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https://www.readbyqxmd.com/read/28731945/the-changing-paradigm-of-radiotherapy-in-the-elderly-population
#1
Myer Raphael Pfeffer, Philip Blumenfeld
There is increasing awareness of the special needs for care of the elderly cancer patient. Newer precise conformal radiotherapy techniques allow the safe delivery of higher doses of radiotherapy to the target tumor while reducing the dose to surrounding critical organs. This has led to a shortening of radiotherapy protocols for both curative and palliative indications. We review these novel techniques and protocols and the published clinical studies that include elderly patients treated with these techniques...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28725249/two-years-results-of-electronic-brachytherapy-for-basal-cell-carcinoma
#2
Rosa Ballester-Sánchez, Olga Pons-Llanas, Cristian Candela-Juan, Blanca de Unamuno-Bustos, Francisco Javier Celada-Alvarez, Alejandro Tormo-Mico, Jose Perez-Calatayud, Rafael Botella-Estrada
PURPOSE: The use of radiation therapy (RT) for non-melanoma skin cancer (NMSC) has been changing throughout the last century. Over the last decades, the use of radiotherapy has surged with the development of new techniques, applicators, and devices. In recent years, electronic brachytherapy (eBT) devices that use small x-ray sources have been introduced as alternative to radionuclide dependence. Nowadays, several devices have been incorporated, with a few series reported, and with a short follow-up, due to the recent introduction of these systems...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28709816/-current-knowledge-on-perioperative-treatments-of-non-small-cell-lung-carcinomas
#3
REVIEW
S Brosseau, C Naltet, M Nguenang, V Gounant, P Mordant, B Milleron, Y Castier, G Zalcman
Surgery is still the main treatment in early-stage of non-small cell lung cancer with 5-year survival of stage IA patients exceeding 80%, but 5-year survival of stage II patients rapidly decreasing with tumor size, N status, and visceral pleura invasion. The major metastatic risk in such patients has supported clinical research assessing systemic or loco-regional perioperative treatments. Modern phase 3 trials clearly validated adjuvant or neo-adjuvant platinum-based chemotherapy in resected stage I-III patients as a standard treatment of which value has been reassessed several independent meta-analyses, showing a 5% benefit in 5y-survival, and a decrease of the relative risk for death around from 12 to 25%...
July 11, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28706761/rapidly-fatal-radiation-induced-glioblastoma
#4
Ivy Ng, Char Loo Tan, Tseng Tsai Yeo, Balamurugan Vellayappan
Glioblastoma (GBM) typically occurs as a primary tumour (i.e., primary GBM) and predominantly affects elderly patients. The remaining ~10% occur as a result of malignant progression from lower grade astrocytic tumours (i.e., secondary GBM). Although there are no certain causative environmental agents, prior radiation exposure may play a role. We report on a patient who had been treated six years prior for a vestibular schwannoma with high-dose conventional radiotherapy and subsequently developed a rapidly fatal glioblastoma at the same location...
June 11, 2017: Curēus
https://www.readbyqxmd.com/read/28705182/chemoradiation-in-elderly-esophageal-cancer-patients-rationale-and-design-of-a-phase-i-ii-multicenter-study-osage
#5
Stéphanie Servagi-Vernat, Gilles Créhange, Franck Bonnetain, Cécile Mertens, Etienne Brain, Jean François Bosset
BACKGROUND: The management of elderly patients with cancer is a therapeutic challenge and a public health problem. Definitive chemoradiotherapy (CRT) is an accepted standard treatment for patients with locally advanced esophageal cancer who cannot undergo surgery. However, there are few reports regarding tolerance to CRT in elderly patients. We previously reported results for CRT in patients aged ≥75 years. Following this first phase II trial, we propose to conduct a phase I/II study to evaluate the combination of carboplatin and paclitaxel, with concurrent RT in unresectable esophageal cancer patients aged 75 years or older...
