bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of brain metastases from thyroid carcinoma
Authors: McWilliams Robert R. , Giannini Caterina , Hay Ian D. , Atkinson John L. , Stafford Scott L. , Buckner Jan C. 
Published: July 2003

AbstractBACKGROUNDBrain metastasis is an uncommon, morbid complication of metastatic thyroid carcinoma. Because of its rarity, management often is problematic. To help contribute to the management of this disease entity, the authors present herein what to their knowledge is the largest series reported to date in which all patients had biopsy proven confirmation of their brain metastases.METHODSThe authors report a series of 16 patients with metastatic thyroid carcinoma to the brain who were treated between 1976–2000. The Mayo Clinic database was used to locate and review charts and radiology and pathology reports, and all biopsy specimens were reviewed by one pathologist. The histologic types of carcinoma included 10 papillary carcinomas, 2 follicular carcinomas, 1 Hürthle cell carcinoma, 1 medullary carcinoma, 1 insular carcinoma, and 1 anaplastic carcinoma. Given the small sample size, statistical analyses were not performed.RESULTSSurgical resection of brain metastases was associated with a trend toward longer survival (20.8 months vs. 2.7 months for no surgical intervention in selected patients) Whole brain external beam radiation therapy produced disease regression in three of the four evaluable patients. Gamma knife radiosurgery and radioactive iodine therapy appear to play limited, but beneficial, therapeutic roles. Overall, survival after the diagnosis of brain metastasis is reported to be longer than that noted with other solid tumors (17.4 months), and the majority of patients die of their extracranial disease (85% in the current series).CONCLUSIONSThe results of the current study indicate that local therapies appear to control brain metastases in the large majority of thyroid carcinoma patients with metastases to the brain. Cancer 2003;98:356–62. © 2003 American Cancer Society.DOI 10.1002/cncr.11488
Probably benign lesions at breast magnetic resonance imaging
Authors: Liberman Laura , Morris Elizabeth A. , Benton Catherine L. , Abramson Andrea F. , Dershaw D. David 
Published: July 2003

AbstractBACKGROUNDThe purpose of the current study was to determine the frequency of ‘probably benign’ interpretations at breast magnetic resonance (MR) imaging screening of high‐risk women and the frequency of subsequent malignancy in these women.METHODSThe authors performed a retrospective review of the records of 367 asymptomatic women with normal mammograms who had a high risk of developing breast cancer and whose first breast MR imaging screening examinations occurred during a 2‐year period. The number of “probably benign” interpretations was determined, and follow‐up data were obtained.RESULTSA “probably benign” interpretation was given to 89 (24%) of 367 women. Follow‐up MR imaging was performed for 70 (79%) of 89 women, with a median follow‐up time of 11 months (range, 1–24 months). Twenty women subsequently underwent biopsy at a median of 9 months (range, 1–18 months) after MR imaging, due to progression on follow‐up MR imaging (n = 14) or for other reasons (n = 6). Malignancies were found in 9 women, constituting 45% of the 20 women who underwent biopsy and 10% of the 89 women with probably benign lesions. In 6 of the 9 women who developed malignant disease (7% of the 89 women in the study), the malignancy was detected by follow‐up MR imaging of an area that previously was interpreted as probably benign. Tumor histology was ductal carcinoma in situ (DCIS) in five patients and infiltrating ductal carcinoma in four.CONCLUSIONSA “probably benign” interpretation was given to 24% of high‐risk women at their first breast MR imaging screening examination. In 7–10% of women with “probably benign” interpretations, malignant disease subsequently developed in an area initially judged to be probably benign; of these malignancies, more than half were DCIS, and more than half were detected by MR imaging only. Cancer 2003;98:377–88. © 2003 American Cancer Society.DOI 10.1002/cncr.11491
High expression of cathepsin B in transitional bladder carcinoma correlates with tumor invasion
Authors: Eiján Ana M. , Sandes Eduardo O. , Riveros María D. , Thompson Sebastián , Pasik Leonardo , Mallagrino Hector , Celeste Francisco , Casabé Alberto R. 
Published: July 2003

