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[PMID]:29206996
[Au] Autor:Fokas E; Ströbel P; Fietkau R; Ghadimi M; Liersch T; Grabenbauer GG; Hartmann A; Kaufmann M; Sauer R; Graeven U; Hoffmanns H; Raab HR; Hothorn T; Wittekind C; Rödel C; German Rectal Cancer Study Group
[Ad] Endereço:Department of Radiotherapy and Oncology, University of Frankfurt, Frankfurt, Germany.
[Ti] Título:Tumor Regression Grading After Preoperative Chemoradiotherapy as a Prognostic Factor and Individual-Level Surrogate for Disease-Free Survival in Rectal Cancer.
[So] Source:J Natl Cancer Inst;109(12), 2017 Dec 01.
[Is] ISSN:1460-2105
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: We investigated tumor regression grading (TRG) as a prognostic marker and individual-level surrogate for disease-free survival (DFS) in patients with rectal carcinoma treated within the Chirurgische Arbeitsgemeinschaft fur Onkologie/Arbeitsgemeinschaft Radiologische Onkologie/Arbeitsgemeinschaft Internistische Onkologie (CAO/ARO/AIO)-04 randomized trial. Methods: TRG was recorded prospectively using the Dworak classification in 1179 patients after preoperative fluorouracil-based chemoradiotherapy (CRT) with or without oxaliplatin. Multivariable analysis was performed using Cox regression models adjusted for treatment arm, resection status, and pathologic stage. Individual-level surrogacy of TRG for DFS was examined using the four Prentice criteria (PC1-4). All statistical tests were two-sided. Results: With a median follow-up of 50 months, the addition of oxaliplatin to fluorouracil-based CRT led to statistically significantly improved three-year DFS (75.9%, 95% CI = 72.3 to 79.5, vs 71.3%, 95% CI = 67.6 to 74.9, P = .04, PC 1) and a shift toward more advanced TRG groups ( P < .001, PC 2) compared with CRT with fluorouracil alone. The three-year DFS was 64.6% (95% CI = 57.3 to 71.9), 77.6% (95% CI = 74.5 to 80.7), and 92.3% (95% CI = 88.4 to 96.2) for TRG 0 + 1 (poor regression), TRG 2 + 3 (intermediate regression), and TRG 4 (complete regression), respectively ( P < .001, PC 3). TRG constituted an independent prognostic factor for DFS (TRG 2 + 3 vs TRG 0 + 1, HR = 0.68, 95% CI = 0.51 to 0.90, P = .007). Due to multicollinearity, TRG 4 and pathologic stage could not be tested within the same model. The treatment effect on DFS was captured by TRG, satisfying individual-level PC4. Conclusions: Higher TRG after preoperative CRT predicted a favorable long-term outcome. At the individual patient level, TRG was a surrogate marker for DFS. Further phase III trials are needed to validate TRG as a surrogate at trial level.
[Mh] Termos MeSH primário: Carcinoma/secundário
Carcinoma/terapia
Recidiva Local de Neoplasia
Neoplasias Retais/patologia
Neoplasias Retais/terapia
[Mh] Termos MeSH secundário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Quimiorradioterapia Adjuvante
Intervalo Livre de Doença
Feminino
Fluoruracila/administração & dosagem
Seguimentos
Seres Humanos
Masculino
Margens de Excisão
Gradação de Tumores
Recidiva Local de Neoplasia/patologia
Neoplasia Residual
Compostos Organoplatínicos/administração & dosagem
Período Pré-Operatório
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Organoplatinum Compounds); 04ZR38536J (oxaliplatin); U3P01618RT (Fluorouracil)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1093/jnci/djx095


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[PMID]:29374717
[Au] Autor:Yanagi M; Sasaki K; Uchikado Y; Omoto I; Arigami T; Kurahara H; Uenosono Y; Sakoda M; Maemura K; Natsugoe S
[Ad] Endereço:Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
[Ti] Título:Effect of Neoadjuvant Chemoradiotherapy on Lymph Node Micrometastases in Thoracic Esophageal Cancer.
