tbuckley/cabot-search huggingface dataset:
Safety and efficacy of same-day administration of pegfilgrastim in patients (pts) receiving chemotherapy for gastrointestinal (GI) malignancies.
Authors: Robert M. Matera, Valerie Relias, Wasif M. Saif
Journal: Journal of Clinical Oncology (2017)

10112 Background: Pegfilgrastim is typically administered 24 hours after chemotherapy per package insert; however some pts are unable or unwilling to return for this additional visit due to work or transportation especially with regimens consisting of infusional 5-FU. Same-day dosing eliminates need for this additional visit. Results from prior studies in other tumor types are inconclusive as few support same-day dosing whereas others show inferiority. Purpose of our study was to determine safety and efficacy of administering pegfilgrastim on same day as chemotherapy in pts with GI malignancies. Methods: A single-institution retrospective review was conducted of pts with GI malignancies who received chemotherapy and same-day pegfilgrastim (6 mg) within 1 hour of completion of chemotherapy from Jan 2014 through Jan 2017. Decision to administer pegfilgrastim was based on NCCN or ASCO recommendations. As per institutional guidelines, pts were counseled on risks of same-day pegfilgrastim prior to its administration. Data was collected on demographics, clinic notes and complete blood counts. Analyses included neutropenia, febrile neutropenia, hospitalization, use of antibiotics or bone pain. Results: A total of 536 chemotherapy cycles in 69 pts were analyzed. Median age was 60 years (range 32-87) with 46% of pts ≥ 65. Pts had an average of 4 risk factors for febrile neutropenia: advanced disease, gender, age &gt; 65 and chemotherapy regimen. Most common malignancy was colon (48%), pancreas (17%) and gastric (17%). Most commonly used regimens included mFOLFOX6 (42%), FOLFIRINOX (23%) and FOLFIRI (12%). Median absolute neutrophil count nadir for all cycles was 4538/uL (range: 1160-25168). Grade 1 and 2 neutropenia developed in 6 of 536 (1%) cycles. Bone pain reported in 3 pts (4%). There were no episodes of grade 3 or 4 neutropenia or febrile neutropenia. None had dose reductions, chemotherapy delays, hospitalizations, or antibiotic use due to neutropenia. Conclusions: We believe our study is the first in GI malignancies to report that same-day pegfilgrastim administration may be as effective and safe as next-day administration, benefiting pts and might reduce costs.
Stage III pulmonary large cell neuroendocrine carcinoma (LNEC).
Authors: Lingling Du, Pamela Parker Samson, Saiama Naheed Waqar, Danielle Carpenter, Ashiq Masood, Siddhartha Devarakonda, Cliff Grant Robinson, Ramaswamy Govindan, Varun Puri, Daniel Morgensztern
Journal: Journal of Clinical Oncology (2016)

8536 Background: Pulmonary large cell neuroendocrine carcinoma (LNEC) is an uncommon lung cancer subtype, initially described in 1991 and classified as a high grade neuroendocrine tumor. Since the data on demographics and outcomes of patients (pts) with stage III LNEC are limited to mostly small retrospective studies, we evaluated this group of pts using the National Cancer Database (NCDB), which captures data from approximately 70% of the cancer cases in the United States. Methods: Pts with LNEC diagnosed between 2004 and 2013 were identified among all patients with lung cancer registered in the NCDB. Demographic variables were summarized using descriptive statistics. Kaplan-Meier method was used to determine overall survival (OS) according to treatment type in patients with stage III disease and the differences in median OS were compared by log-rank test. Results: Among the 1,365,500 pts with lung cancer from NCDB in the study period, there were 9,787 (0.72%) with LNEC. The distributions of stages I to IV were 24.2%, 10.6%, 19.3% and 45.9%, respectively. The median age at presentation for stage III was 65 (range 18-90). Among the 1,768 pts with stage III disease, excluding T3N1, the treatment included surgery (S) (31.8%), chemotherapy (C) (12.0%), radiation (RT) (4.7%), chemoradiotherapy (CRT) (42.8%) and no therapy (8.7%). Among pts receiving CRT, the OS was better in stage IIIA compared to IIIB (median OS 18.2 vs 14.4 months, 5-year OS 21% vs 12%, P < 0.001). The median and 5-year OS for patients with stage IIIA according to treatment was CRT – 18.2 months (m) and 21%, S + C – 24.5 m and 32% and S + CRT – 27.0 m and 25%. OS was significantly better for the two S arms compared to CRT (S+C vs CRT, P = 0.001 and S + CRT vs CRT, P = 0.03) but not between the two S arms (P= 0.48). Conclusions: LNEC is an uncommon disease with a stage distribution similar to other NSCLC subtypes. In patients with stage IIIA, S was associated with survival advantage compared to CRT and there was no benefit from triple modality therapy.