AbstractBACKGROUNDCathepsin B (CB) is a lysosomal cysteine proteinase synthesized as a zymogen of 39–47 kilodaltons (kD), which is subsequently converted into an active single‐ chain form of 33 kD (CB33) and, by additional processing, into the active 2‐chain form containing a heavy chain of 27–29 kD (CB27‐29) and a light chain of 4–6 kD. Increased or altered CB expression has been documented in a variety of tumor cells, but to the authors' knowledge only one study published to date has reported clinicopathologic significance for CB in transitional cell carcinoma (TCC) of the bladder.METHODSIn this work, CB expression was determined by Western blot analysis in TCC bladder tissue from 30 patients. Nontumor bladder tissue was also analyzed for CB expression.RESULTSThe study results demonstrate higher expression of CB in TCC invasive tumors than in superficial bladder carcinoma. Furthermore, whereas normal bladder only expressed the 29‐kD CB protein, tumor and peritumoral tissue demonstrated the 27‐ to 29‐kD CB form. Immunohistochemical staining did not evidence changes in CB localization between tumor and nontumor tissue.CONCLUSIONSAccording to the results of the current study, bladder tumor progression appears to be associated with quantitative changes in CB protein expression, as well as with qualitative changes related to the type of CB expressed. Cancer 2003;98:262–8. © 2003 American Cancer Society.DOI 10.1002/cncr.11493
Phase II trial of paclitaxel, estramustine, etoposide, and carboplatin in the treatment of patients with hormone‐refractory prostate carcinoma
Authors: Smith David C. , Chay Christopher H. , Dunn Rodney L. , Fardig Jude , Esper Peg , Olson Karin , Pienta Kenneth J. 
Published: July 2003

AbstractBACKGROUNDPreclinical data suggest that the combination of intravenous (i.v.) paclitaxel, carboplatin, oral etoposide, and oral estramustine (TEEC) has significant activity in patients with advanced, hormone‐refractory prostate carcinoma. The authors conducted this clinical trial to evaluate the addition of carboplatin to the three‐drug combination of paclitaxel, estramustine, and etoposide (TEE).METHODSTwenty patients with carcinoma of the prostate that was progressing despite hormone therapy were enrolled on this Phase II trial. Patients were treated with oral estramustine, 280 mg three times daily, and oral etoposide, 50 mg/m2, once daily on Days 1–7, with i.v. paclitaxel, 135 mg/m2, over 1 hour followed by carboplatin (area under the curve, 5) on Day 2 of each 21‐day treatment cycle. Patients were evaluated for response after three cycles, and three additional cycles were given to responding or stable patients.RESULTSNineteen patients were evaluable for response, and 12 patients had measurable disease at baseline. The measurable response rate was 58% (7 of 12 patients; 95% confidence interval [95% CI], 28–85%), and all of those were partial responses. Eleven patients had decreases > 50% from their baseline prostate specific antigen levels during therapy, for a response rate of 58% (95% CI, 34–80%) by this criterion. The median time to disease progression was 5.5 months, with a median survival of 14.2 months. Major toxicities included Grade (according to version 2 of the National Cancer Institute Common Toxicity Criteria) 4 neutropenia in 4 patients, Grade 4 thrombocytopenia in 4 patients, and anemia ≥ Grade 3 in 4 patients. One patient had a deep vein thrombosis.CONCLUSIONSThe combination of TEEC was active in patients with hormone‐refractory prostate carcinoma. The regimen was tolerable, with primarily hematologic toxicity. The addition of carboplatin to TEE did not appear to add to the efficacy of the three‐drug combination of antimicrotubule agents. Cancer 2003;98:269–76. © 2003 American Cancer Society.DOI 10.1002/cncr.11494
Treatment and prognosis of patients with intracranial nongerminomatous malignant germ cell tumors
Authors: Ogawa Kazuhiko , Toita Takafumi , Nakamura Katsumasa , Uno Takashi , Onishi Hiroshi , Itami Jun , Shikama Naoto , Saeki Naokatsu , Yoshii Yoshihiko , Murayama Sadayuki 
Published: July 2003

