Type Of Antineoplastic Treatment Research Articles

Cytotoxic Activity of Antineoplastic Agents on Fertility: A Systematic Review.

To analyze the long-term effects of antineoplastic treatments on patient fertility. The studies were selected through the New PubMed, Scielo and Lilacs databases along with references used for the creation of the present work. For the selection of studies, articles published between the periods from January 1, 2015 to April 6, 2020 in the English, Portuguese and Spanish languages were used. As inclusion criteria: cohort studies and studies conducted in vitro. As exclusion criteria: review articles, reported cases, studies that do not address thematic reproduction, studies that do not address the cancer theme, articles that used animals, articles that address the preservation of fertility and articles in duplicate in the bases. The collected data included: age of the patient at the beginning of treatment, type of neoplasm, type of antineoplastic treatment, chemotherapy used, radiotherapy dosage, radiotherapy site, effect of antineoplastic agents on fertility and number of patients in the study. Thirty studies were evaluated, antineoplastic chemotherapy agents and radiotherapy modulate serum hormone levels, reduces germ cell quantities and correlated with an increase in sterility rates. The effects mentioned occur in patients in the prepubertal and postpubertal age. Antineoplastic treatments have cytotoxic effects on the germ cells leading to hormonal modulation, and pubertal status does not interfere with the cytotoxic action of therapies.

A case-control study of dental abnormalities and dental maturity in childhood cancer survivors

The aim of this study was to evaluate dental abnormalities and dental maturity (DM) in the permanent dentition of childhood cancer survivors (CCSs) in comparison with that of healthy individuals. A retrospective, case-control study, with convenience sampling, evaluated 111 panoramic radiographs (PRs) of CCSs compared with 111 PRs of healthy individuals matched for age and gender. Dental anomalies (DAs) were associated with age of cancer diagnosis and type of antineoplastic treatment. DM was assessed by using the Demirjian method. A higher prevalence of microdontia, hypodontia, and dental root anomalies were present in CCSs compared with healthy individuals (P < .05). CCSs were the only individuals with 10 or greater DAs compared with healthy individuals. Microdontia was the only DA associated with age of cancer diagnosis less than 71 months (P < .05). Impacted teeth were associated with multimodal cancer treatment (P < .001). DM did not present a significant statistical difference between CCSs and healthy individuals (P > .05). CCSs had a higher prevalence of DAs without DM alteration compared with healthy individuals. Age of cancer diagnosis and type of treatment can influence the prevalence of some dental abnormalities.

Health-related quality of life of patients with squamous cell carcinoma: a comparison according to tumor location.

The aim of this study was to evaluate the health-related quality of life (QOL) of patients with squamous cell carcinoma (SCC) according to tumor location. The sample consisted of 27 patients with primary SCC in the oral cavity (n = 15), pharynx (n = 7), and larynx (n = 5) who were undergoing cancer treatment at the Cancer Hospital of Londrina, regardless of age, sex, clinical stage, and type of antineoplastic treatment. Health-related QOL was evaluated using the 30-item Cancer-Quality of Life Questionnaire (QLQ-C30), the 35-item Head and Neck Cancer-Quality of Life Questionnaire (QLQ-HN35), and the University of Washington Quality of Life Questionnaire (UW-QOL). These questionnaires were administered individually to each patient before ambulatory care. Sociodemographic data (age and sex) and clinical data (T stage, tumor location, and type of antineoplastic treatment) were collected from the patients' medical records. Scores were compared according to tumor location using the chi-squared test and one-way analysis of variance (p < 0.05). No score differed significantly according to tumor location. It can be concluded that the health-related QOL of patients with SCC was not influenced by tumor location.

Management of Cancer-Associated Upper Extremity Deep Vein Thrombosis with and without Venous Catheters at a Tertiary Care Center