[So] Source:Anticancer Res;38(2):893-900, 2018 02.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:AIM: The purpose of this study was to clarify the effect of neoadjuvant chemoradiotherapy (nCRT) on lymph node micrometastasis (LNM) in esophageal squamous cell carcinoma (ESCC). PATIENTS AND METHODS: The therapeutic efficacy of nCRT was analyzed in 41 ESCC patients randomized to the Surgery group (n=21) and the nCRT group (n=20). Lymph node specimens from patients were classified into two categories, micrometastasis (MM) and tumor cell microinvolvement (MI), after immunohistochemical evaluation. RESULTS: The incidence rates of patients presenting MM with or without MI or MI alone in the Surgery group were significantly higher than those in the nCRT group. The 10-year survival rate of 15 patients with simultaneous histological metastasis (HM) and LNM was significantly lower than that in the 26 patients without LNM. Within the nCRT group, the 10-year survival rates of patients with versus those without HM were not significantly different; however, the 10-year survival rate of the 5 patients with simultaneous HM and LNM was significantly lower than that of the 15 patients without LNM. CONCLUSION: ESCC patients with LNM may benefit from nCRT, and evaluation of the simultaneous presence of HM and LNM may facilitate accurate prediction of survival in ESCC patients.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/tratamento farmacológico
Carcinoma de Células Escamosas/radioterapia
Neoplasias Esofágicas/tratamento farmacológico
Neoplasias Esofágicas/radioterapia
Linfonodos/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Carcinoma de Células Escamosas/patologia
Carcinoma de Células Escamosas/cirurgia
Quimiorradioterapia Adjuvante
Neoplasias Esofágicas/patologia
Neoplasias Esofágicas/cirurgia
Feminino
Seres Humanos
Imuno-Histoquímica
Metástase Linfática
Masculino
Meia-Idade
Terapia Neoadjuvante
Micrometástase de Neoplasia
Estadiamento de Neoplasias
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE


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[PMID]:29313371
[Au] Autor:Marquardt M; Anderson C; Ginader T; Parkhurst J; Pagedar N; Bayon R; Clamon G; Hoover A; Buatti J
[Ad] Endereço:1 Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
[Ti] Título:Utility of 3-Month Surveillance F-18 FDG PET/CT in Surgically Resected Oral Squamous Cell Carcinoma.
[So] Source:Ann Otol Rhinol Laryngol;127(3):185-191, 2018 Mar.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To evaluate the performance of surveillance F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) 1 year after imaging in oral squamous cell carcinoma (OSCC) patients treated with definitive surgery and adjuvant (chemo)radiotherapy (RT). METHODS AND MATERIALS: Surveillance PET/CT accuracy was retrospectively evaluated in OSCC patients receiving surgical resection and (chemo)RT. Pathologic risk factors were assessed for influence on accuracy of the post-RT PET/CT. RESULTS: Fifty-four patients with median follow-up of 3.8 years met inclusion criteria. A PET/CT obtained a median of 3.4 months after RT revealed 11 (20.4%) instances of true disease recurrence: 4 locoregional alone, 6 distant alone, and 1 patient with locoregional and distant disease. Locoregional detection sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 55.6%, 75.0%, 33.3%, and 88.2%, respectively. For distant recurrence, the respective values were 100%, 95.2%, 77.8%, and 100%. Absence of bone invasion, absence of pT4 disease, and disease within the tongue were independently associated with higher sensitivity ( P = .048). Perineural invasion was associated with increased specificity ( P = .027), and tumor location in the tongue was associated with a higher PPV ( P = .007) on surveillance PET/CT. CONCLUSIONS: Post-RT PET/CT accuracy information for surgically managed OSCC patients demonstrates significant associations with pathologic factors.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas
Fluordesoxiglucose F18/farmacologia
Neoplasias de Cabeça e Pescoço
Recidiva Local de Neoplasia/diagnóstico
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Idoso
Carcinoma de Células Escamosas/epidemiologia
Carcinoma de Células Escamosas/patologia
Carcinoma de Células Escamosas/terapia
Quimiorradioterapia Adjuvante/métodos
Precisão da Medição Dimensional
Feminino
Neoplasias de Cabeça e Pescoço/epidemiologia
Neoplasias de Cabeça e Pescoço/patologia
Neoplasias de Cabeça e Pescoço/terapia
Seres Humanos
Iowa/epidemiologia
Masculino
Meia-Idade
Imagem Multimodal
Esvaziamento Cervical/métodos
Invasividade Neoplásica
Compostos Radiofarmacêuticos/farmacologia
Estudos Retrospectivos
Procedimentos Cirúrgicos Operatórios/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Radiopharmaceuticals); 0Z5B2CJX4D (Fluorodeoxyglucose F18)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417751474


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[PMID]:29390548
[Au] Autor:Huang MJ; Wang XD; Hu YJ; Yang J; Li K
[Ad] Endereço:Nursing Department.
