scholarly journals Effects of COVID-19 Pandemic on the Treatment of Pancreatic Cancer: A Perspective from Central Europe

2021 ◽  
Vol 38 (2) ◽  
pp. 158-165
Author(s):  
Ilaria Pergolini ◽  
I. Ekin Demir ◽  
Christian Stöss ◽  
Klaus Emmanuel ◽  
Robert Rosenberg ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Central Europe ◽  
Pancreatic Surgery ◽  
Online Survey ◽  
Viral Infections ◽  
High Volume ◽  
Tumor Board ◽  
Standards Of Care ◽  
The Impact

Background: This survey aimed to register changes determined by the COVID-19 pandemic on pancreatic surgery in a specific geographic area (Germany, Austria, and Switzerland) to evaluate the impact of the pandemic and obtain interesting cues for the future. Methods: An online survey was designed using Google Forms focusing on the local impact of the pandemic on pancreatic surgery. The survey was conducted at 2 different time points, during and after the lockdown. Results: Twenty-five respondents (25/56) completed the survey. Many aspects of oncological care have been affected with restrictions and delays: staging, tumor board, treatment selection, postoperative course, adjuvant treatments, outpatient care, and follow-up. Overall, 60% of respondents have prioritized pancreatic cancer patients according to stage, age, and comorbidities, and 40% opted not to operate high-risk patients. However, for 96% of participants, the standards of care were guaranteed. Discussion/Conclusions: The first wave of the COVID-19 pandemic had an important impact on pancreatic cancer surgery in central Europe. Guidelines for prompt interventions and prevention of the spread of viral infections in the surgical environment are needed to avoid a deterioration of care in cancer patients in the event of a second wave or a new pandemic. High-volume centers for pancreatic surgery should be preferred and their activity maintained. Virtual conferences have proven to be efficient during this pandemic and should be implemented in the near future.

Clinicians’ perspectives on strategies to improve cross-institutional collaboration and coordination of pancreatic cancer care for rural patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13532-e13532
Author(s):  
Matthew DePuccio ◽  
Natasha A Kurien ◽  
Angela Sarna ◽  
Ann Scheck McAlearney ◽  
Aslam Ejaz
Keyword(s):  
Pancreatic Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Cancer Care ◽  
High Volume ◽  
Institutional Collaboration ◽  
Phone Calls ◽  
Tumor Boards ◽  
Cancer Specialists ◽  
The Impact

e13532 Background: Rural pancreatic cancer patients often lack access to high-volume pancreatic cancer specialists. This lack of access can result in fragmented cancer care—when patients receive care at multiple institutions—and necessitates that specialists engage in cross-institutional collaboration. In the context of fragmented pancreatic cancer care, the strategies specialists use to facilitate collaboration across institutions are poorly understood. Methods: We conducted semi-structured interviews with cancer specialists (medical, surgical, and radiation oncologists) from a high-volume pancreas cancer center (n = 9) and rural community cancer centers (n = 11) to examine specialists’ coordination practices related to treating and co-managing pancreatic cancer patients across their respective institutions. Using qualitative methods, two of the co-authors independently coded the interview transcripts to identify themes related to cross-institutional coordination practices, noting improvement opportunities and facilitative strategies. Results: Cancer specialists described multiple practices to coordinate cross-institutional care including one-on-one phone calls and using a shared electronic medical record or secure email to exchange clinical notes. In recognizing the limitations of these practices, specialists acknowledged the need to develop and implement communication systems that could facilitate real-time discussions and information sharing between high-volume and rural specialists to coordinate diagnostic and treatment plans. Cross-institutional virtual tumor boards were viewed as a potentially useful approach to foster shared clinical decision-making and treatment plan development across institutions, but specialists perceived that logistical, institutional, and technological challenges could limit the use of this approach. Regardless, specialists indicated that cross-institutional virtual tumor boards could help disseminate treatment recommendations as well as identify barriers to care for mutually-shared rural cancer patients. Specialists also indicated that a dedicated patient navigator could help facilitate cross-institutional coordination by bridging communication between specialists while also assisting cancer patients with issues related to housing, transportation, scheduling, and treatment finances. Conclusions: It is important for cancer specialists treating rural cancer patients to have strategies that support efficient communication and decision-making. Cross-institutional virtual tumor boards and dedicated patient navigators are two such strategies that may help facilitate collaboration between high-volume and rural cancer specialists. Future research should examine the impact of these strategies on patients receiving cancer care at multiple institutions.

scholarly journals Impact of COVID-19 on multiple sclerosis care and management: Results from the European Committee for Treatment and Research in Multiple Sclerosis survey

2021 ◽  
pp. 135245852110053
Author(s):  
Emilio Portaccio ◽  
Mattia Fonderico ◽  
Bernhard Hemmer ◽  
Tobias Derfuss ◽  
Bruno Stankoff ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Access To Care ◽  
Online Survey ◽  
Dimethyl Fumarate ◽  
Standards Of Care ◽  
Treatment Practices ◽  
European Committee ◽  
Disease Modifying Therapy ◽  
Anti Cd20 ◽  
The Impact

