Complementary medicine use during adjuvant radiotherapy of breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12088-e12088
Author(s):  
Rebecca Buecker ◽  
Ulrich Schafer
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Disease Progression ◽  
Complementary Medicine ◽  
Adjuvant Radiotherapy ◽  
Postoperative Radiotherapy ◽  
Treatment Regimes ◽  
Curative Radiotherapy ◽  
Significant Difference ◽  
Grade Ii

e12088 Background: Complementary medicine (CM) is used widely in cancer patients, mostly in palliative treatment regimes or during chemotherapy. In contrast, the use of CM during curative Radiotherapy (RT) is less frequent.The aim of this study was to evaluate the influence of CM with regard to toxicity and recurrence during postoperative radiotherapy for breast cancer. Methods: Between 2010 and 2013 all patients intended for adjuvant radiotherapy for breast cancer received a questionnaire concerning the use of CM e.g. Vitamins, trace elements, enzymes, natural herbs etc. (yes / no) and if yes what kinds. Radiotherapy was applied with 50.4 Gy to the whole breast and a Boost of 10.8 Gy in 6.5 weeks.6 weeks after radiotherapy the side effects were analyzed. Follow up for progression rates was done yearly. Results: A total number of 879 patients with breast cancer completed the questionnaire, 641 (73%) did not take any CM and 238 (27%) took CM. There were almost 40 different products mentioned and the most common were magnesium (n=71) and selenium (n=38). The RT side effects (Dermatitis RTOG grade 0, I, II, III/IV) 6 weeks after completion of RT were as follow: in the non CM group 53% grade 0, 41% grade I, and 6% grade II, 0% grade III/IV. And in the CM group 54%, 39%, 9%, and 0% respectively. The corresponding side effects for the group taking magnesium were 35% 42%, 6% and 1% and for the selenium group 47%, 47%, 5% and 0%. There was no significant difference in side effects between the non CM and CM patients, respectively magnesium and selenium group . The sum of all registered disease progression (0 years – 5 years) were in the non CM group 6.4%, in the CM group 6.3%, in the magnesium group 5.6% and in the selenium group 7.9%, no significant difference could be detected between all groups. Conclusions: In this cohort, 27 % of patients used CM during adjuvant radiotherapy of breast cancer. The most commonly product is magnesium followed by selenium. A measurable influence of CM on RT side effects or disease progression could not be identified.

scholarly journals Gastric Side Effects and the Stomach Dosimetric Analysis in Left-Sided Breast Cancer Radiotherapy in Free-Breathing and Deep Inspiration Breath-Hold Technique

2021 ◽  
Author(s):  
Dong Yang ◽  
Ying Piao ◽  
Fengshun Yuan ◽  
Hongtao Chen ◽  
Ding Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Adjuvant Radiotherapy ◽  
Hormone Receptors ◽  
Breath Hold ◽  
Breast Cancer Patients ◽  
Breast Radiotherapy ◽  
Breast Cancer Radiotherapy ◽  
Surgical Methods ◽  
Significant Difference

Abstract Background Adjuvant radiotherapy following surgery reduces the local recurrence and improves the prognosis. However, a considerable part of patients developed digestive reaction in daily treatment. In order to explore the correlation between breast radiotherapy and gastric toxicity, we investigated the clinic symptoms and stomach dose during DIBH or FB mode while left-sided breast cancer patients (LSBCP) receiving radiotherapy. Methods In the study, 124 LSBCP received adjuvant radiotherapy after surgery at our department were analyzed clinical characteristics and enquired about gastrointestinal side effects after treatment. Moreover, dosimetric parameters were assessed. Results There was no statistically significant difference between the two groups in age, T staging, N staging, hormone receptors, human epidermal receptor-2 (HER2), surgical methods, fractionated regimen, and chemotherapy conditions. Stomach volumes, the use of the DIBH gating technique (FB/DIBH), and higher fractionated dose (Dmax/F) were associated with a statistically significantly greater risk for acute radiotherapy toxicity. Conclusion In order to cut down gastric side effects after breast radiotherapy, large meals should be avoided before treatment. DIBH treatment should be implemented in centers where conditions are satisfied to reduce radiotherapy side effects. Furthermore, dose limitation in stomach should be considered when the radiotherapy plan was formulated, especially for the patients treated with hypofractionated radiotherapy.

