scholarly journals Effect of chemotherapy on serum nitric oxide levels in advanced stage breast cancer patients

Author(s):  
Charushila Y. Kadam ◽  
Subodhini A. Abhang

Background: The role of nitric oxide is still unclear in advanced breast cancer patients undergoing adjuvant chemotherapy. This study was undertaken to investigate the effect of chemotherapy on serum nitric oxide levels in advanced stage breast cancer patients.Methods: In this observational study, clinically and histopathologically proven sixty female patients with advanced stage breast cancer were included. According to Tumor-Node-Metastasis (TNM) classification, patients were further grouped as stage III and stage IV. Thirty healthy and age-matched female controls were selected for comparison. Blood was collected from healthy controls and from breast cancer patients after surgery prior to chemotherapy and after three weeks of administration of first adjuvant chemotherapy cycle. Serum nitric oxide levels were measured by spectrophotometric method.Results: Significantly higher concentrations of serum nitric oxide were observed in breast cancer patients before chemotherapy in stage III (p<0.0001) and stage IV (p<0.0001) of the disease as compare to concentrations in healthy controls. The serum levels of nitric oxide were significantly decreased in stage III as well as stage IV of breast cancer patients after three weeks of receiving first adjuvant chemotherapy cycle as compare to levels before chemotherapy (p<0.0001), however serum nitric oxide levels were higher in stage III (p=0.0036) and stage IV (p<0.0001) of the disease as compare to healthy controls.Conclusions: Chemotherapy drug administration causes decrease in serum nitric oxide levels in advanced stages of breast cancer patients. Monitoring serum nitric oxide levels could be used to predict patients’ response to chemotherapy treatment in breast cancer.

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10765-10765
Author(s):  
C. J. Tai ◽  
C. K. Pan ◽  
C. H. Wu ◽  
C. S. Chen

10765 Background: In this study, we are evaluating the utilizing trastuzumab as an adjuvant combination with chemotherapy in an half year interval for breast cancer (1–3). Methods: Patients after October 2000 with HER2-positive (3+ by immunohistochemistry; if 2+, should fit over expression by FISH) stage II/III breast cancer who received adjuvant trastuzumab (4mg/kg ×1, then 2mg/kg/wk ×22, equals 6 bottles of trastuzumab) in combination with chemotherapy. The chemotherapy utilized for stage II breast cancer patients received CEF only and for those patients with LN(+) but ER/PR(−/−) also added paclitaxel for another 4 cycles besides CEF with interval of 3 weeks, and for those with stage III breast cancer patient with ER or PR(+), the docetaxel was given with CEF for 6 cycles). Clinical response rates were followed by using imaging studies with chest films, CT scanning, bone scan and sonography. Results: Overall, there were 37 patients enrolled in this study. The median age was 43 years old (22–74 y/o). Two patients (including the youngest one) were found to have bilateral breast cancer on diagnosis but both were still alive without disease so far. There were 3 patients developed disease progression after adjuvant chemotherapy with trastuzumab and 2 of them died thereafter and all these 3 patients were stage III disease. The oldest patient was one of the exception without receiving adjuvant chemotherapy and received monotherapy of trastuzumab only and so far, she was still alive without disease. The side effect including chills (24.32%), dizziness (8.10%), cough (2.10%), cold sweating (2.10%). Conclusions: For her2/neu overexpression patients, trastuzumabwith chemotherapy may have positive role in adjuvant therapy. In this study, our main goal is to achieve patient’s treatment outcome in disease free status. Nonetheless, the cost was high if we applied trastuzumab as adjuvant therapy with 1- or 2-year interval (4–6). Even if this required further time to demonstrate this study’s final outcome, I suppose that utilization of trastuzumab as adjuvant treatment plus chemotherapy in a half interval will be a good alternative treatment option. No significant financial relationships to disclose.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 670-670 ◽  
Author(s):  
K. Lee ◽  
B. Kim ◽  
S. Lee ◽  
W. Han ◽  
D. Kim ◽  
...  

670 Background: Bcl-2 is an anti-apoptotic marker and regulated by hormonal receptor pathways in breast cancer. We performed this study to assess the prognostic significance of ER, PR, p53, c-erbB2, bcl-2, Ki-67, and EGFR as a marker for relapse in breast cancer patients who received same adjuvant therapy in a single institution. Methods: A cohort of 154 curatively resected breast cancer patients who had 4 lymph nodes or more and received doxorubicin and cyclophosphamide followed by paclitaxel (AC/T) as adjuvant chemotherapy was analyzed for clinicopathologic characteristics including disease-free survival (DFS). Patients with ER and/or PR expression received 5 years of tamoxifen following AC/T. The markers were analyzed by immunohistochemistry. Results: Median f/u duration was 25 months and 32 patients (20.8%) had recurrences. Stage (IIIa vs. IIIc) affected recurrences significantly, however, types of surgery, histology, histologic grade, presence of endolymphatic emboli, or close resection margin did not. Among the immunohistochemical markers, bcl-2 expression was the only one to be associated significantly with prolonged DFS (median 54 mo in bcl-2 (−) vs. not reached in bcl-2 (+); p=0.016). Furthermore, bcl-2 was an independent prognostic factor for DFS in multivariate analysis. Bcl-2 expression was significantly correlated with ER expression (p<0.001), and inversely correlated with c-erbB2 overexpression (p=0.027). Patients with both ER and bcl-2 expression had a longer DFS compared to the other patients (not reached vs. 54 mo, p=0.019). Patients with bcl-2 expression had a significantly longer DFS even in ER (+) subgroups (not reached vs 54 mo; p=0.011). Patients with c-erbB2 overexpression, ER (−) and bcl-2 (−) had a shorter DFS than the others (38 mo vs. not reached; p=0.029). Conclusions: In our homogenous patient cohort, bcl-2 expression was correlated with ER expression, and inversely correlated with c-erbB2 overexpression. Bcl-2 was an independent prognostic factor for DFS in curatively resected stage III breast cancer patients. No significant financial relationships to disclose.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8556-8556
Author(s):  
S. B. Schagen ◽  
B. Kreukels ◽  
F. Van Dam

