bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is survivorship care plan discussion important to patients?
Authors: Leatherwood Amy Eiko , Thomas Charles R. 
Published: February 2017

e276 Background: The 2015 Commission on Cancer standard requires that cancer survivors receive a personalized survivorship care plan (SCP). There are variations on how this plan is delivered, depending on time and available staff. These can include mailing the SCP, delivering the SCP at the conclusion of a visit, and fully discussing the SCP at a survivorship visit. There is a need to evaluate the growth in patient satisfaction with not only receipt of SCP, but also personalized care and education regarding the SCP and follow up. Methods: A simple, anonymous questionnaire was routinely given, for quality assurance purposes, to cancer patients who had completed treatment in a radiation oncology setting. Patients were given the questionnaire at the conclusion of a survivorship visit, during which they had received an SCP with full discussion and explanation by the nurse practitioner. The questionnaire asks two questions: 1) Did you find the survivorship visit helpful and/or educational? 2) Was it more helpful to have the survivorship summary explained to you in person? These questions could be answered with a “yes” or “no” answer. Results: This data collection is at a preliminary stage. We received 19 completed questionnaires from patients. Of these 19 questionnaires, 18/19 or 95% of responses were “yes” for question 1. For question 2, 18/19 or 95% of responses were “yes.” Conclusions: This information on patient-perceived value of survivorship visits and SCPs is at an early stage, and more responses will be needed to confirm its validity in the future; however, preliminary data show that the majority of patients are finding survivorship summaries to be helpful and educational to them. Patients are also indicating that visits “in person,” with face-to-face explanation of survivorship summaries, are more helpful than receiving a summary without verbal involvement or explanation.
Health care providers’ perspective on communication of cancer diagnosis and treatment plan to geriatric patients.
Authors: Lanka Himabindu , Zirker William , Dorokhine Igor 
Published: February 2017

e277 Background: Physician communication with patients is vital to deliver a proper diagnosis. In addition, it is important to appropriately answer questions to improve the quality of care especially with geriatric patients with cancer. However, patients feel their questions are not being answered in a timely manner. Multiple international studies involving oncologists have identified communication barriers such as cultural differences, paternalistic views and family dynamics. Furthermore, barriers to communication in geriatric patients are cognitive impairment and hearing loss. The aim of this study is to assess health care providers’ perspective on communicating cancer diagnosis and treatment plan in geriatric population. Methods: A ten-question survey was created and was emailed to health care providers using Survey Monkey. Data analysis consisted of distribution frequency and Chi-squared test/Fischer test. Results: 69 health care providers’ participated in the survey. 13 of the 69 (18.8%) did not see any geriatric patients with cancer and were excluded from the study. Amongst the communication parameters assessed, 85% of them said they had a particular approach to diagnosis. 76.9% of them included side effects of chemotherapy, risks and benefits of treatment and an option of no treatment in their initial treatment plan. Also, 67.3% of them included advance directives, hospice and prognosis in their initial plan. (Table 1) An adequate comparison was not possible due to the small sample size. Conclusions: In communicating cancer diagnosis and treatment plan, health care providers’ feel that they adequately answer questions and address needs of their geriatric patients. [Table: see text]
The Life Raft Group and establishment of the Virtual GIST Tumor Board in partnership with NIH.
Authors: Rothschild Sara , Menos Mildred , Scherzer Norman J. , Durborow Michelle 
Published: February 2017

e278 Background: In 2008, the National Institutes of Health (NIH) launched an in-person clinic for the Pediatric and Wild-type GIST community allowing clinicians and researchers from across the world to collaborate with each other and meet patients and their families firsthand. This led to several important breakthroughs, including investigating germline mutations in the succinate dehydrogenase complex (SDH), which helps physicians understand how wild-type GISTs are formed, and that Pediatric GIST can be diagnosed after age 18 and should thus be titled “SDH-deficient GIST.” Yet, decreases in government funding have reduced the number of in-person meetings to one per year. To supplement this loss of an in-person clinic, The Life Raft Group partnered with the NIH to launch the Virtual GIST Tumor Board. Methods: The process is an augmentation of how virtual tumor review boards work. If selected, doctors of GIST patients log on and review their de-identified patient case with a panel of experts using the internet, secure servers, and state-of-the-art video conferencing software. The LRG uses cutting-edge technology to connect the local treating physicians and their team with key opinion leaders in the field of Pediatric (SDH-deficient) GIST. Participants virtually access radiology films such as CT scans and other necessary medical reports to help review particular cases and provide advice. Results: The Virtual GIST Tumor Board has met twice, and reviewed cases from patients as far away as Latin America and the Ukraine. The physicians of these patients have elevated the level of care they provide due to the interaction with experts the Board makes possible. Conclusions: The purpose of the Pediatric GIST Virtual Tumor Board is to bring together leading experts to discuss pediatric/wild-type (SDH-deficient) GIST cases, and be an educational resource for physicians. It is transformative, because it provides valuable access for patients and doctors who would not be able to attend an in-person clinic due to resources or distance; educates doctors on the most up to date treatment options, trials, and studies; serves as a triage to bring patients to the in-person clinic; and encourages collaborative efforts of leading GIST experts around the world.
Late events audit of sequential studies of seminoma after carboplatin.
Authors: Oliver Tim R. D. 
Published: February 2017

