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Moore, Halle C. F., Michael W. Parsons, Guang H. Yue, Lisa A. Rybicki, and Vlodek Siemionow. "EEG for evaluation of “chemobrain.”." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 1076. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.1076.
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1076 Background: Cognitive impairment is a poorly understood and worrisome potential complication of adjuvant chemotherapy (CT). We sought to evaluate electroencephalography (EEG) as a means to measure neurophysiologic function in women receiving CT for early breast cancer. Methods: Women planning to undergo CT for operable breast cancer and age-similar controls were evaluated at baseline, during CT and at 1 year with neurophysiologic assessments. Testing included a brief fatigue inventory (BFI), brief mental fatigue assessment (BMF), Processing Speed Index (PSI) derived from Digit Symbol Coding and Symbol Search subtests of the Wechsler Adult Intelligence Scale, and a sustained elbow flexion physical task (PT). EEG recordings were obtained at rest and after the cognitive and physical tasks. Data were analyzed using repeated measures of analysis of variance. Results: Eight patient/control pairs completed baseline and on-treatment evaluations; 7 pairs also completed the 1 year assessment (1 pair withdrawn due to a second malignancy). Subjective mental fatigue measured by BMF is similar for patients and controls at baseline but BMF scores increase significantly during CT for patients relative to controls (p=0.033), recovering to no difference at one year. Differences in PSI are not observed between patients and controls or at the different time points. BFI scores are greater in patients at all 3 time points but endurance on the PT is no different from controls. During chemotherapy EEG total spectrum amplitudes in patients are greater than in controls at rest (p=0.05) and following both the cognitive (p<0.001) and physical (p<0.001) tasks. EEG activity prior to chemotherapy and at one year is not different between patients and controls. For patients but not controls EEG readings after the cognitive task demonstrate greater amplitude than pre-task readings during the time of CT treatment only (p=0.012) with a similar trend seen for the physical task (p=0.06). Conclusions: Patient-perceived mental and physical fatigue during chemotherapy correspond to significant changes in EEG brain activity patterns but not to cognitive testing or physical endurance testing. EEG may offer a sensitive means to measure alterations in brain function associated with CT.
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Su, Ashley, Léonie Dupuis, Jeremy Jueng, Anuj Kunadia, Ian Brooks, Ritika Sinha, Fahad Siddiqui, et al. "Use of artificial intelligence for analyzing emotion vs patient global impression of change of melanoma treatments." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e24177-e24177. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e24177.
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e24177 Background: The link between melanoma patients’ emotions and their impressions of treatments response are poorly understood. With the rise of social media, patients use online platforms to communicate their concerns related to melanoma treatments. In this study, we utilize real-world data collected from social media with search terms focused on treatment-specific Patients’ Global Impression of Change (PGIC) compared with their emotions. We aim to identify and focus melanoma patient perspective trends to improve patient-centered care. Methods: Social media data mining of search terms were extracted from millions of publicly available interactions on Twitter and other online platforms from May/2008 to January/2020 using Crimson Hexagon (database of real-time social media posts). Results: For chemotherapy posts, the top three emotions by volume were negative alongside negative PGIC “worse” (Worse/Sadness 700, Worse/Fear 596, Worse/Disgust 403, and “decline” (Decline/Sadness 262, Decline/Fear 186, Decline/Disgust 57). Interestingly, Sadness, Fear, and Disgust were as prevalent alongside positive PGIC “well” and “cured” (Well/Sadness 3577, Well/Fear 2545, and Well/Disgust 1770; Cured/Sadness 518, Cured/Disgust 275, and Cured/Fear 167). For Keytruda treatment posts, emotions in negative PGIC “worse” were (Worse/Fear 117, Worse/Anger 68, Worse/Sadness 6). In positive PGIC “well”, results were (Well/Fear 880, Well/Sadness 366, Well/Anger 186). Further analysis will compare these emotional sentiments with a spectrum of PGIC terms and specific types of melanoma treatments. Conclusions: To our knowledge, this is the first investigation of online patient melanoma treatments associated with PGIC terms. The findings indicate a trend of negative emotions even when patients have reported wellness or being cured by treatment. While treatments may be effective, patients are not necessarily satisfied. Correlating changes in emotions with perceived changes in disease severity can provide insight into patient perspectives, which has implications in translating clinical response and a need for continued emotional support in patients with treatment response.
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Murad Junior, Munir, Arthur Nascimento, Alexandre Fonseca De Castro, Lilian Paiva, Amandio S. Fernandes, and Luiz Adelmo Lodi. "The use of a chatbot based on artificial intelligence to collect patients reported outcomes in oncology practice. A pilot study with real-world data." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e19119-e19119. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e19119.
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e19119 Background: There is growing interest in enhancing symptoms monitoring during routine cancer care using patient-reported outcomes (PROs). The quality of evidence that demonstrates clinical benefits of this type of assistance is also increasing. However, the best method for this approach is evolving and there are many barriers to implement these tools in the real world scenario. We aim to describe a pilot study about a chatbot with artificial intelligence developed to collect PROs and to optimize adherence to systemic cancer treatment. Methods: This is a case series that reports the first patients in a private oncology clinic in Belo Horizonte, Southeast Brazil who consecutively underwent regular conversations with a chatbot based on artificial intelligence. Data was collected from February the 23th to December the 3rd 2019. The virtual assistant interacted with the patient in four different ways, being the first three of these an active search from the chatbot: a) search for adverse events, b) adherence to oral treatment c) screening for depression d) spontaneous patient demand (not an active search). Results: Interaction with the chatbot was offered to 193 patients. A total of 107 patients were included. Of these 74% were female, 55% older than 60 years and 22% had at least 7 years education.194 protocols of treatment were analysed, 66% of these being chemotherapy regimens and 23% hormone therapy. Oral drugs corresponded to 23% of the protocols. The main adverse events reported were fatigue 20%, nausea 13%, pain 11%, diarrhea 10%, lack of appetite 6%. Adverse effects were classified by patients as grade III or IV approximately 24% of the time. For patient safety the system runs a script twice a day to detect any adverse effect and send it to the service attended. A total of 3883 dialogues were initiated, the majority of which (3772) was carried out by the machine. Only 3% of the dialogues were spontaneously initiated by the patients. Once the conversation started, adherence was considerably satisfactory since engagement was 73% for questions about adherence to oral medications and 76% of people reported at least one adverse event. Conclusions: An initial barrier must be surpassed since the chatbot was offered to 193 patients and 86 (44%) did not register for use. Once the contact started, we understand that the use of AI is promising since the engagement rates were very good. It is important to highlight the potential capacity for early identification of symptoms since most dialogues were initiated by the virtual assistant.
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Souza, Juliana, and Daniele Neves. "Active search for toxicity reduces delay on chemotherapy." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): 6548. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.6548.
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6548 Background: Interdisciplinary teamwork involves health care professionals working as a team with the purpose of discussing individual cases and recommending care plans. In october 2015, the breast cancer interdisciplinary team (BCIT) was implemented in our outpatient oncology clinic. This team includes oncology physician, pharmaceutist, psychologist, nutritionist and oncology nurse. Since 2018, the oncology nurse does active search for toxicity (AST) in order to solve early symptoms. Methods: We evaluated outcomes of breast cancer patients who finished neoadjuvant/adjuvant chemotherapy and received BCIT care at our oncology clinic from october 2015 to November 2018. Results: Of 200 pts who had finish treatment, 139 pts (69.5%) received adjuvant chemotherapy and 61 pts (30.5%) neoadjuvant schedule. Median age was 52,64 years (range:30.6-82.3y). At diagnosis, 50 pts (25%) were stage I, 101 pts (50.5%) were stage II, and 49 pts (24.5%) were stage III. When we compared before and after AST, there were no significant difference between mean age (54.13y vs 54.06y, p:0.97), colony stimulating factor use (p:0.10), cold-cap use (p:0.81), and timing of chemotherapy (p:0.13). There were 7 hospitalizations during chemotherapy, with no significant difference with AST (5pt vs 2pt, p: 0.82). However, patients in AST had significantly lower mean delay to complete chemotherapy (9.4 days vs 4.2 days p:0.003). After median follow up 17 months, there were 9 progression disease and 4 deaths. 1-year and 3-year overall survival rate was 99,2% and 95,1%, respectively. Conclusions: AST increased adherence to chemotherapy, with lower delay on chemotherapy treatment. There were no significant difference with colony stimulating factor use, cold-cap use, timing of chemotherapy, and hospitalization.
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Harrington, K. J., and H. E. Lambert. "The search for optimal chemotherapy for advanced epithelial ovarian cancer." Clinical Oncology 7, no. 6 (January 1995): 359–65. http://dx.doi.org/10.1016/s0936-6555(05)80005-6.
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Berenbaum, MC. "Direct search methods in the optimisation of cancer chemotherapy regimens." British Journal of Cancer 61, no. 1 (January 1, 1990): 101–9. http://dx.doi.org/10.1038/bjc.1990.22.
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Luo, Shiyao, Ying Zhu, Yiping Li, Li Chen, Shunzhong Lv, Yuan Zhang, Liang Ge, and Wenwu Zhou. "Targeted Chemotherapy for Breast Cancer Using an Intelligent Doxorubicin-Loaded Hexapeptide Hydrogel." Journal of Biomedical Nanotechnology 16, no. 6 (June 1, 2020): 842–52. http://dx.doi.org/10.1166/jbn.2020.2935.
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Self-assembling peptide hydrogels have a high water content, good biocompatibility and have become a competitive research object in the fields of tissue engineering, cancer treatment and drug delivery. In our research, a hexapeptide with high pH sensitivity was designed and synthesized by utilizing a solid-phase synthesis method. Under physiological conditions, the peptide could self-assemble into a hydrogel. When it reached the tumor acidic microenvironment, the peptide was degraded and doxorubicin was released to exert its antitumor effect. A series of physicochemical properties were investigated, including gelling ability, secondary structure, micromorphology, rheological properties and drug release studies. The results illustrated that PIDO peptide hydrogel has good pH responsiveness and injectability. In vitro cytotoxicity experiments and in vivo antitumor experiments showed that PIDO peptide hydrogel has a highly effective therapeutic effect on tumor cells and is less toxic to normal tissues. Our research provides a promising option for targeted drug delivery and sustainable release.
