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Thomas Hendrix Beckham, Paul Bernard Romesser, Andries Hijlke Groen, Christopher Sabol, Ashok R Shaha, Mona Sabra, Thomas Brinkman, Daniel J Spielsinger, Sean McBride, Jillian Tsai, Nadeem Riaz, R Michael Tuttle, James A Fagin, Eric J Sherman, Richard J Wong, Nancy Y Lee
BACKGROUND: Differentiated thyroid cancer typically has an indolent clinical course but can cause significant morbidity by local progression. Surgery can be difficult due to the proximity to critical normal structures in the neck. Our objective was to review the safety, feasibility, and outcomes of definitive-intent intensity modulated radiation therapy (IMRT) and to analyze whether patients receiving concurrent chemotherapy (CC-IMRT) had higher rates of disease control and survival over IMRT alone in patients with unresectable or gross residual disease (GRD)...
August 14, 2018: Thyroid: Official Journal of the American Thyroid Association
Sjors Klompmaker, Ugo Boggi, Thilo Hackert, Roberto Salvia, Matthew Weiss, Hiroki Yamaue, Herbert J Zeh, Marc G Besselink
Approximately 30% of all pancreatic cancer patients have locally advanced (AJCC stage 3) disease. A sub-group of these patients-where the cancer only involves the celiac axis-may benefit from distal pancreatectomy with celiac axis resection (DP-CAR). Previous studies have shown that DP-CAR offers a survival benefit to a selected group of patients with otherwise unresectable pancreatic cancer, when performed by experienced pancreatic cancer treatment teams at high-volume centers. This article proposes a standardized approach to DP-CAR, including routine neoadjuvant (FOLFIRINOX) chemotherapy...
August 13, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Takayuki Oishi, Kazuki Sato, Tatsuya Morita, Jennifer W Mack, Hideki Shimodaira, Masanobu Takahashi, Shin Takahashi, Akira Inoue, Yasuko Murakawa, Masanori Kawahara, Chikashi Ishioka, Mitsunori Miyashita
Background: Although reports have described the perceptions of curability among patients with unresectable/recurrent cancer and the quality of death and dying, the association between patients' perceptions and physicians' disclosures of incurability remained unexplored. This survey aimed to evaluate the association between patients' perceptions of curability and physicians' disclosures of incurability. Methods: In this cross-sectional, multicenter, observational study in Japan, we asked outpatients with unresectable/recurrent solid cancers about their perceptions of incurability...
August 9, 2018: Japanese Journal of Clinical Oncology
Daiki Kayano, Seigo Kinuya
Metaiodobenzylguanidine (MIBG) is structurally similar to the neurotransmitter norepinephrine and specifically targets neuroendocrine cells including some neuroendocrine tumors. Iodine-131 (I-131)-labeled MIBG (I-131 MIBG) therapy for neuroendocrine tumors has been performed for more than a quarter-century. The indications of I-131 MIBG therapy include treatment-resistant neuroblastoma (NB), unresectable or metastatic pheochromocytoma (PC) and paraganglioma (PG), unresectable or metastatic carcinoid tumors, and unresectable or metastatic medullary thyroid cancer (MTC)...
August 2018: Nuclear Medicine and Molecular Imaging
F Huguet, E Rivin Del Campo, D Antoni, V Vendrely, P Hammel
At diagnosis, about 15% of patients with pancreatic cancer present with a resectable tumour, 50% have a metastatic tumour, and 25% a locally advanced tumor (non-metastatic but unresectable due to vascular invasion) or borderline resectable. Despite the technical progress made in the field of radiation therapy and the improvement of the efficacy of chemotherapy, the prognosis of these patients remains very poor. Recently, the role of radiation therapy in the management of pancreatic cancer has been much debated...
