Tuesday, August 14, 2012

Socio-economic implications of cancer survivorship: Results from the PROFILES registry

Publication year: 2012
Source:European Journal of Cancer, Volume 48, Issue 13
Floortje Mols, Melissa S.Y. Thong, Pauline Vissers, Tamar Nijsten, Lonneke V. van de Poll-Franse
Introduction The goal of this large population-based study was to examine the socio-economic implications of cancer survivorship. Methods Individuals alive and diagnosed with colorectal cancer and melanoma between 1998 and 2007 or Hodgkin lymphoma, non-Hodgkin lymphoma or multiple myeloma between 1999 and 2008 as registered in the Eindhoven Cancer Registry received a questionnaire on work changes and problems with obtaining a new (or extended) health care insurance, life insurance or a home loan; 70% (n =2892) responded. Results Results showed that 28% of all cancer patients experienced changes in their work situation after cancer. Most of them switched to part-time work or stopped working entirely. Patients (3.4%) who tried to obtain a different or upgrade their health care insurance experienced problems and in most cases, these were eventually resolved. Problems with life insurance were somewhat more common with 18% of those who tried to obtain a life insurance experiencing problems. The majority of these patients was rejected by the insurance company (61%) or was accepted at a higher premium (22%). Of the 21% who tried to obtain a home loan, 9% experienced problems. However, 22.2% got accepted eventually, 27.8% got accepted but at a higher mortgage payment and 22.2% got rejected but were eventually accepted by another bank. Conclusions Almost a third of cancer survivors experienced changes in their work situation after cancer. Problems with obtaining health insurance, life insurance and home loans were also common.






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Paediatric brain tumours treated at a single, tertiary paediatric neurosurgical referral centre from

Publication year: 2012
Source:Journal of Clinical Neuroscience
Mahesh Ramanan, Raymond Chaseling
Paediatric brain tumours are the most common solid tumour of childhood and the most common cancer cause of death among children. A retrospective review of 313 histopathologically proven brain tumours over an 11-year period has been performed at the Children's Hospital Westmead, New South Wales, Australia, to determine proportions and locations of different tumours, age distribution, survival rates and usage of various treatment modalities. Pilocytic astrocytoma was the most common paediatric brain tumour (29%) followed by medulloblastoma (12%) and ependymoma (6%). Most tumours were histologically benign (59%), and 42% of tumours were located in the posterior fossa. The average age at diagnosis was 7.9years. About 50% of children were treated with surgery alone, whereas the other 50% had surgery or biopsy plus adjuvant treatment. The overall one-year survival rate was 89% and the five-year survival rate was 80%. The five-year survival rates for pilocytic astrocytoma was 91%; medulloblastoma, 75%; ependymoma, 82%; and high grade glioma, 15%. Thus, a large proportion of paediatric brain tumours were histologically benign and were treated with surgery alone, but a subset of benign tumours required adjuvant treatment and were associated with mortality (25%). The overall survival rates were high and are improving, although for some tumours, such as high grade glioma, the outlook remains poor.






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Monday, August 13, 2012

Stereotactic radiosurgery of intracranial tumors: a comparison of intensity-modulated radiosurgery and dynamic conformational arc


Stereotactic radiosurgery of intracranial tumors: a comparison of intensity-modulated radiosurgery and dynamic conformational arc

Marcos Dellaretti, Júlio Leonardo Barbosa Pereira, Eduardo Tagawa, and Mariana Pedrini

Purpose: Intensity-modulated radiosurgery (IMRT) and dynamic conformational arc (DCA) are two techniques for linac-stereotactic radiosurgery using the micro-multileaf collimator. The objective of this study is to examine advantages and disadvantages of these techniques in the treatment of treatment of intracranial tumors.

Materials and Methods: SRS treatment plans were developed for 21 patients with vestibular schwannoma, glomus jugulare, pituitary adenoma and cavernous sinus meningioma. For all patients, we developed an IMRT and a DCA plan using BrainLab Iplan 4.1. Plans were evaluated using the target coverage conformity index (CI), homogeneity index (HI), Gradient Index (GI) and doses in critical structures (optic pathways and brainstem).

Results: In the overall comparison of both techniques, HI and CI was better in the IMRT group, showing a statistically significant difference. The GI was similar in two groups. Comparison of the mean dose in critical structures of the techniques revealed no statistically significant differences. The DCA plan was acceptable in 9 patients and IMRT in 15 patients. IMRT was preferred in 14 out of 15 patients due to better CI and lower dose in critical structures with adequate target coverage.

Conclusions: IMRT is the preferred stereotactic radiosurgery technique for most intracranial benign tumors close to critical structures.

