European Cancer Research Research Articles

Abstract 1685: The EurOPDX Research Infrastructure: Supporting European and worldwide cancer research with patient-derived xenografts

Abstract Counteracting high failure rates in oncology drug development and improving therapeutic management of cancer patients requires preclinical models that can account for the complexity and heterogeneity of human tumors. Patient-derived cancer xenografts (PDXs) maintain histopathological features and genetic profiles of the original patient tumors and are increasingly recognized as reliable models to predict treatment efficacy and discover sensitivity and resistance biomarkers with immediate clinical relevance.Launched in 2013, the EurOPDX Consortium now gathers 18 academic research institutions throughout Europe and in the US (www.europdx.eu). The goal of the Consortium is to maximize exploitation of PDXs and other patient-derived models for cancer research by: (i) integrating institutional collections into a multicentre repository; (ii) defining common standards to improve the quality and reproducibility of oncology preclinical data; (iii) sharing models within and outside the consortium to perform collaborative precision oncology “xenopatient” trials. Building on its first successes, EurOPDX is now teaming up with other key academic and SME partners in a four-year project to build the “EurOPDX Distributed Infrastructure for Research on patient-derived Xenografts" (EDIReX project, Horizon 2020 grant no. 731105).This new cutting-edge European infrastructure offers access to PDX resources for academic and industrial cancer researchers through 6 state-of-the-art installations or “nodes”. We will present the specific objectives of the project, including our work towards standardization and optimization of biobanking, quality control and data tracking, and the performance of in vivo drug efficacy experiments. Access to the resource, including the distribution of cryopreserved samples from established models, the structured biobanking of user-developed models and the performance of drug efficacy studies, is offered through a grant application system which last deadline is planned mid-June 2020. Selection of the models by users and browsing of PDXs annotation data is made possible thanks to the newly-developed EurOPDX Data Portal (dataportal.europdx.eu), which will display approximately 1,000 models by April 2020 (including 700+ models of colorectal cancer, 80+ gastric and 80+ breast cancer models).We aim to improve preclinical and translational cancer research and promote innovation in oncology by integrating a European PDX repository and facilitating access to this much-needed resource for European and worldwide researchers. Citation Format: Emilie Vinolo, Joaquin Arribas, Andrea Bertotti, Alejandra Bruna, Annette T. Byrne, Robert B. Clarke, Nathalie Conte, Steven de Jong, Didier Decaudin, Zdenka Dudova, Jos Jonkers, Daniela Krasser, Ales Krenek, Luisa Lanfrancone, Eleonora Leucci, Elisabetta Marangoni, Gunhild Mari Maelandsmo, Michaela Th. Mayrhofer, Terrence F. Meehan, Jens Henrik Norum, Hector G. Palmer, Alejandro Piris Gimenez, Leo Price, Sergio Roman-Roman, Francesca Sarno, Violeta Serra, Laura Soucek, Livio Trusolino, Marieke van de Ven, Luca Vezzadini, Alberto Villanueva, Andrea Wutte, Enzo Medico, on behalf of the EurOPDX Research Infrastructure. The EurOPDX Research Infrastructure: Supporting European and worldwide cancer research with patient-derived xenografts [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1685.

Effect of family support on quality of postoperative life in patients with digestive cancer.