[Ti] Título:Short-course neoadjuvant chemoradiotherapy and surgery are beneficial in Chinese patients: A retrospective study.
[So] Source:Medicine (Baltimore);96(51):e9394, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Preoperative neoadjuvant chemoradiotherapy (NACR) is used to reduce tumor size for easier resection or improved resectability rates. Considering the difficulties regarding health insurance and health resources in China, an evidence-based short-course neoadjuvant chemoradiotherapy with surgery to cure patients was performed. This study compared the postoperative effects between short-course neoadjuvant chemoradiotherapy and surgery and surgery without neoadjuvant chemoradiotherapy.The current retrospective study was based on a rectal cancer database, including 274 patients diagnosed with rectal cancer between January 2014 and October 2016. Data were analyzed with respect to curative rate, postoperative recovery indicators (times to nasogastric tube, urinary catheter, and drainage tube removal and times to first oral feeding and passing of flatus postsurgery), chemoradiotherapy-related indicators [white blood cell count (WBC) and carcinoembryonic antigen (CEA) levels], and adverse effects indicators, evaluated according to Common Terminology Criteria for Adverse Events Version 4.0.There was no significant difference between the combined therapy and surgery groups (P > .05) in terms of radical resection rates and the times to urinary catheter removal and passing flatus (P > .05). Statistically significant differences (P < .05) in terms of earlier time for removal of the nasogastric and drainage tubes and time to first oral feeding were observed in the combined therapy group. The decreases in WBC and CEA levels in the combined therapy group were significantly greater than those in the surgery group 1 week after surgery (P < .05); after 1 month, the CEA decrease in the combined therapy group was significantly greater than that in the surgery group (P < .05). More patients in the combined therapy group experienced vomiting, indigestion, dehydration, oral mucositis, sensory neuritis, and alopecia compared with those in the surgery group 1 week after surgery (P < .05); after 1 month, only the incidence of alopecia was higher in the combined therapy group (P < .05).The combined therapy group demonstrated earlier postoperative recovery compared with the surgery group. Short-course neoadjuvant chemoradiotherapy with surgery may lead to postoperative treatment-related adverse effects of varying degrees; however, these adverse effects eventually improve with time.
[Mh] Termos MeSH primário: Adenocarcinoma/terapia
Antineoplásicos/uso terapêutico
Quimiorradioterapia Adjuvante
Terapia Neoadjuvante
Neoplasias Retais/terapia
Reto/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
China
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Melhoria de Qualidade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009394


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[PMID]:28464745
[Au] Autor:Bakke KM; Hole KH; Dueland S; Grøholt KK; Flatmark K; Ree AH; Seierstad T; Redalen KR
[Ad] Endereço:a Department of Oncology , Akershus University Hospital , Lørenskog , Norway.
[Ti] Título:Diffusion-weighted magnetic resonance imaging of rectal cancer: tumour volume and perfusion fraction predict chemoradiotherapy response and survival.
[So] Source:Acta Oncol;56(6):813-818, 2017 Jun.
