bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thalidomide for patients with recurrent lymphoma
Authors: Pro Barbara , Younes Anas , Albitar Maher , Dang Nam H. , Samaniego Felipe , Romaguera Jorge , McLaughlin Peter , Hagemeister Fredrick B. , Rodriguez Maria A. , Clemons Marilyn , Cabanillas Fernando 
Published: March 2004

AbstractBACKGROUNDThalidomide has significant clinical activity in patients with multiple myeloma. However, its activity against other lymphoid tumors is unknown. The authors reported their experience with thalidomide in patients with recurrent/refractory non‐Hodgkin lymphoma and in patients with Hodgkin disease.METHODSNineteen patients (median age, 62 years) who had undergone a median of 5 previous treatment regimens were treated with escalating doses of thalidomide (200–800 mg per day) until disease progression or prohibitive toxicity was observed. The authors measured serum levels of angiogenesis factors before and after treatment.RESULTSOne patient (5%) with evidence of recurrent gastric mucosa—associated lymphoid tissue lymphoma achieved a complete response, and 3 patients (16%) achieved stable disease.CONCLUSIONSThe current study suggests that thalidomide has limited single‐agent activity in heavily pretreated patients with recurrent or refractory lymphoma. Cancer 2004. © 2004 American Cancer Society.
Salvage chemotherapy with cyclophosphamide for recurrent, temozolomide‐refractory glioblastoma multiforme
Authors: Chamberlain Marc C. , Tsao‐Wei Denice D. 
Published: March 2004

AbstractBACKGROUNDThe primary objective of the current prospective Phase II study of cyclophosphamide (CYC) in adult patients with recurrent, temozolomide‐refractory glioblastoma multiforme was to evaluate 6‐month progression‐free survival (PFS).METHODSForty patients (28 men and 12 women) ages 28–67 years (median age, 51.5 years), with recurrent glioblastoma multiforme were treated. All patients had been treated previously with surgery and involved‐field radiotherapy (median dose, 60 grays [Gy]; range, 59–61 Gy). In addition, all patients were treated adjuvantly with either nitrosourea‐based chemotherapy (21 patients: procarbazine, lomustine, and vincristine in 13 patients; carmustine in 8 patients) or temozolomide (19 patients). Twenty‐one patients who were treated previously with a nitrosourea were treated with temozolomide at the time of first recurrence. Twenty‐one patients were treated with CYC at the time of second recurrence, and 19 patients were treated with CYC at the time of first recurrence. CYC was administered intravenously on 2 consecutive days (750 mg/m2 per day) every 4 weeks (operationally defined as a single cycle). Neurologic and neuroradiographic evaluations were performed every 8 weeks.RESULTSAll patients were evaluable. In total, 170 cycles of CYC (median, 2 cycles; range, 2–12 cycles) were administered. CYC‐related toxicity included alopecia in all patients (100%), anemia in 6 patients (3.5%), thrombocytopenia in 7 patients (4.1%), and neutropenia in 9 patients (5.3%). Four patients required transfusions (two required red blood cell transfusion, and two required platelet transfusion). One patient developed neutropenic fever without bacteriologic confirmation. No treatment‐related deaths occurred. Seven patients (17.5%; 95% confidence interval [95% CI], 8–33%) exhibited a neuroradiographic partial response, 11 patients (27.5%; 95% CI, 15–44%) had stable disease, and 22 patients (55%) had progressive disease after a single cycle of CYC. The time to tumor progression ranged from 2 months to 18 months (median, 2 months). Survival ranged from 3 months to 24 months (median, 4 months). In patients with either a neuroradiographic response or stable disease (n = 18 [45%]), the median time to tumor progression was 6 months (range, 4–18 months; 95% CI, 6–8 months), and the median survival was 10 months (range, 5–24 months; 95% CI, 8–10 months). The 6‐month PFS rate was 20%.CONCLUSIONSCYC exhibited modest efficacy with acceptable toxicity in the current cohort of adult patients with recurrent glioblastoma multiforme, all of whom had previously experienced treatment failure after temozolomide chemotherapy. Cancer 2004. © 2004 American Cancer Society.
Pegylated liposomal doxorubicin‐efficacy in patients with recurrent high‐grade glioma
Authors: Hau Peter , Fabel Klaus , Baumgart Ulrike , Rümmele Petra , Grauer Oliver , Bock Annekatrin , Dietmaier Christopher , Dietmaier Wolfgang , Dietrich Jörg , Dudel Christine , Hübner Franz , Jauch Tanya , Drechsel Elisabeth , Kleiter Ingo , Wismeth Cäcile , Zellner Anton , Brawanski Alexander , Steinbrecher Andreas , Marienhagen Jörg , Bogdahn Ulrich 
Published: March 2004

