Potential role of chemoradiotherapy for metastatic pancreatic cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 344-344
Author(s):  
D. Y. Lee ◽  
J. M. Robertson ◽  
J. Huang ◽  
J. H. Margolis ◽  
S. Balaraman ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Patients ◽  
Performance Status ◽  
Metastatic Pancreatic Cancer ◽  
Categorical Variables ◽  
Ecog Performance Status ◽  
Term Survival ◽  
Kaplan Meier ◽  
Radiotherapy Dose

344 Background: Patients with metastatic pancreatic cancer have a poor outcome and the radiotherapy is typically only given to patients requiring palliation. We analyzed our institutional pancreas database to compare the outcome between chemotherapy alone vs. chemoradiotherapy. Methods: From January 2000 to December 2008, 199 metastatic pancreatic cancer patients were retrospectively analyzed. 13 (6.5%) patients received chemoradiotherapy and 186 (93.5%) patients received chemotherapy alone. Chemotherapy regimens consisted of 5-fluorouracil, gemcitabine, erlotinib, or cisplatin. The follow-up time was calculated from the time of diagnosis to the date of death or the last contact. Kaplan-Meier analysis was used to calculate the overall survival (OS). Results: Median OS was 5.3 months for all patients. Median OS was 4.9 months (0.4–27.0) for patients treated with chemotherapy alone and 7.8 months (0.6–44.1) for those treated with chemoradiotherapy (p = 0.013). Univariate survival analysis of categorical variables for patients treated with chemoradiotherapy revealed that age, race, gender, location of metastatic site, T stage (T3 v. T4) or nodal stage were not significant. However, ECOG performance status (1 v. 2/3) and the dose of radiation (<35 v. >35 Gy) received were associated with improved survival (p = 0.013, p=0.049). Median OS was 12.9 months for ECOG 1 vs. 5.6 months for ECOG 2/3. Median OS was 11.1 months for patients treated with radiotherapy dose > 35 Gy vs. 5.9 months for those who received less than 35 Gy. 3/13 (23%) patients who received chemoradiotherapy lived nearly two years or more. Conclusions: Metastatic pancreatic cancer patients with good performance score may benefit from chemoradiotherapy. Long-term survival was observed in this selected group. No significant financial relationships to disclose.

Role of chemoradiotherapy in advanced biliary cancers.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14694-e14694
Author(s):  
Asha Nayak ◽  
Sameer Arora ◽  
Edward J. Kruse
Keyword(s):  
Cancer Patients ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Performance Status ◽  
Categorical Variables ◽  
Ecog Performance Status ◽  
Term Survival ◽  
Tract Cancer ◽  
Kaplan Meier ◽  
Radiotherapy Dose

e14694 Background: Patients with metastatic biliary tract cancers have a poor outcome and radiotherapy is administered largely to patients with an intent of palliation. We analyzed our institutional biliary tract cancer database to compare the outcome between chemotherapy alone vs. chemoradiotherapy. Methods: From January 2005 to December 2010, 126 metastatic and inoperable biliary cancer patients were retrospectively analyzed. 59(46.8%) patients received chemoradiotherapy(CRT) and 67(53.1%) patients received chemotherapy alone. Chemotherapy regimens consisted of 5-fluorouracil, gemcitabine, or cisplatin. CRT patients received 3D-CRT with a median dose of 30 Gy (range, 25-35Gy ) at 1.8-2 Gy per fraction per day.Patients were categorized into Gall bladder, extrahepatic or intrahepatic bileduct cancers .The follow-up time was calculated from the time of diagnosis to the date of death or the last contact. Kaplan-Meier analysis was used to calculate the overall survival (OS). Results: Median OS was 6.6 months for all patients. Median OS was 6.9 months (0.8-26.0) for patients treated with chemotherapy alone and 10.2 months (0.8-46.9) for those treated with chemoradiotherapy (p = 0.002). Univariate survival analysis of categorical variables for patients treated with chemoradiotherapy revealed that age, race, gender, location of metastatic site, site of primary tumor ,T stage (T3 v. T4) or nodal stage were not significant. However, ECOG performance status (1 v. 2/3) and the dose of radiation (<30 v. >30 Gy) received were associated with improved survival (p = 0.002, p=0.032). Median OS was 13.2 months for ECOG 1 vs. 4.3 months for ECOG 2/3. Median OS was 12.3 months for patients treated with radiotherapy dose more than 30 Gy vs. 6.4 months for those who received less than 30 Gy. 12/59(20.3%) patients who received chemoradiotherapy lived approximately 2 years longer. Conclusions: Metastatic biliary tract cancer patients with good performance score may benefit from chemoradiotherapy, and this modality did not increase the mortality. Long-term survival was observed in this selected group.

