Length Of Chemotherapy Research Articles

Neuro-oncology Treatment Strategies for Primary Glial Tumors.

Primary brain tumors underwent reclassification in the 2021 World Health Organization update, relying on molecular findings (especially isocitrate dehydrogenase mutations and chromosomal changes in 1p, 19q, gain of chromosome 7 and loss of chromosome 10). Newer entities have also been described including histone 3 mutant midline gliomas. These updated pathologic classifications improve prognostication and reliable diagnosis, but may confuse interpretation of prior clinical trials and require reclassification of patients diagnosed in the past. For patients over seventy, multiple studies have now confirmed the utility of shorter courses of radiation, and the risk of post-operative delirium. Ongoing studies are comparing proton to photon radiation. Long term follow up of prior clinical trials have confirmed the roles and length of chemotherapy (mainly temozolomide) in different tumors, as well as the wearable novottf device. New oral isocitrate dehydrogenase inhibitors have also shown efficacy in clinical trials.

Faktor-Faktor Yang Berhubungan Dengan Kualitas Hidup Pasien Kanker

Introduction: Cancer is a disease caused an abnormal cell growth due to the change in the expression of a gene, attacking cells or tissues to be around so that damage occurs. The condition can give a major change for the patient, either physically, psychologically, economically, or other. These changes can result in a decreased quality of life in people with cancer. Objectives: This study aims to identify the factors associated with quality-of-life patients with cancer. Method: This research is a quantitative study with a cross-sectional approach, using the WHOQOL-BERF questionnaire. The study was conducted from December 2017 to January 2018. Samples in this study were 33 respondents. Data analysis using chi-square and Kendall tau b. Result: The results of the bivariate analysis showed that family support had a significant relationship between the quality of life (P-value = 0.010), while age, sex, length of chemotherapy, level of education, and occupation did not significantly relate with quality of life. Conclusion: The recommendations of this study are health workers can provide support such as psychological counseling, nutrition, and pharmacology.

P1.18-27 Chemoradiotherapy of Inoperable Non-Small Cell Lung Cancer (NSCLC) with IGRT Technique Using TomoTherapy HD

Concurrent chemoradiotherapy (CCRT) of locally advanced NSCLC is considered a standard of care last two decades without important improvement except of adjuvant check-point inhibitor therapy. We present one-institutional results of chemoradiotherapy of inoperable NSCLC using daily 3D IGRT with TomoTherapy HD unit. A total of 39 patients with inoperable NSCLC staged by UICC7 and treated since April 2015 till September 2018 were included. Clinical data and radiation plans were retrospectively reviewed. Survival was analysed using Kaplan-Meier method, univariate analysis was done using Cox regression model. Our preferential chemotherapy regimen was cisplatin/vinorelbine three-weekly, carboplatin doublet with vinorelbine or paclitaxel was acceptable as well. Standard radiation dose was 66Gy/33fractions/6.5 weeks, daily MVCT was done. Minimal and median follow-up was 7/30 months, respectively. Patient characteristics were as follows: mean age 66 years, male 46%, stage II+IIIA/IIIB/locoregional recurrences 44%/33%/23%, respectively. PET/CT was done in 77% of patients. Histology: adenocarcinoma 41%, squamous 38.5%, NOS 20.5%. All patients had chemotherapy, 59% cisplatin-based, 41% carboplatin-based, full radiation dose of 66Gy was delivered to 69% of patients, mean size of PTV was 366ml. CCRT had 69% patients. Subsequently, only one patient passed radical surgery, check-point inhibitors were used in 5 patients as second line palliative therapy. We observed low treatment toxicity, radiation esophagitis grade 1-2 in 64%, grade 3 in one patient. Radiation pneumonitis of grade 1-2 started in 13% of patients. Median survival and median time to progression (TTP) was 35.3 and 22.3 months, 2-year survival and TTP 63% and 44%, respectively. The reason of progression was mainly distant metastases alone (26%) or with locoregional failure (15%). Only locoregional progression occurred in 8% of patients. Univariate analysis did not find any difference in survival or TTP by age, gender, tumour location, regimen and length of chemotherapy, or concurrent treatment delivery. Non-significant trend of better outcome of stage II+IIIA, squamous cancer, higher dose of radiation and shorter interval between chemotherapy and radiotherapy start was observed. Only significant variable was size of PTV. With cut-off 440ml the patients having greater size of PTV had significantly worse survival in compare with those with smaller one (HR 4.209, 95%CI: 1.519;11.665). Chemoradiation of inoperable NSCLC with IGRT technique using TomoTherapy HD has excellent results with 77% of durable local control, 63% of 2-year survival and nearly 3-year median survival. Only negative prognostic factor was higher size of PTV.

