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[PMID]:29401495
[Au] Autor:Stewart SA; Clive AO; Maskell NA; Penz E
[Ad] Endereço:Dalhousie University, Halifax, NS, Canada.
[Ti] Título:Evaluating quality of life and cost implications of prophylactic radiotherapy in mesothelioma: Health economic analysis of the SMART trial.
[So] Source:PLoS One;13(2):e0190257, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The SMART trial is a UK-based, multicentre RCT comparing prophylactic radiotherapy and symptom-based (deferred) radiotherapy in 203 patients with Malignant Pleural Mesothelioma who had undergone large bore pleural interventions. Using costs and quality of life data collected alongside the clinical trial, we will estimate the cost-effectiveness of prophylactic radiotherapy compared to deferred radiotherapy over a 1-year period. METHODS: Healthcare utilization and costs were captured during the trial. Utility weights produced by the EQ-5D questionnaire were used to determine quality-adjusted life-years (QALY) gained. The incremental cost-effectiveness ratio was calculated over the one-year trial period. RESULTS: Costs were similar in the immediate and deferred radiotherapy groups: £5480.40 (SD = £7040; n = 102) and £5461.40 (SD = £7770; n = 101) respectively. There was also no difference in QALY: 0.498 (95% CI: [0.45, 0.547]) in the prophylactic radiotherapy group versus 0.525 (95% CI: [0.471, 0.580]) in the deferred group. At a willingness to pay threshold of £30,000/QALY there was only a 24% chance that prophylactic radiotherapy was cost-effective compared to deferred radiotherapy. CONCLUSIONS: There was no significant effect of prophylactic radiotherapy on quality of life in the intervention group, nor was there any discernable decrease in healthcare costs. There is little evidence to suggest that prophylactic radiotherapy is a cost-effective intervention in this population. TRIAL REGISTRATION: ISRCTN72767336 with ISRCTN.
[Mh] Termos MeSH primário: Economia Médica
Custos de Cuidados de Saúde
Mesotelioma/radioterapia
Qualidade de Vida
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Análise Custo-Benefício
Feminino
Seres Humanos
Masculino
Meia-Idade
Radioterapia/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190257


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Svidzinski, Terezinha Inez Estivalet
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[PMID]:29262785
[Au] Autor:da Silva EM; Mansano ESB; Miazima ES; Rodrigues FAV; Hernandes L; Svidzinski TIE
[Ad] Endereço:Department of Medical Mycology, State University of Maringá, Av. Colombo, 5760, C.P, Maringá, PR, 87020-900, Brazil.
[Ti] Título:Radiation used for head and neck cancer increases virulence in Candida tropicalis isolated from a cancer patient.
[So] Source:BMC Infect Dis;17(1):783, 2017 Dec 20.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Studies have shown that radiation from radiotherapy increases the yeast colonization of patients. However it is not clear, if such radiation alters the yeast itself. The aim of the present study was therefore to report the direct impact of gamma radiation on Candida tropicalis. METHODS: C. tropicalis was obtained from a patient with a carcinoma, a suspension of this yeast containing 2.0 × 10 colony forming units per milliliter was prepared. It was submitted to gamma radiation dosage similar to that used in the treatment of head and neck cancer. After a cumulative dose of 7200 cGy some virulence attributes of C. tropicalis, including macro and micromorphological characteristics, adhesion and biofilm abilities, murine experimental infection and phagocytosis resistance were evaluated on irradiated and non-irradiated yeasts. RESULTS: After irradiation the colony morphology of the yeast was altered from a ring format to a smooth appearance in most colonies. Scanning electron microscopy revealed notable differences in the structures of both these colonies and the yeast cells, with the loss of pseudohyphae following irradiation and an increase in extracellular matrix production. The adherence and biofilm production of the yeast was greater following irradiation, both in terms of the number of yeasts and total biomass production on several abiotic surfaces and TR146 cells. The phagocytic index of the irradiated yeasts was not statistically different; however, the presence of cellular debris was detected in the kidneys of infected animals. Mice infected with irradiated yeasts developed an infection at the site of the yeast inoculation, although systemic infection was unchanged. CONCLUSIONS: Our findings show for the first time that C. tropicalis, one of the most important yeasts from colonization, which cause fatal candidemia in cancer patients, is affected by gamma irradiation, with changes to its virulence profile.
