Safety and Outcome Measures of First-in-Human Intraperitoneal α Radioimmunotherapy With 212Pb-TCMC-Trastuzumab
Purpose: One-year monitoring of patients receiving intraperitoneal (IP) 212Pb-TCMC-trastuzumab to provide long-term safety and outcome data. A secondary objective was to study 7 tumor markers for correlation with outcome. Methods: Eighteen patients with relapsed intra-abdominal human epidermal growth factor receptor-2 expressing peritoneal metastases were treated with a single IP infusion of 212Pb-TCMC-trastuzumab, delivered (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Experimental Therapeutics Source Type: research

The Association Between Out-of-Pocket Costs and Adherence to Adjuvant Endocrine Therapy Among Newly Diagnosed Breast Cancer Patients
We examined medical and pharmacy claims for the 1-year period after initiating AET using the Truven Health Analytics MarketScan database. Adherence was defined as ≥80% proportion of days covered. Mean out-of-pocket costs for AET fill were measured as the sum of copayments, coinsurance, and deductibles and adjusted to 30-day amounts. Using a multivariable logistic regression model we calculated adjusted risk ratios controlling for age, comorbidities, type of surgery, use of chemotherapy and/or radiation therapy, average out-of-pocket costs for other services, and pharmacy use characteristics. Results: Of the 6863 wome...
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Breast Source Type: research

Axillary Ultrasound Fine Needle Aspiration Biopsy: Is There a Role in the Post Z-0011 Era?
Objectives: Axillary ultrasound with fine needle aspiration (AXUSFNA) in early-stage breast cancer has required reappraisal. ACOSOG Z-0011 and after mapping of the axilla: radiotherapy or surgery have shown that women with limited nodal disease at sentinel lymph node biopsy got no survival advantage with completion axillary node dissection. We hypothesize that AXUSFNA may be sufficiently accurate for staging for some patients and sentinel lymph node biopsy need not be performed. We define the false negative rate (FNR) of AXUSFNA in different subsets of patients. Materials and Methods: This retrospective cohort study i...
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Breast Source Type: research

Clinical Outcomes After Lung Stereotactic Body Radiation Therapy in Patients With or Without a Prior Lung Resection
Objectives: Tumor control (TC), toxicity and survival, following stereotactic body radiation therapy (SBRT) were compared between patients with and without a prior lung resection (PLR). Materials and Methods: The study is comprised of 130 patients with 141 peripheral tumors treated with SBRT at our institution from 2009 to 2013. Primary TC and lobar control (LC) were defined per RTOG 0236. Toxicity was scored using Common Terminology Criteria for Adverse Events version 4.0. Survival/TC and toxicity were compared between patients with and without PLR using the Kaplan-Meier method and cumulative incidence, respectively....
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Thoracic Source Type: research

A Review of the Surgical Management of Extrathoracic Solitary Fibrous Tumors
Conclusions: Routine long-term follow-up is essential for benign and malignant disease to enable early detection and treatment of recurrent disease. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Soft Tissue Source Type: research

Outcome After Surgery for Extremity Soft Tissue Sarcoma in Patients Presenting With Metastasis at Diagnosis
Conclusions: Extremity STS patients who present with metastasis at diagnosis have a poor prognosis. Patients who undergo metastasectomy have a better chance for prolonged survival. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Soft Tissue Source Type: research

Benefit of Radiotherapy in Extraskeletal Myxoid Chondrosarcoma: A Propensity Score Weighted Population-based Analysis of the SEER Database
Conclusions: The receipt of EBRT is associated with a CSS benefit in localized EMC. Aggressive local therapy, including EBRT, should be considered in these patients. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Soft Tissue Source Type: research