[Is] ISSN:1651-226X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In locally advanced rectal cancer (LARC), responses to preoperative treatment are highly heterogeneous and more accurate diagnostics are likely to enable more individualised treatment approaches with improved responses. We investigated the potential of diffusion-weighted magnetic resonance imaging (DW MRI), with quantification of the apparent diffusion coefficient (ADC) and perfusion fraction (F), as well as volumetry from T2-weighted (T2W) MRI, for prediction of therapeutic outcome. MATERIAL AND METHODS: In 27 LARC patients receiving neoadjuvant chemotherapy (NACT) before chemoradiotherapy (CRT), T2W- and DW MRI were obtained before and after NACT. Tumour volumes were delineated in T2W MRI and ADCs and Fs were estimated from DW MRI using a simplified approach to the intravoxel incoherent motion (IVIM) model. Mean tumour values and histogram analysis of whole-tumour heterogeneity were correlated with histopathologic tumour regression grade (TRG) and 5-year progression-free survival (PFS). RESULTS: At baseline, high tumour F predicted good tumour response (TRG1-2) (AUC = 0.79, p = 0.01), with a sensitivity of 69% and a specificity of 100%. The combination of F and tumour volume (F /V ) gave the highest prediction of poor tumour response (AUC = 0.93, p < 0.001) with a sensitivity of 88% and a specificity of 91%, and also predicted PFS (p < 0.01). Baseline tumour ADC was not significantly related to therapeutic outcome, whereas a positive change in ADC from baseline to after NACT, ΔADC, significantly predicted good tumour response (AUC = 0.83, p < 0.01, 83% sensitivity, 73% specificity), but not PFS. CONCLUSIONS: The MRI parameter F/V at baseline was a remarkably strong predictor of both histopathologic tumour response and 5-year PFS in patients with LARC.
[Mh] Termos MeSH primário: Quimiorradioterapia Adjuvante/mortalidade
Imagem de Difusão por Ressonância Magnética/métodos
Terapia Neoadjuvante/mortalidade
Neoplasias Retais/patologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Processamento de Imagem Assistida por Computador/métodos
Gradação de Tumores
Perfusão
Estudos Prospectivos
Curva ROC
Neoplasias Retais/mortalidade
Neoplasias Retais/terapia
Taxa de Sobrevida
Resultado do Tratamento
Carga Tumoral
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1080/0284186X.2017.1287951


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[PMID]:29381948
[Au] Autor:Qin Y; Zhang HB; Ke CS; Huang J; Wu B; Wan C; Yang CS; Yang KY
[Ad] Endereço:Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei.
[Ti] Título:Primary extraskeletal myxoid chondrosarcoma in cerebellum: A case report with literature review.
[So] Source:Medicine (Baltimore);96(47):e8684, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Extraskeletal myxoid chondrosarcoma (EMC) is a rare malignant neoplasm of which intracranial EMC is the rarest. PATIENT CONCERNS: We present an unusual case report of a 41-year-old woman who was sent to the emergency department for a sudden headache and other symptoms related to increased intracranial pressure. INTERVENTIONS: Emergent CT revealed an occupying lesion in the left cerebellum with surrounding edema. A complete surgical excision of the lesion through a transcortical approach was performed. After the operation, this patient received adjuvant radiotherapy and temozolomide treatment. DIAGNOSES: Pathology diagnosis was an intracranial EMC. OUTCOMES: The patient survives with no tumor recurrence as of the last follow-up. Progression-free survival exceeded 20 months. LESSONS: We have reviewed the literature and here summarize the diagnosis and treatment options for intracranial EMC. Diagnosis and treatment options of this rare disease are discussed.
[Mh] Termos MeSH primário: Neoplasias Cerebelares
Cerebelo
Condrossarcoma
Dacarbazina/análogos & derivados
Neoplasias de Tecido Conjuntivo e de Tecidos Moles
Procedimentos Neurocirúrgicos/métodos
[Mh] Termos MeSH secundário: Adulto
Antineoplásicos Alquilantes/administração & dosagem
Neoplasias Cerebelares/complicações
Neoplasias Cerebelares/patologia
Neoplasias Cerebelares/fisiopatologia
Neoplasias Cerebelares/cirurgia
Cerebelo/diagnóstico por imagem
Cerebelo/cirurgia
Quimiorradioterapia Adjuvante/métodos
Condrossarcoma/complicações
Condrossarcoma/patologia
Condrossarcoma/fisiopatologia
Condrossarcoma/cirurgia
Dacarbazina/administração & dosagem
Feminino
Seres Humanos
Hipertensão Intracraniana/diagnóstico
Hipertensão Intracraniana/etiologia
Neoplasias de Tecido Conjuntivo e de Tecidos Moles/complicações
Neoplasias de Tecido Conjuntivo e de Tecidos Moles/patologia
Neoplasias de Tecido Conjuntivo e de Tecidos Moles/fisiopatologia
Neoplasias de Tecido Conjuntivo e de Tecidos Moles/cirurgia
Tomografia Computadorizada por Raios X/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Alkylating); 7GR28W0FJI (Dacarbazine); YF1K15M17Y (temozolomide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008684


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[PMID]:29374729
[Au] Autor:Hausmann D; Liu J; Budjan J; Reichert M; Ong M; Meyer M; Smakic A; Grimm R; Strecker R; Schoenberg SO; Wang X; Attenberger UI
[Ad] Endereço:Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany daniel.hausmann@ksb.ch.