[Mh] Termos MeSH primário: Candida tropicalis
Candidíase Invasiva
Neoplasias de Cabeça e Pescoço
Radioterapia/efeitos adversos
Virulência/efeitos da radiação
[Mh] Termos MeSH secundário: Biofilmes
Candida tropicalis/patogenicidade
Candida tropicalis/efeitos da radiação
Neoplasias de Cabeça e Pescoço/complicações
Neoplasias de Cabeça e Pescoço/radioterapia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2879-6


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[PMID]:29400039
[Au] Autor:Plantier D; Gusmão de Araújo J; Portmann D; Guindi S
[Ti] Título:Cholesteatoma and osteoradionecrosis after radio­therapy of the temporal bone: Surgical aspects.
[So] Source:Rev Laryngol Otol Rhinol (Bord);136(4):163-5, 2015.
[Is] ISSN:0035-1334
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:Introduction: The treatment for head and neck cancer with radiotherapy can cause different alterations of the auditory system. We report two cases of chronic otitis of the external and middle ear secondary to osteoradionecrosis of the temporal bone. This article aims to report the experience of the surgical approach in such condition. Cases report: The first patient was treated with radiotherapy in his childhood for a cerebellar tumor. He developed years later a cholesteatoma which invaded the mastoid cavities through a destruction of the external auditory canal. The second was treated for a malignant parotid tumour 15 years before by surgery and radiotherapy. She developed a chronic otorrhea with a partial destruction of the bony external auditory canal. Both patients were treated by surgery with reconstruction including bone, cartilage, fascia and skin grafts. The outcome was good in both cases. Osteo­radio­necrosis of the temporal bone is a rare but serious complication of radiotherapy for head and neck cancer. This complication can occur even many years after the treatment. Our two cases demonstrate a way to solve this pathology. A long term supervision with regular cares is essential in order to get a good healing. Due to the improvement of the radiation therapy we could expect less complications of this type in the future.
[Mh] Termos MeSH primário: Colesteatoma da Orelha Média/etiologia
Osteorradionecrose/etiologia
Radioterapia/efeitos adversos
Osso Temporal/patologia
[Mh] Termos MeSH secundário: Adulto
Neoplasias Cerebelares/radioterapia
Colesteatoma da Orelha Média/cirurgia
Feminino
Seres Humanos
Masculino
Meia-Idade
Osteorradionecrose/cirurgia
Neoplasias Parotídeas/radioterapia
Osso Temporal/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE


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[PMID]:29157615
[Au] Autor:Jaccard A
[Ad] Endereço:Department of Clinical Hematology, Reference Center for AL Amyloidosis, CHU, 2 Avenue ML King, Limoges 87000, France. Electronic address: arnaud.jaccard@chu-limoges.fr.
[Ti] Título:POEMS Syndrome: Therapeutic Options.
[So] Source:Hematol Oncol Clin North Am;32(1):141-151, 2018 02.
[Is] ISSN:1558-1977
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Treatment of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome should be directed at the underlying plasma cell clone with risk-adapted therapy based on the extent of the plasma cell disorder. Radiation therapy is effective for patients with a localized presentation, without bone marrow involvement, and 1 to 3 bone lesions. Patients with disseminated disease should receive, preferably, high-dose chemotherapy with peripheral blood transplantation. Low-dose melphalan and dexamethasone or new agents used in myeloma are also effective. The most promising agent is lenalidomide, which could be given before high-dose therapy or radiation to get rapid neurologic responses.
[Mh] Termos MeSH primário: Síndrome POEMS/terapia
Transplante de Células-Tronco de Sangue Periférico
Talidomida/análogos & derivados
[Mh] Termos MeSH secundário: Aloenxertos
Seres Humanos
Síndrome POEMS/diagnóstico
Síndrome POEMS/patologia
Radioterapia
Talidomida/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
4Z8R6ORS6L (Thalidomide); F0P408N6V4 (lenalidomide)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171122
[St] Status:MEDLINE


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[PMID]:28452903
[Au] Autor:Maschio M; Dinapoli L; Zarabla A; Maialetti A; Giannarelli D; Fabi A; Vidiri A; Cantelmi T
[Ad] Endereço:*Center for Tumor-Related Epilepsy, UOSD Neurology, †Biostatistic Unit, Departments of ‡Oncology, §Radiology, and ∥Service of Psychiatry, Regina Elena National Cancer Institute, Rome, Italy.
