bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Phase III trial of sequential adjuvant chemotherapy for operable breast carcinoma
Authors: Assikis Vasily , Buzdar Aman , Yang Ying , Smith Terry , Theriault Richard , Booser Daniel , Valero Vicente , Walters Ronald , Singletary Eva , Ames Frederick , Hortobagyi Gabriel 
Published: May 2003

AbstractBACKGROUNDThe current study was performed to assess whether sequential potentially noncross‐resistant chemotherapy prolongs disease‐free survival (DFS) and overall survival (OS) in patients with operable breast carcinoma.METHODSSeven hundred eighty‐nine patients were registered and followed for a median of 10 years. They were treated in two groups. In Group 1, patients age < 50 years or age > 50 years but with either negative or unknown estrogen receptor (ER) status were randomized to receive 6 cycles of 5‐fluorouracil, doxorubicin, and cyclophosphamide (FAC) alone or followed by 4 cycles of methotrexate and vinblastine (MV). In Group 2, patients age ≥ 50 years with ER‐positive disease were randomized to receive either tamoxifen or combination chemotherapy (FAC + MV) for 10 cycles. Analysis was performed according to allocated treatment (intention to treat), with all randomized patients included.RESULTSIn Group 1 there were no significant differences with regard to DFS or OS between the two treatment arms. The DFS at 5 years was 0.70 and 0.76, respectively, for FAC compared with FAC+MV (P = 0.26). The OS was similar for both groups (0.84 vs. 0.83). It is interesting to note that there was a statistically nonsignificant trend for improved DFS in the FAC + MV arm for patients who were ER‐positive. In Group 2, tamoxifen alone led to more prolonged DFS compared to FAC+MV (0.78 vs. 0.66, respectively) but this did not reach statistical significance (P = 0.28). OS also was associated with a trend (P = 0.86) toward prolonged survival for the tamoxifen arm compared with the FAC+MV arm (0.85 vs. 0.74, respectively).CONCLUSIONSThe results of the current trial concerning sequential adjuvant chemotherapy for operable breast carcinoma, which to our knowledge contains the longest follow‐up presented to date, failed to demonstrate any additional benefit from the addition of 4 cycles of MV to 6 cycles of FAC chemotherapy. Cancer 2003;97:2716–23. © 2003 American Cancer Society.DOI 10.1002/cncr.11396
Tailored messages, external barriers, and women's utilization of professional breast cancer screening over time
Authors: Lauver Diane Ruth , Settersten Lori , Kane Janet H. , Henriques Jeffrey B. 
Published: May 2003

AbstractBACKGROUNDThe efficacy of tailored messages on women's utilization of professional breast screening over time has not been examined often or in combination with external barriers (e.g., costs and access). The objectives of this study were to test the effects of alternative messages on mammography and clinical breast examination (CBE) utilization over time and to examine the combined effects of such messages and external barriers.METHODSIn a randomized, controlled trial, three message conditions were compared: no message (control group), recommendations about screening, or recommendations plus tailored discussion (on beliefs, feelings, costs, and access). Messages were delivered by advanced practice nurses over the telephone. Participants were women ages 51–80 years who had not had mammography in the prior 13 months. Outcome measures were women's mammography and CBE utilization 3–6 months postintervention (short‐term follow‐up) and 13–16 months after short‐term follow‐up (long‐term follow‐up).RESULTSBoth messages promoted mammography and CBE utilization at short‐term follow‐up. Utilization increased over time in all groups. Mammography utilization was greater for the tailored‐message group compared with the recommendations‐only group at long‐term follow‐up. Messages and external barriers had combined effects (Ps < 0.01). Among participants with high external barriers, participants in the message conditions—especially the tailored message—had the highest screening rates; among participants with low barriers, screening rates were similar across conditions.CONCLUSIONSClinicians can tailor discussions on beliefs, feelings, cost, and access about screening to promote professional breast screening over time, especially with women who have not had mammograms as recommended and who have external barriers to screening. Cancer 2003;97:2724–35. © 2003 American Cancer Society.DOI 10.1002/cncr.11397
Elevated serum endostatin is associated with poor outcome in patients with non‐Hodgkin lymphoma
Authors: Bono Petri , Teerenhovi Lasse , Joensuu Heikki 
Published: May 2003