scholarly journals Long-term survival of pancreatic cancer patients treated with multimodal therapy combined with WT1-targeted dendritic cell vaccines

2018 ◽  
Vol 15 (2) ◽  
pp. 397-406 ◽  
Author(s):  
Shuichi Hanada ◽  
Tomoko Tsuruta ◽  
Kouichi Haraguchi ◽  
Masato Okamoto ◽  
Haruo Sugiyama ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Dendritic Cell ◽  
Cancer Patients ◽  
Multimodal Therapy ◽  
Term Survival ◽  
Long Term Survival ◽  
Dendritic Cell Vaccines

scholarly journals Survival of Critically Ill Oncologic Patients Requiring Invasive Ventilatory Support: A Prospective Comparative Cohort Study With Nononcologic Patients

2019 ◽  
pp. 1-8
Author(s):  
Rene López ◽  
Suraj Rajesh Samtani ◽  
Jose Miguel Montes ◽  
Rodrigo Perez ◽  
Maria Jose Martin ◽  
...  
Keyword(s):  
Critically Ill ◽  
Performance Status ◽  
Chronic Health Evaluation ◽  
Health Evaluation ◽  
Ecog Performance Status ◽  
Term Survival ◽  
Mechanically Ventilated ◽  
Oncologic Patients

PURPOSE Cancer is in the process of changing to become a chronic disease; therefore, an increasing number of oncologic patients (OPs) are being admitted to intensive care units (ICUs) for supportive care of disease or therapy-related complications. We compare the short- and long-term outcomes of critically ill mechanically ventilated OPs with those of their nononcologic counterparts. PATIENTS AND METHODS We performed a prospective study of patients admitted to our ICU between October 2017 and February 2019. Demographic, physiologic, laboratory, clinical, and treatment data were obtained. The primary outcome was survival at 28 days and at the end of the follow-up period. Secondary outcomes were survival according to acute severity scoring (Acute Physiology and Chronic Health Evaluation II score), Eastern Cooperative Oncology Group (ECOG) performance status, and Charlson comorbidity index. RESULTS A total of 1,490 patients were admitted during the study period; 358 patients (24%) were OPs, and 100 of these OPs were supported with mechanical ventilation. Seventy-three percent of OPs had an ECOG performances status of 0 or 1, and 90% had solid tumors. Reason for admission to the ICU was postoperative admission in 44 patients and neutropenic infection in 10 patients. The follow-up period was 148 days (range, 42 to 363 days). Survival at 28 days was similar between OPs and nononcologic patients and associated with the Acute Physiology and Chronic Health Evaluation II score. However, long-term survival was lower in OPs compared with nononcologic patients (52% v 76%, respectively; P < .001) and associated with poor ECOG performance status. CONCLUSION Short-term survival of critically ill, mechanically ventilated OPs is similar to that of their nononcologic counterparts and is determined by the severity of the critical illness.

Safety of long-term administration of capecitabine in metastatic breast cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10755-10755
Author(s):  
M. Lomas ◽  
J. Salvador ◽  
M. Ruiz ◽  
J. L. Bayo
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Performance Status ◽  
Metastatic Breast ◽  
Term Treatment ◽  
Breast Cancer Patients ◽  
Ecog Performance Status ◽  
Long Term Treatment

10755 Background: To evaluate the effectiveness and tolerability of long -term treatment with capecitabine in metastatic breast cancer patients. Capecitabine (C) has been administered offering clinical benefit to women with metastatic breast cancer (MBC) (ORR: 42%). The aim of this trial was to evaluate the efficacy and tolerance of capecitbine in long-term treatment, administered as first, second and third line treatment in MBC. Methods: Patients ≥ 18 years old with MBC, ECOG performance status (PS) ≤2, HER-2 neu negative, non-chemotherapy naive were included in this prospective, multicentre, non-randomized. To date, twenty-two ambulatory patients were evaluable for toxicity and response. Median age 59.2 years (37–81). All of patients had previously received adjuvant treatment. Hormonal therapy were allowed as clinically required. They received three weekly cycles of oral capecitabine 1000–1250 mg/m2 twice daily, days 1–14, followed one week rest until progression or relapse. Results: The overall response rate (ORR) is including PR, CR, and EE 78%. The median treatment duration was 14 months, median range (3–32). Median progression-free and overall survival have not yet been reached. The most common grade ½ (NCIC CTC) treatment related adverse events were /23, hand foot syndrome 4/23, diarrea 1/23. Conclusions: These preliminary data confirm that the treatment with capecitabine (C) is an effective and well tolerated regiment in metastatic breast cancer patients. No significant financial relationships to disclose.

