Onkologie[JOURNAL]
Sun
200 papers
Correlation between biological marker expression and F-fluorodeoxyglucose uptake in cervical cancer measured by positron emission tomography.
Park SI, Suh DS, Kim SJ … +2 more , Choi KU, Yoon MS
Onkologie · 2013 · PMID 23548964 · Publisher ↗
BACKGROUND: This study aimed to determine whether several biologic markers were associated with (18)fluorine-fluorodeoxyglucose ((18)F-FDG) uptake in patients with carcinoma of the cervix. PATIENTS AND METHODS: 60 patien...
BACKGROUND: This study aimed to determine whether several biologic markers were associated with (18)fluorine-fluorodeoxyglucose ((18)F-FDG) uptake in patients with carcinoma of the cervix. PATIENTS AND METHODS: 60 patients with International Federation of Gynecology and Obstetrics (FIGO) stages IA2 to IIB cervical cancer, who underwent (18)FDG positron emission tomography/computed tomography (PET/CT), were included in the current study. All patients underwent radical hysterectomy. Tumor sections were stained by immunohistochemistry for glucose transporter 1 (GLUT1), carbonic anhydrase-IX (CA-IX), vascular endothelial growth factor (VEGF), hexokinase type I (HK-I), hexokinase type II (HK-II), and cytoplasmic and nuclear hypoxia-inducible factor (HIF) 1α. RESULTS: The expression of GLUT1 (p = 0.005), VEGF (p = 0.021), HK-II (p = 0.009), and cytoplasmic HIF1α (p = 0.024) was significantly associated with a higher median standardized uptake value (SUVmax). There was a positive correlation between (18)F-FDG uptake and GLUT1 (p = 0.008), CA-IX (p = 0.030), HK-II (p < 0.001) as well as cytoplasmic HIF1α (p = 0.016), whereas this relationship was not observed among the VEGF, HK-I and nuclear HIF1α. CONCLUSION: The data presented in this study indicate that (18)F-FDG uptake is associated with the presence of GLUT1, VEGF, nuclear HK-II, and cytoplasmic HIF1α. There was also a significant correlation among the rate of expression of GLUT1, HK-II, cytoplasmic HIF1α, and CAIX in carcinomas of the cervix.
Analysis of the EGFR mutation status in head and neck squamous cell carcinoma before treatment with Gefitinib.
Bontognali S, Pless M, Brutsche MH … +3 more , Fischer C, Rochlitz C, Buess M
Onkologie · 2013 · PMID 23548963 · Publisher ↗
BACKGROUND: The efficacy of chemotherapy in metastatic and recurrent squamous cell carcinomas of the head and neck (HNSCC) remains unsatisfactory. Gefitinib offers a new therapeutic option with comparable results and bet...
BACKGROUND: The efficacy of chemotherapy in metastatic and recurrent squamous cell carcinomas of the head and neck (HNSCC) remains unsatisfactory. Gefitinib offers a new therapeutic option with comparable results and better tolerability than chemotherapy. We conducted this study to see if mutations in the epidermal growth factor receptor (EGFR) might predict the therapeutic benefit in HNSCC patients. PATIENTS AND METHODS: In a pilot trial, 8 patients with metastatic or recurrent HNSCC were treated palliatively with gefitinib (500 mg/day orally). Forceps biopsies were taken to confirm tumor recurrence and to perform an EGFR mutation analysis. RESULTS: The EGFR status could be determined in 6 of the 8 patients. 5 patients had no EGFR gene mutation, and 1 patient showed a silent guanine-to-adenosine mutation in position 2607. Even without any relevant mutation in the EGFR, we observed partial remission in 3 of 6 patients treated with gefitinib. We also observed that an additional 4 patients had stable disease for at least 10 weeks. The median progression-free survival was 6.25 months, and the median overall survival was 7.39 months. CONCLUSION: In HNSCC, there are tumor responses to gefitinib without protein-altering mutations in the EGFR gene.
Single-source tumor documentation - reusing oncology data for different purposes.
Ries M, Prokosch HU, Beckmann MW … +1 more , Bürkle T
Onkologie · 2013 · PMID 23486003 · Publisher ↗
We present a path towards single-source tumor documentation established at the Comprehensive Cancer Center Erlangen-Nürnberg (CCC-EN). Our goal was to derive data for cancer quality assurance and certification, cancer re...
