bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age, comorbidity, and the risk of death in men with PSA failure following radiation therapy.
Authors: Martin Neil E. , Chen Ming-Hui , Beard Clair , Nguyen Paul Linh , Loffredo Marian , Renshaw Andrew A. , Kantoff Philip W. , D'Amico Anthony Victor 
Published: February 2017

82 Background: Life expectancy data based on age and comorbidity may identify men with favorable post-radiation prostate-specific antigen (PSA) failure kinetics unlikely to experience metastasis despite withholding androgen deprivation therapy (ADT). Methods: Of 206 men with unfavorable-risk prostate cancer (PC) enrolled on a randomized trial of radiation vs. radiation + ADT, 108 had a PSA failure and 53 who did not receive slavage ADT because the PSA had not meet a pre-specified criteria of 10 ng/mL (n=41) or had significant comorbidity (n=12) and were followed with q1 year (yr) bone scan and q6 month (mo) PSA formed the study cohort. Comorbidity, age and established prognostic factors were evaluated with Cox regression to determine factors associated with death after PSA failure. Results: Median age at and interval to PSA failure and PSA doubling time were 76.6 yr (interquartile range [IQR] 71.8-79.3), 49.1 mo (IQR: 37.7 – 87.4), and 25 mo (IQR: 13.1 – 42.8) respectively. After a median follow up of 4.0 yr (IQR: 2.0 – 12.5) post PSA failure, 24 (45%) men died, none from PC and no one developed metastases. The median last follow up PSA was 3.6 ng/mL (IQR: 1.8 - 8.3). Increasing age at PSA failure (adjusted hazard ratio [AHR]: 1.14; 95% CI: 1.03 – 1.25; p=0.008) and the presence of moderate to severe comorbidity (AHR: 12.5; 95% CI: 3.81 – 41.0; p<0.001) were significantly associated with an increased risk of death on multivariate analysis. At 4 yr, 86% above the median age at PSA failure and with moderate or severe comorbidity had died compared to 16% whose age was at the median or less and with no or minimal comorbidity (p< 0.001). Conclusions: Men over age 76 with significant comorbidity and a PSA doubling time > 2 yr following post-radiation PSA failure appear to be good candidates for surveillance. [Table: see text]
Long-term efficacy of stereotactic body radiotherapy for localized prostate cancer: A multi-institutional pooled analysis.
Authors: Kupelian Patrick , Katz Alan J. , Freeman Debra , Kaplan Irving D. , Fuller Donald B. , Bolzicco Giampaolo , Collins Sean P. , Meier Robert , Wang Jason , King Christopher R. 
Published: February 2017

9 Background: The purpose of this study is to report biochemical relapse-free survival (bRFS) rates for a group of localized prostate cancer patients from a pooled multi-institutional dataset with at least 5 years follow-up after stereotactic body radiotherapy (SBRT). Methods: The outcome data from 1101 patients treated with SBRT between 2003 and 2011 were pooled from 8 institutions. A subset of 135 cases had a minimum 5 years follow-up. All 135 cases had clinical stage T1 or T2A disease. The distribution by Gleason score (GS) was <6 in 80% and 7 in 20%. The median pretreatment PSA (iPSA) level was 5.1 ng/ml (range: 0.1-27.8). The distribution by risk was 77% low, 21% intermediate, and 2% high risk. The median dose was 36.25 Gy (35-40 Gy range) delivered either with 4 or 5 fractions. The prescribed dose groups were as follows: 35 Gy in 42%, 36.25 Gy in 47%, and >38 Gy in 11%. Androgen deprivation therapy was given to 21% of patients. Biochemical relapse, defined as a rise > 2 ng/ml above nadir, was determined in a total of 4 failures. Results: The median follow-up for all 135 cases was 60 months (range 60 to 72). For all patients, the bRFS rate at 5 years was 97%. The 5-year actuarial bRFS rates for GS < 6, and Gleason score 7 were 98%, and 92%, respectively (p=0.15). The 5-year actuarial bRFS rates for low versus intermediate/high-risk patients were 99% and 93%, respectively (p=0.11). The 5-year actuarial bRFS rates for patients receiving 35 Gy versus >36.25 Gy were 93% and 100%. No difference in bRFS was observed with the use of androgen deprivation (p=0.78). Multivariate analysis showed only GS to be an independent predictor of relapse (p=0.03); iPSA (p=0.10) and radiation dose (0.97) were not. Conclusions: In a relatively large cohort of localized prostate cancer patients treated with SBRT, long follow-up period (>5 years), excellent efficacy was demonstrated with 97% of patients being free from relapse. For low and intermediate risk cases, these results compare favorably with other modalities with similar follow-up periods. Although a trend for worse outcome was seen with total radiation doses of 35 Gy, this was not confirmed on multivariate analysis.
Benefits of immediate versus delayed palliative care to informal family caregivers of persons with advanced cancer: Outcomes from the ENABLE III randomized clinical trial.
Authors: Dionne-Odom J Nicholas , Azuero Andres , Lyons Kathleen , Li Zhongze , Tosteson Tor , Li Zhigang , Hull Jay , Frost Jennifer , Hegel Mark , Dragnev Konstantin H. , Akyar Imatullah , Bakitas Marie 
Published: February 2017

