bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retrospective analysis of outcomes of cisplatin (CDDP) versus non cisplatin based treatment regimens for concurrent chemoradiotherapy (CCRT) in locally advanced squamous cell head and neck cancer (LA-SCCHN).
Authors: Ashraf Syed Muhammad Mushtaq , Raufi Ali Mehmood , Barnett William R , Williams James Benjamin , Skeel Roland T. 
Published: May 2019

e17564 Background: Different dosing schedules of CDDP are being used as standard of care for CCRT in LA-SCCHN, but there are no adequately powered trials to directly compare other non-CDDP regimens with CDDP to identify the optimal CCRT regimen. Methods: After obtaining IRB approval, we reviewed medical records from hospital tumor registry for consecutive patients with LA-SCCHN to retrieve data regarding demographics, diagnosis and treatment with definitive CCRT between December 2012 and December 2016. All patients had followed up for at least 24 months after completion of treatment. Results: 155 patients were included in the analysis. They fell into 2 groups: 89 (57.4%) had been administered CDDP and 66 (42.6%) received non-CDDP based regimen. In the latter group, 30 (45.5%) received cetuximab, 30 (45.5%) received carboplatin with paclitaxel, 1 (1.5%) received carboplatin with 5-fluorouracil and 5 (7.6%) received carboplatin alone. The majority of patients in both groups had oropharyngeal involvement, approximately 65%. All patients completed treatment with intensity-modulated radiation therapy. Median age was 57 years in CDDP group and 67 years in non-CDDP group. Patients in both groups were predominantly male, Caucasian, with positive smoking history. 67% patients in CDDP & 59% in non-CDDP group were HPV positive. The 2-year overall survival (OS) from initiation of treatment was 73.9% in CDDP and 62.1% in non-CDDP group (hazard ratio = 1.63, 95% CI 0.92 – 2.87, p = 0.092). Comparing non-CDDP regimens with CDDP, cetuximab appeared to confer better 2 year OS in HPV positive patients (HR 0.63, 95% CI 0.40 – 0.98, p = 0.040). Median time-to-treatment failure was 33 months in CDDP group and 24 months in non CDDP group. Conclusions: In this retrospective comparison, there was no significant difference in the 2 year overall survival in patients with locally advanced squamous cell head and neck cancers being treated with cisplatin based concurrent chemoradiotherapy regimen versus a non-cisplatin based regimen.
Does weekly versus daily low-dose of concurrent cisplatin have any effect on compliance and clinical outcomes in cases of locally advanced head and neck cancers?
Authors: Garg Ayush , Kumar Piyush , Chauhan Arvind Kumar , Kumar Pavan 
Published: May 2019

e17569 Background: Concurrent Cisplatin with radiotherapy improves outcomes in locally advanced squamous cell carcinomas of the head neck.Cisplatin at 35mg/m2(weekly) raise compliance & hospitalization. There are only few reports on efficacy and toxicity of low dose Cisplatin (6mg/m2). Hence the purpose of this study was to evaluate the compliance and clinical outcomes between two concurrent cisplatin chemotherapy regimens & to see long term effects. Methods: Total 50 patients were included in study from Nov 2015 to Mar 2017 with 25 in each group. Radiotherapy given 70Gy/35# in 7weeks & Cisplatin at 35mg/m2 weekly (Group I) and 6mg/m2 daily (Group II). Assessment of toxicity was done by RTOG scoring criteria. WHO Response criterion was used to assess clinical response. Median follow up was 6 months. Results: Group I(80%) and Group II(84%)patients completed Radiotherapy. In Group I 48% patients received less than 6 cycles and Group II 40% received ≤25 cycles chemotherapy. Median OTT in Group I & II in was 51 & 52days. Neutropenia & Mucositis statistically insignificant between both groups.There was no statistical difference in complete response between the two groups. In Group I 40% patients developed Progressive disease on follow up as compared to 12% in Group II(p-0.02). After 1.5 years of follow up, Group I vs Group II 4 patients had complete response, 6 had recurrence & 11 vs 4 patients expired (p-0.03). At a median follow up of 6 months overall survival in Group I and II was 56% and 44%(p-0.39). While as median disease free survival in Group I & II was 6.6 & 11.9 months(p-0.14). Conclusions: Low dose daily Cisplatin offers ease of administration in the outpatient clinic, better tolerability and better quality of life.Group II patients were more compliant in terms of patients receiving chemotherapy or completing radiotherapy. At median follow up of 6 months there was no statistical difference in terms of overall and disease-free survival. The statistical difference was seen in terms of patients expired in Group I (44%) as compared to Group II (16%). Therefore, we need a larger number of patients for the use of low dose Cisplatin to be evaluated in future clinical trials.
Precision oncology for the treatment of salivary gland tumors.
Authors: Rieke Damian Tobias , Lamping Mario , Leyvraz Serge , Kim Theo Daniel , Brinkmann Lutz , Tessmer Antje , Fischer Lars , Busse Antonia , Horak Peter , Mock Andreas , Tinhofer Inge , Messerschmidt Clemens , Blanc Eric , Beule Dieter , Klauschen Frederick , Klinghammer Konrad Friedrich , Froehling Stefan , Ochsenreither Sebastian , Keilholz Ulrich 
Published: May 2019