TCT-804 Comparative Validation of the ALPHA Score, a Novel Risk Model Including Vascular Access Site for Predicting 30-Day Mortality in Patients Treated With Primary PCI
Authors: Istvan Hizoh, Gyongyver Banhegyi, Dominika Domokos, Laszlo Major, Peter Andrassy, Peter Andreka, Dávid Becker, Andrea Buttl, Attila Cziraki, Csaba Andras Dezsi, Istvan Edes, Tamas Forster, Bela Herczeg, Andras Janosi, Andras Katona, Robert Kiss, Zsolt Koszegi, Geza Lupkovics, Gergely Nagy, Lajos Nagy, Ebrahim Noori, Janos Tomcsanyi, Gábor Veress, Zoltan Ruzsa, Bela Merkely
Journal: Journal of the American College of Cardiology (2018)
Disparities in the management of stage I small cell lung carcinoma (SCLC): A National Cancer Database (NCDB) analysis.
Authors: Zaheer Ahmed, Punita Grover, Lara Kujtan, Kevin F Kennedy, Muhammad Omer Toor, J Russell Davis, Janakiraman Subramanian
Journal: Journal of Clinical Oncology (2017)

8563 Background: Effective treatment of stage I SCLC requires both surgical resection and chemotherapy. We analyzed the National Cancer Database (NCDB) for the treatment patterns and disparities in the management of stage I SCLC. Methods: We identified patients with clinical stage I SCLC from the NCDB. Median and 5-year survival were calculated using Kaplan Meier analysis. Multivariable logistic regression model was used to determine the factors that can predict surgical resection. Results: We identified 4,849 patients with clinical stage I SCLC diagnosed between 2004 and 2012. We divided them into 4 treatment groups; surgical resection with chemotherapy (n = 774, 15.9%), surgical resection without chemotherapy (n = 423, 8.7%), non-surgical treatment (n = 2,978, 61.4%) and no treatment (n = 674, 13.9%). 5-year survival for each group was 47%, 36%, 22% and 11% respectively, ( p-value &lt; 0.001). Among patients who underwent surgical resection, lobectomy (67.1%) was the most common procedure followed by sub-lobar resection (28.8%) and pneumonectomy (2.8%) with 5-year survival of 48%, 34% and 33% respectively, ( p-value &lt; 0.001). Multivariate analysis identified that elderly (age ≥ 70) patients, African-Americans, patients with low income and Medicaid are less likely to undergo surgery, ( p-value &lt; 0.001). Patients receiving treatment at academic cancer centers, right sided tumors and Charlson score ≥ 1 are more likely to receive surgery, ( p-value &lt; 0.001). Conclusions: Despite better outcomes only 25% of patients undergo surgery for stage I SCLC. Over the years there has been only a modest increase in the proportion of patients undergoing resection. We have identified significant disparities in the treatment of patients with stage I SCLC. Our data clearly show the need to educate physicians on appropriate delivery of care for patients with stage I SCLC.