We present a path towards single-source tumor documentation established at the Comprehensive Cancer Center Erlangen-Nürnberg (CCC-EN). Our goal was to derive data for cancer quality assurance and certification, cancer registry documentation and cancer research directly from routine care documentation. Therefore, clinical documentation activities were analyzed and a cancer data superset, containing these required elements, was developed. This superset was then split into appropriate clinical documentation packages, and the existing information technology infrastructure was analyzed and adapted to accommodate those documentation packages. A clinical documentation package is the amount of cancer-relevant data that can be captured within a clinical encounter. This grouping of data enables integration into existing clinical documentation workflows. We present examples in which single-source tumor documentation has been successfully established at the CCC-EN. The resulting cancer documentation reference model is described and its transferability to other institutions discussed.
Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment.
de Wit M, Ortner P, Lipp HP … +6 more , Sehouli J, Untch M, Ruhnke M, Mayer-Steinacker R, Bokemeyer C, Jordan K
Onkologie · 2013 · PMID 23486002 · Publisher ↗
BACKGROUND: Cytotoxic extravasation is a rare but potentially serious and painful complication of intravenous drug administration in oncology. Literature is anecdotal, and systematic clinical trials are scarce. The Germa...
BACKGROUND: Cytotoxic extravasation is a rare but potentially serious and painful complication of intravenous drug administration in oncology. Literature is anecdotal, and systematic clinical trials are scarce. The German working group for Supportive Care in Cancer (ASORS) has prepared an expert opinion for the diagnosis, prophylaxis and management of cytotoxic extravasation based on an interdisciplinary expert panel. MATERIAL AND METHODS: A Pubmed search was conducted for diagnosis, risk factors, symptoms, prophylaxis, and treatment of extravasation by the respective responsible expert. A writing committee compiled the manuscript and proposed the level of recommendation. In a consensus meeting, 13 experts reviewed and discussed the current practice in diagnosis and management of cytotoxic extravasation. In a telephone voting among the experts, the level of recommendation by ASORS was determined. RESULTS: Every effort should be made to reduce the risk of extravasation. Staff training, patient education, usage of right materials and infusion techniques have been identified to be mandatory to minimalize the risk of extravasation. Extravasation must be diagnosed as soon as possible, and specific therapy including antidotes dependent on the extravasated drug should be initiated immediately. An extravasation emergency set should be available wherever intravenous cytotoxics are applied. Documentation and post-treatment follow-up are recommended. CONCLUSION: We have developed a literature- and expert-based consensus recommendation to avoid cytotoxic extravasation. It also provides practical management instructions which should help to avoid surgery and serious late effects.
Complete pathological remission of locally advanced, unresectable pancreatic cancer (LAPC) after intensified neoadjuvant chemotherapy.
Hartlapp I, Müller J, Kenn W … +6 more , Steger U, Isbert C, Scheurlen M, Germer CT, Einsele H, Kunzmann V
Onkologie · 2013 · PMID 23486001 · Publisher ↗
BACKGROUND: Unresectable locally advanced pancreatic cancer (LAPC) has an extremely poor prognosis. Results of neoadjuvant (radio-)chemotherapy approaches aiming at achieving resectability are currently not satisfactory....
BACKGROUND: Unresectable locally advanced pancreatic cancer (LAPC) has an extremely poor prognosis. Results of neoadjuvant (radio-)chemotherapy approaches aiming at achieving resectability are currently not satisfactory. CASE REPORT: We report the case of a 67-year-old woman with histologically confirmed pancreas carcinoma that was not resectable on first surgical exploration who achieved a well-documented complete pathological remission (pCR). The carcinoma became resectable after consecutive neoadjuvant treatment with nanoparticle albumin-bound (nab)-paclitaxel/gemcitabine and FOLFIRINOX chemotherapy regimens. CONCLUSION: This is the first reported LAPC case in which neoadjuvant chemotherapy alone has been shown to lead to demonstrated pCR. CA19-9 levels, but not imaging criteria, were useful for response prediction and timing of the Whipple's procedure. The findings in this case suggest possible conceptual changes in the treatment approach for LAPC, and indicate that the new effective chemotherapy regimens should be integrated into clinical trials for LAPC.
Sudden extramedullary blast crisis of chronic myeloid leukemia manifesting as T-cell lymphoblastic lymphoma.
