bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical efficacy analysis of preoperative neoadjuvant chemotherapy in patients with pulmonary adenocarcinoma during stage IIIA.
Authors: Zhang Ting ting , Cheng Ying 
Published: October 2019

128 Background: The purpose of this study is to compare the effectiveness and safety of neoadjuvant chemotherapy with targeted therapy. In order to explore the best treatment mode of lung cancer in local progression period. Methods: 42 patients with stage IIIA lung adenocarcinoma who were admitted to the Cancer Hospital of Jilin Province from 2015 to 2017 were retrospectively analyzed. They received at least 2 cycles of neoadjuvant chemotherapy or at least 6 weeks of new adjuvant targeted therapy before surgery. Results: 42 patients who met the criteria were included in this study, all of them were stage IIIA lung adenocarcinoma. Of the total number of cases, a total of 13 patients received preoperative assisted single drug EGFR-TKI treatment (including Eluotini) and 27 patients received preoperative assisted chemotherapy. Two patients received neoadjuvant chemotherapy before receiving new adjuvant targeted therapy. In patients with EGFR sensitive mutations in stage IIIA, the objective remission rate of newly assisted TKI therapy was 63.2 %, while neoadjuvant chemotherapy was 36.8 % (P = 0.021). Of the 13 patients who received new assisted targeted treatment before surgery, 11 patients continued to receive targeted treatment after the first efficacy evaluation (3 weeks): After the first efficacy evaluation PR case continued to be treated with TKI The tumor can continue to shrink until 3 months, However, there was no significant change in tumor size after the first evaluation of SD continued with TKI treatment. There was no difference between the two groups in postoperative complications, postoperative pleural drainage and postoperative hospitalization time. Conclusions: Compared with preoperative neoadjuvant chemotherapy, neoadjuvant targeted therapy has a good effect in patients with pulmonary adenocarcinoma with EGFR mutation in stage IIIA. Patients with partial remission for the first treatment evaluation can try to continue TKI treatment for 1 month after surgical resection.
Prognostic value of tumor parameters measured by MRI in cervical cancer patients receiving CCRT.
Authors: Sun Chang , Zhang Hanyi , Lang Jinyi , Lu Shun 
Published: October 2019

129 Background: This study aimed to evaluate the response of solid tumors after the completion of external beam radiotherapy (EBRT) and investigate the prognostic value of tumor parameters such as tumor volume and size (TV & TS) and tumor volume reduction rate (TVRR) early during the treatment in local advanced cervical cancer patients. Methods: We retrospectively reviewed 310 Chinese patients with locally advanced cervical cancer. They were all received concurrent chemoradiotherapy (CCRT) during the treatment based on intensity modulated radiotherapy (IMRT). Clinical data at the time of diagnosis, including FIGO stage, TV and TS were measured by pelvic magnetic resonance imaging (MRI) before and after EBRT were available. Information about distant metastasis, relapse and date of death was also collected, with a follow-up until Aug 2018. Youden index was used to identify the optimal cut-off point of continuous tumor parameters and divide patients into subgroups. Prognostic factors (age, FIGO stage, RT dose, pre-RT TS and TV, mid-RT TS and TV, TVRR) were using the log-rank test and Cox regression models to analyze the association between predictors and time-to-event outcomes. Results: The median follow-up time was 50 months. In univariate analysis, the FIGO stage, TVRR, TV and TS were associated with overall survival rate. Interestingly, the group of higher TVRR showed a better OS, PFS and LRFS than the group of lower TVRR ( P <0.05). Moreover, the groups of lower TV and TS showed better OS, PFS and LRFS than the higher groups, respectively. In the OS-related multivariate analysis, the mid-RT TV remained statistically significant after adjustment for age and FIGO stage ( P < 0.05). In the PFS-related multivariate analysis, the tumor volume reduction rate (TVRR) remained statistically significant after adjustment for age, FIGO stage, TS, and TV ( P <0.05). In addition, in the LRFS-related multivariate analysis, TVRR also remained statistically significant after adjustment for age, FIGO stage, TS, and TV ( P<0.05). Conclusions: Our results confirmed that tumor parameters including TS, TV and TVRR, measured before the completion of CCRT, are valuable prognostic factors in patients with locally advanced cervical cancer.
Genomic analysis reveals somatic mutations of ATM gene in DNA repair confer exceptional target lesion response to radiation therapy.
Authors: Lee Jason Joon Bock , Yang Andrew Jihoon , Chang Jee Suk , Kim Han Sang , Yoon Hong In , Shin Sang Joon , Kim Yong Bae , Koom Woong Sub , Ahn Joong Bae 
Published: October 2019