[Ti] Título:Image Quality Assessment of 2D 3D T2WI and Evaluation of Ultra-high b-Value (b=2,000 mm/s ) DWI for Response Assessment in Rectal Cancer.
[So] Source:Anticancer Res;38(2):969-978, 2018 02.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:AIM: The purpose of this IRB-approved, retrospective study was to compare image quality between 2D and high-resolution 3D, T2-weighted (T2WI) magnetic resonance imaging (MRI) sequences and to investigate the additional value of ultra-high b-value diffusion-weighted imaging (DWI; b=2,000 mm/s ) for both rectal cancer staging and evaluating treatment response. MATERIALS AND METHODS: From 12 February to 24 August 2016, 26 consecutive patients (22 males, four females; mean age: 61.9±14.0 years) with histologically-proven rectal cancer. In total 31 examinations [12 prior to and 19 after chemoradiation (CRT)] were included. The patients underwent pelvic MRI on a 3.0-T scanner (Magnetom Skyra, Erlangen, Germany). Three radiologists (3, 4, and 5 years of experience in MRI, respectively) independently assessed all images and rated the image quality of DWI (b=800 mm/s ), apparent diffusion coefficient map, DWI (b=2,000 mm/s ), 3D sagittal T2WI, 3D axial T2WI, 2D sagittal T2WI, and 2D axial T2WI of each patient, respectively. In addition, signal intensity ratios (SIR) were calculated between rectal cancer and obturator internus muscle (background) in all patients after CRT on DWI (b=2,000 mm/s ) and correlated with histopathological regression grade (RG). RESULTS: Tumor delineation was significantly better by 2D T2WI than 3D T2WI both before and after CRT (before CRT: Z=-3.2, p=0.02; after CRT: Z=-4.408, p<0.001; all: Z=-5.192; p<0.001) and was the preferred method, although image quality ratings were not significantly different (3D sagittal: 4.00±0.48; 2D sagittal: 4.03±0.34, p=0.713; 3D axial: 3.85±0.61, 2D axial: 3.78±0.64, p=0.537). Independent t-test showed significantly higher SIR between those with RG 1 or 2 (moderate response: mean score=2.02) and those with RG 3+4 (good response: mean score=0.8) (t=3.044, p=0.011). In those with RG 4 (complete response), SIR of b2000 was 0.946 compared to a 1.41 average of the whole cohort. In two patients, tumor was invisible on b2000 following CRT (RG 3 and 4, respectively). Interobserver agreement was mostly good (κ≥0.6) regarding image quality assessment, except for poor agreement (κ=0.4) in DWI (b2000) between the two less-experienced readers. CONCLUSION: In conclusion, 3D T2WI might be useful for evaluating response to neoadjuvant therapy in a comprehensive, cost-effective protocol, where 2D imaging seems to be preferable. In addition, DWI (b2000) may be beneficial in assessing both the primary and the residual tumor after CRT in rectal cancer and SIR may be helpful in assessing response to CRT.
[Mh] Termos MeSH primário: Adenocarcinoma/patologia
Imagem de Difusão por Ressonância Magnética/métodos
Interpretação de Imagem Assistida por Computador/métodos
Imagem Tridimensional/métodos
Garantia da Qualidade dos Cuidados de Saúde
Neoplasias Retais/patologia
[Mh] Termos MeSH secundário: Adenocarcinoma/terapia
Adulto
Idoso
Idoso de 80 Anos ou mais
Quimiorradioterapia Adjuvante
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Variações Dependentes do Observador
Neoplasias Retais/terapia
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE


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[PMID]:28454573
[Au] Autor:Kim SW; Chun M; Ryu HS; Chang SJ; Kong TW; Oh YT; Kang SH
[Ad] Endereço:Department of Radiation Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea.