Wei J, Huang M, Wang Y … +1 more , Zhou J
Onkologie · 2013 · PMID 23486000 · Publisher ↗
BACKGROUND: Chronic myeloid leukemia (CML) is usually diagnosed in the chronic phase. An extramedullary blast crisis mimicking a T-cell lymphoma is a rare finding. CASE REPORT: A 35-year-old man presented with multiple l...
BACKGROUND: Chronic myeloid leukemia (CML) is usually diagnosed in the chronic phase. An extramedullary blast crisis mimicking a T-cell lymphoma is a rare finding. CASE REPORT: A 35-year-old man presented with multiple lymphadenopathy 2 months after diagnosis of Philadelphia chromosome (Ph)-positive CML in the chronic phase. Cervical lymph node biopsy later indicated an extramedullary blast crisis resembling T-cell lymphoblastic lymphoma (TLBL). The tumor mass was composed of primitive lymphoid cells expressing terminal deoxynucleotidyl transferase (TdT), CD3, CD43, CD5, CD99, and Bcl-2. Although the pathological diagnosis, confirmed by 2 independent pathological centers, was more typical of TLBL, fluorescence in situ hybridization (FISH) analysis showed the bcr-abl fusion gene within the blastic tumor cells. The FISH finding confirmed that the mass represented an extramedullary, immature blastic transformation of CML rather than a de novo T-cell lymphoma. CONCLUSION: The diagnosis of de novo TLBL should be suspected before excluding the extramedullary blast phase of CML.
MicroRNA-21 as an indicator of aggressive phenotype in breast cancer.
Ozgün A, Karagoz B, Bilgi O … +3 more , Tuncel T, Baloglu H, Kandemir EG
Onkologie · 2013 · PMID 23485999 · Publisher ↗
OBJECTIVE: The recently discovered microRNAs (miRNAs) are non-protein-coding, endogenous small RNAs. The aim of this study was to investigate the relationship between microRNA-21 (miR-21) and the clinicopathological feat...
OBJECTIVE: The recently discovered microRNAs (miRNAs) are non-protein-coding, endogenous small RNAs. The aim of this study was to investigate the relationship between microRNA-21 (miR-21) and the clinicopathological features of breast cancer. MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded (FFPE) tissue samples were collected from 15 patients who had undergone surgery for primary breast cancer. The miR-21 expression levels in normal and cancer tissues were analyzed using real-time quantitative reverse transcriptase polymerase chain reaction (real-time qRT-PCR). The correlations between the miR-21 expression level and the stage of disease, the tumor size, lymph node involvement, hormone receptor status, human epidermal growth factor receptor 2 (HER2) status, and disease-free survival (DFS) were investigated. RESULTS: The miR-21 expression levels were significantly higher in patients with stage III disease, patients with more than 3 axillary lymph node metastases and HER2-positive patients than in patients with stage I-II disease, patients with 1-3 axillary lymph node metastases and HER2-negative patients (p = 0.005, p = 0.037, and p = 0.014, respectively). Patients with high miR-21 expression level had a significantly shorter DFS than patients with low miR-21 expression level (median DFS: 18 and 56 months, respectively; p = 0.004). CONCLUSION: These results show that miR-21 is an indicator of an aggressive breast cancer phenotype and that it may be a new therapeutic target in the treatment of breast cancer in the future.
Are somatic symptoms a legitimate part of the depression profile in prostate cancer patients?
Sharpley CF, Bitsika V, Christie DH
Onkologie · 2013 · PMID 23485998 · Publisher ↗
BACKGROUND: Although depression is often reported in prostate cancer patients, some tests of depression omit the somatic criteria that are listed for Major Depressive Episode, arguing that these may be confounded by the...
BACKGROUND: Although depression is often reported in prostate cancer patients, some tests of depression omit the somatic criteria that are listed for Major Depressive Episode, arguing that these may be confounded by the cancer itself. However, this omission may be challenged in terms of the particular somatic symptoms that have been associated with prostate cancer. Therefore, the present study investigated the relative contribution to total depression scores made by the somatic criteria for Major Depressive Episode that were not caused by prostate cancer. PATIENTS AND METHODS: 491 prostate cancer patients completed the Zung Self-Rating Depression Scale. Data were analysed to compare the predictive power of 5 subsets of depression on patients' total depressive scores. RESULTS: Somatic symptoms were the most powerful predictor of total depression scores, followed by anhedonia and depressed mood, with similar findings for depression clinical status. Emotional symptoms and cognitive confusion were not significant predictors of total depression scores but did predict depression clinical status. CONCLUSION: Valid and reliable assessment of depression and selection of appropriate treatment options in prostate cancer patients requires consideration of somatic items which match the DSM-IV-TR criteria for Major Depressive Episode.