July 13, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28698783/lenalidomide-and-temozolomide-combination-in-a-very-elderly-patient-with-cns-relapse-of-diffuse-large-b-cell-lymphoma
#6
Emanuele Cencini, Alberto Fabbri, Umberto Arrigucci, Alfonso Cerase, Monica Bocchia
Central nervous system (CNS) relapse is an infrequent but severe complication for DLBCL patients, associated with poor prognosis. Intravenous prophylaxis with high-dose methotrexate has shown promising results but is rarely feasible in elderly and/or nephropathic patients. A 83 years old woman with CNS relapse occurred 6 months after chemoimmunotherapy. The patient was defined ineligible for radiotherapy (RT) and started oral Temozolomide 250mg daily for 5 consecutive days without any improvement after 1st cycle...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28697858/accelerated-partial-breast-irradiation-for-elderly-women-with-early-breast-cancer-a-compromise-between-whole-breast-irradiation-and-omission-of-radiotherapy
#7
Shakeel Sumodhee, Johan Levy, Emmanuel Chamorey, Daniel Lam Cham Kee, Marie-Eve Chand, Mathieu Gautier, Isabelle Peyrottes, Emmanuel Barranger, Jean-Michel Hannoun-Levi
PURPOSE: Regarding adjuvant radiation therapy making decision for elderly women, Albert (2013) published a nomogram predicting the mastectomy-free survival (MFS) rate with or without adjuvant irradiation. Based on this approach, we proposed to investigate the use of accelerated partial breast irradiation (APBI) vs. whole breast irradiation (WBI) or endocrine therapy alone in elderly low-risk breast cancer patients. METHODS AND MATERIALS: For each elderly woman treated by conserving surgery and APBI (multicatheter interstitial high-dose-rate brachytherapy), 5- and 10-year MFS rates were calculated...
July 8, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28693792/cholangiocarcinoma
#8
REVIEW
Michela Squadroni, Luca Tondulli, Gemma Gatta, Stefania Mosconi, Giordano Beretta, Roberto Labianca
Biliary tract cancer accounts for <1% of all cancers and affects chiefly an elderly population, with predominance in men. We distinguish cholangiocarcinoma (intrahepatic, hilar and distal) and gallbladder cancer, with different pathogenesis and prognosis. The treatment is based on surgery (whenever possible), radiotherapy in selected cases, and chemotherapy. The standard cytotoxic treatment for advanced/metastatic disease is represented by the combination of gemcitabine and cisplatin, whereas fluoropyrimidines are generally administered in second line setting...
August 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28685404/analysis-of-factors-influencing-the-access-to-concomitant-chemo-radiotherapy-in-elderly-patients-with-high-grade-gliomas-role-of-mmse-age-and-tumor-volume
#9
Andrea Di Cristofori, Barbara Zarino, Claudia Fanizzi, Giorgia Abete Fornara, Giulio Bertani, Paolo Rampini, Giorgio Carrabba, Manuela Caroli
High grade gliomas (HGG) are tumors with a rapidly progressive course and the standard of care consists of surgery and chemo-radiotherapy. Elderly patients with HGG usually have a worse prognosis due to their comorbidities and difficulties in accessing or completing adjuvant treatments. The purpose of our study was to assess the influence of pre-operative factors (MMSE, age, sex, KPS, tumor volume) on the post-operative access to chemo-radiotherapy in the elderly population. In addition, the influence of the access to adjuvant therapies on overall survival (OS) was assessed...
July 6, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28684242/-hypofractionated-stereotactic-body-radiation-therapy-for-adrenal-metastases
#10
G Dupic, J Biau, A Bellière-Calandry, M Lapeyre
Adrenal glands are a common site for metastatic spread since they represent the fourth metastatic site of solid tumors. Interest in local ablative treatments of oligometastases is growing since literature suggests better progression-free survival, quality of life and potentially overall survival in selected patients. Surgery remains the first treatment of adrenal oligometastases because results are good, with a long enough follow-up. However, stereotactic radiotherapy appears to be comparable to surgery and could be proposed to elderly, unfit, inoperable patients, or even to patients whose systemic treatment should not be suspended for too long...
