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American Journal of Clinical Oncology

Somedeb Ball, Timothy J Brown, Avash Das, Rohan Khera, Sahil Khanna, Arjun Gupta
INTRODUCTION: Neutropenic diets are commonly prescribed to cancer patients with neutropenia with the intention of reducing rates of infection. These diets are restrictive and are associated with lower patient satisfaction and possibly malnutrition. Further, it is unclear if these restrictive diets are effective in reducing infection. We performed a meta-analysis on the rates of infection reported in trials comparing the neutropenic diet to unrestricted diets in cancer patients with neutropenia...
January 8, 2019: American Journal of Clinical Oncology
Andrew J Bishop, J Andrew Livingston, Dejka M Araujo, Bryan S Moon, Shreyaskumar Patel, Wei-Lien Wang, Alexander J Lazar, Christina L Roland, B Ashleigh Guadagnolo
OBJECTIVE: We evaluated our experience treating patients with extraskeletal osteosarcoma (ESOS) using combined modality local therapy, including surgery and radiation therapy (RT), to investigate local control (LC) and other survival endpoints. METHODS: We reviewed the records of 21 consecutive patients with nonmetastatic, ESOS treated with RT in combination with surgery at our institution from 1984 to 2015. Postoperative RT was used for 10 patients (48%) to a median dose of 60 Gy (range, 60 to 68 Gy)...
January 4, 2019: American Journal of Clinical Oncology
Sara Moore, Bonnie Leung, Jonn Wu, Cheryl Ho
OBJECTIVES: Metastatic non-small cell lung cancer (NSCLC) has a poor prognosis. Most patients present with stage IV, and many patients treated curatively with stage I to III develop recurrent metastatic disease. It is unknown whether the natural history differs between patients with recurrent versus de novo metastatic NSCLC. We hypothesized that de novo metastatic status is associated with decreased overall survival compared with recurrent metastatic disease. MATERIALS AND METHODS: A retrospective review was completed of all patients with NSCLC referred to BC Cancer from 2005 to 2012...
January 2, 2019: American Journal of Clinical Oncology
Kevin J Zhang, Greg Dyson, Joshua L Gatz, Michael E Silverman, Anteneh A Tesfaye, Anthony F Shields, Philip A Philip
OBJECTIVES: Adenocarcinoma of the pancreas represents the third leading cause of cancer-related death in the United States. Drug combinations, FOLFIRINOX (5-FU, leucovorin, irinotecan, and oxaliplatin) and gemcitabine/nab-paclitaxel, showed a clinically meaningful benefit when compared with single-agent gemcitabine in phase III trials. The goal of this study was to investigate whether there was an increase in overall survival (OS) for patients treated for metastatic pancreatic cancer after the introduction of the above regimens...
December 31, 2018: American Journal of Clinical Oncology
Jeffrey M Ryckman, Swati M Surkar, Waqar Haque, E Brian Butler, Bin S Teh, Vivek Verma
INTRODUCTION: Adjuvant management of anaplastic oligodendrogliomas (AOs) and anaplastic oligoastrocytomas (AOAs) is guided by 2 seminal phase III trials, one of which utilized radiotherapy (RT) followed by chemotherapy (CT) (RT-CT), and the other in which CT was followed by RT (CT-RT). Both paradigms are endorsed by the National Comprehensive Cancer Network because no direct comparison in the first-line (nonprogressive) setting has been performed to date. This study of a contemporary national database sought to evaluate practice patterns and outcomes between both approaches...
December 27, 2018: American Journal of Clinical Oncology
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Alessandra Casuccio
AIM: The aim of this study was to assess the factors which influence the care pathway after discharge from an acute palliative supportive care unit (APSCU). METHODS: Patients' demographics, indications for admission, kind of admission, the presence of a caregiver, awareness of prognosis, data on anticancer treatments in the last 30 days, ongoing treatment (on/off or uncertain), the previous care setting, analgesic consumption, and duration of admission were recorded...
December 27, 2018: American Journal of Clinical Oncology
Nikhil V Kamat, Lynn Million, Dong-Han Yao, Sarah S Donaldson, David G Mohler, Matt van de Rijn, Raffi S Avedian, Daniel S Kapp, Kristen N Ganjoo
BACKGROUND: As a diagnosis of exclusion, Undifferentiated Pleomorphic Sarcoma (UPS) has unclear clinical characteristics. The objective of this retrospective cohort study is to investigate which clinical and prognostic factors of primary lower-extremity UPS will determine failure. METHODS: We retrospectively reviewed 55 primary lower-extremity UPS cases treated at Stanford between 1998 and 2015. Overall Survival (OS) and Disease-Free Survival (DFS) curves were calculated...