[Ti] Título:Long-term results of early adjuvant concurrent chemoradiotherapy for high-risk, early stage uterine cervical cancer patients after radical hysterectomy.
[So] Source:BMC Cancer;17(1):297, 2017 04 28.
[Is] ISSN:1471-2407
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim of the present study was to investigate the long-term survival outcomes and toxicities associated with our experienced early administration of adjuvant concurrent chemoradiotherapy (CCRT). METHODS: Ninety-eight patients with pelvic lymph node metastasis, positive resection margin, and/or parametrial invasion who received adjuvant CCRT between 1995 and 2011 were analyzed retrospectively. The first cycle of platinum-based adjuvant chemotherapy was initiated within 2-3 weeks after surgery (median, 12 days) and continued every 4 weeks for a total of 4 cycles. Adjuvant radiotherapy was performed during the second and third cycles of chemotherapy. RESULTS: After a median follow-up period of 119 months for survivors, 13 patients (13.3%) experienced recurrence and 11 patients died of cancer during the follow-up period. The 5-year recurrence-free survival and cancer specific survival rates were 87.6% and 90.6%, respectively. Ninety-four patients (95.9%) received ≥3 cycles of chemotherapy. Total radiation dose of ≥45 Gy was delivered in 91 patients (92.9%). Grade 3-4 hematologic and gastrointestinal toxicities developed in 37 (37.8%) and 14 (14.3%) patients during CCRT, respectively. CONCLUSION: The present study confirmed the long-term safety and encouraging survival outcomes of early administration of adjuvant CCRT, suggesting the benefits of early time to initiation of adjuvant treatments.
[Mh] Termos MeSH primário: Histerectomia/métodos
Avaliação de Resultados (Cuidados de Saúde)/métodos
Neoplasias do Colo do Útero/cirurgia
Neoplasias do Colo do Útero/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Quimiorradioterapia Adjuvante/efeitos adversos
Quimiorradioterapia Adjuvante/métodos
Diarreia/etiologia
Feminino
Seres Humanos
Histerectomia/efeitos adversos
Estimativa de Kaplan-Meier
Leucopenia/etiologia
Metástase Linfática
Meia-Idade
Análise Multivariada
Estadiamento de Neoplasias
Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos
Fatores de Tempo
Neoplasias do Colo do Útero/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1186/s12885-017-3299-0


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[PMID]:29173768
[Au] Autor:Yamauchi Y; Safi S; Muley T; Warth A; Herth FJF; Dienemann H; Hoffmann H; Eichhorn ME
[Ad] Endereço:Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany; Translational Lung Research Center (TLRC), Heidelberg, Member of German Center for Lung Research (DZL), Germany.
[Ti] Título:C-reactive protein-albumin ratio is an independent prognostic predictor of tumor recurrence in stage IIIA-N2 lung adenocarcinoma patients.
[So] Source:Lung Cancer;114:62-67, 2017 Dec.
[Is] ISSN:1872-8332
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To systematically evaluate the prognostic value of nutrition/inflammation-based markers for recurrence-free survival (RFS) in pN2-stage IIIA lung adenocarcinoma patients. MATERIALS AND METHODS: Data from 156 patients who had pathologically confirmed pN2-stage IIIA primary lung adenocarcinoma and received complete surgical resection from 2010 to 2014 were retrospectively analyzed. The data for Glasgow prognostic score (GPS), modified GPS (mGPS), high-sensitivity mGPS, C-reactive protein/albumin ratio (CAR), neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and prognostic nutritional index were analyzed. Univariate and multivariate Cox proportional-hazards regression analyses were used to identify the prognostic factors associated with RFS. RESULTS: The optimal cutoff value for the CAR was set at 0.6. A significant correlation was found between the CAR and RFS (P=0.001) by univariate analysis. Multivariate analysis between RFS and the factors selected from univariate analysis showed that ECOG performance status, pneumonectomy, multi-level N2, and high CAR were independent predictors of RFS. CONCLUSION: The CAR was the best prognostic marker to predict tumor recurrence in pN2-stage IIIA lung adenocarcinoma patients among the 7 nutrition/inflammation-based markers. The preoperative CAR may identify patients with a high risk of postoperative tumor recurrence.