AbstractBACKGROUNDEndostatin is a cleaved fragment of collagen Type XVIII and has antiangiogenic activity. The clinical significance of circulating, soluble endostatin (S‐endostatin) is not known.METHODSPretreatment S‐endostatin and serum vascular endothelial growth factor (S‐VEGF) levels were measured in 143 patients with non‐Hodgkin lymphoma (NHL) using competitive enzyme immunoassays and were compared with the levels from a control group (n = 24 participants).RESULTSS‐endostatin levels varied widely from 4.5 ng/mL to 116 ng/mL (median, 29.6 ng/mL), and the median level was higher in patients with NHL compared with patients in the control group (16.4 ng/mL; P = 0.05). High S‐endostatin levels were associated with advanced disease stage (P < 0.0001) and high serum VEGF levels at diagnosis (P = 0.017). The median 5‐year survival rate for patients who had S‐endostatin concentrations within the highest tertile (> 36.0 ng/mL) was only 34% compared with 57% in patients who had lower S‐endostatin levels (P = 0.019). A high S‐endostatin level also was associated with a poor outcome in patients with large cell diffuse and immunoblastic lymphoma, which was the largest subgroup within the series (n = 60 patients). Patients who had high pretreatment levels of both S‐VEGF and S‐endostatin had particularly poor outcomes. High S‐endostatin levels had an independent, adverse influence on survival it was entered as a factor into a multivariate analysis together with the factors included in the International Prognostic Index (relative risk, 1.80; 95% confidence interval, 1.08–2.98; P = 0.0024).CONCLUSIONSHigh pretreatment levels of S‐endostatin are associated with high serum VEGF levels and poor survival in patients with NHL. Prospective studies are warranted to establish the clinical value of longitudinal S‐endostatin measurements. Cancer 2003;97:2767–75. © 2003 American Cancer Society.DOI 10.1002/cncr.11399
A pilot study of transcatheter arterial interferon embolization for patients with hepatocellular carcinoma
Authors: Yuen Man‐Fung , Ooi Clara Gaik‐Cheng , Hui Chee‐Kin , Wong Wai‐Man , Wong Benjamin Chun‐Yu , Chan Annie On‐On , Lai Ching‐Lung 
Published: May 2003

AbstractBACKGROUNDSystemic, high–dose interferon‐α treatment given three times per week subcutaneously induces tumor regression in approximately 30% of patients with inoperable hepatocellular carcinoma (HCC). The objective of the current study was to determine the efficacy and safety of transcatheter arterial interferon embolization for the treatment of patients with inoperable HCC.METHODSEighteen patients with inoperable HCC were recruited to receive 3 different doses of interferon‐α‐2b (10 megaunits [MU]/m2, 30 MU/m2, or 50 MU/m2) at intervals of 8–12 weeks. Their tumor response, adverse events, and survival were monitored.RESULTSIn 14 patients with nondiffuse HCC, complete responses and partial responses (> 50% tumor reduction) were observed in 28.6% and 35.7% of patients, respectively. One of four patients with diffuse HCC had a partial response. Thirty‐eight percent of patients had normalization of their α‐fetoprotein level. The median ferritin level at the last follow‐up was reduced significantly (765 pmol/L; range, 457–2720 pmol/L) compared with the baseline level (1980 pmol/L; range, 1100–3300 pmol/L; P = 0.011). The median survival was 15.9 months. Transient fever and rigor were the most common side effects observed. Five patients (27.8%) developed hypothyroidism. No significant liver decompensation was observed.CONCLUSIONSThis pilot study showed that transcatheter arterial interferon embolization was an effective method for the treatment of patients with inoperable HCC without significant hepatic toxicity. Cancer 2003;97:2776–82. © 2003 American Cancer Society.DOI 10.1002/cncr.11400
Neoadjuvant photodynamic therapy as a new approach to treating hilar cholangiocarcinoma
Authors: Wiedmann Marcus , Caca Karel , Berr Frieder , Schiefke Ingolf , Tannapfel Andrea , Wittekind Christian , Mössner Joachim , Hauss Johann , Witzigmann Helmut 
Published: May 2003