Digestive tumors are malignant tumors of epithelial origin with high rates of morbidity and mortality worldwide. At present, surgery is the main treatment for patients with digestive tumors. In this study, we conducted a survey of patients with digestive cancers to explore the influence of family support on postoperative quality of life, with the aim of providing a basis of reference for further improvement of the quality of life of such patients. A total of 82 patients with digestive cancer who underwent surgery in Hospital of Chengdu University of Traditional Chinese Medicine between October, 2018 and April, 2019 were selected to take part. The self-made questionnaire, the European Cancer Research and Treatment Organization's Core Quality of Life Questionnaire for Cancer Patients, and the Family Support Scale were used to investigate the patients, and the collected data were statistically analyzed. The family support scores of the 82 enrolled patients ranged from 5 to 15 points, with an average score of (8.86±2.47) points; 60 cases (73.17%) scored ≥10 points and 12 cases (26.83%) scored <10 points. Patients who were married, aged under 30 years old, or employed as civil servants had higher family support scores than other patients (P<0.05). The scores for physical function, emotional function, and overall health status/quality of life in patients who had a high family support score were higher than those in patients who had a low family support score (P<0.05). According to the logistic regression model, Patients with higher age, getting married, with education level of bachelor degree or above, occupation as farmer and with other digestive tract tumor got higher family support score. (P<0.05). Good family support can effectively improve quality of postoperative life for patients with digestive cancer. Education, age, occupation and marriage are all independent factors that affect family support.

Abstract B41: Piritramide analgesia reduces CEA mRNA-positive circulating tumor cells’ presence compared to morphine and epidural analgesia following radical colon cancer surgery

Abstract Purpose: Piritramide is a strong opioid widely used for postoperative analgesia (PA) in Europe while morphine and epidural PA are well established worldwide. Our retrospective analysis revealed that compared to morphine, piritramide improved cancer-specific survival in patients undergoing radical colon cancer surgery. Since circulating tumor cells’ (CTCs) presence has negative effect on colon cancer survival, we hypothesized that different types of PA could affect postoperative CTCs levels. Patients and Methods: In total, 60 patients undergoing radical colon cancer surgery were enrolled in this prospective, randomized, two-center pilot study. Patients were randomized to receive either piritramide, morphine, or epidural PA. The presence of carcinoembryonic antigen (CEA) and cytokeratin 20 (CK-20) mRNA positive CTCs in peripheral blood was measured at four points (before and immediately after surgery, on postoperative day 2, and one month after surgery) using quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR). Perioperative treatment was standardized. Results: In piritramide-treated patients, the levels of CEA mRNA positive cells were significantly lower on postoperative day 2 compared to other patients (p=0.04). CK-20 mRNA positive cells levels remained similar. In all groups, CTCs levels returned to preoperative baseline one month after surgery. Groups were similar regarding age, sex, ASA status, TNM, and grading. Conclusion: Compared to morphine and epidural analgesia, piritramide reduces postoperative CEA mRNA-positive circulating tumor cells’ presence following radical colon cancer surgery. Further trials enrolling larger numbers of patients are needed. Acknowledgments: This study was supported by Ministry of Health of the Czech Republic (NV18-03-00470), Ministry of Education, Youth and Sport of the Czech Republic (LO1304, LM2015089), European Regional Development Fund (ENOCH CZ.02.1.01/0.0/0.0/16_019/0000868) and Cancer Research Czech Republic. Citation Format: Josef Srovnal, Emil Berta, Alona Rehulkova, Monika Vidlarova, Petr Prasil, Lubomir Vecera, Petr Stourac, Pavla Kourilova, Marian Hajduch. Piritramide analgesia reduces CEA mRNA-positive circulating tumor cells’ presence compared to morphine and epidural analgesia following radical colon cancer surgery [abstract]. In: Proceedings of the AACR Special Conference on Advances in Liquid Biopsies; Jan 13-16, 2020; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(11_Suppl):Abstract nr B41.

Changes in breast cancer management during the Corona Virus Disease 19 pandemic: An international survey of the European Breast Cancer Research Association of Surgical Trialists (EUBREAST)

