tbuckley/cabot-search huggingface dataset:
Disorders of taste (dysgeusia) in head and neck cancer patients on concomitant CT/RT.
Authors: Gouri Shankar Bhattacharyya, Hemant Malhotra, K Govind Babu, Amish Vora, Tapati Barman
Journal: Journal of Clinical Oncology (2017)

e18199 Background: Head &amp; Neck cancer is a major problem in India and developing countries related to use of tobacco. Locally advanced oral cavity cancers form a majority of cancers of this region. Common method of treatment of this region is to use concomitant radiation with chemotherapy and/or biotherapy. One of the side effects of regional treatment is loss of taste or dysfunction of taste. This although common has not been properly evaluated or reported. Its impact although conceivable is not used in dietary modifications or tailoring treatment. Methods: Taste discrimination was assessed using high medium and low concentration of sweet salty sour and bitter tasting solution. Cross-sectional observational study was designed to describe the prevalence of taste dysfunction in a group of Head &amp; Neck cancer survivors with oral cancers. Survivors were required to be disease free for at least 3 months symptomatically and imaging wise. Only patients found fit on cognitive assessments as well as capable of comprehending language were asked to fill a simple seven question graded chart. Results: Non parametric approach was done for taste score. Descriptive statistics were used for taste scores and self-reported taste changes. 90 patients were included. Age group 49y – 80y. 58 patients were above the age of 65y. 1/3 rd of the patients were females. All patients were locally advanced patient and the commonest site was oral cavity and oro-pharynx – 80%. Participants performed poorly on the taste test. The commonest disturbance in taste was in sweet and sour. 20% of patients had bitter and metallic taste in mouth. 1/3 rd of patients had no taste. Patients with maintained taste did not lose weight. Long term taste dysfunction persisted in about 30% of patients. Conclusions: Head &amp; Neck cancer survivors have taste dysfunctions. Taste recognition is demonstrated at low and high concentrations as well as persistent bitter and metallic phantom taste. It may persist for long periods of time. Recognizing this problem is important so the clinicians can help survivor scope with the problem.
Do female elite athletes experience more complicated childbirth than non-athletes? A case–control study
Authors: Thorgerdur Sigurdardottir, Thora Steingrimsdottir, Reynir Tomas Geirsson, Thorhallur Ingi Halldorsson, Thor Aspelund, Kari Bø
Journal: British Journal of Sports Medicine (2018)

Previous studies have suggested that female athletes might be at higher risk of experiencing complications such as caesarean sections and perineal tears during labour than non-athletes. Our aim was to study delivery outcomes, including emergency caesarean section rates, length of the first and second stages of labour and severe perineal tears, in first-time pregnant elite athletes compared with non-athletes.This is a retrospective case-control study comparing birth outcomes of primiparous female elite athletes engaging in high-impact and low-impact sports compared with non-athletic controls. The athletes had prior to birth competed at a national team level or equivalent. Participant characteristics and frequency of training for at least 3 years before a first pregnancy were collected via a self-administered questionnaire. Information on delivery outcome was retrieved from the Icelandic Medical Birth Registry.In total, 248 participated, 118 controls, 41 low-impact and 89 high-impact elite athletes. No significant differences were found between the groups with regard to incidence of emergency caesarean section or length of the first and second stages of labour. The incidence of third-degree to fourth-degree perineal tears was significantly higher (23.7%) among low-impact athletes than in the high-impact group (5.1%, p=0.01), but no significant differences were seen when the athletes were compared with the controls (12%; p=0.09 for low-impact and p=0.12 for high-impact athletes).Participation in competitive sports at the elite level was not related to adverse delivery outcome, including length of labour, the need for caesarean section during delivery and severe perineal tears.
OS4.3 The BReMen trial: Patients with benign meningioma - is rehabilitation really necessary?
Authors: A F Kessler, K Krause, B Al-Shameri, J Weiland, T Linsenmann, R Ernestus, C Hagemann, M Löhr, E Jentschke
Journal: Neuro-Oncology (2018)