Expression of Rac1, HIF-1α, and VEGF in gastric carcinoma: correlation with angiogenesis and prognosis.
Zhan H, Liang H, Liu X … +3 more , Deng J, Wang B, Hao X
Onkologie · 2013 · PMID 23485997 · Publisher ↗
BACKGROUND: The aim of this study was to investigate the relationship between the expression of hypoxia-inducible factor-1α (HIF-1α), Ras-related C3 botulinum toxin substrate 1 (Rac1), and vascular endothelial growth fac...
BACKGROUND: The aim of this study was to investigate the relationship between the expression of hypoxia-inducible factor-1α (HIF-1α), Ras-related C3 botulinum toxin substrate 1 (Rac1), and vascular endothelial growth factor (VEGF), as well as their correlation with angiogenesis and prognosis in gastric carcinoma. MATERIAL AND METHODS: The expression of Rac1, HIF-1α, VEGF, and CD34 (described in terms of microvessel density, MVD) was determined by immunohistochemical staining of tissues from 60 radically resected gastric cancer specimens. RESULTS: The proportion of specimens expressing Rac1, HIF-1α, and VEGF was 37/60 (61.7%), 35/60 (58.3%), and 40/60 (66.7%), respectively. The levels of Rac1, HIF-1α, and VEGF expression were significantly correlated with Lauren's classification, lymph node metastasis, and pathologic staging (p < 0.05). There were positive correlations between MVD and the expression of Rac1, HIF-1α, and VEGF. The mean survival time and 5-year survival rate in cases with positive Rac1, HIF-1α, and VEGF expression and MVD ≥ 26.3 were significantly shorter than those with negative Rac1, HIF-1α, and VEGF expression and MVD < 26.3. CONCLUSION: Rac1, HIF-1α, and VEGF play an important role in tumor invasion and metastasis, especially in tumor angiogenesis. Thus, testing the expression of Rac1, HIF-1α, and VEGF may be a useful index for treatment and prognosis.
Everolimus in metastatic renal cell carcinoma after failure of initial vascular endothelial growth factor receptor-tyrosine kinase inhibitor (VEGFr-TKI) therapy: results of an interim analysis of a non-interventional study.
Bergmann L, Goebell PJ, Kube U … +13 more , Kindler M, Herrmann E, Janssen J, Schmitz J, Weikert S, Steiner G, Jakob A, Staehler MD, Steiner T, Overkamp F, Albrecht M, Guderian G, Doehn C
Onkologie · 2013 · PMID 23485996 · Publisher ↗
BACKGROUND: Everolimus is approved for treatment of anti-vascular endothelial growth factor (VEGF)-refractory patients with metastatic renal cell carcinoma (mRCC). Clinical trials rarely mirror treatment reality. Thus, a...
BACKGROUND: Everolimus is approved for treatment of anti-vascular endothelial growth factor (VEGF)-refractory patients with metastatic renal cell carcinoma (mRCC). Clinical trials rarely mirror treatment reality. Thus, a broader evaluation of everolimus is valuable for routine use. PATIENTS AND METHODS: A German multicenter non-interventional study documented mRCC patients starting everolimus after failure of initial VEGF-targeted therapy. Primary endpoint was effectiveness, defined as time to progression (TTP) according to investigator assessment (time from first dose to progression). RESULTS: Of 382 documented patients, 196 were included in this interim analysis. In the efficacy population (n = 165), median TTP was 7.0 months (95% confidence interval (CI) 5.1-9.0). Among patients with < or ≥ 6 months of previous VEGF-targeted therapy, median TTP was 6.6 months (95% CI 3.8-not estimable) and 7.4 months (95% CI 4.6-9.6), respectively. Most common adverse events were anemia (13%) and dyspnea (14%). Physicians assessed high tolerance and documented high adherence to everolimus therapy (approximately 97%). CONCLUSION: In routine clinical practice, everolimus is effective, as measured by median TTP (longer than median progression-free survival in RECORD-1 trial), and well tolerated. Our results support everolimus use in anti-VEGF-refractory patients with mRCC.