BackgroundCorona Virus Disease 19 (COVID-19) had a worldwide negative impact on healthcare systems, which were not used to coping with such pandemic. Adaptation strategies prioritizing COVID-19 patients included triage of patients and reduction or re-allocation of other services. The aim of our survey was to provide a real time international snapshot of modifications of breast cancer management during the COVID-19 pandemic. MethodsA survey was developed by a multidisciplinary group on behalf of European Breast Cancer Research Association of Surgical Trialists and distributed via breast cancer societies. One reply per breast unit was requested. ResultsIn ten days, 377 breast centres from 41 countries completed the questionnaire. RT-PCR testing for SARS-CoV-2 prior to treatment was reported by 44.8% of the institutions. The estimated time interval between diagnosis and treatment initiation increased for about 20% of institutions. Indications for primary systemic therapy were modified in 56% (211/377), with upfront surgery increasing from 39.8% to 50.7% (p < 0.002) and from 33.7% to 42.2% (p < 0.016) in T1cN0 triple-negative and ER-negative/HER2-positive cases, respectively. Sixty-seven percent considered that chemotherapy increases risks for developing COVID-19 complications. Fifty-one percent of the responders reported modifications in chemotherapy protocols. Gene-expression profile used to evaluate the need for adjuvant chemotherapy increased in 18.8%. In luminal-A tumours, a large majority (68%) recommended endocrine treatment to postpone surgery. Postoperative radiation therapy was postponed in 20% of the cases. ConclusionsBreast cancer management was considerably modified during the COVID-19 pandemic. Our data provide a base to investigate whether these changes impact oncologic outcomes.

Symptom patterns, physical function and quality of life among head and neck cancer patients prior to and after surgical treatment: A prospective study.

This study aimed to evaluate patterns of symptoms, physical function and quality of life (QoL) among patients with head and neck cancer (HNC) prior to, 3-9 days post-surgery, and one month post-surgery. A prospective, repeated-measures design with consecutively-identified sampling was used to recruit HNC patients undergoing surgical treatment. Data collected included demographic and clinical characteristics, symptoms by M.D. Anderson Symptom Inventory-Head and Neck Module-Chinese version (MDASI-H&N-C), physical function and QoL by Function Subscales of European Cancer Research Treatment Organization Quality of Life Core Scale (EORTC QLQ C30). 105 HNC patients suffered multiple symptoms prior to and after surgery. Pain, difficulty with voice/speech, disturbed sleep and problems with mucus (30.48%~91.43%) were the most prevalent symptoms prior to and post-surgery. Numbers of symptoms as well as specific symptoms, such as fatigue, dry mouth, problems with mucus, pain and disturbed sleep, were significantly associated with poor physical function (p<0.05). Tracheostomy, feeding tube and age were also linked with poor physical function and poor QoL (p<0.05). Findings of our study underscore the importance of managing symptoms in HNC patients to ensure patients' physical function and QoL prior to and after surgical treatment. Further research should focus on developing targeted interventions for symptoms that are linked to HNC patients' poor physical function and QoL.

Evaluation of Commercially Available Real-Time Polymerase Chain Reaction Assays for the Diagnosis of Invasive Aspergillosis in Patients with Haematological Malignancies.

Early diagnosis of invasive aspergillosis (IA) is a challenge. Non-specific clinical and radiologic findings, as well as difficulties in conventional diagnostic method application, may delay correct diagnosis. Nowadays, nucleic acid-based assays have reduced the need for conventional antigen detection and culture-based methods and provided new opportunities for patient care. Aspergillus PCR is now included in the latest European Cancer Research and Treatment Organization/Mycosis Study Group definition updates. We evaluated the performance of commercial real-time polymerase chain reaction (PCR) MycAssay Aspergillus PCR and Artus Aspergillus RG PCR assays and compared the results with galactomannan enzyme immunoassay. During 41 febrile neutropenic episodes, 168 serum samples were collected from 32 patients with haematological malignancies. IA diagnosis was established according to the revised guidelines of the European Organization for Research and Treatment of Cancer/Mycoses Study Group. Twenty-one probable episodes were identified. There were no proven IA cases in the study. In 20 episodes, patients did not fulfil the established criteria for the IA diagnosis. Artus Aspergillus RG PCR assay had a sensitivity of 47.6% and specificity of 100%, while those of MycAssay Aspergillus PCR were 61.9% and 100%, respectively. Two different PCR assays were used in this study. Although there are many studies that evaluated MycAssay Aspergillus PCR, data regarding Artus Aspergillus RG PCR assay are scarce. We found moderate sensitivity and high specificity in the diagnosis of IA in patients with haematological malignancy in both PCR methods. Our results demonstrated that commercial PCR assays can be applied for the early diagnosis and pre-emptive treatment of IA.