130 Background: Somatic mutations of genes involved in DNA repair (e.g. ATM and BRCA1/2) may result in chemotherapy resistance and poor prognosis, but may confer sensitivity to radiation therapy. In this study, we aimed to the hypothesis that patients with such mutations may be more susceptible to radiotherapy. Methods: Using prospectively collected RT registry, we identified patients who underwent both RT to gross disease and NGS panel screening between 2013 and 2019 (N = 27,664). From a cohort of 134 patients, 33 patients with somatic mutation in ATM or BRCA 1/2 were identified and closely matched with 33 patients without mutation using propensity score based on radiation dose and histology. Results: Infield response rate was evaluated in 66 patients with 90 gross lesions (ATM mutation, 11 patients and BRCA 1/2 mutation, 22 patients). The median tumor size and RT dose was 24 mm (3-140) and 40 Gy (12-66), respectively. Stark differences were seen in infield complete response rate, overall response rate, and local control rate at target lesions by ATM mutation (mutation vs. no mutation; 50% vs. 8%, 61% vs. 24%, and 94% vs. 58%, P < .05). Response duration was also longer ATM mutation (median 11 vs. 3 months, P = .001). However, RT-related toxicities were not different (17% vs. 11%, P = .515) and no severe toxicity occurred. Conclusions: ATM mutations confer exceptional responses to radiation therapy, even with palliative dose, which has potential therapeutic implications.
Cost effectiveness of treatment-free remission in chronic myeloid leukemia patients: A report from a developing country.
Authors: Sattar Wasim 
Published: October 2019

131 Background: Current recommendations for first line therapy in chronic phase chronic myeloid leukemia (CP-CML) is life-time use of tyrosine kinase inhibitors (TKI's). Unfortunately, the financial burden of continuous TKI therapy is unsustainable especially in developing countries. In Pakistan, an access-program for Imatinib (IM) and Nilotinib is available; the cost of therapy is subsidized with the Government paying for 3 months and Novartis for 9 months. Updated results from several trials support continued long term durability of treatment free remission (TFR). We attempted TFR in our patients in an attempt to reduce financial burden and improve quality of life for the patients. We aimed to evaluate the economic impact of discontinuing imatinib versus continuous use of imatinib in patients taking IM 400mg. Methods: 57 patients of CP-CML taking Imatinib 400 mg for the last 10 years who were negative by FISH for at least 3 years or in MR 4.5 at least once in 12 months were evaluated. Of these 30 were screening failures, 4 patients refused consent prior to screening and 25 were eligible for the trial. Two consecutive RQ-PCR were performed 3 months apart prior to enrollment. Patients were eligible if they achieved MR 4.5 for at least 3 months prior to entering the study. Molecular response was assessed by Quantitative BCR-ABL RQ-PCR every 4 weeks after discontinuation for year 1 and 8 weeks at year 2. Cost of Imatinib 400 mg per month was calculated as well as the cost of BCR-ABL RQ-PCR by gene expert for the trial. Results: Of the enrolled 25 patients, 10 lost their deep molecular response and were restarted on therapy, 5 withdrew consent after screening.10 patients are currently on trial at varying time intervals (10-14 months) of cessation of imatinib. The cost of one month of imatinib is US $ 800 and the cost of RT PCR is $ 67. TFR translated into approximately US 1.2 million saved. Conclusions: The discontinuation of TKI in this small subset of patients has resulted in remarkably large savings with significant impact on the meager health budget in our resource limited setting.
Impact of adjuvant chemotherapy using gemcitabine plus S-1 after surgical resection for advanced biliary cancer.
Authors: Fukushima Kentaro , Motoyama Hiroaki , Shimizu Akira , Notake Tsuyoshi , Ikehara Tomohiko , Hayashi Hikaru , Yasukawa Koya , Kobayashi Akira , Soejima Yuji 
Published: October 2019