Wanna Get Away? Maintenance Treatments and Chemotherapy Holidays in Gynecologic Cancers.

Epithelial ovarian cancer has a very high rate of relapse after primary therapy; historically approximately 70% of patients with a complete clinical response to surgery and adjuvant chemotherapy will relapse and die of the disease. Although this number has slowly improved, cure rates remain less than 50%. As such, maintenance therapy with the aim of preventing or delaying disease relapse and the goal of improving overall survival has been the subject of intense study. Numerous earlier studies with agents ranging from radioactive phosphorus to extended frontline therapy or to monthly taxol administration demonstrated encouraging improvements in progression-free survival (PFS) only to find, disappointingly, no benefit in overall survival. In addition, the PFS advantage of maintenance therapy was associated with disconcerting side effects such that maintenance therapy was not adapted as standard of care. Studies with bevacizumab and PARP inhibitors have demonstrated a PFS advantage with a manageable side-effect profile. However, an overall survival advantage remains unclear, and the use of these approaches thus remains controversial. Furthermore, in recurrent disease, the length of chemotherapy and benefits of extended chemotherapy is unclear. Thus, additional trials assessing maintenance strategies in ovarian and other gynecologic malignancies are needed.

Profile of Skin pH in Leukaemia's Children with Chemotherapy Treatments at Haji Adam Malik General Hospital, Medan.

BACKGROUND:One of the treatments for leukaemia is chemotherapy. Side effects and toxicity of this treatment can be seen on the skin, adnexal, and mucous membranes. They might increase potential hydrogen (pH) value on the skin surface, therefore, disrupting epidermal barrier defences.AIM:To describe the pH of the skin in children with leukaemia who received chemotherapy.SUBJECT AND METHOD:This study was an observational descriptive, cross-sectional study, conducted from March until December 2016 with 32 children with leukaemia who treated at Haji Adam Malik General Hospital, Medan as subjects. Skin pH was measured by a pH meter.RESULT:We found mean skin pH in ALL (6.28 ± 0.58), CML (5.9 ± 0) and AML (6.5 ± 0.50). The mean skin pH after 1-5 weeks of chemotherapy was 6.13 ± 0.49, at 6-10 weeks (6.32 ± 0.51), and at 11-15 weeks (7.12 ± 0.36). The mean skin pH of patients with two drugs (5.98 ± 0.44), four drugs (6.28 ± 0.55), and six drugs (6.63 ± 0.56).CONCLUSION:The highest mean of skin pH were obtained in AML group, 11-15 weeks length of chemotherapy and group with six drugs regimen.

Impact of Oncotype-DX testing on choice of chemotherapy.

e12049 Background: The Oncotype DX test has been shown to change treatment plans in ~30% of cases, but it is unclear if it changes the type of chemotherapy offered. We sought to determine if the availability of Oncotype DX testing in BC resulted in a change in the type of chemotherapy regimens used on early stage breast cancer pts. Methods: This was a cohort study in which pts treated in the 2 years prior to the availability of Oncotype Dx testing were compared to pts treated in the 2 years after it became available in BC. Charts were audited and divided into pre- and post- availability of Oncotype DX testing. The groups were compared for differences in length of chemotherapy (12 vs > 12 weeks), type of agents used (anthracycline vs non-anthracycline) and myelosuppressive potential of regimen chosen. Results: A total of 831 pts fulfilled enrollment criteria; 360 were seen in the pre Oncotype era and 471 were seen in the post Oncotype era. A total of 250 (30.1%) pts were treated with chemotherapy in both cohorts with a median age of 59 for both groups (range of 29-80 and 24-80 respectively, p = NS). There was a decrease of 11.5% in pts receiving chemotherapy from 36.6% to 25.1% (p = 0.0003). Of the pts who received chemotherapy, there was a shift away from regimens containing anthracycline (49.2% vs 32.2%, p = 0.0070) and a shift towards more myelosuppressive chemotherapy regimens (p = 0.0344). There was a significant difference in the duration of chemotherapy regimens chosen with post Oncotype era pts receiving short course chemotherapy 69.5% of the time, compared to only 56.8% in the pre Oncotype era (p = 0.0491). Conclusions: The availability of Oncotype DX testing has resulted in a shift towards use of shorter, more myelosuppressive, non-anthracycline containing chemotherapy protocols. Since being publicly available, fewer pts are receiving chemotherapy but our data suggests a 10% change in treatment plan compared to the 30% change seen in other literature. Further study is warranted to ensure long term outcomes are not negatively impacted by the move towards shorter chemotherapy regimens.

