scholarly journals Tumor lysis syndrome following radiation therapy in metastatic pancreatic cancer: A case report

2017 ◽  
Vol 4 (4) ◽  
pp. 22
Author(s):  
Erin J. Song ◽  
Julian C. Hong ◽  
Brian G. Czito
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Radiation Oncology ◽  
Radiation Treatment ◽  
Treatment Options ◽  
Tumor Lysis Syndrome ◽  
Hematologic Malignancies ◽  
Metastatic Pancreatic Cancer ◽  
Potential Treatment ◽  
Tumor Lysis

A 65-year-old female presented to radiation oncology for potential treatment options due to metastatic pancreatic cancer and significant abdominal pain. Imaging demonstrated a large pancreatic mass with lymphadenopathy, vascular encasement, and liver metastases. She initiated palliative radiation treatment and developed persistent nausea and vomiting, as well as significant laboratory derangements. She was subsequently admitted and diagnosed with tumor lysis syndrome, though this diagnosis is usually an oncologic emergency seen with hematologic malignancies following chemotherapy. 

scholarly journals Spontaneous Tumor Lysis Syndrome due to Uterine Leiomyosarcoma with Lung Metastases

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Vivek Alaigh ◽  
Debapriya Datta
Keyword(s):  
Renal Failure ◽  
Solid Tumors ◽  
Cardiac Arrhythmias ◽  
Lung Metastases ◽  
Tumor Lysis Syndrome ◽  
Hematologic Malignancies ◽  
Uterine Leiomyosarcoma ◽  
Tumor Lysis ◽  
Cell Destruction ◽  
Spontaneous Tumor Lysis Syndrome

Tumor lysis syndrome (TLS) is an oncologic emergency characterized by a combination of metabolic derangements (hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia) caused by rapid turnover from cell destruction in certain cancers. These metabolic derangements can lead to seizures, cardiac arrhythmias, renal failure, and death. TLS is usually seen after the initiation of chemotherapy for hematologic malignancies. TLS occurring spontaneously, without initiation of chemotherapy, is rare and its occurrence in solid tumors is rarer still. We report a case of spontaneous TLS in a patient with leiomyosarcoma of the uterus, with metastasis to lung. Such a case has never been reported before.

Outcome of tumor lysis syndrome in pediatric patients with hematologic malignancies – a single-center experience from Pakistan

2016 ◽  
Vol 14 (11) ◽  
pp. 457-465
Author(s):  
Armaghan-e-Rehman Mansoor ◽  
Mohammad Faizan Zahid ◽  
Mujtaba Mubashir ◽  
Zehra Fadoo ◽  
Anwar ul Haq ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Tumor Lysis Syndrome ◽  
Hematologic Malignancies ◽  
Single Center ◽  
Tumor Lysis ◽  
Single Center Experience

The mitochondrial metabolism inhibitor CPI-613 in combination with mFOLFIRINOX for pancreatic adenocarcinoma.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 264-264
Author(s):  
Angela Tatiana Alistar ◽  
Rodwige Desnoyer ◽  
Ralph D'Agostino
Keyword(s):  
Pancreatic Cancer ◽  
Clinical Trial ◽  
Phase I ◽  
Response Rate ◽  
Treatment Options ◽  
Objective Response ◽  
Stage Iv ◽  
Phase I Clinical Trial ◽  
Glutamine Metabolism ◽  
Metastatic Pancreatic Cancer

264 Background: Stage IV pancreatic cancer is a lethal disease with limited treatment options. Current standard practice is combination chemotherapy with FOLFIRINOX or Gemcitabine + Abraxane. Despite these two new treatment options, the response rate and survival are limited in stage IV pancreatic cancer. The glycolic and mitochondrial metabolisms are aberrant in pancreatic cancer and translate into chemo-resistance. Inhibition of glutamine metabolism can potentially synergize with therapies that increase intracellular reactive oxygen species such as chemotherapy. CPI -613 is a novel anti-mitochondrial developed by Cornerstone Pharmaceuticals. Methods: A phase I clinical trial with mFOLFIRINOX+ CPI-613 in never treated for stage IV pancreatic cancer patients was initiated. The goals of this phase 1trial are: (1) To determine the Maximum Tolerated Dose (MTD) of CPI-613, when used in combination with mFOLFIRINOX, in patients with metastatic pancreatic cancer, (2) To assess the safety of CPI-613/ mFOLFIRINOX combination in patients with metastatic pancreatic cancer, and (3) To obtain preliminary data on efficacy of treatment with CPI-613/ mFOLFIRINOX Results: The MTD for CPI 613 was identified at 500mg/m2. The treatment combination is feasible and well-tolerated. The combination treatment was not found to have higher toxicity than FOLFIRINOX alone. The objective response rate was 53.9 % which is higher than FOLFIRINOX alone (reported as 31.6%). One patient has a complete radiologic and clinical response and two other patients have near complete responses. Conclusions: The preliminary efficacy data of this phase I clinical trial will inform a multi-institutional randomized phase II study of FOLFIRINOX vs. m FOLFIRINOX+ CPI613 in the near future. Clinical trial information: NCT01835041.

scholarly journals Impact of COVID-19 on Radiation Oncology, an Austrian Experience