Despite the good prognosis of benign meningioma, little is known about eventual impairment of patients’ psychological quality of life (pQoL), social and neuropsychological functioning after surgery. These patients might even fail to re-integrate into their private and work environment. Participating in a rehabilitation program (rehab) might be of advantage, but the impact is still undetermined. The BReMen trial (Belastung und Rehabilitation bei Meningeompatienten) aims to approach these topics. In a prospective 2-year-follow up trial 80 patients with newly diagnosed meningioma WHO°I are planned to be included. Test time points included pre- (T1), post-surgery (T2), 3, 6, 12 and 24 months post-surgery (T3-T6). Patients` characteristics included: age, gender, educational training, localization/size of meningioma, Barthel-, distress- and work-ability-index, time to return to work.Test batteries focused on pQoL and affect: Short Form-36 Health questionnaire (SF-36), EORTC Quality of Life Questionnaire - Score 30, EORTC Quality of Life Questionnaire for brain tumor patients, PHQ-9 depression score, GAD 7 general anxiety score. Cognitive functioning was meassured by Regensburger Wortflüssigkeitstest, Verbaler Lern- und Merkfähigkeitstest (VLMT), Trail Making Test A and B, Farb-Wort-Test, Aufmerksamkeits-Belastungstest (d2-R) and Wechsler-Memory-Scale-Revised. This interim analysis focused on SF-36 scores, PHQ-9 and distress levels, VLMT and d2-R. So far, 50 patients were recruited, 18 patients dropped out, 32 patients reached T5. 16 of them chose to participate in rehab after surgery, 17 patients refused. Both groups presented an increasing memory function till T5 independently of rehab.Patients with a lower pQoL preferred to enter rehab, improving their SF-36 scores afterwards but again declined at T5. Similarly, patients with a higher depression score also favored rehab with a positive long term effect, thereby declining their distress levels. Additionally, patients showed a higher attention at T5 (d2-R) after rehab compared to T1, while patients without rehab declined. The decline of patients’ depression levels and improved attention might reflect the benefit of rehab. However, the re-decline of their pQoL following rehab one year after resection could be a hint for an advantage of long-term neuropsychological support in addition to short term rehab. Hopefully, these questions will be answered with the final analysis of this trial.
Patient-reported outcomes, emoji, and activity measured on the Apple Watch in cancer patients.
Authors: Carrie A. Thompson, Kathleen J. Yost, Alicia Bartz, Amanika Kumar, Kathryn Jean Ruddy, Daniela L. Stan, Joon H. Uhm, Rahma M. Warsame, Thomas E. Witzig, Paul J Novotny, Jeffrey Sloan
Journal: Journal of Clinical Oncology (2018)

6501 Background: Patient-reported outcomes (PROs) are important measures in patients with cancer, but may be burdensome to collect. We aimed to measure PROs via mobile technology, using novel emoji PRO scales and associations between PROs and wearable data. Methods: Adult patients (pts) with diagnosis ( < 5 years) of lymphoma, myeloma, brain, pancreatic, breast, and ovarian cancer, life expectancy of > 6 months, and ownership of an iPhone ≥5.0 were recruited and provided with an Apple Watch. Pts completed baseline and weekly PROs for 12 weeks: PROMIS physical function, fatigue, sleep, social/role function short forms; single-item linear analog self-assessment (LASA) of quality of life (QOL), fatigue, and physical function. Pts were randomized into 3 groups for mode of survey response: paper, iPhone, and Watch. Watch and iPhone groups completed an emoji mood scale and an emoji ordinal scale for physical, emotional, and overall QOL. Activity levels were analyzed using the square root of the average daily values to minimize the effects of outliers. Associations between PROs and activity levels were assessed using Spearman correlations for univariate analyses, stepwise linear regression models for multivariate associations, and mixed models for longitudinal associations. Results: From 2/2017-8/2017, 296 pts were recruited. Pts wore the watch for an average of 9.8 hours/day and did 4590 mean steps/day (SD 3724). Weekly survey response rates ranged from 60% (Watch group) to 77% (iPhone group). Logging more steps/day was associated with less fatigue and sleep disturbance, better global physical QOL, physical function, and social function, while more minutes of exercise/day was associated with better global mental QOL and sleep. Spearman correlations showed very strong associations between the emoji ordinal scale and LASAs: -0.80 for fatigue, 0.70 for physical well-being, 0.68 for emotional well-being, and 0.75 for overall QOL (all p < 0.001). The baseline emoji mood scale was strongly related to all baseline PROMIS PROs (all p < 0.001). Conclusions: Collecting PROs in cancer patients via mobile technology is feasible. Apple Watch activity data is significantly associated with PROs, and emoji scales are a promising tool.
A pilot study evaluating the impact of hospital hospitality houses (HHH) programs on the quality of life and mood of patients and their caregivers following hematopoietic stem cell transplant (HCT).
Authors: Maria Emma Torres, Gerardo Colon-Otero
Journal: Journal of Clinical Oncology (2018)