AbstractBACKGROUNDOnly 20–30% of patients with hilar cholangiocarcinomas (CC) are candidates for potentially curative resection. However, even after curative (R0) resection, these patients have a disease recurrence rate of up to 76%. The current prospective Phase II study investigated photodynamic therapy (PDT) as a neoadjuvant treatment for CC.METHODSSeven patients with advanced proximal bile duct carcinoma were evaluated. Patients were treated with PDT at the area of tumor infiltration and 2 cm beyond and underwent surgery after a median period of 6 weeks (range, 3–44 weeks).RESULTSOne patient had a Bismuth–Corlette Type II tumor, two patients had Type IIIa, one patient had Type IIIb, and three patients had Type IV. Cholestasis parameters after PDT decreased significantly. No relevant adverse events from PDT occurred except for minor intraoperative phototoxicity in one patient. Three patients underwent right‐sided liver resections, two patients underwent left‐sided liver resections, and one patient received a combined hilar resection with partial pancreatoduodenectomy (PD) due to tumor extension into the distal bile duct. Liver transplantation and PD were performed in another patient. In all patients, R0 resection was achieved. Four patients developed minor surgical complications, even though the bilioenteric anastomoses were sewn to PDT‐pretreated bile ducts. No viable tumor cells were found in the inner 4 mm layer of the surgical specimens. The PDT‐pretreated epithelium of the tumor‐free proximal resection margins exhibited only minimal inflammatory infiltration. Tumors recurred in 2 patients 6 and 19 months after surgery. The 1‐year recurrence free survival rate was 83%.CONCLUSIONSNeoadjuvant PDT for hilar CC is a low‐risk procedure with efficient selective destruction of the superficial 4 mm layer of bile duct tumor without complications exceeding series without neoadjuvant PDT. Neoadjuvant PDT should be evaluated prospectively to determine whether it reduces the rate of local disease recurrence after potentially curative resection. Cancer 2003;97:2783–90. © 2003 American Cancer Society.DOI 10.1002/cncr.11401
Perceptions and attitudes of clinical oncologists on complementary and alternative medicine
Authors: Hyodo Ichinosuke , Eguchi Kenji , Nishina Tomohiro , Endo Hisashi , Tanimizu Masahito , Mikami Ichiro , Takashima Shigemitsu , Imanishi Jiro 
Published: May 2003

AbstractBACKGROUNDThe prevalence of complementary and alternative medicine (CAM) is increasing worldwide because of the growing public interest in natural or holistic therapies and because of the flow of information through the Internet. However, there is a lack of communication between cancer patients and their physicians on topics relating to CAM. The authors performed a cross‐sectional survey to evaluate the perceptions and attitudes of Japanese clinical oncologists toward cancer CAM.METHODSThe CAM questionnaires were sent to 2118 clinical oncologists. The questionnaires gathered data on background (age, gender, years in practice, specialty, and knowledge of cancer CAM), perception (effectiveness/ineffectiveness, scientific evidence, and drug interactions), and attitude (experience with and response to CAM users). Questions about oncologists' perceptions and attitudes to CAM were limited to herbs and other natural products that were sold over the counter.RESULTSOne hundred sixty‐six questionnaires were returned as undeliverable. Of the remaining questionnaires, 751 were returned (a response rate of 39%). Two‐thirds of the responders were surgical oncologists and most of the remaining responders were medical oncologists. The majority of oncologists (82%) believed that CAM products were ineffective against cancer. The main reason for this belief was a lack of reliable information (as cited by 85% of oncologists). Only 13% of oncologists had experienced CAM‐associated disease improvement in their cancer patients. Of all the oncologists, 84% considered the possibility of drug interactions between anticancer drugs and CAM products. The majority of oncologists (80%) replied that they could neither promote the use of CAM products nor recommend quitting the products, when they were asked about the use of CAM products by cancer patients.CONCLUSIONSNegative perceptions of CAM products persist among clinical oncologists. A lack of proven effectiveness of CAM products and concerns about drug interactions with anticancer treatment suggest a need for both accurate information on CAM products and clinical trials. Cancer 2003;97:2861–8. © 2003 American Cancer Society.DOI 10.1002/cncr.11402
Reflections of a cancer survivor/research scientist
Authors: Zebrack Brad 
Published: May 2003

Abstract[Our original introduction to Listen to the Patient is published again to emphasize the Journal's commitment to this important series.]For more than 50 years, Cancer has been devoted to exploring every facet of malignant neoplasia, from morphology to therapy, from epidemiology to biology, from historical perspective to basic science. One aspect, however, needs emphasis, namely, the human being who bears the burden of the cancer. For this reason and with the encouragement of the Editor, we have undertaken to remedy this situation by directing attention to the fears and frustrations, hopes and expectations, and feelings and thoughts of all kinds of the person who has cancer, who is worried about it, and who is dependent on physicians specialized in its diagnosis and management. For doctors to be understanding of the very deep needs of patients with cancer, it is requisite that they be privy to authentic, but often unspoken, expressions of a patient's anxieties about physical and emotional pain, loss of control over personal destiny, and plain dread of dying and of the end of cherished relationships.Barrie R. Cassileth, Ph.D. Integrative Medicine Service, Memorial Sloan‐Kettering Cancer Center, New York, New York.A. Bernard Ackerman, M.D. Ackerman Academy of Dermatopathology, New York, New York. Cancer 2003;97:2707–9. © 2003 American Cancer Society.DOI 10.1002/cncr.11404
Gemcitabine combined with carboplatin in patients with malignant pleural mesothelioma
Authors: Favaretto Adolfo G. , Aversa Savina M. L. , Paccagnella Adriano , Manzini Vincenzo De Pangher , Palmisano Valentina , Oniga Francesco , Stefani Micaela , Rea Federico , Bortolotti Luigi , Loreggian Lucio , Monfardini Silvio 
Published: May 2003