e17577 Background: Salivary gland tumors (SGT) represent a rare and heterogeneous group of malignancies. No standard treatment exists in the advanced situation and the prognosis is poor. We here report characteristics and clinical outcomes of patients with SGT discussed at the Charité molecular tumor board (MTB). Methods: Patients with advanced cancer and no curative treatment option were discussed at the Charité MTB. Eligible patients underwent fresh tissue sampling and subsequent whole exome (WES) and RNA sequencing (RNA-seq) and immunohistochemical analyses (EGFR, HER2, AR as well as validation tests) or panel sequencing. Results from molecular testing were discussed at the MTB and patients were followed-up after recommendations were made. Results: 24 patients (median age 56 years, 13 male, 11 female) with advanced SGT were presented at the MTB between 2016 and 2019 (9 adenoidcystic carcinomas, 5 adenocarcinomas, 3 mucoepidermoid, 2 carcinosarcoma, 5 miscellaneous). WES/RNA sequencing was performed on tumor tissue from 16 patients. 2 patients were not included in the sequencing program and WES/RNA-Seq was ongoing for another 4 patients at the time of analysis. For another 2 patients, panel sequencing and IHC analysis, respectively was done. Results from analyses were discussed and a median of 2 recommendations, ranked by priority according to prespecified evidence levels, were made for 17 patients, each. Most commonly proposed treatment options by the MTB were FGFR inhibitors in 6 patients, mTOR or PARP inhibitors in 5 each, EGFR, HDAC inhibitors or antiandrogen therapy in 4, each. Treatments following MTB recommendations were initiated in 8 patients, 1 of which received a second recommended therapy after progression (antiandrogen therapy in 4, EGFR inhibitor in 2, a PDGFR, mTOR and PARP inhibitor in 1, each). A clinical benefit (CR = 1; Mixed Response = 1, SD = 3) was achieved in 5 patients, including a complete response in a patient with a metastatic adenocarcinoma of the parotid gland, treated with antiandrogen therapy. Conclusions: Precision oncology represents a feasible treatment strategy in patients with advanced SGT and shows early evidence of activity in a subset of patients. These results suggest further exploration of personalized therapy in these hard-to-treat tumors.
Factors associated with recurrence and death in patients with aggressive hobnail morphology papillary thyroid carcinoma.
Authors: Sharrett Jonathan Matthew , Li Hong , Shah Akeesha , Nasr Christian , Scharpf Joseph , Koyfman Shlomo A. , Joshi Nikhil , Geiger Jessica Lyn 
Published: May 2019

