tbuckley/cabot-search huggingface dataset:
Low intensity pulsed ultrasound (LIPUS) for bone healing: a clinical practice guideline
Authors: Rudolf W Poolman, Thomas Agoritsas, Reed A C Siemieniuk, Ian A Harris, Inger B Schipper, Brent Mollon, Maureen Smith, Alexandra Albin, Sally Nador, Will Sasges, Stefan Schandelmaier, Lyubov Lytvyn, Ton Kuijpers, Loes W A H van Beers, Michael H J Verhofstad, Per Olav Vandvik
Journal: BMJ (2017)

#### What you need to know #### Linked articles in this BMJ Rapid Recommendations cluster Does low intensity pulsed ultrasound (LIPUS) accelerate recovery in adults and children who have experienced bone fractures or osteotomy (cutting of a bone)? An expert panel rapidly produced these recommendations based on a linked systematic review triggered by a large multicentre randomised trial in adults with tibial fracture. Fracture is common (see box 1). Bones can also be broken for medical reasons; osteotomy is a procedure whereby a bone is cut to shorten, lengthen, or to change its alignment. Following osteotomy, the bone has similar healing problems as traumatic fractures, and may require more extensive recovery.1 #### Box 1: Background information ##### Bone fracture ##### LIPUS
Novel Gene Therapy Strategy for Hemophilia a By Hydrodynamic Gene Delivery Combined with Non-Viral Piggybac Transposon Vector in Canine Model
Authors: Masashi Noda, Hideto Matsui, Yasunori Matsunari, Sunao Ochi, Midori Shima, Yasushi Fukuoka, Takeshi Sato, Hiroshi Anai, Kimihiko Kichikawa, Masanari Nakayama, Akitsu Hotta, Mitsuhiko Sugimoto
Journal: Blood (2015)
Diagnostic Dilemmas in Oncology
Authors: Samuel Ejadi, Jeffrey Rosenblum, David Berd, Peter McCue, Michael Mastrangelo
Journal: Journal of Clinical Oncology (2000)

Article Tools Diagnostic Dilemmas in Oncology Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2000.18.17.3187 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 10963647 Diagnostic Dilemmas in Oncology Samuel EjadixSamuel EjadiSearch for articles by this author , Jeffrey RosenblumxJeffrey RosenblumSearch for articles by this author , David BerdxDavid BerdSearch for articles by this author , Peter McCuexPeter McCueSearch for articles by this author , Michael MastrangeloxMichael MastrangeloSearch for articles by this author Show More Johns Hopkins University, Baltimore, MD, and Thomas Jefferson University, Philadelphia, PA https://doi.org/10.1200/JCO.2000.18.17.3187 First Page Full Text PDF Figures and Tables © 2000 by American Society of Clinical Oncology
Phase I study of paclitaxel (TXL), doxorubicin (ADM) and carboplatin (CBDCA) combination therapy (TAC) in patients with high-risk and recurrent endometrial cancer
Authors: T. Sugiyama, H. Omi, J. Kigawa, M. Hatae, M. Suzuki, H. Tsuda
Journal: Journal of Clinical Oncology (2005)

5084 Background: TXL, ADM and CBDCA demonstrated high response rates (26%–36%) in each single agent for advanced and recurrent endometrial cancer. The purpose of this study was to determine the maximum-tolerated dose (MTD) and recommended dose (RD) of TAC therapy for future phase II or III studies. Methods: Eligible patients (pts) with high-risk or recurrent endometrial cancer had ECOG PS 0–2, were aged between 20 to 75, and exhibited adequate organ functions. Existence of prior chemotherapy and measurable disease were not regulated. Pts received intravenously a combination of ADM on day1 and CBDCA/TXL on day2. DLT was defined as grade 4 hematologic toxicity or grade 3 non-hematologic toxicity excluding nausea, vomiting and anorexia. RD was defined as one dose level below the dose at which 3/3 or al least 3/6 pts experienced DLT. The dose levels examined and DLTs were shown in Table below. Results: A total of 24 pts were enrolled and received chemotherapy between 06/2003 and 10/2004. No DLT was observed at dose levels 1 and 2. At dose level 3, one DLT (grade 4 neutropenia) of 3 pts was observed, and 3 pts were added. DLTs of dose level 5 were ileus(G3) and deep vein thrombosis(DVT :G3). At dose level 6, 1/3 pts showed grade 4 neutropenia. 4 of 24 pts have measurable disease : CR/PR/PD=1/2/1. Conclusions: MTD was not be established at the final level 6, but we concluded that the RD of TXL/ADM/CBDCA (TAC therapy) was 150/40/5, respectively, because 2 non-hematologic toxicities at level 5 and one hemotologic toxicity at level 6 were observed. TAC therapy was well tolerated and seemed to be active. TAC therapy will be a candidate of promising chemotherapy for high-risk and advanced/recurrent endometrial caner. No significant financial relationships to disclose.
High incidence of early metabolic syndrome in germ cell tumor: Report from a tertiary cancer center in India.
Authors: Bivas Biswas, Deepak Dabkara, Sandip Ganguly, Amit Dutt Dwary, Indranil Ghosh, Saugata Sen, Sumit Mukhopadhyay, Satyadip Mukherjee, Sujoy Gupta, Indranil Mallick, Pradip Mondal, Monish De
Journal: Journal of Clinical Oncology (2016)