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Jing, Xunan, Yanzi Xu, Daomeng Liu, Youshen Wu, Na Zhou, Daquan Wang, Kai Yan, and Lingjie Meng. "Intelligent nanoflowers: a full tumor microenvironment-responsive multimodal cancer theranostic nanoplatform." Nanoscale 11, no. 33 (2019): 15508–18. http://dx.doi.org/10.1039/c9nr04768a.
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Multistage pH/H2O2/redox-responsive 3D nanoflowers that fully exploit the tumor microenvironment achieve highly specific guided multimode diagnosis with excellent synergistic chemotherapy and photodynamic therapy effects both in vitro and in vivo.
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Kilgallen, Aoife B., Urška Štibler, Markella I. Printezi, Marrit Putker, Cornelis J. A. Punt, Joost P. G. Sluijter, Anne M. May, and Linda W. van Laake. "Comparing Conventional Chemotherapy to Chronomodulated Chemotherapy for Cancer Treatment: Protocol for a Systematic Review." JMIR Research Protocols 9, no. 10 (October 21, 2020): e18023. http://dx.doi.org/10.2196/18023.
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Background Chronomodulated chemotherapy aims to achieve maximum drug safety and efficacy by adjusting the time of treatment to an optimal biological time as determined by the circadian clock. Although it is a promising alternative to conventional (non–time-stipulated) chemotherapy in several instances, the lack of scientific consensus and the increased logistical burden of timed administration limit the use of a chronomodulated administration protocol. Objective With the goal to increase scientific consensus on this subject, we plan to conduct a systematic review of the current literature to compare the drug safety and efficacy of chronomodulated chemotherapy with those of conventional chemotherapy. Methods This systematic review will comply with the PRISMA (Preferred Reporting Items for the Systematic Reviews and Meta-Analysis) guidelines. In order to identify relevant studies, we conducted a comprehensive search in PubMed and Embase on May 18, 2020. We included clinical studies that compare either the safety or efficacy of chronomodulated chemotherapy with that of conventional chemotherapy. Potential studies will be reviewed and screened by 2 independent reviewers. Quality assessment will be performed using the National Institutes of Health’s Study Quality Assessment Tool (Quality Assessment of Controlled Intervention Studies). Disagreements will be resolved by consulting a third independent reviewer. Results This protocol has received funding, and the search for studies from databases commenced on May 18, 2020. The systematic review is planned to be completed by October 31, 2020. Conclusions In this systematic review, we will compare drug safety and drug efficacy for cancer patients who were administered either chronomodulated chemotherapy or conventional chemotherapy. Moreover, we will highlight the outcomes and quality of the selected trials for this review. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020177878; https://tinyurl.com/y53w9nq6 International Registered Report Identifier (IRRID) PRR1-10.2196/18023
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Hu, Cheng, Weihua Zhuang, Tao Yu, Liang Chen, Zhen Liang, Gaocan Li, and Yunbing Wang. "Multi-stimuli responsive polymeric prodrug micelles for combined chemotherapy and photodynamic therapy." Journal of Materials Chemistry B 8, no. 24 (2020): 5267–79. http://dx.doi.org/10.1039/d0tb00539h.
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Hesketh, P. J., M. G. Kris, S. M. Grunberg, T. Beck, J. D. Hainsworth, G. Harker, M. S. Aapro, D. Gandara, and C. M. Lindley. "Proposal for classifying the acute emetogenicity of cancer chemotherapy." Journal of Clinical Oncology 15, no. 1 (January 1997): 103–9. http://dx.doi.org/10.1200/jco.1997.15.1.103.
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PURPOSE To propose a classification of the acute emetogenicity of antineoplastic chemotherapy agents, and to develop an algorithm to define the emetogenicity of combination chemotherapy regimens. METHODS A Medline search was conducted to identify (1) clinical trials that used chemotherapy as single-agent therapy, and (2) major reviews of antiemetic therapy. The search was limited to patients who received commonly used doses of chemotherapy agents, primarily by short (< 3 hours) intravenous infusions. Based on review of this information and our collective clinical experience, we assigned chemotherapy agents to one of five emetogenic levels by consensus. A preliminary algorithm to determine the emetogenicity of combination chemotherapy regimens was then designed by consensus. A final algorithm was developed after we analyzed a data base composed of patients treated on the placebo arms of four randomized antiemetic trials. RESULTS Chemotherapy agents were divided into five levels: level 1 (< 10% of patients experience acute [< or = 24 hours after chemotherapy] emesis without antiemetic prophylaxis); level 2 (10% to 30%); level 3 (30% to 60%); level 4 (60% to 90%); and level 5 (> 90%). For combinations, the emetogenic level was determined by identifying the most emetogenic agent in the combination and then assessing the relative contribution of the other agents. The following rules apply: (1) level 1 agents do not contribute to the emetogenic level of a combination; (2) adding > or = one level 2 agent increases the emetogenicity of the combination by one level greater than the most emetogenic agent in the combination; and (3) adding level 3 or 4 agents increases the emetogenicity of the combination by one level per agent. CONCLUSION The proposed classification schema provides a practical means to determine the emetogenic potential of individual chemotherapy agents and combination regimens during the 24 hours after administration. This system can serve as a framework for the development of antiemetic guidelines.
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Prabukumar, M., L. Agilandeeswari, and K. Ganesan. "An intelligent lung cancer diagnosis system using cuckoo search optimization and support vector machine classifier." Journal of Ambient Intelligence and Humanized Computing 10, no. 1 (December 18, 2017): 267–93. http://dx.doi.org/10.1007/s12652-017-0655-5.
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Punke, Alexandra P., and JA Waddell. "Creation and evaluation of a cancer chemotherapy order review guide for use at a community hospital." Journal of Oncology Pharmacy Practice 25, no. 1 (August 21, 2017): 25–43. http://dx.doi.org/10.1177/1078155217726162.
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The proper evaluation of cancer chemotherapy orders is necessary for patients to receive safe and effective treatment. The chemotherapy treatment setting is evolving resulting in hospital pharmacists without extensive oncology training or experience now being responsible for evaluation of chemotherapy orders. The primary objective was to create a step-by-step chemotherapy order evaluation guide with a detailed explanation for each step. The secondary objective was to evaluate non-oncology trained pharmacists' ability to accurately review simulated chemotherapy orders post-education using the guide. A two-page chemotherapy order evaluation guide was created based on an accepted method of chemotherapy order review consisting of the following eight steps: regimen verification, clinical trial protocol verification, body surface area calculation, dose calculation, laboratory values, emesis prophylaxis, adjunctive or supportive care measures, and pharmacy labels. A literature search was performed for each step. A detailed explanation for each step was written as a separate component from the guide to encompass the literature search information and current guidelines in a more comprehensive manner. Non-oncology trained community hospital pharmacists were educated on use of the guide for approximately 30 min. The guide was evaluated using timed simulated chemotherapy orders pre- and post-education consisting of a general chemotherapy order and a carboplatin dosing order. Nineteen pharmacists were tested with simulated chemotherapy orders. A significant difference was detected between the pre- and post-education for both the general chemotherapy (p = 0.00032) order and carboplatin dosing order (p = 0.031).
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Hotta, Katsuyuki, Keitaro Matsuo, Hiroshi Ueoka, Katsuyuki Kiura, Masahiro Tabata, and Mitsune Tanimoto. "Role of Adjuvant Chemotherapy in Patients With Resected Non–Small-Cell Lung Cancer: Reappraisal With a Meta-Analysis of Randomized Controlled Trials." Journal of Clinical Oncology 22, no. 19 (October 1, 2004): 3860–67. http://dx.doi.org/10.1200/jco.2004.01.153.
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Purpose The role of adjuvant chemotherapy in patients with resected non–small-cell lung cancer (NSCLC) remains to be defined. This study was aimed at re-evaluating the effectiveness of adjuvant chemotherapy in patients with resected NSCLC, by performing a meta-analysis of relevant trials. Methods We performed a literature search to identify trials reported after the publication of a meta-analysis in 1995, comparing patients with NSCLC receiving chemotherapy after surgery with those undergoing surgery alone. The hazard ratio (HR) was estimated to assess the survival advantage of adjuvant chemotherapy. Results Eleven trials conducted on a total of 5,716 patients were identified by the literature search. In these trials, hazard ratio estimates suggested that adjuvant chemotherapy yielded a survival advantage over surgery alone (HR, 0.872; 95% CI, 0.805 to 0.944; P = .001). In a subset analysis, both cisplatin-based chemotherapy (HR, 0.891; 95% CI, 0.815 to 0.975; P = .012) and single-agent therapy with tegafur and uracil (UFT; HR, 0.799; 95% CI, 0.668 to 0.957; P = .015) were found to yield a significant survival benefit. The toxicities of adjuvant chemotherapy were found to be generally mild. Conclusion This is the first updated meta-analysis demonstrating the importance of cisplatin-based chemotherapy and single-agent UFT therapy as adjuvant chemotherapy in the treatment of resected NSCLC. Although the results must be carefully interpreted because of one limitation (the meta-analysis was performed with abstracted data), they raise critical issues that must be resolved in future studies.
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Alam, M. N., J. Y. Qing, P. Beale, C. Chan, and F. Huq. "Novel palladiums alone and in combination with phytochemicals in search of affordable chemotherapy." European Journal of Cancer 69 (December 2016): S83. http://dx.doi.org/10.1016/s0959-8049(16)32843-x.
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Samson, David J., Jerome Seidenfeld, Kathleen Ziegler, and Naomi Aronson. "Chemotherapy Sensitivity and Resistance Assays: A Systematic Review." Journal of Clinical Oncology 22, no. 17 (September 1, 2004): 3618–30. http://dx.doi.org/10.1200/jco.2004.04.077.