scholarly journals Gastric side effects and the stomach dosimetric analysis in left-sided breast cancer radiotherapy in free-breathing and deep inspiration breath-hold technique

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Dong Yang ◽  
Ying Piao ◽  
Fengshun Yuan ◽  
Hongtao Chen ◽  
Ding Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Adjuvant Radiotherapy ◽  
Hormone Receptors ◽  
Breath Hold ◽  
Breast Cancer Patients ◽  
Breast Radiotherapy ◽  
Breast Cancer Radiotherapy ◽  
Surgical Methods ◽  
Significant Difference

Abstract Background Adjuvant radiotherapy following surgery reduces the local recurrence and improves the prognosis. However, a considerable part of patients developed digestive reaction in daily treatment. In order to explore the correlation between breast radiotherapy and gastric toxicity, we investigated the clinic symptoms and stomach dose during DIBH or FB mode while left-sided breast cancer patients (LSBCP) receiving radiotherapy. Methods In the study, 124 LSBCP received adjuvant radiotherapy after surgery at our department were analyzed clinical characteristics and enquired about gastrointestinal side effects after treatment. Moreover, dosimetric parameters were assessed. Results There was no statistically significant difference between the two groups in age, T staging, N staging, hormone receptors, human epidermal receptor-2 (HER2), surgical methods, fractionated regimen, and chemotherapy conditions. However, larger stomach volumes and higher fractionated dose (Dmax/F) were associated with a statistically significantly greater risk for acute radiotherapy toxicity. In addition, the use of the DIBH gating technique (FB/DIBH) reduced the incidence of digestive reactions. Conclusion In order to cut down gastric side effects after breast radiotherapy, large meals should be avoided before treatment. DIBH treatment should be implemented in centers where conditions are satisfied to reduce radiotherapy side effects. Furthermore, dose limitation in stomach should be considered when the radiotherapy plan was formulated, especially for the patients treated with hypofractionated radiotherapy.

scholarly journals Comparing the efficacy and side-effects of PDLASTA® (Pegfilgrastim) with PDGRASTIM® (Filgrastim) in breast cancer patients: a non-inferiority randomized clinical trial

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Safa Najafi ◽  
Maryam Ansari ◽  
Vahid Kaveh ◽  
Shahpar Haghighat
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Single Dose ◽  
Side Effects ◽  
Randomized Clinical Trial ◽  
Cancer Patients ◽  
Injection Site Reaction ◽  
Study Groups ◽  
Breast Cancer Patients ◽  
Significant Difference

Abstract Background The objective of this study was to compare the efficacy and side effects of a single dose (Pegfilgrastim or PDL) or repeated six daily injections (Filgrastim or PDG) during chemotherapy courses in breast cancer patients in a non-inferiority clinical trial. Methods In this randomized clinical trial, 80 patients were recruited and allocated randomly to two equal arms. In one group, a single subcutaneous dose of PDL was injected the day after receiving the chemotherapy regimen in each cycle. The second arm received a subcutaneous injection of PDG for six consecutive days in each cycle of treatment. The side effects of GCF treatment and its effect on blood parameters were compared in each cycle and during eight cycles of chemotherapy. Results Hematologic parameters showed no significant differences in any of the treatment courses between the two study groups. The comparison of WBC (p = 0.527), Hgb (p = 0.075), Platelet (p = 0.819), Neutrophil (p = 0.575), Lymphocyte (p = 705) and ANC (p = 0.675) changes during the eight courses of treatment also revealed no statistically significant difference between the two study groups. Side effects including headache, injection site reaction and muscle pain had a lower frequency in patients receiving PDL drugs. Conclusion It seems that PDL is non-inferior in efficacy and also less toxic than PDG. Since PDL can be administered in a single dose and is also less costly, it can be regarded as a cost-effective drug for the treatment of chemotherapy-induced neutropenia. Trial registration IRCT20190504043465N1, May 2019.

