Monday, October 28, 2013
National Guideline Clearinghouse | Guidelines on urothelial carcinomas of the upper urinary tract.
Blogger's Note: of interest to Lynch Syndrome patients; this guideline published by the NGC was previously published in full early 2013, however, this format is simpler to read
National Guideline Clearinghouse | Guidelines on urothelial carcinomas of the upper urinary tract.
EvidenceUpdates/Professional commentaries: Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysis
EvidenceUpdates
INTERPRETATION: Continuing widespread use of vitamin D for osteoporosis prevention in community-dwelling adults without specific risk factors for vitamin D deficiency seems to be inappropriate.
Sunday, October 27, 2013
Pancreatic Atrophy — A New Late Toxic Effect of Sorafenib
NEJM
" We report reproducible evidence of irreversible pancreatic atrophy in two patients after long-term treatment with sorafenib."
Placebo and Nocebo Effects in Randomized Controlled Trials: The Implications for Research and Practice
abstract
Placebo
and nocebo effects are known to contribute significantly to the
response to symptom control, including analgesia. Clinical trial
methodologies using placebo controls are designed to identify the
magnitude of these effects in the research context. An adequately
powered, randomized, double-blind, placebo-controlled trial of ketamine
in cancer pain has recently been reported, which demonstrated no net
clinical benefit for ketamine over and above that of placebo. Rates of
placebo and nocebo responses were high. The setting of a clinical trial
provides an opportunity to quantify the nonpharmacologic aspects of
patient responses to analgesia, raising important clinical and ethical
issues for practice. The findings of the ketamine study are analyzed in
the context of a methodological discussion of placebo and nocebo
effects, what is known about the biological and psychological bases for
each of these, and their implications for a clinical trial design in the
palliative care setting. Along with reviewing the use of ketamine after
this negative trial, clinicians need to remain aware of the strength
and significance of both placebo and nocebo responses in their own
practices and the biopsychosocial complexity of why and how patients
actually respond to pain management strategies. The results of this
study strongly reinforce the importance of the therapeutic relationship
and the context of care.
New Approaches to Understand Cognitive Changes Associated With Chemotherapy for Non-Central Nervous System Tumors
abstract
Context
Researchers
have described a constellation of cognitive deficits (e.g., impairments
in executive functions, working memory, attention, and
information-processing speed) associated with cancer treatment, and
specifically chemotherapy, for non-central nervous system tumors.
However, findings have been inconsistent, largely because of measurement
and study design issues.
Objectives
To
propose ways for researchers to more clearly delineate and characterize
the mild cognitive deficits and related outcomes that appear to affect a
subset of cancer patients and suggest methods to make more effective
use of the existing data to understand risk factors for impaired
neuropsychological functioning.
Methods
We
examined the literature on the relationship between chemotherapy and
cognitive impairment, as well as related literature on
neuropsychological measurement, structural and functional neuroimaging,
alternative measures of health outcomes, and integrative data analysis.
Results
A
more comprehensive picture of cognitive functioning might be obtained
by incorporating nontraditional ecological measures, self-reports,
computational modeling, new neuroimaging methods, and markers of
occupational functioning. Case-control and integrative data analytic
techniques potentially could leverage existing data to identify risk
factors for cognitive dysfunction and test hypotheses about the etiology
of these effects.
Conclusion
There
is a need to apply new research approaches to understand the real-world
functional implications of the cognitive side effects of chemotherapy
to develop and implement strategies to minimize and remediate these
effects before, during, and after cancer treatment.
Changes in Symptom Intensity Among Cancer Patients Receiving Outpatient Palliative Care
abstract
Context
Symptom
changes are usually reported using summary statistics such as mean
and/or median, which may obscure the treatment effect.
Objectives
The
main objective of this retrospective study was to determine the
magnitude of symptom changes as assessed by the Edmonton Symptom Assessment System (ESAS) also after outpatient palliative care at the first
follow-up visit.
Methods
We
reviewed 1612 consecutive patients with cancer who were referred to the
outpatient Supportive Care Center and who completed the ESAS at the
initial and first follow-up visits between January 2003 and December
2010. All patients received interdisciplinary care led by the palliative
care specialists following an institutional protocol.
