Wednesday, December 7, 2011

Targeted Drugs, Lung CT Screening Top Cancer Advances in 2011

Report from leading oncologists' group finds strides were made against tough-to-treat tumors

HealthDay news image

Source: HealthDay





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Correlation of low SLC22A18 expression with poor prognosis in patients with glioma

Publication year: 2011
Source: Journal of Clinical Neuroscience, Available online 5 December 2011
Sheng-Hua Chu, Yan-Bin Ma, Dong-Fu Feng, Hong Zhang, Zhi-An Zhu, ...
We investigated the expression of the putative tumor suppressor SLC22A18 to evaluate it as a prognostic marker in glioma patients. Immunohistochemical and Western blot analyses of clinical tissue samples obtained from 120 patients with glioma were performed. Low expression of SLC22A18 was observed in 71.7% of patients. Loss of SLC22A18 expression in glioma was significantly related to pathological grade (p = 0.003). High pathological grade (World Health Organization III–IV) was correlated with negative (low or absent) expression of SLC22A18, which was correlated with a significantly shorter overall patient survival than in those with positive (high) expression (p = 0.007). Multivariate Cox regression analysis indicated that SLC22A18 expression level is an independent survival prognostic factor for patients with glioma (p = 0.011). Western blotting analysis confirmed decreased expression of SLC22A18 in glioma tissues compared with adjacent brain tissues. This study suggests that SLC22A18 functions as a tumor suppressor in glioma and represents a candidate biomarker for long-term survival in this disease.





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2011 Nobel Laureate Ralph Steinman Explains Discovery of Cells Used for Cancer Treatment [Video]

In the quest to cure cancer, many researchers have started looking beyond toxic chemicals and harsh radiation and instead are trying to harness the body's immune system.

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A third of all cancers in the UK are potentially preventable, finds review

A third (more than 100 000 cases) of all cancers in the United Kingdom are caused by just four risk factors and are potentially preventable, concludes a comprehensive review of the evidence.The...





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Tuesday, December 6, 2011

Decision-making in the end-of-life phase of high-grade glioma patients

Publication year: 2011
Source: European Journal of Cancer, Available online 5 December 2011
Eefje M. Sizoo, H. Roeline W. Pasman, Janine Buttolo, Jan J. Heimans, Martin Klein, ...
BackgroundDuring the disease course of high-grade glioma (HGG) patients, the goal of therapy eventually shifts from primarily life-prolongation to primarily sustaining the quality of life as good as possible. End-of-life care is aimed at prolongation of life with good quality, but inevitably also may require medical decisions for prevention and relief of suffering with a potential life shortening effect. Few data are available on this end-of-life decision (ELD) making process in HGG patients, with decreased consciousness, confusion or cognitive deficits preventing them to participate. In this study the ELD-making process in HGG patients is described.MethodsPhysicians and relatives of a cohort of 155 deceased HGG patients were identified to fill in a questionnaire regarding the end-of-life conditions (patients' ELD preferences, patients' competence) and ELD-making (forgoing treatment and the administration of drugs with a potential life-shortening effect) for their patient or relative. Data were analysed with descriptive statistics.FindingsOf 101 patients, physicians completed surveys including questions about ELDs (62% response rate). More than half of the patients relatively early became incompetent to make decisions due to delirium, cognitive deficits and/or decreasing consciousness. In 40% of patients the physician did not discuss ELD preferences with his/her patient. At least one ELD was made in 72% of patients, most often this comprised the withdrawal of dexamethasone. Palliative sedation was performed in 30% of patients and physician assisted death in 7%.InterpretationELDs are common practises amongst HGG patients, although their preferences towards ELDs are frequently unknown to the physician. Because the majority of patients become incompetent towards death, participation in ELD-making is only possible with advanced care planning. Hence, timely discussion of ELD preferences is encouraged.





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Monday, December 5, 2011

Atypical teratoid/rhabdoid tumors: the need for more active therapeutic measures in younger patients

Abstract  
Despite active and aggressive therapeutic measures, atypical teratoid/rhabdoid tumors (AT/RTs) are without doubt one of the most malignant brain tumors that occur during childhood. These tumors are more prevalent in children less than 3 years of age, and the prognosis is worse in these young children. Medical records of 14 patients diagnosed at our institution were reviewed. Patients diagnosed with AT/RT at our institution between 1997 and 2009 were identified. Clinical data for those patients with pathologic confirmation of AT/RTs were reviewed regarding surgery, adjuvant treatment, and survival. A total of 14 patients were identified. One patient who died 3 days after initial surgery was excluded, and 13 patients were recruited. Of the 13 patients, 7 were less than 1 year of age, and only 2 were over 3 years of age. Nine patients showed dissemination at diagnosis. Four patients were treated with radiation therapy (RTx), and 2 of these were less than 3 years of age. Ten patients had chemotherapy (CTx), and 3 of these underwent high dose chemotherapy and autologous peripheral blood stem cell transplantation. The median progression-free survival (PFS) was 4 months, and the median overall survival (OS) was 9 months. Univariable analysis revealed age more than 1 year, CTx, and RTx to be significant factors for better PFS and OS. None of the variables were significant in multivariable analysis. Young patients with AT/RT have a bad prognosis. An aggressive therapeutic strategy needs to be profiled for this age group.