e19500 Background: The quality of life (QOL) of hematopoietic stem cell transplantation (HCT) patients and their caregivers declines steeply with worsening depression during the first 8 days following stem cell infusion (SCI). In view of this, unique opportunities to develop programs in the confined environment of a Hospital Hospitality House (HHH) to prevent the observed decrease in the QOL and address the depression of the patients and caregivers exist. Methods: We conducted a longitudinal pilot study to collect preliminary data on the impact of post-HCT living arrangements on the quality of life and mood of HCT patients and their caregivers. Patients scheduled to undergo a HCT and their caregivers completed research QOL questionnaires at the following time points: 15 days prior SCI, and 1 day, 8 days, and 30 days post-SCI. The pre-defined primary endpoint was differences in overall QOL of patients and their caregivers staying at a HHH vs. hotel at day 30, as measured by LASA. Results: A total of 44 patients and 44 caregivers were enrolled in this study from Jul 2016-Jan 2017. Day 1 post SCI QOL was worse in the HHH patients (mean = 46.9 vs. 67.6, p = 0.0069). Patients who stayed at HHH were older (63.2 vs. 55.4, p = 0.0279). A multivariate analysis showed that the time point of questionnaire administration had the greatest effect on the overall QOL of patients, with day 8 post HCT showing the most significant worsening in QOL of patients (~20 points, p = 0.0006). A review of data from the entire cohort of patients revealed older patients ( > 60) reported a significantly lower QOL at day 30 post HCT (mean 51.6 vs. 75.3, p = 0.0170) and lower QOL at other time points. Conclusions: Age, type of HCT and baseline QOL significantly influence patients’ QOL following SCT, accounting for the observed worse QOL of patients in the HHH subset. Staying at an HHH improved caregivers’ emotional QOL. Pre-transplant QOL screening is likely to identify patients at risk of significant worsening of QOL post SCT. Evaluation of interventions directed at older patients and patients with low baseline QOL, delivered at the control environment of HHH are worth pursuing.
Risk stratification of smoldering multiple myeloma (SMM): Predictive value of free light chains and group-based trajectory modeling (GBTM).
Authors: Ajai Chari, Vernon Wu, Erin Moshier
Journal: Journal of Clinical Oncology (2017)

8031 Background: A serum free light chain ratio (FLCR) ≥ 100 and bone marrow plasma cell (BMPC) ≥ 60% have recently been classified as myeloma defining events to identify a group of SMM patients at high risk (ie. &gt; 50% risk at 2 years) of organ damage. However rates of progression for FLCr range from 30% to 98%. Reasons for the discrepancy include selection/referral bias, patient heterogeneity, and lack of consideration of disease evolution. The objective of this study was to determine the predictive value of baseline FLCR &gt; 100 and BMPC &gt; 60% in our patient population and also to determine the significance of m spike and FLC evolution using GBTM. Methods: We retrospectively investigated the predictive value of these events, including involved–uninvolved FLC (dFLC), in 273 consecutive SMM patients seen at our institution between 2010 and 2015. GBTM uses the outcomes of groups of individuals with similar trajectories over time (vs apriori assumptions of % change) to model population trajectories. Results: In patients with FLCR ≥ 100 at diagnosis, the median time to progression was 23 mos with 2-year progression of 52%. In patients with BMPC ≥ 60% at diagnosis, median time to progression was 25 months with 2-year progression of 47%. For 111 patients available for analysis, GBTM two distinct trajectories in dFLC during the 1st year. 18% of patients fell into a high risk group experiencing a 171% increase in dFLC at 1 year vs the remaining patients only had a 16% increase. The high risk group had a median TTP of 13.7 mos versus not reached for the remaining (log-rank p = 0.0063). Similarly the 25% of patients who had a 62% increase in mean m spike within 1 year had TTP of 27 mos versus the remaining 75% who had no increase had a median TTP of 84 mos (log rank p = 0.0943). Conclusions: Our results not only confirm a more modest 52% 2 year risk of PD with an FLCR &gt; 100 and dFLC &gt; 100, but also suggest that a high risk dFLC trajectory evolution may help identify a SMM high risk group, with a median TTP of only 13.7 mos. Results of multivariate analysis and sensitivity/specificity comparisons of baseline as well as evolving biomarkers will be presented at the meeting.
Hypertension and beta-blocker use as prognostic and predictive factors in metastatic colorectal cancer: A retrospective analysis of NCIC CTG CO.17.
Authors: Shelly Sud, Christopher J. O'Callaghan, Christos Stelios Karapetis, Caleb Jonker, Timothy Jay Price, Niall C. Tebbutt, Jeremy David Shapiro, Guy A. Van Hazel, Nick Pavlakis, Peter Gibbs, Mark Jeffery, Lillian L. Siu, Sharlene Gill, Ralph Wong, Derek J. Jonker, Dongsheng Tu, Rachel Anne Goodwin
Journal: Journal of Clinical Oncology (2016)