FRI0209 Rate of cerebral microemboli in aps can be influenced via blockade of gpiib/iiia platelet receptor with tirofiban
Authors: C Specker, A Perniok, T Menge, M Siebler, M Schneider
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Patients with antiphospholipid syndrome (APS) are prone to thromboembolism. So far, the only predictive parameters for further complications are their number in patient’s history and perhaps the titre of aPL. Derived from clinical investigation of stroke and obvious analogies between cerebrovascular ischemia (CVI) in patients with carotid artery disease (CAD) and patients with APS, a novel non-invasive method using transcranial Doppler (TCD) is used for detection of so called ‘microembolic signals’ (MES) in the cerebral vasculature. In patients with CAD, these ‘microemboli’ proved to correlate with past and impending symptoms of CVI allowing for therapeutic stratification by their detectability. We found very similar signals in the cerebral bloodstream of APS patients with a history of CVI. Detectability of MES in APS implies occlusive thromboembolism and not vasculitis as the underlying mechanism at least in arterial cerebrovascular manifestations of this state. However, Doppler signal properties (i.e. the reflected energy) do not allow for direct estimation of the signal’s substrate size or -composition. <h3>Objectives</h3> To further elucidate the pathophysilogical substrate of MES in APS. <h3>Methods</h3> Repeated TCD monitoring in a 38 year old female APS patient with ongoing transitory ischaemic attacks and high rate of MES before and after intravenous administration of Tirofiban, a potent, synthetic, highly selective and reversible inhibitor of platelet gpIIb/IIIa receptor which binds fibrinogen on the platelet’s surface. <h3>Results</h3> Within one hour the rate of MES decreased from ~50/hr to &lt;5/hr on three successive occasions accompanied by cessation of clinical symptoms. Using flowcytometry, platelet-leucocyte aggregates found increased before administration of Tirofiban were also reduced considerably. <h3>Conclusion</h3> The finding that MES are influenced by blockade of the platelet gpIIb/IIIa receptor and correlate with platelet-leucocyte aggregates argues for a central role of thrombocytes in APS with CVI. This might favour to look for thrombocyte targeted prophylactic therapy in APS. Whether detection of MES can also serve to monitor such therapies has still to be proved. <h3>References</h3> Specker C, Rademacher J, Sohngen D, Sitzer M, Janda I, Siebler M, Steinmetz H, Schneider M. Cerebral microemboli in patients with antiphospholipid syndrome. Lupus 1997;6(8):638–44 Specker C, Perniok A, Brauckmann U, Siebler M, Schneider M. Detection of cerebral microemboli in APS – introducing a novel investigation method and implications of analogies with Carotid artery disease. Lupus 1998;7(Suppl 2):75–80
Prognostic impact of primary tumor location in advanced urothelial carcinoma: The EORTC series.
Authors: Marco Moschini, Shahrokh F. Shariat, Maria De Santis, Joaquim Bellmunt, Cora N. Sternberg, Bertrand F. Tombal, Laurence Collette, Morgan Roupret
Journal: Journal of Clinical Oncology (2017)

e16034 Background: The prognostic relevance of the primary location of urothelial cell carcinoma (UCC) on outcomes is poorly documented. This parameter has been studied in 3 EORTC trials in advanced UCC that included patients with different initial primary tumor locations. Methods: We used the data prospectively collected in three EORTC advanced UCC studies 30924 (M-VAC versus High dose M-VAC), 30986 (MCAVI versus GC, among patients unfit for CDDP), 30987 (GC-Paclitaxel versus GC, among patients fit for CDDP). Ineligible patients and other tumor locations were excluded. Patients all had measureable distant metastases or unresectable UCC and WHO performance status 0-2. Patients were grouped by primary tumor location as bladder (BCa) versus upper urinary tract (UTUC). PFS and OS by tumor location was tested in Cox proportional hazard regression stratified by study and treatment using at 2-sided α of 0.05. Results: Of the 1,039 patients, 85.3% and 14.7% patients had BCa and UTUC, respectively. Patient and disease characteristics (Table) suggested better performance status and slightly more males among patients with GCa. With a median follow up of 4.8 years (IQR:4.0-6.7), 733 deaths were recorded and 925 had progressed or died. OS and PFS did not differ significantly by tumor location overall (P=0.317 and P=0.685 respectively, Table 1), but there is significant heterogeneity across treatments (heterogeneity P=0.0450 for OS and P=0.0121 for PFS) with a suggestion of differential results in the M-CAVI arm for unfit patients. Conclusions: Primary UTUC location is uncommon in advanced UCC and did not seem to markedly impact PFS or OS. However, the findings may vary according to treatment. [Table: see text]
The US Training System for Physicians—Need for Deeper Analysis
Authors: S. Claiborne Johnston
Journal: JAMA (2018)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