  • Content Type Journal Article
  • Category Clinical Study - Patient Study
  • Pages 1-7
  • DOI 10.1007/s11060-011-0769-0
  • Authors
    • Ji Yeoun Lee, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea
    • In-Kyeong Kim, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea
    • Ji Hoon Phi, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea
    • Kyu-Chang Wang, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea
    • Byung-Kyu Cho, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea
    • Sung-Hye Park, Department of Pathology, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
    • Hyo Seop Ahn, Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
    • Il Han Kim, Department of Radiation Oncology, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
    • Seung-Ki Kim, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea





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Atypical teratoid/rhabdoid tumors: the need for more active therapeutic measures in younger patients

Abstract  
Despite active and aggressive therapeutic measures, atypical teratoid/rhabdoid tumors (AT/RTs) are without doubt one of the most malignant brain tumors that occur during childhood. These tumors are more prevalent in children less than 3 years of age, and the prognosis is worse in these young children. Medical records of 14 patients diagnosed at our institution were reviewed. Patients diagnosed with AT/RT at our institution between 1997 and 2009 were identified. Clinical data for those patients with pathologic confirmation of AT/RTs were reviewed regarding surgery, adjuvant treatment, and survival. A total of 14 patients were identified. One patient who died 3 days after initial surgery was excluded, and 13 patients were recruited. Of the 13 patients, 7 were less than 1 year of age, and only 2 were over 3 years of age. Nine patients showed dissemination at diagnosis. Four patients were treated with radiation therapy (RTx), and 2 of these were less than 3 years of age. Ten patients had chemotherapy (CTx), and 3 of these underwent high dose chemotherapy and autologous peripheral blood stem cell transplantation. The median progression-free survival (PFS) was 4 months, and the median overall survival (OS) was 9 months. Univariable analysis revealed age more than 1 year, CTx, and RTx to be significant factors for better PFS and OS. None of the variables were significant in multivariable analysis. Young patients with AT/RT have a bad prognosis. An aggressive therapeutic strategy needs to be profiled for this age group.

  • Content Type Journal Article
  • Category Clinical Study - Patient Study
  • Pages 1-7
  • DOI 10.1007/s11060-011-0769-0
  • Authors
    • Ji Yeoun Lee, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea
    • In-Kyeong Kim, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea
    • Ji Hoon Phi, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea
    • Kyu-Chang Wang, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea
    • Byung-Kyu Cho, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea
    • Sung-Hye Park, Department of Pathology, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
    • Hyo Seop Ahn, Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
    • Il Han Kim, Department of Radiation Oncology, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
    • Seung-Ki Kim, Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744 Republic of Korea





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Malignant potential of pleomorphic xanthoastrocytoma

Publication year: 2011
Source: Journal of Clinical Neuroscience, Available online 3 December 2011
Tamara M. Vu, Simon V. Liubinas, Michael Gonzales, Katharine J. Drummond
Pleomorphic xanthoastrocytoma (PXA) is a low-grade astrocytic tumour that occasionally progresses to a higher grade. We have extensively reviewed the literature on the potential for malignant transformation of PXA. An illustrative case of a PXA transforming to glioblastoma multiforme is presented.





