , Feng Mei 
Published: June 2021

e18018 Background: Concurrent chemoradiotherapy (CCRT) is the main treatment for locally advanced nasopharyngeal carcinoma (LANPC). The prognosis of the patients with the same stage receiving the same treatment varies greatly. We aimed to investigate the dynamic changes of apparent diffusion coefficient (ADC) map from diffusion weighted MRI (DWI) of primary tumor (PT) and metastatic lymph nodes (LN) for NPC patients during RT process, and analyzed the potential correlations with volume reduction and objective response rate (ORR). Methods: A total of 50 NPC patients treated with CCRT were enrolled in this prospective study. All patients received a planned total dose of 66 to 70Gy in 33 fractions at 5 fractions per week using Image-guided intensity modulated radiotherapy (IGRT). The CCRT protocol was cisplatin (80-100mg/m2) every 3 weeks for 3 cycles. All patients received DWI scan at pre-RT, the 5th and 15th fractions and immediately post-RT on a 3.0T MRI system (b=0, 500, 800s/mm2) system. The ADC values of PT and LN were acquired on ADC map. RECIST1.1criteria was used to evaluate the ORR for both PT and LN. Clinical predictors of complete response (CR) were evaluated using log-rank test. Multivariate analyses were calculated using the logistic regression model. Receiver-operating characteristic (ROC) curve was used to determine the cut-off value of ADC value. P <0.05. Results: After the completion of C CRT, the ORR of the PT was 100% (CR 75%, PR 25%), and that of the LN also reached 100% (CR 52%, PR 48%). Mean ADC increases and volume reductions in PT and LN were observed during RT. In the first stage (from pre-RT to the 5th fraction), the mean ADC increased significantly by 20.78% (PT), 22.96% (LN), while the volumes of PT and LN had minimal changes (PT:18.42cm3vs 16.72cm3, LN: 4.67cm3 vs 4.12cm3). In the second stage (from the 5th fraction to post-RT), the mean ADC increased by 45.58% (PT), 41.2% (LN), the volumes decreased by 86.07% (PT), 61.6% (LN). The increased mean ADC at the first stage had a positive correlation with the volume reduction after RT (r PT=0.32; r LN=0.40). Univariate analysis showed significant differences in the age, the changes of 3D-ADC at the 5th RT and the volume of PT and LN before RT (VPT, VLN) between CR group and PR group(p<0.05), The binary logistic regression analysis demonstrated the ADC changes and the VPT, VLN were predictor of PT and LN efficacy evaluation. ROC analysis suggested the ADC changes had the better performance for PT and LN efficacy evaluation. The cut-off the ADC value changes of PT and LN was 193.52mm2/s (AUC = 0.750, p = 0.008) , 173.80mm2/s (AUC = 0.822, p < 0.001) respectively. Conclusions: 3D-ADC values of PT and LN increased dramatically during RT for NPC patients. The 3D-ADC value of PT and LN was an independent prognostic factor for NPC patients. Early ADC changes at the 5th fraction might be a new and sensitive biomarker to predict the efficacy for NPC patients.
Outcome of neoadjuvant chemotherapy (NACT) with paclitaxel plus carboplatin and oral metronomic chemotherapy (OMCT) in patients with technically unresectable oral cavity squamous cell carcinoma (SCC).
Authors: Kashyap Lakhan , Patil Vijay Maruti , Dhumal Sachin , Noronha Vanita , Joshi Amit , Menon Nandini , Prabhash Kumar 
Published: June 2021