Editorial

May 2020 be a rewarding year of change. The recent commitment of the European Commission and policymakers to fight cancer in partnership is expected to bring forward the changes long required in the field. Molecular Oncology will stay at the forefront of all developments in the area of oncology by providing a flexible platform for European and International cancer research.

The Azeri Version of European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30): Translation and Validation

Objective:Quality of life in cancer patients has become an important outcome measure. This study aimed to translate and validate the European Cancer Research and Treatment Core Quality of Life Questionnaire (EORTC QLQ-C30) in Azerbaijan. Methods:Forward-backward procedure was applied to translate the EORTC QLQ-C30 from English into Azeri. Then a cross sectional study was conducted to validate the questionnaire in Azerbaijan. A sample of patients with confirmed diagnosis of oral cancer completed the Azeri version of the questionnaire from January 2017 to December 2018. Construct validity was assessed by performing know groups comparison and item-scale correlation matrix. Reliability was examined by estimating the Cronbach’s alpha coefficient for internal consistency. Results:In all 141 patients with oral cancer participated in the study. Known groups comparison indicated that the Azeri version of EORTC QLQ-C30 well differentiated between patients who differed in the disease stage. Those with higher stage reported lower functioning and higher symptoms. In addition item-scale correlation matrix showed a good correlation between items and its own hypothesized subscales as expected (Pearson correlation coefficient ranging from 0.735-0.978). The Cronbach’s alpha coefficient ranged form 0.68 to 0.94 indicating acceptable results for the internal consistency of the questionnaire. Conclusion:This preliminary validation study proved that the Azeri version of EORTC QLQ-C30 is a valid measure of quality of life in cancer patients. However, studies with other cancer patients and stronger psychometric evaluations are recommended.

The European Cancer Patient Coalition and its central role in connecting stakeholders to advance patient-centric solutions in the mission on cancer.

There is an urgent need for solutions to the economic and social inequalities in cancer care that still exist in many European countries. Patient preferences, ‘big data’, mobile digital technology and molecular and genomic profiling are among the innovative research topics that connect cancer patients to comprehensive cancer centres, and link translational research to cancer diagnosis, treatment and care. The question is whether Europe can deliver the complex infrastructure needed for universal coverage and equitable access to cancer care. The European Cancer Patient Coalition (ECPC), the leading ‘umbrella’ cancer patient organisation in Europe, has a central role in bringing the unmet needs of patients with cancer to the forefront of cancer policy, care and research. The ECPC is a respected and reliable partner in the oncology community and has effectively collaborated with institutional stakeholders and organisations, as well as with the European Commission, on cancer research projects and in the development of tools to advance health care and cancer policies at the European and national level. The ECPC believes that innovation cannot emerge and grow without patient involvement and is fully committed to increasing patient education and contribution in cancer research through its active participation in various European cancer research programmes and educational resources. The ECPC is expected to play a major role in the mission on cancer, given its previous achievements in policy and research to help overcome the inequalities in cancer prevention, treatment, rehabilitation and survivorship care. The mission on cancer will be facilitated by active collaboration between patient organisations and scientists, clinicians, politicians and industry, with the aim of identifying important research questions regarding quality of life and social issues for cancer patients of all ages.

Towards a mission-oriented approach to cancer in Europe: an unmet need in cancer research policy.