AbstractBACKGROUNDDoxorubicin exhibits high efficacy in malignant glioma cell cultures. Nonetheless, as a standard formulation, doxorubicin has not been used clinically, due to poor penetration of the blood‐brain barrier. Furthermore, doxorubicin is known to induce tumor resistance genes. To address both of these issues, the authors investigated the use of pegylated liposomal doxorubicin (Caelyx™; Essex Pharma, Munich, Germany) alone (Trial 1) and in combination with tamoxifen (Trial 2) in two sequentially performed nonrandomized prospective Phase II trials involving patients with recurrent high‐grade glioma.METHODSTwenty patients were included in each trial. Progression‐free survival at 6 months (PFS‐6) and toxicity were the primary endpoints. Expression of the tumor resistance proteins multidrug resistance protein 1 (MDR‐1) and multiple resistance protein (MRP) was evaluated by immunohistochemical methods and by sestamibi–single‐photon emission computed tomography (SPECT).RESULTSThe overall response rate (including cases of disease stabilization) was 40% in both Trial 1 and Trial 2. PFS‐6 was 15%, and the median time to disease progression was 17 weeks. It is noteworthy that 40% of patients with Grade III tumors had long‐term responses, which lasted for up to 3 years. There was no significant difference between Trial 1 and Trial 2 in terms of efficacy. Both regimens were well tolerated, with the main side effect being palmoplantar erythrodysesthesia. The authors found no correlation between clinical response and expression of tumor resistance genes or between clinical response and SPECT data.CONCLUSIONSPegylated liposomal doxorubicin administered alone or in combination with tamoxifen is safe and moderately effective in patients with recurrent high‐grade glioma. None of the putative predictors for response that were evaluated proved to be significant in this setting. Cancer 2004. © 2004 American Cancer Society.
A multicenter study of the prognosis and treatment of adult brain ependymal tumors
Authors: Reni Michele , Brandes Alba Ariela , Vavassori Vittorio , Cavallo Giovanna , Casagrande Federica , Vastola Francesca , Magli Alessandro , Franzin Alberto , Basso Umberto , Villa Eugenio 
Published: March 2004

AbstractBACKGROUNDThe current analysis of outcomes in a large series of adult patients with intracranial ependymal tumors contributes to the characterization of the primary prognostic factors and to the therapeutic management of this rare disease, for which limited information is available in the literature.METHODSThe authors analyzed data on patient and tumor characteristics, treatment, and survival in a series of 70 patients age > 17 years with pathologic diagnoses of brain ependymal tumors from 4 institutions.RESULTSThe 5‐ and 10‐year overall survival (OS) rates (± standard errors) were 67% ± 6% and 50% ± 8%, respectively. The 5‐ and 10‐year failure‐free survival (FFS) rates were 43% ± 7% and 24% ± 6%, respectively. Younger age and infratentorial tumor location were associated with longer survival. Among patients with Grade 2 ependymoma (n= 51), 21 (41%) received no postsurgical treatment. These 21 patients had a 5‐year OS rate of 78% ± 10% and a 10‐year OS rate of 68% ± 13%; the 5‐ and 10‐year FFS rates for these patients were 47% ± 12% and 12% ± 11%, respectively. Twenty‐six patients with Grade 2 ependymoma (51%) received postoperative radiotherapy (RT). These 26 patients had a 5‐year OS rate of 71% ± 9% and a 10‐year OS rate of 59% ± 11%; the 5‐ and 10‐year FFS rates for these patients were 54% ± 10% and 34% ± 10%, respectively. Among patients with Grade 2 ependymoma, neither OS nor FFS differed significantly between those who did not receive postoperative RT and those who did; however, these two groups were heterogeneous with respect to prognostic factors. On multivariate analysis, RT use exhibited a trend toward improved OS and was significantly predictive of improved FFS.CONCLUSIONSThe current analysis does not rule out the possibility that deferral of RT at the time of recurrence could have a detrimental effect on FFS or OS in patients with Grade 2 ependymoma, regardless of the degree of ablation. The role of postoperative RT for patients who undergo imaging‐based macroscopic total resection remains to be addressed. Cancer 2004. © 2004 American Cancer Society.
The histologic grade is a main prognostic factor for patients with intracranial ependymomas treated in the microneurosurgical era
Authors: Korshunov Andrey , Golanov Andrey , Sycheva Regina , Timirgaz Valery 
Published: March 2004