AbstractBACKGROUNDMalignant pleural mesothelioma (MPM) is increasing rapidly worldwide. Currently, pemetrexed plus cisplatin chemotherapy showed a survival advantage versus cisplatin alone. No impact on patient survival of surgery, radiotherapy, or their combination has been demonstrated.METHODSEight centers in northeastern Italy participated in a Phase II multicenter study. Chemotherapy was comprised of carboplatin area under the concentration‐time curve 5 on Day 1 and gemcitabine 1000 mg/m2 on Days 1, 8, and 15. This cycle was repeated every 4 weeks.RESULTSBetween July 1996 and September 2000, 50 patients were treated. Of the sample, 68% were males, 88% had a Eastern Cooperative Oncology Group performance status score of 0–1, 56% had Stage I–II disease, 68% had epithelioid histology, and 62% had no previous treatments. The delivered dose intensity of gemcitabine was 617 mg/m2 per week, which was 82% of the planned dose (750 mg/m2 per week). For carboplatin, the delivered dose intensity was 80 mg/m2 per week. Overall, 44% of 15th day doses were omitted or reduced. Twenty‐six percent of the patients had partial responses (95% confidence interval: 15–40%) and 24% had disease progression. None of the patients had complete responses. The median response duration was 55 weeks (range, 13–113 weeks). Patients had good clinical benefit. For example, 46% had improved dyspnea, 40% improved in weight, and 26% experienced pain reduction. Patients developed Grade 3–4 leukopenia during 18 cycles (11%) of chemotherapy. Grade 3–4 thrombocytopenia occurred more frequently, i.e., there were 24 episodes (15%) among 17 patients. Grade 3 anemia developed among patients during eight cycles (5%). None of the patients developed Grade 3–4 nonhematologic toxicity. The median survival of this sample of patients was 66 weeks with 53%, 30%, and 20% of patients alive at 1, 2, and 3 years, respectively. The median progression‐free survival period was 40 weeks.CONCLUSIONSThe gemcitabine/carboplatin combination is a valid option in the treatment of MPM due to its acceptable toxicity profile, the good response rate, and the clinical benefit to patients. Minor adjustments in schedule (3‐week cycles instead of 4‐week cycles) would permit a more optimal treatment administration. Cancer 2003;97:2791–7. © 2003 American Cancer Society.DOI 10.1002/cncr.11405
cDNA microarray analysis of gene expression in pathologic stage IA nonsmall cell lung carcinomas
Authors: Nakamura Haruhiko , Saji Hisashi , Ogata Akihiko , Hosaka Makoto , Hagiwara Masaru , Saijo Takamoto , Kawasaki Norihito , Kato Harubumi 
Published: May 2003

AbstractBACKGROUNDThe relationship between altered gene expression and tumor progression in lung carcinoma has yet to be characterized. Gene expression in pathologic Stage IA nonsmall cell lung carcinoma specimens was analyzed using a cDNA microarray.METHODSSurgical specimens were used for the current study. The pathologic stage was IA (AJCC) in five tumors, IB in two, IIA in one, IIIA in one, and IIIB in one. Seven tumor specimens were adenocarcinomas and three were squamous cell carcinomas. Paired mRNAs from carcinoma cells and normal lung tissue specimens from the same lobe were labeled with different fluorochromes during cDNA probe synthesis in a reverse‐transcription reaction. Both synthesized, labeled cDNA probes were mixed and hybridized to the microarray. The signal intensity of each spot was measured by laser scanner and gene expression was quantified as the tumor‐to–normal fluorescence ratio (T:N ratio). The gene was overexpressed when the T:N ratio was greater than 2.0 and underexpressed when the ratio was less than 0.5.RESULTSOverall, 40 (9.4%) of the 425 genes evaluated were overexpressed, and 74 genes (17.4%) were underexpressed. In the 5 Stage IA tumor specimens, 31 (7.3%) genes were overexpressed and 76 (17.9%) were underexpressed. For 30 genes (7.1%), expression was different in Stage IA tumor specimens compared with more advanced tumor specimens.CONCLUSIONSThe cDNA microarray system showed that numerous alterations of gene expression were present in early‐stage nonsmall cell lung carcinoma specimens. Cancer 2003;97:2798–805. © 2003 American Cancer Society.DOI 10.1002/cncr.11406
Congestive heart failure in patients treated with doxorubicin
Authors: Swain Sandra M. , Whaley Fredrick S. , Ewer Michael S. 
Published: May 2003