A phase II trial of weekly gemcitabine and bevacizumab in combination with abdominal radiation therapy in patients with localized pancreatic cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15043-15043 ◽  
Author(s):  
W. Small ◽  
M. Mulcahy ◽  
A. Benson ◽  
S. Gold ◽  
R. Bredesen ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Performance Status ◽  
Metastatic Pancreatic Cancer ◽  
Organ Function ◽  
Ecog Performance Status ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
The Mean ◽  
Grade 3

15043 Purpose: To evaluate the response rate, survival and toxicity of non-metastatic pancreatic cancer patients treated with a combination of, Gemcitabine, Bevacizumab and Radiotherapy. Materials and Methods: Eligibility included patients with non- metastatic pancreatic cancer, standard organ function and ECOG performance status of 0 or 1. The patients received three cycles of therapy. Cycle one was 21 days and consisted of Gemcitabine days 1 and 8 and Bevacizumab days 1 and 15. Cycle 2 was 28 days and consisted of Gemcitabine days 1, 8, and 15, Bevacizumab days 8 and 22 and Radiotherapy days 1–5, 8–12, and 15–19. Cycle three was 21 days and delivered Gemcitabine days 1 and 8, and Bevacizumab day 8. The Gemcitabine dose was 1,000 mg/m2, Bevacizumab at 10 mg/kg and Radiotherapy was delivered to the gross tumor volume only for a total dose of 36 Gy at 2.4 Gy/fraction. Response was determined on week ten with cross sectional imaging and CA 19–9. Toxicities were scored utilizing CTC version 3.0. Resectable patients were to undergo surgery 8 (currently amended to 6) weeks after the last dose of Bevacizumab. Results: Ninteen patients have been enrolled on study from 10/10/05 - 1/4/07. Twelve patients are evaluable for toxicity and response. Ten (83%) had a grade 3 toxicity. The grade 3 toxicities included cytopenias (9), DVT (2), Dehydration (2), hypotension (1), mucositis (1), increased LFT’s (2), Anorexia (1), nausea (1) and fatigue (1).There were no Grade 4 or 5 toxicities. All but one patient completed all three cycles. Radiographic response at 10 weeks was noted to be stable in 10 (83%) patients. Two patients progressed distantly (liver and abdomen). The mean CA 19–9 pre and post treatment CA 19–9 was 1519.56 and 356.09 respectively. One patient underwent surgical resection. The mean follow up is 4.83 months. At last follow up nine patients were alive. Conclusions: The combination of full dose Gemcitabine, Bevacizumab and Radiotherapy was generally well tolerated with no Grade 4 toxicities and the majority of Grade 3 toxicities hematologic. All but one patient completed all three cycles. Responses were limited to a reduction in CA 19–9. Nine patients remain alive. Accrual to the trial continues. No significant financial relationships to disclose.

Safety and efficacy of modified FOLFIRINOX in pancreatic cancer: A retrospective experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14614-e14614 ◽  
Author(s):  
Hemchandra Mahaseth ◽  
John S. Kauh ◽  
Edith Brutcher ◽  
Natalyn Nicole Hawk ◽  
Sungjin Kim ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Performance Status ◽  
Single Agent ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Metastatic Pancreatic Cancer ◽  
Clinical Activity ◽  
Ecog Performance Status ◽  
Emory University ◽  
Grade 3