[Ti] Título:Zonisamide in Brain Tumor-Related Epilepsy: An Observational Pilot Study.
[So] Source:Clin Neuropharmacol;40(3):113-119, 2017 May/Jun.
[Is] ISSN:1537-162X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Epilepsy heavily affects the quality of life (QoL) of patients with brain tumor because in addition to taking treatments for the oncological illness, patients are required to live with the long-term taking of antiepileptic drugs (AEDs). The AEDs' adverse effects are common in these patients and can negatively influence their perceptions of their QoL.We conducted an observational pilot study in patients with brain tumor-related epilepsy to verify efficacy, tolerability, and impact on QoL and global neurocognitive performances of zonisamide (ZNS) in add-on. MATERIALS AND METHODS: We recruited 13 patients (5 females, 8 males; mean age, 49.6 years) presenting uncontrolled seizures. At first visit and at final follow-up at 6 months, patients underwent neurological examination, evaluation of adverse events, and cognitive and QoL tests. A seizure diary was given. RESULTS: Eight patients underwent chemotherapy, 3 underwent radiotherapy, and 5 had disease progression. Mean dosage of ZNS at final follow-up was 300 mg/d.Of 9 patients who reached the sixth month follow-up, the mean weekly seizure number before ZNS had been 3.2 ± 5.0, and at final follow-up, the mean weekly seizure number was 0.18 ± 0.41 (P = 0.05).Compared with baseline, we observed stability in all cognitive domains, except for verbal fluency that significantly worsened.Results on QoL tests showed that QoL remained unchanged over time, which could indicate that ZNS did not influence the patients' perceived QoL. CONCLUSIONS: Zonisamide as add-on in our patients seems to be well tolerated and efficacious in controlling seizures. Despite having limitations represented by the fact that our study is observational, with a small study population and a short follow-up period, our results confirm that when choosing an AED, in addition to efficacy, the drug's effect on patients' QoL also needs to be considered, especially for patients facing many psychosocial challenges, such as those with brain tumor-related epilepsy.
[Mh] Termos MeSH primário: Anticonvulsivantes/uso terapêutico
Neoplasias Encefálicas/fisiopatologia
Disfunção Cognitiva/prevenção & controle
Epilepsia/tratamento farmacológico
Isoxazóis/uso terapêutico
Nootrópicos/uso terapêutico
Qualidade de Vida
[Mh] Termos MeSH secundário: Antineoplásicos/efeitos adversos
Antineoplásicos/uso terapêutico
Neoplasias Encefálicas/tratamento farmacológico
Neoplasias Encefálicas/radioterapia
Disfunção Cognitiva/induzido quimicamente
Disfunção Cognitiva/etiologia
Disfunção Cognitiva/fisiopatologia
Terapia Combinada/efeitos adversos
Resistência a Medicamentos
Quimioterapia Combinada/efeitos adversos
Epilepsia/induzido quimicamente
Epilepsia/etiologia
Epilepsia/fisiopatologia
Feminino
Seguimentos
Seres Humanos
Itália
Transtornos da Linguagem/induzido quimicamente
Transtornos da Linguagem/etiologia
Transtornos da Linguagem/fisiopatologia
Transtornos da Linguagem/prevenção & controle
Masculino
Meia-Idade
Projetos Piloto
Radioterapia/efeitos adversos
Índice de Gravidade de Doença
Comportamento Verbal/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anticonvulsants); 0 (Antineoplastic Agents); 0 (Isoxazoles); 0 (Nootropic Agents); 459384H98V (zonisamide)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/WNF.0000000000000218


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[PMID]:28742054
[Au] Autor:Camattari R
[Ad] Endereço:Department of Physics and Earth Sciences, University of Ferrara, Via Saragat 1/c, 44122 Ferrara and INFN section of Ferrara, Italy.
[Ti] Título:Laue lens for radiotherapy applications through a focused hard x-ray beam: a feasibility study on requirements and tolerances.
[So] Source:Phys Med Biol;62(18):7249-7266, 2017 Aug 21.
