tbuckley/cabot-search huggingface dataset:
First experience of prostate brachytherapy under hypnosedation.
Authors: Olivier Chapet, Edwige Rigal, Corina Udrescu, Abdeslam Hassouni, Alain Ruffion, Vincent Piriou
Journal: Journal of Clinical Oncology (2016)

149 Background: Hypnosedation is an alternative to general or spinal anesthesia and may reduce bleeding, postoperative recovery time, as well as potential side-effects of anesthesia. In our department, hypnosedation has been used for prostate brachytherapy (PBT). Levels of pain, comfort, anxiety and satisfaction were evaluated prospectively and are reported. Methods: Twenty-seven patients were treated with BT under hypnosedation. Anesthesia was limited to a perineal injection of 30cc of xylocaine. The same radiation-oncologist and the same anesthesiologist performed all the interventions and hypnosedations, respectively. A dose of 145Gy was delivered to the prostate using iodine-125 linked-seeds. In case of pain or discomfort during hypnosedation, the patient could ask to switch from hypnosedation to general anesthesia. Visual Analog Scales (VAS), from 0 to 10 points, were used to evaluated the lowest, mean and highest level of pain, comfort and anxiety. The VAS forms were completed by the patients in the same day (D1), before (anxiety and pain) and after the intervention (pain and comfort), and 8 weeks later (pain and comfort). Results: Only two patients had a general anesthesia, because they didn’t reach the hypnotic level and failed to follow the hypnosedation procedure. In the table below are presented the results (average and range) of the VAS scores for pain and comfort for the remaining 25 patients. Twenty-four (88.9%) patients would choose this approach again and recommend it to other patients. One patient would prefer a general anesthesia due to the discomfort of the position during the procedure (leg cramps). For all the patients, the short post-operative recovery time and their active participation to the treatment were two major advantages of the hypnosedation. Conclusions: To our knowledge, this is the first experience of brachytherapy under hypnosedation. Our first results demonstrate that hypnosedation is a feasible and comfortable alternative method to anesthesia, perfectly suitable for PBT. [Table: see text]
Cytogenetic, Molecular and Clinical Features Associated with Rare CBFB-MYH11 Fusion Transcripts in Patients (Pts) with Acute Myeloid Leukemia (AML) and inv(16)/t(16;16)
Authors: Colin G Edwards, Kati Maharry, Krzysztof Mrózek, Sebastian Schwind, Peter Paschka, Deedra Nicolet, Jessica Kohlschmidt, Thomas W Prior, Yue-Zhong Wu, Jonathan E. Kolitz, William Blum, Mark J. Pettenati, Paola Dal Cin, Andrew J. Carroll, Michael A Caligiuri, Richard A. Larson, Guido Marcucci, Clara D. Bloomfield
Journal: Blood (2011)
Potential activity and safety of gemcitabine and oxaliplatin (GEMOX) in different histologic subtypes of advanced thyroid cancer.
Authors: Y. Vano, S. Vignot, L. Hassani, R. Mouawad, D. Khayat, L. Leenhardt, J. Spano
Journal: Journal of Clinical Oncology (2010)

e16011 Background: Patients with advanced, incurable thyroid cancer have few satisfactory therapeutic options. In this present study we assessed the activity and safety of the association of gemcitabine and oxaliplatin (gemox) in patients with different histology of advanced thyroid cancer refractory to I-131 treatment. Methods: Twelve patients with advanced thyroid cancer (4 papillary, 6 vesicular, and 2 mixed) were evaluated from our specialized hospital. All were refractory to I-131 treatment with a median age of 64 years. All patients received a combination of gemcitabine (1,000 mg/m2) + oxaliplatin (100 mg/m2) every two weeks until progression, limiting toxicity or a plained stop at 12 cycles. The response was evaluated by Response Evaluation Criteria in Solid Tumors after 4 cycles. Results: At this time, twelve patients were evaluated over our series. Complete and partial responses were observed in 1 and 5 patients respectively, yielding an ORR of 50%. Stable disease was reported in another 4 patients (33%). Objective responses were noted in 83 % (5 out of 6) vesicular subtypes. This combination was generally well tolerated, no grade IV toxicity was observed. The most common treatment-related adverse event being asthenia (n = 10 with 3 grade III), peripheral neuropathy (n=11 with 1 grade III), diarrhea (n=1), anemia (n=12), thrombopenia (n=5), neutropenia (n=4 with 1grade III). There was no toxic death related to the treatment. Conclusions: The GEMOX regimen remains effective and well tolerated in advanced differentiated thyroid cancer. thus, further evaluation of this new combination seems warranted and will be presented. No significant financial relationships to disclose.
A retrospective analysis assessing effects of cytotoxic versus cytostatic agents on body mass, nutritional parameters, and performance status in patients with exocrine pancreas cancer enrolled in phase I and II trials.
Authors: John Philip Schwerkoske, Erkut Borazanci, Katy Schroeder, Lei Zhang, Gayle S. Jameson, Joyce Rosemarie Schaffer, Jeffery A. Nieves, Daniel D. Von Hoff
Journal: Journal of Clinical Oncology (2015)