e18034 Background: NACT is often used in technically unresectable oral cavity SCC to improve resection rate. NACT regimen based on combination of maximum tolerated doses (MTD) and metronomic chemotherapy will debulk the tumor and subsequently inhibit angiogenesis which may overcome drug resistance of MTD schedule. We assessed outcome and tolerance of this combination as NACT in patients with technically unresectable oral cavity SCC. Methods: This is retrospective analysis of prospectively maintained data. Fourteen patients having technically unresectable oral cavity SCC received NACT with paclitaxel (175mg/m2) plus carboplatin (AUC5) every 3 weekly (MTD schedule) and OMCT (methotrexate 9mg/m2 once a week, celecoxib 200mg twice daily and erlotinib 150mg once daily). Patient were assessed clinically and radiologically after minimum of two cycles for surgery. Kaplan-Meier method was used for survival analysis. We report resectability, survival and tolerance of this regimen. Results: Median age of the patients was 38 years, and twelve patients (85%) were male. Twelve (85%) and two (15%) patients had buccal mucosa and oral tongue primary, respectively. AJCC 2017 stage IVA and IVB disease was present in twelve (85%) and two (15%) patients, respectively. Reason for technical unresectabilty was skin edema above zygoma in five (36%), high infratemporal fossa involvement in five (36%), nodal encasement of major vessels in two (14%) and posterior extent of oral tongue tumor into oropharynx in two (14%) patients. Median number of NACT administered were three. Tumor of nine patients (65%; 95% CI = 39%-89%) were deemed resectable after NACT. Eight patients underwent surgery and tumor of one patient showed pathologic complete response. Median follow up was 14.6 months (95% CI = 14.1 - 15 months). Median progression free survival was 11.4 months (95% CI = 7.9 – 15 months). Median overall survival (OS) was not reached while OS at 15 months was 63.5% (95% CI = 37.8% - 89.2%). Common grade 3/4 toxicities (CTCAE 5.0) were neutropenia in eight (57%), thrombocytopenia in three (21%), febrile neutropenia, hypokalemia and diarrhoea in two patients (14%) each. Two patients required in-patient supportive care for adverse events. Conclusions: Paclitaxel and carboplatin along with OMCT is well tolerated and less resource intensive regimen which leads to favorable resection rate and survival in patients with technically unresectable oral cavity SCC.
The genomic architechtures of tumor-adjacent tissues, plasma and saliva reveal evolutionary underpinnings of relapse in head and neck squamous cell carcinoma.
Authors: Wu Ping , Yu Zicheng , Xie Chubo , Yang Ling , Xia Xuefeng , Yi Xin , Tang Yaoyun 
Published: June 2021

e18046 Background: Head and neck squamous cell carcinoma (HNSCC) is characterized by dismal prognosis, nonetheless limited studies have unveiled the mechanisms underlying HNSCC relapse. Methods: Next-generation sequencing 1 5 was performed to identify somatic mutations in 188 matched samples including primary tumors, tumor adjacent tissues (TATs), pre- and post-operative plasma, saliva and peripheral blood lymphocytes (PBLs) from 27 patients. Evolutionary relationship between TATs and tumors were analyzed. The dynamic changes of tumor- and TAT-specific mutations in liquid biopsies were monitored together with survival analysis. Results: Alterations were detected in 27/27 and 19/26 tumors and TATs respectively. TP53 was the most prevalent genes mutated in TATs. Some TATs shared mutations with primary tumors, while some other TATs were evolutionarily unrelated to tumors. Notably, TP53 mutations in TATs are stringently associated with premalignant transformation and indicative of worse survival (HR=14.01). TAT-specific mutations were also detected in pre- and/or post-operative liquid biopsies, and indicative of disease relapse. Conclusions: TATs might undergo the processes of premalignant transformation, tumorigenesis, and eventually relapse by either inheriting tumorigenic mutations from ancestral clones where tumor originated or gaining private mutations independent to primary tumor. Detection of tumor- and/or TAT-specific genetic alterations in post-operative biopsies shows profound potential in prognostic use.
The effect of household wealth on financial debt after cancer diagnosis.
Authors: Hussaini Syed , Dana Mia , Nicholas Lauren 
Published: June 2021

