scholarly journals Definitive re‑irradiation of locally recurrent esophageal cancer after trimodality therapy in patients with a poor performance status

2020 ◽  
Vol 13 (1) ◽  
pp. 27-32
Author(s):  
Daniel Kim ◽  
Sana Raoof ◽  
Nayan Lamba ◽  
Grace Lee ◽  
Danielle Bitterman ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Trimodality Therapy ◽  
Locally Recurrent

Outcome of trimodality-eligible esophagogastric cancer (EC) patients who declined surgery after preoperative chemoradiation.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 6-6 ◽  
Author(s):  
Takashi Taketa ◽  
Arlene M Correa ◽  
Akihiro Suzuki ◽  
Mariela Anabel Blum ◽  
Jeffrey Edwin Lee ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Performance Status ◽  
Preoperative Staging ◽  
Poor Performance ◽  
Complete Response ◽  
Endoscopic Biopsy ◽  
Preoperative Chemoradiation ◽  
Poor Performance Status ◽  
Trimodality Therapy ◽  
Esophagogastric Cancer

6 Background: Patients with localized EC eligible for resection at presentation should receive trimodality therapy (chemoradiation and surgery). However, surgical resection is not always performed in these patients because of poor performance status or reluctance in eligible patients to proceed with surgical resection after preoperative chemoradiation. Reports on the outcome of such patients are rare. Methods: Between 2002 and 2010, we identified 599 trimodality-eligible EC patients in our prospective database. All patients had extensive baseline staging, preoperative chemoradiation, and preoperative staging that included endoscopic biopsy and PET-CT. Of 599 patients, 32 patients declined surgery. Results: The median age was 70 years (range, 55-81), 29 patients (90.6%) were men and 30 (93.8%) were Caucasian. Majority had baseline stage II (44%) or III (38%) cancer. All 32 patients had an adenocarcinoma (moderate: 53.1%, poorly: 46.9%) and reached a clinical complete response (negative biopsy and PET in the physiologic range) post-chemoradiation. Four patients had salvage surgery and 3 are alive. Overall, 22 patients remain alive at a median follow up of 33.1 months (95% CI, 28.1-38.1). 3-year overall survival (OS) and relapse-free survival (RFS) were 65.1±10.4% and 37.5±10.3%. Median OS and RFS were 54.2 months (95% CI, 25.7-82.7), 30.4 months (95% CI, 16.3-44.5). Conclusions: Although the outcome of patients with EC who decline surgical resection after chemoradiation is reasonable, the lack of a validated approach to esophageal preservation dictates that trimodality therapy remains the standard of care in patients with potentially resectable EC.

PS02.112: A RETROSPECTIVE STUDY OF NEOADJUVANT 5-FU, DOCETAXEL, AND NEDAPLATIN (UDON) COMBINATION CHEMOTHERAPY FOR ADVANCED ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 152-153
Author(s):  
Yutaka Kimura ◽  
Osamu Shiraishi ◽  
Hisato Kawakami ◽  
Hiroto Ueda ◽  
Mitsuru Iwama ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Retrospective Study ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
High Dose ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Triplet Regimen

Abstract Background In Japan, pre-operative5-FU and cisplatin (CDDP) (FP) combination therapy has been the standard neoadjuvant chemotherapy (NAC) for advanced resectable esophageal cancer (EC), whereas the efficacy of docetaxel (DTX)-containing triplet regimen, FP plus DTX has been reported (Yamasaki M, et al, Ann Oncol 2017). However, for frail patients, such as patients with old age, chronic renal failure, poor performance status, severe commodities or malnutrition, high dose CDDP is not generally recommended in terms of toxicity. We have been developing non-CDDP-containing triplet regimen, 5-FU, DTX, and nedaplatin (NED) (UDON) on a phase I/II trial basis. This retrospective study aimed to investigate the safety and efficacy of NAC with UDON combination for advanced EC. Methods Eleven patients with advanced resectable EC who were unsuitable for the administration of high dose CDDP were enrolled in this study. Patients received two cycles of NAC with UDON (5-FU, 640 or 800 mg/m2, day1–5, DTX, 28 or 35 mg/m2, day1 and 15 and NED, 72 or 90 mg/m2, day1, q28) followed by esophagectomy. Primary endpoint was response rate and secondary endpoint was adverse event (AE). Results The median age was 73 years (range: 58–80) with eight patients being aged 70 or older. ECOG PS was 1/2: 7/4. The main location of the tumor was Ce/Ut/Mt/Lt/Ae: 1/1/7/1/1 and cStage was IIA/IIB/IIIA/IIIB/IIIC/IV: 2/2/4/0/2/1. The RR (CR + PR) was 82% (CR/PR/SD/PD: 1/8/2/0). The pathological response was grade 0/1a/1b/2/3: 2/3/3/2/1. Major grade 3 or 4 adverse events included neutropenia (27%), febrile neutropenia (27%), diarrhea (18%), enteritis (9%) and hyponatremia (27%). The postoperative morbidity included recurrent nerve palsy (36%), aspiration (27%), pneumonia (18%), anastomotic leakage (9%) and delirium (36%). There was no treatment-related death and no reoperation. Conclusion NAC with UDON for advanced resectable EC unsuitable for the administration of high dose CDDP might be feasible and effective. We are planning a phase II clinical study based on the present results. Disclosure All authors have declared no conflicts of interest.

scholarly journals COVID-19 and cancer registries: learning from the first peak of the SARS-CoV-2 pandemic