e281 Background: Seminoma is the least malignant subtype of testicular germ cell cancer and has the least risk of metastasis at presentation. Less established compared with its radio-sensitivity, is the fact that it is more chemo-sensitive than non-seminoma. Despite reporting single agent Platinum data in 1982 which supported this concept, most standards of care do not treat seminoma differently from non-seminoma. This abstract reviews personal series some with more than 30 years follow up primarily using email follow up with access to clinical support as required to support this concept. Methods: A total of 97 metastatic seminoma (20 cisplatin, 77 Carboplatin) treated 1980-2006, 167 Stage 1 cases receiving either 1 or two courses of adjuvant therapy treated 1985-2006 and 54 cases receiving chemotherapy as part of testis conservation (12 single agent Platinum and 42 BEP therapy) treated between 1978 and 2006. Prior to 1996 participation was through verbal informed consent and since this time ethical committee approval has been obtained for the ongoing studies. Results: A total of 11 relapses have occurred in patients in 5 studies of carboplatin monotherapy in 264 patients with various stages of seminoma. All have been salvaged by BEP as have 16 relapses after I course carboplatin in the MRC TE19 randomised trial No relapses have occurred after 24 months despite median of 96 months follow-up, 51(19%) > 20 years. Though late malignant and non-malignant events have occurred, the frequency in the cohort followed between 10 and 15 years (n = 93) is not in excess of age matched controls. Conclusions: While in primum non noce does not trump the Sword of Damocles, the lack of any problems to date provide justification for further prospective evaluation of this less toxic option in patient preference studies.
A novel risk score for prediction of hypersensitivity reactions in cancer patients receiving carboplatin: Retrospective observational analysis.
Authors: Suppramote Orawan , Pongpunpisand Prapatsara , Ladkam Kanlaya , Rujirawat Somkiat 
Published: February 2017

e282 Background: Hypersentitivity reactions (HSRs) from carboplatin are high incidence and most severity in Chulabhorn hospital. These reactions are associated with several causes including patient factors and experience in drug used. A reliable and valid tool for evaluated risk of HSRs before started carboplatin infusion should lead to prevent or decrease severity of the reactions. We innovated risk score to screen patient at high risk of HSRs. Methods: From October 2013 to September 2014, all cancer patients who received carboplatin in Chulabhorn hospital were included. A retrospective study design to developed risk scoring system for prediction of patients at high risk of carboplatin hypersensitivity called “Hypersensitivity risk score”. The hypersensitivity risk score was calculated for all patients receiving carboplatin and data for carboplatin hypersensitivity were obtained from medical records. Expected and observed HSRs were analyzed by using receiver operating characteristic (ROC) curve. Results: Seventy-three cancer patients received carboplatin and five (7%) patients had HSRs. Our scoring algorithm based on cancer type, number of carboplatin retreatment, duration between each retreatment, and number of carboplatin infusions prior to first reaction. All significant predictors were weighted into points and categorized to risk group which ranged from 0 to 8 . The ROC analysis for hypersensitivity risk score indicated good predictive accuracy with an area under the curve of 0.96 (95 %CI: 0.91-1.00). Data showed high sensitivity (80%) and specificity (94.85%) for a risk score cut-off of 4. The hypersensitivity risk score clearly differentiated the low (0-1), intermediate (2-3) and intermediate-high (4-5) and high (6-8) risk patients. Conclusions: The hypersensitivity risk score is a simple scoring system with high predictive value and differentiates low versus high risk patients. This score should be used for screen high risk of hypersensitivity reactions in patients receiving carboplatin.
An international, population-level initiative to promote healthy lifestyle practices among prostate cancer survivors.
Authors: Chan June M. , Newton Robert Usher , Culos-Reed S. Nicole , Faithfull Sarah , Lambert Sylvie , Kenfield Stacey A. , Van Blarigan Erin , Lyons Karen S , Ramsdill Justin , Zahavich Ashley , Duncan Lindsay , Hart Nicolas , Dew Mike , Moe Esther L , Dixon Cyril , Winters-Stone Kerri M 
Published: February 2017