December 15, 2018: American Journal of Clinical Oncology
Blair Murphy, Joshua Walker, Solange Bassale, Debra Monaco, Jerry Jaboin, Jeremy Ciporen, Matthew Taylor, Charlotte Dai Kubicky
OBJECTIVES: The anti-CTLA-4 and antiprogrammed cell death-1 (PD-1) therapies have significantly improved survival of patients with metastatic melanoma. However, there is limited data regarding the interaction between immunotherapy (IT) and stereotactic radiosurgery (SRS) in patients with brain metastasis, particularly how combination therapy may affect toxicity and intracranial tumor control. METHODS: We retrospectively reviewed 26 patients with metastatic melanoma who received immune check point inhibitors and SRS for brain metastasis from 2011 to 2017...
December 14, 2018: American Journal of Clinical Oncology
Hind Rafei, Faysal Haroun, Imad A Tabbara
Multiple myeloma (MM) is a B-cell malignancy characterized by the abnormal proliferation of clonal plasma cells in the bone marrow leading to end-organ manifestations. Despite the advancement in the therapy and care of patients with MM, relapse and resistance to standard therapy remain significant. The development of immunotherapy as a treatment modality for many types of cancers has led investigators to explore its use in MM in order to elicit myeloma-targeted immune responses, especially given that immune dysregulation is an underlying feature in the pathogenesis and progression of MM...
December 14, 2018: American Journal of Clinical Oncology
Camille C Gunderson, Britt K Erickson, Ivy Wilkinson-Ryan, Sara K Vesely, Charles A Leath, Paola A Gehrig, Kathleen N Moore
BACKGROUND: The Multinational Association of Supportive Care of Cancer (MASCC) risk-index score has been validated as a stratification tool for febrile neutropenia (FN) risk in a heterogeneous group of cancer patients; recently, it has been deemed a suitable tool in gynecologic oncology patients in a retrospective study. This is a prospective multi-institutional study wherein we sought to validate MASCC score for stratifying FN morbidity in gynecologic oncology patients. METHODS: IRB approval was obtained at 4 institutions for prospective data collection of gynecologic cancer patients admitted with FN from 3/1/2013 to 9/1/2014...
December 14, 2018: American Journal of Clinical Oncology
Rafael L Batista, Nina R C Musolino, Valter A S Cescato, Gilberto O da Silva, Raphael S S Medeiros, Clarissa G B Herkenhoff, Ericka B Trarbach, Malebranche B Cunha-Neto
BACKGROUND: Complete tumor removal by transsphenoidal surgery is usually difficult for large nonfunctioning pituitary adenomas (NFPAs). A validated medical treatment may be useful for their management. This study evaluates the clinical efficacy of the dopaminergic agonist cabergoline for residual NFPA. DESIGN, SETTING, AND PARTICIPANTS: We conducted a randomized, parallel, open-label clinical trial that compared cabergoline with nonintervention in patients with residual NFPA after transsphenoidal surgery over 2 years...
December 11, 2018: American Journal of Clinical Oncology
Zhaohui Jin, Marie Holubek, William R Sukov, Christopher A Sattler, Anne E Wiktor, Robert B Jenkins, Tsung-Teh Wu, Harry H Yoon
BACKGROUND: Our purpose was to evaluate the prognostic impact of pathologically confirmed esophageal adenosquamous carcinoma (ASC) and its association with HER2 status and clinicopathologic characteristics. METHODS: Among 796 patients with esophageal or gastroesophageal junction adenocarcinoma who underwent curative resection, surgical pathology reports were reviewed, and suspected ASC was confirmed utilizing p63 and CK5/6 immunostaining. HER2 status was determined using immunohistochemistry and fluorescence in situ hybridization...
December 3, 2018: American Journal of Clinical Oncology
Neha P Amin, Jill Remick, Manuj Agarwal, Nina A Desai, Carmen Bergom, Charles B Simone
OBJECTIVE: The objective of this study was to report on US radiation oncologists' (ROs) practice patterns and perceptions of concurrent radiation (RT) and immunotherapy (IT) (CRI). METHODS: A 22-question survey was emailed to radiation oncologists in February 2018. CRI was defined as RT completed within 1 week before initial IT infusion through 4 weeks after final IT infusion. RESULTS: Of the 323 respondents from 45 states, 88% had experience treating a patient with CRI, including 51% private and 48% academic physicians...
