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https://www.readbyqxmd.com/read/28342938/the-impact-of-neoadjuvant-therapy-on-the-histopathological-features-of-pancreatic-ductal-adenocarcinoma-a-systematic-review-and-meta-analysis
#1
REVIEW
Stephan Schorn, Ihsan Ekin Demir, Carmen Mota Reyes, Cemil Saricaoglu, Nicole Samm, Rebekka Schirren, Elke Tieftrunk, Daniel Hartmann, Helmut Friess, Güralp Onur Ceyhan
BACKGROUND: Due to increased rates of curative tumor resections exceeding 60% after FOLFIRINOX-treatment, neoadjuvant therapy/NTx is increasingly recognized as an effective therapy option for downstaging borderline or locally advanced pancreatic ductal adenocarcinoma/PDAC. Yet, the effects of NTx on the common histopathological features of PDAC have not been systematically analysed. Therefore, the aim of the current study was to assess the impact of NTx on relevant histopathological features of PDAC...
March 14, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28335780/considerable-interobserver-variation-in-delineation-of-pancreatic-cancer-on-3dct-and-4dct-a-multi-institutional-study
#2
Eva Versteijne, Oliver J Gurney-Champion, Astrid van der Horst, Eelco Lens, M Willemijn Kolff, Jeroen Buijsen, Gati Ebrahimi, Karen J Neelis, Coen R N Rasch, Jaap Stoker, Marcel van Herk, Arjan Bel, Geertjan van Tienhoven
BACKGROUND: The delineation of pancreatic tumors on CT is challenging. In this study, we quantified the interobserver variation for pancreatic tumor delineation on 3DCT as well as on 4DCT. METHODS: Eight observers (radiation oncologists) from six institutions delineated pancreatic tumors of four patients with (borderline) resectable pancreatic cancer. The study consisted of two stages. In the 3DCT-stage, the gross tumor volume (GTV) was delineated on a contrast-enhanced scan...
March 23, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28314992/prognostic-impact-of-normalization-of-serum-tumor-markers-following-neoadjuvant-chemotherapy-in-patients-with-borderline-resectable-pancreatic-carcinoma-with-arterial-contact
#3
Yoshiaki Murakami, Kenichiro Uemura, Takeshi Sudo, Yasushi Hashimoto, Naru Kondo, Naoya Nakagawa, Kenjiro Okada, Shinya Takahashi, Taijiro Sueda
PURPOSE: The survival benefit of neoadjuvant therapy for patients with borderline resectable pancreatic carcinoma has been reported recently. However, prognostic factors for this strategy have not been clearly elucidated. The aim of this study was to clarify prognostic factors for patients with borderline resectable pancreatic carcinoma who received neoadjuvant chemotherapy. METHODS: Medical records of 66 patients with pancreatic carcinoma with arterial contact who intended to undergo tumor resection following neoadjuvant chemotherapy were analyzed retrospectively...
March 17, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28293715/a-phase-1-study-of-gemcitabine-nab-paclitaxel-s-1-gas-combination-neoadjuvant-chemotherapy-for-patients-with-locally-advanced-pancreatic-adenocarcinoma
#4
Naru Kondo, Yoshiaki Murakami, Kenichiro Uemura, Takeshi Sudo, Yasushi Hashimoto, Naoya Nakagawa, Shinya Takahashi, Hiroki Ohge, Taijiro Sueda
PURPOSE: To determine a recommended dose for a biweekly combination neoadjuvant chemotherapy including gemcitabine, nab-paclitaxel, and S-1 (GAS) for patients with locally advanced pancreatic ductal adenocarcinoma (LAPC). METHODS: Patients with borderline resectable or unresectable LAPC without distant metastasis were eligible for this study. The planned dosages of gemcitabine (mg/m(2), day 1), nab-paclitaxel (mg/m(2), day 1), and S-1 (mg/day, days 1-7) were 800/100/60-100 at level 1, and 1000/125/60-100 at level 2...
