Effects Of Oncological Treatment Research Articles

The Effects of Oncological Treatment on Redox Balance in Patients with Uveal Melanoma.

(1) Background: Uveal malignant melanoma is the most common adult eye cancer and presents metabolic reprogramming that affects the tumoral microenvironment by altering the redox balance and producing oncometabolites. (2) Methods: The study prospectively evaluated patients undergoing enucleation surgery or stereotactic radiotherapy for uveal melanoma by following systemic oxidative-stress redox markers serum lipid peroxides, total albumin groups and total antioxidant levels (3) Results: Serum antioxidants and lipid peroxides were elevated from pre-treatment to longer-term follow-up. Antioxidants inversely correlated to lipid peroxides: higher in stereotactic radiosurgery patients pre/6/12/18 months post-treatment (p = 0.001-0.049) versus higher lipid peroxides in enucleation surgery patients pre/after/6 months post-treatment (p = 0.004-0.010). An increased variance in serum antioxidants was observed for enucleation surgery patients (p < 0.001), however enucleation did not increase mean serum antioxidants or albumin thiols; only lipid peroxides were increased post-enucleation (p < 0.001) and at 6-month follow-up (p = 0.029). Mean albumin thiols were increased for 18- and 24-month follow-ups (p = 0.017-0.022). Males who had enucleation surgery presented higher variance in serum determinations and overall higher lipid peroxides values pre/post-treatment and at the 18-month follow-up. (4) Conclusions: Initial oxidative stress-inducing events of surgical enucleation or stereotactic radiotherapy for uveal melanoma are followed by a longer-term inflammatory cascade gradually subsiding at later follow-ups.

Fertility Preservation in Girls and Women: State of Art and Future Possibilities

Objective: Many women worldwide are diagnosed with cancer in prepubertal, postpubertal and childbearing age. Oncological treatments can compromise future fertility through different mechanisms mainly depending on the type of treatment and the age of the patient. International societies recommend that cancer patients should receive information regarding the effects of oncological treatments on their reproductive health and cancer survivors should not be discouraged from becoming pregnant. About a quarter of these patients still do not receive an adequate counselling and young cancer survivors may face several barriers to conceiving a pregnancy due to the concerns from gynaecologists and oncologists. This review aims to investigate the infertility risk for female cancer patients who undergo oncological treatments and to provide an overview of actual and future fertility preservation possibilities for female cancer patients. Mechanism: We examined the current and future possibilities of preserving fertility for women with cancer in the available literature. Findings in brief: Different fertility preservation techniques have been developed in order to ensure the possibility for cancer survivors to complete their family planning after cancer. Oocyte/embryo freezing and ovarian tissue cryopreservation are the established choices, but the research is still going on to increase the success rate of these techniques and to develop other techniques to overcome actual limitations. Patients with a systemic oncological disease such as leukaemia could particularly benefit from the new experimental techniques which involve the creation of an artificial ovary or the in vitro growth of follicles or even the obtaining of mature oocytes from stem cells. All these techniques would allow the achievement of pregnancy without the risk of reintroducing malignant cells within autologous cryopreserved ovarian tissue transplantation. Regarding the concerns over pregnancy in cancer survivors, research is rapidly advancing and reassuring data are increasing. Conclusions: The rate of utilisation of gametes, embryos or ovarian tissue previously stored for fertility preservation is still low and the motivations can be various. Further data are needed in order to reassure both women and oncologists about the safety of pregnancy in cancer survivors and in order to increase the rate of women experiencing pregnancy after cancer.