132 Background: The impact of adjuvant chemotherapy for advanced biliary cancer remains controversial. We previously failed to show survival benefit of adjuvant gemcitabine chemotherapy (UMIN000014018). The aim of this study was to evaluate the safety and efficacy of adjuvant gemcitabine plus S-1 chemotherapy after surgical resection for advanced biliary cancer. Methods: Between January 2006 and May 2019, a total of 110 patients who underwent surgical resection for biliary cancer (UICC Stage II or more) were enrolled in this study. Of these, 33 patients subsequently received 12 cycles of adjuvant chemotherapy (GS group), and 77 patients underwent surgery alone (S group). A cycle of chemotherapy consisted of oral S-1 70mg/m2 for 7 consecutive days and intravenous gemcitabine 1000mg/m2 on day 7, followed by a 1-week break from chemotherapy. Clinicopathological factors and patient survival were compared between the two groups. Results: GS group had significantly younger patients ( P = 0.036) and higher UICC T factor ( P = 0.001). Surgical procedure was significantly different in the two groups (P = 0.010). Other patient demographics and tumor characteristics were similar between the two groups. The completion rate of adjuvant chemotherapy was 57.6%, and there was no treatment-related deaths. All grades and grade 3/4 adverse event were seen in 60.6% and 33.3%, respectively. Three-year recurrence-free and overall survival rates were significantly higher in GS group than S group (61.9% vs. 34.4%, P = 0.016; 77.6% vs. 39.7%, P < 0.001, respectively). Conclusions: Adjuvant chemotherapy using gemcitabine plus S-1 was well tolerated and it would be an effective treatment strategy for the patients with resected advanced biliary cancer. Based on these results, randomized controlled study should be warranted.
Comprehensive analysis of maintenance therapy after first-line treatment with pemetrexed and platinum-containing double drug regimen combined by bevacizumab in EGFR wild type advanced non-squamous NSCLC.
Authors: Zhang XiangHua , Ma LiXia , Cheng Ying , Cui HongXia 
Published: October 2019

133 Background: Pemetrexed combined with platinum was the standard treatment for first-line EGFR wild type non-squamous NSCLC , but further research is needed to confirm the safety of pemetrexed and bevacizumab treatment in maintenance therapy after first-line treatment in advenced non-squamous NSCLC. Methods: Total 60 patients with newly diagnosed advanced non-squamous NSCLC admitted to the hospital from June 2015 to June 2017, which were ARMS confirmed the EGFR wild type. In the observation group, bevacizumab +pemetrexed+ platinum was maintained with bevacizumab (BAP-B group). Control group: bevacizumab + pemetrexed + platinum was maintained with pemetrexed (BAP-A group). 60 patients completed 4- 6 cycles of chemotherapy and maintenance therapy for more than 4 cycles. The curative effect was evaluated According to Recis 1.1.The toxic reaction was evaluated WHO chemotherapeutic drug toxicity. The quality of life of patients were evaluated by EORTC QLQ-LC43. All the data were processed by SPSS19.0. P < 0.05 was statistically significant. Results: 33 cases in BAP-B and 27 cases in BAP-A . In this study, BAP-B & BAP-A : ORR 61.0% & 50.0% (P > 0.05);DCR 73.5 & 64.8 % ( P>0.05), median PFS 9.6 m & 7.2 m (P < 0.05), OS:18.2 m & 12.6 m (P < 0.05). Adverse incidence: BAP-B & BAP-A: leukopenia rate 43.0% & 41.2% hemoglobin reduction 40.0% & 38.5%; The reaction rate of digestive tract was 35.3% & 34.5%. There was no significant difference between the two groups. The incidence of hypertension in BAP-B (18.8%) was higher than that in BAP-A (0%) (P < 0.05). The incidence of proteuria in BAP-B (8.8%) was higher than that in BAP-A (2.0%) (P < 0.05), BAP-A and BAP-B (P < 0.05). The quality of life score of EORTC QLQ-C43 was (73.17 ±2.75) & (59.68 ±2.52), which was higher than that before treatment (52.75 ±2.02) & (53.01 ±1.98), and the score of BAP-A was higher than that of BAP-B(P < 0.05). Conclusions: The first line treatment of advanced EGFR wild type non-squamous NSCLC needs comprehensive consideration of curative effect, survival time, safety, quality of life and economic problems in order to choose the most suitable treatment.
The landscape of treatment and overall survival analysis of elderly patients with advanced breast cancer in China National Cancer Center.
Authors: Guan Xiuwen , Ma Fei , Xu Binghe 
Published: October 2019