LBA9513 Background: Family caregivers of individuals with advanced cancer experience significant burden and diminished QOL; few interventions have been found to reduce these outcomes. Methods: Randomized clinical trial conducted from 10/11/2010 to 9/5/2013 of immediate versus delayed (initiated 12 weeks after randomization) entry patients (n=207) and caregivers (n=122) into ENABLE (Educate, Nurture, Advise, Before Life Ends), a phone-based concurrent oncology palliative care intervention. QOL (Caregiver Quality of Life-Cancer, lower scores=better QOL), depression (Center for Epidemiological Study-Depression) and burden (Montgomery Borgatta Caregiver Burden Scale; subjective burden [SB], objective burden [OB]; demand burden [DB]) measures were collected at baseline, 6, 12, 18, and 24 weeks, and every 12 weeks until patient death or study completion. Results: Estimated treatment effects (immediate minus delayed) for caregivers from randomization to 12 weeks were (mean [SE]): -3.1 [2.3] for QOL (P=.17), -4.1 [1.3] for depression (P=.003), -1.0 [0.4] for SB (P=.02), 0.3 [0.6] for OB (P=.60), and -0.5 [0.6] for DB (P=.39). Estimated treatment effects (immediate minus delayed) from intervention initiation to 12 weeks were (mean [SE]): -6.4 [3.4] for QOL (P=.06), -7.4 [2] for depression (P<.001), -1.0 [0.6] for SB (P=.08), -0.6 [0.7] for OB (P=.44), and -0.5 [0.8] for DB (P=.50). Estimated treatment effects (immediate minus delayed) measured backwards from the time of patient’s death were (mean [SE]): of -4.9 [2.6] for QOL (P=.07), -3.8 [1.5] for depression (P=.02), -1.1 [0.4] for SB (P=.01), -0.6 [0.6] for OB (P=.26), and -0.7 [0.6] for DB (P=.22). Conclusions: Caregivers in the immediate group had lower depression, SB, and trends towards better QOL in comparisons up to 12 weeks, following initiation of the intervention in both groups, and in the terminal decline analysis. These results suggest that concurrent oncology palliative care should be initiated as early as possible to maximize benefit to caregivers. Clinical trial information: NCT01245621.
Improving screening mammography return rates in overdue women: A randomized study of signed reminder letters from family physicians.
Authors: Chan Elisa K. , Wilson Christine , Tyldesley Scott , Lai Anky , Sam Janette , Harry Ritinder , Nichol Alan 
Published: February 2017

1 Background: For asymptomatic women aged 50 to 74 with an average risk for developing breast cancer, screening mammography (SM) is recommended every 2 years in British Columbia (BC). The Screening Mammography Program of BC (SMP) uses a schedule of multiple postcard reminders, which achieves an on-time (within 30 months) participation rate of 54% among those aged 50 to 69. The purpose of this study was to determine whether the SM return rate of overdue women could be improved by a reminder letter signed by their family physicians. Methods: Eligible women met the following criteria: prior normal SM, age 52 to 74, overdue by 30 to 48 months from their last SM and had agreed to being contacted for research by the SMP. All family physicians in BC were invited to participate. Consenting physicians signed the study letters, which encouraged SM, for all of the overdue women in their practice. Women were randomized to receive a postcard reminder or a postcard reminder and the signed family physician reminder letter. Six months after the mailing, the SMP database was queried to determine the SM return rate. Results: In BC, 822 physicians participated in the study and 5,385 women with signed letters were randomized. SMP sent a postcard to 2,689 women and a postcard and letter to 2,696 women. The age, number of prior SMs and time overdue were not statistically different between the arms. Within 6 months, 600 women (22.3%) in the postcard arm returned, while 894 women (33.2%) in the postcard and letter arm returned (odds ratio 1.7, p < 0.0001). The maximum difference between the SM return rates was observed at 4 months. On multivariable analysis, women who had >1 previous SM were more likely to return compared to those who only had 1 previous SM (odds ratio 2.2, p < 0.0001). Women who were 30 to 36 months overdue were more likely to return compared to those who were 42 to 48 months overdue (odds ratio 2.4, p < 0.0001). Conclusions: A signed family physician reminder letter is a simple and effective intervention to improve screening mammography return rates in overdue women.
BRCA 1 and BRCA 2 mutations in Saudi breast cancer patients (single institution).
Authors: Abulkhair Omalkhair A. M. 
Published: February 2017