e14614 Background: Conroy et al reported a significant improvement in overall survival of patients with metastatic pancreatic cancer treated with FOLFIRINOX compared to single agent gemcitabine. The regimen was associated with significant grade 3/ 4 toxicities, such as myelosuppression(46%), fatigue(24%), vomiting(15%) and diarrhea (13%). In order to improve the toxicity profile, we have modified FOLFIRINOX (mFOLFIRINOX) regimen by removing the bolus 5-FU and adding the routine use of growth factor prophylaxis. We present our experience with mFOLFIRINOX in patients with locally advanced or metastatic pancreatic cancer. Methods: After obtaining IRB approval, patients with a diagnosis of pancreatic cancer were identified from the Emory University tumor registry. Twenty eight patients who received at least one dose of mFOLFIRINOX (5-FU 2400 mg/m2 CIVI over 46 hours, leucovorin 400 mg/m2, oxaliplatin 85 mg/m2, irinotecan 180 mg/m2 and pegfilgrastim 6 mg every two weeks ) were selected and their charts were retrospectively reviewed for safety, response, and survival. Results: Of 28 patients, 14 (50%) were male, 18 (64%) white, 8 (29%) black and other 2(7%). Median age was 63 (50-75) and ECOG performance status 0-1. Nineteen (68%) patients had primary tumor located in head of pancreas. Eight patients (29%) experienced grade 3/4 toxicities, i.e., nausea/vomiting (11%), diarrhea (11%), fatigue (11%), neuropathy (4%), neutropenia (4%), thrombocytopenia(4%), and sepsis not-related to neutropenia (4%). No grade 3/4 anemia or febrile neutropenia was noted. mFOLFIRINOX controlled the disease in 20 patients (71%) with 2 CR, 4 PR and 14 SD. With a median follow up of 5.5 months, median overall or progression free survival is not reached. Two patients have died and six patients have progressed. Conclusions: Modified FOLFIRINOX is well tolerated in this US population. The clinical activity appears very promising with majority of patients being free of progression.

Long-term survival and performance status of cancer patients after discharge from ICU (intensive care unit).

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e18744-e18744
Author(s):  
Marta Zafra ◽  
Andres Carrillo ◽  
Maria Angeles Vicente ◽  
Manuel Sánchez Cánovas ◽  
Alejandra Ivars Rubio ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cancer Patients ◽  
Performance Status ◽  
Term Survival ◽  
Long Term Survival ◽  
And Performance

Early mortality in metastatic lung cancer: A SEER population data analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 9103-9103
Author(s):  
Opher Globus ◽  
Jair Bar ◽  
Amir Onn ◽  
Inbal Uri ◽  
Sivan Lieberman ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Population Data ◽  
Early Mortality ◽  
Categorical Variables ◽  
Metastatic Lung Cancer ◽  
Term Survival ◽  
Lung Cancer Patients ◽  
Metastatic Lung

9103 Background: Millions of dollars invested in improving outcomes for metastatic lung cancer patients are essentially aimed at extending long term survival, with significant benefits being achieved over the last decade. However, little is known about lung cancer patients who die rapidly after diagnosis, potentially being deprived of these advances. We analyzed population-based data to describe real-world outcomes in metastatic lung cancer patients focusing on patients with early mortality. Methods: Using the Survival, Epidemiology and End Results (SEER) Database we analyzed adult metastatic lung cancers diagnosed between 1994-2014. This period was divided into 3 equal time periods: 1994-2000 (TP1), 2001-2007 (TP2) and 2008-2014 (TP3). Early mortality was defined as death within 2 months of diagnosis. Correlations between categorical variables were analyzed with chi squared tests and survival was analyzed using the Kaplan-Meier method. Results: Of 276,527 patients diagnosed with metastatic lung cancer, median age was 67 (range 20-105) and 154,465 (56%) were males. Thirty eight percent (103,830) of all patients died within 2 months of diagnosis. Of these early deaths, 96,344 (92.8%) were due to lung cancer. While the 2-year survival almost doubled from TP1 compared to TP3 (6% vs 11%, p < 0.001), the percentage of patients who died within 2 months only marginally improved (39.7% vs. 36.2% in TP1 vs TP3, respectively). For patients surviving at least 2 months, 2-year survival increased from 10% to 18% in TP1 vs TP3 (p < 0.001). Factors associated with early mortality include age > 65 (45% vs 31%), unmarried status (42% vs 34%), male sex (39% vs 36%), liver metastases (47% vs 32%) and large cell carcinoma vs adenocarcinoma (44% vs 36%) (all p < 0.001). Conclusions: While there has been a steady improvement in the long-term overall survival of patients with metastatic lung cancer, over one third of patients still die within 2 months of diagnosis. This has only marginally improved in the last 20 years. Research is urgently needed to identify causative and treatable factors.