March 14, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28280624/the-concept-of-borderline-resectable-pancreatic-cancer-limited-foundations-and-limited-future
#5
John A Windsor, Savio George Barreto
Pancreatic ductal adenocarcinoma (PDAC) is traditionally treated by a surgery-first approach. The development and adoption of the concept of borderline resectable PDAC, which extends the role of surgery, is based on the proposition that neoadjuvant therapy (NAT) will increase the resection rate, margin negative rate and overall survival. There are a number of issues with this concept and a critical review of these suggests that it is based on limited foundations and likely has a limited future.
February 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28256908/assessment-with-cone-beam-computed-tomography-of-intrafractional-motion-and-interfractional-position-changes-of-resectable-and-borderline-resectable-pancreatic-tumors-with-implanted-fiducial-marker
#6
Shingo Ohira, Masaru Isono, Yoshihiro Ueda, Takero Hirata, Reiko Ashida, Hidenori Takahashi, Masayoshi Miyazaki, Masaaki Takashina, Masahiko Koizumi, Teruki Teshima
OBJECTIVES: The volume of targets to which a high radiation dose can be delivered is limited for pancreatic radiotherapy. We assessed changes in movements of pancreatic tumors between simulation and treatment, and determined compensatory margins. METHODS: For 23 patients, differences in implanted fiducial marker motion magnitude (MMM) and mean marker position (MMP) between 4DCT and CBCT were measured. Subsequently, residual uncertainty was simulated after no action level (NAL) and extended NAL (eNAL) protocols were adopted...
March 3, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28247128/the-self-care-practices-of-family-caregivers-of-persons-with-poor-prognosis-cancer-differences-by-varying-levels-of-caregiver-well-being-and-preparedness
#7
J Nicholas Dionne-Odom, Wendy Demark-Wahnefried, Richard A Taylor, Gabrielle B Rocque, Andres Azuero, Aras Acemgil, Michelle Y Martin, Meka Astin, Deborah Ejem, Elizabeth Kvale, Karen Heaton, Maria Pisu, Edward E Partridge, Marie A Bakitas
PURPOSE: Little is known about the impact of family caregiving for adults with poor prognosis cancer on caregivers' own individual self-care practices. We explored differences in caregivers' discrete self-care practices associated with varying levels of caregiver well-being, preparedness, and decision-making self-efficacy. METHODS: Cross-sectional survey within eight community-based southeastern U.S. cancer centers was conducted. Family caregivers of Medicare beneficiaries ≥65 years with pancreatic, lung, brain, ovarian, head and neck, hematologic, or stage IV cancer completed measures of individual self-care practices (health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, stress management, and sleep), well-being (anxiety, depression, and health-related quality of life [HRQoL]), preparedness, and decision-making self-efficacy...
March 1, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28237643/adjunctive-role-of-preoperative-liver-magnetic-resonance-imaging-for-potentially-resectable-pancreatic-cancer
#8
Hyoung Woo Kim, Jong-Chan Lee, Kyu-Hyun Paik, Jingu Kang, Young Hoon Kim, Yoo-Seok Yoon, Ho-Seong Han, Jaihwan Kim, Jin-Hyeok Hwang
BACKGROUND: The adjunctive role of magnetic resonance imaging of the liver before pancreatic ductal adenocarcinoma has been unclear. We evaluated whether the combination of hepatic magnetic resonance imaging with multidetector computed tomography using a pancreatic protocol (pCT) could help surgeons select appropriate candidates and decrease the risk of early recurrence. METHODS: We retrospectively enrolled 167 patients in whom complete resection was achieved without grossly visible residual tumor; 102 patients underwent pCT alone (CT group) and 65 underwent both hepatic magnetic resonance imaging and pCT (magnetic resonance imaging group)...
