scholarly journals Infectious Morbidity in Pediatric Patients Receiving Neoadjuvant Chemotherapy for Sarcoma

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1990
Author(s):  
Denise Willmer ◽  
Stefan K. Zöllner ◽  
Frieder Schaumburg ◽  
Heribert Jürgens ◽  
Thomas Lehrnbecher ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Unknown Origin ◽  
Tumor Type ◽  
Infectious Morbidity ◽  
Primary Endpoints ◽  
Pediatric Sarcoma ◽  
Younger Age ◽  
Potential Impact ◽  
Infectious Burden ◽  
New Diagnosis

The purpose of this retrospective, single-center cohort study was to assess the infectious burden in pediatric sarcoma patients during neoadjuvant chemotherapy. The review included all patients with a new diagnosis of Ewing sarcoma, osteosarcoma or soft tissue sarcoma between September 2009 and December 2018 who were enrolled in the EWING 2008, CWS SoTiSaR and EURAMOS clinical trial or registry. Primary endpoints were the occurrence of febrile neutropenia (FN) and microbiologically documented infection (MDI). Parameters with a potential impact on FN and MDI were also analyzed. A total of 170 sarcoma patients (median age: 13 years, range: 0–21; 96 m/74 f) received 948 chemotherapy courses (median: 6; range: 2–8). Of these patients, 58.8% had ≥1 FN episode and 20.6% ≥ 1 MDI. FN occurred in 272/948 courses (28.7%) with fever of unknown origin (FUO) in 231 courses and 45 MDI and 19 clinically documented infections (CDI) occurring in a total of 57 courses. Patients enrolled in EWING 2008 had significantly more FN (p < 0.001), infections (p = 0.02) and MDI (p = 0.035). No infection-related deaths were observed. Younger age, tumor type and localization, and higher median and maximum mucositis grades were significantly associated with higher numbers of FN (p < 0.001), and younger age (p = 0.024) and higher median mucositis grade (p = 0.017) with MDI. The study shows substantial infectious morbidity in sarcoma patients during neoadjuvant chemotherapy treatment and opportunities to improve prevention and management.

Duodenal Bulb Adenocarcinoma Benefitted from Neoadjuvant Chemotherapy: A Case Report

Chemotherapy ◽  
2017 ◽  
Vol 62 (5) ◽  
pp. 290-294 ◽  
Author(s):  
Geng-Yuan Zhang ◽  
Jie Mao ◽  
Bin Zhao ◽  
Bo Long ◽  
Hao Zhan ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Comprehensive Evaluation ◽  
Duodenal Bulb ◽  
Treatment Modalities ◽  
Pathological Examination ◽  
Upper Gastrointestinal Endoscopy ◽  
Tumor Type ◽  
Low Incidence ◽  
Rare Malignancy ◽  
Upper Gastrointestinal

Duodenal bulb adenocarcinoma is an extremely rare malignancy in the alimentary tract which has a low incidence rate and nonspecific symptoms. It is difficult to diagnose early, and the misdiagnosis rate is high. CT, MRI, upper gastrointestinal endoscopy, and other advanced imaging modalities should be combined to make a comprehensive evaluation. The diagnostic confirmation of this tumor type mainly depends on the pathological examination. The combination of surgery with other treatment modalities is effective. A review of reports on duodenal bulb adenocarcinoma with chemotherapy revealed 6 cases since 1990. However, there are few reports on neoadjuvant chemotherapy for the disease. In this report, preoperative S-1 in combination with oxaliplatin neoadjuvant chemotherapy achieved a complete pathological response in the treatment of duodenal bulb adenocarcinoma. Neoadjuvant chemotherapy shows a better clinical efficacy in the treatment of duodenal bulb adenocarcinoma, but its value needs to be further verified.

Pathological outcomes of HER2-positive early breast cancer patients treated with neoadjuvant trastuzumab or dual anti-HER2 therapy and carboplatin with docetaxel: A Maria Sklodowska-Curie National Research Institute of Oncology experience.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12655-e12655
Author(s):  
Agnieszka I. Jagiello-Gruszfeld ◽  
Izabela Lemanska ◽  
Renata Sienkiewicz ◽  
Ewa Szombara ◽  
Roman Dubianski ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Adverse Events ◽  
Early Breast Cancer ◽  
Pathological Complete Response ◽  
Demographic Data ◽  
Neoadjuvant Treatment ◽  
Complete Response ◽  
Tumor Type ◽  
Dual Blockade