Radiation doses in mammography exams: Effects of oncological treatments

IntroductionBreast cancer treatments cause breast changes that are detectable in subsequent mammography exams. This work investigates if these changes are perceived as differences in breast composition by automatic exposure systems, and if such differences are high enough to have impact in exam doses. MethodsData was obtained for 226 patients treated with unilateral conservative surgery followed by radiotherapy (S&RT) of the left (114) or right (112) breast, who had mammographic exams in direct digital GE units, Senographe DS (SenoDS) or Senographe Essential (Essential). The relevant data was extracted from Digital Imaging and Communications in Medicine (DICOM) images, and the Mean Glandular Dose (MGD) was calculated using the model of Dance. ResultsCompression force and area were 15–30% lower for treated breasts (S&RT) relative to untreated, while compressed breast thickness (CBT), incident air kerma (Ki) and MGD were 14–17%, 22–28% and 10–18% higher, respectively. The variation of MGD and Ki with CBT is similar for treated and untreated breasts. High values of Ki, MGD and CBT occur for some treated breasts with relatively small areas, probably as a result of less compressible breast tissue. Equipment-determined composition was found to be similar for treated and untreated breasts. ConclusionTreated breasts are imaged with slightly higher doses as a result of higher CBT, but the dependence of Ki and MGD on CBT remains unchanged. There is no need to separate data for treated and untreated breasts in large-scale analysis of exam doses.

Safety of standardised treatments for haematologic malignancies as regards to testicular endocrine function in children and teenagers.

Does standardised treatments used in children and adolescents with haematologic malignancies, including acute lymphoblastic (ALL) or myeloid leukaemia (AML) and non-Hodgkin lymphoma (NHL), affect endocrine function of the developing testes? Therapy of haematologic malignancies do not provoke an overt damage of Sertoli and Leydig cell populations, as revealed by normal levels of anti-Müllerian hormone (AMH) and testosterone, but a mild primary testicular dysfunction may be observed, compensated by moderate gonadotropin elevation, during pubertal development. Evidence exists on the deleterious effect that chemotherapy and radiotherapy have on germ cells, and some attention has been given to the effects on Leydig and Sertoli cells of the adult gonads, but information is virtually non-existent on the effects of oncologic treatment on testicular somatic cell components during childhood and adolescence. A retrospective, analytical, observational study included 97 boys with haematological malignancies followed at two tertiary paediatric public hospitals in Buenos Aires, Argentina, between 2002 and 2015. Clinical records of males aged 1-18years, referred with the diagnoses of ALL, AML or NHL for the assessment of gonadal function, were eligible. We assessed serum levels of AMH and FSH as biomarkers of Sertoli cell endocrine function and testosterone and LH as biomarkers of Leydig cell function. All hormone levels were normal in the large majority of patients until early pubertal development. From Tanner stage G3 onwards, while serum AMH and testosterone kept within the normal ranges, gonadotropins reached mildly to moderately elevated values in up to 35.9% of the cases, indicating a compensated Sertoli and/or Leydig cell dysfunction, which generally did not require hormone replacement therapy. Serum inhibin B determination and semen analysis were not available for most patients; therefore, we could not conclude on potential fertility impairment or identify whether primary Sertoli cell dysfunction resulted in secondary depleted spermatogenesis or whether primary germ cell damage impacted Sertoli cell function. The regimens used in the treatment of boys and adolescents with ALL, AML or NHL in the past two decades seem relatively safe for endocrine testicular function; nonetheless, a mild primary testicular endocrine dysfunction may be observed, usually compensated by slightly elevated gonadotropin secretion by the pituitary in adolescents, and not requiring hormone replacement therapy. No clinically relevant risk factor, such as severity of the disease or treatment protocol, could be identified in association with the compensated endocrine dysfunction. This work was partially funded by grants PIP 11220130100687 of Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) and PICT 2016-0993 of Fondo para la Investigación Científica y Tecnológica (FONCYT), Argentina. R.A.R., R.P.G. and P.B. have received honoraria from CONICET (Argentina) for technology services using the AMH ELISA. L.A.A. is part-time employee of CSL Behring Argentina. The other authors have no conflicts of interest to disclose.

Tissue engineering for paediatric patients.

The effects of oncological treatment, congenital anomalies, traumatic injuries and post-infection damage critically require sufficient amounts of tissue for structural and functional surgical reconstructions. The patient&rsquo;s own body is typically the gold standard source of transplant material, but in children autologous tissue is available only in small quantities and with severe morbidity at donor sites. Engineering of tissue grafts starting from a small amount of autologous material, combined with suitable surgical manipulation of the recipient site, is expected to enhance child and adolescent health, and to offer functional restoration for long-term wellbeing. Moreover, engineered tissues based on patient-derived cells represent invaluable models to investigate mechanisms of disease and to develop/test novel therapeutic approaches. In view of these great opportunities, here we introduce the currently limited successful implementation of tissue engineering in paediatric settings and discuss the open challenges in the field. A particular focus is on the specific needs and envisioned strategies in the areas of bone and osteochondral regeneration in children.