July 3, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28673362/clinical-outcomes-of-retrograde-intra-arterial-chemotherapy-concurrent-with-radiotherapy-for-elderly-oral-squamous-cell-carcinoma-patients-aged-over-80%C3%A2-years-old
#11
Yuichiro Hayashi, Kenji Mitsudo, Kaname Sakuma, Masaki Iida, Toshinori Iwai, Hideyuki Nakashima, Yoshiyuki Okamoto, Toshiyuki Koizumi, Senri Oguri, Makoto Hirota, Mitomu Kioi, Izumi Koike, Masaharu Hata, Iwai Tohnai
BACKGROUND: The aim of this retrospective observational study was to evaluate toxicities, overall survival, and locoregional control in elderly oral squamous cell carcinoma patients who had undergone retrograde intra-arterial chemotherapy combined with radiotherapy. METHODS: Thirty-one elderly patients over 80 years old with oral squamous cell carcinoma were enrolled in present study. The treatment schedule consisted of intra- arterial chemotherapy (docetaxel, total 60 mg/m(2); cisplatin, total 150 mg/m(2)) and daily concurrent radiotherapy (total, 60 Gy) for 6 weeks...
July 3, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28668866/histology-based-combination-induction-chemotherapy-for-elderly-patients-with-clinical-stage-iii-non-small-cell-lung-cancer
#12
Giuseppe L Banna, Hector Josè Soto Parra, Marine Castaing, Maria Vittoria Dieci, Giuseppe Anile, Maurizio Nicolosi, Salvatore Strano, Francesco Marletta, Valentina Guarneri, Pierfranco Conte, Rohit Lal
AIM: To explore the feasibility and activity of a histology-based induction combination chemotherapy for elderly patients with clinical stage III non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients aged ≥70 years with stage IIIA and IIIB lung squamous cell carcinoma (SCC) or adenocarcinoma were treated with three cycles of carboplatin and gemcitabine or pemetrexed, respectively, followed by definitive radiotherapy or surgery. The primary endpoint was the overall response rate (ORR) following induction...
July 2017: Anticancer Research
https://www.readbyqxmd.com/read/28666541/management-of-elderly-women-with-endometrial-cancer
#13
Holm Eggemann, Tanja Ignatov, Elke Burger, Serban Dan Costa, Atanas Ignatov
BACKGROUND: Elderly women with endometrial cancer receive less therapy in comparison with their younger counterparts. The exact reason(s) for this treatment strategy remains unclear. PATIENTS AND METHODS: We performed a multicenter, retrospective registry-based study of 1550 patients with endometrial cancer. The outcome measure was the reason for not performing the indicated treatment. RESULTS: Median follow-up was 76.8months. A total of 1550 women were eligible for analysis: 353 (22...
June 27, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28664182/abdominal-radical-trachelectomy-for-vaginal-cancer-a-case-report
#14
Mari Matsuoka, Rumiko Yamamoto, Natsuki Tsuji, Koichi Terakawa, Tadayoshi Nagano
•Vaginal cancer is most common in elderly woman and very rare in young woman.•Stage I vaginal cancer is treated with surgery and radiotherapy.•Vaginal cancer in a young patient was treated by intra-arterial chemotherapy followed by abdominal radical trachelectomy.
August 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28659250/cutaneous-kaposi-sarcoma-during-treatment-with-superpotent-topical-steroids-and-methotrexate-for-bullous-pemphigoid-three-cases
#15
Raphaëlle Binois, Marion Nadal, Eric Esteve, Anne De Muret, Rémy Kerdraon, Tarik Gheit, Massimo Tommasino, Pauline Gaboriaud, Antoine Touze, Mahtab Samimi
Iatrogenic Kaposi sarcoma (KS) has previously been reported in patients with bullous pemphigoid (BP), in relation to systemic steroids. To report three cases of previously unreported cutaneous KS during treatment with superpotent topical steroids (STS) and methotrexate (MTX). All patients were elderly men with BP treated with STS for 2 to 32 months (cumulative doses: 2,700-9,150 g) before MTX was introduced (dosage: 10-12.5 mg/week). KS occurred one to nine months after the combined therapy. In one case, KS rapidly resolved after withdrawal of MTX...