Introduction: Data on management of upper extremity deep vein thrombosis(UEDVT) in patients with cancer is limited. Patients in this subgroup were excluded from the large clinical trials that showed the efficacy of extended duration low-molecular-weight heparin (LMWH) for cancer-associated thrombosis. Furthermore, risk factors for cancer-associated UEDVT in patients who do not have central lines in situ have not been well defined. The goal of our study was to determine the risk factors for cancer-associated UEDVT and to examine the approach to management of these patients in a real-world setting.Methods: We conducted a retrospective review of 200 consecutive patients who were assessed for cancer-associated UEDVT between January 2010 and June 2014 at a tertiary care center. Outcome measures were recurrent VTE, and major and clinically relevant non-major bleeding. Risk factors for recurrent VTE and bleeding were assessed using multivariable analysis.Results: Median duration of follow-up 11 months. Median age was 61.5 years and 55% were male. Cancer subtypes included colorectal (24%), lung (15%), breast (14%), lymphoma (10%), leukemia (5%), esophageal (4%), pancreatic (4%), head & neck (3%), sarcoma (2%), and others 17%. Metastatic disease at the time of diagnosis was present in 37% of patients and 7% of the study population had a previous history of VTE. Of the study population, 138 (69%) had line-associated UEDVT. Risk factors for UEDVT other than presence of a line after univariate analysis were lung cancer, breast cancer and extrinsic compression of vessels by local tumour on diagnostic imaging.The proportion of patients with UEDVT in the absence of a line according to cancer subtype was as follows: lung cancer (83%), pleural mesothelioma (66%), breast cancer (51%) and head & neck cancer (50%). Of these patients, greater than half had evidence of local mass effect on vessels on diagnostic imaging studies. Of the 138 patients with line-associated UEDVT, 20 (15%) had their line removed within one week of diagnosis for reasons unrelated to thrombosis and 107 (84%) had their line removed after completion of at least 3 months of anticoagulant therapy.Recurrent VTE was documented in 35 patients (17.5%), of which 16 (8%) were UEDVT (PE - 10, lower limb DVT-8, other-2). Recurrent VTE while receiving anticoagulants occurred in 23 (65.7%) of all recurrences and in 10 (62.5%)of UEDVT recurrences. Recurrent VTE occurred in 26 patients with a central line and in 9 patients without a central line. All of the patients with recurrent VTE had solid tumours, and 45% had metastatic disease. Multivariant analysis revealed that male gender(OR 2.42, 95% CI;1.1-5.1,p-value=0.02) and active cancer at the end of follow-up (OR 2.47, 95% CI; 0.1-0.9, p-value=0.04) were the only factors significantly associated with recurrent VTE (Figure 1 and 2). None of the following were significant risk factors for recurrence: type of antineoplastic treatment, accompanying PE, white cell count, initial UEDVT while anticoagulated, cancer stage, previous VTE, number of involved venous segments, removal of line during first week after index event or switching to a different anticoagulant. In the group with UEDVT without a venous catheter, the presence of radiologically proven extrinsic compression of vessels was not statistically associated with recurrent VTE.Patients were treated with LMWH for a median duration of 5 months. Six and 8 patients were switched to rivaroxaban and warfarin, respectively. Clinically relevant non-major bleeding occurred in 24 patients (12%), 61% of the bleeds were gastrointestinal and 83% of the bleeds occurred while receiving anticoagulants. On multivariate analysis, bleeding was significantly associated with ongoing anticoagulation (OR 5.6, 95% CI;1.6-19.3, p-value=0.006) and liver metastasis (OR 7.2, 95% CI;0.9-7.2, p-value=0.05). The use of concomitant clopidogrel or aspirin significantly increased the risk of bleeding (OR 6.6 and 5.5, respectively).Conclusions: While the presence of a venous catheter was the primary risk factor for UEDVT for the majority of our cohort, extrinsic compression of vessels by local tumour appeared to be equally important for certain cancer types. Furthermore, our finding that the majority of recurrent events did not occur in the upper limb suggests that UEDVT may be predictive of overall increased thrombogenic risk rather than just a local effect caused by the line. [Display omitted] [Display omitted] DisclosuresLinkins:Bayer: Honoraria, Research Funding; Pfizer: Honoraria.

Debridement could be a solution to promote healing of established oral mucositis in children

The aim of the study was to present a novel approach to promote healing of established oral mucositis and to alleviate symptom clusters in a group of children who were on induction chemotherapy. A clinical prospective study. Children (40) diagnosed with Grade 3 or 4 oral mucositis were randomly assigned into two groups: In Group I (n=20), accumulated debris on ulcerations was removed (debridement); In Group II (n=20), subjects had no debridement. The condition of oral lesions, speech, lips, teeth, saliva, gingiva, and swallowing ability were examined 3 x week during the study. All subjects received the same oral care regimen. They were well balanced in respect of age, the type of antineoplastic treatment, and the number. Debridement promoted resolution and decreased the severity of oral mucositis significantly. Thus, the subjects had less oral discomfort, pain, and nutritional difficulties. The data were entered in the SPSS 13.0 program, and the tests used were Kolmogorov-Smirnov, Shapiro-Wilk, Mann-Whitney, and Spearman's correlation coefficient with a 5% significance level. Well-controlled, prospective clinical studies related to the management of established oral mucositis will lead to the development of potential interventions and improved patient care.

Clinical outcome of patients with anti-Hu-associated encephalomyelitis after treatment of the tumor.