e12655 Background: Pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) for breast cancer predicts the risk of recurrence and increasingly may indicate the need for additional therapy postoperatively. Methods: A retrospective analysis was performed in two cohorts of patients (pts) treated with docetaxel, trastuzumab and carboplatin (TCH) or with docetaxel, carboplatin and dual blockade (TCH-P) in the neoadjuvant setting in patients with early breast cancer (tumor size < 50 mm and > 10 mm and cN0 or cN1) in our Clinic, and who had definitive surgery was conducted. Demographic data, size, grade, tumor type, receptor status prior to neoadjuvant treatment, pathological complete response (pCR) rates, and adverse effects were analyzed. The pCR was defined as ypT0 ypN0. Results: Patient in cohort A (n = 58) received TCH x 6 cycles and in cohort B (n = 25) TCH-P x 6 cycles. Median age was 51 (range 23 to 76 years) in cohort A and 46 (range: 30-68) in cohort B. In cohort A 37 (64%) of pts was HR-positive, in cohort B only 9 (36%) pts . The most common adverse events in both groups were neutropenia, diarrhea, chemotherapy induced polyneuropathy and febrile neutropenia. There are no significant differences in the frequency of adverse events in two cohorts. There was no symptomatic heart failure, but 6 pts (10%) in cohort A and 5 pts (16%) in cohort B had > 10% asymptomatic decrease in LVEF. All patients were evaluable for pCR. Higher rates of pCR were achieved in the HER2pos/HRneg pts: 66% (n = 14) in cohort A, and 87% (n = 14) in cohort B. In group HER2pos/HRpos pts, the pCR rate was 48% (n = 18) vs 55% (n = 5) respectively. Conclusions: In HER2positive early breast cancer, a dual blockade (trastuzumab and pertuzumab) together with carboplatin and docetaxel neoadjuvant chemotherapy achieved higher rates of pCR ( 76%) compared with pts treated with trastuzumab, carboplatin and docetaxel (56%). However, a much higher percentage of pCR was observed in the group of patients with non-luminal cancers, who received a double blockade (87% vs 66%).

scholarly journals Neoadjuvant Chemotherapy for Duodenal GIST: A Case Report

2017 ◽  
Vol 102 (1-2) ◽  
pp. 81-86
Author(s):  
Akiyoshi Seshimo ◽  
Masayoshi Tsuchiya ◽  
Yoshinobu Ueda ◽  
Makiko Kasuga ◽  
Mikiko Taneichi ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Hepatic Cirrhosis ◽  
Unknown Origin ◽  
Outer Side ◽  
Hepatitis C Infection ◽  
Complete Excision ◽  
Kit Mutation ◽  
Stromal Tumors ◽  
Duodenal Gist ◽  
Exon 11

The principal treatment for gastrointestinal stromal tumors (GISTs) is surgical; and complete excision is important, but cannot always be achieved. For such cases, neoadjuvant chemotherapy (NAC) with imatinib mesylate (IM) has been recommended. A case of a GIST of the second portion of the duodenum for which pancreatoduodenectomy was indicated, and for which partial resection was made possible as a result of cytoreduction by IM NAC, is reported. A 64-year-old man with pancytopenia due to hepatic cirrhosis caused by hepatitis C infection received repeated blood transfusions because of anemia of unknown origin starting 2 years earlier. Most recently, the patient had melena with hemoglobin of 5.1 mg/dL. Diagnostic imaging showed a solid tumor, 55 × 48 × 65 mm3, in the second portion of the duodenum showing mainly extramural development. Endoscopic aspiration biopsy showed proliferation of KIT-positive spindle-shaped heterotypic cells. GIST was diagnosed, and an exon 11 KIT mutation was found. Because of the exon 11 mutation, neoadjuvant IM was started at 400 mg/day and then eventually maintained at 300 mg/day for 10 months. Regular CT examinations showed gradual tumor shrinkage. At surgery, a tumor with strong extramural growth was found on the outer side of the duodenum that invaded the retroperitoneum. The tumor was excised as a mass, and the duodenum was resected partially. There has been no recurrence at 9 years postoperatively. Evaluating KIT exon mutations and predicting the effectiveness of NAC appear useful for determining the treatment policy for advanced GISTs.

scholarly journals Rectal Carcinoma, Mayo Hospital Experience

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Zulfiqar A Chaudhry ◽  
Farid Ahmad Khan ◽  
Khuda Dad Tarrar ◽  
Salman Akhtar ◽  
Shamim Ahmad Khan ◽  
...  
Keyword(s):  
Rectal Carcinoma ◽  
Local Community ◽  
Age Group ◽  
Management Guideline ◽  
Lower Rectum ◽  
Younger Age ◽  
Carcinoma Rectum ◽  
New Diagnosis ◽  
A Prospective Study ◽  
Time Of Operation

