Modern Possibilities of Organ-Preserving Treatment in Children with Intraocular Retinoblastoma

2018 ◽  
Vol 5 (3) ◽  
pp. 175-187 ◽  
Author(s):  
O. V. Gorovtsova ◽  
T. L. Ushakova ◽  
V. G. Polyakov
Keyword(s):  
Drug Delivery ◽  
Survival Rate ◽  
Cancer Therapy ◽  
Neoadjuvant Chemotherapy ◽  
Patient Survival ◽  
Focal Therapy ◽  
Local Drug Delivery ◽  
Large Size ◽  
Intraocular Retinoblastoma

Retinoblastoma is one of highly curable diseases; today the total 5-year survival rate in patients with retinoblastoma exceeds 95%. The article summarizes the current world experience on treatment of patients with intraocular retinoblastoma. The treating skills of intraocular malignant tumor in children are a balance between the patient’s life and the preservation of an eye and its visual functions. The complex and challenging task is the treatment of common intraocular retinoblastoma groups «C», «D», «E» when the large size or localization of the tumor does not allow performing the local (focal) destruction of the tumor. As a rule, in such cases neoadjuvant chemotherapy (CT) is performed at the first stage in order to reduce the size of the tumor for further focal therapy. However, the analysed data on the effectiveness of neoadjuvant CT in combination with focal or radiotherapy demonstrated the limited possibilities of the proposed therapy. Local drug delivery in cancer therapy became a real breakthrough in the organ-preserving treatment of children with large intraocular retinoblastoma. The most widely used current methods of local drug delivery are intravitreal (IVitC) and selective intra-arterial chemotherapy (SIAC) as monotherapy or in combination with neoadjuvant CT and focal therapy which significantly increased the percentage of preserved eyes without radiotherapy administration or damage to the patient survival. The review discusses the different IVitC and SIAC techniques, chemotherapy schemes, dosages of chemotherapy, immediate and long-term complications of treatment.

scholarly journals Short term and long term survival rate and risk factors of graft rejection after deceased donor kidney transplantation: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Seyed Mohammad Kazem Aghamir ◽  
Mohammad Saatchi
Keyword(s):  
Risk Factors ◽  
Survival Rate ◽  
Graft Rejection ◽  
Patient Survival ◽  
Meta Analysis ◽  
Deceased Donor ◽  
Patient Death ◽  
Short Term ◽  
Term Survival

Abstract The purpose of the current meta-analysis is to determine the short-term and long-term graft and patient survival after deceased donor (DD) transplantation, as well as to determine prognostic factors. Method : Articles published until March 2019 in PubMed, Scopus, and Google Scholar databases, reporting short-term and/or long term graft and patient survival were searched. In addition to this, we included articles that analyzed the hazard ratio (HR) of graft rejection and/or patient death caused by DD related risk factors. The summary measures of this study included the survival rate, the HR of graft rejection, and patient death in response to DD related risk factors. This study, which is the first comprehensive meta-analysis of graft and patient survival rates after transplantation from the deceased donor, showed that overall short and long-term survival of graft and patient is desirable. In addition to this, it confirms that ECD and DCD recipients have a lower graft survival rate than standard donors.

Outcomes of a two-drug chemotherapy regimen for retinoblastoma

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9064-9064
Author(s):  
P. E. Zage ◽  
J. Weinstein ◽  
M. B. Mets ◽  
J. B. Lasky ◽  
S. Goldman
Keyword(s):  
Survival Rate ◽  
Focal Therapy ◽  
Current Treatment ◽  
External Beam Radiation ◽  
Secondary Malignancy ◽  
Beam Radiation ◽  
Group V ◽  
Treatment Regimens ◽  
Intraocular Retinoblastoma ◽  
Salvage Rate

9064 Background: Retinoblastoma is the most common intraocular tumor of childhood in the U.S. and has an overall survival rate of over 90%. The optimal treatment regimen for intraocular retinoblastoma has not yet been established. Current treatment regimens for retinoblastoma involve combinations of chemotherapy with focal therapy. We report here the results of an institutional retinoblastoma treatment trial to determine the vision- and globe-salvage rates and associated toxicity of a regimen combining carboplatin and etoposide with focal therapy. Methods: 29 patients diagnosed with either bilateral retinoblastoma or unilateral retinoblastoma in infants under 12 months of age were treated prospectively with carboplatin and etoposide plus focal therapy between 1992 and 2004 at Children’s Memorial Hospital in Chicago. External beam radiation therapy (EBRT) and enucleation were utilized as needed. Results: The regression rate after 6 cycles of chemotherapy was 85.4%. 7 eyes received EBRT and 22 eyes were enucleated. The overall vision salvage rate without EBRT was 50%, with a vision salvage rate of eyes with Reese-Ellsworth (R-E) groups I-IV tumors of 82.6%. The vision salvage rate of eyes with R-E group V tumors was 20%. The vision salvage rate for eyes with Murphree groups A and B was 77.3%, but only 26.9% for groups C and D. The 10-year estimated EBRT/enucleation-free survival rate was 47%. There were no treatment related mortalities and minimal long-term side effects, with one case of secondary malignancy. Conclusions: The combination of carboplatin and etoposide with focal therapy is a well-tolerated regimen that avoids EBRT and has acceptable vision salvage rates for R-E groups I-IV and Murphree groups A and B retinoblastoma. Patients with R-E group V and Murphree groups C and D retinoblastoma do less well with chemotherapy and require more intensive or novel approaches to therapy. No significant financial relationships to disclose.