[Is] ISSN:1361-6560
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Focusing a hard x-ray beam would represent an innovative technique for tumour treatment, since such a beam may deliver a dose to a tumour located at a given depth under the skin, sparing the surrounding healthy cells. A detailed study of a focusing system for hard x-ray aimed at radiotherapy is presented here. Such a focusing system, named Laue lens, exploits x-ray diffraction and consists of a series of crystals disposed as concentric rings capable of concentrating a flux of x-rays towards a focusing point. A feasibility study regarding the positioning tolerances of the crystalline optical elements has been carried out. It is shown that a Laue lens can effectively be used in the context of radiotherapy for tumour treatments provided that the mounting errors are below certain values, which are reachable in the modern micromechanics. An extended survey based on an analytical approach and on simulations is presented for precisely estimating all the contributions of each mounting error, analysing their effect on the focal spot of the Laue lens. Finally, a simulation for evaluating the released dose in a water phantom is shown.
[Mh] Termos MeSH primário: Lentes
Radioterapia/efeitos adversos
Radioterapia/instrumentação
[Mh] Termos MeSH secundário: Estudos de Viabilidade
Seres Humanos
Neoplasias/radioterapia
Imagens de Fantasmas
Dosagem Radioterapêutica
Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1088/1361-6560/aa81fa


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[PMID]:29291278
[Au] Autor:van Loon Y; Hendriksma M; Langeveld TPM; de Jong MA; Baatenburg de Jong RJ; Sjögren EV
[Ad] Endereço:1 Department of Otorhinolaryngology, Head & Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.
[Ti] Título:Treatment Preferences in Patients With Early Glottic Cancer.
[So] Source:Ann Otol Rhinol Laryngol;127(3):139-145, 2018 Mar.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: For early glottic carcinoma, the 2 main treatment modalities are radiotherapy (RT) and transoral CO laser microsurgery (TLM). The aim of this study was to investigate treatment preferences and considerations in patients with early glottic carcinoma (T1-T2) who were given a choice between TLM and RT. SUBJECTS AND METHODS: Patients with early glottic cancer (suspected or confirmed extended T1 or limited T2) were counseled by an ENT-surgeon. A subset of 32 patients was also counseled by a radiotherapist. Treatment choice and considerations were recorded and analyzed. RESULTS: Of 175 patients, 168 patients (96%) chose TLM, and 7 patients (4%) chose RT. The most common reason for choosing TLM was shorter treatment and more treatment options in case of recurrence. Subanalysis showed that additional counseling by the radiotherapist did not seem to affect our patients' preferences for TLM in this group. CONCLUSIONS: The majority of patients in our study prefer TLM to RT when given a choice. Reasons given indicate that optimizing future treatment options and practical considerations seemed more important to our patients than primary functional outcome. Further research is needed to study patient-related and physician-related factors to gain more insight into this complicated process of shared decision making.
[Mh] Termos MeSH primário: Carcinoma
Glote/patologia
Neoplasias Laríngeas
Terapia a Laser
Preferência do Paciente/estatística & dados numéricos
Radioterapia
[Mh] Termos MeSH secundário: Carcinoma/patologia
Carcinoma/psicologia
Carcinoma/terapia
Feminino
Seres Humanos
Neoplasias Laríngeas/patologia
Neoplasias Laríngeas/psicologia
Neoplasias Laríngeas/terapia
Terapia a Laser/métodos
Terapia a Laser/psicologia
Terapia a Laser/estatística & dados numéricos
Masculino
Microcirurgia/métodos
Meia-Idade
Recidiva Local de Neoplasia
Estadiamento de Neoplasias
Países Baixos
Radioterapia/métodos
Radioterapia/psicologia
Radioterapia/estatística & dados numéricos
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180102
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417749253


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[PMID]:29390253
[Au] Autor:Tao Z; Gao J; Qian L; Huang Y; Zhou Y; Yang L; He J; Yang J; Wang R; Zhang Y
[Ad] Endereço:Anhui Provincial Cancer Hospital.
[Ti] Título:Factors associated with acute oral mucosal reaction induced by radiotherapy in head and neck squamous cell carcinoma: A retrospective single-center experience.