e287 Background: Growing evidence suggests that specific lifestyle practices (e.g., diet and exercise) may delay cancer progression among prostate cancer survivors (PCS) and restore post-treatment quality of life. However, there are limited efforts to translate this knowledge to sustainable behavior change among PCS at a population level. Methods: TrueNTH is an international partnership to develop innovative evidence-based interventions and care models to improve the physical and mental wellbeing of PCS. Within TrueNTH, four countries (U.S.A., Australia, Canada, U.K.) are developing solutions to improve lifestyle practices among PCS. Australia is implementing face-to-face and telehealth delivery of exercise and dietary programs facilitated by a web-based portal. Canada is implementing group-based exercise and yoga programs combined with a web-based portal to deliver exercise, nutrition and stress-reduction resources for PCS and caregivers. The U.K. is implementing a healthy living pharmacy approach to deliver tailored diet and exercise advice and support to men. The U.S. will implement a scalable web-based portal that reaches PCS, providers and partners and provides personalized exercise prescriptions and dietary advice, interactive guidance, and behavioral support via social media, tele-exercise, and face-to-face communities. Results: TrueNTH initiatives are in various phases of a three-year project. Australia has enrolled 30 of 80 men across 2 sites and via telehealth, and demonstrated acceptance of the portal. Canada has enrolled 30+ men in exercise programs and will soon add 4 sites and launch their portal. The UK has evaluated assessment protocols in 2 sites and will soon add a 3rd site and implement the pharmacy-based program. The U.S. is building the portal and supportive tools and will begin a trial in Fall 2016. Conclusions: Each TrueNTH program shares common goals to improve lifestyle practices among PCS. Common metrics across initiatives will allow for a global comparison of implementation approaches and assessment of impact at a population level. TrueNTH will utilize this initiative to create a lifestyle survivorship program that improves the lives of PCS worldwide.
Underserved community-based walking program for breast cancer survivors.
Authors: Tjoe Judy Angela , Piacentine Linda B. , Robinson Karen M. , Ng Alexander V. , Waltke Leslie J. , Sinner Angela A. 
Published: February 2017

e288 Background: Advancements in early detection and new treatment options have improved outcomes for breast cancer survivors (BCS). With increased survivorship, improving quality of life (QOL) may be a challenge for some women. Exercise improves QOL for BCS and decreases recurrence, but, despite this many women do not routinely exercise. Underserved areas are at particular risk. Few studies have examined factors influencing exercise initiation and maintenance in underserved areas among minority overweight women. The purpose of this mixed methods study was to examine physiological outcomes and motivational factors in a community-based goal oriented walking program for BCS. Methods: A convenience sample of female BCS was recruited from an inner-city community center 12-week walking program. Women participated in physiological testing and focus groups before and after the program. Data was collected regarding strength, fitness, quality of life, and motivation of the women. Quantitative data was analyzed with paired t-tests. Two researchers independently analyzed focus groups’ transcriptions and like statements and phrases were coded. Themes emerged after discussions between the researchers. Results: The 13 participants [overweight BMI (n = 2), and obese BMI (n = 11)] had a mean survivorship of 5.4 years (range .25-14.5) years. Only 7 participants completed both pre and post physiological testing. Functional endurance significantly improved as indicated by the 6 Minute Walk Test (pre = 503(56), post = 570 (63) meters, mean(sd)), p = 0.02). While overall QOL did not improve, functional well-being showed significant improvement. Two focus group sessions were held at the beginning (n = 13) and end (n = 11) of the program. Themes emerged identifying 1) Treatment Weight Gain, 2) Familial Support, 3) Not Wanting to Go it Alone, 4) The Team Made the Difference Conclusions: Female BCS spoke of interpersonal and environmental factors involved in the decision to engage and maintain exercise with the walking program. Further research is needed to examine exercise motivation in underserved, overweight and obese breast cancer survivors.
Nimotuzumab in combination with preoperative concurrent chemoradiotherapy for locally advanced esophageal squamous cell carcinoma: A prospective trial.
Authors: Wu Xiaoyuan , Chen Yongshun , Yang Yuanyuan , Hao Daxuan , Li Xue , He Chunyu , Liu Jinsong , Wang Jianhua 
Published: February 2017