488 Background: Late metabolic syndrome is well known in survivors of testicular germ cell tumor (GCT). Literature about early metabolic syndrome is scarce. Methods: Single institutional review of testicular GCT between June’2011 and December’2014. Patients with minimum post-treatment follow-up of 6 months were screened for signs of metabolic syndrome as per National Cholesterol Education Program (NCEP), if they had recorded blood pressure ≥130/85 mm of Hg and/or ≥10% weight gain from baseline. Partial metabolic syndrome was defined as - at least one abnormal criteria as per NCEP. Results: Sixty-three patients of testicular GCT completed treatment and were eligible for evaluation. Twenty-five patients fulfilled the screening criteria with median follow-up of 15 months (range: 6-40); median age of 35 years (range: 24-65). Treatment protocol was combined platinum based chemotherapy in 68% (n=17/25), single agent carboplatin in 20% (n=5/25), and surveillance only in 12% (n=3/25). Complete metabolic syndrome was found in 36% (n=9/25), partial metabolic syndrome in 44% (n=11/25). Blood pressure ≥130/85 mm of Hg was found in 64% (n=16/25), serum triglyceride ≥1.7 mmol/L in 61% (n=14/23), serum HDL cholesterol &lt;1 mmol/L in 76% (n=16/21), and fasting plasma glucose ≥5.6 mmol/L in 30% (n=6/20). Median weight gain was 5 Kg (range: 2-14). Conclusions: Features of early metabolic syndrome (complete or partial) were detected in 80% of testicular GCT survivors in symptomatic and screened patients, and also in those who were in surveillance or who received single agent carboplatin only. So, all testicular GCT survivors should be screened for early metabolic syndrome and early intervention should be initiated as it may have significant long-term effects on mortality and morbidity.
Long-term treatment of newly-diagnosed multiple myeloma with low-dose thalidomide, dexamethasone and zoledronate (TDZ)
Authors: U. Klueppelberg, I. Shapira, L. Chen, M. C. Aloba, E. Smith, N. Palanisamy, J. Schmidt, M. Moezi, O. Batuman
Journal: Journal of Clinical Oncology (2005)

6697 Background: The efficacy and safety of long-term use of TDZ in newly-diagnosed multiple myeloma (MM) is unknown and subject of this phase II trial. Zoledronate mitigates bone resorption and inhibits tumor growth and angiogenesis, and was expected to boost the therapeutic effect of thal/dex. Methods: Of 34 consecutive enrollees, 29 (20F/9M) were evaluable. Mean age was 61 (43–82), 8 patients had stage 2, 20 had stage 3 MM, 4 were HIV+ women on HAART. Patients received thalidomide 100 mg QD, dexamethasone 10–40 mg PO on Days 1–4, 9–12, and 17–20 monthly for 6 months, then on 4 days/month; and zoledronate 4 mg IV monthly, until progression. Response was stratified according to reduction of M-protein levels as: >50% (partial response, PR), >90% (very good PR, VGPR), 25–50% (minor response, MR). The cumulative probability of response (CPR) (±standard error) was estimated by Kaplan-Meier approach. Results: Mean duration of treatment with TDZ was 12 months. So far 13 patients have been followed for 12–24 months. Age-adjusted one-year survival is 74.4% and is identical to SEER data (73.7%). No deaths occurred after 10 months, whereas cumulative survival for the SEER population dropped to 60.1% at two years. All HIV+ patients remain in remission. Average time to response was 5.9 months, with 42% of patients responding within 4 months. PR occurred in 62%, including 28% VGPR with a CPR of 73% (±20.6) within 10 months. MR was observed in 28%. Maintenance of PR and VGPR over 1 year was achieved in 67%. The CPR of at least a minor response by 10 months was 100%. 1 patient progressed and 3 relapsed. Also, 1 patient died of secondary malignancy, and another of myocardial infarction. Thromboembolism occurred in 6 cases, prompting addition of aspirin 81 mg/day to the protocol. Other toxicities were not observed. Conclusions: The non-myelotoxic combination regimen TDZ is effective in the long-term management of new MM, including HIV+ patients on HAART. There may be a synergistic effect between thal/dex and zoledronate, allowing for lower doses of thalidomide than those used in earlier protocols. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Celgene, Novartis
Sensitive detection of protein biomarkers using silver nanoparticles enhanced immunofluorescence assay
Authors: Li-Jun Zhao, Ru-Jia Yu, Wei Ma, Huan-Xing Han, He Tian, Ruo-Can Qian, Yi-Tao Long
Journal: Theranostics (2017)