Reduction of Chemotherapy–Induced Side Effects by Complementary Medicine in Breast Cancer Patients

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Beuth J ◽  
◽  
Böwe R ◽  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Cancer Patients ◽  
Complementary Medicine ◽  
Sodium Selenite ◽  
Lens Culinaris ◽  
Proteolytic Enzymes ◽  
Clinical Investigation ◽  
Breast Cancer Patients ◽  
Complementary Treatment

This clinical investigation was performed to evaluate the benefit of Complementary Medicine (CM) in breast cancer patients undergoing adjuvant Chemotherapy (ChT). Patients and Methods: The patients (n=668) were treated according to international guidelines with adjuvant ChT. As to reduce the side effects, the patients were complementarily treated with a combination of sodium selenite, proteolytic plant enzymes (bromelaine and papain) and Lens culinaris lectin. On Case Report Formulas (CRFs) assessment of side effects of ChT was documented at defined times during adjuvant ChT and additional complementary treatment. Validation was carried out by scoring from 1 (no side-effects/optimal tolerability) to 6 (extreme side-effects/extremely bad tolerability), however, only patients suffering from severe side effects (symptom scores 4 and higher) were enrolled into this investigation. Results: The severity of side-effects of ChT was significantly reduced by complementary treatment. Mean scores of symptoms declined for sleep disorder, fatigue, lack of drive (p<0.05) and for arthralgia, hot flushes, mucosal dryness, nausea, vomiting, diarrhea, loss of appetite, pain of tumour (p<0.001). Conclusion: This investigation confirms benefits of indication-based complementary treatment with the combination of sodium selenite, proteolytic enzymes and Lens culinaris lectin in breast cancer patients, e.g. reduction of side-effects of adjuvant ChT.

Comparison of First-line Pazopanib and Sunitinib in Metastatic Renal Cell Carcinoma: Experiences of the Urologic Cancer Centre for Research and Innovation

2019 ◽  
Author(s):  
Emily C.L. Wong ◽  
Camilla Tajzler ◽  
Gaurav Vasisth ◽  
Amanda Zhu ◽  
Mathilda Chow ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Side Effects ◽  
Cell Carcinoma ◽  
Disease Progression ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Significant Difference

Abstract Background: Sunitinib and pazopanib are orally-administered tyrosine kinase receptor inhibitors (TKIs) approved as first-line therapy for the treatment of metastatic renal cell carcinoma (mRCC). The IMDC criteria are a predictive prognostic model for patients with mRCC when stratified into three prognosis groups: favourable, intermediate and poor. We retrospectively compared the efficacy and safety of sunitinib and pazopanib as first-line therapy for patients with mRCC in our single institution database. Methods: Retrospective analysis was done to compare progression-free survival (PFS) and side effects of sunitinib and pazopanib as first-line therapy in patients with mRCC. Patients were stratified into prognosis groups according to IMDC criteria. Disease assessment was performed on measurable aspects of disease based on computed tomography or magnetic resonance imaging reports. Survival analysis was performed using the Kaplan-Meier method and Cox regression, with disease progression as the endpoint.Results: Data was obtained from 228 patients with mRCC who were treated with either pazopanib (n=57) or sunitinib (n=171). No significant difference in PFS was found between sunitinib and pazopanib (HR for disease progression or all-cause death, 1.10; 95%CI: 0.76-1.57, p=0.62). Median PFS time for patients receiving sunitinib was 9.4 months and for pazopanib, 8.5 months. Median PFS for patients with intermediate-risk disease was similar between groups (9.4 months vs. 9.2 months, respectively, p=0.93). However, patients treated with sunitinib experienced a greater number of side effects compared to pazopanib. Conclusions: Sunitinib and pazopanib are similarly efficacious as first-line therapy for mRCC. However, adverse events are lower with pazopanib.