Results
The
distribution of the magnitude of symptom changes was stratified by
baseline intensities. Patterns were similar for different ESAS items. At
the follow-up visit (median: 15 days later), 52–74% of patients showed a
decrease of one or more points in the ESAS score. However, 48–80% of
patients with moderate/severe intensity at baseline complained of
symptoms with an ESAS score of four or more after outpatient palliative
care. Symptoms with absent/mild intensity worsened, ranging from a mean
of −3.04 to 0.12 at the first follow-up visit, whereas symptoms with
moderate/severe intensity improved from −0.2 to 3.86 (P < 0.001).
Conclusion
A
considerable proportion of patients with moderate or severe intensity
at baseline still had symptoms with an ESAS score of four or more.
Patients with absent/mild intensities at baseline complained of symptom
exacerbation at the first follow-up visit. Various strategies are needed
to optimize symptom control in advanced cancer.
selected open access publications: search terms - 'ovarian cancer' '2013'
Hindawi Publishing Corporation
about us
Search Results [1–10 of 26 articles]
Ovarian and Breast Cancer Spheres Are Similar in Transcriptomic Features and Sensitive to Fenretinide, Haiwei Wang, Yuxing Zhang, and Yanzhi Du
BioMed Research International
Volume 2013 (2013), Article ID 510905, 11 pages
New Hypothesis on Pathogenesis of Ovarian Cancer Lead to Future Tailored Approaches, P. Rescigno, I. Cerillo, R. Ruocco, C. Condello, S. De Placido, and M. Pensabene
BioMed Research International
Volume 2013 (2013), Article ID 852839, 13 pages
Clinicopathological Impact of ABCC1/MRP1 and ABCC4/MRP4 in Epithelial Ovarian Carcinoma, Marina Bagnoli, Giovanni L. Beretta, Laura Gatti, Silvana Pilotti, Paola Alberti, Eva Tarantino, Mattia Barbareschi, Silvana Canevari, Delia Mezzanzanica, and Paola Perego
BioMed Research International
Volume 2013 (2013), Article ID 143202, 7 pages
Detection of MUC1-Expressing Ovarian Cancer by C595 Monoclonal Antibody-Conjugated SPIONs Using MR Imaging, Daryoush Shahbazi-Gahrouei and Mohammad Abdolahi
The Scientific World Journal
Volume 2013 (2013), Article ID 609151, 7 pages
Meta-Analysis of Microarray Data Identifies GAS6 Expression as an Independent Predictor of Poor Survival in Ovarian Cancer, Michelle Buehler, Brian Tse, Alix Leboucq, Francis Jacob, Rosmarie Caduff, Daniel Fink, Darlene R. Goldstein, and Viola Heinzelmann-Schwarz
BioMed Research International
Volume 2013 (2013), Article ID 238284, 9 pages
Molecular Profiling Predicts the Existence of Two Functionally Distinct Classes of Ovarian Cancer Stroma, Loukia N. Lili, Lilya V. Matyunina, L. DeEtte Walker, Benedict B. Benigno, and John F. McDonald
BioMed Research International
Volume 2013 (2013), Article ID 846387, 9 pages
Ovarian Cancer Stem Cells: A New Target for Cancer Therapy, Qinglei Zhan, Chunmei Wang, and Saiming Ngai
BioMed Research International
Volume 2013 (2013), Article ID 916819, 10 pages
Microvesicles as Potential Ovarian Cancer Biomarkers, Ilaria Giusti, Sandra D’Ascenzo, and Vincenza Dolo
BioMed Research International
Volume 2013 (2013), Article ID 703048, 12 pages
Serum Anti-Müllerian Hormone Levels in Patients with Epithelial Ovarian Cancer, Pawel Walentowicz, Pawel Sadlecki, Magdalena Krintus, Grazyna Sypniewska, Aneta Mankowska-Cyl, Marek Grabiec, and Malgorzata Walentowicz-Sadlecka
International Journal of Endocrinology
Volume 2013 (2013), Article ID 517239, 6 pages
MDR Gene Expression Analysis of Six Drug-Resistant Ovarian Cancer Cell Lines, Radosław Januchowski, Karolina Wojtowicz, Patrycja Sujka-Kordowska, Małgorzata Andrzejewska, and Maciej Zabel
BioMed Research International
Volume 2013 (2013), Article ID 241763, 10 pages
Search Results [11–20 of 26 articles]
Cumulative Genetic Risk Predicts Platinum/Taxane-Induced Neurotoxicity (ovarian cancer patients)
abstract
Purpose: The combination
of a platinum and taxane are standard of care for many cancers, but the
utility is often limited due to debilitating
neurotoxicity. We examined whether
single-nucleotide polymorphisms (SNP) from annotated candidate genes
will identify genetic
risk for chemotherapy-induced neurotoxicity.