AbstractBACKGROUNDThe relative roles of surgical resection, radiotherapy, and chemotherapy in the management of patients with intracranial nongerminomatous malignant germ cell tumors have been controversial. The authors retrospectively investigated the results of different treatment regimens in patients with these tumors.METHODSThe records of 41 patients who were treated between 1981 and 2001 were reviewed. They were grouped into patients with a good prognosis (n = 3), an intermediate prognosis (n = 24), and a poor prognosis (n = 14) based on the histology of their tumors. Fifteen patients (37%) underwent surgical resection and received radiotherapy, and 26 patients (63%) also received chemotherapy. The median follow‐up of 18 patients who remained alive was 61 months (range, 14–194 months).RESULTSThe 5‐year actuarial overall survival rates for patients in the good prognosis, intermediate prognosis, and poor prognosis groups were 100%, 68%, and 8%, respectively. In the analysis, histology alone had a statistically significant impact on overall survival (P < 0.0001). All 3 patients in the good prognosis group were treated successfully with surgical resection and radiotherapy. In the intermediate prognosis group, the 5‐year actuarial overall survival rate was 44% for patients who underwent surgical resection and received radiotherapy (n = 9) and 84% for patients who also received chemotherapy (n = 15; P = 0.01). Patients in the poor prognosis group who underwent surgical resection and received radiotherapy (n = 3) or who underwent incomplete resection and received both radiotherapy and chemotherapy (n = 8) all died of disease, whereas 2 of 3 patients who underwent macroscopic total resection and received both radiotherapy and chemotherapy survived free of disease.CONCLUSIONSThe treatment of patients with intracranial nongerminomatous malignant germ cell tumors should be based on tumor histology. For patients who had a good prognosis (mature teratoma with germinoma), surgical resection and radiotherapy were sufficient; however, for patients in the intermediate prognosis group, multimodal treatment, including surgical resection, radiotherapy, and chemotherapy, was effective. Conversely, for patients in the poor prognosis group, more intensive multimodal treatment, including macroscopic total resection, may improve the survival rate. Cancer 2003;98:369–76. © 2003 American Cancer Society.DOI 10.1002/cncr.11495
Hepatic cryotherapy and regional chemotherapy with or without resection for liver metastases from colorectal carcinoma
Authors: Yan Dong Bo , Clingan Philip , Morris David L. 
Published: July 2003

AbstractBACKGROUNDThe number of hepatic metastases for which resection or ablation is appropriate remains controversial.METHODSA retrospective analysis was performed of prospectively collected data from patients with liver metastases from colorectal carcinoma who underwent hepatic cryotherapy and hepatic arterial chemotherapy (HAC) with or without undergoing resection. Patients routinely had preoperative bone scans, chest computed tomography (CT) scans, and abdominal angio‐CT scans. Positron emission tomography scans were unavailable. All patients were followed until June 2002 or until death occurred. Kaplan–Meier and Cox regression methods were used to evaluate the impact of 17 potentially prognostic factors on survival.RESULTSOne hundred seventy‐two patients who underwent hepatic cryotherapy and HAC with or without undergoing liver resection for in situ eradication of metastases formed the basis of this report. One patient (0.6%) died postoperatively from myocardial infarction. The morbidity rate was 27.9%. The median survival was 28 months (range, 0–98 months). The factors age ≤ 50 years, well‐differentiated or moderately differentiated primary tumor, small cryolesions (< 3.5 cm), complete eradication of extrahepatic metastases at cryotherapy, and low preoperative carcinoembryonic antigen (CEA) levels were associated independently with a favorable outcome. In addition, a univariate analysis showed that the absence of untreated extrahepatic disease at laparotomy, postoperative CEA normalization, and a large decline in CEA levels were significant statistically. The number of lesions was not prognostic. One hundred forty‐six patients (84.9%) who underwent a complete operation had 1‐year, 2‐year, 3‐year, 4‐year, and 5‐year survival rates of 89%, 65%, 41%, 24%, and 19%, respectively. The median survival of patients with 1 metastasis, 2 metastases, 3 metastases, 4 metastases, 5 metastases, 6 or 7 metastases, and 8–12 metastases were 32 months, 29 months, 30 months, 31 months, 27 months, 37 months, and 21 months, respectively (P = 0.7859). Twenty‐five patients had 6 or 7 lesions, and their 5‐year survival rate was 25%.CONCLUSIONSWhen all colorectal hepatic lesions were eradicated, the numbers of hepatic metastases were not prognostic of survival in patients with liver metastases from colorectal carcinoma. Cancer 2003;98:320–30. © 2003 American Cancer Society.DOI 10.1002/cncr.11498
Prolonged gemcitabine infusion in advanced non–small cell lung carcinoma
Authors: Ceribelli Anna , Gridelli Cesare , De Marinis Filippo , Fabi Alessandra , Gamucci Teresa , Cortesi Enrico , Barduagni Maria , Antimi Mauro , Maione Paolo , Migliorino Maria R. , Giannarelli Diana , Cognetti Francesco 
Published: July 2003