2021 ◽  
Author(s):  
Alvin J. X. Lee ◽  
Karin Purshouse
Keyword(s):  
Risk Factors ◽  
Performance Status ◽  
Poor Performance ◽  
Cancer Registries ◽  
Adverse Outcomes ◽  
Smoking History ◽  
Poor Performance Status ◽  
International Studies ◽  
Patients With Cancer ◽  
Increased Risk

AbstractThe SARS-Cov-2 pandemic in 2020 has caused oncology teams around the world to adapt their practice in the aim of protecting patients. Early evidence from China indicated that patients with cancer, and particularly those who had recently received chemotherapy or surgery, were at increased risk of adverse outcomes following SARS-Cov-2 infection. Many registries of cancer patients infected with SARS-Cov-2 emerged during the first wave. We collate the evidence from these national and international studies and focus on the risk factors for patients with solid cancers and the contribution of systemic anti-cancer treatments (SACT—chemotherapy, immunotherapy, targeted and hormone therapy) to outcomes following SARS-Cov-2 infection. Patients with cancer infected with SARS-Cov-2 have a higher probability of death compared with patients without cancer. Common risk factors for mortality following COVID-19 include age, male sex, smoking history, number of comorbidities and poor performance status. Oncological features that may predict for worse outcomes include tumour stage, disease trajectory and lung cancer. Most studies did not identify an association between SACT and adverse outcomes. Recent data suggest that the timing of receipt of SACT may be associated with risk of mortality. Ongoing recruitment to these registries will enable us to provide evidence-based care.

scholarly journals Clinical indicators for the incidence of postoperative ileus after elective surgery for colorectal cancer

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yosuke Namba ◽  
Yuzo Hirata ◽  
Shoichiro Mukai ◽  
Sho Okimoto ◽  
Seiji Fujisaki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Body Weight ◽  
Postoperative Ileus ◽  
Elective Surgery ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Clinical Indicators ◽  
Patient Morbidity ◽  
Two Factors

Abstract Background The occurrence of postoperative ileus leads to increased patient morbidity, longer hospitalization, and higher healthcare costs. No clear policy on postoperative ileus prevention exists. Therefore, we aim to evaluate the clinical factors involved in the development of postoperative ileus after elective surgery for colorectal cancer. Methods We retrospectively analyzed patients who underwent elective surgery involving bowel resection with or without re-anastomosis for colon cancer between April 2015 and March 2020. The primary readout was the presence or absence of postoperative ileus. Univariate and multivariate analyses were used to identify pre- and intraoperative risk factors, and the incidence of postoperative ileus was assessed using independent factors. Results Postoperative ileus occurred in 48 out of 356 patients (13.5%). In multivariate analysis, male sex poor performance status, and intraoperative in–out balance per body weight were independently associated with postoperative ileus development. The incidence of postoperative ileus was 2.5% in the cases with no independent factors; however, it increased to 36.1% when two factors were observed and 75.0% when three factors were matched. Conclusions We discovered that male gender, poor performance status, and intraoperative in–out balance per body weight were associated with the development of postoperative ileus. Of these, intraoperative in–out balance per body weight is a controllable factor. Hence it is important to control the intraoperative in–out balance to lower the risk for postoperative ileus.

scholarly journals Feasibility and effectiveness of afatinib for poor performance status patients with EGFR-mutation-positive non-small-cell lung cancer: a retrospective cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chiao-En Wu ◽  
Ching-Fu Chang ◽  
Chen-Yang Huang ◽  
Cheng-Ta Yang ◽  
Chih-Hsi Scott Kuo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Disease Control ◽  
Performance Status ◽  
Poor Performance ◽  
Small Cell ◽  
Poor Performance Status ◽  
Small Cell Lung ◽  
Nsclc Patients

Abstract Background Afatinib is one of the standard treatments for patients with epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC). However, data on the use of afatinib in patients with poor performance status (PS ≥ 2) are limited. This study aimed to retrospectively review the clinical outcomes and safety of afatinib treatment in EGFR-mutation-positive (EGFRm+) NSCLC patients with PS ≥ 2. Methods The data for 62 patients who were treated at Linkou Chang Gung Memorial Hospital from January 2010 to August 2019 were retrospectively reviewed. Patients’ clinicopathological features were obtained, and univariate and multivariate analyses were performed to identify possible prognostic factors. Data on adverse events were collected to evaluate general tolerance for afatinib therapy. Results Until February 2020, the objective response rate, disease control rate, median progression-free survival (PFS), and overall survival (OS) were 58.1% (36/62), 69.4% (43/62), 8.8 months, and 12.9 months, respectively. The absence of liver metastasis (PFS: p = 0.044; OS: p = 0.061) and good disease control (p < 0.001 for PFS and OS) were independent favorable prognostic factors for PFS and OS. Bone metastasis (p = 0.036) and dose modification (reduction/interruption, p = 0.021) were predictors of disease control. Conclusion Afatinib demonstrated acceptable efficacy and safety in the current cohort. This study provided evidence to support the use of afatinib as a first-line treatment in EGFRm+ NSCLC patients with poor PS.

Limited impact of palliative chemotherapy on survival in advanced solid tumours in patients with poor performance status

2011 ◽  
Vol 13 (6) ◽  
pp. 426-429 ◽  
Author(s):  
Alfonso Sánchez-Muñoz ◽  
Elisabeth Pérez-Ruiz ◽  
María Isabel Sáez ◽  
José Manuel Trigo ◽  
M. Mar Galindo ◽  
...  
Keyword(s):  
Palliative Chemotherapy ◽  
Performance Status ◽  
Poor Performance ◽  
Solid Tumours ◽  
Poor Performance Status ◽  
Limited Impact
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