[So] Source:Medicine (Baltimore);96(50):e8446, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To investigate risk factors for acute oral mucosal reaction during head and neck squamous cell carcinoma radiotherapy.A retrospective study of patients with head and neck squamous cell carcinoma who underwent radiotherapy from November 2013 to May 2016 in Anhui Provincial Cancer Hospital was conducted. Data on the occurrence and severity of acute oral mucositis were extracted from clinical records. Based on the Radiation Therapy Oncology Group (RTOG) grading of acute radiation mucosal injury, the patients were assigned into acute reaction (grades 2-4) and minimum reaction (grades 0-1) groups. Preradiotherapy characteristics and treatment factors were compared between the 2 groups. Multivariate logistic regression analysis was used to detect the independent factors associated with acute oral mucosal reactions.Eighty patients completed radiotherapy during the study period. Oral mucosal reactions were recorded as 25, 31, and 24 cases of grades 1, 2, and 3 injuries, respectively. Significant differences between acute reaction and minimum reaction groups were detected in cancer lymph node (N) staging, smoking and diabetes history, pretreatment platelet count and T-Helper/T-Suppressor lymphocyte (Th/Ts) ratio, concurrent chemotherapy, and total and single irradiation doses.Multivariate analysis showed that N stage, smoking history, single dose parapharyngeal irradiation, and pretreatment platelet count were independent risk factors for acute radiation induced oral mucosal reaction. Smoking history, higher grading of N stage, higher single dose irradiation, and lower preirradiation platelet count may increase the risk and severity of acute radiation oral mucosal reaction in radiotherapy of head and neck cancer patients.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/radioterapia
Neoplasias de Cabeça e Pescoço/radioterapia
Estomatite/etiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Análise Multivariada
Contagem de Plaquetas
Radioterapia/efeitos adversos
Dosagem Radioterapêutica
Estudos Retrospectivos
Fatores de Risco
Índice de Gravidade de Doença
Fumar/efeitos adversos
Estomatite/classificação
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008446


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[PMID]:28463152
[Au] Autor:Yang DD; Muralidhar V; Mahal BA; Labe SA; Nezolosky MD; Vastola ME; King MT; Martin NE; Orio PF; Choueiri TK; Trinh QD; Spratt DE; Hoffman KE; Feng FY; Nguyen PL
[Ad] Endereço:Harvard Medical School, Boston, Massachusetts.
[Ti] Título:National Trends and Predictors of Androgen Deprivation Therapy Use in Low-Risk Prostate Cancer.
[So] Source:Int J Radiat Oncol Biol Phys;98(2):338-343, 2017 06 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Androgen deprivation therapy (ADT) is not recommended for low-risk prostate cancer because of its lack of benefit and potential for harm. We evaluated the incidence and predictors of ADT use in low-risk disease. METHODS AND MATERIALS: Using the National Cancer Database, we identified 197,957 patients with low-risk prostate cancer (Gleason score of 3 + 3 = 6, prostate-specific antigen level <10 ng/mL, and cT1-T2a) diagnosed from 2004 to 2012 with complete demographic and treatment information. We used multiple logistic regression to evaluate predictors of ADT use and Cox regression to examine its association with all-cause mortality. RESULTS: Overall ADT use decreased from 17.6% in 2004 to 3.5% in 2012. In 2012, 11.5% of low-risk brachytherapy patients and 7.6% of external beam radiation therapy patients received ADT. Among 82,352 irradiation-managed patients, predictors of ADT use included treatment in a community versus academic cancer program (adjusted odds ratio [AOR], 1.60; 95% confidence interval [CI], 1.50-1.71; P<.001; incidence, 14.0% vs 6.0% in 2012); treatment in the South (AOR, 1.51), Midwest (AOR, 1.81), or Northeast (AOR, 1.90) versus West (P<.001); and brachytherapy use versus external beam radiation therapy (AOR, 1.32; 95% CI, 1.27-1.37; P<.001). Among 25,196 patients who did not receive local therapy, predictors of primary ADT use included a Charlson-Deyo comorbidity score of ≥2 versus 0 (AOR, 1.42; 95% CI, 1.06-1.91; P=.018); treatment in a community versus academic cancer program (AOR, 1.61; 95% CI, 1.37-1.90; P<.001); and treatment in the South (AOR, 1.26), Midwest (AOR, 1.52), or Northeast (AOR, 1.28) versus West (P≤.008). Primary ADT use was associated with increased all-cause mortality in patients who did not receive local therapy (adjusted hazard ratio, 1.28; 95% CI, 1.14-1.43; P<.001) after adjustment for age and comorbidity. CONCLUSIONS: ADT use in low-risk prostate cancer has declined nationally but may remain an issue of concern in certain populations and regions.