Today, cancer is a significant challenge for society, healthcare systems and the growing number of affected patients and their families. This article argues that new paradigms and conditions for responsible science and innovation policy across the European Union (EU) require (i) the collective action of Research & Development institutions, (ii) a system approach to health systems, higher education and patient organizations, and (iii) new initiatives to encourage international cooperation across an enlarged Europe; no single country can successfully fight the disease(s) on its own. Recently, a cancer mission was proposed (Celis and Pavalski, 2017), the origins of which are rooted in the continuous efforts of the research community, cancer patient organizations, member states and the European Commission during nearly two decades to address the fragmentation and lack of coordination of European cancer research; these efforts led to the creation of Cancer Core Europe and Cancer Prevention Europe, consortia aimed at linking therapeutic and prevention geometries. Ultimately, the platform/infrastructure will be composed of networks of Comprehensive Cancer Centres and cancer research centres across Europe to reach the critical mass of expertise, patients and collaborative portfolio of projects that are necessary to promote science‐driven and social innovations in the era of personalized (precision) cancer medicine. Employing a mission‐oriented approach to achieve the goal of ensuring a long life expectancy for three out of four cancer patients by 2030 is likely to have a particularly positive impact on the way European citizens’ value science and knowledge. It will change the lives of many families across Europe and beyond and should be oriented to ensure that Europe is at the forefront when it comes to quality of life. It is our collective responsibility to ensure that not a single person or region in Europe is left behind.

Cancer Core Europe: A European cancer research alliance realizing a research infrastructure with critical mass and programmatic approach to cure cancer in the 21st century

Translational cancer research covers the whole cancer research continuum from basic to preclinical to early clinical, late clinical and outcomes research. Basic-preclinical research is the “engine” for early clinical research bridging the early translational research gap. Cancer Core Europe has been created to construct a sustainable, high level, shared research infrastructure platform with research collaborations and taskforces (data sharing, clinical trials, genomics, immunotherapy, imaging, legal & ethical problems, and education & training) having representatives from all seven member centres, in a controlled expansion model. In parallel, a consortium of ten cancer prevention centres was established, Cancer Prevention Europe, to support the complete cancer prevention research continuum. Cancer Core Europe is launching at present the Basket of Baskets trial, which is the largest personalized cancer medicine trial effort in Europe. At present, Cancer Core Europe and Cancer Prevention Europe are in the process of integrating therapeutics and prevention strategies to address in partnership the increasing cancer problem. By offering innovative approaches for cancer research, links to the healthcare systems, development of quality-assured multidisciplinary cancer care, as well as the assessment of long-term outcomes, the infrastructure is expected to serve as a hub to connect with other centres in Europe as well as on other continents. In this manner Cancer Core Europe and Cancer Prevention Europe prepare to tackle the “Mission on Cancer”, with infrastructure and proofs of concept for therapeutics and prevention, research for assessment of effectiveness, health economics and added value for patients and the healthcare systems.

Mapping the European cancer research landscape: An evidence base for national and Pan-European research and funding

BackgroundCancer research is among the most active biomedical research domains for the European Union (EU). However, little quantitative empirical evidence is available to guide the decisions on the choice of disease site to study, specific research domain focus or allocation of research resources. To inform national/supranational cancer research policy, high-resolution intelligence is needed. MethodsWe performed a bibliometric analysis of European cancer research papers in the Web of Science from 2002 to 2013 to quantify research activity in each of the 28 EU Member States, along with Iceland, Norway and Switzerland (EUR31), which cancer sites/research domains they addressed, and their sources of financial support (2009–2013). FindingsCancer research papers from EUR31 correlated well with national Gross Domestic Products (r2 = 0.94). However, certain cancer sites (lung, oesophagus and pancreas) were under-researched relative to their disease burden, whereas central nervous system and blood cancers were more generously supported than their burden would warrant. An analysis of research domains indicated a paucity of research on radiotherapy (5%), palliative care (1.2%) and quality of life (0.5%). European cancer research funding in 2012–2013 amounted to ∼€7.6 billion and came from diverse sources, especially in western Europe/Scandinavia, where in nine countries the charitable sector outspent the government but not in Eastern Europe where charitable research funding barely exists. InterpretationSeveral countries need to increase their cancer research outputs substantially, and/or alter their research portfolios to better match their growing (and changing) cancer burden. More co-ordination among funding agencies is required, so that resources can be attuned to align activities to research gaps and perceived clinical needs. In Eastern Europe, the charitable funding sector needs to be developed, so that both public and patient advocacy can have an active role in research.