Are patients ready to participate in diet intervention trials in oncology? Experience from renal cell carcinoma (RCC) patients.

628 Background: Diet intervention in oncology is currently under investigation. Nevertheless, some cancer patients are increasingly using various diet interventions with the hope to optimize the anti-tumor response or to control the side effects of oncological treatment. Thus, well conducted prospective trials are required. In order to design such trials, we conducted a prospective study in order to estimate(a) the number of patients already using diet interventions on their own and (b) the percentage of patients who would agree to follow a restrictive diet in combination to antitumoral treatment within a prospective trial, if offered by their oncologist. Methods: Metastatic RCC patients seen at a single institution as outpatient clinic between April and May 2018, were offered to take part in an anonymous feasibility questionnaire. Questions included current treatment status for RCC, gender, height, and weight and explored (a) self diet restriction practices and (b) willingness to take part in trial(s) that would evaluate various diet interventions: fasting, ketogenic, vegetarian or vegan diets (each of them being explained). The proposed diet intervention was supposed to be for a minimum of 3 months. Results: Overall, 119 patients filled out the questionnaire. Median age was 61,5 years, 79(66.3%) were under systemic treatment. At time of data collection, 7.5% patients reported ketogenic diet practices, 0.9% fasting, none vegan or vegetarian diet. Regarding willingness to take part in “diet therapeutic trials”, 42.0% of patients claimed to agree to participate in a ketogenic diet trial, 29.4% of patients would agree to take part in a trial exploring fasting, 28.5% a vegetarian diet trial, and 14.2% of patients a vegan diet trial. No link between being under treatment and willingness to participate in trial was observed (p = 0.365). Conclusions: For the first time, we report feasibility of diet intervention within an homogenous population of patients with RCC. Almost half of patients are really keen in participating, with more interest for ketogenic diet and fasting. Such study raises the question of the feasibility of such trials, and obviously would make randomized trials very challenging.

Wpływ leczenia onkologicznego na rozwój zębów u dzieci z guzem mózgu – opis przypadków

Wpływ leczenia onkologicznego na rozwój zębów u dzieci z guzem mózgu – opis przypadków

Effects of oncological treatments on semen quality in patients with testicular neoplasia or lymphoproliferative disorders

Pretherapy sperm cryopreservation in young men is currently included in good clinical practice guidelines for cancer patients. The aim of this paper is to outline the effects of different oncological treatments on semen quality in patients with testicular neoplasia or lymphoproliferative disorders, based on an 8-year experience of the Cryopreservation Centre of a large public hospital. Two hundred and sixty-one patients with testicular neoplasia and 219 patients with lymphoproliferative disorders who underwent chemotherapy and/or radiotherapy and pretherapy semen cryopreservation were evaluated. Sperm and hormonal parameters (follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, inhibin B levels) were assessed prior to and 6, 12, 18, 24 and 36 months after the end of cancer treatment. At the time of sperm collection, baseline FSH level and sperm concentration were impaired to a greater extent in patients with malignant testicular neoplasias than in patients with lymphoproliferative disorders. Toxic effects on spermatogenesis were still evident at 6 and 12 months after the end of cancer therapies, while an improvement of seminal parameters was observed after 18 months. In conclusion, an overall increase in sperm concentration was recorded about 18 months after the end of cancer treatments in the majority of patients, even if it was not possible to predict the evolution of each single case 'a priori'. For this reason, pretherapy semen cryopreservation should be considered in all young cancer patients.

Fertility considerations in young women with hematological malignancies

The need for practice guidelines for fertility preservation in young women with hematological malignancies has been increased. To develop recommendations, publications relevant to fertility preservation and hematological cancers were identified through a PubMed database search and reviewed systematically, focusing on the effects of oncological treatments on fertility as well as on the efficacy, feasibility and risks of existing fertility preservation methods.