[Mh] Termos MeSH primário: Antagonistas de Androgênios/uso terapêutico
Neoplasias da Próstata/tratamento farmacológico
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos/estatística & dados numéricos
Centros Médicos Acadêmicos/tendências
Adulto
Idoso
Idoso de 80 Anos ou mais
Braquiterapia/utilização
Institutos de Câncer/estatística & dados numéricos
Institutos de Câncer/tendências
Centros Comunitários de Saúde/estatística & dados numéricos
Centros Comunitários de Saúde/tendências
Crioterapia/utilização
Bases de Dados Factuais/estatística & dados numéricos
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
National Cancer Institute (U.S.)/estatística & dados numéricos
Gradação de Tumores
Modelos de Riscos Proporcionais
Prostatectomia/utilização
Neoplasias da Próstata/epidemiologia
Neoplasias da Próstata/radioterapia
Neoplasias da Próstata/cirurgia
Radioterapia/utilização
Risco
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Androgen Antagonists)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:28449703
[Au] Autor:van Leeuwen CM; Oei AL; Chin KWTK; Crezee J; Bel A; Westermann AM; Buist MR; Franken NAP; Stalpers LJA; Kok HP
[Ad] Endereço:Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. c.m.vanleeuwen@amc.uva.nl.
[Ti] Título:A short time interval between radiotherapy and hyperthermia reduces in-field recurrence and mortality in women with advanced cervical cancer.
[So] Source:Radiat Oncol;12(1):75, 2017 Apr 27.
[Is] ISSN:1748-717X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Combined radiotherapy and hyperthermia is a well-established alternative to chemoradiotherapy for advanced stage cervical cancer patients with a contraindication for chemotherapy. Pre-clinical evidence suggests that the radiosensitizing effect of hyperthermia decreases substantially for time intervals between radiotherapy and hyperthermia as short as 1-2 h, but clinical evidence is limited. The purpose of this study is to determine the effect of the time interval between external beam radiotherapy (EBRT) and same-day hyperthermia on in-field recurrence rate, overall survival and late toxicity in women with advanced stage cervical cancer. METHODS: Patients with advanced stage cervical cancer who underwent a full-course of curative daily EBRT and (4-5) weekly hyperthermia sessions between 1999 and 2014 were included for retrospective analysis. The mean time interval between EBRT fractions and same-day hyperthermia was calculated for each patient; the median thereof was used to divide the cohort in a 'short' and 'long' time-interval group. Kaplan-Meier analysis and stepwise Cox regression were used to compare the in-field recurrence and overall survival. Finally, high-grade (≥3) late toxicity was compared across time-interval groups. DNA repair suppression is an important hyperthermia mechanism, DNA damage repair kinetics were therefore studied in patient biopsies to support clinical findings. RESULTS: Included were 58 patients. The 3-year in field recurrence rate was 18% and 53% in the short (≤79.2 min) and long (>79.2 min) time-interval group, respectively (p = 0.021); the 5-year overall survival was 52% and 17% respectively (p = 0.015). Differences between time-interval groups remained significant for both in-field recurrence (HR = 7.7, p = 0.007) and overall survival (HR = 2.3, p = 0.012) in multivariable Cox regression. No difference in toxicity was observed (p = 1.00), with only 6 and 5 events in the short and long group, respectively. The majority of DNA damage was repaired within 2 h, potentially explaining a reduced effectiveness of hyperthermia for long time intervals. CONCLUSIONS: A short time interval between EBRT and hyperthermia is associated with a lower risk of in-field recurrence and a better overall survival. There was no evidence for difference in late toxicity.
[Mh] Termos MeSH primário: Hipertermia Induzida/mortalidade
Recidiva Local de Neoplasia/mortalidade
Radioterapia/mortalidade
Neoplasias do Colo do Útero/mortalidade
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Terapia Combinada
Feminino
Seguimentos
Seres Humanos
Meia-Idade
Recidiva Local de Neoplasia/patologia
Recidiva Local de Neoplasia/terapia
Prognóstico
Estudos Retrospectivos
Taxa de Sobrevida
Fatores de Tempo
Neoplasias do Colo do Útero/patologia
Neoplasias do Colo do Útero/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1186/s13014-017-0813-0



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