To evaluate 1) the effect of the tumor treatment on the clinical course of paraneoplastic encephalomyelitis (PEM) with anti-Hu antibodies, 2) the impact of immunotherapy on the tumor evolution, and 3) the outcome of the small cell lung cancer (SCLC) of PEM patients compared with that of patients without PEM. The authors retrospectively analyzed 51 PEM patients (42 with SCLC, 9 with other tumors) who received antineoplastic treatment with (25 patients) or without (26) concomitant immunotherapy. Tumor response was assessed at the end of the antineoplastic treatment. Progression of PEM was defined as a change of at least 1 point in the Rankin scale measured at the onset and at the end of the tumor treatment. To evaluate the outcome of SCLC, 27 PEM patients with SCLC were matched one-to-one with SCLC patients without PEM for age, performance status, tumor stage, and type of antineoplastic treatment. Thirty-six (70%) patients were neurologically stable at the end of the tumor treatment. In a logistic regression analysis, tumor complete response was the only predictor of PEM stabilization (OR 7.07; 95% CI 1.68 to 29.76; p = 0.006). Immunotherapy did not modify the outcome of the tumor and PEM. Median survival was similar in SCLC patients with and without PEM, but the probability of survival at 30 months was higher in PEM patients with SCLC (OR 5.26; 95% CI 1.0004 to 27.6902; p = 0.03). Complete response of the tumor seems to have a favorable influence on the course of paraneoplastic encephalomyelitis (PEM). Concomitant immunotherapy does not adversely affect the tumor outcome. The small cell lung cancer of PEM patients may have a slightly better evolution than that of patients without PEM.

Epoietin alfa in lung cancer

There is a high frequency of hematopoietic abnormalities in patients with neoplastic disorders, anemia being one of the most common and important, especially in lung cancer patients undergoing chemotherapy. A number of factors are able to affect the incidence and severity of chemotherapy-induced anemia: the type of chemotherapy, chemotherapy dose-intensity, chemotherapy duration, prior treatment, baseline Hb value and entity of Hb decrease during chemotherapy. An impaired erythroid marrow response to erythropoietin (EPO) and reduced EPO levels in response to anemia may contribute to the development of this form of anemia in lung cancer patients. Recombinant human EPO has been successfully used in the treatment of anemia. EPO increases the red cells mass and eliminates by approximately 50% the need for blood transfusions in patients with chronic anemia of cancer. EPO is also effective in the prevention of anemia of cancer patients. Besides increasing the levels of hemoglobin, EPO is also able to significantly improve the quality of life and performance status of anemic patients with cancer. EPO is well tolerated and the only drawbacks are represented by its cost and the need for a prolonged parenteral treatment. The use of EPO can be optimized by taking into consideration some predicting factors, by modulating the dose and by using iron support. In patients with lung cancer, the objective of EPO treatment may vary from palliation to survival improvement according to stage, type of antineoplastic treatment and prognosis. To take maximum advantage from its efficacy, EPO treatment in lung cancer patients needs to be individualized by identifying for each patient the risk of severe anemia and the objective of treatment.

Alcoholism: Independent Predictor of Survival in Patients With Head and Neck Cancer

Despite recognition of the high prevalence of alcoholism among patients with head and neck cancer, the prognostic importance of alcoholism has not been evaluated adequately. Previous investigators have speculated that alcoholic patients may have a poorer prognosis than nonalcoholic patients because of more advanced stage of cancer, the immunosuppressive effects of alcohol, and an increased rate of death due to other alcohol-related diseases. The goal of this population-based study was to identify the features of alcoholism that are associated with survival for patients with head and neck cancer and to develop an alcoholic severity staging system from a composite of the independent features of alcoholism. This prospective study included 649 patients who were diagnosed with cancer of the oral cavity, oropharynx, hypopharynx, or larynx during the period from September 1, 1983, through February 28, 1987, in a three-county area of western Washington state that participates in the Surveillance, Epidemiology, and End Results Program of the U.S. National Cancer Institute. Details on lifetime alcohol consumption, treatment for alcoholism, abstinence from alcohol prior to the diagnosis of cancer, and alcohol-related health problems were ascertained through in-person interviews near the time of diagnosis. Patients were classified as either nonalcoholics or alcoholics according to their responses to questions from the Michigan Alcoholism Screening Test. The measures of alcohol consumption and abuse that were found to be independently associated with 5-year survival by logistic regression analysis were combined using conjunctive consolidation to create a final composite variable, called an alcoholic severity stage. Cox proportional hazards regression analysis was done to estimate the relative risk (R) of death within 5 years due to specific causes of death for each of the alcoholic severity stages. Alcoholism (RR = 2.06; 95% confidence interval [CI] = 1.43-2.98) and a history of alcohol-related systemic health problems (i.e., liver disease, pancreatitis, delirium tremens, or seizures) (RR = 2.76; 95% CI = 1.69-4.49) were associated with an increased risk of death, whereas abstinence (i.e., the consumption of fewer than one drink per week at 1 year prior to the diagnosis of cancer) (RR = 0.62; 95% CI = 0.39-0.97) was associated with a decreased risk of death. These associations were independent of age, site of cancer, anatomical stage, histopathologic grade, smoking, and type of antineoplastic treatment. Patients in the two worst alcoholic severity stages had an increased risk of dying not only of head and neck cancer but also of cardiovascular disease, pulmonary disease, and other alcohol-related causes. Alcohol abuse, measured by alcohol consumption, functional impairment, a history of alcohol-related health problems, or abstinence, can provide important prognostic information for patients with head and neck cancer. Our results suggest that sobriety among alcoholic patients can lead to prolonged survival.