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Oncology, cancer, neurology

Egle Ramelyte, Sabrina A Schindler, Reinhard Dummer
Introduction The introduction of immunotherapies into clinical practice has substantially improved the prognosis of metastatic melanoma patients as well as patients suffering from other cancers. The two FDA-approved checkpoint inhibitors against PD-1 (nivolumab and pembrolizumab) have been shown to significantly improve patient survival while being less toxic than previous treatment options. Areas covered The current scientific literature on safety and adverse events (AEs) related to anti-PD-1 therapies has been investigated with special attention to case reports and to the latest results announced at the major clinical cancer and melanoma meetings, including ASCO (American Society of Clinical Oncology), ESMO (European Society of medical Oncology) and EADO (European Association of Dermato-Oncology) annual meetings...
October 13, 2016: Expert Opinion on Drug Safety
Jessyca Couto Otoni, Julia Noschang, Thábata Yaedu Okamoto, Diego Rosseman Vieira, Michel Souto Mayor Petry, Lucas de Araujo Ramos, Paula Nicole Vieira Pinto Barbosa, Almir Galvão Vieira Bitencourt, Rubens Chojniak
To evaluate the imaging methods used at the emergency department (ED) of a cancer center, with emphasis on computed tomography (CT). A descriptive, retrospective, single-center study was conducted by reviewing imaging exams and medical records, after approval of the institution's Ethics Review Board. The demographic data, cancer history, and imaging exam requested were evaluated for all patients and the indications and results of head, chest, and abdominopelvic CT scans were also evaluated. During the study period, there were 8710 visits to the ED, and 5999 imaging studies were requested in 3788 patients (43...
October 8, 2016: Emergency Radiology
Malte Mohme, Klaus Christian Mende, Theresa Krätzig, Rosemarie Plaetke, Kerim Beseoglu, Julian Hagedorn, Hans-Jakob Steiger, Frank W Floeth, Sven O Eicker
Spinal cord or cauda equina compression (SCC) is an increasing challenge in clinical oncology due to a higher prevalence of long-term cancer survivors. Our aim was to determine the clinical relevance of SCC regarding patient outcome depending on different tumor entities and their anatomical localization (extradural/intradural/intramedullary). We retrospectively analyzed 230 patients surgically treated for SCC. Preoperative status for pain and neurological impairment were correlated to the degree of compression, tumor location, and early as well as short-term follow-up outcome parameters...
October 7, 2016: Neurosurgical Review
Craig Nolan, Lisa M DeAngelis
PURPOSE OF REVIEW: The purpose of this review is to provide a practical clinical approach to confusion in the patient with cancer. Confusion in the cancer population has a broader differential diagnosis than in the general medical population. The clinician must consider the usual differential diagnoses as well as causes unique to the cancer patient including direct complications from the cancer and indirect complications related to cancer treatment. RECENT FINDINGS: In the recent age of precision medicine, the oncologist now utilizes the genomic profile of both the patient and the tumor to provide advanced biologic therapies including targeted anticancer drugs, antiangiogenic agents, and immunotherapy...
September 26, 2016: Current Opinion in Neurology
Giancarlo D'Andrea, Lucia Palombi, Giuseppe Minniti, Alessandro Pesce, Paolo Marchetti
OBJECTIVE: Brain metastases occur between 10 and 40% of patients with cancer and are more common than primary brain tumors (30-40%) and their incidence is growing because of the improvements in control of systemic disease, the prolonged survival and the better radiological detection. Modern treatment of brain metastases dramatically changed their expected prognosis that traditionally has been considered very poor referring such patients only to palliation because their terminal stage, and new prognostic indexes have been proposed to evaluate them...
September 22, 2016: World Neurosurgery
Astra Cabaj, Monika Bekiesińska-Figatowska, Agnieszka Duczkowska, Marek Duczkowski
The amount of people living with cancer is increasing; they live longer and have thus a higher risk of developing neurological complications. Magnetic resonance as a diagnostic procedure of choice in detecting the reasons of neurological/psychiatric symptoms in oncological patients is nowadays relatively easily accessible. Early diagnosis established by radiologists familiar with neurological entities that may follow cancer treatment allow clinicians to provide proper treatment, even if the diagnosis seems unbelievable...