e18552 Background: Cancer is the 2nd most common cause of death in the country, eclipsed only by heart disease. Cancer care is increasingly characterized by financial toxicity related to high-cost treatments, though it is unknown whether other chronic conditions impose similar financial harms. Methods: We conducted a retrospective analysis of the Health and Retirement Study participants interviewed between 2012-2018. This is a national, longitudinal survey conducted every two years of adults 50 and older and their spouses. We used fixed effect regression models to compare changes in financial debt among households with new diagnosis of cancer, other major chronic conditions (diabetes, stroke, or heart disease), and no new health diagnosis (or health shock). Since more affluent households may respond to health shocks differently, we estimated separate comparisons for households above versus below median wealth in 2012, prior to new health conditions. We assessed use of any non-housing financial debt, credit card debt, and home equity lines of credit among the subset of homeowning households. Results: In this study of 14,153 households, average age at interview was 62 years, with 43% male, 70% White, 22% Black, 13% Hispanic, and 70% with up to high school education. Of this population, 25% held credit card debt, 70% owned a home, 18% had a home equity line of credit, and 9% used a home equity line of credit. Among households with below median wealth when they entered the study in 2012 ( < $23,000 in $2016), a new cancer diagnosis was associated with a 4.7 percentage point increase in financial debt (12.5% effect size, p < 0.05). Participants diagnosed with a chronic condition (heart condition, stroke or diabetes) were 3.6 percentage points more likely to develop financial debt (9.6%, p < 0.05) compared to households that did not develop a new chronic condition. Such differences were eliminated in participants in a house with above median wealth. There was no difference in credit card debt, availability of home equity line of credit, or use of home equity line of credit for participants with a new diagnosis. Conclusions: New diagnosis of cancer or a chronic condition were associated with increased financial debt for older Americans living in a household that were below median wealth.
Health disparities in New Zealand Māori with pancreatic cancer at Lakes District health board.
Authors: Camburn Laura , Hari Dass Prashanth 
Published: June 2021

e18554 Background: Global health disparities between ethnicities have been well documented in pancreatic cancer treatment & outcomes. However, pancreatic cancer treatment & survival outcomes between ethnicities, particularly NZ Māori have been poorly documented in our region. Aim to review whether health disparities existed between Māori and New Zealand European patients (NZE) treated with pancreatic cancer. Methods: Patients diagnosed with pancreatic cancer at LDHB between 01 Jul 2014 to 31 Mar 2020 were identified using the faster cancer treatment data. This was cross checked against surgical and Oncology referrals. Electronic notes were reviewed to collect data on ethnicity, patient demographics, presentation, treatment and survival. Results: A total of 69 patients; 25 identified as Māori and 44 NZE. Performance status at presentation was similar between Māori and NZE patients; 64% and 61% respectively, having ECOG 0-1. Majority of patients presented with unresectable locally advanced or metastatic disease (Māori 92% vs NZE 82%). 9% presented with resectable disease, 4% were borderline resectable, only 4 (6%) patients underwent surgical resection. Median overall survival was 34 days for Māori versus 94 days for NZE patients. 72% of Māori patients had an OS < 60 days compared to 39% of NZE, however OS at 6 months was similar in both groups (28% Māori v 27% NZE). For locally advanced disease, similar rates of receipt of chemotherapy (71% vs 62%) were documented between Māori and NZE respectively. Of the 16 Māori patients with metastatic disease at presentation none received palliative chemotherapy compared to 6 / 23 (26%) NZE. Conclusions: Regardless of ethnicity relatively small numbers of our patients have curative surgery which is of concern. Despite adequate performance status at presentation and comparable outcomes in the locally advanced setting, NZ Māori were less likely to receive palliative chemotherapy in the metastatic setting. Further research is warranted to explain and reduce this disparity.
Is chimeric antigen receptor T cell (CART) a destination procedure? Lower socioeconomic class who live farther from center have less access to CART.
Authors: Ahmed Nausheen , Shippey Ernie , Kus Crissy , Appenfeller Allison , Hoffmann Marc Steven , Tun Aung M. , Ganguly Siddhartha , Shune Leyla , Devine Clint , Bansal Rajat , Abhyankar Sunil H. , Mushtaq Muhammad Umair , McGuirk Joseph 
Published: June 2021

