American journal of clinical oncology
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Am. J. Clin. Oncol. · Feb 2013
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of lymphedema in patients with axillary lymph node dissections to those with sentinel lymph node biopsy followed by immediate and delayed ALND.
The purpose of the study was to show that delayed axillary lymph node dissection (ALND) has higher rates of lymphedema compared with immediate ALND, using data from NSABP-B32 at Beaumont Hospital. ⋯ The rate of lymphedema was higher in delayed ALND but not statistically significant. Comparison, however, is difficult, given the limited sample size. We urge the other centers of NSABP-B32 to validate this, by contacting the node-positive patients for measurements. The lymphedema rate for SLNB alone was 0% and approached statistical significance when compared with node-negative ALND.
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Am. J. Clin. Oncol. · Oct 2010
Multicenter Study Comparative StudyPopulation-based analysis of the frequency of anemia and its management before and during chemotherapy in patients with malignant lymphoma.
In patients with hematologic malignancies, chemotherapy can further suppress bone marrow production. Whereas measures to correct anemia can improve patients' function and quality of life, the intervention threshold and the methods of correcting anemia in patients with malignant lymphoma are not clear. This study evaluates the frequency of anemia and the interventions used to correct anemia before and during chemotherapy for patients with Hodgkin and non-Hodgkin lymphomas. ⋯ Anemia was common prior to and during chemotherapy in patients with malignant lymphoma. The threshold of anemia intervention varied, with transfusion being the predominant method used. The rates of intervention for anemia were low in patients with anemia, despite randomized trials showing that anemia correction can improve fatigue and quality of life.
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Am. J. Clin. Oncol. · Oct 2010
Multicenter Study Comparative Study Clinical TrialHigh-dose-rate prostate brachytherapy: an excellent accelerated-hypofractionated treatment for favorable prostate cancer.
The radiobiology of prostate cancer appears to favor large fractions. Accelerated hypofractionation treatments may therefore be used to improve the therapeutic ratio, particularly when the doses to rectum and bladder are kept below the prostate dose. The 5-year experience at William Beaumont Hospital (WBH) and the California Endocurietherapy Center (CET) with accelerated-hypofractionated high-dose-rate (HDR) monotherapy in favorable prostate cancer is presented. ⋯ Although the same 5-year BC rates were achieved with HDR (248 patients) and LDR (206 patients) monotherapy, HDR brachytherapy was associated with less acute and chronic genitourinary and gastrointestinal toxicities. As another accepted standard of care, accelerated hypofractionated HDR monotherapy is target specific and efficient radiobiologically than EBRT which has many smaller doses per fraction. It could be considered today as the best option in accelerated hypofractionated prostate cancer treatment.
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Am. J. Clin. Oncol. · Dec 2008
Multicenter StudyHistopathological response to preoperative chemoradiation for resectable pancreatic adenocarcinoma: the French Phase II FFCD 9704-SFRO Trial.
This study suggests that pancreatic adenocarcinoma is a chemoradiosensitive tumor and that preoperative chemoradiation provides antitumoral effect associated with major histopathological response in 50% of patients and a high R0 resection rate. Evaluation of histopathological response to neoadjuvant therapy may serve as a surrogate marker for treatment efficacy and remains an active area of investigation. ⋯ This study suggests that some pancreatic adenocarcinomas are chemoradiosensitive and that preoperative chemoradiation provides antitumoral effect associated with major histopathological response in 50% of patients and a high R0 resection rate. Further research is needed to determine the biologic difference between responders and nonresponders, to evaluate the predictive value of treatment response parameters, and to optimize the chemoradiation regimen.
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Am. J. Clin. Oncol. · Aug 2007
Multicenter StudyCan serum markers be used to predict acute and late toxicity in patients with lung cancer? Analysis of RTOG 91-03.
To identify factors that are predictive of satisfactory acute and long-term pulmonary tolerance of definitive irradiation and, conversely, factors that are predictive of excessive impairment of pulmonary functions. To determine if there is any correlation between early elevation of biochemical markers obtained in blood of irradiated patients and subsequent pulmonary abnormalities as detected by clinical findings, pulmonary function tests, and/or radiographic findings of pneumonitis/fibrosis. ⋯ Elevated levels of serum IL-6 after 10 Gy of lung irradiation appear to predict grade >or=2 acute lung toxicity, and high serum levels of surfactant apoproteins at 20 Gy correlated with grade >or=2 late pulmonary toxicity. These findings need to be confirmed but could be useful in a model to predict risk of pulmonary injury with high doses of radiation. For future studies, it is necessary to evaluate serum markers at multiple time-points during treatment, and quality control is critical during the collection, storage, and analysis of these serum markers.