Impact of Androgen Deprivation Therapy on Overall Mortality in Prostate Brachytherapy Patients With Low Pretreatment Testosterone Levels
Objectives: To evaluate whether the use of androgen deprivation therapy (ADT) in prostate brachytherapy patients impacts overall mortality (OM) in patients with lower pretreatment serum testosterone levels compared with those with normal or high baseline serum testosterone. Materials and Methods: From October 2001 to May 2014, 1916 patients underwent brachytherapy and had a pretreatment serum testosterone. Baseline serum testosterone values were collected prospectively before initiation of therapy. Median follow-up was 7.2 years. In total, 26% of the patients received ADT, primarily men with higher risk disease. OM an...
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Challenges in Management of Squamous Cell Carcinoma of the Anus in New England and Across the United States: A Review of the National Cancer Data Base
Background: Management of squamous cell carcinoma of the anus (SCCA) is becoming more relevant, as its incidence continues to increase. The purpose of this study was to evaluate regional and national data to assess trends in epidemiology, access to cancer center care, and overall management strategies in SCCA. Study Design: A review of available data from the American College of Surgeons Committee on Cancer National Cancer Data Base focused on incidence, sex, age, stage at diagnosis, distance traveled for care, and utilization of therapy as first course of treatment (FCT). The analysis included 40,817 patients treated...
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Tolerability and Long-term Outcomes of Dose-Painted Neoadjuvant Chemoradiation to Regions of Vessel Involvement in Borderline or Locally Advanced Pancreatic Cancer
Conclusions: We found that DP-neoadjuvant chemoradiation to regions of vessel involvement is both feasible and well tolerated. In addition, we demonstrated that over one third of patients with initially deemed unresectable disease were able to undergo surgical resection after receiving neoadjuvant therapy including DP-chemoradiation. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

A Multicenter Phase II Study of Gemcitabine, Capecitabine, and Bevacizumab for Locally Advanced or Metastatic Biliary Tract Cancer
Conclusions: Addition of bevacizumab to gemcitabine/capecitabine did not improve outcome in an unselected group of patients with advanced BTC compared with historical controls. The selective benefit of vascular endothelial growth factor inhibition in BTC remains to be explored. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Impact of Postoperative Adjuvant Chemotherapy Following Long-course Chemoradiotherapy in Stage II Rectal Cancer
Objectives: Use of adjuvant chemotherapy (AC) following neoadjuvant chemoradiation (nCRT) is controversial in rectal cancer (RC). We assessed a multi-institutional database to determine if there was benefit from AC for pathologic stage II RC patients and whether the addition of oxaliplatin to fluoropyrimidine (OXAC) therapy impacted outcomes. Materials and Methods: We included patients who underwent nCRT and had pathologic stage II (ypT3/4 ypN0) tumors. Disease-free survival and overall survival were assessed. Multivariate Cox models adjusting for age, sex, Eastern Cooperative Oncology Group, high-risk features (pT4, ...
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Programmed Cell Death-Ligand 1 (PD-L1) Expression in Anal Cancer
Conclusions: PD-L1 positivity was associated with worse CRR and CER, and marginally worse CMR. The effect on progression-free and overall survival needs to be validated in a study with a larger sample size. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Hyperfractionated Accelerated Reirradiation for Patients With Recurrent Anal Cancer Previously Treated With Definitive Chemoradiation
Conclusions: Hyperfractionated accelerated re-RT was well-tolerated in patients with previously irradiated anal cancer. Patients treated with either definitive re-RT or re-RT followed by surgical resection had excellent rates of overall survival and freedom from local progression. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Clinical and Economic Evaluation of Treatment Strategies for T1N0 Anal Canal Cancer
Conclusions: There was no statistically significant difference in survival among the treatment alternatives for T1N0 anal canal cancer. Given that surgery/ablation costs less than RT or CRT and might be cost-effective compared with RT and CRT, it is crucial to explore this finding further in this era of limited health care resources. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Phase II Study of Adjuvant Chemoradiotherapy Using Docetaxel/Cisplatin/5-Fluorouracil Before and After Intensity-modulated Radiotherapy With Concurrent Docetaxel in Patients With Completely (R0) Resected Gastric Carcinoma
Conclusions: These results demonstrate that this adjuvant regimen is active with an acceptable toxicity profile. A randomized phase 3 trial comparing the Intergroup 0116 chemoradiotherapy regimen with this regimen is underway. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Molecular Predictors of Response to Neoadjuvant Chemoradiation for Rectal Cancer
Objectives: To determine whether the expression of specific molecular markers in the rectal cancer biopsies prior to treatment, can correlate with complete tumor response to chemoradiotherapy (CRT) as determined by the pathology of the surgical specimen. Methods: We retrospectively examined pretreatment rectal biopsies of patients aged 18 years or older with locally advanced rectal cancer who had been treated with neoadjuvant CRT and surgical resection in our tertiary-care, university-affiliated medical center, between January 2001 and December 2011. Samples were analyzed for expression of B-cell lymphoma 2, P53, Ki67...
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Intraoperative Radiotherapy in the Era of Intensive Neoadjuvant Chemotherapy and Chemoradiotherapy for Pancreatic Adenocarcinoma
Conclusions: IORT in addition to intensive neoadjuvant chemotherapy and chemoradiotherapy was not associated with increased toxicity when used with resection or exploratory laparotomy, and was associated with encouraging survival rates in patients with close/positive margins and patients with unresectable disease. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Pretreatment Tumor Thickness as a Predictor of Pathologic Complete Response to Neoadjuvant Chemoradiation Therapy for Stage II/III Rectal Adenocarcinoma
Conclusions: We concluded that pretreatment tumor thickness is an independent predictor for pCR of stage II/III rectal adenocarcinoma to the neoadjuvant CRT. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Concurrent Radiotherapy and Triweekly Carboplatin for the Definitive Treatment of Locally Advanced Laryngeal Carcinoma
Conclusions: In patients with LALC who are suboptimal candidates for high-dose cisplatin, our experience suggests that tCb AUC 5 with concurrent radiotherapy provides acceptable outcomes with tolerable toxicity. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Head and Neck Source Type: research