e17590 Background: Papillary thyroid carcinoma (PTC) with hobnail morphology (HM) is an aggressive variant associated with poorer outcomes compared to classical PTC, with a little over 100 cases reported in the literature. We aim to identify prognostic factors potentially associated with recurrence and death in the largest single institutional experience of PTC with HM. Methods: From an IRB approved registry, we identified all PTC HM cases with patient, diagnostic and treatment data and outcomes. Hobnail variant (HV) PTC had ≥30% HM; pure hobnail features (PHF) had < 30% HM without tall cell morphology (TCM) & multi variant features (MVF) had both HM & TCM. Demographic and clinical features at time of HM diagnosis that were potentially associated with 3-yr event free (death or recurrence) survival (EFS) were evaluated using Kaplan-Meir method (KM). Results: Forty-five (median age 55 yo, range 19-86 yo; 66.7% female) HM pts (35 HM at initial PTC, 10 at recurrence) were evaluable. Majority were ECOG 0 (84.1%). HM: 44.4% MVF, 37.8% PHF, & 17.8% HV; 68.9% pT3/T4; 64.4% node positive; & 15.6% metastatic. Positive surgical margins (+SM) with HM in 31.8%. RAI at HM given to 73%. Overall EFS was 83.5% at 1-yr & 69.6% at 2-yr. Of 13 events at 3 yrs, 4 were deaths (3 from PTC) & 9 recurrences. All events were in those > 55 yo (p < 0.001) with pT3/T4 disease (p = 0.01). Non-0 ECOG (KM 2-yr EFS: 28.6% vs 77.7%, p = 0.002), cT3/T4 (49.5% vs 85.5%p = 0.004), and +SM (32.1% vs 92.1%, p = 0.001) were also associated with EFS compared to their counterpart. HM grouping, RAI, initial HM vs HM at recurrence, sex, and tumor size were not statistically significant. Conclusions: To our knowledge, this is the largest reported cohort of PTC with HM. We identified several factors potentially associated with recurrence and death. There was no difference in outcomes between HV versus PHF versus MVF, which raises question to validity of 30% cutoff in defining “variant” versus “features of variant”. Age > 55 yo, T3/T4 disease, and +SM exhibited significantly inferior EFS. Further evaluation in a multi-institutional cohort will help in validating these findings and help identify patients who warrant more aggressive initial treatment.
A survey of cancer patients’ rehabilitation therapy needs in Southwest China.
Authors: Jin Zhou , Li Fang , Xiaodong Peng , Jingjing Peng , Shasha Jiang , Lang He , Xiaoshan Wang , Jiang Zhu , Bin Ye , Chi Du , Zhujuan Xiong , Qian Gao 
Published: May 2019

e18003 Background: Medical advance in the recent decades has turned cancer into a chronic disease. At the same time, quality of life (LoF) during the treatment period has emerged as a new concern of cancer patients. Rehabilitation therapy, which can help patients conquer fear and be more engaged in the process, has gradually attracted more attentions in China. We designed a survey, for both the cancer patients and their families, to understand their view of the rehabilitation therapy. Methods: We sent paper-based surveys to volunteers consisted of cancer patients and their families. Majority of patients are from 10 cancer centers at the southwest region of China. The main cancer types are lung cancer, breast cancer and colon cancer. The survey questions focus on: patients and their families’ engagement of the treatment, their view on rehabilitation therapy, and their method preference for the rehabilitation therapy. Results: We sent 2,000 copies of the survey and received 1,920 valid inputs. Below are the key findings. 1. Their biggest concern: the outcome of the treatment 55.8%, side effects 19.7%, financial burden 12.8% and mental stress 11.5%. 2. The importance of the rehabilitation therapy as compared to traditional medical treatment, such as surgery and chemotherapy: equally important 67.8%, less important 17.7%, more important 10.1%, no preference 4.4%. 3. The necessity of rehabilitation therapy: very necessary 65.7%, somewhat necessary 22.7%, not necessary 11.6%. 4. The first three reasons for participating rehabilitation therapy: it helped go through the treatment 42.8%, it improved quality of life 31.6% and it helped release their mental stress 22.3%. 5. The best form to conduct rehabilitation therapy: face-to-face communicate with the doctors 60.6%, telecommunication 15.8% and combination of both 22.1%. Conclusions: The results of the survey strongly indicate the demands for rehabilitation therapy. Patients started to understand it – more than half of them think it is as important as the traditional medical treatment. Patients’ quality of life and mental health, which is part of the holistic treatment, are gradually recognized. Next, we plan to group our survey results by types of cancers, patients and their families’ genders and age, as well as the local economics, to better understand the data. We hope this study can serve as a data point to help build China’s rehabilitation therapy infrastructure.
Treatment delays in localized breast cancer: A NCDB analysis.
Authors: Bhandari Shruti , Ngo Phuong , Mudra Sarah , Murray Drew Carl Drennan , Lele Rachana Shirish , Srivastava Sudhir , Wu Xiaoyong , Rai Shesh , Mandadi Mounika , Riley Elizabeth Carloss 
Published: May 2019