August 9, 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Richard Li, Wei-Hsien Hou, Joseph Chao, Yanghee Woo, Scott Glaser, Arya Amini, Rebecca A Nelson, Yi-Jen Chen
Background: Limited data are available to guide management of patients with stage I-III gastric cancer not undergoing potentially curative surgical resection. We compared survival outcomes associated with chemotherapy alone versus chemoradiation (CRT) in the treatment of nonmetastatic gastric cancer. Methods: Patients with gastric adenocarcinoma from 2004 to 2015 were identified using the National Cancer Database. Patients were excluded if they had surgery, metastatic disease, or T0, Tis, or T1a disease. Logistic regression was used to evaluate predictors of CRT use...
August 2018: Journal of the National Comprehensive Cancer Network: JNCCN
E A Aalbersberg, B J de Wit-van der Veen, M W J Versleijen, L J Saveur, G D Valk, M E T Tesselaar, M P M Stokkel
INTRODUCTION: Somatostatin receptor imaging with PET is the standard of care for patients with a neuroendocrine tumour (NET). Since therapy and imaging with somatostatin analogues utilize the same receptor, current guidelines recommend withdrawing long-acting somatostatin analogues for 3-4 weeks prior to somatostatin receptor PET imaging. The aim of this study is to prospectively assess the effect of lanreotide use on the uptake of 68 Ga-DOTATATE intra-individually 1 day prior to and 1 day post injection of lanreotide...
August 10, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Jason Yongsheng Chan, Zewen Zhang, Winston Chew, Grace Fangmin Tan, Chloe Liwen Lim, Lingyue Zhou, Wei Lin Goh, Eileen Poon, Nagavalli Somasundaram, Sathiyamoorthy Selvarajan, Kesavan Sittampalam, Francis Chin, Jonathan Teh, Mann Hong Tan, Khee Chee Soo, Melissa Teo, Mohamad Farid, Richard Quek
Peripheral blood indices of systemic inflammation such as the neutrophil-lymphocyte ratio (NLR) have been shown to be prognostic in various cancers. We aim to investigate the clinical significance of these indices in patients with soft tissue sarcoma (STS). Seven hundred and twelve patients with available blood counts at diagnosis and/or metastatic relapse were retrospectively examined. An optimal cutoff for NLR-high (>2.5) in predicting overall survival (OS) was determined using receiver operating curve analyses...
August 10, 2018: Scientific Reports
Cody Wolfe, Tarek Y El Ahmadieh, Salah G Aoun, Awais Z Vance, Kimmo J Hatanpaa, Bryan Wohlfeld
BACKGROUND: Juvenile Xanthogranuloma is a rare, non-Langerhan's cell histiocytic disorder that primarily presents as multiple cutaneous lesions in young males. Solitary lesions in the spinal column are a particularly rare presentation of this disease, and CNS involvement can portend a poor prognosis. This report highlights an unusual case of an adult woman with an unresectable JXG of the lumbar spine. A review of the published cases of thoracolumbar JXG and the current state of the literature in regard to diagnosis and treatment is presented...
August 7, 2018: World Neurosurgery
Francesca Comito, Valentina Ambrosini, Francesca Sperandi, Barbara Melotti, Andrea Ardizzoni
Pembrolizumab is an immune checkpoint inhibitor approved for the treatment of patients with unresectable or metastatic melanoma. Appearance of bone metastases, either osteolytic or osteoblastic, during treatment qualifies as disease progression. We report the case of a 64-year-old White woman with a metastatic melanoma undergoing second-line treatment with pembrolizumab. At first evaluation, after 3 months of therapy, computed tomography scans showed the onset of osteosclerotic lesions and a significant reduction in all the previously identified metastases; on the contrary, a fluorine-18-fluorodeoxyglucose PET showed the normalization of fluorine-18-fluorodeoxyglucose uptake in all the baseline lesions, including bone metastases...