AbstractBACKGROUNDEpendymomas account for 3–5% of all intracranial malignancies and occur most often in children and young adults. These neoplasms continue to generate considerable controversy with regard to their rational clinical management. It has been shown that the histologic classification of ependymoma is a significant predictor of clinical outcome in patients with ependymoma.METHODSEpendymomas from 258 patients who underwent microsurgery at a single institution were evaluated histologically to elucidate the prognostic utility of a recently proposed grading scheme. Pathologic and clinical data then were compared using univariate and multivariate analyses.RESULTSIncreasing grade of ependymoma malignancy was found to be associated strongly and independently with worse clinical outcomes in terms of both event‐free survival and overall survival. The effect of radiotherapy also was found to be related to histologic grade and was more beneficial for patients who had anaplastic ependymomas and had undergone complete tumor removal.CONCLUSIONSThe application of a uniform diagnostic criteria for grading ependymomas highlighted the key role of tumor histology in clinical outcome in a cohort of patients who were treated in the microsurgical era. The recently proposed grading scheme is likely to be practically useful, reproducible, and clinically applicable. Cancer 2004. © 2004 American Cancer Society.
Optimism and survival in lung carcinoma patients
Authors: Schofield Penelope , Ball David , Smith Jennifer G. , Borland Ron , O'Brien Peter , Davis Sidney , Olver Ian , Ryan Gail , Joseph David 
Published: March 2004

AbstractBACKGROUNDIt is popular belief that the psychologic response to a diagnosis of cancer influences survival in patients with cancer; however, research has produced contradictory results. In this prospective study, the authors investigated the relation between pretreatment levels of optimism and survival in patients with nonsmall cell lung carcinoma (NSCLC).METHODSTwo hundred four patients who were participating in a randomized trial that compared accelerated and conventional radiotherapy with and without carboplatin chemotherapy were asked to complete two questionnaires assessing optimism. The first assessment was just prior to commencing treatment and the second assessment took place after completing treatment. Survival was measured from the date of randomization to the date of death. Surviving patients were followed until February 8, 2001.RESULTSThe pretreatment questionnaire was completed by 179 patients, and 148 of those patients completed the posttreatment questionnaire. There was a small but significant reduction in optimism scores after treatment (P = 0.005). There was no association noted between pretreatment optimism and progression‐free survival (P = 0.52, unadjusted; P = 0.22, adjusted for Eastern Cooperative Oncology Group performance status and patient age), nor was there an association noted between pretreatment optimism and overall survival (P = 0.36, unadjusted; P = 0.19, adjusted for disease stage).CONCLUSIONSThere was no evidence that a high level of optimism prior to treatment enhanced survival in patients with NSCLC. Encouraging patients to “be positive” only may add to the burden of having cancer while providing little benefit, at least in patients with NSCLC. Cancer 2004. © 2004 American Cancer Society.
Frequency and risk factors for meningioma in clinically healthy 75‐year‐old patients
Authors: Krampla Wolfgang , Newrkla Stephan , Pfisterer Wolfgang , Jungwirth Susanne , Fischer Peter , Leitha Thomas , Hruby Walter , Tragl Karl Heinz 
Published: March 2004