Abstract 14472: Indications for ICD Implantation Differ Between Women and Men

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sebastian Ingelaere ◽  
Ruben Hoffmann ◽  
Georges Mairesse ◽  
Yves R Vandekerckhove ◽  
Jean-Benoît le Polain de Waroux ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Nyha Class ◽  
Total Mortality ◽  
Categorical Variables ◽  
Multivariate Logistic Regression ◽  
Icd Implantation ◽  
Term Survival ◽  
Kaplan Meier ◽  
The Impact

Introduction: The impact of gender on ICD implantation practice and survival remain a topic of controversy. We analysed differences between men and women in patients implanted with an ICD in Belgium. Methods: The Belgian governmental health care institution (RIZIV/INAMI) keeps track of every ICD implantation by a digital registry. Participation is mandatory for reimbursement. From this registry, we analysed all new ICD implantations between 01/02/2010 and 31/01/2019 in Belgian patients. We compared men with women for baseline patient characteristics. We used a Chi 2 test for categorical variables (NYHA class, primary vs secondary prevention, underlying heart disease, type of device, QRS duration, presence of atrial fibrillation, diabetes and other comorbidity, center volume, population density and average income of the area of residency) and a Mann-Whitney U test for continuous variables [age and ejection fraction(EF)]. We used the Bonferroni method to correct for multiple testing. Secondly, we performed a Kaplan-Meier analysis. At last, we performed a multivariate logistic regression for 3-year and total mortality. Results: Only 3146 (20.8%) on 14747 implantations were in women. Women were significantly younger and had a better EF compared to men. Except for oncological history, women had less comorbidities (table 1). More women functioned in NYHA class > II and had a QRS > 150ms, which was consistent with a higher CRT-D vs VVI/DDD ratio. Kaplan-Meier showed a survival benefit in women (log-rank, p=<0.001). Further exploration with multivariate logistic regression showed that female gender was significant protective for long-term total mortality, but not for short-term 3-year mortality. Conclusions: Only a minority of patients implanted with a new ICD in Belgium are women. Their clinical profile differs from men. Their long-term survival is better, which can in part be explained by differences in indications and comorbidities.

Abstract 274: Follow-Up of Young Acute Aortic Dissection Patients: How They Differ from Older Patients

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Ellen K Brinza ◽  
Lindsay Hagan ◽  
Arturo Evangelista ◽  
Eric M Isselbacher ◽  
Marek P Ehrlich ◽  
...  
Keyword(s):  
Adverse Events ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Categorical Variables ◽  
Term Survival ◽  
Long Term Survival ◽  
Kaplan Meier ◽  
Chi Square Analysis

Background: Young patients (pts) with acute aortic dissection (AAD) have distinct risk factors and presenting symptoms compared to older pts, but whether these differences extend past discharge is relatively unknown. Methods: Among pts presenting with AAD enrolled in the International Registry of Acute Aortic Dissection, pts <40 (N=280) were compared with pts ≥ 40 (N=3585). Chi-square analysis or Fischer’s Exact test were performed for categorical variables; age was compared using Student’s T-test. Kaplan-Meier curves were generated for freedom from adverse events rates 0-60 months following discharge. Mean follow-up was 28.6 months. Results: Significant differences in demographics and history were noted between pts <40 and the older cohort. Young pts more commonly had type A AAD (71.8%, 201/280, v. 64.6%, 2317/ 3585, p<0.016), while type B AAD was more typical in older pts (p<0.016). On imaging studies, pts <40 were less likely to present with IMH (7.3%, 246/3355, v. 2.3%, 6/266, p=0.002), but were more likely to have a patent false lumen (77.9%, 141/181, v. 62.1%, 1425/2295, p<0.001). Surgical management was more common in young pts, for both AAD types. In-hospital complications or mortality did not differ between groups. Kaplan-Meier analysis demonstrated better long-term survival in young pts compared to those ≥ 40 (p=0.029). Kaplan-Meier analyses of freedom from adverse events at 5 years illustrated no difference in aortic growth between groups, but significantly more late interventions in younger pts (p=0.006). Conclusions: Young pts show distinct differences in comparison to older pts, specifically regarding presentation, AAD type and management. Long-term survival and follow-up intervention rates are higher in young pts.

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