August 7, 2018: Anti-cancer Drugs
Alicja Puszkiel, Gaëlle Noé, Audrey Bellesoeur, Nora Kramkimel, Marie-Noëlle Paludetto, Audrey Thomas-Schoemann, Michel Vidal, François Goldwasser, Etienne Chatelut, Benoit Blanchet
Dabrafenib is a potent and selective inhibitor of BRAF-mutant kinase that is approved, as monotherapy or in combination with trametinib (mitogen-activated protein kinase (MAPK) kinase (MEK) inhibitor), for unresectable or metastatic BRAF-mutated melanoma, advanced non-small cell lung cancer and anaplastic thyroid cancer harbouring the BRAFV600E mutation. The recommended dose of dabrafenib is 150 mg twice daily (bid) under fasted conditions. After single oral administration of the recommended dose, the absolute oral bioavailability (F) of dabrafenib is 95%...
August 9, 2018: Clinical Pharmacokinetics
Reinhard Dummer, Olivier Michielin, Mirjam Chantal Nägeli, Simone M Goldinger, Federico Campigotto, Ulrike Kriemler-Krahn, Herbert Schmid, Alberto Pedroncelli, Sara Micaletto, Dirk Schadendorf
Introduction: Somatostatin analogues exert antitumour activity via direct and indirect mechanisms. The present study was designed to assess the safety and efficacy of pasireotide in patients with BRAF -wild type (WT) and NRAS -WT metastatic melanoma. Patients and methods: Patients with unresectable and/or metastatic melanoma or Merkel cell carcinoma were eligible. Pasireotide was administered at different doses for ≤8 weeks in dose-escalation phase, followed by long-acting pasireotide 80 mg or lower dose in case of toxicity in follow-up phase up to six additional months...
2018: ESMO Open
Roni Nitecki, Colleen M Feltmate
Vulvar squamous cell carcinoma (VSCC) is a rare tumor of the female genital tract. While previously considered a disease of older women, the epidemiologic landscape is changing with more young women diagnosed with VSCC and its precursor lesions. This may be secondary to the global increase in human papillomavirus (HPV) infection of the lower genital tract. While VSCC precursor lesions have been described for many years, the terminology, and thus the understanding and reproducibility of these lesions have been debated...
July 5, 2018: Current Problems in Cancer
Edward Willems, Bart Smet, Franceska Dedeurwaerdere, Mathieu D'Hondt
Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver malignancy with poor survival rates. Surgical resection is the only curative treatment option, yet only a small portion of cases are resectable. In unresectable situations, suggested therapy consists of a systemic chemotherapy regimen with cisplatinum and gemcitabine. Selective internal radiation therapy (SIRT) has been proposed as an alternative treatment option and may lead to downstaging of unresectable iCCA to surgery. We present a case of a female patient diagnosed with an unresectable iCCA treated with SIRT in order to obtain downstaging...
August 9, 2018: Acta Chirurgica Belgica
Lin Shui, Yu-Shen Wu, Huapeng Lin, Pixian Shui, Qin Sun, Xiaopin Chen
BACKGROUND/AIMS: Conversion therapy can convert unresectable metastatic colorectal cancer (mCRC) into resectable. However, the optimal conversion regimen was not yet defined. This meta-analysis aimed to compare the efficacy and safety of the triplet chemotherapy (FOLFOXIRI) plus bevacizumab (Bev) with doublet chemotherapy (FOLFOX/FOLFIRI) plus Bev in conversion therapy. METHODS: Randomized controlled trials (RCTs) from databases, including Pubmed, EMBASE, Cochrane clinical trials, clinicaltrial...
