scholarly journals Particle Beam Therapy Tolerance and Outcome on Patients with Autoimmune Diseases: A Single Institution Matched Case–Control Study

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5183
Author(s):  
Giulia Riva ◽  
Barbara Vischioni ◽  
Sara Gandini ◽  
Stefano Cavalieri ◽  
Sara Ronchi ◽  
...  
Keyword(s):  
Autoimmune Diseases ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Particle Beam ◽  
Particle Therapy ◽  
Control Group ◽  
Cancer Type ◽  
Organ Specific ◽  
Radiation Induced ◽  
Grade 3

It is unclear whether autoimmune diseases (ADs) may predispose patients to higher radiation-induced toxicity, and no data are available regarding particle therapy. Our objective was to determine if cancer patients with ADs have a higher incidence of complications after protons (PT) or carbon ion (CIRT) therapy. METHODS. In our retrospective monocentric study, 38 patients with ADs over 1829 patients were treated with particle therapy between 2011 and 2020. Thirteen patients had collagen vascular disease (CVD), five an inflammatory bowel disease (IBD) and twenty patients an organ-specific AD. Each patient was matched with two control patients without ADs on the basis of type/site of cancer, type of particle treatment, age, sex, hypertension and/or diabetes and previous surgery. RESULTS. No G4–5 complications were reported. In the AD group, the frequency of acute grade 3 (G3) toxicity was higher than in the control group (15.8% vs. 2.6%, p = 0.016). Compared to their matched controls, CVD–IBD patients had a higher frequency of G3 acute complications (27.7 vs. 2.6%, p = 0.002). There was no difference between AD patients (7.9%) and controls (2.6%) experiencing late G3 toxicity (p = 0.33). The 2 years disease-free survival was lower in AD patients than in controls (74% vs. 91%, p = 0.01), although the differences in terms of survival were not significant. CONCLUSIONS. G3 acute toxicity was more frequently reported in AD patients after PT or CIRT. Since no severe G4–G5 events were reported and in consideration of the benefit of particle therapy for selected cancers, we conclude that particle therapy should be not discouraged for patients with ADs. Further prospective studies are warranted to gain insight into toxicity in cancer patients with ADs enrolled for particle therapy.

Mecobalamin as a Neuroprotective Effector against Oxaliplatin-Based Chemotherapy in Colon and Rectal Cancer Patients

Care Weekly ◽  
2021 ◽  
pp. 1-5
Author(s):  
Li Hongyan ◽  
Lu Wanting ◽  
Li Fei
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Sensory Neuropathy ◽  
Control Group ◽  
Placebo Control ◽  
Case Group ◽  
Colon And Rectal Cancer ◽  
Grade 3

Palliative chemotherapy prolongs survival and improves quality of life. However, a variety of chemotherapeutics including oxaliplatin can cause severe side effects during treatments, leading to painful symptoms that might result in the interruption of cancer treatment. Although adding oxaliplatin to fluorouracil and leucovorin in adjuvant chemotherapy for colon and rectal cancer may improve disease-free survival, it also increases grade 3–4 sensory neuropathy. Our study aimed to determine whether oral Mecobalamin is neuroprotective against oxaliplatin-induced neuropathy. Forty-six stage III colon and rectal cancer patients receiving adjuvant biweekly oxaliplatin were randomized to oral Mecobalamin (1,500 mg; case group) or placebo (control group). Clinical neurological and electrophysiological evaluations were performed at baseline and after 4, 8, and 12 treatment cycles. Treatment-related toxicity was evaluated based on National Cancer Institute (NCI) criteria. After four cycles of chemotherapy, 9 of 23 patients in the control group and 8 of 23 patients in case group experienced grade 1 sensory neuropathy. After eight cycles, 13 patients experienced sensory neuropathy (grade 2–4 toxicity) in the control group; however, no patients in the case group experienced sensory neuropathy (P < 0.05). After 12 cycles, grade 2–4 sensory neuropathy was observed in 20 patients in the control group, but only in 4 patients in the case group (P < 0.05). We did not observe any significant electrophysiological changes in the case group after 4, 8, or 12 cycles of chemotherapy. Thus, we demonstrated that oral Mecobalamin reduces the incidence of neuropathy in colon and rectal cancer patients receiving oxaliplatin-based adjuvant chemotherapy.