June 28, 2017: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/28646345/increasing-utilization-of-regional-nodal-irradiation-in-elderly-node-positive-women-and-declining-emphasis-on-demographic-factors
#16
Jason K Molitoris, Tejan Diwanji, James W Snider, Emily C Bellavance, Susan B Kesmodel, Paula Rosenblatt, Katherine Tkaczuk, Soren M Bentzen, Randi J Cohen, Elizabeth M Nichols, Sally B Cheston, Steven J Feigenberg
PURPOSE: To evaluate the practice patterns for the use of regional nodal irradiation (RNI) in treatment of elderly women with low volume node-positive breast cancer in the setting of breast conservation surgery (BCS). METHODS: Women aged 70-89 diagnosed with unilateral, pathologic T1-2N1M0 breast cancer from 2004 to 2013, who underwent BCS and received radiotherapy were identified from the National Cancer Database. In 2011, two major trials were presented that helped define indications for RNI...
June 23, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28629376/radiation-therapy-for-older-patients-with-brain-tumors
#17
REVIEW
Giuseppe Minniti, Andrea Riccardo Filippi, Mattia Falchetto Osti, Umberto Ricardi
The incidence of brain tumors in the elderly population has increased over the last few decades. Current treatment includes surgery, radiotherapy and chemotherapy, but the optimal management of older patients with brain tumors remains a matter of debate, since aggressive radiation treatments in this population may be associated with high risks of neurological toxicity and deterioration of quality of life. For such patients, a careful clinical status assessment is mandatory both for clinical decision making and for designing randomized trials to adequately evaluate the optimal combination of radiotherapy and chemotherapy...
June 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28624714/patient-reported-outcomes-of-autologous-fat-grafting-after-breast-cancer-surgery
#18
A W W Brown, M Kabir, K A Sherman, F Meybodi, J R French, E B Elder
INTRODUCTION: Autologous fat grafting (AFG) can be used as an adjunct in breast cancer surgery to improve contour defects. Few previous studies have assessed patient reported outcomes (PROs) for AFG. This study analysed AFG use and assessed PROs in terms of physical and psychosocial well-being. MATERIALS AND METHODS: All patients undergoing AFG were identified from a prospective database and asked to complete the validated BREAST-Q questionnaire and a tool to assess patient-perceived change after AFG (5-point Likert-type scale)...
June 15, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28620141/impact-of-persistence-on-survival-of-patients-with-breast-cancer-treated-with-endocrine-therapy-in-northeast-china-a-prospective-study
#19
Peng Xing, Huiting Dong, Qun Liu, Fan Yao, Yingying Xu, Bo Chen, Xinyu Zheng, Yunfei Wu, Feng Jin, Jiguang Li
The purpose of this prospective study is to investigate the impact of endocrine treatment persistence on the survival of patients with estrogen receptor-positive breast cancer treated with endocrine therapy and identify the risk factors influencing the treatment persistence. We enrolled 1085 patients from Northeast China who were diagnosed as stage I-III, estrogen receptor-positive breast cancer between January 2007 and December 2010. The prognostic factors for disease-free survival (DFS) and overall survival (OS) of patients were identified using univariate and multivariate Cox proportional hazards regression models...
June 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28604459/definitive-chemoradiotherapy-in-elderly-cervical-cancer-patients-a-multiinstitutional-analysis
#20
Ozan Cem Guler, Sezin Yuce Sari, Sumerya Duru Birgi, Melis Gultekin, Ferah Yildiz, Cem Onal
OBJECTIVE: The aim of the study was to investigate the prognostic factors for survival and treatment-related toxicities in older (≥65 years) cervical cancer patients treated with definitive chemoradiotherapy. In addition, we sought to compare the outcomes between the older elderly (≥75 years) and their younger old counterparts (age, 65-74 years). MATERIALS AND METHODS: We retrospectively reviewed medical records from 269 biopsy-proven nonmetastatic cervical cancer patients treated with external radiotherapy and intracavitary brachytherapy at the departments of radiation oncology in 2 different universities...
June 10, 2017: International Journal of Gynecological Cancer
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