July 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Dieter Hayn, Markus Falgenhauer, Martin Kropf, Michael Nitzlnader, Stefan Welte, Hubert Ebner, Ruth Ladenstein, Gudrun Schleiermacher, Barbara Hero, Günter Schreier
Opsoclonus Myoclonus Syndrome (OMS) is a rare disease in children which is often associated with neuroblastoma and, therefore, requires treatment by pediatric neurologists and oncologists. The ongoing OMS trial investigates questions related to OMS and potentially underlying neuroblastomas. To support this trial with an adequate IT infrastructure, linkage of neuroblastoma research databases with the OMS electronic data capture (EDC) system was required. Therefore, an EDC system for the OMS trial was developed and integrated into the research infrastructure of the European Network for Cancer Research in Children and Adolescents (ENCCA) project...
2016: Studies in Health Technology and Informatics
Sushma Jonna, Leslie Chiang, Jingxia Liu, Maria B Carroll, Kellie Flood, Tanya M Wildes
PURPOSE: Survival in older adults with cancer varies given differences in functional status, comorbidities, and nutrition. Prediction of factors associated with mortality, especially in hospitalized patients, allows physicians to better inform their patients about prognosis during treatment decisions. Our objective was to analyze factors associated with survival in older adults with cancer following hospitalization. METHODS: Through a retrospective cohort study, we reviewed 803 patients who were admitted to Barnes-Jewish Hospital's Oncology Acute Care of Elders (OACE) unit from 2000 to 2008...
November 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Ellen G Hoeffner
Traditional and newer agents used to treat cancer can cause significant toxicity to the central nervous system. MRI of the brain and spine is the imaging modality of choice for patients with cancer who develop neurologic symptoms. It is important to be aware of the agents that can cause neurotoxicity and their associated imaging findings so that patients are properly diagnosed and treated. In some instances conventional MRI may not be able to differentiate posttreatment effects from disease progression. In these instances advanced imaging techniques may be helpful, although further research is still needed...
August 2016: Hematology/oncology Clinics of North America
Timothy P Heffron
In addition to each of the factors that govern the identification of a successful oncology drug candidate, drug discovery aimed at treating neurological cancer must also consider the presence of the blood-brain-barrier (BBB). The high level of expression of efflux transporters (eg P-gp and Bcrp) at the BBB limits many small molecules from freely reaching the brain, where neurooncologic malignancies reside. Furthermore, many of the targets identified for the potential treatment of CNS malignancies suggest that kinase inhibitors, capable of penetrating the BBB to reach their target, would be desirable...
July 14, 2016: Journal of Medicinal Chemistry
Filipa Fontes, Susana Pereira, José Manuel Castro-Lopes, Nuno Lunet
OBJECTIVES: To quantify the prevalence of neurological complications among breast cancer patients at one and three years after diagnosis, and to identify factors associated with neuropathic pain (NP) and chemotherapy-induced peripheral neuropathy (CIPN). MATERIAL AND METHODS: Prospective cohort study including 475 patients with newly diagnosed breast cancer, recruited among those proposed for surgical treatment (Portuguese Institute of Oncology, Porto). Patients underwent a neurological evaluation and had their cognitive function assesses with the Montreal Cognitive Assessment, before treatment and at one and three years after enrollment...
October 2016: Breast: Official Journal of the European Society of Mastology
Luis Cabezón-Gutiérrez, Parham Khosravi-Shahi, Sara Custodio-Cabello, Francisco Muñiz-González, Maria Del Puerto Cano-Aguirre, Soledad Alonso-Viteri
BACKGROUND: Episodic breathlessness (EB) or dyspnea is a common symptom with a very negative impact on the quality of life of patients with cancer and with non-oncological advanced diseases, mainly cardiorespiratory and neurological. OBJECTIVE: The purpose of this non-systematic review is to ascertain the role played by opioids in the management of episodic breathlessness. METHODS: A non-systematic literature review was done in the databases MEDLINE, COCHRANE, and DATABASE, and articles of greater scientific rigor, mainly reviews or prospective studies/randomized clinical trials published to date (August 2015), were selected...
September 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Chad G Rusthoven, Robert C Doebele
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
August 20, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Karin Diserens, Jean-Paul Robert, Cristina Pellet, Loric Berney, Marc Levivier, Andreas F Hottinger
New treatment modalities in oncology, radiation oncology and surgery have led to a significant improvement in life expectancy for cancer patients. Some will however develop severe neurologic deficits that will impact their quality of life. To limit this impact, it is essential to offer optimal neurorehabilitation. In this context, a pilot project of early and intensive neurorehabilitation for brain tumor patients has been set up. A collaboration between the teams of neurooncology, acute neurorehabilitation and neurosurgery from the CHUV and the Clinique La Lignière allows an intensive and direct neurorehabilitation following neurosurgery...