[Mh] Termos MeSH primário: Adenocarcinoma/patologia
Albuminas/análise
Proteína C-Reativa/análise
Inflamação/sangue
Neoplasias Pulmonares/patologia
Recidiva Local de Neoplasia/patologia
[Mh] Termos MeSH secundário: Adenocarcinoma/mortalidade
Adenocarcinoma/cirurgia
Adenocarcinoma/terapia
Idoso
Biomarcadores/sangue
Plaquetas/patologia
Quimiorradioterapia Adjuvante/métodos
Quimioterapia Adjuvante/métodos
Feminino
Seres Humanos
Inflamação/patologia
Neoplasias Pulmonares/mortalidade
Neoplasias Pulmonares/cirurgia
Neoplasias Pulmonares/terapia
Linfócitos/patologia
Masculino
Meia-Idade
Recidiva Local de Neoplasia/sangue
Estadiamento de Neoplasias
Neutrófilos/patologia
Avaliação Nutricional
Valor Preditivo dos Testes
Prognóstico
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Albumins); 0 (Biomarkers); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:29245282
[Au] Autor:Won YG; Seo KJ; Hyeon J; Shin OR; Chang E; Sun S; Won HS; Ko YH; Na SJ; Lee SL; Ku YM; Lee DS
[Ad] Endereço:aDepartment of Radiation OncologybDepartment of Hospital PathologycDivision of Oncology, Department of Internal MedicinedDepartment of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
[Ti] Título:Gastroenteropancreatic-origin neuroendocrine carcinomas: Three case reports with favorable responses following localized radiotherapy and a review of literature.
[So] Source:Medicine (Baltimore);96(49):e9009, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The radiotherapy (RT) responses of gastroenteropancreatic (GEP)-origin neuroendocrine tumors remain unclear. We report cases of favorable response after localized RT of GEP-origin neuroendocrine carcinomas (GEP-NECs). PATIENT CONCERNS: 1. An 82-year-old male presented with a lower esophageal mass. Positron emission tomography computed tomography (PET-CT) scan showed a lower esophageal mass and gastrohepatic lymph nodes. 2. A 52-year-old female presented with abdominal discomfort. CT scan showed a 9.8 cm-sized enhancing mass in the lesser sac abutting the stomach, pancreas and liver. 3. A 54-year-old male patient presented with anal pain and bleeding. CT scan showed a remnant mass in the perirectal area after trans-anal excision. DIAGNOSES: The diagnoses of GEP-NECs were pathologically confirmed by biopsy or excision, and immunohistochemical stainings of Ki-67, CD56, synaptophysin and chromogranin-A. INTERVENTIONS: 1. The patient was treated with definitive RT. 2. The patient was treated with RT after two cycles of etoposide-cisplatin chemotherapy. 3. The patient was treated with adjuvant RT. OUTCOMES: 1. Complete remission was achieved based on CT scan four months after RT. 2. CT scan showed partial regression of the mass with a 5 cm-diameter at six months after RT. Adjuvant chemotherapy was administered after RT. 3. The residual mass was almost completely regressed at CT scan four months after RT. LESSONS: In cases of GEP-NECs, RT can be a useful treatment modality with favorable tumor response for patients with inoperable conditions or those suffering from bulky tumor masses.
[Mh] Termos MeSH primário: Neoplasias Intestinais/patologia
Neoplasias Intestinais/radioterapia
Tumores Neuroendócrinos/patologia
Tumores Neuroendócrinos/radioterapia
Neoplasias Pancreáticas/patologia
Neoplasias Pancreáticas/radioterapia
Neoplasias Gástricas/patologia
Neoplasias Gástricas/radioterapia
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Quimiorradioterapia Adjuvante/métodos
Feminino
Seres Humanos
Neoplasias Intestinais/diagnóstico
Neoplasias Intestinais/terapia
Masculino
Meia-Idade
Tumores Neuroendócrinos/diagnóstico
Tumores Neuroendócrinos/terapia
Neoplasias Pancreáticas/diagnóstico
Neoplasias Pancreáticas/terapia
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons
Neoplasias Gástricas/diagnóstico
Neoplasias Gástricas/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009009



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