For patients having rectal carcinoma, resection offers the only chance of cure. The approach to operation is influenced by the finding at sigmoidoscopy, degree of fixity of the growth as assessed by rectal examination and the histology of the tumor. In the study different operative option according to the site of tumor and demographic aspect of the rectal carcinoma in local community were studied. It is a prospective study carried out at Mayo Hospital, Lahore Pakistan to assist in the development of the management guideline. In this study, 50 patients with new diagnosis of carcinoma rectum were included. Out of the 50 patients 44% had tumor of the upper rectum 16% in the middle and 40% in the lower rectum. In 96% of the cases histology was adenocarcinoma and 2% each for melanoma and lymphoma. Resection of the primary disease in 92% of the cases, 20% of the cases presented with acute obstruction and 4% of the cases were inoperable. Curative resection was possible in 80% of the cases, palliation was achieved in 12% cases and 4% of the cases deemed inoperable at the time of operation. Incidence of rectal carcinoma is higher in younger age group being < 40 and resection of the primary tumor is the cure in early cases.

scholarly journals Fertility-Sparing Surgery In Early Stage Cervical Cancer

2018 ◽  
Vol 12 (1) ◽  
pp. 37
Author(s):  
IN Gede Budiana ◽  
Tjokorda Gede Astawa Pemayun
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Early Stage ◽  
Reproductive Function ◽  
Reproductive Age ◽  
Radical Trachelectomy ◽  
Fertility Sparing Surgery ◽  
Younger Age ◽  
Fertility Sparing ◽  
Early Stage Cervical Cancer

Cervical cancer is a malignancy in women that cause major impacts, not only biologically, but also in various aspects of life. On patients during reproductive age, cervical cancer poses severe sexual and reproductive debilitation. Trend in the onset of first diagnosis is moving towards younger age, and mostly affect women in their reproductive age. This would give a bad impact on the sustainability of the patient’s reproductive function. Until now, fertilitysparing approach for the management of early-stage cervical cancer is still rare in Indonesia. However, some options of conservative surgical therapy are available for patients who desire fertility, namely conization, simple tracellectomy, radical trachelectomy, and also neoadjuvant chemotherapy. These options have been proven effective and safe, while maintaining patients’ reproductive functions. ABSTRAKKanker serviks merupakan suatu penyakit keganasan pada wanita yang memiliki dampak luas, tidak hanya pada tubuh penderita, namun juga berbagai aspek kehidupan penderita. Pada penderita di usia reproduktif, kanker serviks menimbulkan masalah seksual dan reproduksi yang berat bagi penderita. Kini usia dimana terjadinya kanker serviks mulai menunjukkan kecenderungan yang semakin muda yang tentunya memberikan dampak buruk terhadap keberlangsungan fungsi reproduksi pasien. Hingga saat ini, tatalaksana kanker serviks stadium awal dengan pendekatan fertility-sparing masih jarang dilakukan di Indonesia. Namun, beberapa pilihan terapi bedah konservatif tersedia bagi pasien yang menginginkan fertilitas, yakni konisasi, trakelektomi sederhana, trakelektomi radikal. hingga pemberian kemoterapi neo-adjuvant. Pilihan terapi ini telah terbukti efektif dan aman, serta mampu mem pertahankan fungsi reproduksi pasien.

scholarly journals Significance of Platinum Distribution to Predicts Platinum Resistance in Ovarian Cancer After Platinum Treatment in Neoadjuvant Chemotherapy

2021 ◽  
Author(s):  
Kaname Uno ◽  
Nobuhisa Yoshikawa ◽  
Akira Tazaki ◽  
Shoko Ohnuma ◽  
Kazuhisa Kitami ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Adjuvant Chemotherapy ◽  
Neoadjuvant Chemotherapy ◽  
Inductively Coupled Plasma ◽  
Advanced Ovarian Cancer ◽  
Type A ◽  
Platinum Resistance ◽  
Tumor Type ◽  
Platinum Based Chemotherapy ◽  
Platinum Accumulation

Abstract Most advanced ovarian cancer patients experience recurrence and develop resistance to platinum-based agents. However, the diagnosis of platinum resistance based on platinum-free interval is not always accurate and timely. In this study, we employed laser ablation inductively coupled plasma mass spectrometry to visualize platinum distribution in the tissues at the time of interval debulking surgery following neoadjuvant chemotherapy. Twenty seven patients with advanced high grade serous ovarian cancer were enrolled. Two distinct patterns of platinum distribution were observed. Type A (n = 16): platinum accumulation at the adjacent stroma but little in the tumor; type B (n = 11): even distribution of platinum through tumor and adjacent stroma. Type A was significantly correlated with worse prognosis (P = 0.031). Patients classified in type A and treated with platinum-based adjuvant chemotherapy after operation were significantly shorter period of recurrence after last platinum-based chemotherapy (P = 0.020) and diagnosed with “platinum-resistant recurrence”. Treatment with non-platinum-based chemotherapy after operation could be effective for the patients who were classified in type A. Our data indicate that the platinum resistance can be predicted prior to recurrence with platinum distribution. Thus, we will be able to select more appropriate adjuvant chemotherapy, which may possibly lead to improve patient’s prognosis.