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Purpose This systematic review evaluates evidence comparing therapy guided by chemotherapy sensitivity and resistance assays with empiric chemotherapy, emphasizing survival outcomes. Methods Prospective studies were sought comparing patients treated contemporaneously by assay-guided chemotherapy and empiric therapy. An initial MEDLINE search and a search performed by a Working Group of the American Society of Clinical Oncology were reviewed with attention to prespecified study selection criteria. Results This review identified 10 studies meeting selection criteria, plus one retrospective study, using seven different assays. Only two studies randomly assigned patients to assay-guided treatment or empiric treatment. Five of nine nonrandomized studies found significantly higher response rates for patients who received assay-guided therapy compared with those treated empirically. One of the two randomized trials found a significantly higher response rate in the assay-guided group. Four additional studies found response rates favoring assay-guided therapy, but comparisons did not achieve statistical significance. Two nonrandomized studies found overall survival to be significantly improved with assay-guided therapy. One randomized study used a cross-over design that made it difficult to determine whether survival differed between groups, while the other randomized trial found no difference in survival. Six studies provided no comparison of groups on baseline patient characteristics. Only one study reported adverse events data. Conclusion While higher response rates for assay-guided therapy have been observed, differences may be attributable to bias or confounding. Little evidence on survival is available. These results do not establish the relative effectiveness of assay-guided treatment and empiric treatment. Randomized trials are needed.
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Sterling, Lynn, Luc van Lonkhuijzen, Job Nyangena, Elkanah Orango, Matthew Strother, Nafthali Busakhala, and Barry Rosen. "Protocol Development for Ovarian Cancer Treatment in Kenya: A Brief Report." International Journal of Gynecologic Cancer 21, no. 2 (January 2011): 424–27. http://dx.doi.org/10.1097/igc.0b013e3182060316.
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Introduction:Ovarian cancer is a leading cause of cancer death for Kenyan women. Most women are diagnosed with an advanced stage of disease. The current North American standard of care includes surgery followed by carboplatin and paclitaxel. Neither drug is available for Kenyan women. We performed a literature search investigating chemotherapy in low-resource countries with the aim to write an evidence-based chemotherapy protocol for women diagnosed with ovarian cancer in Eldoret, Kenya, at the Moi Teaching and Referral Hospital.Methods:We systematically searched PubMed and EMBASE for articles describing chemotherapy treatment outcomes of ovarian epithelial cancer in low-resource settings. After data analysis, a secondary review was undertaken on randomized controlled trials (RCTs) aligning with chemotherapy availability in Kenya.Results:We identified 1184 articles. Fourteen met our criteria: ovarian epithelial cancer, low resource, chemotherapy use, and survival or response data. No publications were RCTs or had a cohort larger than 100 patients. There was no consistency in drug choice between studies. After this search, we reviewed commonly quoted and relevant RCTs and meta-analyses conducted on ovarian cancer since the 1980s. Although RCTs in the developed world suggest carboplatin and taxol provide optimal survival benefit, these drugs are unavailable in Kenya. Cyclophosphamide and cisplatin provide the next most optimal survival benefit, with acceptable and manageable toxicity. Because these drugs are more available and affordable in Kenya, we have developed a protocol recommending their use, which has been accepted by the Moi Teaching and Referral Hospital.Conclusions:Currently, there is a paucity of published RCTs that may guide treatment in low-resource settings. One considerable barrier to establishing and evaluating chemotherapy protocols in low-resource settings may be the cost of chemotherapy drugs. There needs to be an international movement to make cancer chemotherapeutics available at lower prices in low-resource settings.
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Oshima, Takashi, Naoya Sakamoto, Takaki Yoshikawa, Yasushi Rino, Chikara Kunisaki, Wataru Yasui, Toshio Imada, and Munetaka Masuda. "Search for biomarkers of stage II/III gastric cancer and development of individualized therapy." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 4068. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.4068.
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4068 Background: Standard therapy for stage II/III gastric cancer is curative resection followed by adjuvant chemotherapy. Treatment outcomes are expected to be further improved by the development of individualized therapy based on new biomarkers. We have extracted mRNA from frozen specimens of gastric cancer to construct a cDNA bank and searched for new biomarkers of stage II/III gastric cancer. We report currently available results. Methods: The study group comprised 256 patients with stage II/III gastric cancer in whom at least 5 years had passed since surgery (among whom 149 received S-1 as adjuvant chemotherapy). A total of 130 genes were selected on the basis of the results of comprehensive DNA microarray analyses and extraction from serial analysis of gene expression (SAGE) libraries, and other studies. Relative expression levels of each gene in gastric cancer tissue and adjacent normal mucosa were measured by quantitative PCR, and the relations between clinicopathological factors and treatment outcomes were studied. In addition, using 9 types of gastric cancer cell lines, we knocked down the new cancer biomarkers obtained in this study with small interfering RNA (siRNA) and performed functional analysis. Results: In patients with resected stage II/III gastric cancer, INHBA, IGF-1R, CLDN7, and DPD genes were independent prognostic factors. In the subgroup of patients who received S-1-based adjuvant chemotherapy, IGF-1R, INHBA, SULF1, REG4, MMP11, and KIAA1199 genes were independent prognostic factors. Knockdown of the KIAA1199 gene with siRNA markedly inhibited the proliferative and invasive activities of the gastric cancer cell lines and lowered resistance to 5-fluorouracil. Conclusions: Investigatory studies of new biomarkers of gastric cancer identified prognostic factors for patients with resected stage II/III gastric cancer and those who received adjuvant chemotherapy with S-1. At present, the development of small molecule drugs that target KIAA1199 and the joint development of risk stratification tools with the goal of individualized therapy for stage II/III gastric cancer are ongoing.
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Zahedi, H., N. Mehrshad, and K. Anvari. "Intelligent modelling of oesophageal cancer treatment and its use to determine the dose of chemotherapy drug." Journal of Medical Engineering & Technology 36, no. 5 (June 7, 2012): 261–66. http://dx.doi.org/10.3109/03091902.2012.682112.
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Schrag, Deborah, Harinder S. Garewal, Harold J. Burstein, David J. Samson, Daniel D. Von Hoff, and Mark R. Somerfield. "American Society of Clinical Oncology Technology Assessment: Chemotherapy Sensitivity and Resistance Assays." Journal of Clinical Oncology 22, no. 17 (September 1, 2004): 3631–38. http://dx.doi.org/10.1200/jco.2004.05.065.
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Purpose To develop a technology assessment of chemotherapy sensitivity and resistance assays in order to define the role of these tests in routine oncology practice. Methods The American Society of Clinical Oncology (ASCO) established a Working Group to develop the technology assessment. The Working Group collaborated with the Blue Cross and Blue Shield Association (BCBSA) Technology Evaluation Center. The Working Group developed independent criteria for selecting articles for inclusion in the ASCO assessment, and developed a structured data abstraction tool to facilitate review of selected manuscripts. One Working Group member and an ASCO staff member independently reviewed the 1,139 abstracts identified by the BCBSA comprehensive literature search, and by an updated literature search performed by ASCO using the BCBSA search strategy (1966 to January 2004). Of the 12 articles included in this technology assessment, eight were identified by the original BCBSA systematic review, one was provided by industry, and three were identified by the ASCO updated literature review. Results Review of the literature does not identify any CSRAs for which the evidence base is sufficient to support use in oncology practice. Recommendations The use of chemotherapy sensitivity and resistance assays to select chemotherapeutic agents for individual patients is not recommended outside of the clinical trial setting. Oncologists should make chemotherapy treatment recommendations on the basis of published reports of clinical trials and a patient's health status and treatment preferences. Because the in vitro analytic strategy has potential importance, participation in clinical trials evaluating these technologies remains a priority.
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Monteiro-Oliveira, Bruno B., Ana Carolina Coelho-Oliveira, Tatiane S. A. David, Adriana T. Brito, Ana Carla A. Cruz, Genice G. Souza, and Laisa L. Paineiras-Domingos. "The therapeutic use of essential oils in the care of cancer patients in chemotherapy: A systematic review." Brazilian Journal of Health and Biomedical Sciences 20, no. 1 (May 13, 2021): 36–45. http://dx.doi.org/10.12957/bjhbs.2021.59744.
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Introducton: Chemotherapy is an important therapy in the treatment of cancer. Nausea, vomiting and worsening quality are some adverse effects of chemotherapy. Aromatherapy is an ancient technique that uses essential oils for physical and psychological/emotional improvement and is able to reduce the symptoms of chemotherapy and can be an excellent complementary technique.Objective: The aim of this systematic review was to determine the effects of aromatherapy on the adverse effects of chemotherapy in patients diagnosed with cancer. Methods: A search in three database PubMed, EMBASE and SCOPUS. Five studies that analyzed the use of aromatherapy to evaluate the reduction of the adverse effects of chemotherapy in a cancer patient, published only in English were included. Two reviewers, which independently examined titles and abstracts, identified records through database search and reference screening and irrelevant studies were excluded based in eligibility criteria. Relevant full texts were analyzed for eligibility, and all selected studies were included in this systematic review. Results: Five studies were included in this systematic review. This review suggests that aromatherapy reduces nausea, frequency of vomiting and improves quality of sleep. Conclusion: Aromatherapy is an effective technique to reduce nausea, the frequency of vomiting and improves the quality of sleep of patients diagnosed with cancer and undergoing chemotherapy. However, more randomized clinical trials with a good methodological quality are necessary to confirm the preliminary findings of this systematic review.
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Moxley, Katherine M., and D. Scott McMeekin. "Endometrial Carcinoma: A Review of Chemotherapy, Drug Resistance, and the Search for New Agents." Oncologist 15, no. 10 (October 2010): 1026–33. http://dx.doi.org/10.1634/theoncologist.2010-0087.
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Mazzotta, Elisabetta, Lorena Tavano, and Rita Muzzalupo. "Thermo-Sensitive Vesicles in Controlled Drug Delivery for Chemotherapy." Pharmaceutics 10, no. 3 (September 5, 2018): 150. http://dx.doi.org/10.3390/pharmaceutics10030150.