Modelling of organ-specific radiation-induced secondary cancer risks following particle therapy

2016 ◽  
Vol 120 (2) ◽  
pp. 300-306 ◽  
Author(s):  
Camilla H. Stokkevåg ◽  
Mai Fukahori ◽  
Takuma Nomiya ◽  
Naruhiro Matsufuji ◽  
Grete May Engeseth ◽  
...  
Keyword(s):  
Particle Therapy ◽  
Secondary Cancer ◽  
Cancer Risks ◽  
Organ Specific ◽  
Radiation Induced

Non-Organ Specific Autoantibodies in Malignant Diseases

1975 ◽  
Vol 20 (5) ◽  
pp. 203-208 ◽  
Author(s):  
Elizabeth S. Gray ◽  
A. L. C. McLay ◽  
W. D. Thompson ◽  
D. Donald ◽  
C. H. W. Horne
Keyword(s):  
Cancer Patients ◽  
Healthy Adult ◽  
Matched Control ◽  
Control Group ◽  
Age Related ◽  
Increased Risk ◽  
Organ Specific ◽  
Immunological Surveillance ◽  
Expected Increase ◽  
Apparently Healthy

A significant increase in non-organ specific autoantibodies is demonstrated in 13 per cent of the sera from 202 patients with histologically proven malignancies, as compared with only 4 per cent of sera from 214 age and sex matched control patients. It appears that the incidence of autoantibodies is related to the histological type of the tumour but not to the presence or absence of tumour dissemination. While the control group shows the expected increase in both incidence and titre of autoantibodies with increasing age, the malignant patients show no such pattern, i.e. in cancer patients autoantibodies occur with equal frequency and at similar titres regardless of age. The absence of an age related increase in incidence and titre of non organ specific autoantibodies does not appear to have been reported previously. Our findings lend support to the hypothesis that cancer is associated with a breakdown of immunological surveillance, not only in old but also in young cancer patients. Thus the finding of non organ specific autoantibodies, especially to smooth muscle antigen, in an apparently healthy adult could be considered evidence of such a breakdown, carrying with it an increased risk of neoplasia.

A case-control study evaluating differences in resource utilization between diabetic and non-diabetic cancer patients undergoing chemotherapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6126-6126
Author(s):  
M. D. Robertson ◽  
T. J. George ◽  
M. Chang ◽  
L. C. Richardson
Keyword(s):  
Cancer Patients ◽  
Resource Utilization ◽  
Case Control Study ◽  
Disease Free Survival ◽  
Case Control ◽  
Measurement Scale ◽  
Secondary Outcome ◽  
Cancer Type ◽  
Outpatient Visits ◽  
Control Study

6126 Background: Patients with diabetes mellitus (DM) and cancer have been noted to have worse overall and disease-free survival compared to those without DM. However, there is a paucity of data addressing why diabetic cancer patients have worse outcomes. We performed a retrospective case-control study to evaluate cancer patients undergoing chemotherapy comparing persons with and without DM to evaluate differences in resource utilization and mortality. Methods: Using chart review and tumor registry data from January 2001 through December 2003, we identified DM patients 18 years or older, treated with chemotherapy at the Gainesville Veterans Administration Medical Center (GVAMC) for lung, colon, or head and neck cancer. Non-diabetic (Non-DM) controls were matched for age, cancer type and stage. A comorbidity score was calculated based on a previously validated measurement scale, Adult Comorbidity Evaluation 27 (ACE-27). The primary outcome measure was the number of inpatient hospital days in the first year after diagnosis. Secondary outcome measures included the total number of outpatient visits, emergency room (ER) visits, infusion room visits for chemotherapy, blood transfusions, home health consults, telephone calls, and mortality. Results: A total of 42 DM cases and 42 non-DM controls were identified who had undergone similar treatments with radiation and surgery. The DM patients had higher comorbidity ACE 27 scores when corrected for the cancer being treated, median 3.0 versus 2.0, p < 0.005. The table summarizes the results. Mortality was the same (15) for both the DM and non-DM patients at one year. Conclusions: Cancer patients with DM undergoing chemotherapy have significantly more comorbidities and utilize more outpatient visits compared to non-DM. However, all other measures of resource utilization and mortality appear similar. Further studies to identify causes of increased utilization should be done. [Table: see text] No significant financial relationships to disclose.