e18023 Background: Breast cancer remains the second leading cause of cancer death despite continued advances. Delayed treatment results in worse outcomes. Association with treatment location and trend over time are not well described. Methods: National Cancer Database identified 1042844 stage I-III breast cancer patients treated from 2004 - 2014. Multivariable analysis identified clinical and socioeconomic factors associated with delayed treatment and overall survival (OS). Results: Patients had a median age of 61y and a median time to treatment of 25 days. Time to treatment was ≤30d in 50.9%, 31 - 60d in 35.9%, 61 - 90d in 8.7% and > 90d in 4.5% of patients. Percentage of patients with delayed treatment increased from 2004 to 2014 (For 61 - 90d: 6% to 10.6% and > 90d: 3.3% to 5.1%). Multivariable analysis showed younger age, black race, no insurance/Medicaid, a higher comorbidity score, and later stage disease were significantly associated with treatment delay [Table]. OS was significantly worse with delayed treatment (HR: 1.11; 95% CI 1.08 - 1.13; p < 0.001). Treatment at an academic facility was associated with treatment delays, however OS was better compared to community facility (HR: 0.81; 95% CI 0.79 - 0.82; p < 0.001). Conclusions: Treatment delays of > 90 days were rare but associated with worse OS. Despite the small percentages overall, this study shows an increase in treatment delays over the last 10 years. Academic centers were associated with treatment delays, but the OS was improved compared to other locations. Historic risk factors to timely treatment were again identified, despite increased efforts to reduce disparities. Further analysis of practice patterns is needed to better understand the direct clinical impact of these findings, especially in vulnerable populations. [Table: see text]
A new model of care for patients with central nervous system cancers.
Authors: Nevel Kathryn Sara , Konig Franchesca , Skakodub Anna , Davis Mary Elizabeth , Sibilla Maryann , Harrison Mabel , Rawlins-Peters Gayle , Jean-Charles Dominique , Zankowsky Anastasia , Gilman Jody , Kelly Brian , Zavolas Stephanie , Reiner Anne S. , Panageas Katherine , Diamond Eli L. , Carver Alan , DeAngelis Lisa Marie , Barnett Kara , Ruppert Lisa Marie , Pentsova Elena 
Published: May 2019

e18029 Background: Patients (pts) with primary or metastatic central nervous system (CNS) cancers often have multiple physical, psychosocial, and spiritual needs. Neurological impairments can transform relationship dynamics as loved ones become caregivers. These issues are difficult to address within a single outpatient oncology clinic. Methods: The Neurological Multidisciplinary Care Clinic (MdCC) at Memorial Sloan Kettering Cancer Center was a pilot study from 08/2017 to 01/2019 to foster a new model of care for complex pts with CNS cancers to identify and address their needs. The MdCC team, comprised of a neurologist, nurse, physiatrist, physical therapist, social worker(SW), case manager(CM), dietitian(RD), and chaplain. During a 3-hour visit, MdCC providers saw each pt/caregiver. Since 11/2017 participants completed validated surveys on unmet needs, financial strain, and home equipment prior to their visit and satisfaction surveys afterward. Descriptive statistics were used to analyze results. Results: Seventy-six pts were seen: 37 were female, median age 60. Of these 76 pts, 63 had primary CNS cancers; glioblastoma (51%) and high-grade glioma (HGG) (29%). Fifty-five were receiving cancer-directed therapy at the time of MdCC. Over 70% had never seen a SW, CM, RD, or physiatrist prior to MdCC. Pts’ most commonly reported need was “not being able to do the things I used to do”; for caregivers it was “I need my partner to have an ongoing CM.” Seventy-four pts (97%) received symptom management recommendations. Prognosis/coping with cancer was discussed with 70 (92%) which increased signed health care proxy forms by 11% and DNR orders by 3%. New/updated physical therapy was ordered for 48 pts (61%), orthotics for 8 (10%), and new equipment for 12 (15%). Five pts were referred to a food assistance program. Forty-five pts completed a satisfaction survey; of these, 96% were highly satisfied, and would recommend MdCC to others. Conclusions: Pts’/caregivers’ unmet needs were effectively identified and addressed in this new model, and an emphasis on supportive and coordinated care contributed to high pt/caregiver satisfaction. We therefore propose to offer this clinic for all pts with HGG to improve pts’ well-being, quality of care, and increase pt/caregiver satisfaction.
AI platform in mammography to screening breast cancer: A sole-center experience.
Authors: Li Jie , Zhang Zhicheng , Chang Jia , Lin Bo , Lv Weiming 
Published: May 2019