8556 Background: Cognitive deficits are reported in several studies in women with breast cancer treated with adjuvant chemotherapy. The current aim was to investigate whether breast cancer patients that had deviant cognitive performance on neuropsychological tests one year after treatment, differed from patients with intact performance on neurophysiological parameters and self-reported complaints, this time examined five years post treatment. Methods: 63 breast cancer patients treated with CMF chemotherapy underwent neuropsychological testing one year post therapy. Their performance was compared to that of healthy controls (n=60). 26 of these patients were examined neurophysiologically 4 years after the initial neuropsychological assessment. Neurophysiological assessment included quantitative EEG, auditory oddball task and a visual information processing task with concurrent EEG registration. Patients were also interviewed regarding cognitive complaints experienced in daily life. Results: At the initial neuropsychological assessment 33.3% of breast cancer patients treated with CMF chemotherapy were classified as cognitively impaired compared to 10% of healthy controls (p=.01). At the neurophysiological assessment four years later, patients that scored in the impaired range on the initial neuropsychological examination had significantly longer P3 latencies and reduced P3 amplitudes in an information processing task. The impaired patients also made more errors, had longer reaction times, and reported more cognitive complaints. Conclusion: The results of this study show converging neuropsychological and neurophysiological evidence for the persistence of cognitive problems in breast cancer patients up to five years after completion of CMF chemotherapy. [Table: see text] No significant financial relationships to disclose.


2000 ◽  
Vol 18 (14) ◽  
pp. 2695-2701 ◽  
Author(s):  
Christine B. Brezden ◽  
Kelly-Anne Phillips ◽  
Mohamed Abdolell ◽  
Terry Bunston ◽  
Ian F. Tannock

PURPOSE: Breast cancer patients receiving chemotherapy have complained of difficulties in their ability to remember, think, and concentrate. This study assessed whether there are differences in cognitive function between breast cancer patients treated with standard-dose adjuvant chemotherapy compared with healthy controls. PATIENTS AND METHODS: The High Sensitivity Cognitive Screen and the Profile of Mood States (POMS) were used to assess cognitive function and mood in a group of 107 women. The women consisted of 31 breast cancer patients receiving adjuvant chemotherapy (group A), 40 breast cancer patients who had completed adjuvant chemotherapy a median of 2 years earlier (group B), and 36 healthy controls (group C). RESULTS: Univariate analysis showed statistically significant differences (P = .009) in overall cognitive function scores between groups A and C, with poorer function in patients receiving adjuvant chemotherapy. These differences remained significant (P = .046) when controlling for age, education level, and menopausal status. More patients had moderate or severe cognitive impairment in groups A and B than in controls (P ≤ .002). There were no significant differences in POMS scores between the groups, suggesting that the differences seen in cognitive scores were unlikely to be because of mood disturbance. CONCLUSION: Cognitive differences were observed in breast cancer patients receiving adjuvant chemotherapy compared with healthy controls. These differences did not seem to be caused by significant differences in mood disturbance between the two groups. If confirmed, these results have substantial implications for informed consent, counseling, and psychosocial support of patients receiving adjuvant chemotherapy for breast cancer.


2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 117-117
Author(s):  
Laila Samiian ◽  
Dale F. Kraemer ◽  
Ryan Butterfield ◽  
Sarah Rausch Osian

117 Background: The age-adjusted death rate from breast cancer in Duval County is higher than the national average, with 26 deaths per 100,000 for all women. Breast cancer mortality is 38% higher for black women (37 per 100,000) in Duval County, than for white women (24 per 100,000). We sought to evaluate county specific breast cancer disparity data, in an effort to begin designing effective targeted interventions to reduce the disparities. Methods: Data on female breast cancer cases from 2004-2010 was extracted using the Florida Cancer Data System (FCDS). This data was analyzed using traditional descriptive statistics. Additional classification included health zones within Duval County, race, insurance, and age. Government (Tricare) and private or commercial insurance were combined in one group. The primary outcome was Stage at diagnosis, and time from diagnosis to treatment. Results: Using the FCDS, 6,502 new breast cancers were identified in Duval County from 2004–2010. Of these women, 73% were white, 24% black, 5% Hispanic, 2% Asian, and 2% unknown/other. Health Zone 1 which represents the urban core, has the largest population of Black women with breast cancer (76%), followed by health zone 5 and 4 (35% and 19%). Health Zone 1 has the highest volume of uninsured (10% vs 4% average for zones 2-6), and Medicaid breast cancer patients (8% vs 4% average for zones 2-6), and the lowest number of breast cancer patients with Government/Private insurance (33% vs 56%). Black women had higher percentage of advanced stage IV disease than any other race (8 % vs 4 %, p< .001). Women in Health Zone 1 are more likely to present with stage IV breast cancer than any other health zone in Duval County (10% vs 5%, p<0.01). Medicaid patients followed by the uninsured had the highest rate of stage IV at diagnosis (20% and 12% vs 4%, p<.001). Time from diagnosis to treatment was found to be longest in Black women (29 days vs 26 days, p< .001), Health Zone 1 (30 days vs county average 27 days, p<. 001), and those who were uninsured or had Medicaid (34 days vs 25 days for private insurance, p<0.001). Conclusions: Living in the urban core, black race, lack of insurance, and Medicaid funding was significantly associated with advanced stage at diagnosis and longer time from diagnosis to treatment in Duval County, Florida.


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