10 Background: Breast cancer is the commonest malignancy among Saudi females accounting for 25% of all female cancers with a median age at diagnosis of 47 years (1,2). In Saudi, breast cancer showed an increased incidence attributed to many factors such as different lifestyles, reproductive pattern, family history, which was reported to account for 59%, dietary or cultural practice of Saudi women (2,3,4,5). The multifunctional and highly penetrant BRCA 1 and BRCA 2 are the two major breast cancer pre-disposition genes, accounting for about 20% of breast cancer families (6,7). To our knowledge, the prevalence of BRCA 1 and BRCA 2 mutations in native Saudi population is sparse (8,9). Our aim is to describe the findings of BRCA mutation testing in native Saudi patients with breast cancer in a large Ministry of National Guard Health Affairs (NGHA) community-based teaching hospital. Methods: In this study, 75 out of 516 patients with breast cancer who were clinically and histopathologically diagnosed at NGHA from October 2010 to April 2014 were included. Selection criteria: aged ≤ 40 years bilateral breast cancer, triple-negative breast cancer, strongly first degree family history at young age and male breast cancer. Molecular alterations were performed by direct gene sequencing, multiple ligation – dependent probe amplification (MLPA) at Bioscentia human genetic testing in Germany. Results: 75 native Saudi were enrolled and test performed for them. 18 patients (24%) were found to have mutation of which 10 in BRCA One and six in BRCA 2. Two have both BRCA 1 and BRCA 2. Seven patients have the same with deleterious mutations in BRCA 1 gene. Two of them are mother and daughter and other five are unrelated. The mean age of breast cancer diagnosis in the mutation carriers was 38 years. Triple negative breast cancer (TNBC) diagnosed in six patients, bilateral breast cancer diagnosed in one, first-degree family history in eight and second degree in 10 patients and four with no family history. Conclusions: BRCA 1 and BRCA 2 mutations are an important contributor to the etiology of breast cancer in Saudi women. A mutation in BRCA 1, C 1648 > C p, Asn550His in exon 10 has been reported as disease causing (11) and it is found in our study in seven patients. Such mutation might be specific for Saudi, so further studies are highly recommended.
Androgen receptor (AR) and phospho-AR protein levels in invasive breast cancers and survival outcomes: Indication of a new prognostic marker.
Authors: Iwase Hirotaka , Takeshita Takashi , Omoto Yoko , Ibusuki Mutsuko , Yamamoto Yutaka 
Published: February 2017

11 Background: Androgen receptor (AR) in breast cancer may serve as a useful prognostic and predictive marker. We examined the expression patterns of AR and AR phosphorylated at serine-213/210 (pAR213/210) in breast cancer by immunohistochemistry, and evaluated their association with clinicopathological parameters and prognoses. Methods: The levels of AR nuclear protein expression were determined in tissue samples of 379 consecutive female patients with invasive breast cancer. In samples that showed detectable AR, the levels of pAR213/210nuclear and cytoplasmic expression were determined. All samples were scored semiquantitatively using a histoscore. Results: Nuclear staining of AR was observed in 76% of the samples. Elevated AR protein expression correlated with non-aggressive parameters and longer relapse-free survival (RFS) (p < .0001) and breast cancer-specific survival (BCSS) (p < .0001). Nuclear and cytoplasmic pAR213/210 were observed in 72.4% and 11.9%, respectively, of the tested samples. Although no statistically significant relationship between pAR213/210 nuclear expression and clinicopathological parameters was observed, increased expression of cytoplasmic pAR213/210 was associated with high nuclear grade (p = .026), estrogen receptor (ER) α-negative (p = .023), progesterone receptor (PgR)-negative (p = .034), human epidermal growth factor receptor 2 (HER2)-positive (p = .043), and Ki-67-positive (p = .026) tumors. Conversely, nuclear pAR213/210 expression correlated with longer RFS (p = .027) and BCSS (p = .0031), but cytoplasmic pAR213/210expression was not related with RFS and BCSS. Conclusions: AR and its phosphorylation at serine-213/210 are significant in breast cancer progression and prognosis. The expression levels of pAR213/210 could have potential as a new prognostic marker of breast cancer.
State of the research on breast cancer in young women.
Authors: Esser Michelle , Rowe Jean , McCann Megan , Lewis Stacy 
Published: February 2017

