BACKGROUND: Because of inconsistent results from previous studies on the association of IL-12B +1188 A/C polymorphism with cancer risk, a meta-analysis was performed to assess the association. MATERIALS AND METHODS: A li...BACKGROUND: Because of inconsistent results from previous studies on the association of IL-12B +1188 A/C polymorphism with cancer risk, a meta-analysis was performed to assess the association. MATERIALS AND METHODS: A literature search was performed to identify all relevant studies to May 31, 2012, with a restriction to English and Chinese publications. Pooled data were estimated using a random-effects model. RESULTS: 17 publications were included in the meta-analysis. The results indicated that the polymorphism was significantly associated with a decreased risk for overall cancer (odds ratio (OR), 95% confidence interval (CI): 0.86, 0.76-0.97, p = 0.007; 0.80, 0.68-0.95, p = 0.012; and 0.88, 0.78-0.99, p = 0.032, respectively for dominant model, recessive model, and allele analysis) or nasopharyngeal cancer and hepatocellular carcinoma. This association was also found in Asians (OR, 95% CI: 0.89, 0.80-0.99, p = 0.031; 0.82, 0.68-0.98, p = 0.027; and 0.89, 0.80-1.00, p = 0.047, respectively for dominant model, recessive model, and allele analysis), but not in Europeans and Americans. CONCLUSION: The present study indicates that the IL-12B +1188 A/C polymorphism could play a protective role in the development of cancer. More investigations involving various cancer types among various populations are needed.
Temozolomide (TMZ) is an oral alkylating agent used for the treatment of recurrent or newly diagnosed malignant gliomas with significant survival benefit. TMZ is generally well tolerated and safe. The most common side ef...Temozolomide (TMZ) is an oral alkylating agent used for the treatment of recurrent or newly diagnosed malignant gliomas with significant survival benefit. TMZ is generally well tolerated and safe. The most common side effects are mild to moderate, and are represented by fatigue, nausea, vomiting, thrombocytopenia, and neutropenia. However severe hematologic adverse events (HAEs), including myelodysplastic syndrome and aplastic anemia, have also been reported. In this review we present an overview of the available literature of HAEs after exposure to TMZ.
BACKGROUND: Ovarian cancer is rarely diagnosed in women of reproductive age; however, this coincidence seems to increase due to changes in lifestyle. Available evidence on the prognostic impact of fertility-sparing surge...BACKGROUND: Ovarian cancer is rarely diagnosed in women of reproductive age; however, this coincidence seems to increase due to changes in lifestyle. Available evidence on the prognostic impact of fertility-sparing surgery (FSS) is sparse, and there is an emerging need to consolidate such evidence. MATERIALS AND METHODS: Systematic review of the literature, including testing for heterogeneity and meta-analytical odds ratio (OR) calculations. RESULTS: 15 studies comprising 913 patients met the inclusion criteria for this review. Out of the 913 patients undergoing FSS, 11.4% developed recurrence during observation. Stage IB/C tumors were nearly twice as likely to recur as stage IA tumors (OR 1.72, 95% confidence interval (CI) 1.12-2.64, p < 0.05), and the risk of recurrence was 4 times higher in G2/3 compared to G1 tumors (4.26, 95% CI 2.31-7.86, p < 0.0001; and stage IC/G2/3 vs. stage IC/G1: OR 2.04, 95% CI 0.86-4.85, p > 0.05). A non-significant risk elevation was attributed to stage IC/G1 compared to stage IA/G1 (OR 1.48, 95% CI 0.66-3.16, p > 0.05). CONCLUSIONS: FSS with unilateral salpingo-oophorectomy is only advisable for unilateral grade 1 tumors. Further studies employing contemporary classification criteria, such as low- versus highgrade malignancies, a strictly standardized regimen of surgical staging, and meticulous reporting of recurrence localization, may help develop more differentiated recommendations.