February 22, 2017: Surgery
https://www.readbyqxmd.com/read/28179342/phase-i-study-of-nab-paclitaxel-plus-gemcitabine-as-neoadjuvant-therapy-for-borderline-resectable-pancreatic-cancer
#9
Ken-Ichi Okada, Seiko Hirono, Manabu Kawai, Motoki Miyazawa, Atsushi Shimizu, Yuji Kitahata, Masaki Ueno, Shinya Hayami, Hiroki Yamaue
BACKGROUND/AIM: The aim of this study was to investigate the safety and feasibility of neoadjuvant nab-paclitaxel plus gemcitabine therapy for patients with borderline resectable pancreatic carcinoma (BRPC). PATIENTS AND METHODS: The study was a prospective single-center phase I trial for patients with BRPC. The primary endpoint was the toxicity, and secondary endpoints were the resection rate, the R0 resection rate and quality of life (QOL) regarding the peripheral sensory neuropathy (PSN)...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28176472/suspected-atypical-haemolytic-uraemic-syndrome-in-two-post-partum-patients-with-foetal-death-in-utero-responding-to-eculizumab
#10
REVIEW
Justin Chua, Kathy Paizis, Simon Z He, Peter Mount
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) is a rare condition with the triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Other conditions that present in a similar manner peri-partum include thrombotic thrombocytopaenic purpura, and pregnancy associated conditions including HELLP syndrome (haemolysis, elevated liver enzymes and low platelets), severe pre-eclampsia and less commonly acute fatty liver of pregnancy. CASE REPORTS: We describe two cases of suspected aHUS, who presented post-partum with foetal death-in-utero at 33 and 37 weeks respectively...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28156569/differences-in-self-care-behaviors-by-varying-levels-of-caregiving-intensity-performance-and-well-being-among-family-caregivers-of-patients-with-high-mortality-cancer
#11
Wendy Demark-Wahnefried, Richard A Taylor, Gabrielle Betty Rocque, Andres Azuero, Aras Acemgil, Michelle Y Martin, Meka Astin, Deborah Ejem, Elizabeth Ann Kvale, Karen Heaton, Maria Pisu, Edward E Partridge, Marie Bakitas
239 Background: Family caregivers of high-mortality cancer patients perform vital tasks that deter from their own self-care. We aimed to determine differences in self-care behaviors by varying levels of caregiving intensity, well-being, and performance. METHODS: Cross-sectional survey conducted in community settings of 8 cancer centers in AL, FL, and TN. Two-hundred and ninety-four family caregivers of Medicare beneficiaries diagnosed with pancreatic, lung, brain, ovarian, head & neck, hematologic, or stage IV cancer completed measures of self-care behaviors, including health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, stress management, and sleep; anxiety and depression; health-related quality of life (HRQoL); caregiver competence and preparedness; and decision-making self-efficacy...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156557/a-pilot-trial-of-early-specialty-palliative-care-for-patients-with-advanced-pancreatic-cancer-challenges-encountered-and-lessons-learned
#12
Nathan Bahary, Rene Claxton, Julie Childers, Dio Kavalieratos, Linda King, Barry C Lembersky, Seo Young Park, Greer A Tiver, Robert Arnold
110 Background: Palliative care trials face implementation barriers. We describe challenges encountered in a pilot trial of early specialty palliative care for patients with pancreatic cancer. METHODS: We conducted a mixed-methods pilot randomized controlled trial of early specialty physician-led palliative care in advanced pancreatic cancer. Recently diagnosed patients with borderline, locally-advanced, or metastatic pancreatic cancer and their caregivers (total N=60) were recruited from clinic at a comprehensive cancer center and randomized (2:1) to receive monthly specialty palliative care visits for 3 months in addition to standard oncology care vs...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28144084/should-every-patient-with-pancreatic-cancer-receive-perioperative-neoadjuvant-therapy
#13
REVIEW
Ulrich Nitsche, Bo Kong, Alexander Balmert, Helmut Friess, Jörg Kleeff
Pancreatic ductal adenocarcinoma is a highly aggressive disease, and medical as well as surgical therapeutic options are limited. This article reviews stage dependent treatment options, with a special focus on the current controversy of perioperative treatment regimens in initially borderline resectable or locally advanced patients. Neoadjuvant treatment can potentially increase the rate of complete tumor resection and may be more effective than adjuvant systemic therapy. Further, in the case of disease progression during or after neoadjuvant therapy, patients can be spared extensive surgery...