Keywords: Intensity-modulated radiosurgery, dynamic conformational arc, radiosurgery and intracranial tumors.

http://www.oldcitypublishing.com/JRSBRT/JRSBRTcontents/JRSBRTv1n4contents.html
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Sunday, August 12, 2012

Predictive factors for craniopharyngioma recurrence. A systematic review and illustrative case repor

Publication year: 2012
Source:World Neurosurgery
Ruth Prieto, José M. Pascual, Issa Subhi-Issa, Manuela Jorquera, Miguel Yus, Roberto Martínez
Background And Objective Recurrence of craniopharyngiomas (CPs) represents a frequent and unpredictable incident. Rapid tumor recurrence within a few months after surgery has been rarely reported. Non definitive predictive factors for rapid CP recurrence have been identified to date. We have systematically analyzed the tumor factors that presumably influence in CP recurrence. Methods We present the histological and immunohistochemical analysis of an infundibulo-tuberal CP that was operated twice within a three-month interval due to rapid recurrence. We investigated the differential characteristics of the subgroup of CPs that recurred in large surgical series published in the literature, along with cases reporting rapid tumor recurrence after surgery. Results Specimens of our case showed an adamantinomatous CP with whorl-like arrays and thick peritumoral gliosis. Ki-67 labelling index (LI) in primary and recurrent samples was 20% and 15%, respectively. P53 LI was 18% and 15%, respectively. The thorough analysis of literature showed that presence of tumor remnants and missing radiotherapy treatment after subtotal removal are strong predictors of tumor recurrence. Third-ventricle involvement, large tumor size, tight adherence to surrounding structures and presence of whorl-like arrays might also foster recurrence. High Ki-67 levels, p53 expression and an intense reactive gliosis might point to rapid tumor growth. Conclusion Reliable tumor markers which predict CP recurrence are still lacking. The CP features presumably related to a higher risk of its recurrence are thought to be a larger tumor size, a tight adherence to the hypothalamus, the presence of whorl-like arrays and high Ki-67 and p53 levels.






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Thursday, August 9, 2012

Tecnologia da Informação e a Medicina: App Dor de Cabeça para iPhone e iPad: auxílio no diagnóstico

App Dor de Cabeça para iPhone e iPad: auxílio no diagnóstico da Cefaléia

App Dor de Cabeça é uma ferramenta para Cefaléia, que auxilia o paciente e o médico no seu diagnóstico. Com ele é opossível registrar os dias e horários das crises de dor de cabeça, a intensidade e a localização da dor, os sintomas que acompanham as crises, os remédios em uso  e até alarme para lembrar de tomar o remédio no horário certo.

  
 As informações ficam salvas em nuvem para que você não corra o risco de perder nada. Possibilitando acessar os seus dados em qualquer dispositivo Apple® conectado a internet.

Tudo isso transforma-se em um relatório completo para que seu médico possa identificar com precisão a causa do problema e receitar o tratamento ideal.





Funcionalidades
✓ Cadastro de medicamentos utilizados
✓ Alarme para lembrar o horário do remédio
✓ Diário de registro das crises (dia, horário, intensidade, sintomas, localização da dor)
✓ Dados sincronizados em nuvem
✓ Registro do período menstrual (fator importante para dores de cabeça nas mulheres)
✓ Histórico das crises
✓ Compartilhar histórico com o seu médico

App Dor de Cabeça
Idioma: português
Preço: $1,99

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Trial design on prophylaxis and treatment of brain metastases: Lessons learned from the EORTC Brain

Publication year: 2012
Source:European Journal of Cancer
Matthias Preusser, Frank Winkler, Laurence Collette, Sven Haller, Sandrine Marreaud, Riccardo Soffietti, Martin Klein, Jaap C. Reijneveld, Jörg-Christian Tonn, Brigitta G. Baumert, Paula Mulvenna, Dirk Schadendorf, Renata Duchnowska, Anna Sophie Berghoff, Nancy Lin, David A. Cameron, Yazid Belkacemi, Jacek Jassem, Damien C. Weber
Brain metastases (BM) occur in a significant proportion of cancer patients and are associated with considerable morbidity and poor prognosis. The trial design in BM patients is particularly challenging, as many disease and patient variables, statistical issues, and the selection of appropriate end-points have to be taken into account. During a meeting organised on behalf of the European Organisation for Research and Treatment of Cancer (EORTC), methodological aspects of trial design in BM were discussed. This paper summarises the issues and potential trial strategies discussed during this meeting and may provide some guidance for the design of trials in BM patients.