Retesting the psychometric characteristics of the European cancer research and treatment organization’s quality of life questionnaire palliative care 15 Turkish version (EQRTC QLQ C15-PAL) and evaluating the influencing factors

Abstract Purpose The study aimed to retest the reliability and validity of the European Organization for Research and Treatment of Cancer-Core Quality of Life-15 Items Questionnaire for Palliative Care (EQRTC QLQ-C15-PAL) for the Turkish society and examine the influencing factors. Methods The study was conducted in cancer patients who applied palliative treatment in the Dokuz Eylul University Oncology Institute Medical Oncology Division between May of 2014 and January of 2015. The demographic data collection form, performance status, and the EQRTC QLQ-C15-PAL scale were employed in order to gather data. Results A total of 164 patients completed the study. The total Cronbach's alpha value for the scale was 0.794. The mean scores including the overall questionnaire, and subscales, which were calculated after two measurements conducted at an interval of three weeks, presented a statistically significant difference (p Conclusion It has been shown that the scale is a valid/reliable instrument to detect the quality of life of Turkish cancer patients.

Safeguarding the future of independent, academic clinical cancer research in Europe for the benefit of patients

Cancer is a complex disease that is constantly evolving. It is now the most common cause of death in Europe after cardiovascular diseases. There are inequalities among European countries, potentially unsustainable healthcare systems impacting quality of cancer care and increasing number of patients with cancer with rare conditions.Clinical and translational research are the backbone in establishing scientific advances as novel treatments and advancing progress to the benefit of patients. Commercially sponsored clinical trials are responsible for developing new medicines that can treat various disease areas, including cancer. It is important to note, however, that these clinical trials only assess the viability of compounds that are chosen by a commercial entity that funds the entire process. By their design and focus, these trials need to fulfil commercial interests and market expectations, which do not always coincide with patients’ needs.As soon or even before novel treatments and compounds obtain formal market authorisation, academia will take these existing and new medicines to further conduct research in order to optimise their use, develop new combinations and with a strong focus on the patients and their needs. Established standard of care most commonly relies on clinical cancer research stemming from non-commercial entities, cooperative groups or academic clinical research.This article provides a consensus on the definition of academic research, illustrates its added value and suggests and calls to European Union institutions to support this type of research for the benefit of patients.

Assessment of the Quality of Life in Turkish Breast Cancer Patients.

Breast cancer significantly influences the quality of life (QoL) in women. The aim of this study was to assess the QoL in breast cancer patients and to determine the factors that have an effect on the QoL. We used sociodemographic data questionnaire, European Cancer Research and Treatment Organization QLQ-C30 questionnaire and linear regression analysis to determine the factors that affect the QLQ-C30 global health score, functional score, and symptom score. This study included 113 patients with a median age of 50.61 years (range: 17-80 years). Half of the patients used complementary and alternative treatments, 45.5% used painkillers, and 19.4% used antidepressants. The most important factors related to the global health score were the place of birth, use of painkillers, and employment status. The most important factors related to the functional status were the disease stage at the time of diagnosis and the information status about the disease. The most important factors related to symptom status were age, the disease stage at the time of diagnosis, the information status about the disease, and psychiatric referral. The findings indicated the consistency and strength of the relationship between clinical and sociodemographic factors and the QoL in breast cancer patients. Psychological support, when necessary, and the use of painkillers and antidepressants may improve the QoL in breast cancer patients.