Racial differences in development of immune-related adverse events.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e15148-e15148 ◽  
Author(s):  
Shruti Bhandari ◽  
Rohit Kumar ◽  
Laura Nice ◽  
Anmol Cheema ◽  
Goetz H. Kloecker
Keyword(s):  
African Americans ◽  
Adverse Events ◽  
Autoimmune Diseases ◽  
Racial Differences ◽  
Checkpoint Inhibitors ◽  
Single Agent ◽  
Retrospective Chart Review ◽  
Cancer Type ◽  
Immune System Activation ◽  
Grade 3

e15148 Background: Immune-related adverse events (irAEs) due to immune checkpoint inhibitors (ICIs) are caused by non-specific immune system activation and develop in 30-70% of patients. The goal of this study is to examine the association of race with the development of irAEs secondary to ICIs as autoimmune diseases generally exhibit racial differences. Methods: A retrospective chart review was done using University of Louisville pharmacy database. Patients with solid cancers who received ICIs between Jan 2016 to June 2019 were included. IrAEs were identified through the review of electronic medical records. Descriptive analysis evaluated the incidence and severity of irAEs. Multivariable logistic regression was used to calculate standardized incidence of irAEs among Whites and African Americans. Results: A total of 476 patients were included in this study. The mean age was 61 years, 57% were males and 89.7% were whites. A majority of patients had melanoma (50%). The remainder of the dataset included lung (33.4%), gastrointestinal (7.4%), head & neck (4.8%), breast (2.5%) and genitourinary (1.9%) cancers. ICIs included single agent anti-PD-1 (74.8%), single agent anti-PD-L1 (9.4%), combination anti-CTLA-4 with anti-PD-1 (7.1%). Some patients were also treated with > 1 ICI as subsequent therapy (8.6%). Overall, the rate of irAEs was 44.3% with 33.8% grade 1-2 and 12.4% grade 3-4 irAEs. There was no difference in development of any grade irAEs in Whites as compared to African Americans after adjusting for age, sex, cancer type and ICIs (44.3% vs 44.2%; OR: 0.99, 95% CI: 0.50 – 1.97; p = 0.99). There was also no difference in development of grade 3-4 irAEs in whites as compared to African Americans (12.8% vs 14.5%; OR: 1.16, 95% CI: 0.43 – 3.12; p = 0.75). Conclusions: In this study, we found no racial difference in the development of irAEs between Whites and African Americans. This is in contrast to general autoimmune diseases which exhibit racial differences with higher prevalence among African Americans compared to Whites. We will continue to accrue patients to this study as larger sample size is needed to confirm these findings.

CT findings of acute radiation-induced pneumonitis in breast cancer

2021 ◽  
pp. 20200997
Author(s):  
Wonguen Jung ◽  
Sung Shine Shim ◽  
Kyubo Kim
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Postoperative Radiotherapy ◽  
Acute Radiation ◽  
Breast Cancer Patients ◽  
Ct Findings ◽  
Dose Volume ◽  
Radiation Induced ◽  
Grade 3

Objectives: To evaluate the computed tomography (CT) findings of acute radiation pneumonitis (RP) in breast cancer patients undergoing postoperative radiotherapy, and to analyze clinico-dosimetric factors associated with acute RP. Methods: Between 2015 and 2017, 61 patients with breast cancer who underwent follow-up chest CT at 3 months after radiotherapy were analyzed. The degree of acute RP on CT was evaluated by the change of extent and scoring system (grade 0, no RP; Grade 1, ground-glass opacities (GGOs); Grade 2, GGOs and/or consolidations; Grade 3, clear focal consolidation; Grade 4, dense consolidation). The dosimetric parameters were calculated from the dose-volume histogram of RT. Results: The acute RP on CT was scored as follows: grade 0, in 37.7%, Grade 1 in 13.1%, Grade 2 in 44.3%, and Grade 3 in 4.9%. The median extent of RP in patients with Grades 1 to 3 was 6.2 ml (range, 0.2–95.9). There were no clinico-dosimetric factors significantly associated with the presence of RP or its severity. One patient developed symptomatic RP. Conclusions: This study showed no correlation between acute RP and clinico-dosimetric factors, and acute RP based on CT findings were much more common than symptomatic RP. Advances in knowledge: CT findings of acute RP or extent of RP were not significantly related to clinico-dosimetric factors in breast cancer patients.