December 3, 2018: American Journal of Clinical Oncology
Erica S Tsang, Hui-Li Wong, Ying Wang, Daniel J Renouf, Winson Y Cheung, Howard J Lim, Sharlene Gill, Jonathan M Loree, Hagen F Kennecke
OBJECTIVES: There is limited randomized data to guide second-line chemotherapy selection in advanced pancreatic cancer (APC). We aimed to characterize predictors and outcomes of second-line chemotherapy in patients with APC. METHODS: We identified all patients with APC [locally advanced (LAPC) or metastatic (MPC)] who received ≥1 cycle of first-line chemotherapy between January 2012 and December 2015 across 6 cancer centers in British Columbia, Canada. Baseline characteristics and survival outcomes were summarized...
November 28, 2018: American Journal of Clinical Oncology
Julieta Leone, Ariel O Zwenger, Bernardo A Leone, Carlos T Vallejo, José P Leone
OBJECTIVES: To analyze differences in overall survival (OS) between male breast cancer (MBC) and female breast cancer (FBC) according to tumor subtype compared with other factors. MATERIALS AND METHODS: We evaluated men and women with breast cancer between 2010 and 2013 with known hormone receptor (HR) status and human epidermal growth factor receptor 2 (HER2) status reported to the National Cancer Institute's Surveillance, Epidemiology, and End Results program...
November 28, 2018: American Journal of Clinical Oncology
Shing Fung Lee, Ting Ying Ng, Frank Chi Sing Wong
OBJECTIVES: Previous studies reported that prognostic nutritional index (PNI), a marker of host inflammatory and nutritional status, is associated with prognoses in a number of cancer types. Thus, we investigated PNI at diagnosis as a prognostic factor in FL. METHODS: We reviewed FL patients in Tuen Mun Hospital, Hong Kong from 2000 to 2014 (n=88). PNI was calculated by serum albumin (g/L)+5×absolute lymphocyte count (10/L). We determined the best PNI cut-off value using receiver-operating characteristic curves...
November 28, 2018: American Journal of Clinical Oncology
Taylor R Cushman, Sherif G Shaaban, Amy C Moreno, Chi Lin, Vivek Verma
PURPOSE: Patients with unresectable cT4b esophageal cancer (EC) are rare and largely excluded from prospective trials. As a result, current treatment recommendations are based on limited evidence. This study sought to evaluate national practice patterns and outcomes for this population and evaluated 3 primary cohorts: patients receiving chemotherapy (CT) with or without subtherapeutic radiotherapy (RT), definitive chemoradiotherapy (CRT), or CT with or without RT followed by definitive surgery...
November 28, 2018: American Journal of Clinical Oncology
Liat Hammer, Menahem Laufer, Zohar Dotan, Raya Leibowitz-Amit, Raanan Berger, Shira Felder, Ilana Weiss, Yaacov Richard Lawrence, Zvi Symon
PURPOSE/OBJECTIVES: The main purpose of this study was to report treatment outcomes of definitive image-guided accelerated hypofractionated radiation therapy for elderly patients with muscle-invasive bladder cancer unsuitable for surgery or trimodality therapy. MATERIALS AND METHODS: Patients with confirmed muscle-invasive or high-risk T1 transitional cell carcinoma of the bladder, stage T1-T4aN0M0, who underwent transurethral resection of bladder tumor were irradiated with 45 Gy in 15 fractions...
November 16, 2018: American Journal of Clinical Oncology
Justine Philteos, Brij S Karmur, Alireza Mansouri
Gliomas, that do not respond to alkylating agent chemotherapy, can be made more sensitive to chemotherapy through promotor mediated epigenetic silencing of the MGMT gene. MGMT is one of the important markers in glioblastomas as it not only predicts response to therapy but may also be used as an independent prognostic marker. As such, MGMT is gaining increasing traction in diagnosis, prognostication, and therapeutic decision-making for these highly malignant gliomas. Although, MGMT promotor methylation status is becoming more commonly used in neuro-oncology; this test remains imperfect...
November 15, 2018: American Journal of Clinical Oncology
Shrinivas Rathod, Rashmi Koul, Bashir Bashir, Amitava Chowdhury, Arbind Dubey
With the obvious benefit from low dose computed tomography to reduce the lung cancer-specific mortality, lung cancer screening is on the rise. With the implementation of the screening programs, diagnosis of early stage lung cancer is expected to increase, and small cell lung cancer (SCLC) would account for 10% of screen-detected lung cancer. Apart from Concurrent chemoradiation (CRT), the present guidelines virtually do not support other options for radiation (RT). There is a paucity of data addressing the role of Stereotactic Body Radiation Therapy (SBRT) in SCLC and we conducted the current systematic review on this topic...
November 8, 2018: American Journal of Clinical Oncology
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