Cancer Core Europe: A consortium to address the cancer care – Cancer research continuum challenge

European cancer research for a transformative initiative by creating a consortium of six leading excellent comprehensive cancer centres that will work together to address the cancer care-cancer research continuum.Prerequisites for joint translational and clinical research programs are very demanding. These require the creation of a virtual single ‘e-hospital’ and a powerful translational platform, inter-compatible clinical molecular profiling laboratories with a robust underlying computational biology pipeline, standardised functional and molecular imaging, commonly agreed Standard Operating Procedures (SOPs) for liquid and tissue biopsy procurement, storage and processing, for molecular diagnostics, ‘omics’, functional genetics, immune-monitoring and other assessments. Importantly also it requires a culture of data collection and data storage that provides complete longitudinal data sets to allow for: effective data sharing and common database building, and to achieve a level of completeness of data that is required for conducting outcome research, taking into account our current understanding of cancers as communities of evolving clones. Cutting edge basic research and technology development serve as an important driving force for innovative translational and clinical studies. Given the excellent track records of the six participants in these areas, Cancer Core Europe will be able to support the full spectrum of research required to address the cancer research- cancer care continuum. Cancer Core Europe also constitutes a unique environment to train the next generation of talents in innovative translational and clinical oncology.

Investigation of the life quality of the rectal intestinal stoma patients and their families

Objective To investigate and analysis the life quality of the rectal intestinal stoma patients and their families in three level of first -class hospital of Shanghai city .Methods One hundred and three patients with the rectal intestinal stoma and their families were surveyed by the quality of life core questionnaire of the European cancer research and treatment organization （EORTC QLQ-C30） and the simple health status questionnaire （SF-36） to assess their quality of life.Results The life quality of the rectal intestinal stoma patients was at a low level within three months after operation .The overall score of the life quality of the rectal intestinal stoma patients was （46.53 ±25.79）, and was lower than （51.56 ±24.61） in the national norm, and the difference was statistically significant （ t =-2.115, P 〈0.05）.The overall health score of SF-36 in patients＇ families was （54.65 ±23.19）, and was lower than （84.40 ±32.40） in the national norm, and the difference was statistically significant （t=-17.970, P〈0.01）.Compared the national norm , no significant differences were found in the scores of physiological function , body pain, emotional function, mental health in the rectal intestinal stoma patients and their families （P〉0.05）.The scores of physiological roles , vitality, social function in the rectal intestinal stoma patients and their families were lower than those of the national norms , and the difference was statistically significant （P〈0.05）.The body function, role function, cognitive function, social function, in the rectal intestinal stoma patients were positive correlation with the life quality of their families （r=0.198, 0.167, 0.072, 0.072, respectively;P〈0.01 or P〈0.05）.Conclusions The life quality of the early rectal intestinal stoma patients and their families are not optimistic , and the life quality of patients interacts with the life quality of their families.The life quality of the rectal intestinal stoma patients is actively improved by the medical personnel , and the medical personnel should care for the life quality of patients ＇ families.During the intervention the life quality of patients and their families should be taken as a whole , and the medical personnel should provide the families with necessary support and guidance . Key words: Rectal cancer; Intestinal stoma; Quality of life ; Family members

Changes in European Cross-Border Cancer Research and Treatment

1% ( € 10 billion) of overall public health spending ( € 1,000 billion) in the 27 EU states. That may change with the Cross-Border Health Care Directive, which passed in January 2011 and goes into effect in 2013. As with the E112 form, the patient’s home country health service will require prior authorization for treatment, but only if a hospital stay is involved or the treatment is very expensive. According to the parliament report on the directive, “the aim is absolutely not to encourage cross-border health care as such but to ensure its availability, safety, and quality.” Under the directive, a patient’s request can be refused only if the treatment could quickly be obtained in the patient’s home country or for doubts about the qualifi cations of the physician in the other member state. Each member state must establish at least one national patient contact point for information on health providers, reimbursement procedures, and when prior authorization is necessary. Patients may choose between public or private facilities. However, the directive’s stipulation that patients bear any costs incurred beyond the level reimbursed by their home country might deter some patients. Long-term care and organ transplants are exempt. And the directive doesn’t cover travel and accommodation costs. The European Commission estimates that under the new rules, overall EU 27-state public health spending will go up by just € 30 million a year.

The High Tide of Cancer Research in Europe

The launch of the European edition of The Oncologist is announced.

ACGT newsletter (Farewell article).

ACGT newsletter (Farewell article).