2021 ◽  
Vol 28 (6) ◽  
pp. 4776-4785
Author(s):  
Julian Mangesius ◽  
Christoph Reinhold Arnold ◽  
Thomas Seppi ◽  
Stephanie Mangesius ◽  
Mario Brüggl ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Cancer Treatment ◽  
Radiation Oncology ◽  
Radiation Treatment ◽  
Treatment Options ◽  
Fractionation Schedules ◽  
Lower Count ◽  
Substantial Drop ◽  
Future Management

The COVID-19 pandemic has an unprecedented impact on cancer treatment worldwide. We aimed to evaluate the effects of the pandemic on the radiation treatment of patients in order to provide data for future management of such crises. We compared the number of performed radiotherapy sessions of the pandemic period from February 2020 until May 2021 with those of 2018 and 2019 for reference. At our department, no referred patients had to be rejected or postponed, nor any significant changes in fractionation schedules implemented. Nevertheless, there was a substantial drop in overall radiotherapy sessions in 2020 following the first incidence wave of up to −25% (in June) in comparison to previous years. For breast cancer, a maximum decline of sessions of −45% (July) was recorded. Only a short drop of prostate cancer sessions (max −35%, May) followed by a rebound (+42%, July) was observed. Over the investigated period, a loss of 4.4% of expected patients never recovered. The severe impact of COVID-19 on cancer treatment, likely caused by retarded diagnosis and delayed interdisciplinary co-treatment, is reflected in a lower count of radiotherapy sessions. Radiation oncology is a crucial cornerstone in upholding both curative treatment options and treatment capacity during a pandemic.

scholarly journals Tumor Lysis Syndrome in a Patient With Gastric Adenocarcinoma

2020 ◽  
Vol 8 ◽  
pp. 232470962093342 ◽  
Author(s):  
Prasanth Lingamaneni ◽  
Parth Desai ◽  
Madhu Mathew Vennikandam ◽  
Krishna Moturi ◽  
Anmol Baranwal ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Adenocarcinoma ◽  
Early Recognition ◽  
Tumor Lysis Syndrome ◽  
Altered Mental Status ◽  
Hematologic Malignancies ◽  
High Morbidity ◽  
Laboratory Findings ◽  
Tumor Lysis ◽  
Metabolic Complication

Tumor lysis syndrome (TLS) is a severe metabolic complication that usually occurs in patients with aggressive tumors who undergo treatment with chemotherapy. Traditionally, it was mainly associated with hematologic malignancies. However, over the past 4 decades, there have been increasing reports of TLS in solid tumors. We report a case of TLS in a patient with gastric cancer, as a complication of FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin) chemotherapy. Our patient was a 48-year-old man with metastatic gastric adenocarcinoma who presented with altered mental status and slurred speech. On examination, he was confused and disoriented, but the rest of his examination, including vitals, was unremarkable. Laboratory findings on admission were significant for an elevated uric acid of 14.5 mg/dL, creatinine of 4.1 mg/dL, and phosphorus of 6.9 mg/dL. He had received his first cycle of FOLFOX chemotherapy 4 days prior to admission. The constellation of electrolyte abnormalities and the temporal relationship to chemotherapy led to the diagnosis of chemotherapy-induced TLS. He was treated with aggressive fluid repletion and rasburicase, following which the electrolyte derangements resolved, and he improved clinically. This case highlights the importance of early recognition of TLS in patients with gastric cancer. Initiation of early treatment can reduce the high morbidity and mortality associated with this oncologic emergency.

scholarly journals Patterns of care in metastatic pancreatic cancer: patient selection in clinical routine

2019 ◽  
Vol 12 ◽  
pp. 175628481987763 ◽  
Author(s):  
Werner Scheithauer ◽  
Paul Martin Putora ◽  
Birgit Grünberger ◽  
Wolfgang Eisterer ◽  
Ewald Wöll ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Decision Trees ◽  
Patient Selection ◽  
Performance Status ◽  
Treatment Options ◽  
Metastatic Pancreatic Cancer ◽  
Decision Criteria ◽  
First Line ◽  
Clinical Routine ◽  
Treatment Algorithms

Background: The management of patients with metastatic pancreatic cancer (mPC) is challenging, and the optimal treatment strategy is debated among experts. In an attempt to identify treatment decision criteria and to investigate variations in the first-line management of this disease, we performed an analysis of treatment algorithms among experts in the field of pancreatic cancer. The aim of this study was to identify relevant criteria in the complex process of patient selection and decision making for the management of mPC patients. Methods: Experts from the ABCSG (Austrian Breast and Colorectal Cancer Study Group) Pancreatic Cancer Club were contacted and agreed to participate in this analysis. Eight experts from seven centers in Austria provided their decision algorithms for the first-line treatment of patients with mPC. Their responses were converted into decision trees based on the objective consensus methodology. The decision trees were used to identify consensus and discrepancies. Results: The final treatment algorithms included four decision criteria (performance status, age, comorbidities, and symptomatic disease) and six treatment options: mFOLFIRINOX, gemcitabine + nab-paclitaxel, gemcitabine mono, 5-FU mono, gemcitabine/erlotinib, and best supportive care (BSC). Conclusions: We identified consensus for the treatment of young and fit patients with mFOLFIRINOX. With higher age and reduced performance status, gemcitabine + nab-paclitaxel was increasingly used. For patients with Eastern Co-operative Oncology Group Performance Status (ECOG PS) 4, BSC was the treatment of choice. Among experts, different decision criteria and treatment options are implemented in clinical routine. Despite multiple options in current recommendations, a consensus for specific recommendations was identified.

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