scholarly journals Computed tomography–based image-guided brachytherapy for cervical cancer: correlations between dose–volume parameters and clinical outcomes

2017 ◽  
Vol 59 (1) ◽  
pp. 67-76 ◽  
Author(s):  
Takeaki Kusada ◽  
Takafumi Toita ◽  
Takuro Ariga ◽  
Hitoshi Maemoto ◽  
Seiji Hashimoto ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Local Control ◽  
Organs At Risk ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Oncologic Outcomes ◽  
Image Guided ◽  
Future Challenges ◽  
Grade 3

AbstractThis study evaluated the oncologic outcomes and complications of cervical cancer patients in terms of CT-based image-guided brachytherapy (IGBT) parameters. Of 68 cervical cancer patients treated with definitive radiotherapy/concurrent chemoradiotherapy, most received whole-pelvis external beam RT (EBRT) of 40 Gy in 20 fractions, pelvic EBRT with central shield of 10 Gy in 5 fractions, and CT-based IGBT of 18 Gy in 3 fractions prescribed to point A. Cumulative EBRT and IGBT doses were calculated as the total equivalent dose in 2 Gy fractions (EQD2). The median follow-up was 31 (3–52) months. The 2-year overall survival, local control, pelvic control, and disease-free survival rates of the 68 patients were 92%, 83%, 82% and 73%, respectively. The HR-CTV D90, length from the tandem axis to left/right margin of the HR-CTV (T-LR), and HR-CTV volume were significant IGBT parameters for predicting local/pelvic control. Patients who received an HR-CTV D90 of &gt;60 Gy, compared with ≤60 Gy, had significantly better local/pelvic control. Furthermore, 70 Gy was a marginally significant HR-CTV D90 cut-off affecting local control. T-LR was an independent IGBT parameter predicting local/pelvic control on multivariate analysis. Three patients developed Grade 3 or higher treatment-related complications. The D2cm3 of organs at risk were not significant predictors of complications. Future challenges for further improving outcomes include additional interstitial needles for irregularly shaped HR-CTVs, and moderate dose escalation, especially for patients with poor tumor responses.

scholarly journals The Significance of SIX1 as a Prognostic Biomarker for Survival Outcome in Various Cancer Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Guang Zhu ◽  
Ying Liu ◽  
Lei Zhao ◽  
Zhenhua Lin ◽  
Yingshi Piao
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Cancer Patients ◽  
Human Cancer ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Cancer Type ◽  
Free Survival ◽  
Cancer Types ◽  
Disease Free

Sine Oculis Homeobox Homolog 1 (SIX1) is reported to promote cancer initiation and progression in many preclinical models and is demonstrated in human cancer tissues. However, the correlation between SIX1 and cancer patients’ prognosis has not yet been systematically evaluated. Therefore, we performed a systematic review and meta-analysis in various human cancer types and extracted some data from TCGA datasets for further verification and perfection. We constructed 27 studies and estimated the association between SIX1 expression in various cancer patients’ overall survival and verified with TCGA datasets. Twenty-seven studies with 4899 patients are include in the analysis of overall, and disease-free survival, most of them were retrospective. The pooled hazard ratios (HRs) for overall and disease-free survival in high SIX1 expression patients were 1.54 (95% CI: 1.32-1.80, P&lt;0.00001) and 1.83 (95% CI: 1.31-2.55, P=0.0004) respectively. On subgroup analysis classified in cancer type, high SIX1 expression was associated with poor overall survival in patients with hepatocellular carcinoma (HR 1.50; 95% CI: 1.17-1.93, P =0.001), breast cancer (HR 1.31; 95% CI: 1.10-1.55, P =0.002) and esophageal squamous cell carcinoma (HR 1.89; 95% CI: 1.42-2.52, P&lt;0.0001). Next, we utilized TCGA online datasets, and the consistent results were verified in various cancer types. SIX1 expression indicated its potential to serve as a cancer biomarker and deliver prognostic information in various cancer patients. More works still need to improve the understandings of SIX1 expression and prognosis in different cancer types.