Safety evaluation of high-intensity focused ultrasound in patients with pancreatic cancer.
Wang K, Zhu H, Meng Z … +4 more , Chen Z, Lin J, Shen Y, Gao H
Onkologie · 2013 · PMID 23485995 · Publisher ↗
INTRODUCTION: This study was performed to analyze the safety of high-intensity focused ultrasound (HIFU) for treating pancreatic cancer. METHODS: 224 cases with advanced pancreatic cancer were enrolled into this study. R...
INTRODUCTION: This study was performed to analyze the safety of high-intensity focused ultrasound (HIFU) for treating pancreatic cancer. METHODS: 224 cases with advanced pancreatic cancer were enrolled into this study. Real-time sonographic images were taken, and vital signs, liver and kidney function, skin burns, local reactions, and systemic effects were monitored and recorded before, during, and after HIFU. Computed tomography or magnetic resonance imaging (MRI) was also performed before and after HIFU. RESULTS: Serum amylase level increased in 16 cases (7.1%) 1 day after HIFU treatment, and 9 of these cases also had abnormal urinary amylase levels. Gastrointestinal (GI) dysfunction such as abdominal distension and anorexia with slight nausea was observed in 10 cases (4.5%) after HIFU treatment. 1 case with pancreatic head cancer developed obstructive jaundice 2 weeks after HIFU treatment. Vertebral injury, identified by MRI, occurred in 2 cases, although no symptoms were seen. No severe complications such as skin burns, lesion bleeding, GI tract bleeding or GI perforation were observed in any of the cases. CONCLUSION: For specific patients, HIFU treatment is a safe, non-invasive treatment for pancreatic cancer but requires careful preoperative preparation and exact operative performance.
The impact of computed tomography on early glottic cancer outcomes.
Mourad WF, Hu KS, Shourbaji RA … +5 more , Ishihara D, Lin W, Kumar M, Blakaj DM, Harrison LB
Onkologie · 2013 · PMID 23485994 · Publisher ↗
PURPOSE: Aim of this study was to evaluate the impact of computed tomography (CT)-based simulation and planning on early glottic cancer outcomes and toxicity. METHODS: This is a single-institution retrospective study of...
PURPOSE: Aim of this study was to evaluate the impact of computed tomography (CT)-based simulation and planning on early glottic cancer outcomes and toxicity. METHODS: This is a single-institution retrospective study of 253 patients with T1-2 glottic cancer who underwent radiation therapy (RT) from January 1998-2010. Group A (80%) underwent 2-dimensional RT (2DRT) and group B (20%) 3-dimensional RT (3DRT). 76% of patients in group A and 84% in group B had T1 cancer. The median dose and fraction size were 63 Gy and 2.25 Gy, respectively. RESULTS: With a median follow-up of 83, 93, and 30 months for the whole cohort, group A and B, respectively, the loco-regional control (LRC) was 97.6%. The rate of LRC for T1 disease was 99.5% and for T2 disease 91%. According to the RT modality, rates of LRC were 99.4 and 100% in groups A and B for T1, and 89.8 and 100% for T2. Long-term toxicity was negligible in both groups. Kaplan-Meier Curve showed the 5-year cause-specific survival to be 100%. Chi-square and multivariate analysis tests showed a significant relationship between CT simulation (3DRT) and LRC (p < 0.0001). CONCLUSION: CT-based simulation and planning provided better LRC and less acute side effects compared to 2DRT.
Model calculations to quantify clinical and economic effects of pathogen inactivation in platelet concentrates.
Berger K, Bauer M, Schopohl D … +2 more , Henschler R, Ostermann H
Onkologie · 2013 · PMID 23429333 · Publisher ↗
BACKGROUND: Future shortages in platelet supply are expected in Germany due to demographic changes. A rising cancer incidence will lead to an increasing demand for platelet concentrates (PCs) while the number of potentia...
