Chemotherapy Treatment In Women Research Articles

Breast Cancer: Clinical-Epidemiological Profile and Toxicities of Women Receiving Treatment with Taxanes in the Amazon Region.

Breast cancer is the most common malignant disease and the leading cause of mortality among women worldwide. Antineoplastic chemotherapy is one of its primary treatments, typically based on the class of drugs known as taxanes. Despite their proven therapeutic efficacy, these drugs can induce severe toxicities, leading to dose limitations or even treatment discontinuation. The objective of this study was to describe the clinical-epidemiological profile, risk factors, and toxicities of taxane-based chemotherapy treatment in women with breast cancer in the Amazon region. This is a cross-sectional, quantitative, and descriptive study conducted with 300 women diagnosed with breast cancer undergoing taxane treatment. Most patients were in the 40-49 age range, of brown ethnicity, and had completed elementary school. The majority of patients had risk factors such as alcoholism and a sedentary lifestyles. Most women had their first pregnancy between the ages of 18 and 21, breastfed their children, had menarche between the ages of 12 and 13, and were pre-menopausal and with a family history of cancer. The most frequent histological type was non-special invasive carcinoma and the Luminal B subtype. Most participants in this study showed taxane toxicity, with neurotoxicity being the most frequent. These findings reveal the importance of early detection, comprehensive risk factors, and effective management of treatment toxicities to improve patient outcomes in breast cancer care in the Amazon region.

Treatment-Induced Bone Marrow Enhancement at MRI in Breast Cancer Patients Receiving Granulocyte-Colony Stimulating Factor Adjunct to Chemotherapy

Granulocyte-colony stimulating factor (G-CSF) induces the reconversion of fatty bone marrow to hematopoietic bone marrow. The bone marrow changes are detectable as signal intensity changes at MRI. The aim of this study was to evaluate sternal bone marrow enhancement following G-CSF and chemotherapy treatment in women with breast cancer. This retrospective study included breast cancer patients who received neoadjuvant chemotherapy with adjunct G-CSF. The signal intensity of sternal bone marrow at MRI on T1-weighted contrast-enhanced subtracted images was measured before treatment, at the end of treatment, and at 1-year follow-up. The bone marrow signal intensity (BM SI) index was calculated by dividing the signal intensity of sternal marrow by the signal intensity of the chest wall muscle. Data were collected between 2012 and 2017, with follow-up until August 2022. Mean BM SI indices were compared before and after treatment, and at 1-year follow-up. Differences in bone marrow enhancement between time points were analyzed using a one-way repeated measures ANOVA. A total of 109 breast cancer patients (mean age 46.1±10.4 years) were included in our study. None of the women had distal metastases at presentation. A repeated-measures ANOVA determined that mean BM SI index scores differed significantly across the three time points(F[1.62, 100.67]=44.57, p<.001). At post hoc pairwise comparison using the Bonferroni correction BM SI index significantly increased between initial assessment and following treatment (2.15 vs 3.33, p<.001), and significantly decreased at 1-yearfollow-up (3.33 vs 1.45, p<.001). In a subgroup analysis, while women younger than 50 years had a significant increase in marrow enhancement after G-CSF treatment, in women aged 50 years and older, the difference was not statistically significant. Treatment with G-CSF as an adjunct to chemotherapy can result in increased sternal bone marrow enhancement due to marrow reconversion. Radiologists should be aware of this effect in order to avoid misinterpretation as false marrow metastases.