In Vivo Evaluation of 5-Fluorouracil-Containing Self-Expandable Nitinol Stent in Rabbits: Efficiency in Long-Term Local Drug Delivery

2010 ◽  
Vol 99 (7) ◽  
pp. 3009-3018 ◽  
Author(s):  
Sheng-Rong Guo ◽  
Zhong-Min Wang ◽  
Ya-Qiong Zhang ◽  
Lei Lei ◽  
Jing-Min Shi ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Local Drug Delivery ◽  
In Vivo Evaluation ◽  
Nitinol Stent

scholarly journals Mucoadhesive systems in dentistry: A review

2016 ◽  
Vol 4 (2) ◽  
pp. 25
Author(s):  
Rishi Rath ◽  
Siddharth Tevatia ◽  
Anukriti Rath ◽  
Ashish Behl ◽  
Vishal Modgil ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Present Article ◽  
Oral Mucosa ◽  
Treatment Plan ◽  
Salivary Flow ◽  
Local Drug Delivery ◽  
Correct Selection ◽  
Two Factors ◽  
Pharmacologic Agents

For any treatment plan to succeed, two factors are paramount correct selection and application of pharmacologic agents and patient compliance. But what happens when both these are followed judiciously, but the medicine itself does not stay long enough to finish its action? Then we need something that will make the medicine stick literally. That is when bioadhesives have their say. Long-term adhesion of drugs to the oral mucosa is usually prevented by the continuous salivary flow and the mechanical movements of the tongue. Therefore, formulations acting as vehicle for local drug delivery to the oral mucosa need to have excellent mucoadhesive properties. The present article reviews mucoadhesive systems with various formulations that can be used in dentistry to improve local drug delivery.

Control of Cancer Growth Using Two Input Autonomous Fuzzy Nanoparticles

NANO ◽  
2015 ◽  
Vol 10 (04) ◽  
pp. 1550062 ◽  
Author(s):  
Fahimeh Razmi ◽  
Reihaneh Kardehi Moghaddam ◽  
Alireza Rowhanimanesh
Keyword(s):  
Drug Delivery ◽  
Side Effects ◽  
Cancer Therapy ◽  
Cancer Cells ◽  
Simple Structure ◽  
Medication Use ◽  
Drug Carriers ◽  
Local Drug Delivery ◽  
Cancer Growth ◽  
Simulation Results

A major challenge in cancer therapy is destroying cancer cells with least side effects on healthy cells. In this paper, autonomous drug-encapsulated nanoparticle (ADENP) with a real feedback control is recommended to prevent from the growth of cancerous tumors and treatment of them. The proposed ADENPs, swarmly perform local drug delivery which leads to significant reduction in side effects on healthy tissues in comparison to global drug delivery. The proposed ADENPs every moment, take feedback directly from drugs and cancer cells and at any time decide how much drugs to release. Also, these ADENPs have the capability of distinguishing unhealthy from healthy tissues, and medication use of these nanoparticles is more efficient than drug carriers. Another feature of these ADENPs is their simple structure in comparison to nanorobots. Simulation results show that ADENPs successfully reduce the number of cancer cells with minimal side effects.

scholarly journals Effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bin Huang ◽  
Zuan Yu ◽  
Risheng Liang
Keyword(s):  
Quality Of Life ◽  
Survival Rate ◽  
Concurrent Chemoradiotherapy ◽  
Patient Survival ◽  
Cox Regression Analysis ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Objective Glioblastoma multiforme (GBM) is the most common primary malignant central nervous system (CNS) tumor. The Stupp regimen is the standard treatment, although the optimal number of temozolomide (TMZ) treatment cycles remains controversial. We compared the effects of standard 6 cycles versus > 6 cycles of TMZ chemotherapy post-surgery with concurrent chemoradiotherapy on primary GBM patient survival. Patients and methods We performed a single center retrospective study of GBM patients that underwent total resection, concurrent chemoradiotherapy, and at least 6 cycles of adjuvant TMZ chemotherapy from June 2011 to August 2018. Patients were divided into 2 groups based on adjuvant TMZ treatment plan: Group A(n = 27): standard 6-cycle adjuvant TMZ therapy and Group B(n = 26): > 6 cycles of adjuvant TMZ therapy. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Continuous variables were analyzed by ANOVA, and the Kaplan-Meier method was used to evaluate PFS and OS. Univariate and multivariate COX analyses determined correlation between survival rates and covariates. We used The Mini Mental State Examination (MMSE) and Karnofsky Performance Status (KPS) to assess patients’ neurocognitive function and quality of life. Results After follow-up, median PFS was 15 months in in Group A (95%CI 9.5–20.5) and 20.1 months in Group B (95%CI 15.9–24.4). Group A median OS was 19.4 months (95%CI 15.5–23.2), compared to 25.6 months in Group B (95%CI 20.4–30.8). The 2-year survival rate of Groups A and B was 36% was 66%, respectively (P = 0.02). and 5-year survival was 7% in both. Multivariate COX regression analysis showed association between patient PFS and long-period adjuvant chemotherapy, but not OS. There were no significant difference in disability or quality of life during treatment with Stupp protocol, but differences in MMSE and KPS were in favour of the Groups B after year 1 of the treatment (P < 0.05). Conclusions Long-term adjuvant TMZ chemotherapy was beneficial for PFS and 2-year survival rate in GBM patients, and improved their quality of life contemporarily. But OS was not significantly improved.