P05.55 Tumor location may be more predictive than histology for postoperative cerebellar mutism: case series
Authors: W C Gump
Journal: Neuro-Oncology (2018)

Assessment of complications from posterior fossa tumor surgery in children have been confounded by nonstandard definitions and nomenclature regarding speech, cognitive, and coordination deficits. Recently, a new definition of postoperative pediatric cerebellar mutism syndrome (PPCMS), emphasizing delayed onset reduced speech/mutism and emotional lability, has been proposed. A single-center, single-surgeon case series of posterior fossa brain tumor surgeries over a 6-year period was retrospectively reviewed. The relationships of PPCMS and discharge disposition to tumor location and diagnosis were examined. Tumor location was categorized as intrinsic to the 4th ventricle, cerebellar hemisphere, or brainstem; ventral brainstem and cerebellopontine angle tumors were excluded. Diagnosis was stratified as low grade or high grade histology. Discharge disposition was to home or an inpatient rehabilitation facility. 23 patients, age 11 months to 17 years at time of surgery, were studied. 9 patients had high grade histology (8 medulloblastoma, 1 anaplastic ependymoma) and 14 were low grade (7 pilocytic astrocytoma, 5 ganglioglioma, 2 low grade astrocytoma). By location, there were 12 4th ventricle, 7 cerebellar hemisphere, and 3 intrinsic brainstem tumors. 3 patients demonstrated PPCMS, all of which arose from 4th ventricle tumors (2 pilocytic astrocytomas, 1 medulloblastoma). By histology, 3 of 9 high grade and 8 of 14 low grade patients were discharged to inpatient rehab. By location, 7 of 12 4th ventricle and 2 of 7 cerebellar hemisphere patients were discharged to inpatient rehab. Tumor location may be more predictive than histology of PPCMS and postoperative discharge disposition. Larger multiinstitutional studies using standardized definitions will better clarify PPCMS risk factors.
P01.128 Clinical epidemiology and risk factors for survival rate for high-grade glioma patients treated at the National Cancer Centre Hospital, Dharmais, Jakarta, Indonesia
Authors: R A Hendrojogi, S A Wilopo
Journal: Neuro-Oncology (2018)

Globally high-grade glioma (HGG) represents one of the most common intraparenchymal tumours of the CNS. However, there is no report on the epidemiology of the HGG tumours from Indonesia. The aim of this study is to report the clinical epidemiology and risk factors for survival rate of HGG treated at the top of referral cancer hospital in Indonesia. We performed an institutional review board (IRB) approved retrospective study on patients who underwent treatment at our hospitals. Between January 2015 and May 2017, we admitted 40 patients with histologically confirmed HGG comprised of oligodendroglioma (10%), astrocytoma grade III (23%) and IV (67%). We assessed risks factors of having HGG, including to sex, age, histopathology, radiation and chemotherapy received. Data on radiation was confirmed by the record at the Department of radiology. We produce Kaplan-Meier for survival curves and the relative hazard rates (Cox’s regression) using STATA software version 15.0. Out of 40 patients admitted, there 18 females (45%) and 22 (55%) were admitted to hospital. There is no difference between ages of male and female (mean 45.1 with 95% CI: 36.9- 53.3 vs mean 43.7 with 95% CI: 35.8–51.6 years) using t-test with p= 0.806. Those patients received treatments of temozolomide with radiosensitizer (38%), radiation (83%), and phenytoin (57%). Most patients presented clinical symptoms such as hemiparesis (83%), motoric disturbance (80%), headache (78%), nerves deficit (60%), and seizures (50%). Status at the end of follow-up are following: survive (13 or 33%), death (18 or 45%) and censored or loss of follow up (9 or 23%). As results the overall median survival is only 12 months and proportion of surviving up to 15 months is 40%. Assessment of risk factors indicated that sex is not a risk factor for the incidence of HGG (log-rank test p=0.80) with hazard rate for female is 1.1 and 95% CI: 0.39 -2.91. Most patients are diagnosed after the age of 40 years (82.5%). Among patient age over 60 years compared to age less than 40, the risk of dying is almost 4 times (RR=3.9, CI=1,1—13.6) and median survival among 60 years and above is only less than 4 months. Patients with grade IV have higher risk of dying compared with others group but statistically not significant (RR=2.0, CI=0.6–7.1). Similarly, patients received radiation were having relatively better survival compared those did not received radiation (RR=2.3, CI=0.71—7.3). The prognosis for patients with HGG is unfortunately very poor with median survival is less than 12 months, especially among age 60 years and above, not received radiation and glioblastoma grade IV. All patients were treated with optimal management at the Cancer Centre Hospital which has better facilities and health providers. This finding suggests that patients HGG treated at other centre hospitals will have poorer prognosis in Indonesia.