137 Background: As elderly patients usually suffer from medical complications of cardiovascular diseases, respiratory diseases, diabetes, etc, they lack of tolerance to surgery, anesthesia and chemotherapy. Therefore, the choice of treatment in elderly advanced breast cancer (ABC) patients may be different from the young. Methods: We summarized the clinicopathological characteristics and therapeutic regimens of 2063 females with ABC hospitalized between January 2003 and December 2018 from Database in China National Cancer Center. Contemporary comparison was performed between 221 elderly patients (≥60) and 1204 young patients (<60). Besides, survival data was compared with 21185 ABC in SEER database. Results: The median overall survival (OS) of elderly patients in China National Cancer Center was 35.5 months (95% CI 28.1 to 43.0), significantly longer than that in SEER database (20.0 months, P< 0.001). The median OS of elderly patients was significantly shorter than that of the young (35.5 vs 43.9 months, P= 0.007), which is similar to the survival feature in SEER database (34.0 vs 20.0 months, P< 0.001). Compared with the young, significantly more elderly patients suffered from the medical complications of hypertension (30.3% vs 9.5%, χ2= 73.194, P< 0.001), diabetes (14.5% vs 4.7%, χ2= 30.302, P< 0.001) and heart disease (6.3% vs 1.7%, χ2= 18.141, P< 0.001). In Luminal-like patients, the percentage of receiving first-line endocrine therapy in elderly patients was significantly larger than that of the young(26.9% vs 9.5%, χ2= 37.599, P< 0.001). Moreover, in Luminal-like population, the elderly patients underwent first-line endocrine therapy resulted in better OS than those underwent first-line chemotherapy (49.9 vs 32.6 months, P= 0.029), while no significant difference was observed between these two therapeutic mode in the young( 56.9 vs 48.8 months, P= 0.294). Conclusions:The proportion of elderly ABC patients with medical complications is significantly larger than that of the young, which may lead to the difference in treatment decision making. In Luminal-like elderly patients, receiving first-line endocrine therapy may result in better survival than chemotherapy.
Cancer care through the fire and flames: Three-year experience in utilizing of oncologic electronic consultation and referral system in the red zone of Thailand.
Authors: Rattanakhot Nanthiya , Dechaphunkul Arunee , Sunpaweravong Patrapim , Sathitruangsak Chirawadee , Songserm Maliwan , Jiratrachu Rungarun , Sangthawan Duangjai , Peerawong Thanarpan , Rordlamool Paytai , Phungrassami Temsak , Sakdejayont Siwat 
Published: October 2019

14 Background: “The South Thailand Insurgency” is burning violence in the deep south of Thailand. The insurgency which has been ongoing since 2004 has played out in the three southernmost districts of the country Pattani, Yala and Narathiwat and some area of Songkhla, so-called the “Red Zone”. The chronic terrorism had major affected on cancer service. Many cancer patients gave up on their lives due to struggle with the disease itself, financial constraints due to longstanding economic downturn and security concerns during travelling led to high loss to follow-up rate and treatment delay. We, an oncology service team working at Songklanagarind hospital, the only one cancer center served this area together with primary doctors and nurses in the Red Zone created a network and utilized an oncology-specific electronic consultation and referral system to make more efficient care. We reported its performance in 3 years period. Methods: Electronic consultation system (E-consult) was a web-based program developed to provide advice and facilitate the referral process in cancer care. Since October 2015, we prospectively surveyed the impact of this pilot project on the quality of service by counting waiting time, number of center visit until treatment, unnecessary referral avoidance, patient and potential cost saving compared to normal referral system. Results: E-consult reached out to 7 hospitals and 589 cancer patients successfully referred through E-consult. Among patients from the Red Zone, without E-consult, their average waiting time was 56.4 days, number of visit was 6.5 visits. The estimated financial burden was $758.8 per patient. After implementation of E-consult in 259 patients, average time to treatment was 41.5 days (p = 0.006) and a number of the counter visit was 2.3 visits (p < 0.001). Estimated financial burden could be reduced to $358.7(p < 0.001). Ultimately, we prevented 28 patients from unnecessary referral. Conclusions: In this special context the electronic referral system was helpful to improve medical access, timeliness to specialist care, saving the patients’ family time and resources. This model is widely applicable to oncology referral chain.
Oncotarget (ONCOALVO): A custom NGS panel for therapeutic decision in solid tumors refractory to conventional therapy.
Authors: Murad Andre Marcio 
Published: October 2019