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Wednesday, August 8, 2012

Risk Of Brain Tumors May Be Lower In Those With Allergies

New research adds to the growing body of evidence suggesting that there's a link between allergies and reduced risk of a serious type of cancer that starts in the brain. This study suggests the reduced risk is stronger among women than men, although men with certain allergy profiles also have a lower tumor risk...





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Expression of VAV1 in the tumour microenvironment of glioblastoma multiforme

Abstract  
Even though much progress has been made towards understanding the molecular nature of glioma, the survival rates of patients affected by this tumour have not changed significantly over recent years. Better knowledge of this malignancy is still needed in order to predict its outcome and improve patient treatment. VAV1 is an GDP/GTP exchange factor for Rho/Rac proteins with oncogenic potential that is involved in the regulation of cytoskeletal dynamics and cell migration. Here we report its overexpression in 59 patients diagnosed with high-grade glioma, and the associated upregulation of a number of genes coding for proteins also involved in cell invasion- and migration-related processes. Unexpectedly, immunohistochemical experiments revealed that VAV1 is not expressed in glioma cells. Instead, VAV1 is found in non-tumoural astrocyte-like cells that are located either peritumouraly or perivascularly. We propose that the expression of VAV1 is linked to synergistic signalling cross-talk between cancer and infiltrating cells. Interestingly, we show that the pattern of expression of VAV1 could have a role in the neoplastic process in glioblastoma tumours.

  • Content Type Journal Article
  • Category Clinical Study - Patient Study
  • Pages 1-9
  • DOI 10.1007/s11060-012-0936-y
  • Authors
    • Juan Luis Garcia, Research Unit, IECSCYL-Hospital Universitario de Salamanca. IBSAL, IBMCC (USALCSIC), Paseo San Vicente 58, 37007 Salamanca, Spain
    • Jose Couceiro, Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
    • Juan Antonio Gomez-Moreta, Neurosurgery Service, Hospital Universitario de Salamanca, Salamanca, Spain
    • J. M. Gonzalez Valero, Research Unit, IECSCYL-Hospital Universitario de Salamanca, Paseo San Vicente 58, 37007 Salamanca, Spain
    • Angel Santos Briz, Department of Pathology, Hospital Universitario de Salamanca, Salamanca, Spain
    • Vincent Sauzeau, Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
    • Eva Lumbreras, Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
    • Manuel Delgado, Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
    • Cristina Robledo, Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
    • Monica Lara Almunia, Neurosurgery Service, Hospital Universitario de Salamanca, Salamanca, Spain
    • Xose R. Bustelo, Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
    • Jesus M. Hernandez, Centro de Investigación del Cáncer and Instituto de Biología Molecular y Celular del Cáncer IBSAL, IBMCC (USALCSIC) Department of Haematology, Hospital Universitario de Salamanca, Paseo San Vicente 58, 37007 Salamanca, Spain





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Sunday, August 5, 2012

Confira Dor de Cabeça

Dor de Cabeça

Confira este app na App Store:

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Dor de Cabeça

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Categoria: Medicina

Atualizado: 02/08/2012
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Saturday, August 4, 2012

Risk factors of brain metastases in completely resected pathological stage IIIA-N2 non-small cell lu

Background Brain metastases (BM) is one of the most common failures of locally advanced non-small cell lung cancer (LA-NSCLC) after combined-modality therapy. The outcome of trials on prophylactic cranial irradiation (PCI) has prompted us to identify the highest-risk subset most likely to benefit from PCI. Focusing on patients with completely resected pathological stage IIIA-N2 (pIIIA-N2) NSCLC, we aimed to assess risk factors of BM and to define the highest-risk subset.Methods Between 2003 and 2005, the records of 217 consecutive patients with pIIIA-N2 NSCLC in our institution were reviewed. The cumulative incidence of BM was estimated using the Kaplan-Meier method, and differences between the groups were analyzed using log-rank test. Multivariate Cox regression analysis was applied to assess risk factors of BM.Results Fifty-three (24.4%) patients developed BM at some point during their clinical course. On multivariate analysis, non-squamous cell cancer (relative risk [RR]: 4.13, 95% CI: 1.86-9.19; P = 0.001) and the ratio of metastatic to examined nodes or lymph node ratio (LNR) [greater than or equal to] 30% (RR: 3.33, 95% CI: 1.79-6.18; P = 0.000) were found to be associated with an increased risk of BM. In patients with non-squamous cell cancer and LNR [greater than or equal to] 30%, the 5-year actuarial risk of BM was 57.3%.Conclusions In NSCLC, patients with completely resected pIIIA-N2 non-squamous cell cancer and LNR [greater than or equal to] 30% are at the highest risk for BM, and are most likely to benefit from PCI. Further studies are warranted to investigate the effect of PCI on this subset of patients.





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