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Thermo-sensitive vesicles are a promising tool for triggering the release of drugs to solid tumours when used in combination with mild hyperthermia. Responsivity to temperature makes them intelligent nanodevices able to provide a site-specific chemotherapy. Following a brief introduction concerning hyperthermia and its advantageous combination with vesicular systems, recent investigations on thermo-sensitive vesicles useful for controlled drug delivery in cancer treatment are reported in this review. In particular, the influence of bilayer composition on the in vitro and in vivo behaviour of thermo-sensitive formulations currently under investigation have been extensively explored.
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Mahon, Kate L., Susan M. Henshall, Robert L. Sutherland, and Lisa G. Horvath. "Pathways of chemotherapy resistance in castration-resistant prostate cancer." Endocrine-Related Cancer 18, no. 4 (May 12, 2011): R103—R123. http://dx.doi.org/10.1530/erc-10-0343.
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Chemotherapy remains the major treatment option for castration-resistant prostate cancer (CRPC) and limited cytotoxic options are available. Inherent chemotherapy resistance occurs in half of all patients and inevitably develops even in those who initially respond. Docetaxel has been the mainstay of therapy for 6 years, providing a small survival benefit at the cost of significant toxicity. Cabazitaxel is a promising second-line agent; however, it is no less toxic, whereas mitoxantrone provides only symptomatic benefit. Multiple cellular pathways involving apoptosis, inflammation, angiogenesis, signalling intermediaries, drug efflux pumps and tubulin are implicated in the development of chemoresistance. A thorough understanding of these pathways is needed to identify biomarkers that predict chemotherapy resistance with the aim to avoid unwarranted toxicities in patients who will not benefit from treatment. Until recently, the search for predictive biomarkers has been disappointing; however, the recent discovery of macrophage inhibitory cytokine 1 as a marker of chemoresistance may herald a new era of biomarker discovery in CRPC. Understanding the interface between this complex array of chemoresistance pathways rather than their study in isolation will be required to effectively predict response and target the late stages of advanced disease. The pre-clinical evidence for these resistance pathways and their progress through clinical trials as therapeutic targets is reviewed in this study.
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Neville, A. M., R. Bettelheim, R. D. Gelber, J. Säve-Söderbergh, B. W. Davis, R. Reed, J. Torhorst, R. Golouh, H. F. Peterson, and K. N. Price. "Factors predicting treatment responsiveness and prognosis in node-negative breast cancer. The International (Ludwig) Breast Cancer Study Group." Journal of Clinical Oncology 10, no. 5 (May 1992): 696–705. http://dx.doi.org/10.1200/jco.1992.10.5.696.
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PURPOSE An international trial (formerly Ludwig Trial V) has been conducted in 1,275 subjects to ascertain if perioperative chemotherapy is beneficial for node-negative breast cancer patients and to identify subgroups of patients who benefit from this therapy. PATIENTS AND METHODS Node-negative breast cancer patients were randomized to receive either one cycle of perioperative chemotherapy or no adjuvant treatment. A detailed pathology review was conducted in 1,203 of the 1,275 patients enrolled. Stepwise Cox regression analysis was used to search for factors either predicting chemotherapeutic responsiveness and/or influencing disease-free survival (DFS). RESULTS As expected, primary tumor size, grade, and the presence of peritumoral vascular invasion are the most important prognostic factors. Perioperative chemotherapy provides a DFS advantage at 5 years of median follow-up and such treatment is more effective for estrogen receptor-negative than for estrogen receptor-positive tumors, for histologic grade 2 and 3 than for grade 1 tumors, and for patients in whom no axillary lymph node metastases were found even after serial sectioning and review by the Central Pathology Laboratory. CONCLUSION Hormone receptor status and tumor grade are important factors for predicting responsiveness to perioperative chemotherapy in node-negative breast cancer.
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Bakhniuk, K. D. "Perioperative chemotherapy for locally advanced operable gastric cancer (literature review)." Practical oncology 4, no. 1 (May 17, 2021): 5–10. http://dx.doi.org/10.22141/2663-3272.4.1.2021.229866.
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Background. Gastric cancer remains the leading cause of cancer morbidity and mortality in the world. According to Globocan, in 2020 the incidence of gastric cancer was 5.6 % (1,089,103 people), with mortality of 7.7 % (768,793 people). According to the Cancer Registry of Ukraine for 2017–2018, gastric cancer is the second leading cause of death after lung cancer in men. By the time of diagnosis, almost 70 % of patients have a locally advanced or generalized tumor process, which reduces the possibility of radical surgical treatment. Surgical treatment remains the main method of treatment for gastric cancer, but the prognosis is poor even after high-quality surgical treatment due to the high frequency of recurrences (20–60 %) and insufficient effectiveness of adjuvant therapy. The purpose of the study: to analyze studies that have tested various schemes of neoadjuvant treatment for gastric cancer and to present the results of key promising studies on this treatment technology. Materials and methods. We conducted a literature review that included randomized and nonrandomized clinical trials from 2010 to 2020. The search was conducted using electronic scientometric databases PubMed, Embase, Scopus, Web of Science, MedLine, Cochrane Library, as well as abstracts of the annual congresses of the American Society of Clinical Oncology and the European Society for Medical Oncology. The key words of the search were: neoadjuvant chemotherapy, perioperative chemotherapy, gastric neoplasm, gastric cancer, randomized controlled trial, treatment of gastric cancer, disseminated gastric cancer, D2 dissection. The selection criteria were: studies comparing different regimens of perioperative chemotherapy without the addition of chemoradiation therapy, targeted therapy over the past 10 years. Results. Thirty publications were found for the above-mentioned keywords. Among these sources, there were 10 randomized clinical trials, 8 non-randomized clinical trials, 4 meta-analyzes, 8 literature reviews. Conclusions. Analysis of these data indicates the presence of only 3 randomized controlled trials on the efficacy and safety of perioperative chemotherapy for locally advanced gastric cancer that met the selection criteria. There are shortcomings in the design of the analyzed studies: no reliable data on adequate lymph dissection, inclusion into the study of patients not only with gastric cancer, but also with other cancer sites (gastroesophageal adenocarcinoma, cancer of the lower esophagus). The above arguments suggest that the recognition of the FLOT as the only effective and safe regimen for neoadjuvant polychemotherapy in locally advanced gastric cancer is not a well-founded postulate, but requires further planned clinical trials of appropriate quality.
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Tarasov, Vadim V., Vladimir N. Chubarev, Ghulam Md Ashraf, Samira A. Dostdar, Alexander V. Sokolov, Tatiana I. Melnikova, Susanna S. Sologova, et al. "How Cancer Cells Resist Chemotherapy: Design and Development of Drugs Targeting Protein-Protein Interactions." Current Topics in Medicinal Chemistry 19, no. 6 (May 2, 2019): 394–412. http://dx.doi.org/10.2174/1568026619666190305130141.
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Background:Resistance toward chemotherapeutics is one of the main obstacles on the way to effective cancer treatment. Personalization of chemotherapy could improve clinical outcome. However, despite preclinical significance, most of the potential markers have failed to reach clinical practice partially due to the inability of numerous studies to estimate the marker’s impact on resistance properly.Objective:The analysis of drug resistance mechanisms to chemotherapy in cancer cells, and the proposal of study design to identify bona fide markers.Methods:A review of relevant papers in the field. A PubMed search with relevant keywords was used to gather the data. An example of a search request: drug resistance AND cancer AND paclitaxel.Results:We have described a number of drug resistance mechanisms to various chemotherapeutics, as well as markers to underlie the phenomenon. We also proposed a model of a rational-designed study, which could be useful in determining the most promising potential biomarkers.Conclusion:Taking into account the most reasonable biomarkers should dramatically improve clinical outcome by choosing the suitable treatment regimens. However, determining the leading biomarkers, as well as validating of the model, is a work for further investigations.
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Schloss, Janet Margaret, Maree Colosimo, and Luis Vitetta. "Chemotherapy-induced peripheral neuropathy management." Journal of Clinical Oncology 34, no. 3_suppl (January 20, 2016): 154. http://dx.doi.org/10.1200/jco.2016.34.3_suppl.154.
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154 Background: Neurological complications such as chemotherapy-induced peripheral neuropathy (CIPN) and neuropathic pain are frequent side-effects of neurotoxic chemotherapy agents. An increasing survival rate and frequent administration of adjuvant chemotherapy treatments involving neurotoxic agents makes it imperative that accurate diagnosis, prevention and treatment of these neurological complications be implemented to minimize the burden experienced by patients undergoing these treatments. Methods: To determine the potential use of pharmaceuticals, nutraceuticals and herbal medicines as adjuvants in cancer treatments a critical literature review was conducted by electronic and manual search on nine databases. These include PubMed, the Cochrane Library, Science Direct, Scopus, EMBASE, MEDLINE, Google Scholar and two Chinese databases CNKI and CINAHL. Thirty studies were selected for pharmaceutical agents, twenty-four studies for nutraceuticals and thirty-four studies for herbal medical trials. Seven acupuncture trials were also identified in relation to CIPN management. Data was collated and organised into chemotherapy drugs, agent’s trialled, number of participants, results and recommendations. Results: For pharmaceutical agents, amifostine has possible ototoxicity protection for children in cisplatin and duloxetine as a treatment option for pain. For nutraceuticals, vitamin E was found to have protective abilities for cisplatin ototoxicity, omega 3 fatty acids for taxane administration and vitamin B6 and lipoic acid for oxaliplatin CIPN. In herbal medicine, Goshajinkigan showed great promise for oxaliplatin-IPN protection. Vitamin B12 deficiencies have also been found to increase the onset and severity of CIPN. Conclusions: Currently, no pharmaceutical, nutraceutical or complementary agent has been found to be completely beneficial in preventing or treating CIPN. It is suggested clinicians identify the best option from the research to assist patients in both possible prevention and treatment of CIPN. In addition, research has found that a vitamin B12 deficiency may potentiate moderate to severe CIPN presentation and testing of this vitamin is suggested.