438 Background: The 5-year survival for pancreatic adenocarcinoma is poor, and patients increasingly turn to experimental agents after conventional treatments have failed. Novel chemotherapeutic agents undergo rigorous phase I and II trials to confirm efficacy, safety, tolerability, and optimal dose for entry into late phase trials. Cytostatic therapies are theorized to have an improved tolerability compared to traditional cytotoxic therapies. Methods: This retrospective study compared the tolerability of cytostatic vs cytotoxic therapies in patients with advanced pancreatic cancer who participated in phase I or II trials at a single institution. Nutrition parameters of weight and albumin, performance status, tumor marker CA 19-9 level, and mean tumor dimension defined by RECIST criteria were obtained for patients within four weeks of trial start date and conclusion. Results: 117 patient trials were assessed in final analysis. No statistically significant difference was observed between patients receiving cytostatic and cytotoxic agents with regards to mean weight loss (1.01 vs 1.30 kg; p =.733), decrease in albumin (0.36 vs 0.29 g/dL; p =.397), and percent change in CA 19-9 (-72% vs -76%; p =.882). Results of change in performance status were similar, with mean increase in ECOG (0.63 vs 0.61; p =.948) and decrease in Karnofsky (13 vs 12, p =.709). There was a statistically significant difference in tumor dimension with cytostatic vs cytotoxic agents (18% vs -3%, p =.043). There were no differences in trends between patients enrolled in one trial compared to those enrolled in multiple trials. Conclusions: This study did not show a significant difference between cytostatic and cytotoxic agents in patients with advanced pancreatic adenocarcinoma in early phase trials with regards to nutritional parameters, performance status, or change in CA 19-9. However, there was a statistically significant change in tumor dimension. Thus, cytotoxic agents have similar tolerability to cytostatic agents and may have additional benefit on tumor burden in patients with advanced pancreatic adenocarcinoma.
Comparison of radiographic characteristics of renal cell carcinoma (RCC) brain metastases treated with vascular endothelial growth factor (VEGF)-directed therapies or radiotherapy.
Authors: Ajay Goud, Kara DeWalt, Courtney Carmichael, JoAnn Hsu, Manasvi Pinnamaneni, Sumanta Kumar Pal
Journal: Journal of Clinical Oncology (2015)

479 Background: With improvements in systemic therapy for metastatic RCC (mRCC), an increased frequency of brain metastases (BM) has been observed, perhaps owing to the central nervous system (CNS) serving as a sanctuary site. The response of BM to VEGF-directed therapies has been poorly characterized. Methods: Patients (pts) with mRCC BM were identified from an institutional database. Selection of pts was further refined to pts who had received either VEGF-directed therapy during their diagnosis with BM or radiotherapy directed to their BM. Only those pts with brain MRI straddling systemic therapy and radiotherapy were selected for analysis. Imaging studies were anonymized and transmitted to an independent radiologist for review. Descriptive statistics were applied to characterize the change in sum of long axis dimensions (SLD) in two separate groups: (1) pts treated with VEGF-directed therapy and (2) pts treated with radiotherapy. Results: Of 276 pts with mRCC in our institutional database, 34 pts with BM were identified. Of these pts, 6 pts had serial MRI assessments at timepoints straddling receipt of VEGF-directed therapy. Pts had received sunitinib (n=2), sorafenib (n=2) or bevacizumab (n=2). A further 13 pts received radiotherapy with MRI imaging straddling delivery of either stereotactic radiation therapy (SRT) and whole brain radiotherapy (WBRT). Of these 19 patients, all patients had clear cell histology, and 13 patients were male. In pts receiving VEGF-directed agents, the average change in SLD of BM was -13.8%. In pts receiving radiotherapy, the average change in SLD was -6.5% (-13.0% in pts receiving SRT and +2.0% in pts receiving WBRT). Qualitatively, greater tumor necrosis and lesser rim enhancement was observed in post-treatment scans amongst pts receiving VEGF-directed agents. Conclusions: This pilot study suggested differences in CNS response with VEGF-directed therapy and radiotherapy. Multicenter collaborations are underway to validate these results in larger series.
Oxygen Desaturation at Rest and after Exercise in Pediatric Sickle Cell Disease Patients: Correlations with Hemolysis and Elevated Tricuspid Regurgitant Jet Velocity.
Authors: Andrew D. Campbell, Caterina Minniti, Sohail R Rana, Onyinye C. Onyekwere, Mehdi Nouraie, Manuel Arteta, Craig Sable, Gregory Ensing, Niti Dham, Deepika S. Darbari, Lori Luchtman-Jones, Gregory J. Kato, Mark Gladwin, Oswaldo Castro, Victor R. Gordeuk
Journal: Blood (2008)
Epithelial growth factor receptor (EGFR) expression in squamous cell cancer of buccal mucosa: Incidence and correlation with tumor characteristics in Indian population.
Authors: A. A. Gore, P. Dwivedi, B. N. Dhabhar, T. K. Saikia
Journal: Journal of Clinical Oncology (2011)