AbstractBACKGROUNDThe prevalence of clinically silent intracranial tumors in specific populations is poorly researched. It is known that, in advanced age groups, the number of clinically manifest meningiomas constitute a small proportion of the actual number of cases. The goals of the current study were to determine the frequency of asymptomatic patients with meningioma in advanced age and to identify risk factors for meningiomas in this population.METHODSBetween May 2000 and November 2002, 532 probands from a specifically defined geographic area of Vienna who were age 75 years underwent a magnetic resonance imaging scan of the brain and were evaluated for the presence of a space‐occupying mass. All probands were examined clinically and neurologically as well as by a neuropsychiatrist. The patients' medical histories were carefully documented with regard to previous diseases, medication, and lifestyle, as were their laboratory reports. The collected data were correlated and similarities among subjects with meningioma were determined.RESULTSNine meningiomas that were unknown until the time of investigation were observed among the 318 women included in the trial (corresponding to a calculated prevalence of 2800/100,000 clinically silent meningiomas in 75‐year‐old women). No tumors were found among men. Associated clinical changes or deficits were not observed in any subject. Apart from advanced age and female gender, no other accepted or well known risk factors were observed in the tumor patients.CONCLUSIONSClinically quiescent meningiomas in the elderly female population were more common than was believed to be the case to date. Known and influenceable risk factors were found to be less important than age and gender. The high frequency of this lesion should be considered when deciding on the treatment of patients with incidentally discovered, clinically quiescent meningiomas. Cancer 2004. © 2004 American Cancer Society.
Quality of colon carcinoma pathology reporting
Authors: Wei Jeffrey T. , Miller Eric A. , Woosley John T. , Martin Christopher F. , Sandler Robert S. 
Published: March 2004

AbstractBACKGROUNDIn 1996, the Association of Directors of Anatomic and Surgical Pathology (ADASP) published recommendations for colon carcinoma reporting. Since this publication, no study has evaluated physician practice in relation to these recommendations. The objectives of the current study were to describe pathology reporting for colon carcinoma, evaluate potential variations in reporting, and identify areas for improvement.METHODSData were obtained from a population‐based study of incident colon carcinoma in 33 counties in North Carolina between 1997 and 2000. All subjects with surgically resected colon carcinoma of tumor stage T2–T4 with available surgical pathology reports were eligible for inclusion in the current analysis. The authors reviewed pathology reports for adherence to recommendations of the ADASP.RESULTSFour hundred thirty‐eight pathology reports were included for analysis. Adherence to ADASP recommendations was < 90% for descriptions of how specimen was received (68%), how specimen was identified (71%), macroscopic depth of penetration (82%), appearance of serosa adjacent to tumor (50%), and status of residual bowel (73%). All other criteria were reported in > 90% of patients. Teaching hospital and contract pathology laboratories had greater adherence to recommendations, compared with community hospital laboratories. Hospitals with the highest colon carcinoma case volume demonstrated greater adherence to recommendations, compared with low‐volume hospitals.CONCLUSIONSPathology reports were effective in communicating most pertinent findings from surgically resected colon carcinoma specimens. Omissions of some critical characteristics did occur, however, and significant variability in reporting existed based on laboratory affiliation and hospital case volume. Cancer 2004. © 2004 American Cancer Society.
Fractionated low‐dose radiotherapy after myeloablative stem cell transplantation for local control in patients with high‐risk neuroblastoma
Authors: Bradfield Scott M. , Douglas James G. , Hawkins Douglas S. , Sanders Jean E. , Park Julie R. 
Published: March 2004

AbstractBACKGROUNDThe optimal administration of radiotherapy for patients with high‐risk neuroblastoma (NB) currently is undefined in the context of modern therapy using myeloablative chemotherapy with autologous stem cell rescue (hematopoietic stem cell transplantation [HSCT]).METHODSThe authors conducted a retrospective review of the records of 21 consecutive patients with high‐risk NB to assess local control and toxicity of external beam radiotherapy (XRT). Therapy included multiagent induction chemotherapy and delayed surgical resection, consolidation of HSCT and local XRT, and 13‐cis‐retinoic acid maintenance therapy. XRT was delivered to the primary site, using postchemotherapy volumes, and to initial metastatic sites with 1–2 cm margins to 2100 centigrays (cGy) using 14 fractions administered once daily.RESULTSFour of 21 patients did not receive XRT due to toxic death (n = 2), disease progression before XRT (n = 1), or parental refusal (n = 1). The median time to XRT post‐HSCT was 54 days. Thirteen patients received a second peripheral blood stem cell infusion after completing XRT. Twelve of the 14 patients who received XRT post‐HSCT and for whom toxicity data were available had Grade 3–4 acute toxicities, including gastrointestinal toxicity (n = 8), hematologic toxicity (n = 9), and infection (n = 1). Nonrecurrent long‐term toxicities included prolonged nutritional deficiency (n = 9) and leg‐length discrepancy (n = 1). Tumors recurred in 7 of 21 patients (5 of 17 patients who received radiotherapy), either within a radiation field (n = 1) or at distant nonirradiated sites (n = 6). The estimated local failure rate was 7% (95% confidence interval [95% CI], 0–14%), with a 2‐year event‐free survival rate of 48% (95% CI, 26–70%).CONCLUSIONSPost‐HSCT, fractionated XRT to 2100 cGy was a tolerable and effective treatment for patients with high‐risk NB, and minimal recurrences were observed at designated XRT sites. Cancer 2004. © 2004 American Cancer Society.
Estimation of an optimal radiotherapy utilization rate for melanoma
Authors: Delaney Geoff , Barton Michael , Jacob Susannah 
Published: March 2004