October 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28134673/tolerability-and-long-term-outcomes-of-dose-painted-neoadjuvant-chemoradiation-to-regions-of-vessel-involvement-in-borderline-or-locally-advanced-pancreatic-cancer
#14
Jennifer Y Wo, Andrzej Niemierko, David P Ryan, Lawrence S Blaszkowsky, Jeffrey W Clark, Eunice L Kwak, Keith D Lillemoe, Lorraine N Drapek, Andrew X Zhu, Jill N Allen, Jason E Faris, Janet E Murphy, Ryan Nipp, Carlos Fernandez-Del Castillo, Cristina R Ferrone, Theodore S Hong
PURPOSE: We reviewed our experience involving patients with borderline resectable or locally advanced pancreatic cancer, treated with the dose-painted (DP) boost technique to regions of vessel involvement which preclude upfront surgical resection. We evaluated patient outcomes with respect to tolerability and treatment outcomes. MATERIALS AND METHODS: We retrospectively reviewed 99 patients with borderline resectable (n=25) or locally advanced pancreatic cancer (n=74) treated with DP-neoadjuvant chemoradiation from 2010 to 2015...
January 27, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28133195/-a-case-of-borderline-resectable-pancreatic-cancer-responding-to-preoperative-gem-plus-nab-ptx-combination-chemotherapy
#15
Takuya Fujimoto, Tomio Ueno, Kazuhiko Sakamoto, Satoshi Matsukuma, Hiroto Matsui, Yoshitaro Shindo, Yukio Tokumitsu, Shinsuke Kanekiyo, Michihisa Iida, Yoshihiro Tokuhisa, Nobuaki Suzuki, Shigeru Takeda, Shigefumi Yoshino, Shoichi Hazama, Hiroaki Nagano
We report a case of borderline resectable(BR)pancreatic cancer, which was eligible for R0 resection following preoperative chemotherapy with GEM plus nab-PTX. A 77-year-old woman presented with brown urine and clay-colored stool. After further examination, she was diagnosed with obstructive jaundice due to pancreatic head cancer. Because the tumor was in contact with the region attached to the SMA nerve plexus, she was also diagnosed with BR-A pancreatic cancer. After 6 courses of preoperative GEM plus nab-PTX combination chemotherapy, she underwent subtotal stomach-preservingpancreaticoduodenectomy with SMV resection and right semicircular SMA nerve plexus dissection...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133191/-a-case-of-successful-stomach-preserving-pancreaticoduodenectomy-with-celiac-artery-resection-after-neoadjuvant-chemoradiation-therapy-for-pancreatic-cancer-with-hepatic-arterial-variation
#16
Yukie Kyakumoto, Masamichi Mizuma, Tomoya Abe, Tatsuyuki Takadate, Koji Fukase, Hideo Otsuka, Naoaki Sakata, Kei Nakagawa, Takanori Morikawa, Hiroki Hayashi, Takeshi Naitoh, Fuyuhiko Motoi, Atsushi Kanno, Tooru Shimosegawa, Michiaki Unno
Here we report a case of successful stomach-preserving pancreaticoduodenectomy with celiac artery resection for pancreatic cancer with hepatic arterial variation. A 70-year-old woman was referred to our hospital for examination and treatment of pancreatic cancer. A CT scan showed a tumor with suspected portal vein invasion at the body and head of the pancreas, in contact with the common hepatic artery and the splenic artery with 360°involvement. Contact with the celiac artery and left gastric artery was less than1 80°...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133097/-a-study-of-gemctabine-plus-nab-paclitaxel-therapy-for-advanced-local-progressive-pancreatic-cancer
#17
Yutaka Itoh, Hiroyuki Saito, Shunsuke Yamagishi, Yuki Suematsu, Miyuki Takahashi, Mao Nakayama, Michiko Fukabori, Akihiko Morita, Kazuhiko Wakabayashi