BACKGROUND: The aim of this study was to compare intensity-modulated radiation therapy (IMRT) vs. 2D and 3D radiotherapy (RT) in the treatment of T1 glottic squamous cell carcinoma in an effort to highlight the advantage...BACKGROUND: The aim of this study was to compare intensity-modulated radiation therapy (IMRT) vs. 2D and 3D radiotherapy (RT) in the treatment of T1 glottic squamous cell carcinoma in an effort to highlight the advantages of IMRT in this particular clinical situation. CASE REPORT: We present the case of an 82-year-old female patient with T1 left true vocal cord squamous cell carcinoma and complete occlusion of the left carotid artery resulting in multiple strokes. The patient underwent definitive RT with 63 Gy (28 × 2.25 Gy). 3 plans were generated: 2D RT, 3D RT, and IMRT. The right carotid artery (Rt.CA) mean dose was 865, 2,065, and 4,268 cGy for IMRT, 3D RT, and 2D RT, respectively. The inferior pharyngeal constrictor (IPC) mean dose was 5,341, 6,456, and 6,451 cGy for IMRT, 3D RT, and 2D RT, respectively. IMRT provided the best homogeneity but at a higher cost and with prolonged treatment time. CONCLUSION: IMRT provided the finest planning target volume coverage with minimal Rt.CA and IPC doses. IMRT is recommended in certain clinical scenarios which are not manageable with other techniques.
BACKGROUND: Extrapulmonary small cell carcinoma is a distinct clinicopathological entity accounting for only 2.5-4% of small cell carcinomas. Here we present a case of primary intracranial small cell carcinoma. CASE REPO...BACKGROUND: Extrapulmonary small cell carcinoma is a distinct clinicopathological entity accounting for only 2.5-4% of small cell carcinomas. Here we present a case of primary intracranial small cell carcinoma. CASE REPORT: A 69-year-old woman with an isolated brain lesion presented with progressive headaches, confusion, nausea, and vomiting. A magnetic resonance imaging scan of the brain revealed a 4 × 3 × 5-cm solitary cystic tumor in the right frontoparietal lobe, accompanied by a midline shift. The mass was resected and pathologically proven to be a small cell carcinoma. The patient was given adjuvant radiotherapy but refused any chemotherapy. At the 12-month follow-up the patient was alive and well. CONCLUSION: Primary intracranial small cell carcinoma presenting as an isolated lesion is extremely rare. While there are no standard treatment guidelines for these patients, the authors believe multimodality treatment including tumorectomy and postoperative radiotherapy should be recommended.
BACKGROUND: Despite the small but significant survival benefit of adjuvant chemotherapy in locally advanced gastric cancer (LAGC), the optimal regimen remains to be determined. We conducted a randomized trial comparing o...BACKGROUND: Despite the small but significant survival benefit of adjuvant chemotherapy in locally advanced gastric cancer (LAGC), the optimal regimen remains to be determined. We conducted a randomized trial comparing oral (PO) chemoimmunotherapy (CITX) with intravenous (IV) CITX in LAGC patients (stages IB-IIIB) with curative resection (≥ D2 dissection). METHODS: The patients were randomized to the IV (5-fluorouracil 500 mg/m(2) weekly for 24 weeks, mitomycin-C 8 mg/m(2) every 6 weeks × 4) or the PO (uracil-ftorafur (UFT) 400-600 mg/day for 12 months) group. Patients in both groups received PO polysaccharide-K (3 g/day for 4 months). The planned number of patients was 368 for proving the non-inferiority of PO CITX compared to IV CITX for overall survival. RESULTS: The trial was closed prematurely after enrolling 82 patients (44 in the IV group, 38 in the PO group). With a median follow-up of 82 months, there were no significant differences in the 5-year disease-free survival (73% vs. 55%, p = 0.358) and overall survival (77% vs. 66%, p = 0.159) between the 2 groups. The IV group demonstrated a higher incidence of grade 2 or 3 neutropenia, thrombocytopenia, and vomiting. CONCLUSIONS: PO CITX with UFT appeared to be at least non-inferior to 5-fluorouracil and mitomycin-C CITX, with lower toxicity in the adjuvant treatment for LAGC.
BACKGROUND: Prognosis and survival for patients with metastatic soft tissue sarcoma (STS) are dismal. Standard first-line systemic chemotherapy is anthracycline-based. Gemcitabine/docetaxel (GD) is a therapeutic option i...BACKGROUND: Prognosis and survival for patients with metastatic soft tissue sarcoma (STS) are dismal. Standard first-line systemic chemotherapy is anthracycline-based. Gemcitabine/docetaxel (GD) is a therapeutic option in the second-line setting. Here we present the data of our single center retrospective analysis, using GD in locally advanced or metastatic disease. PATIENTS AND METHODS: Between 2005 and 2012, a total of 34 patients were identified. The majority of tumors were located in the extremities (19/34, 56%) and abdomen/retroperitoneum (10/34, 29%). Most frequent histologies included leiomyosarcoma (13/34, 38%), liposarcoma (7/34, 21%), and pleomorphic sarcoma (6/34, 18%). RESULTS: Objective response to treatment by RECIST criteria after 3 cycles was low with 6% partial responses (PR, 2/34), 65% stable disease (SD, 22/34), and 29% progressive disease (PD, 10/34). Progression-free survival at 3 and 6 months was 77 and 62%, respectively. Patients with a clinical benefit (defined as PR or SD after the 3rd treatment cycle) had a significantly prolonged median progression-free and overall survival with 8.6 months (p < 0.0001; hazard ratio (HR) 33.1) and 22.4 months (p < 0.0001; HR 12.9), respectively. Most common toxicities included hand-foot syndrome, edema, pancytopenia, febrile neutropenia, and mucositis. CONCLUSION: Overall, we conclude that GD is an active second-line regimen in metastatic STS, with manageable side effects.