BACKGROUND: Future shortages in platelet supply are expected in Germany due to demographic changes. A rising cancer incidence will lead to an increasing demand for platelet concentrates (PCs) while the number of potential donors will decrease. Pathogen inactivation (PI) aims to inactivate various infectious agents including emerging pathogens to extend the shelf-life of PCs and reduce the frequency of acute transfusion reactions (ATRs). In this context, the clinical and economic impact of PI on platelet transfusion was evaluated. MATERIAL AND METHODS: Model calculations were conducted for 2 scenarios considering different production settings. Frequencies of ATRs were based on literature analyses, platelet and ATR costs on cost analyses. RESULTS: The estimated average costs for ATRs of grade 1 and 2, irrespective of origin, and grade 3 (allergic) were € 104, € 238, and € 1,200, respectively. Approximately 400 PC-related ATRs per 10(5) transfusions can be avoided, with estimated savings amounting to € 77,000. The total cost increase was calculated to approximately € 30-50 per PI-treated PC. CONCLUSION: PI potentially saves plasma, prolongs shelf-life, decreases donor deferral, and reduces ATRs. Model calculations considering clinical and safety benefits of PI show a rational cost increase. The impact of PI should be further evaluated from a societal perspective regarding future blood supply and infectious disease globalization.
Fatal cisplatin overdose in the treatment of mediastinal lymphoma with the ESHAP regimen - analysis of the causes of the adverse drug event.
Jurek T, Rorat M, Dys P … +1 more , Swiatek B
Onkologie · 2013 · PMID 23429332 · Publisher ↗
BACKGROUND: Cisplatin is a chemotherapeutic agent that may cause acute (or chronic) organ toxicity. As there is no antidote, prevention of adverse drug events is essential for patients' safety. CASE REPORT: The authors p...
BACKGROUND: Cisplatin is a chemotherapeutic agent that may cause acute (or chronic) organ toxicity. As there is no antidote, prevention of adverse drug events is essential for patients' safety. CASE REPORT: The authors present the case of a 33-year-old woman treated for lymphoma with the ESHAP regimen, who died of an overdose of cisplatin. The drug was administered at a rate 4 times greater than the recommended maximum dose. The first symptom of overdose - partial hearing loss - appeared after administration of the last dose of the drug on day 4 of the chemotherapy course. The initiation of intensive treatment with plasmapheresis and dialyses was ineffective. The patient died 18 days after receiving the last dose of cisplatin. The medication schedule had been prepared by an inexperienced physician. The information on cisplatin dosage had been sourced from a vague instruction in a clinical oncology manual: '100 mg/m(2) continuous i.v. infusion d.1-4'. The instruction was misinterpreted. The patient was given 100 mg/m(2) on each of the 4 days of the treatment. CONCLUSION: Special care must be taken when preparing a medication schedule; the treatment must be checked by an experienced physician and verified by the nursing staff. The patient should be monitored for symptoms of cisplatin intoxication.
Acute stroke secondary to carotid artery dissection in a patient with germ cell tumour: did cisplatin play a role?
Khadjooi K, Adab N, Kenton A
Onkologie · 2013 · PMID 23429331 · Publisher ↗
BACKGROUND: Cisplatin-based chemotherapy - mainly the bleomycin, etoposide and cisplatin (BEP) regimen - has significantly improved the prognosis of testicular germ cell tumours (GCT). However, it has serious vascular si...
BACKGROUND: Cisplatin-based chemotherapy - mainly the bleomycin, etoposide and cisplatin (BEP) regimen - has significantly improved the prognosis of testicular germ cell tumours (GCT). However, it has serious vascular side effects, including acute ischemic stroke. CASE REPORT: A 37-year-old man with no conventional cerebrovascular risk factors presented with right arm clumsiness followed by a transient episode of expressive dysphasia 3 h later. He was receiving the third cycle of BEP for metastatic retroperitoneal GCT. Brain computed tomography (CT) and diffusion-weighted magnetic resonance imaging (MRI) confirmed multiple acute infarctions in the left middle cerebral artery territory. MR angiography and CT angiography showed a dissection with flaps extending into the left internal and external carotid arteries. The patient was anticoagulated and made an almost complete recovery. CONCLUSION: Carotid artery dissection has not been reported as the cause of cisplatin-associated stroke in patients with GCT. This case demonstrates the potential for cisplatin-induced mechanisms causing carotid dissection, particularly considering the close temporal association of BEP and the event in our patient. In young patients with excellent curative potential from GCT, every effort should be made to minimise the risk of disabling side effects of BEP. After a stroke, imaging of intracranial and extracranial arteries, monitoring and correction of serum magnesium is recommended. The decision to continue or discontinue cisplatin-based chemotherapy should be individualised.