AbstractBACKGROUNDPreclinical and clinical evidence suggests that a fixed infusion rate of 10 mg/m2 per minute may be more effective than the standard 30‐minute infusion of gemcitabine. To investigate the activity and toxicity of the cisplatin plus gemcitabine combination with gemcitabine at a fixed infusion rate in patients with advanced non–small cell lung carcinoma (NSCLC), the authors conducted a randomized Phase II trial of cisplatin plus gemcitabine at the 30‐minute standard infusion (calibration arm) or cisplatin plus gemcitabine at a fixed infusion rate (experimental arm).METHODSA total of 112 chemonaive patients with advanced NSCLC entered the study: 57 patients in Arm A and 55 patients in Arm B. The patients were randomly assigned to receive gemcitabine at a dose of 1000 mg/m2 on Days 1, 8, and 15 over 30 minutes (Arm A) or at a rate of 10 mg/m2 per minute (Arm B). In both treatment arms, cisplatin at a dose of 80 mg/m2 was administered on Day 15 every 28 days.RESULTSThe overall response rates in Arms A and B were 26% (95% confidence interval [95% CI], 10–42%) and 34% (95% CI, 17–52%) (intent‐to‐treat‐analysis), respectively. The median time to disease progression was 6 months (range, 1–26 months) and 8 months (range, 2–21 months), respectively, for Arms A and B and the median overall survival was 13 months (range, 2–26 months) for each arm. It is interesting to note that a high response rate (67%) of brain metastases was noted in the experimental arm. Toxicity was tolerable and comparable in the two arms.CONCLUSIONSThe results of this randomized Phase II trial demonstrated that cisplatin plus gemcitabine with gemcitabine at fixed infusion rate (10 mg/m2 per minute) is active and well tolerated in patients with advanced NSCLC. Cancer 2003;98:337–43. © 2003 American Cancer Society.DOI 10.1002/cncr.11501
Megestrol acetate in pediatric oncology patients may lead to severe, symptomatic adrenal suppression
Authors: Orme Lisa M. , Bond Jodie D. , Humphrey Maureen S. , Zacharin Margaret R. , Downie Peter A. , Jamsen Kris M. , Mitchell Susan L. , Robinson Jacqueline M. , Grapsas Natalie A. , Ashley David M. 
Published: July 2003

AbstractBACKGROUNDDespite the widespread use of megestrol acetate (MA) among a growing number of pediatric oncology departments, there is only one published study on the use of MA in children with malignant disease. The objectives of the current study were to examine the effect of MA in improving the nutritional status of children with malignant disease and to describe and consider the implications of MA‐associated adrenal suppression that was found consistently.METHODSMedical records of 19 children with malignant disease who were treated with MA were reviewed. During MA therapy, clinical assessments every 4 weeks included anthropometrics, caloric intake, quality‐of‐life scores, and appetite scores. Serum cortisol levels, lipid profiles (including cholesterol levels) random blood glucose levels, and coagulation screening were measured at 4–6‐week intervals.RESULTSMA use was associated with significant increases in weight, weight z score, middle‐upper arm circumference, triceps skin‐fold thickness, appetite, and caloric intake. MA was extremely useful in aiding the efficient tapering of nasogastric feeds. However, a significant and potentially dangerous decrease in cortisol was seen in 10 of 11 patients tested, with 1 patient who manifested clinical hypoadrenalism with hemodynamic collapse, requiring inotropic support. This is the first report of MA‐associated clinical adrenal suppression in a child with malignant disease.CONCLUSIONSAlthough the results of this study support the ability of MA to improve nutritional status, its use was complicated by severe adrenal suppression in almost all patients tested, with a serious clinical adverse event occurring in one patient. Routine hydrocortisone supplementation throughout MA treatment should be considered as well as larger doses for patients with acute illness and patients who undergo surgery. Cancer 2003;98:397–405. © 2003 American Cancer Society.DOI 10.1002/cncr.11502
Evaluation of pain associated with oral mucositis during the acute period after administration of high‐dose chemotherapy
Authors: Cella David , Pulliam Janis , Fuchs Henry , Miller Carole , Hurd David , Wingard John R. , Sonis Stephen T. , Martin Paul J. , Giles Francis 
Published: July 2003

AbstractBACKGROUNDNo single oral mucositis (OM) assessment scale is universally accepted; the most commonly used scales are deficient because they combine subjective and objective measures and do not capture the patient's perspective. Because pain is the hallmark symptom of OM, the authors sought to determine whether a simple measure of patient‐reported pain was correlated with objective, physician‐assessed measures of OM. The findings of the current study may provide a clinical context for understanding the relation between objective indicators and patients' perceptions of OM.METHODSThree hundred twenty‐three patients receiving stomatotoxic chemotherapy and randomized to receive either iseganan or placebo for treatment of OM underwent periodic objective and subjective evaluations of OM. Objective measures included clinician scoring of stomatitis and dysphagia using the National Cancer Institute Common Toxicity Criteria scales. A subjective measure was obtained by having patients complete a questionnaire (with questions based on an 11‐point numeric scale) regarding oral pain.RESULTSMore than 90% of scheduled oral assessments were obtained. Mouth pain scores were closely related to stomatitis and dysphagia; peak mouth pain coincided with peak stomatitis and dysphagia. Analgesic use increased by 0.7 days for each unit rise on the pain scale. Patients receiving iseganan had a significantly lower level of peak mouth pain than did patients receiving placebo (P = 0.041).CONCLUSIONSA separate measurement of patient‐reported pain was useful for capturing the patient's perspective on OM and was correlated with the physician's objective assessment. These findings support the use of a simple, patient‐reported rating of mouth pain as a clinically relevant and responsive endpoint in clinical trials. This rating system also may provide a straightforward method of following OM in clinical practice. Cancer 2003;98:406–12. © 2003 American Cancer Society.DOI 10.1002/cncr.11505
Reduced bikunin gene expression as a factor of poor prognosis in ovarian carcinoma
Authors: Tanaka Yoshiko , Kobayashi Hiroshi , Suzuki Mika , Kanayama Naohiro , Suzuki Mitsuaki , Yamakawa Toru , Morishita Hideaki , Terao Toshihiko 
Published: July 2003