scholarly journals Extended Field Postoperative Radiotherapy (EFRT) Yields better Outcomes as Compared to Localised Field RT (LFRT) in Radically Resected Gallbladder Cancer (GBC)

2020 ◽  
Vol 5 (4) ◽  
pp. 287-293
Author(s):  
Sushma Agrawal ◽  
Rajan Saxena
Keyword(s):  
Side Effects ◽  
Lymph Nodes ◽  
Survival Data ◽  
Postoperative Radiotherapy ◽  
Demographic Data ◽  
Disease Free Survival ◽  
Concurrent Chemotherapy ◽  
Resection Margins ◽  
Significant Difference ◽  
Extended Field

Background: Postoperative adjuvant RT is recommended in node positive and positive resection margins patients after radical surgery (RS) in GBC. However there are no guidelines to suggest the regions to be irradiated. Our aim is to compare whether EFRT or LFRT improves outcomes. Methods and Materials: Records of GBC patients who underwent adjuvant chemo-radiotherapy after RS, between January 2007 and December 2014 were reviewed. Demographic data, histopathological data, target delineation, RT treatment planning details, concurrent chemotherapy, side-effects of treatment, and survival data were collated. Patients were treated with either of two techniques: Localised field RT [LFRT] [from 2007-2010] or Extended field RT [EFRT] [from 2011-2014] along with concurrent 5-FU/capecitabine. LFRT involved RT to GB bed, peri-portal, common hepatic artery (CHA) and coeliac lymph nodes and EFRT involved RT to GB bed, peri-portal, CHA, coeliac, gastro-duodenal, superior mesenteric and para aortic lymph nodes. The RT dose was 50.4 Gy/28fractions/5.5 weeks. Loco-regional recurrence rate (LRR), Overall (OS) and Disease free Survival (DFS) was computed with Kaplan Meier method.Results: Out of 60 patients reviewed, 30 were treated with EFRT and 30 with LFRT. There was no significant difference in the acute and late side-effects between the two techniques. At a median follow-up of 44 months (range 36-120 months), 37.5 % patients developed LRR (13.3 % vs 40% in EFRT and LFRT, p = NS).The median OS was not reached (NR) vs 42 months and the median DFS was NR vs 30 months in EFRT vs LFRT respectively (p=0.01 and 0.016). The 5 year OS was 80% vs 42% and 5 year DFS was 80% vs 40% for EFRT and LFRT respectively (p=0.01 and 0.016). Conclusions: Based on our findings, we conclude that EFRT reduces LRR and improves survival in patients with absence of lymphovascular space invasion (LVI) and perineural invasion (PNI). This observation is hypothesis generating and merits validation in a randomised study.

scholarly journals RTHP-20. MULTI-INSTITUTIONAL ANALYSIS OF HIGH-RISK WHO GRADE II OLIGODENDROGLIOMA TREATED WITH ADJUVANT RADIOTHERAPY PLUS TEMOZOLOMIDE (TMZ) VERSUS PROCARBAZINE, LOMUSTINE, AND VINCRISTINE (PCV)

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi213-vi214
Author(s):  
Martin Tom ◽  
David Routman ◽  
Nadia Laack ◽  
Kelsey Frechette ◽  
Deborah Park ◽  
...  
Keyword(s):  
High Risk ◽  
Adjuvant Radiotherapy ◽  
Motor Symptoms ◽  
Who Grade ◽  
Chemotherapy Group ◽  
Presenting Symptoms ◽  
Significant Difference ◽  
Grade Ii ◽  
Risk Grade