101 Background: Preoperative chemoradiotherapy is an accepted standard treatment for patients with locally advanced esophageal cancer. Nimotuzumab is a monoclonal antihuman EGFR IgG1 antibody that has demonstrated synergistic activity with both radiotherapy and platinum-based chemotherapy in some solid tumors. The aim of this study is to investigate the safety and efficacy of nimotuzumab in combination with preoperative concurrent chemoradiotherapy for locally advanced esophageal squamous cell carcinoma (ESCC). Methods: Previously untreated patients with stage II-III ESCC received nimotuzumab (200mg per week in weeks1-5), paclitaxel(45 mg/m2 per week in weeks 2-5), cisplatin(20 mg/m2 per week in weeks 2-5) and radiotherapy at a total dose of 40 Gy (2.0Gy/d,5 days per week in weeks 2-5). Esophagectomy was performed 4 weeks after the completion of preoperative strategies. Results: Eighteen eligible patients were enrolled. All patients completed the preoperative regimen, and seventeen patients underwent surgery. The clinical response rate was 94.4% (17/18). The most frequent Grade 1/2 toxicities were esophagitis(12/17), leukocytopenia(14/17), nausea/vomiting(8/17) and fatigue(4/17). Grade 3 leukocytopenia was observed in 11.8 % of patients (3/17). The rate of radical resection was 100%, and the pathological complete response rate was 41.2%(7/17). Downstaging occurred in 15/17 (88.2 %) patients by T stage and 8/17 (47.1%) by N stage. The incidences of postoperative anastomotic leak, pulmonary infection, hoarseness and arrhythmia were 11.8%, 11.8%, 5.9%, and 5.9%, respectively. No perioperative deaths occurred in the study. Conclusions: The regimen of nimotuzumab in combination with preoperative concurrent chemoradiotherapy is safe for locally advanced ESCC. The preoperative strategy is able to achieve substantially high clinical response rate and pathological complete response rate.
Is there a role for neoadjuvant radiation dose escalation in esophageal cancer? A meta-analysis.
Authors: Lobo Laila , Yakoub Danny , Ripat Caroline , Sharma Rishika , Yechieli Raphael 
Published: February 2017

102 Background: In treating esophageal cancer chemo-radiation is used in the definitive as well as neo-adjuvant setting. Optimal dosage of radiation for best outcome has been debated. The aim of this study is to evaluate clinical outcomes of lower radiation dosage compared to higher. Methods: Online search for studies comparing radiation dose from 1990 to present was performed. Primary outcome was overall-survival rates for up to 5 years. Secondary outcomes included post-treatment complications and treatment response. A cut point of 51 Gy and less was considered as lower dose and greater than 51 Gy was considered higher dose. Quality of included studies was evaluated by STROBE criteria. Relative Risk (RR) and 95% Confidence Intervals (CI) were calculated from pooled data. Results: The search strategy yielded 142 studies, 12 met our selection criteria and included 1876 patients receiving radiation for resectable esophageal carcinoma. Of these patients, 1057 received lower and 819 were treated with greater than 51 Gy. Median age was 63 and 64 years for lower and higher radiation dose respectively. Meta-analysis showed no statistically significant difference in survival and toxicities between the two groups. 1 year overall survival (RR = 0.97, 95% CI 0.84-1.13, p = 0.69), 2 year overall survival (RR = 1.29, 95% CI 0.76-2.19, p = 0.34), 3 year overall survival (RR = 1.18, 95% CI 0.83-1.68, p = 0.37), 4 year overall survival (RR = 1.37, 95% CI 0.64-2.94, p = 0.41), 5 year overall survival (RR = 1.11, 95% CI 0.72-1.69, p = 0.64), Esophagitis (RR = 0.76, 95% CI 0.39-1.50, p = 0.43), Dermatitis (RR = 0.98, 95% CI 0.12-7.94, p = 0.99), Fistula formation (RR = 0.72, 95% CI 0.32-1.60, p = 0.42), Hematologic complications (RR = 1.10, 95% CI 0.20-6.02, p = 0.91), Stricture formation (RR = 1.39, 95% CI 0.54-3.58, p = 0.5). Conclusions: Lower radiation dose appears to be as effective as higher dose in esophageal carcinoma with similar toxicity profile and survival rates. Larger prospective randomized trials, focusing on patient-reported quality-of-life are required to consolidate these results.
Role of nutritional status as predictor of survival in oesophageal cancer treated with definitive chemoradiation (dCRT): outcome from SCOPE1, a phase II/III randomised trial of dCRT +/- cetuximab.
Authors: Cox Samantha , Powell Ceri , Carter Ben , Hurt Chris , Mukherjee Somnath , Crosby Tom David Lewis 
Published: February 2017