A randomised controlled trial of interventions for taxane-induced nail toxicity in women with early breast cancer

Onycholysis and paronychia has been associated with chemotherapy treatment for women with breast cancer. Our primary aim was to investigate the effectiveness of different topical interventions to ameliorate nail toxicity. Secondary aims were to explore the full range and severity of possible nail changes associated with taxane-based chemotherapy and the specific impact this had on quality of life, using two novel measures. This was an exploratory randomised controlled trial of three topical interventions (standard care, nail polish or specialist nail drops) for the prevention or reduction of nail changes induced by taxane-based chemotherapy. Outcomes included nail toxicity assessed at three time points (baseline, 3 weeks and 3 months post completion of chemotherapy) using two novel clinical tools (NToX-G12, NToX-QoL) and the Common Terminology Criteria for Adverse Events (CTCAE v3) and EQ-5D-5L. A total of 105 women were recruited (35 in each arm) and monitored up to three months post completion of chemotherapy. Almost 20% of patients were over the age of 60 years. There were 26 withdrawals, the majority from the nail polish arm. Residual Maximum Likelihood REML analysis indicated a significant arm, time and interaction effect for each intervention (p < 0.001). Less nail toxicity was observed in patients receiving specialist nail drops or standard care arms in comparison to those using nail polish. This study provides evidence to support clinicians’ suggestions on nail care recommendations based on the patients’ needs and preferences. Future investigations into comparing or combining cryotherapy and topical solutions that can support patient’s decisions are warranted.

Hematological and biochemical toxicity analysis of chemotherapy in women diagnosed with cervical cancer

ABSTRACT Introduction and objective: We verified the main hematological and biochemical alterations during the chemotherapy treatment for women with cervical cancer. Material and method: A retrospective, analytical and cross-sectional test was performed. The sample consisted of 39 medical records of women who underwent chemotherapy in the period from January to December 2016. The effects of hematological toxicities were evaluated according to erythrogram, leukogram, and platelet parameters, in relation to biochemical toxicities, using levels of serum marker (urea, creatinine, transaminases). Results: It was evidenced that among the chemotherapy protocols used, cisplatin showed a leukogram and plateletgram of 1.06 and 2.09 chances, respectively, for the development of leucopenia and thrombocytopenia during treatment. Conclusion: It was not possible to identify the degree of toxicity of the adverse effects of the treatment, because when these effects were registered in the medical record, they appeared without description, making it difficult to evaluate the degree of toxicity presented.

Frailty as a predictor of delay in initiation of adjuvant chemotherapy treatment in women with ovarian cancer

Objective: To evaluate whether patient frailty is associated with delay between surgery and initiation of chemotherapy in women with ovarian cancer.

1902 Experience of physical activity during adjuvant chemotherapy treatment for women with breast cancer - an interview study

1902 Experience of physical activity during adjuvant chemotherapy treatment for women with breast cancer - an interview study

Abstract P2-10-03: Decision-making surrounding adjuvant chemotherapy in young women with early stage breast cancer

Abstract Background: There is an increasing recognition that many young women with breast cancer will have favorable outcomes without chemotherapy. We sought to characterize decision-making surrounding adjuvant chemotherapy treatment (CT) in this population for whom chemotherapy has historically been a standard of care. Methods: As part of an ongoing, multi-center, prospective cohort of young women diagnosed with breast cancer at age 40 and younger, we identified 657 women with Stage I-III breast cancer. Participants were asked to complete surveys by mail that included questions about socio-demographics, decision-making, and treatment history within the first year following diagnosis. Tumor characteristics were ascertained via pathology and medical record review. We used Chi-square tests to compare: decisional involvement (patient-driven vs. shared vs. physician-driven), degree of confidence, and feeling informed about the CT decision (the latter two measured on a 0-10 scale, categorized as follows: 0-5=low; moderate=6-8; 9-10=high) between women who did and did not receive CT. To explore clinical appropriateness of the CT decision, we used logistic regression to assess the relationship between tumor characteristics and non-receipt of CT among women with Stage I/II disease. Results: Among women with Stage I (n=250), II (n=312), and III (n=95), disease, 66%, 95%, and 100%, received CT, respectively. A greater proportion of women who had CT were highly confident with their decision compared with women who did not have CT (80% vs. 60%, p&amp;lt;0.0001); women who did not have CT were more likely to report a low level of feeling informed about the CT decision compared to women who received CT (20% vs. 5%, p&amp;lt;0.0001). Women who did not have CT were also more likely to report the final CT decision as made by their doctor (49% vs. 28%) and less likely to report a shared decision (33% vs. 59%, p&amp;lt;0.0001). Non-receipt of CT in women with Stage I/II disease (n=546) was associated within having node negative disease, T1 (vs. T2 or larger), Her2- negative, and hormone receptor positive tumors. Conclusion: Although non-receipt of CT would be expected to be viewed favorably by patients and doctors, we found that women who received CT felt more confident and better informed than those who received no CT. Given that women who did not have CT were also less likely to perceive the CT decision as shared, improved communication together with better decisional support may be beneficial, especially for women who do not receive adjuvant chemotherapy. Citation Format: Shoshana M Rosenberg, Karen Sepucha, Kathryn J Ruddy, Lidia Schapira, Steven Come, Virginia Borges, Evan Morgan, Nancy U Lin, Shari Gelber, Rulla M Tamimi, Ann H Partridge. Decision-making surrounding adjuvant chemotherapy in young women with early stage breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-10-03.

