Adjuvant Chemotherapy
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2021 ◽  
Vol 28 (5) ◽  
pp. 4031-4041
Suganija Lakkunarajah ◽  
Daniel A. Breadner ◽  
Hanbo Zhang ◽  
Ellen Yamanaka ◽  
Andrew Warner ◽  

There is evidence that achieving a dose intensity > 80% in adjuvant colon cancer treatment improves survival. In total, 192 consecutive patients with resected stage III and high-risk stage II colon cancer that received adjuvant chemotherapy were retrospectively analyzed. Patients who received at least 6 weeks of adjuvant therapy were included. The primary objective was to assess the influence of dose index (DI) and relative dose intensity (RDI) on DFS and OS at 3 and 5 years in patients receiving fluorouracil-based doublet therapy with oxaliplatin (FOLFOX)(5-FU and oxaliplatin assessed separately), or capecitabine monotherapy. In the capecitabine group, DFS rates for 3 and 5 years were 66.7% and 57.6%, respectively, while OS rates were 80.3% and 66.7%, respectively. Those who received FOLFOX had DFS rates of 76.9% and 71.2% at 3 and 5 years, respectively. OS rates were 86.4% and 76.7% at 3 and 5 years, respectively. Median RDI was 73.8% for capecitabine and 76.3% and 85.6% for the oxaliplatin and 5-FU components respectively. Based on a multivariate analysis in patients receiving FOLFOX, those with an oxaliplatin DI > 80% had improvements in DFS and OS compared to those with an oxaliplatin DI of ≤ 80%. Otherwise, there was no significant difference in DFS or OS when comparing patients who achieved an RDI or a DI of above versus below 80% in the patients receiving adjuvant chemotherapy for resected colon cancer.

2021 ◽  
Thais Reif de Paula ◽  
Prakash Gorroochurn ◽  
Hillary L Simon ◽  
Eric M Haas ◽  
Deborah S Keller

2021 ◽  
pp. 021849232110517
El Hassane Kabiri ◽  
Massine El Hammoumi ◽  
Yassir Sbitti

We report a very rare case of cT1N0M0 lung adenocarcinoma reveling Lambert-Eaton myasthenic syndrome (LEMS). A 69-year-old nonsmoking woman, with several comorbidities consulted for cough and dyspnea. Chest radiograph and CT scanning detected a left lower lobe mass; Needle biopsy confirmed differentiated adenocarcinoma; 18FDG-PET scan and Brain MRI eliminated metastatic disease dissemination. Our patient underwent a left lower lobectomy with mediastinal lymphadenectomy (pT1N0M0), no adjuvant chemotherapy was administrated. One month later patient present a muscle weakness in both lower limbs and fatigability followed by an inability to walk. The diagnosis of LEMS was made from the distinctive electromyogram (EMG) findings and a treatment with Amifampridine (3, 4-diaminopyridine phosphate [3, 4-DAP]) was prescribed with evident efficacy for symptoms.

2021 ◽  
Vol 17 (4) ◽  
pp. 356-362
Erika Barbieri ◽  
Damiano Gentile ◽  
Alberto Bottini ◽  
Andrea Sagona ◽  
Wolfgang Gatzemeier ◽  

2021 ◽  
Vol 16 (1) ◽  
Ao Liu ◽  
Yalin Wang ◽  
Xin Wang ◽  
Liqiong Zhu ◽  
Yu Nie ◽  