e18052 {\rtf1\ansi\ansicpg936\cocoartf1347\cocoasubrtf570 {\fonttbl\f0\froman\fcharset0 Times-Roman;\f1\fnil\fcharset0 Calibri;\f2\fswiss\fcharset0 Helvetica; \f3\fnil\fcharset134 STHeitiSC-Light;\f4\froman\fcharset0 TimesNewRomanPSMT;} {\colortbl;\red255\green255\blue255;\red0\green0\blue0;} \paperw11900\paperh16840\margl1440\margr1440\vieww25400\viewh13600\viewkind0 \deftab720 \pard\pardeftab720 \f0\fs24 \cf2 \expnd0\expndtw0\kerning0 \outl0\strokewidth0 \strokec2 AI platform in mammagraphy to screening breast cancer: a sole center experence. \f1\fs21 \cf0 \kerning1\expnd0\expndtw0 \outl0\strokewidth0 \ \pard\pardeftab720\ri714\qj \cf0 Background: The aim of this study was to use deep convolutional neural network (DCNN) to relieve radiologists ' burden and to minimize misses and interpretation errors of suspicious lesions at digital mammography. Methods: We developed and trained the DCNN model on the training set, then validated it in an internal validation set. The labeled data were used for training the DCNN model, and the mass detection, calcification detection and benign and malignant diagnosis were interpreted respectively. After verifying the feasibility of the DCNN model in the diagnosis of breast cancer, we gradually increased the number of cases in the training set and established the verification set to test the training results. The latest training sets include 21100 atlas of our hospital between April 2010 and October 2017, among which the malignant case atlas is 1774. Each atlas contains 2 ipsilateral mammography images. The verification set includes 1307 atlas, among which the malignant case atlas is 248. Results: The DCNN model achieved high performance in identifying breast cancer patients in the validation sets tested, with sensitivity of 98.02%, specificity of 91.86% \f3 \'a3\'ac \f2 and area under the curve values of 0.9813. As for mass detection, we reached a recall rate of 89.6% on the premise of lowing the false positive to 0.168%. For the latest clinical data between October 2018 and November 2018 including 1043 atlas from 576 patients, the sensitivity was 78.6% (95%CI 62.8-89.1) versus 90.5% (95%CI 76.5 \f4 - \f2 96.9; p=0.021) and specificity was 93.4% (95%CI 91.6 \f4 - \f2 94.8) versus 82.7% (95%CI 80.2 \f4 - \f2 85 \f4 . \f2 0; p<0.0001). Conclusions: The DCNN model showed improved specificity in diagnosis breast cancer compared with a group of skilled radiologists. As the number of cases in the training set increases, the capacity of DCNN model will be further improved.
Real-world data (RWD) and patients reported outcomes (PRO) in breast cancer (BC): Physical, emotional side effects (S/E), financial toxicity (FT), and complementary usage (CM) relations.
Authors: Vorobiof Daniel A. , Malki Eliran , Deutsch Irad , Hasid Lior 
Published: May 2019

e18060 Background: RWD denotes data accumulated via electronic health records as well as cutting edge technology paired with consumer mobile devices. Artificial intelligence (AI) incorporates the use of algorithms and machine learning (ML) software to analyze complex medical data, improving the knowledge of cancer journeys. PRO on 256 BC patients (pts) survey repliers, users of Belong.life, a worldwide social media application for cancer pts, are presented. Methods: From 11/2018 to 01/2019, 256 pts replied to a 37 questions’ survey which included information regarding clinical and emotional S/E, FT and CM use. Results: 98 pts (38%) were < 50 years of age, 158 (62%) > 50 years. Most of the pts (163, 64%) were diagnosed within 2017-8. Most pts had Stage 1 (83 pts,32%) and 2 (94 pts,37%) and 71 pts (28%) had Stage 3-4. 154 (61%) had neo-adjuvant anthracyclines-based treatments, followed by a taxane (docetaxel/paclitaxel). 149 of 256 pts (58%) reported clinical S/E: nausea and vomiting in 77 pts (52%), fatigue in 63 pts (42%), hair loss in 42 pts (28%) and body pain and neuropathy in 13 pts each (8.8%). 90 pts (35%) described various emotional symptoms: depression in 32 pts (35.6%), anxiety 13 (14.4%), ‘up and down’ feelings in 20 pts (22 %). FT was experienced by 100/208 pts (48%). FT was most prevalent in ages 35-50 (51/85pts, 60%) than in 51-65 (41/100pts, 41%). Main reported causes in both groups were loss or absence from work (33% and 51%) and treatment copayments (40% and 21%). CM use was reported by 42/256 pts (16.4%). Most common CM were nutritional, multivitamins, supplements and CBD oil use. ML documented a strong relationship between BC recurrence in 55/256 pts (21.5%), FT in 25/55 pts (45.5%) and CM use in 9/25 pts (36%) vs no FT in 3/30 pts (10%). Conclusions: 256 BC users of the Belong application reported on clinical and emotional S/E, FT and CM use. The high incidence of emotional S/E stresses the need for individualized attention. FT was most prevalent in the younger age group (35-50yrs) due to work loss and treatment copayments. A significant relationship was determined by ML techniques on those patients experiencing BC recurrence, FT and CM use.