Hyaluronic acid prevents immunosuppressive drug-induced ovarian damage via up-regulating PGRMC1 expression.

Chemotherapy treatment in women can frequently cause damage to the ovaries, which may lead to primary ovarian insufficiency (POI). In this study, we assessed the preventative effects of hyaluronic acid (HA) in immunosuppressive drug-induced POI-like rat models and investigated the possible mechanisms. We found that HA, which was reduced in primary and immunosuppressant-induced POI patients, could protect the immunosuppressant-induced damage to granulosa cells (GCs) in vitro. Then we found that HA blocked the tripterygium glycosides (TG) induced POI-like presentations in rats, including delayed or irregular estrous cycles, reduced 17 beta-estradiol(E2) concentration, decreased number of follicles, destruction of follicle structure, and damage of reproductive ability. Furthermore, we investigated the mechanisms of HA prevention effects on POI, which was associated with promotion of GC proliferation and PGRMC1 expression. In conclusion, HA prevents chemotherapy-induced ovarian damage by promoting PGRMC1 in GCs. This study may provide a new strategy for prevention and treatment of POI.

Ocorrência de neutropenia em mulheres com câncer de mama durante tratamento quimioterápico

OBJETIVO: Analisar a ocorrência de neutropenia induzida por drogas utilizadas no tratamento quimioterápico de mulheres com câncer de mama. MÉTODOS: Estudo retrospectivo, com avaliação de 72 prontuários, durante 2003-2006. RESULTADOS: Dos 558 ciclos de quimioterapia realizados, foram registrados 152 eventos adversos nos períodos de neoadjuvância e adjuvância, totalizando 43 casos por toxicidade hematológica. Quanto à ocorrência de neutropenia, 43% apresentaram, pelo menos, um episódio durante o tratamento. Testes de hipótese para comparar as médias dos valores de glóbulos brancos entre as mulheres que apresentaram ou não neutropenia apontaram para valores estatisticamente significantes, nos ciclos dois e três da neoadjuvância e nos ciclos dois, três e quatro da adjuvância. CONCLUSÃO: A neutropenia, tanto na neoadjuvância como na adjuvância ocorreu a partir do segundo ciclo e manteve-se durante o tratamento e foi estatisticamente significante quando foram compadas as mulheres que tiveram ou não esta ocorrência.

Trends in the treatment of breast cancer in Southeast England following the introduction of national guidelines

There is little published evidence on trends in the treatment of breast cancer in England following the publication of the Calman-Hine report in 1995. Reliable national data are available for women with screen-detected breast cancer, but data on women presenting symptomatically have been difficult to collect. Using data from both a clinical audit database and a population-based cancer register, we show that between 1996 and 2003 the rates of mastectomy and chemotherapy treatment for women with breast cancer in Southeast England have increased marginally, whereas there has been a steady decline in the use of hormone therapy and radiotherapy recorded within 6 months of diagnosis.