We studied the significance of gemcitabine plus nab-paclitaxel(GnP)therapy for locally progressive pancreatic cancer. We enrolled 10 patients with local progression without distant metastasis. We used GnP therapy for the ablative borderline resectable(BR)and unresectable(UR)cases based on images that followed NCCN pancreatic cancer treatment guidelines. In 1 case of resectable(R)pancreatic cancer, the tumor was located in the pancreas body but we determined that surgery was impossible because of the underlying disease detected on imaging analysis...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133093/-long-term-survival-after-locally-advanced-pancreatic-ductal-adenocarcinoma-treated-with-multidisciplinary-therapy-a-case-report
#18
Goro Ueno, Daisaku Yamada, Hidetoshi Eguchi, Tadafumi Asaoka, Takehiro Noda, Hiroshi Wada, Koichi Kawamoto, Kunihito Goto, Masaki Mori, Yuichiro Doki
A 60-year-old man visited a hospital with concerns about his physical health, including weight loss, thirst, and polyuria. He was diagnosed with acute onset of diabetes, and a pancreatic head tumor was observed on imaging studies. Computed tomography(CT)indicated that the tumor infiltrated the surrounding major vessels, portal vein(PV, 360 degrees), and superior mesenteric artery(SMA, <180 degrees). Endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)was performed, and he was diagnosed with a borderline resectable(BR)clinical Stage IV a pancreatic ductal adenocarcinoma (PDAC)...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28131667/blood-fibrinogen-levels-discriminate-low-and-high-risk-intraductal-papillary-mucinous-neoplasms-ipmns
#19
M F Nentwich, K Menzel, M Reeh, F G Uzunoglu, T Ghadban, K Bachmann, J Schrader, M Bockhorn, J R Izbicki, D Perez
BACKROUND: The risk assessment of intraductal papillary mucinous neoplasms (IPMN) to either guide patients to surgical resection or watchful waiting is still under debate. Additional markers to better separate low and high-risk lesions would improve patient selection. METHODS: Patients who underwent pancreatic resections for IPMNs between January 2008 and December 2012 with available blood samples were selected and retrospectively assessed. Data on cyst characteristics such as cyst size, duct relation and main-duct dilatation were collected and plasma fibrinogen levels were measured...
January 16, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28105634/does-radiologic-response-correlate-to-pathologic-response-in-patients-undergoing-neoadjuvant-therapy-for-borderline-resectable-pancreatic-malignancy
#20
Brent T Xia, Baojin Fu, Jiang Wang, Young Kim, S Ameen Ahmad, Vikrom K Dhar, Nick C Levinsky, Dennis J Hanseman, David A Habib, Gregory C Wilson, Milton Smith, Olugbenga O Olowokure, Jordan Kharofa, Ali H Al Humaidi, Kyuran A Choe, Daniel E Abbott, Syed A Ahmad
BACKGROUND AND OBJECTIVES: In patients with borderline resectable pancreas cancers, clinicians frequently consider radiographic response as the primary driver of whether patients should be offered surgical intervention following neoadjuvant therapy (NT). We sought to determine any correlation between radiographic and pathologic response rates following NT. METHODS: Between 2005 and 2015, 38 patients at a tertiary care referral center underwent NT followed by pancreaticoduodenectomy for borderline resectable pancreas cancer...
January 20, 2017: Journal of Surgical Oncology
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