A phase I study of the oral platinum agent satraplatin in combination with oral vinorelbine in patients with advanced solid malignancies.
Gallerani E, Cathomas R, Sessa C … +4 more , Digena T, Bartosek AA, Dal Zotto L, von Moos R
Onkologie · 2013 · PMID 23429330 · Publisher ↗
BACKGROUND: The broad spectrum of antitumor activity of the oral platinum satraplatin (S) and vinorelbine (V) were the rationale for performing a phase I trial to define the maximum tolerated (MTD) and the recommended (R...
BACKGROUND: The broad spectrum of antitumor activity of the oral platinum satraplatin (S) and vinorelbine (V) were the rationale for performing a phase I trial to define the maximum tolerated (MTD) and the recommended (RD) dose in adult patients with advanced solid tumors. PATIENTS AND METHODS: 4 dose levels (DLs) of S (mg/m(2)/day, days 1-5) and V (mg/m(2)/day, days 1, 8, 15, and 22) every 28 days were explored: S60/V60 on days 1, 8 and 15 only; S60/V60; S70/V60; and S80/V60. Subsequently, 3 further DLs were evaluated with V omitted on day 22: S70/V60, S80/V60, and S80/V80. RESULTS: Treating 27 patients, the MTD was S80/V80 on days 1, 8, and 15, with 2 dose-limiting toxicities in 2 patients (nausea and vomiting grade (G) 3 with skipping of V on day 15, and neutropenia G4 with infection). The RD was S80/V60 on days 1, 8, and 15. The most frequent toxicities (any G) were nausea (70%), diarrhea (59%), anorexia (37%), vomiting (33%), asthenia (26%), constipation (26%), and paresthesia (18%). Partial responses were observed in 2 platinum-sensitive ovarian cancer patients and in 1 prostate cancer patient. CONCLUSION: The combination of S and V is tolerable at a DL of S80/V60 on days 1, 8, and 15; further evaluations in platinum- and V-sensitive tumor types would be of interest.
Quality of life and symptom evaluation in daily oncology practice: a survey of 150 patients with advanced gastrointestinal tumours receiving palliative chemotherapy.
Schultheis K, Hofheinz RD, Gencer D … +2 more , Blunk JA, Benrath J
Onkologie · 2013 · PMID 23429329 · Publisher ↗
BACKGROUND: Quality of life (QoL) is frequently investigated as a secondary endpoint in clinical trials but is rarely evaluated in clinical practice. The present survey sought to assess the QoL of patients with advanced...
BACKGROUND: Quality of life (QoL) is frequently investigated as a secondary endpoint in clinical trials but is rarely evaluated in clinical practice. The present survey sought to assess the QoL of patients with advanced gastrointestinal tumours receiving palliative chemotherapy. Furthermore, we wanted to compare the results of subscales of the generic EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire, version 3.0) using assessment tools with an emphasis on pain and depression. PATIENTS AND METHODS: 150 patients with gastrointestinal tumours undergoing palliative chemotherapy completed 3 questionnaires. QoL was assessed using the EORTC QLQ-C30, Beck depression inventory (BDI) was utilised to measure the severity of patients' depression and a visual analogue scale (VAS) was applied to measure patient's pain intensity. Correlations between these assessments were calculated. RESULTS: The survey revealed that treatment of pain and depression appeared to be inadequate in the present cohort of patients with metastatic gastrointestinal cancer. Good correlations between EORTC QLQ-C30 subscales and the VAS (r = 0.86), as well as the BDI (r = 0.63) were found. CONCLUSION: The present analysis indicates the need for better symptom control regarding the examples 'pain' and 'depression'. In view of the good correlation between the EORTC QLQ-C30 and the BDI and VAS, further studies on the implementation of the EORTC QLQ-C30 as a screening tool, or for follow-up measurements in daily practice are warranted.
Markers CD40, VEGF, AKT, PI3K, and S100 correlate with tumor stage in gastric cancer.
Tian WY, Chen WC, Li R … +1 more , Liu L
Onkologie · 2013 · PMID 23429328 · Publisher ↗
BACKGROUND: To better understand gastric cancer occurrence and prognosis, we explored the expression of molecules in the CD40 pathway and their correlation with gastric cancer prognosis. PATIENTS AND METHODS: We measured...