117 Background: Young Survival Coalition (YSC) is the premier global organization dedicated to the critical issues unique to young women and breast cancer. In May, 2014, YSC released its Research Agenda which identified the most pressing research questions that must be answered in order to improve the quantity and quality of life for young women affected by breast cancer. Methods: This Research Agenda arose out of an almost two-year-long process created and facilitated by YSC, called the Research Think Tank (RTT). YSC assembled doctors, researchers and advocates to focus on six areas of particular importance to its young constituents: risk factors; treatment; metastasis; quality of life; fertility; and pregnancy. Results: Through the work of the RTT, YSC assessed the current state of knowledge as well as existing gaps in each of the six identified areas. While work is needed in all areas, there have been recent updates and progress regarding treatment and fertility. Additionally, quality of life studies examine the uniqueness of breast cancer in young women, although application of this knowledge through tested interventions, decision aids, or guidelines and tools for physicians are still lacking. Aspects of pregnancy during breast cancer and after breast cancer have been studied but many open questions remain. There has been little progress in understanding why so many breast cancers are diagnosed in the postpartum period, why they tend to be more aggressive, and what can be done to prevent or treat it. Research examining metastasis in young women is rare. Most research focuses on postmenopausal patients, and many studies set criteria that specifically exclude younger women. This is the topic area most in need of work and priority. Similarly, little research focuses on the specific risk factors for early onset breast cancer. These are likely distinct from the risk factors associated with postmenopausal breast cancer yet they are rarely separately examined. Conclusions: Compared to older women, young women generally face more aggressive cancers, lower survival rates, and unique psychosocial concerns. Breast cancer in young women is an area in need of additional work and clarification in order to increase their quantity and quality of life.
Modulation of insulin-like growth factors (IGF I-II) and IGF binding-protein 3 (IGFBP-3) through exercise training in women with breast cancer: A systematic review and meta-analysis.
Authors: Meneses-Echavez Jose F , Ramirez-Velez Robinson , Gonzalez-Jimenez Emilio , Schmidt Rio-Valle Jacqueline , Sanchez Perez Maria Jose , Molina Montes Esther 
Published: February 2017

120 Background: Epidemiological data suggest that Insulin-like growth factor 1 (IGF-1) and IGF binding protein 3 (IGFBP-3) are associated with breast cancer risk, apoptosis and other carcinogenic mechanisms. This metaanalysis evaluates the effects of exercise interventions in controlling serum concentrations of Insulin-like growth factors (IGF1-IGF2) and IGFBP-3 in women with breast cancer. Methods: We incorporated the PRISMA statement. Databases of MEDLINE, Ovid, EMBASE and Cochrane Central Registers were searched to identify randomized controlled trials until March 2014, reporting effect estimates for IGF-1, IGF-2, IGFBP-3 and other secondary outcomes such as insulin, glucose and waist circumference as a body composition measure. An Inverse of variance (IV) with Mantel–Haenszel method was selected for analysis, and a random-effects models were used to assess the pooled estimates in addition to sensitivity analyses, whilst heterogeneity was evaluated using the Chi2 test (P<0.10) and I2 statistics (I2>50%).STATA 12.0 was used for metaanalysis procedures. Results: Six studies were included in the pooled analysis involving 321 patients. Effect estimates showed that exercise training improved IGF-1 (MD= -12.9, 95CI% -16.73 to -9.14, P<0.001), IGF-2 (MD= -43.4, 95CI% -58.5 to -28.3, P<0.001), IGFBP-3 (MD= -0.61, 95CI% -0.69 to -0.53, P<0.001) and waist circumference (MD= -1.133, 95CI% -2.20 to -0.05, P=0.03) in women with breast cancer. Conversely, non-significant differences were observed for Insulin (MD= 0.046, 95CI% -0.24 to 0.34, P=0.7), Glucose (MD=0.22, 95CI% -0.32 to 0.78, P=0.419) and Insulin Resistance (MD= 0.64, 95CI% -0.006 to 1.29, P= 0.06). There was no evidence of publication bias. Conclusions: Exercise is an effective and safe intervention in improving the serum concentrations of insulin like growth factors (IGF1-IGF2) and IGFBP-3 in women with breast cancer, strengthening the physiological effects of exercise in regulating cellular proliferation and apoptosis in breast cancer. Further evidences are encouraged.
Building the case for expanded support services to young breast cancer survivors: An evaluation of a cooperative agreement.
Authors: O'Dell Sarah , House Marnie , Hall Mary Ann , Moore Angela , Fairley Temeika 
Published: February 2017