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Wang, Zehua, Haiou Liu, and Congjian Xu. "Cellular Senescence in the Treatment of Ovarian Cancer." International Journal of Gynecologic Cancer 28, no. 5 (June 2018): 895–902. http://dx.doi.org/10.1097/igc.0000000000001257.
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ObjectiveThis review aimed to update the research and development of cellular senescence in the treatment of ovarian cancer. We discussed the current mechanisms of senescence and the major biomarkers of senescence, especially the methods of cellular senescence in the treatment of ovarian cancer.Materials and MethodsWe collected all relevant studies in PubMed from 1995 to 2017. The search terms included senescence and cancer, senescence and ovarian cancer, senescence-associated secretory phenotype, ovarian cancer and chemotherapy, radiotherapy, or biotherapy. PubMed search with the key words senescence and ovarian cancer lists approximately 85 publications. After excluding the duplicated articles, we selected 68 articles most relevant to senescence and ovarian cancer in this review.ResultsCellular senescence plays a key role in various biological processes of ovarian cancer, which is closely related with the occurrence, development, and treatment of ovarian cancer. Cellular senescence on the one hand can reduce the dose of chemotherapy in ovarian cancer; on the other hand, it also can solve the problem of tumor resistance to apoptosis. Therefore, cellular senescence has been shown to be the third intracellular mechanism of ovarian cancer prevention followed by cellular DNA repair and apoptosis.ConclusionsIn the near future, cellular senescence therapy could be a powerful tool for ovarian cancer treatment.
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Lotfi-Jam, Kerryann, Mariko Carey, Michael Jefford, Penelope Schofield, Catherine Charleson, and Sanchia Aranda. "Nonpharmacologic Strategies for Managing Common Chemotherapy Adverse Effects: A Systematic Review." Journal of Clinical Oncology 26, no. 34 (December 1, 2008): 5618–29. http://dx.doi.org/10.1200/jco.2007.15.9053.
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Purpose Adverse effects of chemotherapy can be severe and can have a significant impact on a person's quality of life. With chemotherapy treatment increasingly administered in the ambulatory setting, there is a need for patients to be informed about effective self-care strategies to manage treatment adverse effects. Advice for patients needs to be based on evidence. This systematic review provides an overview of the intervention research in this area as well as an effectiveness review of nonpharmacologic (self-care) strategies evaluated in high-quality randomized controlled trials (RCTs). Methods An extensive literature search was conducted to identify RCTs relating to self-care strategies for reducing nausea/vomiting, constipation, diarrhea, fatigue, hair loss, or mucositis. Relevant studies published in peer-reviewed journals between 1980 and August 2007 were included. Study characteristics, results and methodologic quality were examined. High-quality RCTs were further analyzed to establish the effectiveness of specific self-care strategies. Results The search identified 77 RCTs. Findings from RCTs of reasonable quality provide limited support for cognitive distraction, exercise, hypnosis, relaxation, and systematic desensitization to reduce nausea and vomiting, psycho-education for fatigue, and scalp cooling to reduce hair loss. Conclusion Although some strategies seem promising, the quality of the RCTs was generally quite low, making it difficult to draw conclusions about the effectiveness of self-care strategies. Future studies require better design and reporting of methodologic issues to establish evidence-based self-care recommendations for people receiving chemotherapy.
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Misra, Sanjeev, Arun Chaturvedi, and NC Misra. "Management of Gingivobuccal Complex Cancer." Annals of The Royal College of Surgeons of England 90, no. 7 (October 2008): 546–53. http://dx.doi.org/10.1308/003588408x301136.
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INTRODUCTION Squamous cell carcinoma of the oral cavity ranks as the 12th most common cancer in the world and the 8th most frequent in males. It accounts for up to one-third of all tobacco-related cancers in India. Cancer of the gingivobuccal complex is especially common in Indians due to their tobacco habits. This review focuses on the management of lower gingivobuccal complex cancers. PATIENTS AND METHODS References for this review were identified by search of Medline and other bibliographic information available in the PubMed database. The search terms carcinoma oral cavity, and cancer oral cavity, buccal mucosa, gingiva, gingivobuccal complex, and alveolus cancer/carcinoma were used. References from relevant articles and abstracts from international conferences were also included. Only articles published in the English language were used. RESULTS Treatment of gingivobuccal complex cancer is primarily surgical. Radical neck dissection, or its modification, is the standard treatment for the node-positive neck. Supraomohyoid neck dissection is the accepted treatment for the node-negative neck. Radiotherapy is usually not the preferred modality of treatment for early gingivobuccal complex cancer. It is used either as postoperative adjuvant treatment or as definitive treatment for advanced cancer with or witihout chemotherapy. Chemotherapy has been used as neo-adjuvant, adjuvant or palliative treatment. Advanced cancers are common and continue to pose a challenge to the multidisciplinary team. CONCLUSIONS Gingivobuccal complex cancer remains a major public health problem despite being highly preventable and easily detectable. Advanced cancers constitute a major proportion of patients presenting for treatment. These patients are difficult to treat and have a poor outcome.
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Chaudhry, Parvesh, and Eric Asselin. "Resistance to chemotherapy and hormone therapy in endometrial cancer." Endocrine-Related Cancer 16, no. 2 (June 2009): 363–80. http://dx.doi.org/10.1677/erc-08-0266.
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Endometrial cancer is the most common gynecological malignancy in developed countries and represents the eighth leading cause of cancer related death in women. The growing incidence of endometrial cancer leads scientists and oncologists to identify effective preventive measures and also molecular markers for diagnosis and prognosis. Chemotherapy and hormone therapy is the mainstay treatment option for advanced and recurrent endometrial cancer and response to therapy is one of the most important factor which favors prognosis and overall survival. In recent years, there have been major advances in the treatment of patients with endometrial cancer. Despite advances made in the treatment of this cancer, the overall survival of patients has not significantly improved because considerable number of patients harbor tumor refractory to these therapies and the majority of the initially responsive tumors become refractory to treatments. Therefore, determination of sensitivity/resistance is becoming increasingly important for individualization of endometrial cancer therapy. The aim of this review is to present the existing knowledge about the molecular markers that could play a crucial role in determining resistance to chemo- and hormone therapy. Extensive literature search for the cell signaling pathways and factors responsible for chemoresistance have been performed and reviewed. Several recent studies suggest that deregulations in the apoptotic pathways (such as p53, Fas/FasL, Bcl-2 family proteins, inhibitor of apoptosis proteins), survival pathways (PI3K/AKT, MAPK), hormone receptor signaling pathways (progesterone receptor), Cyclooxygenase-2 and Her-2 are considered as key factors involved in the onset and maintenance of therapeutic resistance, suggesting that resistance is a multi-factorial phenomenon.
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Sianturi, Elteria, and Dewi Irawati. "The The Effectiveness Of Oral Cryotherapy To Reduce Oral Mucositis Among Cancer Patients Undergoing Chemotherapy: A Literature Review." International Journal of Nursing and Health Services (IJNHS) 2, no. 2 (June 18, 2019): 102–9. http://dx.doi.org/10.35654/ijnhs.v2i2.108.
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Abstract
Background: Oral cryotherapy has been scientifically proven as a non-pharmacological therapy to reduce the incidence of oral mucositis. With the decline in the incidence of oral mucositis, patient’s comfort improved, the length of stay and cost of care decreases, and maximum quality of life is achieved. Aim: To determine the effectiveness of oral cryotherapy in reducing the incidence of oral mucositis in patient undergoing chemotherapy. Method: This paper used literature review. The literature search was conducted of articles published from January 2012 through February 2018 using the PubMed, Embase, Cochrane Library and Ebscohost databases on the effectiveness of oral cryotherapy in reducing oral mucositis in patients undergoing chemotherapy. Result: This search resulted in a total of 8 articles. Evidence has indicated that there is a significance effect of oral cryotherapy in reducing oral mucositis. Conclusion: Oral cryotherapy is one of technique that easy to do, inexpensive and can be tolerated by patients in general, so it can be used widely. It can be used for adults and children with solid tumors, bone marrow transplant patients and for patients with different chemotherapy regimens (single or combination regimens).
Keywords: Oral Cryotherapy, Oral Mucositis, Chemotherapy, patient’s quality of life
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Tian En, Lim, Mark F. H. Brougham, William Hamish B. Wallace, and Rod T. Mitchell. "Impacts of platinum-based chemotherapy on subsequent testicular function and fertility in boys with cancer." Human Reproduction Update 26, no. 6 (September 16, 2020): 874–85. http://dx.doi.org/10.1093/humupd/dmaa041.
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Abstract BACKGROUND Children with cancer often face infertility as a long-term complication of their treatment. For boys, compromised testicular function is common after chemotherapy and currently there are no well-established options to prevent this damage. Platinum-based agents are used to treat a wide variety of childhood cancers. However, platinum agents are not currently included in the cyclophosphamide equivalent dose (CED), which is used clinically to assess the risks to fertility posed by combination chemotherapy in children with cancer. OBJECTIVE AND RATIONALE This was a systematic search of the literature designed to determine the evidence for effects of platinum-based cancer treatment on the prepubertal human testis in relation to subsequent testicular function and fertility. SEARCH METHODS PubMed and EMBASE were searched for articles published in English between 01 January 1966 and 05 April 2020 using search terms including ‘cancer treatment’, ‘chemotherapy’, ‘human’, ‘prepubertal’, ‘testis’, ‘germ cells’, ‘testosterone’ and related terms. Abstracts were screened and full-text articles were obtained for those that met the three major inclusion criteria (age ≤12 years at treatment, exposure to platinum-based chemotherapeutic and measure of reproductive function). Screening of bibliographies for full-text articles was used to identify additional studies. OUTCOMES Our initial search identified 1449 articles of which 20 (1.3%) studies (n = 13 759 males) met all inclusion criteria. A control group (healthy individuals or siblings) was included for 5/20 (25%) studies. A total of 10/20 (50%) studies provided sub-analysis of the relative gonadotoxicity of platinum-based agents. The primary outcome measures were: pregnancies and fatherhood; semen analysis; and hormonal function. For pregnancies and fatherhood, three studies (n = 10 453 males) reported negative associations with platinum-agents, including the largest (n = 5640) controlled study (hazard ratio = 0.56, P = 0.0023), whilst two other studies (n = 1781) with platinum sub-analysis reported no association. For semen analysis (based on World Health Organization criteria), platinum-based chemotherapy was associated with azoospermia in one study (n = 129), whilst another (n = 44) found no association and the remainder did not perform platinum-based sub-analysis. For hormone analysis, conflicting results were obtained regarding potential associations between platinum-based agents and elevated FSH (a proxy for impaired spermatogenesis); however, the majority of these studies were based on low numbers of patients receiving platinum-based chemotherapy. WIDER IMPLICATIONS Overall, these results indicate that platinum-based chemotherapy should be included in clinical calculators, for example CED, used to determine gonadotoxicity for childhood cancer treatment. These findings have important implications for clinicians regarding counselling patients and their carer(s) on fertility risk, guiding requirements for fertility preservation strategies (e.g. testicular tissue cryopreservation) and modification of treatments to reduce or eliminate the risk of infertility in childhood cancer survivors.