103 Background: Malnutrition is common in oesophageal cancer and may be related to the disease or treatment. We aimed to identify nutritional prognostic factors and the outcome of nutritional intervention in patients recruited to the SCOPE1 trial. Methods: 258 patients were randomly allocated to dCRT with or without the addition of cetuximab. Data was collected prior to induction chemotherapy (iCT) and before commencing concurrent CRT. Nutritional Risk Index (NRI) was calculated and categorised; ≥ 100 (no risk of malnutrition), 97.5-100 (mild risk), and < 97.5 (moderate to severe risk). The maximal nutritional intervention (MNI) received was classified as: none, dietary advice, oral supplementation or major intervention (enteral feeding/tube placement). Univariate and multivariate analyses using Cox proportional hazard modelling were conducted to identify predictive factors and important interactions involving MNI. Results: An NRI score < 100 at baseline strongly predicted reduced median overall survival (OS) in multivariate analysis (HR = 12.45, 95% CI 5.24 – 29.57; p = < 0.001). Furthermore, OS was improved in this group if they received dietary advice (HR = 0.12, p = 0.004), oral supplementation (HR = 0.13, p = < 0.001) or major intervention (HR = 0.13, p = 0.003) prior to commencement of iCT, but there was no benefit if intervention occurred after commencement of iCT. Patients on cetuximab arm undergoing major intervention had worse outcomes compared to control (13 months vs 28 months, p = 0.003). Conclusions: Assessment and correction of poor nutritional state at baseline may improve survival outcomes in oesophageal cancer patients treated with dCRT. The benefit of intervention is no longer observed once treatment has commenced, highlighting the need for early nutritional assessment and intervention. Reason for poor OS in patients on cetuximab requiring major intervention is unclear. Clinical trial information: 47718479.
Ten year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center.
Authors: Park Hyungchul , Kim Do Hoon , Gong Eun Jeong , Na Hee Kyong , Ahn Ji Yong , Lee Jeong Hoon , Jung Kee Wook , Choi Kee Don , Song Ho June , Lee Gin Hyug , Jung Hwoon-Yong , Kim Jin-Ho 
Published: February 2017

104 Background: Endoscopic submucosal dissection (ESD) of a superficial esophageal neoplasm (SEN) is a technically difficult procedure. We investigated the clinical outcomes of ESD to determine its feasibility and effectiveness for the treatment of SEN. Methods: Patients who underwent ESD for SEN between August 2005 and June 2014 were eligible for this study. The clinical features of patients and tumors, histopathologic characteristics, adverse events, results of endoscopic resection, and survival were investigated. Results: ESD was performed in 225 patients with 261 lesions, including 70 cases (26.8%) of dysplasias and 191 cases (73.2%) of squamous cell carcinomas. The median age was 65 years (range: 44–86 years), and the male to female ratio was 21.5:1. Median tumor size was 37 mm (range: 5–85 mm) and median procedure time was 45 minutes (range: 9–160 minutes). En bloc resection was performed in 245 of 261 lesions (93.9%), with complete resection in 234 lesions (89.7%) and curative resection in 201 lesions (77.0%). Adverse events occurred in 33 cases (12.6%), including bleeding (1.5%), perforation (4.6%), and stricture (6.5%). During a median follow-up period of 35.0 months (interquartile range: 18–62 months), none of the patients showed local recurrence. The 5-year overall and disease-specific survival rates were 89.7% and 100%, respectively. Conclusions: ESD is a feasible and effective procedure for the treatment of SEN based on our 10-year experience, which showed favorable outcomes.