Detection of biomarkers is extremely important for the early diagnosis of diseases.Here, we developed an easy and highly sensitive fluorescence detection system for the determination of biomarkers by combining the rapid separation of magnetic beads and silver nanoparticles labeled antibodies.An ultrasensitive silver ions fluorescence probe 3', 6'-bis (diethylamino)-2-(2-iodoethyl) spiro[isoindoline-1, 9'-xanthen]-3-one (Ag + -FP) was applied to immunoassay.A significant signal amplification was achieved as the AgNPs can be dissolved by H 2 O 2 and generate numerous Ag + , which would turn "on" the fluorescence of Ag + -FP.Using α-fetoprotein (AFP) and C-reactive protein (CRP) as target analytes, good linear responses were obtained from 0.1 to 10 ng mL -1 and the limits of detection (LOD) were as low as 70 pg•mL -1 and 30 pg•mL -1 , respectively.In addition, the developed system was further evaluated for the detection of real samples including 30 positive serum specimens obtained from hepatocarcinoma patients and 20 negative serum samples, and performs as well as the commercial electrochemiluminescence immunoassay (ECLI) method with less cost and more convenience.Thus, the designed detection system can be used as a promising platform for the detection of a variety of biomarkers and served as a powerful tool in clinical diagnosis.
Interdisciplinary palliative care for patients with lung cancer.
Authors: Betty R. Ferrell, Virginia Sun, Arti Hurria, Mihaela C. Cristea, Dan Raz, Jae Kim, Karen L. Reckamp, Anna Cathy Williams, Tami R. Borneman, Gwen Uman, Marianna Koczywas
Journal: Journal of Clinical Oncology (2015)

130 Background: Palliative care, including symptom management and attention to quality of life (QOL) concerns, should be addressed throughout the trajectory of a serious illness such as lung cancer. This study tested the effectiveness on an interdisciplinary palliative care intervention for patients with stage I-IV non-small cell lung cancer (NSCLC). Methods: Patients undergoing treatments for NSCLC were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group. Patients in the intervention group were presented at interdisciplinary care meetings and appropriate supportive care referrals were made. They also received four educational sessions. In both groups, QOL, symptoms, and psychological distress were assessed at baseline and 12 weeks using surveys which included the FACT-L, FACIT-Sp-12, LCS, and the Distress Thermometer. Results: A total of 491 patients were included in the primary analysis. Patients who received the intervention had significantly better scores for QOL (109.1 vs. 101.4; p &lt; .001), symptoms (25.8 vs. 23.9; p &lt; .001), spiritual well-being (38.1 vs. 36.2; p &lt; .001), and lower psychological distress (2.2 vs. 3.3; p &lt; .001) at 12 weeks, after controlling for baseline scores, compared to patients in the usual care group. Patients in the intervention group also had significantly higher numbers of completed advance care directives (44% vs. 9%; p &lt; .001), and overall supportive care referrals (61% vs. 28%; p &lt; .001). Conclusions: Interdisciplinary palliative care in the ambulatory care setting resulted in significant improvements in QOL, symptoms, and distress for NSCLC patients.
Analysis of IMRT and IGRT in coronary sparing in patients with left-sided breast cancer.
Authors: M. L. Reisner, H. Salmon, G. Pavan, R. Cavalieri, N. Teich, F. M. Vieira, C. G. M. Ferreira
Journal: Journal of Clinical Oncology (2011)