Background: The spread of Coronavirus disease-19 (COVID-19) poses unique challenges in the management of people with multiple sclerosis (PwMS). Objectives: To collect data about the impact of COVID-19 emergency on access to care for PwMS and on MS treatment practices. Methods: Between March and July 2020, the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) promoted an online survey covering patient access to care, management of relapses and visits, disease-modifying therapy (DMT) and experience with COVID-19. Results: Three-hundred and sixty neurologists from 52 countries (68% from Europe) completed the survey. 98% reported COVID-19-related restrictions. Telemedicine was adopted to overcome the limited access to care and was newly activated (73%) or widely implemented (17%). 70% reported changes in DMT management. Interferons and glatiramer were considered safe. Dimethyl fumarate, teriflunomide and fingolimod were considered safe except for patients developing lymphopenia. No modifications were considered for natalizumab in 64%, cladribine in 24%, anti-CD20 in 22% and alemtuzumab in 17%; 18% (for alemtuzumab and cladribine) and 43% (for anti-CD20) considered postponing treatment. Conclusion: The ECTRIMS survey highlighted the challenges in keeping standards of care in clinical practice. Telemedicine clearly needs to be implemented. Gathering data on DMT safety will remain crucial to inform treatment decisions.

scholarly journals The Impact of COVID-19 Infection on the Postoperative Outcomes in Pancreatic Cancer Patients

In Vivo ◽  
2021 ◽  
Vol 35 (2) ◽  
pp. 1307-1311
Author(s):  
NICOLAE BACALBASA ◽  
CAMELIA DIACONU ◽  
CORNEL SAVU ◽  
CARMEN SAVU ◽  
OVIDIU STIRU ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Postoperative Outcomes ◽  
The Impact

The impact of interfractional anatomical changes on the accumulated dose in carbon ion therapy of pancreatic cancer patients

2016 ◽  
Vol 119 (2) ◽  
pp. 319-325 ◽  
Author(s):  
Antonetta C. Houweling ◽  
Kyohei Fukata ◽  
Yoshiki Kubota ◽  
Hirofumi Shimada ◽  
Coen R.N. Rasch ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Carbon Ion Therapy ◽  
Carbon Ion ◽  
Anatomical Changes ◽  
Ion Therapy ◽  
The Impact ◽  
Accumulated Dose

scholarly journals P-152 The impact of 2nd-line treatment after 1st-line gemcitabine plus nab-paclitaxel in advanced pancreatic cancer patients

2020 ◽  
Vol 31 ◽  
pp. S139
Author(s):  
M. Bensi ◽  
B. Di Stefano ◽  
M. Chiaravalli ◽  
M. Ribelli ◽  
A. Spring ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Advanced Pancreatic Cancer ◽  
Line Treatment ◽  
The Impact

scholarly journals RAD51 is a potential marker for prognosis and regulates cell proliferation in pancreatic cancer

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaomeng Zhang ◽  
Ningyi Ma ◽  
Weiqiang Yao ◽  
Shuo Li ◽  
Zhigang Ren
Keyword(s):  
Pancreatic Cancer ◽  
Cell Proliferation ◽  
Overall Survival ◽  
Cancer Cells ◽  
Cancer Patients ◽  
Aerobic Glycolysis ◽  
Cell Counting ◽  
Survival Prediction ◽  
Pancreatic Cancer Cells ◽  
The Impact

Abstract Background The DNA damage and repair pathway is considered a promising target for developing strategies against cancer. RAD51, also known as RECA, is a recombinase that performs the critical step in homologous recombination. RAD51 has recently received considerable attention due to its function in tumor progression and its decisive role in tumor resistance to chemotherapy. However, its role in pancreatic cancer has seldom been investigated. In this report, we provide evidence that RAD51, regulated by KRAS, promotes pancreatic cancer cell proliferation. Furthermore, RAD51 regulated aerobic glycolysis by targeting hypoxia inducible factor 1α (HIF1α). Methods TCGA (The Cancer Genome Atlas) dataset analysis was used to examine the impact of RAD51 expression on overall survival of pancreatic cancer patients. Lentivirus-mediated transduction was used to silence RAD51 and KRAS expression. Quantitative real-time PCR and western blot analysis validated the efficacy of the knockdown effect. Analysis of the glycolysis process in pancreatic cancer cells was also performed. Cell proliferation was determined using a CCK-8 (Cell Counting Kit-8) proliferation assay. Results Pancreatic cancer patients with higher levels of RAD51 exhibited worse survival. In pancreatic cancer cells, RAD51 positively regulated cell proliferation, decreased intracellular reactive oxygen species (ROS) production and increased the HIF1α protein level. KRAS/MEK/ERK activation increased RAD51 expression. In addition, RAD51 was a positive regulator of aerobic glycolysis. Conclusion The present study reveals novel roles for RAD51 in pancreatic cancer that are associated with overall survival prediction, possibly through a mechanism involving regulation of aerobic glycolysis. These findings may provide new predictive and treatment targets for pancreatic cancer.