April 27, 2016: Revue Médicale Suisse
A L Zygulska, M Banach, K Krzemieniecki
Cold-induced neuropathy is the most observed side effect of oxaliplatin. Presence of neuropathy is routinely assessed by electroneurographical examination. The use of electroneurography has not been a part of typical oncological monitoring and treatment protocols, leading to untreated, irreversible damage to patients' peripheral nerves, undiagnosed for long periods of time. 36 colorectal cancer patients followed FOLFOX4 with/without bevacizumab or XELOX were enrolled between February 2013 and January 2015 in the study at the University Hospital Oncological Department, Krakow, Poland...
2016: Neoplasma
Ashley Przybylyski, Peg Esper
BACKGROUND: Adult patients with cancer receiving antineoplastic, targeted, and other immunosuppressive therapies are at risk for severe side effects. Studies link posterior reversible encephalopathy syndrome (PRES) with immunosuppressants used for patients undergoing transplantation, as well as select tyrosine kinase inhibitors (TKIs) and other targeted therapies used in patients with cancer. PRES is a reversible condition with early recognition and management; however, permanent neurologic toxicities have been reported...
June 1, 2016: Clinical Journal of Oncology Nursing
Moom Sinn Aw, Larysa Paniwnyk, Dusan Losic
INTRODUCTION: Drug delivery pertaining to acoustic cavitation generated from ultrasonic (US) irradiation is advantageous for devising smarter and more advanced therapeutics. The aim is to showcase microbubbles as drug carriers and robust theranostic for non-invasive therapies across diverse biomedical disciplines, highlighting recent technologies in this field for overcoming the blood-brain barrier (BBB) to treat cancers and neurological disorders. AREAS COVERED: This article reviews work on the optimized tuning of ultrasonic parameters, sonoporation, transdermal and responsive drug delivery, acoustic cavitation in vasculature and oncology, contrast imaging for real-time magnification of cell-microbubble dynamics and biomolecular targeting...
October 2016: Expert Opinion on Drug Delivery
J L Vercher-Conejero, C Gámez Cenzano
The development of molecular and functional imaging with new imaging techniques such as computed tomography, magnetic resonance imaging, and positron emission tomography (PET) among others, has greatly improved the detection of tumors, tumor staging, and the detection of possible recurrences. Furthermore, the combination of these different imaging modalities and the continual development of radiotracers for PET have advanced our understanding and knowledge of the different pathophysiological processes in cancer, thereby helping to make treatment more efficacious, improving patients' quality of life, and increasing survival...
July 2016: Radiología
Jacobo Guiu-Souto, Manuel Sánchez-García, Rubén Vázquez-Vázquez, Carlos Otero, Victor Luna, Javier Mosquera, Ramón Lobato Busto, Pablo Aguiar, Álvaro Ruibal, Juan Pardo-Montero, Miguel Pombar-Cameán
The last recommendations of the International Commission on Radiological Protection for eye lens dose suggest an important reduction on the radiation limits associated with early and late tissue reactions. The aim of this work is to quantify and optimize the eye lens dose associated to nurse staff during positron emission tomography (PET) procedures. PET is one of the most important diagnostic methods of oncological and neurological cancer disease involving an important number of workers exposed to the high energy isotope F-18...
June 2016: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Malik Tariq Rasool, Kaneez Fatima, Najmi Arshad Manzoor, Syed Arshad Mustafa, Lone Mohammad Maqbool, Wani Shaqul Qamar, Fir Afroz, Nazir Ahmad Khan, Saqib Ahmad Shah, Manan Shah
BACKGROUND AND OBJECTIVES: Malignant spinal cord compression is an oncologic emergency, unless diagnosed early and treated appropriately, can lead to permanent neurological impairment and compromised quality of life of patients. We analyzed the epidemiology and the effect of common interventions on the outcome in these patients. PATIENTS AND METHODS: We conducted a prospective study of 77 patients in the year 2014 and recorded relevant patient and disease characteristics...
April 2016: Indian Journal of Palliative Care
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