127 Background: To determine effective and appropriate communication interventions to address the psychosocial needs of young breast cancer survivors (YBCS), the Centers for Disease Control and Prevention (CDC) established a cooperative agreement with seven organizations offering tailored support and education services to YBCS. The process evaluation of this cooperative agreement aims to document program implementation and the extent to which the cooperative agreement relationship (funding, subject matter expert support, technical assistance, and training) facilitates organizations’ delivery of programs. An additional five organizations were studied for comparison to gain a broader perspective on programmatic offerings for YBCS across the United States. Methods: The evaluation utilizes a multiple case study design, entailing document review, site visits, program observation, and in-depth interviews with program staff to describe program implementation and perceptions related to program effectiveness. Thematic analysis is being utilized to analyze all qualitative data collected. Results: Organizations offer a range of services, including psychosocial support and education to YBCS, YBCS caregivers and health care providers. Services offered cover the cancer care continuum, ranging from the provision of community outreach and education via multiple platforms (e.g., partnership development, online resource compilations, social media) to structured support services offered (e.g., patient navigation, structured support plans, tailored support groups for survivors and caregivers) to relevant YBCS audiences. Specifically, grantee program staff members report that cooperative agreement funding helped to expand and strengthen organizations' YBCS-focused efforts; all organizations offer lessons learned for communication with YBCS. Conclusions: Findings from this evaluation demonstrate the utility of federal funds to help organizations augment existing or create new resources and services for YBCS. Further, findings from this evaluation support the use of tailored interventions as a promising strategy to improve YBCS communication and education efforts.
Can Twitter social media be an effective tool for breast cancer survivor support and education?
Authors: Attai Deanna J. , Landercasper Jeffrey , Schoger Jody M , Staley Alicia C , Cowher Michael S 
Published: February 2017

130 Background: Despite reported benefits, approximately 60% of women do not attend breast cancer support groups. Many online resources for support exist, but information regarding the effects of participation is lacking. We report the results of a Twitter breast cancer support community participant survey. Methods: The Breast Cancer Social Media (#BCSM) Twitter support community began in July 2011. IRB approval with waiver of informed consent was obtained for a de-identified survey which was posted for two weeks on Twitter and on the #BCSM blog and Facebook page. Results: There were 206 respondents, with a median age of 45-54 and 93% being female. 74% were from the United States. 92% were Caucasian. 83% completed a 4-year college degree. 69% had been treated for breast cancer. 14% reported living with metastatic breast cancer. 72% became aware of #BCSM through Twitter. 45% had been participating in the chats for > 12 months. 81% of respondents reported increased overall knowledge about breast cancer. Increased knowledge through #BCSM was reported in all the following specific domains: 86% survivorship, 80% metastatic breast cancer, 70% cancer types and biology, 66% clinical trials and research, 56% treatment options, 56% breast imaging, 54% genetic testing and risk assessment, and 43% radiotherapy. 31% reported that participation led them to seek a second opinion or bring additional information to the attention of their treatment team. 73% percent reported plans to increase their outreach and advocacy efforts as a result of participation. Levels of reported anxiety before and after participation were analyzed. 29 of 43 patients (67%) who initially reported “high or extreme” anxiety reported “low or no” anxiety after participation (p < 0.001). Also, no patients initially reporting “low or no” anxiety prior to participation reported an increase to “high or extreme anxiety” after participation. Conclusions: While many online breast cancer patient resources exist, data documenting patient educational benefits of participation are lacking. This study demonstrates that breast cancer patients’ perceived knowledge can be increased and that their anxiety can be decreased by participation in a Twitter social media support group.