Abstract PURPOSE To compare outcomes of adults with high-risk grade II oligodendroglioma treated with adjuvant radiotherapy plus adjunctive TMZ versus PCV. METHODS We queried a multi-institutional database from the Cleveland Clinic and Mayo Clinic of 158 adults with WHO grade II glioma who were high-risk (age > 40 and/or subtotal-resection [STR]) and underwent adjuvant chemoradiation (TMZ or PCV) between 1997–2017. We included patients with oligodendroglioma by 1p/19q-codeletion or traditional histopathology. Fisher’s exact test was used to associate factors with chemotherapy group. The log-rank test was used to compare OS and PFS by chemotherapy group and clinical characteristics. RESULTS 52 patients were included with a median follow-up of 44 months (range, 3–259). Median age was 44 (range, 22–73), 49 (94%) underwent STR, and 28 (54%) were male. Presenting symptoms were seizure in 35 (67%) patients, sensory in 14 (27%), and motor in 8 (15%). Oligodendroglioma classification was by 1p/19q-codeletion in 27 (52%) and traditional histopathology in 25 (48%) patients. Median radiation dose was 54 Gy (range, 45–60). Chemotherapy was TMZ in 34 (65%) patients and PCV in 18 (35%). Patients who were older (P=0.003), lacked seizures (P=0.03), or had motor symptoms (P=0.04) were more likely to receive TMZ. Median OS was 223 months (95% CI, 181-not estimable) and median PFS was 118 months (95% CI, 69–223). Treatment with TMZ versus PCV was not associated with OS (median 186 vs. 223 months, respectively; P=0.71) or PFS (median 110 vs. 131 months, respectively; P=0.19). Age >40 (P=0.009) and motor symptoms (P=0.027) were associated with adverse OS. Presence of motor symptoms was associated with worse PFS (P=0.008). CONCLUSION There was no statistically significant difference in OS or PFS between adjunctive TMZ versus PCV for adult high-risk grade II oligodendroglioma. A larger cohort with longer follow-up will provide additional insight.

Case-cohort study to determine the value of therapeutic touch in preventing radiation dermatitis.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 103-103
Author(s):  
J. Younus ◽  
M. Lock ◽  
J. Malec ◽  
O. Vujovic ◽  
E. Yu
Keyword(s):  
Breast Cancer ◽  
Median Time ◽  
Skin Pigmentation ◽  
Therapeutic Touch ◽  
Radiation Dermatitis ◽  
Breast Cancer Patients ◽  
Control Cohort ◽  
Significant Difference ◽  
Grade Ii ◽  
The Impact

103 Background: Therapeutic touch (TT) is a noninvasive healing technique. There is evidence of value in various clinical areas, but not during radiotherapy (RT) for breast cancer. The TT Cohort was designed to assess the acceptability, compliance, and side effects of TT. The Control Cohort was used compare the impact of TT in preventing radiation dermatitis. Methods: Early breast cancer patients scheduled to undergo post-conservative surgery RT were selected. TT was administered three times per week during RT. Feasibility was defined a priori as 15 of 17 patients completing all treatments. The effectiveness of TT was evaluated by the NCIC CTC V3 dermatitis scale and EORTC Cosmetic Rating. The quality of life (QOL), mood, and fatigue were assessed by EORTC QLQ C30, POMS, and BFI, respectively. These were assessed at baseline and weekly during treatment. Results: 17 stage I/II breast were prospectively identified for the TT Cohort and 31 patients were prospectively assessed in the Control Cohort. Median age was 63 years (47-79). TT was considered feasible as all 17 patients completed treatment. In the TT Cohort, the worst grade of radiation dermatitis was grade II in 9 patients. One patient did not develop any dermatitis. Median time to develop the worst grade was 20 days. QOL, mood and energy, and fatigue levels were consistent with the previous published studies. In the Control Cohort, the worst grade of radiation dermatitis was grade III in 1 patient. The most common toxicity grade was II in 15 patients. Three patients did not develop any dermatitis. Median time to develop the worst grade was 29 days. There was no statistical difference in the overall cosmetic score and grade II/III toxicity. There was a statistically significant difference in skin pigmentation and edema. Conclusions: This study represents the first evaluation of TT in patients with EBC using objective measures. TT is a feasible addition for the management of dermatitis to a tertiary clinic. TT neither improved overall cosmesis nor grade II/III toxicity.