e18562 Background: Axicabtagene ciloleucel and tisagenlecleucel are commercially available CD19 chimeric antigen receptor T-cell (CART) therapies for B cell malignancies. Manufacturing pharmaceutical companies require patients to stay within 2 hours of the center for 4 weeks post infusion. Most centers require local lodging for that period if residence is over 30 minutes away. Financial burden may limit access. We therefore hypothesized that those who were likely to receive CART therapies were from higher income neighborhoods or lived closer to the facility. Methods: Since most patients get admitted for CART infusion, we used the Vizient CDB database for CART infusion admissions as well as other admissions. Patients over the age of 18 yrs who got commercially available CART between 2018 to 2020 were included. Distance was calculated in miles from patient zip code to treating center. Using census data, lower income neighborhoods (less than $40,000 median household income) were flagged. Results: 81 centers administered CART. We calculated the distance in miles between the patient and the center for both CART admissions as well as for all-cause inpatient admissions. Most admissions (81.2% all-cause vs 78.6% CART) were from neighborhoods with median income > $40,000. Most of the low-income admissions were from neighborhoods <10 miles (13.3% all admissions vs 15.7% CART). 80.6% of all CART patients came from neighborhoods over 10 miles, with 38.2% living over 60 miles away, while only 15.4% all-cause admissions were from > 60 miles. (p<.0001) While 74.9% of higher income CART patients lived beyond 10 miles from center, only 5.7% CART patients lived beyond 10 miles. Results summarized in Table. Conclusions: Most CART patients lived over 10 miles from the center, however less than 10% of them were from lower income neighborhoods. Neighborhood location relative to center and household income influence access and need to be addressed.[Table: see text]
Prognostic impact of obesity in cancer patients with COVID-19 infection: A systematic review and meta-analysis.
Authors: Park Robin , Wulff-Burchfield Elizabeth Marie , Mehta Kathan , Sun Weijing , Kasi Anup 
Published: June 2021

e18578 Background: Obesity is a bona fide risk factor for ICU admission, mechanical ventilation, and mortality in patients (pts) with COVID-19 in the general population. However, whether obesity is a risk factor in cancer pts remains unknown. Herein, we have conducted a systematic review/meta-analysis of obesity and all-cause mortality in cancer pts with COVID-19. Methods: Following PRISMA guidelines,a systematic search of PubMed and Embase as well as major conference proceedings (ASCO/ESMO/AACR) was conducted for publications from inception to 14 January 2020. Observational studies that reported all-cause mortality in cancer pts with lab confirmation or clinical diagnosis of COVID-19 and BMI (obese (>30 kg/m2) vs. non-obese) were included in the analysis. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated with the fixed-effects model based on low heterogeneity. Small sample publication bias was evaluated using the Begg’s Funnel Plot and Egger’s test. Results: After reviewing 3387 studies,3 retrospective cohort studies of 419 obese and 1694 non-obese cancer pts (N=2117) with COVID-19 in both inpatient/outpatient settings that reported outcomes based on obesity were found. The 3 studies were conducted multi-nationally in North America, in France, and in the Netherlands respectively. The median ages of the cohorts ranged 66-68. All studies included various cancers of various stages and were of high quality per Newcastle Ottawa scale (scores 7-9). Fixed effects meta-analysis showed no association between obesity and all-cause mortality (OR 0.95, 95% CI 0.74-1.23) in cancer pts with COVID-19. Heterogeneity was low (I2 = 33%). No significant funnel plot asymmetry was detected per Egger’s test (P=0.2273). The reported OR of each study is outlined in the table. Conclusions: In contrast to the general population, our analysis reveals that obesity is not associated with increased all-cause mortality in cancer pts with COVID-19. Limitations of this study include a limited number of included studies, reliance on retrospective studies, non-use of ethnicity-specific WHO BMI criteria, and limited granularity of the study-reported BMI. Future prospective studies are warranted to assess the complex interplay among anthropomorphic measures, cachexia/sarcopenia, comorbidities associated with the metabolic syndrome, and COVID-19 outcomes in the cancer pt population.[Table: see text]