140 Background: Next-generation sequencing (NGS) of tumor biopsies of solid tumors using commercially available platforms has broadly entered routine clinical practice to test for predictive biomarkers for patients with no available further standard therapies, as diagnostics rely on genomic testing of molecular alterations to enable effective cancer treatment. However, the high cost of large multigenic panels and especially the sequencing of the entire tumor exome is a concern, especially in a developing country such as Brazil. Methods: We report the clinical application of a panel of 57 genes that we call ONCOTARGET (ONCOALVO) which is based on the Thermo Fisher Oncomine Focus Assay, for the rapid and simultaneous detection of single nucleotide variants, short insertions and deletions, copy number variations, and gene rearrangements in 52 cancer genes with therapeutic relevance, but with the addition of 5 additional genes: the homologous recombination repair (HRR) genes BCRA1, BRCA2, ATM and CHEK2 that determine tumor sensitivity to inhibitors of the PARP enzyme and also KDR. 60 diagnostic samples of formalin-fixed, paraffin-embedded material submitted for molecular testing over a 2 year time period were analyzed so far. All patients had advanced solid tumors already refractory to conventional systemic therapy. Libraries were prepared from isolated nucleic acids and sequenced on the Ion Torrent S5 sequencer. Results: We found 40 potential therapy target pathogenic gene aberrations in 30 (50%) patients: KRAS - 10 (25%), BRCA1 - 8(20%), BRCA2 - 8(20%), PIK3CA - 4 (10%) mutations; and also 2 of each: ERBB2 (5%), BRAF-V600E (5%), KIT (5%), ALK (5%) mutations and one (2.5%) CCND1 amplification and one (2.5%) CDK4 mutacion. In 3 (7.5%) patients there were double mutations: BRCA1 and BRCA2 in 2 cases and BRCA2 and KRAS and one case. The Oncotarget workflow enabled a turnaround of 18½ days. Conclusions: ONCOTARGET was found to be a convenient tool for fast, reliable, broadly applicable and cost-effective targeted NGS of tumor samples in routine diagnostics and therapeutic decisions with a potential to become an important asset for precision oncology in Brazil.
Associations between the use of Twitter as a technology platform in oncology and the scientific impact of its users.
Authors: Cheung Winson Y. , Lim Elisa , Kong Shiying 
Published: October 2019

16 Background: Social media channels, such as Twitter, represent relatively new technology platforms for scientific users to disseminate research findings and communicate their views and interpretations to colleagues and followers. To date, the associations between the use of Twitter and the scientific impact of its users are unclear. Methods: All Canadian oncologists who are full members of the American Society of Clinical Oncology were identified from the online membership directory. Users of Twitter were defined as those with an active Twitter account, as of June 2019, and posted at least one tweet within the past year. Data regarding the number of tweets, likes, and followers were collected by an online search of Twitter. Scientific impact of each individual was assessed based on a user’s h-index and number of citations from Google Scholar as well as score from Research Gate. Associations were examined with summary statistics and correlation coefficients. Results: We identified 676 eligible oncologists of whom 80 (12%) and 596 (88%) currently use and do not use Twitter. Among the users, the median number (IQR) of tweets, likes, and followers were 196 (45-865), 325 (86-1,246), and 198 (89-449), respectively. The scientific impact of Twitter users versus non-users was statistically similar (see Table). Likewise, within the group of users, there was no correlation between the number of tweets, likes, and followers and the scientific impact of individuals (correlation coefficients 0.38, 0.34, and 0.41, respectively, all p > 0.05). Conclusions: Only 1 in 10 oncologists use Twitter, but those who use Twitter leveraged this technology platform frequently. There was no association between the use of Twitter and the scientific impact of its users. Views from a minority of oncologists are represented on Twitter. Such bias underscores the need to exercise caution when using social media for scientific knowledge exchange. Regular evaluations of new technologies are warranted to ensure the quality and rigor of their scientific content. [Table: see text]