e21164 Background: Although radiotherapy resulted in a reduction in local recurrence and improvement in 10-year overall survival in breast cancer patients, reports from SEER database showed that it could increase the relative risk of cardiovascular death in 10 years, counterbalancing its improvement in overall survival. The relation between doses to cardiac structures and toxicity has never been well defined and most of the studies only analyze the whole heart dose. The purpose of this study was to analyze the capability of IMRT and IGRT in dose reduction in important substructures of the heart. Methods: Ten patients with left breast cancer were treated with IMRT, using a hybrid-DAO technique (h-DAO). Corrections of patients’ positioning errors were performed daily, with cone beam images (IGRT). A field in field (FIF), another IMRT technique, and a conformal technique (3D) were simulated. The prescribed dose was 50Gy, 2Gy/day. Maximum (Dmax) and median dose in the left anterior descendent coronary (LADC), left ventricle (LV), and the heart were analyzed. Daily positioning errors were corrected for each patient and isocenter was modified according to the observed values. An analysis with the h-DAO technique was made comparing treatment with the hypothetical uncorrected isocenter, to observe if cone beam correction could decrease the heart dose. Results: Median Dmax doses in LADC were 1400cGy, 2794cGy and 3384.cGy. Median dose delivered in the h-DAO technique was 464cGy compared to 949cGy and 1382cGy in the FIF and 3D technique. Median Dmax doses in the LV were 3870cGy, 4780cGy, 4768cGy and median doses were 215cGy, 348cGy and 476cGy in the h-DAO, FIF and 3D techniques. Median Dmax doses of the heart were 4264cGy, 4887cGy, 5004cGy and median doses were 135cGy, 167cGy and 236cGy in the h-DAO, FIF and 3D techniques. Median position errors were 0.3, 0.5 and 0.4cm in lateral, longitudinal and vertical directions. The analysis of the h-DAO with IGRT, showed a reduction of 47%, 59% and 65% in the median dose in LADC, LV and heart. Conclusions: IMRT and IGRT considerably decreased the dose in LADC, LV and heart. Future prospective studies should be encouraged to assess the importance of h-DAO and IGRT in the reduction of cardiovascular mortality.
Effects of dose modification of eribulin mesylate in patients with locally recurrent or metastatic breast cancer.
Authors: Claudio Faria, Xuan Li, Annette Powers, Linda T. Vahdat
Journal: Journal of Clinical Oncology (2013)

157 Background: Eribulin mesylate is indicated for patients with metastatic breast cancer after treatment with ≥ 2 prior chemotherapeutic regimens. Recommended dosing is 1.4 mg/m 2 on specific cycle days with options for dose modification (dose reduction/delay) based on severity and duration of specific toxicities. The goal for therapy is to administer the full studied dose; however, for patients experiencing an adverse event (AE) the impact of dose modification has not yet been explored. The purpose of this study was to determine the effects of dose modification due to AEs on duration of therapy. Methods: Data from patients receiving eribulin in a phase III open label, randomized clinical trial evaluating eribulin vs. ‘Treatment of Physician’s Choice’ (E7389-G000-305) was utilized. Analyses were performed on the population with AEs. Patients were classified into a dose modification cohort for any dose reduction/delay related to an AE, or a dose non-modification cohort for patients who did not receive a dose modification but experienced an AE. Descriptive statistics were calculated and survival analyses were conducted. Results: Overall, 462 patients had an AE that was treatment-related: 204 patients (44.2%) had dose modification (delay only [61.8%], reduction only [17.6%], and both [20.6%]), and 258 (55.8%) did not have dose modification. Average age was 55 years, and most patients were Caucasian (92.4%). Patients with dose modification had a mean of 7.36 (±4.56) chemotherapy cycles and a median of 143 treatment days, while patients without modification had a mean of 5.71 (±3.68) cycles and a median of 105 treatment days (p &lt; 0.001). The median PFS was also longer in the dose modification cohort (130 vs. 92 days based on independent review). However, there were no statistically significant correlation between PFS and dose modification after adjusting for the length of treatment exposure using time-dependent and landmark approaches. Conclusions: Delaying or reducing the dose of eribulin in patients who experience AEs may allow patients to remain on therapy longer. Further prospective studies are warranted to confirm the impact on overall efficacy and safety.
Fluorodeoxyglucose (FDG) positron emission tomography (PET) as an indicator of disease progression for patients with castration-resistant metastatic prostate cancer (CRMPC).
Authors: A. Baklajian, E. R. Dennis, J. R. Buddle, J. J. Fox, H. Schöder, M. J. Morris, S. M. Larson, H. I. Scher
Journal: Journal of Clinical Oncology (2011)