Patients and Methods: A
candidate–gene association study was conducted to validate the relevance
of 1,261 SNPs within 60 candidate genes in 404
ovarian cancer patients receiving platinum/taxane
chemotherapy on the SCOTROC1 trial. Statistically significant variants
were
then assessed for replication in a separate 404
patient replication cohort from SCOTROC1.
Results: Significant associations with chemotherapy-induced neurotoxicity were identified and replicated for four SNPs in SOX10, BCL2, OPRM1, and TRPV1.
The population attributable risk for each of the four SNPs ranged from
5% to 35%, with a cumulative risk of 62%. According
to the multiplicative model, the odds of developing
neurotoxicity increase by a factor of 1.64 for every risk genotype.
Patients
possessing three risk variants have an estimated OR
of 4.49 (2.36–8.54) compared to individuals with 0 risk variants.
Neither
the four SNPs nor the risk score were associated
with progression-free survival or overall survival.
Ovarian Sertoli--Leydig cell tumors: MRI findings and pathological correlation
open access
Background
To investigate the magnetic resonance imaging (MRI) characteristics of ovarian Sertoli-Leydig
cell tumors (SLCT).
Methods
The clinical, MRI and pathological findings of five cases of SLCT were reviewed retrospectively.
MRI appearances of tumors including laterality, shape and size, architecture, wall,
septa and vegetation, signal intensity and contrast-enhancement pattern were evaluated
and correlated with pathological findings.
Results
Two tumors were solid which appeared as low signal intensity on T1-weighted imaging
(T1WI) and moderate on T2-weighted imaging (T2WI) with multiple small cysts in one
of them. The remaining three SLCT were multilocular cystic with the irregularly thickened
wall and septa, and with solid area and mural nodules in one of them. The cystic components
had the same signal intensity as urine. All the solid components were intensely enhanced
after administration of contrast medium. All five tumors were pathologically intermediate
differentiation and at FIGO stage I.
Conclusions
SLCT demonstrate variable MRI morphological appearances. However, the irregularly
thickened wall and septa, the moderate T2WI signal intensity and obvious enhancement
in the solid components are three MRI features.
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.
Background
Sertoli-Leydig cell tumors (SLCT) of ovary are a rare type but well defined clinicopathologic entity of sex cord-stromal tumors, accounting for less than 0.5% of ovarian neoplasms [1]. These tumors are histopathologically characterized by the presence of variable proportions of Sertoli and Leydig cells. Most SLCT occur in young women and are at stage I (International Federation of Gynecology and Obstetrics, FIGO) [2]. Conservative surgery is acceptable for young patients who wish to preserve fertility without compromising 5-year disease-specific
survival [3]. Some clinicopathological studies of SLCT have been reported. To our knowledge, however, only three imaging case reports have been published [4-6]. The present study described the magnetic resonance imaging (MRI) appearances of five patients with SLCT by correlated with pathological findings, with the aim to be familiar with the imaging
appearances of this entity and improve the accuracy of preoperative diagnosis.....
NCCAM/NCI Phase 1 Study of Mistletoe Extract and Gemcitabine in Patients with Advanced Solid Tumors (breast/colorectal/lung/pancreatic)
Mistletoe Extract and Gemcitabine - open access
Conclusion
The combination of mistletoe and gemcitabine was well tolerated and treatment compliance was high. The MTD was gemcitabine 1380 mg/m2 weekly on day one and eight of a 3-week cycle combined with mistletoe 250 mg daily. Gemcitabine pharmacokinetics were not affected by mistletoe. The lack of febrile neutropenia even at higher gemcitabine doses is noteworthy. The formation of ML antibodies is common. A consistent effect of the study regimen on the serum levels of selected cytokines could not be demonstrated. Clinical response of the combination appeared to be similar to single agent gemcitabine reported previously.
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