The Afterlife of Breast Cancer: Exploring the Digital Performativity of Post-Treatment Patienthood

2021 ◽  
pp. 097325862110482
Author(s):  
Neha Gupta
Keyword(s):  
Breast Cancer ◽  
Chronic Illness ◽  
Side Effects ◽  
Gender Identity ◽  
Post Treatment ◽  
Temporal Experience ◽  
Treatment Regimes ◽  
Social Mediation ◽  
It Impacts ◽  
The Everyday

This article looks at the practices of digital performativity of bodies-in-remission on Instagram to detail the affective and temporal experience of post-treatment patienthood. To explore these performativities, I use the images and narratives of the post-treatment breast-cancer body to have a conversation about the vicarious ‘re-experience’ of the malady—now in abeyance—through the discursive register of fear and the clinical haunting of the everyday in trying to offset the side-effects of the treatment regimes. I further argue that these techno-digital enactments of post-treatment patienthood co-emerge through complex ‘intra-actions’ of and within entanglements of materialities, networks, discourses, affect, and multiple registers of techno-social mediation that shape and constrict them. Accordingly, this article is an effort to make sense of how people ‘memorise’ chronic illness and prolonged suffering—especially when it impacts key sources of their gender identity—through negotiations with the temporal-discursive processes of networked communications.

scholarly journals EVA-Scalp: Evaluation of Patient Satisfaction with a Scalp Cooling Device to Prevent Chemotherapy-Induced Alopecia in Breast Cancer Patients

Breast Care ◽  
2019 ◽  
Vol 15 (2) ◽  
pp. 171-177
Author(s):  
Franz-Ferdinand Bitto ◽  
Alexander König ◽  
Thuy  Phan-Brehm ◽  
Thomas Vallbracht ◽  
Julian Gregor Koch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Satisfaction ◽  
Side Effects ◽  
Cancer Patients ◽  
Well Being ◽  
Scalp Cooling ◽  
Breast Cancer Patients ◽  
Significant Difference ◽  
Patient Selection Criteria

Purpose: Scalp cooling (SC) offers a chance to reduce hair loss (HL), but patient satisfaction, the effect on well-being, as well as patient selection criteria have not been sufficiently assessed yet. Methods: In the EVAScalp trial, SC was offered to 70 breast cancer patients who received chemotherapy between November 2015 and September 2018. For SC, the Paxman-Orbis-II System was used. Satisfaction was measured by a questionnaire evaluating the level of depression with the WHO-5 well-being index (WHO-5) plus questions addressing the patient’s experiences and side effects using the SC device. To evaluate efficacy, documentation by photo, by a physician, and by an HL-diary was conducted. Results: Regarding efficacy, a significant difference between chemotherapy regimens is seen. Anthracycline-based therapies led to a stop of SC in 71% of the patients, whereas taxane-based therapies without anthracyclines were associated with a high acceptance of SC, and 88% of patients with paclitaxel-based therapies continued SC throughout their chemotherapy. Overall, only 7.69% of the patients stopped because of side effects. As an indicator for quality of life, WHO-5 was higher (65.8%) in patients with successful SC compared to in patients who stopped SC because of HL or side effects (only 53.0%). The majority of patients (82.22%) with successful SC would recommend SC to other patients. Conclusions: Patients tolerated SC as long as HL was successfully prevented. The well-being of patients with successful SC was significantly higher than that of patients who stopped SC prematurely. In general, SC is a promising approach and improves patient well-being, but there are still limitations to its utility depending on the chemotherapy regimen used.

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