Treatment delay and the risk of relapse in pediatric acute lymphoblastic leukemia

ABSTRACTDelays or interruptions in chemotherapy due to toxicity such as neutropenia or severe infections are common in the treatment of pediatric acute lymphoblastic leukemia (ALL). Based on the reports of worse outcomes in children with poorer compliance with therapy, there has been concern that toxicity-induced therapy interruptions could also compromise treatment outcome. In a retrospective study of treatment delays in our hospital between 2003 and 2013, the case notes of 141 patients were reviewed. The cumulative lengths of delays during the whole length of chemotherapy, during the intensive phase of treatment, and during maintenance treatment were analyzed. Within these categories, delays were split between less and more than the median value. The risk of relapse did not differ between patients with a longer or shorter delay during the total length of treatment or during the intensive phase. In addition, there was a trend when comparing patients above vs below the mean in length of treatment delays during maintenance, and there was a statistically significant difference in relapses when comparing patients in the lowest and highest quartiles of maintenance delays, with fewer relapses among those patients in the highest quartile for treatment delays.

Length of chemotherapy and use of bevacizumab for breast cancer

Length of chemotherapy and use of bevacizumab for breast cancer

Metastasis-induced acute pancreatitis in lung cancer

Lung cancer complicated by metastasis-induced acute pancreatitis (MIAP) is rare and bears a poor prognosis. Information regarding the results of treatment and possible prognostic factors in patients with this clinical setting is limited. The records of 33 patients treated between 1976 and 2003 for histologically confirmed lung cancer complicated by MIAP were reviewed. The relevance of the interval from diagnosis of lung cancer to the occurrence of MIAP; Karnofsky performance status (KPS); white blood cell (WBC) count; levels of lactate dehydrogenase (LDH), glucose, amylase, and lipase; Ranson's score; and the duration of high amylase levels and chemotherapy to survival since MIAP were determined by univariate analysis, and their independent significance tested by multivariate analysis. Survival rates were calculated using the Kaplan-Meier method and the log-rank test. In the univariate analysis, the time interval to MIAP (P=.0484), the KPS (P=.0032), the duration of high amylase levels (P=.007), and length of chemotherapy after diagnosis of MIAP (P=.002) were significant predictors of overall survival. Ranson's score could not be used to predict clinical outcomes. Analysis of the current study indicated that duration of high amylase levels, the KPS when MIAP occurred, and the length of chemotherapy after diagnosis of MIAP are major determinants for overall survival in patients with MIAP complicated by lung cancer. These results may help to design a therapeutic approach in patients with MIAP complicated by lung cancer.

Four to Fifteen Years Follow-up Study on 387 Cases of Pulmonary Tuberculosis Discharged in 1942 through 1953

Three hundred and eighty-seven arbitrarily selected Negro patients with pulmonary tuberculosis who were discharged from Piedmont Sanatorium from January 1, 1942, through December 31, 1953, were followed up from four to 15 years. The mortality from pulmonary tuberculosis was significantly related to the increasing age in men, the younger ages in women, the extent of disease, the presence or absence of cavity, the size and bilateral distribution of cavities, the bacteriologic findings, the length of chemotherapy and the type of treatment. The majority of deaths occurred during the first four years after discharge.