scholarly journals Effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival

2021 ◽  
Author(s):  
Bin Huang ◽  
Zuan Yu ◽  
Risheng Liang
Keyword(s):  
Quality Of Life ◽  
Survival Rate ◽  
Concurrent Chemoradiotherapy ◽  
Patient Survival ◽  
Total Resection ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Objective Glioblastoma multiforme (GBM) is the most common primary malignant central nervous system (CNS) tumor. The Stupp regimen is the standard treatment, although the optimal number of temozolomide (TMZ) treatment cycles remains controversial. We compared the effects of standard 6 cycles versus > 6 cycles of TMZ chemotherapy post-surgery with concurrent chemoradiotherapy on primary GBM patient survival. Patients and Methods: We performed a single center retrospective study of GBM patients that underwent total resection, concurrent chemoradiotherapy, and at least 6 cycles of adjuvant TMZ chemotherapy from June 2011 to August 2018. Patients were divided into 2 groups based on adjuvant TMZ treatment plan: Group A(n = 27): standard 6-cycle adjuvant TMZ therapy and Group B(n = 26): >6 cycles of adjuvant TMZ therapy. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Continuous variables were analyzed by ANOVA, and the Kaplan-Meier method was used to evaluate PFS and OS. Univariate and multivariate COX analyses determined correlation between survival rates and covariates. We used The Mini Mental State Examination (MMSE) and Karnofsky Performance Status (KPS) to assess patients' neurocognitive function and quality of life. Results After follow-up, median PFS was 15 months in in Group A (95%CI 9.5–20.5) and 20.1 months in Group B (95%CI 15.9–24.4). Group A median OS was 19.4 months (95%CI 15.5–23.2), compared to 25.6 months in Group B (95%CI 20.4–30.8). The 2-year survival rate of Groups A and B was 36% was 66%, respectively (P = 0.02). and 5-year survival was 7% in both. Multivariate COX regression analysis showed association between patient PFS and long-period adjuvant chemotherapy, but not OS. There were no significant difference in disability or quality of life during treatment with Stupp protocol, but differences in MMSE and KPS were in favour of the Groups B after year 1 of the treatment (P < 0.05). Conclusions Long-term adjuvant TMZ chemotherapy benefits PFS and 2-year survival rate,Long-term adjuvant TMZ chemotherapy benefits PFS and 2-year survival rate. This could improve quality of life in survivorship,but not highly prognosticate for OS. We do not suggest prolonging TMZ maintenance therapy beyond six cycles in patients with glioblastoma after total resection.

Use of Lipids, Polymers, and Peptides for Drug Delivery and Targeting to Cancer Cells or Specific Organs

2021 ◽  
pp. 276-289
Author(s):  
Sampan Attri ◽  
Shruti Sharma ◽  
Ujjawal Sharma ◽  
Manjita Srivastava ◽  
Subash C. Sonkar ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Cancer Therapy ◽  
Drug Delivery Systems ◽  
Structural Characteristics ◽  
Delivery Systems ◽  
Chemotherapeutic Agents ◽  
Delivery Methods ◽  
Practical Applications ◽  
Low Cytotoxicity

Cancer has been the most deleterious disease in recent times, and unfortunately its spread is increasing. Systemic treatment with chemotherapeutics remains the conventional way of treating many cancers, despite the serious damage long-term chemotherapy can cause in healthy tissues. Many therapeutic strategies have achieved popular practical applications, but drug delivery systems still face challenges associated with safety, and this has led to the development of safer drug delivery methods composed of biocompatible substances. In this respect, lipid-, polymer-, and peptide-based drug delivery systems have been proposed as safer candidates for cancer therapy. These delivery methods are expected to as biodegradable systems with low cytotoxicity for cancer therapy. Therefore, in this chapter, the authors discuss use of lipids, polymers, and peptides as delivery vehicles for chemotherapeutic agents and their structural characteristics.

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