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Mostafa Madmoli and Mahtab Samsamipour. "The Most Important Methods for Reducing Chemotherapy-Induced Nausea and Vomiting In Cancer Patients: A Systematic Review Study." International Healthcare Research Journal 3, no. 1 (April 13, 2019): 3–8. http://dx.doi.org/10.26440/ihrj/0301.04.521065.
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Introduction: Despite the successes that have recently been made in the field of control and prevention of communicable diseases, the incidence of chronic illnesses has increased. And cancer as a chronic disease after accidents and unintentional deaths is the third leading cause of death in children. Given that cancer patients have multiple chemotherapy during their healing period and chemotherapy itself causes a lot of harm to the patient and that nausea and vomiting are a common complication in chemotherapy patients, Therefore, this systematic review was conducted to determine the most important methods for reducing the nausea and vomiting induced by chemotherapy in cancer patients.
Materials and Methods: This study is a systematic review Using the articles published in the last 20 years, it was based on the most important methods for reducing the nausea and vomiting of chemotherapy in cancer patients. The search was carried out in search engines, SID, Magiran, and Google Scholar, Embase, ResearchGate, Sciencedirect, and PubMed in Persian and English. In the first stage, 47 articles were found. Of these, 10 related articles that have been published in the last 20 years have been reviewed.
Results: In this study, we investigated the most important methods for reducing the nausea and vomiting of chemotherapy in cancer patients. In one of these studies, the rate of nausea and vomiting in patients undergoing chemotherapy was studied at the stage. In the first stage, without intervention, in the second phase, music was broadcast to patients using headphones. In the case of nausea, measurements with numerical criteria at 16 and 24 hours and descriptive criteria showed significant difference only at 24 hours after chemotherapy. However, there was no significant difference in vomiting between two stages of chemotherapy.
Conclusion: According to the studied studies, ice massage in the Negan spot can be effective in reducing the frequency and severity of nausea and vomiting in cancer patients undergoing chemotherapy. It can also be said that muscle use reduces nausea in children with chemotherapy malignancy. It is suggested that nurses use ear acupressure technique as a complement to relieve nausea and vomiting caused by chemotherapy.
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Hobday, Timothy J., and Edith A. Perez. "Molecularly Targeted Therapies for Breast Cancer." Cancer Control 12, no. 2 (April 2005): 73–81. http://dx.doi.org/10.1177/107327480501200202.
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Background: The management of patients with localized and advanced breast cancer continues to evolve. Chemotherapy, endocrine therapy, and trastuzumab are effective therapies but leave considerable room for improvement. As the cellular aberrations inherent to cancer cells in general and breast cancer cells specifically are better understood, therapies to target specific cellular pathways continue to be developed with the goal of expanding available effective therapy through better patient selection. Methods: We conducted a computerized search of the medical literature as well as a manual search of selected meeting abstracts. Results: Several targeted therapies are in phase III clinical trials testing their promise in the treatment of breast cancer. Many other agents are completing phase I and II testing. An overview of the most promising agents in clinical development is discussed herein. Conclusions: Targeted therapy for breast cancer is a reality at this time, and several new agents hold promise for expanding and refining the pool of patients likely to further benefit from this approach in the near future.
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Kong, Wei-Yang, Siew Ching Ngai, Bey-Hing Goh, Learn-Han Lee, Thet-Thet Htar, and Lay-Hong Chuah. "Is Curcumin the Answer to Future Chemotherapy Cocktail?" Molecules 26, no. 14 (July 17, 2021): 4329. http://dx.doi.org/10.3390/molecules26144329.
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The rise in cancer cases in recent years is an alarming situation worldwide. Despite the tremendous research and invention of new cancer therapies, the clinical outcomes are not always reassuring. Cancer cells could develop several evasive mechanisms for their survivability and render therapeutic failure. The continuous use of conventional cancer therapies leads to chemoresistance, and a higher dose of treatment results in even greater toxicities among cancer patients. Therefore, the search for an alternative treatment modality is crucial to break this viscous cycle. This paper explores the suitability of curcumin combination treatment with other cancer therapies to curb cancer growth. We provide a critical insight to the mechanisms of action of curcumin, its role in combination therapy in various cancers, along with the molecular targets involved. Curcumin combination treatments were found to enhance anticancer effects, mediated by the multitargeting of several signalling pathways by curcumin and the co-administered cancer therapies. The preclinical and clinical evidence in curcumin combination therapy is critically analysed, and the future research direction of curcumin combination therapy is discussed.
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Huehnchen, Petra, Antonia van Kampen, Wolfgang Boehmerle, and Matthias Endres. "Cognitive impairment after cytotoxic chemotherapy." Neuro-Oncology Practice 7, no. 1 (November 4, 2019): 11–21. http://dx.doi.org/10.1093/nop/npz052.
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Abstract Background Neurotoxicity is a frequent side effect of cytotoxic chemotherapy and affects a large number of patients. Despite the high medical need, few research efforts have addressed the impact of cytotoxic agents on cognition (ie, postchemotherapy cognitive impairment; PCCI). One unsolved question is whether individual cytotoxic drugs have differential effects on cognition. We thus examine the current state of research regarding PCCI. Neurological symptoms after targeted therapies and immunotherapies are not part of this review. Methods A literature search was conducted in the PubMed database, and 1215 articles were reviewed for predefined inclusion and exclusion criteria. Thirty articles were included in the systematic review. Results Twenty-five of the included studies report significant cognitive impairment. Of these, 21 studies investigated patients with breast cancer. Patients mainly received combinations of 5-fluorouracil, epirubicin, cyclophosphamide, doxorubicin, and taxanes (FEC/FEC-T). Five studies found no significant cognitive impairment in chemotherapy patients. Of these, 2 studies investigated patients with colon cancer receiving 5-fluorouracil and oxaliplatin (FOLFOX). Independent risk factors for PCCI were patient age, mood alterations, cognitive reserve, and the presence of apolipoprotein E e4 alleles. Conclusions There is evidence that certain chemotherapy regimens cause PCCI more frequently than others as evidenced by 21 out of 23 studies in breast cancer patients (mainly FEC-T), whereas 2 out of 3 studies with colon cancer patients (FOLFOX) did not observe significant changes. Further studies are needed defining patient cohorts by treatment protocol in addition to cancer type to elucidate the effects of individual cytotoxic drugs on cognitive functions.
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Nicoloso, Milena Sabrina, Monica Schiappacassi, Alessandra Dall’Acqua, Sara D’Andrea, Sara Benevol, Roberto Sorio, Vincenzo Canzonieri, Giorgio Giorda, and Gustavo Baldassarre. "SRSF2 mutations in epithelial ovarian cancer." Cancer Breaking News 5, no. 3 (December 15, 2017): 25–29. http://dx.doi.org/10.19156/cbn.2017.0056.
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Resistance to platinum chemotherapy regimens represents a major obstacle in the successful treatment of epithelial ovarian cancer (EOC) patients. Among the molecular mechanism responsible for resistance to platinum, alternative splicing, which is induced upon platinum treatment, can control apoptosis by regulating the expression of apoptotic protein variants with opposite functions. Alterations in alternative splicing are found in tumors and can hinder apoptotic response. In the present study we sequenced SRSF2, a splicing factor that regulates Caspase-8 and Caspase-9 variants, in search of mutations that could possibly explain alternative mechanisms of platinum resistant in EOC.
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Krzyzanowska, M. K., C. Walker-Dilks, C. Atzema, A. Morris, R. Gupta, R. Halligan, T. Kouroukis, and K. McCann. "Approach to fever assessment in ambulatory cancer patients receiving chemotherapy: a clinical practice guideline." Current Oncology 23, no. 4 (August 8, 2016): 280. http://dx.doi.org/10.3747/co.23.3098.
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BackgroundThis guideline was prepared by the Fever Assessment Guideline Development Group, a group organized by the Program in Evidence-Based Care at the request of the Cancer Care Ontario Systemic Treatment Program. The mandate was to develop a standardized approach (in terms of definitions, information, and education) for the assessment of fever in cancer patients receiving chemotherapy.Methods The guideline development methods included a search for existing guidelines, literature searches in medline and embase for systematic reviews and primary studies, internal review by content and methodology experts, and external review by targeted experts and intended users.Results The search identified eight guidelines that had partial relevance to the topic of the present guideline and thirty-eight primary studies. The studies were mostly noncomparative prospective or retrospective studies. Few studies directly addressed the topic of fever except as one among many symptoms or adverse effects associated with chemotherapy. The recommendations concerning fever definition are supported mainly by other existing guidelines. No evidence was found that directly pertained to the assessment of fever before a diagnosis of febrile neutropenia was made. However, some studies evaluated approaches to symptom management that included fever among the symptoms. Few studies directly addressed information needs and resources for managing fever in cancer patients.Conclusions Fever in patients with cancer who are receiving systemic therapy is a common and potentially serious symptom that requires prompt assessment, but currently, evidence to inform best practices concerning when, where,and by whom that assessment is done is very limited.