e16021 Background: A key motivation for investigating head and neck cancer in India is to understand molecular pathways in carcinogenesis and find indicators of patient survival or markers to select the type of treatment. Methods: We evaluated 50 cases attending our center with squamous cell carcinoma of buccal mucosa (SCCBM) to document the incidence of EGFR over expression of primary tumor; establish a correlation between EGFR over expression by Immunohistochemistry (IHC) and tumor characteristics. Also compare EGFR expression by IHC with the EGFR by FISH. After the Hospital IRB approval, IHC staining for EGFR was performed on the FFPE block of tumor tissue.IHC staining of tissue samples was performed using the Anti EGFR Polyclonal, Biogenex, USA. The tumor tissue was sent to reference laboratory for EGFR analysis by FISH Test code 19041Xa. Data collected was analyzed using SPSS 11.0 for Windows. Results: A total of 50 patients were studied from December 08 to June 10. Mean age was 50.24 years (86% males & 14% females). Tobacco chewing reported by 52%, Betel nut chewing 2% and multiple habits in 34%. Sub mucous fibrosis was noted in 30%, leukoplakia in 8%. Premalignant lesions were associated with higher EGFR expression. No statistical difference was noted in pattern of EGFR expression as per the tumor size, nodal status, stage, grade, cut margin status, LVI and PNI. EGFR over expression by IHC was seen in 62% patients, while FISH revealed EGFR amplification in only 22% of tissue samples. EGFR positive by IHC had a sensitivity of 81.82% & specificity of 38.24%. A statistically significant increase in EGFR over expression (both 2+ and 3 +) with increase in depth of invasion of tumour was noted (p value 0.044). Conclusions: The study demonstrates EGFR over expression (by IHC) in 62% patients with SCCBM in Indian population. Significant EGFR over expression by IHC was noted in tumors with pre malignant lesions. Increasing EGFR expression was noted with increasing depth of tumor.
Performance of a novel TNM staging system for pancreatic neuroendocrine tumors versus the current AJCC staging system.
Authors: Motaz Qadan, Yifei Ma, Brendan C. Visser, Jeffrey A. Norton, George A. Poultsides
Journal: Journal of Clinical Oncology (2013)

156 Background: Adopting a unified staging system for pancreatic neuroendocrine tumors (PNET) has been challenging. Currently, the American Joint Committee on Cancer (AJCC) recommends the use of the pancreatic adenocarcinoma staging system for PNET. We sought to validate this recommendation on a large administrative population database. Methods: Surveillance, Epidemiology, and End Results (SEER) data were used to identify patients with PNET (excluding patients with large cell, small cell, or mixed endocrine-exocrine carcinoma) who underwent curative-intent surgical resection from 1983 to 2008. The discriminatory ability of the AJCC system (recorded by SEER since 2004) was examined and a new TNM system was devised utilizing extent of disease variables. Results: Of 1,202 patients identified, 51% were female. Median age was 55 years (range, 9-93). Lymph node metastasis (present in 43% of patients) was associated with worse overall survival (OS) after resection (10-year OS, 50% vs 63%, p&lt;.0001), as was the presence of distant metastasis (present in 24% of patients, 10-year OS, 35% vs 63%, p&lt;.0001).The current AJCC system (available in 412 patients) distinguished overall survival adequately only between stages I and II, but not between II and III, or III and IV (Table). By modifying the T stage to be based only on size (0-1 cm, 1-2 cm, 2-4 cm, and &gt; 4 cm) and by revising the grouping allocation, we propose a novel TNM system with improved discriminatory ability (Table). Conclusions: In this study validating the current AJCC staging system for PNET, we found stages II, III, and IV to perform similarly. We propose a simplified TNM system that better discriminates between outcomes. [Table: see text]
Feasibility and efficacy of neurocognitive training in patients with high-grade gliomas: A pilot trial
Authors: M. R. Hassler, P. Binder, K. Elandt, J. Lehrner, F. Leutmezer, C. Marosi
Journal: Journal of Clinical Oncology (2008)