A Meta-Analysis of the Neuropsychological Effects of Adjuvant Chemotherapy Treatment in Women Treated for Breast Cancer

ABSTRACT Given the improvement in mortality rates associated with breast cancer, the importance of understanding the long-term neuropsychological consequences of chemotherapy is becoming increasingly vital. This study applies meta-analytic techniques to the scant literature on the relationship between contemporary adjuvant chemotherapy treatment for breast cancer and cognitive dysfunction as examined through neuropsychological indices. Seven studies (involving more than 300 participants) were selected from over 200 potential articles, based on three inclusion criteria: presence of breast cancer, administration of chemotherapy treatment, and use of neuropsychological tests. From these, nine treatment-control comparisons were used to generate 129 Hedge's d effect sizes across the cognitive domains of simple attention, working memory short- and long-term memory, speed of processing, language, spatial abilities, and motor function. Small to medium cumulative effect sizes, showing diminished cognitive function for chemotherapy treatment groups compared to control groups, were obtained for each of the eight cognitive domains. Overall, these results suggest that women who undergo adjuvant chemotherapy as treatment for breast cancer may experience subtle yet consequential cognitive decline.

Cognitive functioning before chemotherapy treatment in women with breast cancer

548 Background: Many women with breast cancer (BC) undergoing chemotherapy report trouble with attention, concentration and memory. A small body of research suggests that attention, processing speed,and memory tend to be the areas most affected. However,most of the studies have looked at women only after treatment,with no pre-treatment assessment. As part of a longitudinal study, we report here pre-chemotherapy assessments of postmenopausal BC patients. Methods: Thirty-two pre-chemo BC patients (DCIS, Stage I and Stage II) were assessed with a battery of neuro-psychological tests and self-report forms measuring: intelligence, memory, attention, language, visuo-spatial and motor functioning, and mood. Results: Thirteen (40%) women were rated as cognitively impaired based on scoring >1 standard deviation below the mean on two or more tests. When we compared this group to the non-impaired patients, significant differences were seen on a number of tests assessing visual-motor function (Pegboard {P=.001 and .0...

Cognitive functioning before chemotherapy treatment in women with breast cancer

548 Background: Many women with breast cancer (BC) undergoing chemotherapy report trouble with attention, concentration and memory. A small body of research suggests that attention, processing speed,and memory tend to be the areas most affected. However,most of the studies have looked at women only after treatment,with no pre-treatment assessment. As part of a longitudinal study, we report here pre-chemotherapy assessments of postmenopausal BC patients. Methods: Thirty-two pre-chemo BC patients (DCIS, Stage I and Stage II) were assessed with a battery of neuro-psychological tests and self-report forms measuring: intelligence, memory, attention, language, visuo-spatial and motor functioning, and mood. Results: Thirteen (40%) women were rated as cognitively impaired based on scoring >1 standard deviation below the mean on two or more tests. When we compared this group to the non-impaired patients, significant differences were seen on a number of tests assessing visual-motor function (Pegboard {P=.001 and .004}, Trailmaking A and B {P=.031, 006},Digit Symbol (P=.015) and Rey {P=.038}), visual memory (BVRT; P=.002)and visual attention(Conner's Continuous Performance Test {Commissions, P=.010; Detectability,P=.022}) independent of age, ethnicity, educational level, and stage of cancer. Conclusions: The results of this study indicate that a significant number of postmenopausal women with BC exhibit objective cognitive deficits pre-treatment in many of the same areas as seen in women after chemotherapy. Thus, to truly understand the cognitive effects of chemotherapy it is necessary to measure pre-treatment functioning in this population to compare with post-treatment changes. In addition,these results may suggest that women with cognitive deficits before chemotherapy may be more vulnerable to the possible effects of chemotherapy and thus be more prone to notice more pronounced changes in their cognitive abilities. No significant financial relationships to disclose.