AbstractBACKGROUNDRadiotherapy is not used commonly in the treatment of patients with malignant melanoma. The benchmark optimal radiotherapy utilization rates for melanoma are largely unknown, despite the fact that melanoma is a very common cancer.METHODSTo develop an evidence‐based benchmark for the optimal proportion of patients with melanoma who should receive radiotherapy, the authors reviewed major treatment guidelines for melanoma. A radiotherapy decision tree was constructed showing the clinical features of melanoma patients for whom radiotherapy was indicated based on evidence. The proportions of melanoma patients with indications for radiotherapy were obtained from epidemiologic data and were used to calculate the optimal proportion of melanoma patients who should receive radiotherapy.RESULTSThe proportion of patients with melanoma for whom radiotherapy is indicated at some point in their illness, according to the best available evidence, was calculated at 23% of all melanoma patients. The utilization rates of radiotherapy for melanoma recorded in actual practice were 13% in New South Wales, 6% in data from the American College of Surgeons, and 1% according to Surveillance, Epidemiology, and End Results data.CONCLUSIONSStrategies for implementing the evidence‐based guidelines are recommended to overcome the shortfall in the use of radiotherapy in the treatment of patients with melanoma. Cancer 2004. © 2004 American Cancer Society.
Recurrence‐free survival rates after external‐beam radiotherapy for patients with clinical T1–T3 prostate carcinoma in the prostate‐specific antigen era
Authors: Khuntia Deepak , Reddy Chandana A. , Mahadevan Arul , Klein Eric A. , Kupelian Patrick A. 
Published: March 2004

AbstractBACKGROUNDThe objective of the current study was to report biochemical recurrence–free survival (bRFS) rates among men with T1–T3 prostate carcinoma who were treated with external‐beam radiotherapy (RT) at the Cleveland Clinic Foundation (Cleveland, OH).METHODSIn total, 1352 patients were identified between 1987 and 2000 with a minimum follow‐up of 1 year (median follow‐up, 55 months; range, 12–189 months). The median radiation dose was 74.0 grays (Gy) (range, 63.0–83.0 Gy). The median radiation doses for patients who received < 68.0 Gy (n = 201), 68.0–72.0 Gy (n = 373), and ≥ 72.0 Gy (n = 778) were 66.6 Gy, 70.0 Gy, and 78.0 Gy, respectively. The RT techniques used were standard RT in 41% of patients, 3‐dimensional conformal RT in 34% of patients, and intensity‐modulated RT in 25% of patients. Androgen‐deprivation (AD) therapy lasting ≤ 6 months was administered to 34% of patients.RESULTSThe 5‐year and 7‐year bRFS rates were 63% and 59%, respectively. On multivariate analysis, T classification (P < 0.001), pretreatment prostate‐specific antigen level (P < 0.001), biopsy Gleason score (P = 0.001), radiation dose (P < 0.001), and year of therapy (P < 0.001) were independent predictors of biochemical failure. Age, race, AD therapy, and RT technique did not predict for biochemical failure. For patients with low‐risk tumors, the 5‐year bRFS rates for those who received RT doses of ≤ 68.0 Gy, 68.0–72.0 Gy, and ≥ 72.0 Gy were 52%, 82%, and 93%, respectively (P < 0.001); for patients with intermediate‐risk tumors, the respective 5‐year bRFS rates were 27%, 51%, and 83% (P < 0.001); and for patients with high‐risk tumors, the respective 5‐year bRFS rates were 21%, 29%, and 71%, respectively (P < 0.001).CONCLUSIONSThe most significant therapeutic factor affecting bRFS rates after RT was radiation dose, rather than AD therapy use or radiation technique. Cancer 2004. © 2004 American Cancer Society.