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Shaikh, Tawseef Ayoub, and Rashid Ali. "An intelligent healthcare system for optimized breast cancer diagnosis using harmony search and simulated annealing (HS-SA) algorithm." Informatics in Medicine Unlocked 21 (2020): 100408. http://dx.doi.org/10.1016/j.imu.2020.100408.
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Zdenkowski, Nicholas, Shefi Mary D'Silva, Kenny Lawson, Penny Reeves, and Frances M. Boyle. "Economic evaluation of neoadjuvant chemotherapy for operable breast cancer." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e12637-e12637. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e12637.
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e12637 Background: Neoadjuvant chemotherapy is widely and increasingly used for patients with operable breast cancer that is large or highly proliferative. Advantages include downstaging of the breast and. axilla, post-neoadjuvant salvage treatments for poor responders, surgical and reconstruction planning, prognostication and to give time for genetic testing. After neoadjuvant therapy, treatment options may change. We aimed to determine the financial impact to the health system, of neoadjuvant chemotherapy compared with surgery first. Methods: A literature search identified data on the probability of receiving certain investigations and treatments, and associated outcome probabilities for neoadjuvant and surgery-first patients. Published health utility results were used. These data were incorporated into a decision analytic economic model. A cost-utility analysis was undertaken, with sensitivity analyses to evaluate the impact of uncertainties in the data. Pricing was based on publicly available costings of investigations and treatment in Australian Dollars (AUD). A value of information analysis was undertaken to determine the value of further research to reduce uncertainty in results. Results: Expected costs for neoadjuvant vs surgery first differed by $77. Neoadjuvant therapy showed higher effectiveness that surgery first (QALY 0.708 vs 0.698 respectively. The average cost per QALY of neoadjuvant therapy was $7,232 AUD (ca. $4825 USD), below the threshold of $50,000 per QALY. In a sensitivity analysis, neoadjuvant therapy dominated when axillary dissection rate was lower than 60% and postmastectomy reconstruction rate was more than 27%. These factors had the greatest impact on results, which were otherwise robust. Probabilistic sensitivity analysis found that neoadjuvant therapy was cost-effective 71% of the time at a willingness-to-pay threshold of $50,000 per QALY. Value of information analysis found that primary research into treatment probabilities and outcome utilities is needed to validate these results. Conclusions: Neoadjuvant systemic therapy is a potentially cost-effective treatment. However, primary contemporary data in directly comparable patient populations is needed, including the impact of post-neoadjuvant systemic therapy.
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Yurttas, Can, Giulia Hoffmann, Alexander Tolios, Sebastian P. Haen, Matthias Schwab, Ingmar Königsrainer, Alfred Königsrainer, Stefan Beckert, and Markus W. Löffler. "Systematic Review of Variations in Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Metastasis from Colorectal Cancer." Journal of Clinical Medicine 7, no. 12 (December 19, 2018): 567. http://dx.doi.org/10.3390/jcm7120567.
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Cytoreductive surgery (CRS), followed by hyperthermic intraperitoneal chemotherapy (HIPEC), combines radical surgery with abdominal heated chemotherapy, constituting a multimodal treatment approach. Since clear standards for HIPEC conduct in colorectal carcinoma (CRC) are lacking, we aimed to provide a comprehensive structured survey. Data sources and study eligibility criteria: A systematic literature search was performed in PubMed, with keywords “HIPEC” and “colorectal cancer”, according to established guidelines. Articles were systematically screened, selecting 87 publications complemented by 48 publications identified through extended search for subsequent synthesis and evaluation, extracting inter alia details on used drugs, dosage, temperature, exposure times, and carrier solutions. Results: Compiled publications contained 171 reports on HIPEC conduct foremost with mitomycin C and oxaliplatin, but also other drugs and drug combinations, comprising at least 60 different procedures. We hence provide an overview of interconnections between HIPEC protocols, used drugs and carrier solutions as well as their volumes. In addition, HIPEC temperatures and dosing benchmarks, as well as an estimate of in vivo resulting drug concentrations are demonstrated. Conclusions and implications: Owing to recent developments, HIPEC conduct and practices need to be reassessed. Unfortunately, imprecise and lacking reporting is frequent, which is why minimal information requirements should be established for HIPEC and the introduction of final drug concentrations for comparability reasons seems sensible.
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Dijkstra, Madelon, Sanne Nieuwenhuizen, Robbert S. Puijk, Bart Geboers, Florentine E. F. Timmer, Evelien A. C. Schouten, Hester J. Scheffer, et al. "The Role of Neoadjuvant Chemotherapy in Repeat Local Treatment of Recurrent Colorectal Liver Metastases: A Systematic Review and Meta-Analysis." Cancers 13, no. 3 (January 20, 2021): 378. http://dx.doi.org/10.3390/cancers13030378.
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The additive value of neoadjuvant chemotherapy (NAC) prior to repeat local treatment of patients with recurrent colorectal liver metastases (CRLM) is unclear. A systematic search was performed in PubMed, Embase, Web of Science, and an additional search in Google Scholar to find articles comparing repeat local treatment by partial hepatectomy and/or thermal ablation with versus without NAC. The search included randomized trials and comparative observational studies with univariate/multivariate analysis and/or matching as well as (inter)national guidelines assessed using the AGREE II instrument. The search identified 21,832 records; 172 were selected for full-text review; 20 were included: 20 comparative observational studies were evaluated. Literature to evaluate the additive value of NAC prior to repeat local treatment was limited. Outcomes of NAC were often reported as subgroup analyses and reporting of results was frequently unclear. Assessment of the seven studies that qualified for inclusion in the meta-analysis showed conflicting results. Only one study reported a significant difference in overall survival (OS) favoring NAC prior to repeat local treatment. However, further analysis revealed a high risk for residual bias, because only a selected group of chemo-responders qualified for repeat local treatment, disregarding the non-responders who did not qualify. All guidelines that specifically mention recurrent disease (3/3) recommend repeat local treatment; none provide recommendations about the role of NAC. The inconclusive findings of this meta-analysis do not support recommendations to routinely favor NAC prior to repeat local treatment. This emphasizes the need to investigate the additive value of NAC prior to repeat local treatment of patients with recurrent CRLM in a future phase 3 randomized controlled trial (RCT).
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Shehata, Mahmoud A., and Nagla Abdel Karim. "Influenza Vaccination in Cancer Patients Undergoing Systemic Therapy." Clinical Medicine Insights: Oncology 8 (January 2014): CMO.S13774. http://dx.doi.org/10.4137/cmo.s13774.
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Background Cancer patients often experience preventable infections, including influenza A and B. These infections can be a cause of significant morbidity and mortality. The increased risk of infection may be because of either cancer itself or treatment-induced immunosuppression. 1 Influenza immunization has been shown to decrease the risk of influenza infection in patients with intact immunity. 2 In cancer patients, active immunization has been shown to confer protective immunity against several infections at similar rates to healthy individuals, which has translated into decreased duration and severity of infection and potentially improved morbidity and mortality. 3 Objectives 1. To assess the efficacy of influenza vaccination in stimulating immunological response in patients with cancer during chemotherapy compared to control groups. 2. To assess the efficacy of influenza vaccination in preventing confirmed influenza and influenza-like illness and/or stimulating immunological response in children with cancer treated with chemotherapy, compared to placebo, no intervention, or different dosage schedules. 3. To determine the adverse effects associated with influenza vaccination in patients with cancer. Search Methods We searched MEDLINE/PubMed database for articles published from 1964 to 2013 using the search terms “cancer,” “adult,” “influenza vaccination,” and “chemotherapy.” Selection Criteria We included studies based on systematic sampling with defined clinical criteria irrespective of the vaccination status of cancer patients. Studies measure the serological response or clinical response to compare between the study group and the control group. Studies assessed the inactivated influenza vaccines and live attenuated influenza vaccine (LAIV) protective serological reaction and the clinical outcomes after vaccination. Data Collection and Analysis Two independent authors assessed the methodological quality of included studies and extracted data. Main Results We included 16 studies (total number of participants = 1,076). None of the included studies reported clinical outcomes. All included studies reported on influenza immunity and adverse reaction on vaccination. We included 6 solid tumor studies and 10 hematological studies. In 12 studies, the serological response to influenza vaccine was compared in patients receiving chemotherapy (n = 425) versus those not receiving chemotherapy (n = 376). In three studies, the serological responses to influenza vaccination in patients receiving chemotherapy are compared to that in healthy adult. Measures used to assess the serological responses included a four-fold rise increase in antibody titer development of hemagglutination inhibition (HI) titer >40, and pre- and post-vaccination geometric mean titers (GMTs). Immune responses in patients receiving chemotherapy were consistently weaker (four-fold rise of 17–52%) than in those who had completed chemotherapy (50–83%) and healthy patients (67–100%). Concerning adverse effects, oncology patients received influenza vaccine, and the side effects described were mild local reactions and low-grade fever. No life-threatening or persistent adverse effects were reported. Authors’ Conclusion Patients with solid and some of hematological tumors are able to mount a serological response to influenza vaccine, but it remains unclear how much this response protects them from influenza infection or its complications. Meanwhile, influenza vaccine appears to be safe in these patients. While waiting results of randomized controlled trials to give us more details about the clinical benefits of the influenza vaccination, the clinicians should consider the currently proved benefits of influenza vaccination on management of the cancer patients undergoing systematic chemotherapy such as decrease in the duration and severity of the of the disease, and significant decrease in influenza-associated morbidity and mortality in these high-risk patients. 3
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Lee, L. M., W. Y. Cheung, and M. K. Krzyzanowska. "A systematic review of the impact of comorbidity on chemotherapy utilization and outcomes in solid tumors." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e20646-e20646. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e20646.