e15025 Background: Adrenergic receptor stimulation is involved in the development of hypertension (HTN), and has been implicated in progression and dissemination of metastases in various tumours including colon cancer. Furthermore adrenergic antagonists, such as beta-blockers (BB), demonstrate inhibition of invasion and migration in colon cancer cell lines and have been associated with decreased mortality in colorectal cancer. We examined the association of baseline HTN (bHTN) and use of BB on overall (OS) or progression-free survival (PFS) of pts with pre-treated, chemotherapy refractory, metastatic colorectal cancer (mCRC). We also examined bHTN as a predictor of Cetuximab (CET) efficacy. Methods: Using data from NCIC CO.17 (CET vs. BSC), we coded bHTN and use of anti-HTN medications (Rx), including BB, for 572 pts. Chi-square test was used to assess association between these variables and baseline characteristics. Univariate and multivariate analyses of OS and PFS by bHTN and BB use were performed using Cox regression models. Results: Pts with bHTN (149/572) and those using BB (60/572) were older, had diminished performance status, and higher creatinine levels. bHTN, BB use and anti-HTN Rx use were not found to be prognostic for improved OS and PFS, though a trend towards significance was noted between BB use and improved PFS (HR 1.38 [0.97- 1.96], p= 0.077). bHTN and BB use were not significant predictors of CET benefit. However, pts with bHTN tended to have a stronger treatment effect in PFS from CET (interaction p = 0.074). Conclusions: In chemo-refractory mCRC, neither bHTN nor BB use is a significant prognostic factor. bHTN and BB use are not predictive factors for CET benefit, though pts with bHTN may benefit from a stronger treatment effect with CET. Patients who are chemo-refractory may be biologically selected and the impact of BB use in earlier lines may thus still warrant investigation. Predictive effects of bHTN. Interaction HR (CET vs BSC) (95% CI) [p-value] HR (95% CI) [p-value] OS bHTN 0.67 (0.45-0.98) [0.038] 1.20 (0.77-1.86) [0.418] No-bHTN 0.77 (0.62 -0.95) [0.015] PFS bHTN 0.49 (0.34-0.69) [<0.0001] 1.43 (0.97-2.11) [0.074] No-bHTN 0.75 (0.62-0.92) [0.005]
Age as a potential new prognostic indicator in primary cutaneous B-cell lymphoma (PCBCL).
Authors: Poorvi Kirit Desai, Magali Van den Bergh, Xiaohui Zhang, Hailing Zhang, Braydon Schaible, Zhenjun Ma, Lubomir Sokol
Journal: Journal of Clinical Oncology (2017)