BACKGROUND: To better understand gastric cancer occurrence and prognosis, we explored the expression of molecules in the CD40 pathway and their correlation with gastric cancer prognosis. PATIENTS AND METHODS: We measured the expression of CD40, VEGF, AKT, PI3K, and S100 in gastric cancer tissues and adjacent normal tissues from 128 patients by immunohistochemistry. RESULTS: The expression of CD40, VEGF, AKT, and PI3K were significantly higher in tumor tissue than in normal tissue, while S100 expression in dendritic cells (DC) was lower. Expression of CD40, VEGF, AKT, and PI3K significantly increased with T stage, while S100 expression decreased with T stage. Lymph node metastasis was associated with low or negative S100 expression. PI3K expression increased with clinical stage, while negative S100 expression was associated with higher clinical stages. Multivariate analysis did not indicate significant associations between any of these markers and recurrence or mortality. CONCLUSION: The correlation between T stage of gastric cancer and the higher expression of CD40, VEGF, AKT, and PI3K, along with lower S100 expression in DC, may provide insights into future targets for more effective immunotherapy for cancer.
Gastrointestinal stromal tumors in Turkey: experiences from 3 centers.
Selcukbiricik F, Yalçın S, Tural D … +4 more , Erdamar S, Demir G, Doğusoy G, Mandel NM
Onkologie · 2013 · PMID 23429327 · Publisher ↗
BACKGROUND: Gastrointestinal stromal tumors (GIST) are rare tumors of the gastrointestinal system. The most common primary site of GIST is the stomach. The treatment is primarily surgery, and the standard medical therapy...
BACKGROUND: Gastrointestinal stromal tumors (GIST) are rare tumors of the gastrointestinal system. The most common primary site of GIST is the stomach. The treatment is primarily surgery, and the standard medical therapy is imatinib. Long-term survival can be obtained with good follow-up and treatment. MATERIALS AND METHODS: In this study, data entry was performed using a web-based patient registry system for patients who were referred to 3 centers and retrospectively were diagnosed with GIST. RESULTS: The study cohort consisted of 249 patients, including 160 men (64.3%) and 89 women (35.7%). The mean age was 59 years (range 21-90 years). Initially, 69.9% of the patients had local disease, while 30.1% had metastatic disease. The tumor was located in the stomach in 45.6% of patients. According to the Fletcher risk classification, the very low risk group included 8 subjects (3.2%), the low risk group included 40 subjects (16.1%), the moderate risk group included 56 subjects (22.5%), and the high risk group included 117 subjects (47%); the unspecified group included 28 subjects (11.5%). CONCLUSION: These data are important for revealing the clinicopathologic characteristics and survival data of patients with GIST, who are treated and followed up in Turkey.
Nipple discharge: role of ductoscopy in comparison with standard diagnostic tests.
Albrecht C, Thele F, Grunwald S … +5 more , Kohlmann T, Hegenscheid K, Utpatel K, Zygmunt M, Ohlinger R
Onkologie · 2013 · PMID 23429326 · Publisher ↗
BACKGROUND: This study aims to assess the role of ductoscopy for detecting intraductal anomalies in patients with nipple discharge in comparison to conventional tests and to find an effective combination of both approach...
BACKGROUND: This study aims to assess the role of ductoscopy for detecting intraductal anomalies in patients with nipple discharge in comparison to conventional tests and to find an effective combination of both approaches. MATERIALS AND METHODS: Prior to duct excision, ductoscopy was performed in 97 women. Histologic and all other diagnostic results were compared. Sensitivity, specificity, and efficiency were calculated for all methods. These parameters were also calculated for all possible test combinations in 12 patients who had completed all tests. RESULTS: Breast sonography reached the highest sensitivity (64.1%) and efficiency (64%); mammography had the highest specificity (100%). The sensitivity of ductoscopy was 53.2%, its specificity 60%, and its efficiency 55.1%. Among combinations of all methods, the combination ductoscopy + galactography was the most sensitive (80%). Mammography, magnetic resonance imaging, and ductoscopy were each 100% specific. Ductoscopy was the most efficient (75%) single method. CONCLUSION: Ductoscopy is a valuable test for diagnosing intraductal lesions in patients with nipple discharge. It is more efficient than conventional tests in patients undergoing all tests.
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