scholarly journals Association of neutrophil-to-lymphocyte ratio with severe radiation-induced mucositis in pharyngeal or laryngeal cancer patients: a retrospective study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yumiko Kawashita ◽  
Masayasu Kitamura ◽  
Sakiko Soutome ◽  
Takashi Ukai ◽  
Masahiro Umeda ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Retrospective Study ◽  
Cancer Patients ◽  
Systemic Inflammation ◽  
Laryngeal Cancer ◽  
Multivariate Logistic Regression ◽  
Kaplan Meier ◽  
Radiation Induced ◽  
Grade 3

Abstract Background The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that informs clinical decisions regarding recurrence and overall survival in most epithelial cancers. Radiotherapy for head and neck cancer leads to mucositis in almost all patients and severe radiation-mucositis affects their quality of life (QOL). However, little is known about the NLR for severe mucositis. Therefore, this study aimed to show the association between the NLR and severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients. Methods In this retrospective study, we determined the incidence of grade 3 mucositis in 99 patients who were receiving definitive radiotherapy or chemoradiotherapy (CRT) for hypopharyngeal or laryngeal cancer. We performed univariate and multivariate logistic regression analyses to investigate the characteristics of grade 3 mucositis. Kaplan–Meier curves and log-rank tests were used to evaluate the occurrence of grade 3 mucositis between two groups with high (NLR > 5) or low (NLR < 5) systemic inflammation. Results The incidence of grade 3 mucositis was 39%. Univariate logistic regression analysis showed that the NLR (Odd ratio [OR] = 1.09; 95% confidence interval [CI] = 1.02–1.16; p = 0.016) and smoking (OR = 1.02; 95% CI = 1.00–1.03; p = 0.048) were significantly associated with grade 3 mucositis. Multivariate logistic regression analysis showed that the NLR was independently associated with grade 3 mucositis (OR = 1.09; 95% CI = 1.01–1.17; p = 0.021). Kaplan–Meier curves also showed that patients with higher NLR (NLR > 5) prior to radiotherapy developed grade 3 mucositis more frequently than those with lower NLR during radiotherapy (p = 0.045). Conclusion This study suggests that a higher NLR is a risk factor and predictor of severe radiation-induced mucositis in hypopharyngeal or laryngeal cancer patients.

scholarly journals Ozone Therapy in the Management of Persistent Radiation-Induced Rectal Bleeding in Prostate Cancer Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Bernardino Clavo ◽  
Norberto Santana-Rodriguez ◽  
Pedro Llontop ◽  
Dominga Gutierrez ◽  
Daniel Ceballos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Rectal Bleeding ◽  
Ozone Therapy ◽  
Serious Adverse Events ◽  
Before And After ◽  
Radiation Induced ◽  
Grade 3 ◽  
To Receive

Introduction. Persistent radiation-induced proctitis and rectal bleeding are debilitating complications with limited therapeutic options. We present our experience with ozone therapy in the management of such refractory rectal bleeding.Methods. Patients (n=12) previously irradiated for prostate cancer with persistent or severe rectal bleeding without response to conventional treatment were enrolled to receive ozone therapy via rectal insufflations and/or topical application of ozonized-oil. Ten (83%) patients had Grade 3 or Grade 4 toxicity. Median follow-up after ozone therapy was 104 months (range: 52–119).Results. Following ozone therapy, the median grade of toxicity improved from 3 to 1 (p<0.001) and the number of endoscopy treatments from 37 to 4 (p=0.032). Hemoglobin levels changed from 11.1 (7–14) g/dL to 13 (10–15) g/dL, before and after ozone therapy, respectively (p=0.008). Ozone therapy was well tolerated and no adverse effects were noted, except soft and temporary flatulence for some hours after each session.Conclusions. Ozone therapy was effective in radiation-induced rectal bleeding in prostate cancer patients without serious adverse events. It proved useful in the management of rectal bleeding and merits further evaluation.

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