AbstractBACKGROUNDDoxorubicin is a highly effective and widely used cytotoxic agent with application that is limited by cardiotoxicity related to the cumulative dose of the drug. A large‐scale study that retrospectively evaluated the cardiotoxicity of doxorubicin reported that an estimated 7% of patients developed doxorubicin‐related congestive heart failure (CHF) after a cumulative dose of 550 mg/m2. To assess whether this estimate is reflective of the incidence in the broader clinical oncology setting, the authors evaluated data from three prospective studies to determine both the incidence of doxorubicin‐related CHF and the accumulated dose of doxorubicin at which CHF occurs.METHODSA group of 630 patients who were randomized to a doxorubicin‐plus‐placebo arm of three Phase III studies, two studies in patients with breast carcinoma and one study in patients with small cell lung carcinoma, were included in the analysis.RESULTSThirty‐two of 630 patients had a diagnosis of CHF. Analysis indicated that an estimated cumulative 26% of patients would experience doxorubicin‐related CHF at a cumulative dose of 550 mg/m2. Age appeared to be an important risk factor for doxorubicin‐related CHF after a cumulative dose of 400 mg/m2, with older patients (age > 65 years) showing a greater incidence of CHF compared with younger patients (age ≤ 65 years). In addition, > 50% of the patients who experienced doxorubicin‐related CHF had a reduction < 30% in left ventricular ejection fraction (LVEF) while they were on study.CONCLUSIONSDoxorubicin‐related CHF occurs with greater frequency and at a lower cumulative dose than previously reported. These findings further indicate that LVEF is not an accurate predictor of CHF in patients who receive doxorubicin. Cancer 2003;97:2869–79. © 2003 American Cancer Society.DOI 10.1002/cncr.11407
Nausea and emesis remain significant problems of chemotherapy despite prophylaxis with 5‐hydroxytryptamine‐3 antiemetics
Authors: Hickok Jane T. , Roscoe Joseph A. , Morrow Gary R. , King David K. , Atkins James N. , Fitch Tom R. 
Published: May 2003

AbstractBACKGROUNDClinical reports suggest that nausea remains a side effect of chemotherapy despite widespread use of serotonin receptor antagonists. This study summarized the frequency, timing, and intensity of postchemotherapy nausea for patients receiving doxorubicin, cisplatin, or carboplatin.METHODSThree hundred sixty chemotherapy‐naïve patients (73% female) were enrolled in a study testing the ability of an information intervention to reduce nausea. Of these, 322 subjects completed the Morrow Assessment of Nausea and Emesis (MANE), as well as a 5‐day self‐report diary, at Cycle 1 (300 subjects completed the MANE and self‐report diary at Cycle 2). All patients received a 5‐hydroxytryptamine‐3 receptor antagonist (ondansetron) with dexamethasone on the day of treatment.RESULTSSeventy‐six percent of the patients developed nausea during the 5‐day period, beginning with the Cycle 1 infusion, and 73% of patients reported delayed nausea (DN) during Days 2–5. The proportions were similar during Cycle 2. Fifty‐five percent of patients described their DN as being of moderate or greater intensity compared with 28% of patients who described acute nausea. Carboplatin was less likely to cause DN than either of the other agents (56% of 106 patients compared with 75% of 47 receiving cisplatin and 83% of 169 taking doxorubicin). The mean peak DN severity was 4.34 (range, 1–7) for doxorubicin, which was significantly higher than the mean peak value for carboplatin (3.66) but was not significantly different from the mean peak value for cisplatin (4.26). Eighteen percent of patients did not experience nausea until Day 3 or later.CONCLUSIONSDespite prophylaxis with ondansetron, the majority of patients receiving one of these common chemotherapy agents experienced nausea. The frequency of DN was nearly twice that of acute nausea. Results show the need for continued development of antiemetics that are effective against DN. Cancer 2003;97:2880–6. © 2003 American Cancer Society.DOI 10.1002/cncr.11408