20667 Background: With increasing survival duration of patients with high-grade gliomas (HGG), preservation of the neurocognitive function begins to emerge as an important topic for the quality of survival. In a pilot trial, we studied the feasibility and outcome of a cognitive group training for patients with HGG. Methods: 7 patients, 3 women and 4 men, with stable HGGs participated in a training program for 10 weeks and completed all training and assessment sessions. All were under antiepileptic drugs. 4 patients suffered from primary (age 32 - 70 y) and 3 patients from secondary glioblastomas (age 21 - 35 y). All patients had been treated with concomitant and adjuvant radiochemotherapy with temozolomide. The delay from treatment start to training ranged from 5 to 20 months. Before and within 4 weeks after the training program, the neurocognitive status of the patients was evaluated by a non involved psychologist, using Hopkins Verbal Learning Test (HVLT -immediate recall, delayed recall, recognition), Trail Making Test A (visual-motor scanning speed) and B (executive function), Trail Making Datasheet (TMT) and Controlled Oral Word Association (COWA - executive function). The neurocognitive training was done with 90 minutes sessions weekly with focus on perception, verbalisation, memorization, long term memory, concentration techniques and creativity training. Results: As well individual patients as the group as a whole showed improvements in all the performed tests (see table). Conclusions: Our pilot study illustrates that neurocognitive training in a group is feasible with patients with HGG and that the patients improved significantly their executive function, learning and memory as well as motor skills. Test Results Test Baseline - End (Standard Deviation) p-Value Trail Making Test A Trail Making Test A 37.6 (19.2) 33.9 (18.2) 0.119 Trail Making Test B 121.3 (87.3) 101.9 (69.8) 0.174 Controlled Oral Word Association 24.4 (15.4) 30.4 (12.2) 0.056 Hopkins Verbal Learning Test (HVLT) 5.4 (2.6) 6.7 (2.4) 0.035 HVLT delayed 5.6 (4.7) 7.3 (3.9) 0.111 HVLT total 1 - 3 19.6 (8.9) 23.6 (8.8) 0.047 No significant financial relationships to disclose.
Helical tomotherapy with concurrent chemotherapy in the treatment of anal canal carcinoma: A review of clinical outcomes at a tertiary referral center.
Authors: John Maclou Longo, Malika Lisa Siker, Ben George, Lauren Kosinski, Kirk A. Ludwig, Mary F. Otterson, James P. Thomas, Lauren Allison Wiebe, Beth Erickson
Journal: Journal of Clinical Oncology (2014)

656 Background: We report the clinical outcomes of patients with anal carcinoma treated with helical tomotherapy (HT) IMRT and concurrent chemotherapy. Methods: From September 2005 to January 2013, 32 patients with squamous cell carcinoma of the anal canal received chemoradiation with HT planned in a consistent manner in parallel to the RTOG 0529 guidelines. Of the patients, 17 (53%) were T1-2, 13 (41%) were T3-T4, 15 (47%) were node positive, and 1 was M1 with para-aortic nodal metastases. There were 7 HIV positive and 3 renal transplant patients. All but 2 patients received 5-fluorouracil and mitomycin C. The median doses to the primary site, involved nodes, and uninvolved nodes were 54 Gy, 50.4 Gy, and 45 Gy, respectively. All acute and late toxicities were scored with the CTCAE v4.0. Results: Median follow-up was 31 months (range 10-97 months). Median length of treatment was 43 days. Twenty-two patients (69%) took a median of 3.5 break days. Acute grade 3-4 hematologic toxicity occurred in 27 patients (84%). There were no grade 4 gastrointestinal or dermatologic toxicities. Eight patients (25%) experienced grade 3 gastrointestinal and dermatologic toxicities. Twenty-one patients (66%) were hospitalized a total of 37 times during chemoradiation or within 90 days of therapy completion. Neutropenic fever was the most common reason for hospitalization, accounting for 30% of admissions. Thirty-one patients were followed for late toxicity with results as follows: 7 patients (23%) had grade 3 gastrointestinal toxicity, 1 patient (3%) had grade 3 dermatologic toxicity, and 3 patients (10%) had grade 3 sexual dysfunction. Nine patients (29%) developed pelvic insufficiency fractures, 5 requiring intervention. The 2-year progression-free and overall survivals were 97% and 97%, respectively. Two patients died; 1 from local progression and 1 from unrelated causes. Conclusions: HT delivering moderate radiation doses consistent with the RTOG 0529 guidelines and chemotherapy paired with aggressive, multidisciplinary management of acute and late toxicities effectively treat squamous cell carcinoma of the anal canal.
Long-term responders to everolimus: A subgroup analysis of the sector study.
Authors: Philippe Barthelemy, Bernard Escudier, Florence Joly, Lionnel Geoffrois, Brigitte Laguerre, Nadine Houede, Marine Gross-Goupil, Vano Yann-Alexandre, Olivier Lucidarme, François Bidault, Nadia Kelkouli, Stephane Oudard
Journal: Journal of Clinical Oncology (2014)