e15193 Background: We have preliminarily shown that FDG PET can be used to demonstrate post-treatment responses to taxane based chemotherapy (Morris, et. al. CCR, 2005). However, it is uncertain how patients who are progressing on treatment will manifest on FDG PET. In this study of FDG PET, we examined patients undergoing treatment with either novel ligand inhibitors or anti-androgens to determine patterns of relapse at the point of biochemical, clinical, or radiographic progression by standard measures. Methods: Under the auspices of an imaging clinical trial and co-registered to clinical trials using either a CYP17 inhibitor or novel anti-androgen, patients with CRMPC were prospectively serially scanned with FDG PET in addition to standard protocol-driven outcome measures. Patients were included in this analysis if they had an FDG PET within 12 weeks of coming off study for progressive disease by the protocol-defined criteria. Using the Prostate Cancer Clinical Trials Consortium (PCCTC) molecular imaging data capture toolset, the FDG PET recorded at progression was compared with baseline and interim PETs and analyzed by any increase in SUVMAXAVG from nadir or the presence of new lesions. Results: Seventy-two patients were scanned, 33 of whom fulfilled the requirements for this analysis. Of this cohort, four patients progressed by a single new or existing lesion, 22 patients progressed by multiple new or existing lesions, and seven patients did not progress by PET. Of the 15 patients who developed new lesions, two patients developed asingle new lesion and 13 developed multiple new lesions. Of the patients who progressed by existing lesions, the median DSUVMAXAVG was 34.38% (4.18-124.29%). Conclusions: The results of this preliminary analysis suggest that progression by PET appears to be manifest by the emergence of multiple resistant target lesions. A minority of patients progress by virtue of a single lesion. Further study will assess whether PET, PSA, standard scans, or clinical criteria is the most relevant measure for predicting survival.
Neoadjuvant gemcitabine-cisplatin (GC) for muscle-invasive bladder cancer (MIBC): Does midway CT staging predict for pathologic complete response (pCR)?
Authors: Jo-An Seah, Raya Leibowitz-Amit, Eshetu G. Atenafu, Nimira Alimohamed, Anthony Michael Joshua, Jennifer J. Knox, Ian Tannock, Srikala S. Sridhar
Journal: Journal of Clinical Oncology (2014)

306 Background: Neoadjuvant cisplatin-based chemotherapy (NC) improves overall survival in MIBC, with pCR post radical cystectomy (RC) linked to better outcomes. NC is underutilized in part due to concerns over disease progression during NC. Midway radiological CT (post 2 NC cycles) may identify patients (pts) progressing on NC who should proceed to definitive therapy (DT). Methods: We reviewed 39 MIBC pts planned to receive 4 cycles of NC (GC) between Jan2005-April2013. Most pts (70%) had midway CT staging. A radiological response was defined as clear improvement in tumour +/- nodal status on CT compared to baseline, taking into account prior trans-urethral resection of bladder tumour; any other result was considered no response. DT consisted of RC, concurrent chemoradiation (CCR), or radiation alone (R). Descriptive statistics and Fisher’s exact test examined associations between disease characteristics and outcomes. Results: Overall, 28 pts (72%) completed planned NC; 7 pts (18%) stopped early due to no response on midway CT; 4 (10%) discontinued due to death (1), sepsis (2), and fatigue (1). Twenty-six pts (67%) had RC, 3 (8%) had CCR, 6 (15 %) had R and 4 (10%) did not receive DT. Of the 26 RC pts – 6 (23%) had a pCR. There were no pCRs among pts who had no radiological response at midway CT. At time of last follow up, 8 pts (21%) had died, 13 (33%) had recurrence/ metastases, and the remainder are being actively followed. Of pts with pCR, there were no recurrences (median follow up 12.2 mo (range 6.3-20.9 mos). The rate of venothromboembolism (VTE) was 26%, and nearly half occurred during NC, but did not affect treatment. Conclusions: Lack of response on midway CT was associated with a lack of pCR at RC, suggesting midway staging may be of value in MIBC receiving NC. The rates of pCR were consistent with reported literature, but rates of VTE appear higher than expected and requires further investigation. [Table: see text]