AbstractBACKGROUNDIn previous studies, the authors showed that various types of cultured tumor cells treated with exogenous bikunin protein or ovarian carcinoma cells transfected with bikunin cDNA have low invasiveness and diminished metastatic potential. This study was carried out to clarify the relation between the expression of individual bikunin mRNA and tumor progression.METHODSForty‐one newly diagnosed ovarian carcinomas were investigated using a semiquantitative reverse transcriptase‐polymerase chain reaction.RESULTSThe authors found that 24 patients had tumors that overexpressed bikunin and that gene expression was reduced in the tumors of the remaining 17 individuals. Bikunin mRNA expression was independent of age, surgical stage, tumor size, degree of differentiation, histologic subtype, and serum CA 125 levels. There was a significant correlation between low expression of bikunin mRNA and lymph node status (P = 0.035) or peritoneal status (P = 0.042). Multivariate analysis indicated that bikunin was an independent prognostic marker (P = 0.013; hazard ratio, 2.30; 95 % confidence interval, 1.13–4.19), even after controlling for lymph node metastasis and the degree of peritoneal dissemination. In addition, low expression was a significant predictor for poor prognosis compared with high expression (2‐year survival rate; 75.0 % vs. 47.1 %, respectively; P < 0.05).CONCLUSIONSThe data suggest that low bikunin mRNA expression by ovarian cacinoma cells may be associated with poor prognosis. It is conceivable that testing for bikunin mRNA may identify patients with ovarian carcinoma who are at high risk for early disease recurrence and a poor prognosis. Cancer 2003;98:424–30. © 2003 American Cancer Society.DOI 10.1002/cncr.11506
Outcome predictors of 84 patients with hematologic malignancies and Fusarium infection
Authors: Nucci Marcio , Anaissie Elias J. , Queiroz‐Telles Flavio , Martins Carlos A. , Trabasso Plínio , Solza Cristiana , Mangini Claudia , Simões Belinda P. , Colombo Arnaldo L. , Vaz Jorge , Levy Carlos E. , Costa Silvia , Moreira Vaneusa A. , Oliveira José Salvador , Paraguay Nestor , Duboc Gisele , Voltarelli Julio C. , Maiolino Angelo , Pasquini Ricardo , Souza Cármino A. 
Published: July 2003

AbstractBACKGROUNDInvasive infection by Fusarium sp. is associated with high mortality in patients with hematologic cancer. Yet to the authors' knowledge, little is known regarding predictors of adverse outcome.METHODSThe authors conducted a retrospective review of the records of patients with hematologic carcinoma and invasive fusariosis who were treated at one institution in the U.S. and at 11 centers in Brazil.RESULTSThe records of 84 patients were evaluated. Neutropenia was present in 83% and 33 patients had undergone stem cell transplantation. Only 18 patients (21%) were alive 90 days after the diagnosis of fusariosis. Multivariate predictors of poor outcome were persistent neutropenia (hazard ratio [HR] of 5.43; 95% confidence interval [95% CI], 2.64–11.11) and use of corticosteroids (HR of 2.18; 95% CI, 1.98–3.96). The actuarial survival rate of patients without any of these factors was 67% compared with 30% for patients who recovered from neutropenia but were receiving corticosteroids and 4% for patients with persistent neutropenia only. None of the patients with both risk factors survived (P < 0.0001).CONCLUSIONSMeasures to reduce the duration of neutropenia, as well as the judicious use of corticosteroids, may reduce the high mortality rate of fusariosis in patients with hematologic cancer. Cancer 2003;98:315–9. © 2003 American Cancer Society.DOI 10.1002/cncr.11510