Abstract Background Whether adjuvant chemotherapy (AC) after concurrent chemoradiotherapy (CCRT) could provide benefit to esophageal squamous cell carcinoma (ESCC) patients is controversial. Therefore, we decided to investigate the potential benefit of AC after CCRT for ESCC and to identify biomarkers predictive of a clinical benefit. Methods We retrospectively analysed the clinical data of ESCC patients with clinical stage II–IVa who underwent CCRT. Then, we compared patients who received CCRT and AC (CCRT + AC group) with those who received CCRT alone (CCRT group). Propensity score analysis, subgroup analysis and an additional Cox regression model were conducted to analyse the predictive factors. The overall survival (OS) and progression-free survival (PFS) rates were taken as the endpoints. Results From January 2013 to December 2017, 244 patients were recruited (n = 131 for CCRT + AC; n = 113 for CCRT alone) for the analysis. After propensity score matching was performed (1:1 and 99 patients for each group) with consideration of the basic clinical characteristics, no significant differences were found in OS (HR = 1.024; 95% CI 0.737–1.423; P = 0.886) or PFS (HR = 0.809; 95% CI 0.582–1.126; P = 0.197) between the two groups. The good short-term response subgroup showed a better PFS and favoured CCRT + AC treatment (HR = 0.542; 95% CI 0.336–0.876; P = 0.008), the independent predictive role of which was confirmed in additional multivariate Cox regression analysis. Conclusions Although AC did not significantly improve PFS and OS for all ESCC patients after CCRT, the short-term response to CCRT might help identify a subgroup that will benefit, which needs further prospective research to confirm.

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Rania Ali Maarouf ◽  
Amgad S Abdel-Rahman ◽  
Samar Ibrahim Mohamed

Abstract Background Breast cancer (BC)is the most commonly occurring cancer in women and the second most common cancer overall.An increase in the rate of breast preservation has come to be expected because of tumor reduction using neo-adjuvant chemotherapy (NAC) for locally advanced cancer and it is important to accurately determine the effects of NAC. Patients and Methods This study was conducted on 30 female patients with histopathologically confirmed breast cancer referred for a PET/CT scan aiming to demonstrate the role of 18F-FDG PET/CT in detecting the pathological response to NAC in BC patients. Results No statistically significant differences were found between the baseline number of lesions and that after three cycles of chemotherapy. Also, no statistically significant differences were found between the mean values of baseline and after three cycles of chemotherapy of both liver activity and size of right breast lesions. Meanwhile, the mean values of SUV of right and left breast lesions as well as the size of left breast lesions were significantly lower after three cycles of chemotherapy when compared to their baseline values. And no statistically significant differences were found between complete and partial therapeutic response in the right breast lesions as well as between complete and no therapeutic response in the left breast lesions as regards baseline SUV and SUV after 3 cycles of chemotherapy. Conclusion It can be concluded that FDG-PET/CT is useful for evaluation of neo-adjuvant chemotherapy for breast cancer. However, more studies are needed to validate the results of the current study.

Wenyu Zhai ◽  
Fangfang Duan ◽  
Dongxia Li ◽  
Qihang Yan ◽  
Shuqin Dai ◽  

2021 ◽  
Vol 07 (04) ◽  
pp. e271-e274
Kirankumar P. Jadhav ◽  
Gayathri Krishnan

AbstractIntestinal intussusception is uncommon in adults. It occurs more often in the small intestine than in the colon. In adults, when small bowel intussusception occurs, it can be due to a malignant lead point. Malignant etiology is most frequently due to diffuse metastatic disease. We present a rare case of an 18-year-old woman who was diagnosed with jejunojejunal, jejunoileal, and colocolic intussusceptions. She presented with vomiting, abdominal pain, and passage of semisolid stools for 5 days. During emergency exploratory laparotomy, multiple polyps were found in the jejunum, ileum, and sigmoid. Jejunotomy and sigmoidotomy were done to remove the respective polyps. The ileal polyp showed hemorrhagic changes; hence, an intraoperative decision was taken to proceed with resection and anastomosis. On histopathological examination, the resected ileal part showed moderately differentiated adenocarcinoma (grade 2) arising from an adenomatous polyp, while the jejunal polyp and sigmoid polyp were adenomatous polyps with low-grade dysplasia. Patient received six cycles of adjuvant chemotherapy consisting of capecitabine and oxaliplatin (CAPEOX regimen). After 2 years, she is symptom free with a normal colonoscopy. The treatment of intussusception in adults typically involves surgery, often with bowel resection as there is always a pathologic leading cause which may be malignant, like in our case.

Meijiao Zhou ◽  
Trevor D. Thompson ◽  
Hui-Yi Lin ◽  
Vivien W. Chen ◽  
Jordan J. Karlitz ◽  

S. Novello ◽  
V. Torri ◽  
C. Grohe ◽  
S. Kurz ◽  
M. Serke ◽  

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