462 Background: Everolimus is considered as a standard of care for the second line treatment of metastatic renal cell carcinoma (mRCC). Currently no clinical or biological predictive factors are available to help physicians to choose the best second line option between everolimus or TKI. Whether correlation exists between response to first line and response to second line remains debatable. Methods: We performed a subgroup analysis of the SECTOR study, a retrospective survey of patients (pts) receiving everolimus after TKI in 26 french centers to analyse long responders to everolimus. Long-term response to everolimus was defined as progression-free &gt;9 months. Recorded variables included: patients characteristics of first line TKI (duration, response), duration of everolimus, efficacy and toxicity as well as overall survival. Results: 164 patients in 26 french cancer centres were included in the SECTOR study between october 2008 and october 2012. All patients received everolimus as second line treatment. Median age was 64.6 y.o, main histological subtype was clear-cell carcinoma (92.3%). Among the whole study cohort, we identified 30 patients (21%) as long-term responders (ranging from 9 to 33 months). Analysis of this patient population is ongoing and will be presented at the meeting. Correlation between long response and prognostic factors, as well as response to first TKI will be determined. Conclusions: Everolimus achieves long-term response in more than 20% of mRCC treated in second line. Prolonged treatment was relatively well tolerated without any unexpected late toxicity. Further investigations, especially biological studies, are warranted to identify predictive factors which will help physicians to identify long-term responder and choose the best second line option for mRCC patients.
Prevalence of K-RAS codon 12 mutations in locally advanced head and neck squamous cell carcinoma and influence with regards to response to chemoradiation therapy
Authors: E. Bissada, Z. Abou-Chacra, X. Weng, L. Guertin, P. Nguyen-Tan, M. Audette, B. Fortin, J. Tabet, M. Bélair, D. Soulieres
Journal: Journal of Clinical Oncology (2008)

17005 Background: RAS gene mutations have been shown to occur in certain malignancies and have an impact on response to treatment and overall prognosis for certain types of cancer, more specifically NSCLC. Studies of these mutations in head and neck oncology literature have shown inconsistent results. Objectives: To determine the prevalence K-RAS codon 12 mutations in patients with locally advanced HNSCC treated with chemo-radiation therapy with/without surgery and to evaluate the impact of these mutations on loco-regional control as well as overall, disease free and distant metastasis free survival. Methods: Out of 428 consecutive patients treated with chemo- radiation therapy in our institution and followed for a median of 37 months, 199 paraffin embedded biopsy or surgical specimens were retrieved. DNA was isolated and analyzed for K-RAS mutational status by PCR and nested PCR techniques. Statistical analysis was performed using Fisher's test for categorical data and Kaplan-Meier's curves and log-rank statistics for failure times. Results: DNA extraction was successful in 197 patients. Of the 197 specimens, 3.5% presented K-RAS codon 12 mutations using a single PCR technique. Patient characteristics did not differ statistically. For mutated cases and non-mutated cases, complete initial response to chemo-radiation therapy was 71 and 73% (p=0.32). LRC was respectively 83 and 32% (p=0.03), DFS was 68 and 27% (p=0.12), distant metastasis free survival was 81 and 100% (p=0.30) and OS was 65 and 57% (p=0.14) at three years. Mutational status results from nested PCR are pending and will be presented at the meeting. Conclusions: K-RAS mutational status, although not associated with a difference in response rate, may influence failure pattern and overall aggressiveness and may influence the type of therapy offered to such patients. No significant financial relationships to disclose.