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e20646 Background: The management of cancer patients (pts) with comorbidities can be challenging as these individuals are underrepresented in oncology clinical trials. We conducted a systematic literature review to determine the impact of comorbidity on utilization, tolerability, and efficacy of chemotherapy among pts with solid tumors. Methods: Using MEDLINE and EMBASE databases, all English-language articles published from 1990–2008 that explored the association between comorbidity and chemotherapy were identified. MeSH and keyword search terms included “comorbidity,” “chemotherapy” and “cancer.” All abstracts were manually reviewed for eligibility based on inclusion and exclusion criteria. Two reviewers independently abstracted data on the design and results of each eligible study, and rated the quality of the article using the STROBE checklist. Results: Of 1,031 citations retrieved by the search, 29 articles met inclusion criteria. Study designs were too heterogeneous to permit a quantitative summary and the overall quality of articles was poor. Comorbidity was investigated most frequently among pts with lung (41%), breast (17%), or colon cancers (17%). Most studies were retrospective (72%), based on cancer registry data (48%), and assessed the effect of cumulative comorbidity based on an index score (76%). Fourteen studies (41%) investigated access and 26 (90%) addressed survival. For pts with comorbidities, the majority reported decreased access (50%) and inferior survival (65%). Of the 12 articles that included both parameters, 6 showed that comorbidity was independently associated with worse survival while 4 demonstrated that impaired access to treatment, not comorbidity, was the stronger predictor of inferior outcomes. Few studies addressed toxicity (24%), ability to complete chemotherapy (7%) or response rates (7%). Among them, no differences based on comorbidity were noted. Conclusions: The evidence regarding the impact of comorbidity on chemotherapy utilization and outcomes among cancer pts is limited and of poor quality. Further better-designed studies are warranted to determine the relationship between decreased access and inferior outcomes and to better define the tolerability and efficacy of chemotherapy in pts with comorbidities. No significant financial relationships to disclose.
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Cardinale, Daniela Maria, Martina Zaninotto, Carlo Maria Cipolla, Claudio Passino, Mario Plebani, and Aldo Clerico. "Cardiotoxic effects and myocardial injury: the search for a more precise definition of drug cardiotoxicity." Clinical Chemistry and Laboratory Medicine (CCLM) 59, no. 1 (January 26, 2021): 51–57. http://dx.doi.org/10.1515/cclm-2020-0566.
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AbstractDrug-induced cardiotoxicity is a major clinical problem; cardiotoxic drugs may induce both cardiac dysfunction and myocardial injury. Several recent studies reported that cardiac troponins measured with high-sensitivity methods (hs-cTn) can enable the early detection of myocardial injury related to chemotherapy or abuse of drugs that are potentially cardiotoxic. Several authors have some concerns about the standard definition of cardiotoxicity, in particular, regarding the early evaluation of chemotherapy cardiotoxicity in cancer patients. Several recent studies using the hs-cTn assay indicate that myocardial injury may precede by some months or years the diagnosis of heart failure (HF) based on the evaluation of left ventricular ejection fraction (LVEF). Accordingly, hs-cTn assay should considered to be a reliable laboratory test for the early detection of asymptomatic or subclinical cardiotoxic damage in patients undergoing cancer chemotherapy. In accordance with the Fourth Universal Definition of Myocardial Infarction and also taking into account the recent experimental and clinical evidences, the definition of drug-cardiotoxicity should be updated considering the early evaluation of myocardial injury by means of hs-cTn assay. It is conceivable that the combined use of hs-cTn assay and cardiac imaging techniques for the evaluation of cardiotoxicity will significantly increase both diagnostic sensitivity and specificity, and also better prevent chemotherapy-related left ventricular (LV) dysfunction and other adverse cardiac events. However, large randomized clinical trials are needed to evaluate the cost/benefit ratio of standardized protocols for the early detection of cardiotoxicity using hs-cTn assay in patients receiving chemotherapy for malignant diseases.
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Hoppe, C., S. Kutschan, J. Dörfler, J. Büntzel, J. Büntzel, and Jutta Huebner. "Zinc as a complementary treatment for cancer patients: a systematic review." Clinical and Experimental Medicine 21, no. 2 (January 26, 2021): 297–313. http://dx.doi.org/10.1007/s10238-020-00677-6.
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AbstractZinc is a trace element that plays an important role in the immune system and cell growth. The role of zinc in cancer treatment has been discussed for some time, however without reaching an evidenced-based consensus. Therefore, we aim to critically examine and review existing evidence on the role of zinc during cancer treatment. In January 2019, a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychINFO, CINAHL and PubMed) to find studies concerning the use, effectiveness and potential harm of zinc therapy on cancer patients. Out of initial 5244 search results, 19 publications concerning 23 studies with 1230 patients were included in this systematic review. The patients treated with zinc were mainly diagnosed with head and neck cancer and underwent chemo-, radio- or concurrent radio-chemotherapy. Interventions included the intake of different amounts of zinc supplements and oral zinc rinses. Outcomes (primary endpoints) investigated were mucositis, xerostomia, dysgeusia, pain, weight, dermatitis and oral intake of nutrients. Secondary endpoints were survival data, quality of life assessments and aspects of fatigue, immune responses and toxicities of zinc. The studies were of moderate quality reporting heterogeneous results. Studies have shown a positive impact on the mucositis after radiotherapy. No protection was seen against mucositis after chemotherapy. There was a trend to reduced loss of taste, less dry mouth and oral pain after zinc substitution. No impact was seen on weight, QoL measurements, fatigue, and survival. The risk of side effects from zinc appears to be relatively small. Zinc could be useful in the prevention of oral toxicities during irradiation. It does not help in chemotherapy-induced side effects.
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Paoli, Severo de, Adenilson de Souza da Fonseca, Flávia de Paoli, Mauro Geller, Giuseppe Antonio Presta, Sebastião David Santos-Filho, and Mário Bernardo-Filho. "A Review of Scientific Papers About Head and Neck Cancers." Brazilian Archives of Biology and Technology 51, spe (December 2008): 63–69. http://dx.doi.org/10.1590/s1516-89132008000700011.
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Head and neck cancer is one of the 10 most frequent cancers worldwide, with an estimated 500000 new cases diagnosed annually. Treatment of head and neck cancers require a multidisciplinary approach due their complexity and the functional and esthetic alterations that cancer can cause. The interest of the scientific community in a specific subject can be evaluated by analyzing of the number and the quality of published papers on the topic. The information obtained from PubMed (www.ncbi.nlm.nih.gov/sites/entrez) has been used as a tool in various publications to aid the evaluation of the scientific interest in specific research areas The aim of this work is to evaluate, using PubMed, the scientific interest in studies of head and neck cancer treatments such as radiotherapy, chemotherapy and surgery. The searches were performed on PubMed for publications from the period of 1949 to 2008 using the search terms "head and neck cancer" and "surgery" or "radiotherapy" or "chemotherapy". The number of publications per year was determined in each search. The percentage of publications was also calculated for each subject in each year. An interest factor in a subject (IFS) was also determined. The number of publications was higher for surgery than chemotherapy or radiotherapy. The calculated 1964 IFS for surgery was 14.79, 12.74 for radiotherapy, and 19.58 for chemotherapy. The 1995 IFS for surgery was 1.99, 2.09 for radiotherapy, and 2.08 for chemotherapy. The relation obtained for 1995 was maintained in the subsequent years. There are more publications related to surgical treatment for head and neck cancer when compared with radiotherapy and chemotherapy. Moreover, in the recent years there has an increased interest in treatments utilizing chemotherapy, or this associated to radiotherapy.
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Haussmann, Jan, Wilfried Budach, Edwin Boelke, Balint Tamaskovics, Freddy Joel Djiepmo Njanang, Stefanie Corradini, Kai Kammers, Ruediger Wessalowski, and Christiane Matuschek. "Comparison of different systemic therapeutic regimes in resectable high-risk soft tissue sarcoma: Results of a network meta-analysis." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 11549. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.11549.
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11549 Background: The treatment of high-risk soft tissue sarcoma of the trunk or the extremities consists of surgical resection with risk-adapted radiation therapy. Further treatment options which can significantly improve local and systemic tumor control including chemotherapy are not well established. Due to the heterogeneity of disease different systemic approaches as well as their application during different time points have been attempted. Methods: We conducted a literature search for randomized clinical trials in the treatment of localized, resectable high-risk soft tissue sarcoma comparing different treatment modalities according to the PRISMA guidelines. We extracted published hazard ratios and number of events for the endpoints of overall and disease-free survival (OS; DFS) as well as local and distant recurrence-free interval (LRFI; DRFI). The different modalities were compared in a network meta-analysis against the defined standard treatment surgery ± radiotherapy using the inverse-variance heterogeneity model (ivhet) with the help of the Microsoft Excel add-in Meta-XL V5.3. Results: The literature search identified 25 studies including 3489 patients. The network analysis showed that adjuvant chemotherapy (adjCTx) results in a significant improvement in overall survival (HR = 0.86; CI-95%: 0.75-0.97; p = 0.017) compared to the standard treatment of surgery ± radiatherapy alone. Combined treatment with regional hyperthermia and neoadjuvant chemotherapy (HTx+nadjCTx) also improves OS (HR = 0.45; CI-95%: 0.20-1.00; p = 0.049). Preoperative chemotherapy alone (nadjCTx) as well as perioperative chemotherapy (periopCTx) resulted both in non-statistically significant improvements in OS (HR = 0.61; CI-95%: 0.29-1.29; p = 0.195) and (HR = 0.48; CI-95%: 0.15-1.55; p = 0.218). Histology-tailored neoadjuvant chemotherapy (tNaCTx) also showed no effect on overall survival (HR = 1.08; CI-95%: 0.45-2.61; p = 0.868). The analysis of DFS, LRFI and DRFI disclosed a similar pattern between the different treatment regimens. Conclusions: The addition of cytotoxic chemotherapy in resectable high-risk soft tissue sarcomas provides a measurable benefit in overall survival. Shifting of systemic therapy to the neoadjuvant setting and combination with regional hyperthermia might be favored. Predictive clinical and molecular markers are needed to evaluate and limit potentional risks prospectively going forward.