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Friday, December 2, 2011

Hydroxyurea for recurrent surgery and radiation refractory high-grade meningioma

Abstract  
Hydroxyurea (HU), an orally administered chemotherapy, has become the de facto standard chemotherapeutic agent in patients with surgically and radiation refractory meningiomas based on a limited literature. A retrospective case series of 35 patients with recurrent WHO Grade 2 (n = 22) or 3 (n = 13) meningioma treated with HU following progression after surgery and radiotherapy was collated with primary study objectives of overall response rate, median and progression free survival (PFS) at 6-months. Thirty-five patients (25 women; 10 men: median age 63 years, range 34–86) with recurrent high-grade meningioma were treated with HU (1,000 mg/m2 orally divided twice per day; one cycle operationally defined as 4 weeks of daily HU). Patients had progressed radiographically after prior therapy with surgery (35/35) and radiotherapy (35/35: external beam radiotherapy 35/35; stereotactic radiotherapy 35/35). No patient received prior chemotherapy or targeted therapy before instituting HU. Patients received 0.5–7 cycles (median 2.0) of HU with modest toxicity (28.5% all grades and 8.5% grade 3+ anemia or fatigue). There were no radiographic responses, 43% of patients had stable disease and 57% manifested progressive disease at first evaluation. The overall PFS was 3.0% at 6 months (median PFS 2.0 months; 95% CI 1.6–2.4). The majority of patients (80%) following progression on HU were subsequently treated on an investigational trial. In this retrospective series, HU though well tolerated and convenient appeared to have very limited activity, raise questions of what constitutes effective salvage therapy and indicates an unmet need for alternative treatments for recurrent high-grade meningiomas.

  • Content Type Journal Article
  • Category Clinical Study - Patient Study
  • Pages 1-7
  • DOI 10.1007/s11060-011-0741-z
  • Authors
    • Marc C. Chamberlain, Division of Neuro-Oncology, Departments of Neurology and Neurological Surgery, University of Washington, Seattle, WA, USA





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Thursday, December 1, 2011

Early rehabilitation after surgery improves functional outcome in inpatients with brain tumours

Abstract  
Clinical experience suggests that application of the fundamental principles of rehabilitation medicine can improve the care of patients with cancer. Despite the high incidence of neurological and functional deficits in patients affected by brain tumours (BTs), rehabilitation treatment of this population is not as well established as it is for patients with other neurological conditions. To assess functional outcome in brain tumour inpatients who underwent early rehabilitation after surgery. 75 patients who had undergone neurosurgery for primary BTs and 75 patients affected by stroke were enrolled in a case-control study. All patients were evaluated by means of a core set of clinical scales (Functional Independence Measure, Sitting Balance score, Standing Balance score, Hauser Index, Massachusetts General Hospital Functional Ambulation Classification). Patients were evaluated before the beginning (T0) and at the end (T1) of rehabilitation treatment. The neurorehabilitation programme consisted of individual 60-min sessions of treatment, administered once a day, six days a week, for four consecutive weeks. Speech therapy was included when aphasia was diagnosed. All the measures of outcome were indicative of substantial improvements for neuro-oncological and for stroke patients (P = 0.000). Analysis of subgroups showed that patients affected by meningioma achieved better results (in efficiency terms) as regards independence in activities of daily living (P = 0.02) and mobility (P = 0.04) compared with patients affected by glioblastoma or stroke. Rehabilitation after surgery can improve functional outcome, justifying the delivery of rehabilitation services, even during the acute phase, to BTs inpatients, irrespective of tumour type.

  • Content Type Journal Article
  • Category Clinical Study - Patient Study
  • Pages 1-8
  • DOI 10.1007/s11060-011-0772-5
  • Authors
    • Michelangelo Bartolo, Neurorehabilitation Unit, IRCCS NEUROMED Mediterranean Neurological Institute, Via Atinense, 18, 86077 Pozzilli, Isernia, Italy
    • Chiara Zucchella, Neurology Unit, Palliative Home-Care Unit for Brain Tumour Patients, Regina Elena National Cancer Institute, Rome, Italy
    • Andrea Pace, Neurology Unit, Palliative Home-Care Unit for Brain Tumour Patients, Regina Elena National Cancer Institute, Rome, Italy
    • Gaetano Lanzetta, Neurorehabilitation Unit, IRCCS NEUROMED Mediterranean Neurological Institute, Via Atinense, 18, 86077 Pozzilli, Isernia, Italy
    • Carmine Vecchione, Stroke Unit, IRCCS NEUROMED Mediterranean Neurological Institute, Pozzilli, Isernia, Italy
    • Marcello Bartolo, Neuroradiological Unit, IRCCS NEUROMED Mediterranean Neurological Institute, Pozzilli, Isernia, Italy
    • Giovanni Grillea, Neuroradiological Unit, IRCCS NEUROMED Mediterranean Neurological Institute, Pozzilli, Isernia, Italy
    • Mariano Serrao, Neurorehabilitation Unit, "Sapienza" University of Rome-Polo Pontino, Latina, Italy
    • Cristina Tassorelli, Neurorehabilitation Unit, IRCCS National Neurological Institute C. Mondino Foundation, Pavia, Italy
    • Giorgio Sandrini, Neurorehabilitation Unit, IRCCS National Neurological Institute C. Mondino Foundation, Pavia, Italy
    • Francesco Pierelli, Neurorehabilitation Unit, IRCCS NEUROMED Mediterranean Neurological Institute, Via Atinense, 18, 86077 Pozzilli, Isernia, Italy





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