e19034 Background: PCBCL is a group of rare lymphoproliferative disorders, with an estimated annual incidence of 2.5 per 1,000,000 persons. Indolent subtypes include Primary Cutaneous Marginal Zone Lymphoma (PCMZL) and Primary Cutaneous Follicular Center Lymphoma (PCFCL). Primary Cutaneous Diffuse Large B-cell Lymphoma (PCDLBCL) is an aggressive subtype with a fatality rate of 50%. The Cutaneous Lymphoma International Prognostic Index (CLIPI) can risk-stratify indolent subtypes, but age is not considered. Here we present our single-institutional analysis of clinicopathologic features and outcomes of patients with PCBCL. Methods: This is a retrospective study of patients evaluated at Moffitt Cancer Center between 01/1990 and 12/2016. Patients were identified using our PCBCL database and diagnosis was verified by independent hematopathologists and dermatopathologists. Staging was determined by ISCL/EORTC criteria. Demographics, subtype, stage, disease course, and CLIPI scores were collected. Continuous and categorical values were tested using Kruskal-Wallis ANOVA method and Fisher’s Exact Test, respectively. Kaplan-Meier curves were produced to determine PFS. Results: We identified 37 patients who met diagnostic criteria for PCBCL (35% PCFCL, 40.5% PCMZL, 13.5% PCDLBCL, and 11% indolent, unspecified). Male:female ratio was 2.4:1. 51% of patients were ≥ 60 years old (yo), and 49% were &lt; 60 yo. 54% had stage T1 disease, 27% T2, and 19% T3. Median PFS for patients &lt;60 was 1.1 years, but was not reached for those ≥60. Mean follow-up time was 2.6 years for all patients. Log-rank test showed a statistically significant difference in PFS between the two age groups (p=0.01). PFS for stage of indolent subtypes showed marginal significance (p &lt;0.06). CLIPI for indolent subtypes did not show a significant difference in PFS. Conclusions: We found that age is a highly statistically significant prognostic parameter in PCBCL, as patients ≥ 60 yo had a longer PFS compared to younger patients, even after adjusting for stage and CLIPI. These results are promising for age as a possible prognostic indicator for PCBCL, but validation is needed with a larger sample size.
Abstract 15330: Angiopoietin Like-2 Contributes to Cerebral Artery Endothelial Dysfunction in Mice
Authors: Carol Yu, Cécile Martel, Adeline Raignault, Nathalie Thorin-Trescases, Eric Thorin
Journal: Circulation (2014)

Introduction: Angiopoietin like-2 (angptl2) is a circulating pro-inflammatory and pro-oxidative protein that is increased in CAD patients. When infused in dyslipidemic mice, it is pro-atherogenic a...
Adapted physical activity and recommendations for second cancers prevention for adolescents and young adults with cancer.
Authors: Julien Carretier, Axel Lion, Béatrice Fervers, Olivia Febvey-Combes, Helen Jane Boyle, Perrine Marec-Berard
Journal: Journal of Clinical Oncology (2018)

1518 Background: While long term survival is about 80%, adolescents and young adults (15-25 years old) with cancer (AYAC) are at increased risk of second primary cancer (SPC). Risk depends on first cancer type, treatment and prevalence of risk factors (smoking, overweight, sedentary lifestyle, environmental exposures...). AYAC have reduced physical activity (PA) and decreased motivation for PA. The objective of this study is to implement a supervised program based on adapted PA (APA) and cancer prevention for AYAC. Methods: AYAC attended supervised APA sessions during the treatment period (4-6 months). Physical activity (IPAQ), quality of life (QLQ-C30) and physical functioning (six-min walk test) were assessed at baseline (T1) and at the end of treatment (T2). They then participated in individual information meetings on SPC risk prevention. At 1 year (T3), they were questioned by phone on pursuit of physical activity and adoption of cancer prevention behaviors. Results: 63 AYAC (39 boys, 24 girls; median age = 19 years) completed T1 and T2; 37 AYAC completed T3. On average, they participated in 4 supervised sessions at the hospital and 16 unsupervised sessions at home during 3.5 months [min 2-max 6]. Preliminary results indicate an increase in the PA level between T1 and T2 (median scores of 360 and 1059 MET-min/week, respectively; P< .0001) and in the six-min walk test from T1 to T2 (median distances of 391 and 464 m, respectively; P< .0001). Median sedentary time decreased from 53.3 h/week at T1 to 37.5 h/week at T2 (P< .01). Global QOL score significantly increased between T1 and T2 (P < .001). Conclusions: This APA program responds to AYAC’s needs for support and information regarding PA and SPC prevention and shows increased PA, physical functioning and QOL for AYAC undergoing cancer treatment. Results will be validated in a multicenter study. Clinical trial information: NCT03336905.