August 9, 2018: Cellular Physiology and Biochemistry
Douglas S Hawkins, Yueh-Yun Chi, James R Anderson, Jing Tian, Carola A S Arndt, Lisa Bomgaars, Sarah S Donaldson, Andrea Hayes-Jordan, Leo Mascarenhas, Mary Beth McCarville, Jeannine S McCune, Geoff McCowage, Lynn Million, Carol D Morris, David M Parham, David A Rodeberg, Erin R Rudzinski, Margarett Shnorhavorian, Sheri L Spunt, Stephen X Skapek, Lisa A Teot, Suzanne Wolden, Torunn I Yock, William H Meyer
Purpose Intermediate-risk rhabdomyosarcoma (RMS) includes patients with either nonmetastatic, unresected embryonal RMS (ERMS) with an unfavorable primary site or nonmetastatic alveolar RMS (ARMS). The primary aim of this study was to improve the outcome of patients with intermediate-risk RMS by substituting vincristine and irinotecan (VI) for half of vincristine, dactinomycin, and cyclophosphamide (VAC) courses. All patients received a lower dose of cyclophosphamide and earlier radiation therapy than in previous trials...
August 9, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Kosmas Daskalakis, Apostolos V Tsolakis
Small intestinal neuroendocrine tumors (SI-NETs) may demonstrate a widely variable clinical behavior but usually it is indolent. In cases with localized disease, locoregional resective surgery (LRS) is generally indicated with a curative intent. LRS of SI-NETs is also the recommended treatment when symptoms are present, regardless of the disease stage. Concerning asymptomatic patients with distant metastases, prophylactic LRS has been traditionally suggested to avoid possible future complications. Even the current European Neuroendocrine Tumor Society guidelines emphasize a possible effect of LRS in Stage IV SI-NETs with unresectable liver metastases...
August 7, 2018: World Journal of Gastroenterology: WJG
Yong Song, Qing Zhou, Xin Zhang, Gong-Yan Chen, Dian-Sheng Zhong, Zhuang Yu, Ping Yu, Yi-Ping Zhang, Jian-Hua Chen, Yi Hu, Guo-Sheng Feng, Xia Song, Qiang Shi, Lu Lu Yang, Luan Di Yao, Lu Jing Zhan, Fan Yang, Yi-Long Wu
OBJECTIVES: This study investigated factors associated with (i) the likelihood of receiving a gene aberration test and (ii) the choice of treatment between chemotherapy and targeted therapy in patients with non-small cell lung cancer (NSCLC) in China. MATERIALS AND METHODS: This cross-sectional study analyzed data previously extracted from the medical charts of patients with unresectable Stage IIIB/IV nonsquamous NSCLC discharged from one of 12 tertiary hospitals in China between August 2015 and March 2016...
September 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Akiko Serizawa, Kiyoaki Taniguchi, Takuji Yamada, Kunihiko Amano, Sho Kotake, Shunichi Ito, Masakazu Yamamoto
BACKGROUND: Although patients with stage IV gastric cancer who respond well to systemic chemotherapy can be treated with gastrectomy, the prognosis of patients with unresectable gastric cancer with para-aortic lymph node metastasis is poor. We herein report a case of remnant gastric cancer with para-aortic lymph node metastasis that was treated with potentially curative conversion surgery after showing a complete response to chemotherapy with S-1 and oxaliplatin (SOX). CASE PRESENTATION: An 81-year-old man was diagnosed with type 3 remnant gastric cancer with giant para-aortic lymph node metastasis, and he received SOX chemotherapy...
August 7, 2018: Surgical Case Reports
Carolyn J Presley, Daiwei Tang, Pamela R Soulos, Anne C Chiang, Janina A Longtine, Kerin B Adelson, Roy S Herbst, Weiwei Zhu, Nathan C Nussbaum, Rachael A Sorg, Vineeta Agarwala, Amy P Abernethy, Cary P Gross
Importance: Broad-based genomic sequencing is being used more frequently for patients with advanced non-small cell lung cancer (NSCLC). However, little is known about the association between broad-based genomic sequencing and treatment selection or survival among patients with advanced NSCLC in a community oncology setting. Objective: To compare clinical outcomes between patients with advanced NSCLC who received broad-based genomic sequencing vs a control group of patients who received routine testing for EGFR mutations and/or ALK rearrangements alone...
August 7, 2018: JAMA: the Journal of the American Medical Association
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