Who gets a referral to oncologists and subsequent treatments for stages III and IV non-small cell lung cancer (NSCLC)?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6007-6007
Author(s):  
Bernardo Haddock Lobo Goulart ◽  
Catherine R. Fedorenko ◽  
David G Mummy ◽  
David K Blough ◽  
Lisel Koepl ◽  
...  
Keyword(s):  
Stage Iv ◽  
Younger Age ◽  
Co Morbidity ◽  
Network Methods ◽  
Treatment Data ◽  
Cancer Specialists ◽  
Morbidity Index ◽  
New Diagnosis ◽  
Medicare Database ◽  
Cancer Network

6007 Background: We identified the physicians initially involved in the management of stages III and IV NSCLC, and explored associations of patient and their initial physician factors with referrals to oncologists and subsequent receipt of guideline-based therapies (GBTs) endorsed by the National Comprehensive Cancer Network. Methods: Using a retrospective cohort design, we identified patients with a new diagnosis of stages III and IV NSCLC from 01/01/2000 to 12/31/2005 included in the Surveillance, Epidemiology, and End Results-Medicare database. After collecting patient sociodemographic, tumor, and treatment data, we linked Unique Physician Identifier Numbers (UPINs) from Medicare claims to the American Medical Association Masterfile database to identify the initial physicians and subsequent referrals to cancer specialists, defined as surgeons, radiation oncologists and oncologists. We used logistic regression to explore associations between: 1) patient and initial physician independent variables with referrals to oncologists; 2) referrals to different combinations of cancer specialists with receipt of stage-specific GBTs, adjusted for confounders. The follow-up period was 12 months or up to 12/31/2006. Results: For 28,977 patients, mean age was 75 years, 53% were male, 83% were white, 51% had stage IV, 37% initially saw an internal medicine doctor, 84% saw at least an oncologist, 31% saw all 3 types of cancer specialists, and 44% received GBTs. Younger age, white race, stage IV, higher income, lower co-morbidity index, initial physicians other than family practice doctors, and referral to pulmonologists were associated with higher likelihood of referral to oncologists (P<0.01 for all factors). Compared to those who saw only an oncologist, those who saw only a surgeon and/or a radiation specialist were less likely to receive GBTs (OR=0.3; 95%CI=0.3-0.4). Among patients who had no referrals or who saw specialties other than oncology, 14% received GBTs. Conclusions: Seeing an oncologist is a critical step in the standard treatment of advanced NSCLC. Yet, race, income, and the type of initial physician may constitute barriers of access to oncologists, which can result in substandard care.

Phẫu thuật bảo tồn khả năng sinh sản trong ung thư cổ tử cung giai đoạn sớm

2020 ◽  
Author(s):  
Lieu Ta Thanh
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Surgical Therapy ◽  
Early Stage ◽  
Reproductive Function ◽  
Reproductive Age ◽  
Radical Trachelectomy ◽  
Younger Age ◽  
Early Stage Cervical Cancer ◽  
First Diagnosis

Cervical cancer is a malignancy in women that cause major impacts, not only biologically, but also in various aspects of life. On patients during reproductive age, cervical cancer poses severe sexual and reproductive debilitation. Trend in the onset of first diagnosis is moving towards younger age, and mostly affect women in their reproductive age. This would give a bad impact on the sustainability of the patient’s reproductive function. Until now, fertilitysparing approach for the management of early-stage cervical cancer is still rare in VietNam.However, some options of conservative surgical therapy are available for patients who desire fertility, namely conization, simple tracellectomy, radical trachelectomy, and also neoadjuvant chemotherapy. These options have been proven effective and safe, while maintaining patients’ reproductive functions

Gynecologic Cancer InterGroup (GCIG) Consensus Review for Ovarian and Primary Peritoneal Low-Grade Serous Carcinomas

2014 ◽  
Vol 24 (Supp 3) ◽  
pp. S9-S13 ◽  
Author(s):  
Charlie Gourley ◽  
John Farley ◽  
Diane M. Provencher ◽  
Sandro Pignata ◽  
Linda Mileshkin ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Clear Cell ◽  
Gynecologic Cancer ◽  
Low Grade ◽  
Tumor Type ◽  
High Grade ◽  
Serous Ovarian Cancer ◽  
Histological Subtypes ◽  
Specific Data ◽  
Younger Age

AbstractLow-grade serous ovarian cancer is a recently described histological subtype of ovarian cancer that is clinically and molecularly distinct from the 4 other main histological subtypes (high-grade serous, clear cell, endometrioid, and mucinous). In particular, it differs from high-grade serous ovarian cancer in that it presents at a much younger age, is more indolent, and is relatively chemoresistant. Very few clinical trials have been performed exclusively in this tumor type; and as such, specific data guiding optimal management are limited.

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