Translating Temporal Interference Brain Stimulation to Treat Neurological and Psychiatric Conditions
Authors: Nir Grossman, Michael S. Okun, Edward S. Boyden
Journal: JAMA Neurology (2018)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Neurology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Neurology journal
Cancers attributable to infectious agents in Nigeria: 2012-2014.
Authors: Michael Kolawole Odutola, Elima Enaji Jedy-Agba, Emmanuel Oga, Festus Igbinoba, Theresa Otu, Emmanuel Ezeome, Ima-Obong Ekanem, Ramatu Hassan, Clement Adebayo Adebamowo
Journal: Journal of Clinical Oncology (2016)

e17035 Background: Infections by certain viruses, bacteria, and parasites have been identified as risk factors for some cancers. We carried out this study to evaluate the numbers of cancers in Nigeria from 2012-2014 that are attributable to infections using data from Population Based Cancer Registries [PBCR] in Nigeria. Methods: We considered cancers associated with Epstein-Barr virus [EBV], Human Papilloma Virus [HPV], Hepatitis B and C Virus [HBV/HCV], Human Immunodeficiency Virus and Human Herpes Virus 8 [HIV/HHV8], Helicobacter pylori and Schistosoma haematobium that have been classified as oncogenic by IARC. We obtained data on the infection associated cancers from the registry databases of 3 PBCR in Nigeria; Abuja, Enugu and Calabar cancer registries. We used PAF for infectious agents associated cancers in developing countries that were calculated using prevalence data and relative risk estimates in previous studies: EBV and Nasopharyngeal [90%], and Hodgkin’s Lymphoma [80%]; HPV and Cervical [100%], Vulval and Vaginal [40%], Anal [90%] and Oropharyngeal cancer [12%] in women, Penile [40%], Anal [90%] and Oropharyngeal cancer [12%] in men; HBV/HCV and Liver [92%], HIV/HHV8 and Kaposi sarcoma [100%], Non Hodgkin Lymphoma [100%]; H. pylori and stomach [74%] and S. haematobiumand Bladder cancer [56.6%]. Results: The 3 PBCR reported 4,861 cancer cases from 2012-2014; 1,875 in males and 2,986 in females. There were 412 infection-associated cancers in males accounting for 22% of total cancers in males, and 351 [85%] of these were attributed to infections. In female, there were 727 infection-associated cancers accounting for 24% of all cancers in females and of these, 674 [93%] were attributable to infections. Cancers of the Cervix [n = 430] and Liver [n = 152] as well as Non-Hodgkin’s Lymphoma [n = 129] were the commonest infection-associated cancers in both sexes. The commonest infectious agents associated with cancers were HPV [n = 453], HIV/HHV8 [n = 199], HBV/HCV [n = 143] and EBV [n = 125]. Conclusions: Our finding suggests that 85% of infection-associated cancers in males and 93% infection-associated cancers in females can be prevented with vaccination, safer risk behaviours, or antiinfective treatments.