Clinical outcomes of pancreas cancer patients with peritoneal spread: Results from the chord consortium.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19268-e19268
Author(s):  
Mehrnoosh Pauls ◽  
Abdulaziz AlJassim AlShareef ◽  
Winson Y. Cheung ◽  
Rachel Anne Goodwin ◽  
Brandon M. Meyers ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Advanced Pancreatic Cancer ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
First Line ◽  
The Impact ◽  
Line Chemotherapy

e19268 Background: Prior studies have demonstrated that clonal cells that give rise to pancreatic peritoneal metastases (PM) are geographically and genetically distinct from clonal cells, giving rise to lung and liver metastases. The objective of this study was to assess if there is a distinct difference in prognosis and therapeutic response among patients with pancreatic cancer with (PM compared to the lung/liver. Methods: Using a retrospective cohort design, medical records from adult patients diagnosed with metastatic adenocarcinoma of the pancreas at five Canadian academic cancer centers (2014 - 2019) were reviewed. Prognostic variables including age, Charlson comorbidity index, ECOG, cigarette smoking, nodal status, sites of metastases, and first line chemotherapy were collected. Cox proportional hazards model (MVA) was used to examine the association between peritoneal involvement and survival, adjusted for measured confounders. Analyses were completed using SAS, where alpha of 0.05 was defined as the level of significance. Results: A total of 1161 patients were included. Metastatic sites included peritoneum (n = 170, 14.6%), lung (n = 145, 12.5%) and liver (n = 563, 48.5%). Patients with PM received first-line FOLFIRINOX (FFX, n = 31), Gemcitabine + nab-paclitaxel (G/N, n = 20), Gemcitabine (G, n = 18), and no treatment (n = 97). In univariate analyses, worse ECOG PS was associated with PM (p = 0.002). The majority of patients died (89%), with a median overall survival (OS) of 3 vs 7 months for patients with PM and those without PM (p < 0.001), respectively. The median OS in patient whom receive first-line chemotherapy was 7 months in FFX group (95% CI 1.66-12.33), 6 months in G/N (95% CI 4.54-7.45) and 2 months in G group (95% CI 1.42-2.57). Patients had significantly better OS when treated with FFX or G/N compared to G alone (p = 0.002). Time to treatment failure was significantly shorter among patient treated with G alone compare to patients treated with FFX and G/N (P < 0.005). Conclusions: In the setting of combination chemotherapy for advanced pancreatic cancer, patients with PM continue to have a poor prognosis. This may be due to the impact of PM on PS and the inability to administer palliative chemotherapy. For eligible patients, FFX or G/N results in a higher OS than G monotherapy.

scholarly journals Dental Practice during COVID-19 in Nepal: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Manoj Humagain ◽  
Rashmi Humagain ◽  
Dinesh Rokaya
Keyword(s):  
Online Survey ◽  
Financial Burden ◽  
Cross Sectional Study ◽  
Standards Of Care ◽  
Dental Practice ◽  
Sectional Study ◽  
Cross Sectional ◽  
High Standards ◽  
Financial Burdens ◽  
The Impact

Introduction: Currently, coronavirus disease (COVID-19) has become pandemic and spread globally. In Nepal, the number of COVID-19 is increasing day-by-day. This research was done to find out the impact of COVID-19 on dentists, patients, and dental practice in Nepal. Methods: This study is a cross-sectional study conducted using an online survey from May 10 to17, 2020. A questionnaire was designed and uploaded in Freeonlinesurveys.com. Following ethical approval, the questionnaire was distributed among 500 dentists, and 406 dentists participated in the study. The survey link was dispersed to the Nepali dentists through social media and e-mail, and the results of the responses were received online. The questionnaire consisted of a total of 34 closed-ended questions containing three parts; demographic details, knowledge of dentists on COVID-19, and the impact of COVID-19 on dentists, patients, and dental treatments. Results: It showed that majority of the participants were females 243 (60%) of the age group 25-29 years with the clinic as the workplace. Patients receive dental treatments only from 40 (10%) of the dentist. A high number of dentists: 284 (70%) were severely affected by the financial burden and were not receiving a salary during this lockdown. About 349(86%) of the dentist think they should do regular dental treatments, but only 101 (25%) think the dentist should do only dental emergency treatments for COVID-19 infected cases. Conclusions: Dentists, patients, and dental practice are severely affected by the COVID-19.The majority of the dentists have faced financial burdens. The dental treatments should be done with high standards of care and infection control following proper recommendations.

Sign in / Sign up

Export Citation Format

Share Document