BACKGROUND: The aim of this retrospective study was to examine the effect of oral trofosfamide in patients with advanced non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients with histologically or cytologic...BACKGROUND: The aim of this retrospective study was to examine the effect of oral trofosfamide in patients with advanced non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients with histologically or cytologically proven NSCLC, who had received at least 2 other therapies, were enrolled. The primary clinical end point was progression-free survival (PFS); secondary end points included overall survival (OS), response rate and toxicity. RESULTS: 23 patients were enrolled, 1 of whom was excluded due to non-compliance. The patients had received a median of 3 prior therapies (range 2-4). Regarding all 22 patients, median PFS was 14 weeks (95% confidence interval (CI) 9.96-18.04). The median OS was 32 weeks (95% CI 17.12-46.88). The median duration of trofosfamide therapy was 10.5 weeks (interquartile range 6.5-17.3). 20 patients (90.9%) had stable disease; 2 were not assessable. Trofosfamide therapy was stopped in 4 patients (18.2%) due to side effects. CONCLUSION: Trofosfamide is an orally applicable, well-tolerated and cost-effective drug that works in patients with advanced NSCLC, who have undergone at least 2 lines of therapy. Trofosfamide seems to be a therapeutic option in NSCLC as a further therapy line. These preliminary data need to be confirmed in a larger trial.
BACKGROUND: Fatigue is a frequent symptom in cancer patients. In Europe and Northern America fatigue questionnaires were developed and tested, but their generalizability to other cultural contexts is largely unknown. The...BACKGROUND: Fatigue is a frequent symptom in cancer patients. In Europe and Northern America fatigue questionnaires were developed and tested, but their generalizability to other cultural contexts is largely unknown. The aim of this study is to provide normative values for the Multidimensional Fatigue Inventory (MFI-20) based on a representative sample of the general population in Colombia and to test psychometric properties. METHODS: 1,500 individuals completed a questionnaire that contained the MFI-20, as well as other questionnaires, and questions on sociodemographic variables and chronic diseases. RESULTS: The mean values of the scales were marginally higher than those for 2 European samples. The mean value of the total score was 44.3 ± 14.1. Women were affected by fatigue more than men, and there was an almost linear age trend, with higher mean scores for older subjects. People with chronic diseases were affected by fatigue more than people without chronic conditions. The best psychometric properties were obtained for the total scale (sum score) of the MFI-20. CONCLUSION: The normative values presented here can help us to assess the individual burden of fatigue in a Latin American context. Psychometric properties of the MFI-20 in Colombia are similar to those obtained in Europe.
BACKGROUND: In 2009, Germany enacted a new law supporting advance directives that led to heated discussions in the media and the public. 3 years after the law passed, we surveyed patients with malignant diseases with reg...BACKGROUND: In 2009, Germany enacted a new law supporting advance directives that led to heated discussions in the media and the public. 3 years after the law passed, we surveyed patients with malignant diseases with regards to their views on advance directives. PATIENTS AND METHODS: Between September 2011 and July 2012 an anonymous survey on advance directives was conducted among 617 patients at the hematology and oncology outpatient department of the University Hospital Mannheim, using a standardized questionnaire developed for this investigation. RESULTS: Of the 503 patients who returned the questionnaire, 31% (n = 157) indicated having an advance directive. Of these 157, 54% (n = 85) completed the advance directive after 2009. 56% (282 out of 503) desired more information on advance directives. Of these, 71% (201 out of 282) wanted their general physician and 45% (128 out of 282) their specialist, to provide more information about this issue. Of the 339 patients without an advance directive, 47% (n = 158) stated that they had 'not worried about that yet'. CONCLUSION: Although the percentage of patients with advance directives has increased since the legislative amendment, more information is still required by patients. It is recommended that physicians should discuss advance directives more frequently with their patients.