Preradiation Chemotherapy for Adult High-risk Medulloblastoma: A Trial of the ECOG-ACRIN Cancer Research Group (E4397)
Conclusions: The OR to this preradiation chemotherapy regimen is lower than anticipated from the adult and pediatric literature raising a question about comparative efficacy of chemotherapy in different age groups. The OS achieved is similar to retrospective adult series, but worse than pediatric outcomes. Although this regimen can be administered without compromising delivery of CSI, our results do not provide support for the use of this neoadjuvant chemotherapy for adult medulloblastoma. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Central Nervous System Source Type: research

Knowledge of Clinical Trial Availability and Reasons for Nonparticipation Among Adolescent and Young Adult Cancer Patients: A Population-based Study
Conclusions: Improvement in AYA cancer patient clinical trial enrollment will require enhancing knowledge about trial availability and addressing this population’s concerns about participating in medical research. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Pediatric Source Type: research

Decreased Risk of Radiation Pneumonitis With Coincident Concurrent Use of Angiotensin-converting Enzyme Inhibitors in Patients Receiving Lung Stereotactic Body Radiation Therapy
Conclusions: Incidental concurrent use of ACEi demonstrated efficacy in diminishing rates of symptomatic pneumonitis in the setting of lung SBRT. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Thoracic Source Type: research

Stereotactic Ablative Radiotherapy (SABR) for Large Renal Tumors: A Retrospective Case Series Evaluating Clinical Outcomes, Toxicity, and Technical Considerations
Conclusions: In this small cohort, renal SABR was delivered with minimal toxicity. A prospective study is underway at our institution to determine maximum tolerable and optimal dosing (NCT02264548). (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Patient-reported Urinary, Bowel, and Sexual Function After Hypofractionated Intensity-modulated Radiation Therapy for Prostate Cancer: Results From a Randomized Trial
We report patient-reported outcomes (PROs) from a randomized trial comparing hypofractionated and conventional prostate radiotherapy. Methods: Men with localized prostate cancer were enrolled in a trial that randomized men to either conventionally fractionated intensity-modulated radiation therapy (CIMRT, 75.6 Gy in 1.8 Gy fractions) or to dose-escalated hypofractionated IMRT (HIMRT, 72 Gy in 2.4 Gy fractions). Questionnaires assessing urinary, bowel, and sexual function were completed pretreatment and at 2, 3, 4, and 5 years after treatment. Results: Of 203 eligible patients, 185 were evaluable for PROs. A total of ...
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Does Specialty Bias Trump Evidence in the Management of High-risk Prostate Cancer?
The objective was to query how specialty influences treatment recommendations for high-risk prostate cancer in 3 clinical settings: upfront management, postoperative management, and management of biochemical recurrences (BCRs) after radiotherapy (RT). We hypothesized that specialty bias would manifest in all settings, trumping available evidence. Methods: A survey of practicing urologists and radiation oncologists was distributed through electronic mail. Questions pertained to upfront management, postoperative treatment, and local salvage for postradiation BCRs. The associations between 26 selected categorical responses...
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

A Phase II Study to Prevent Radiation-induced Rectal Injury With Lovastatin
Conclusions: The primary endpoint of the study was not met. Lovastatin, as administered in this trial, did not reduce the incidence of grade 2 or higher rectal toxicity compared with historical controls. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Outcomes of Node-positive Breast Cancer Patients Treated With Accelerated Partial Breast Irradiation Via Multicatheter Interstitial Brachytherapy: The Pooled Registry of Multicatheter Interstitial Sites (PROMIS) Experience
Conclusions: Patients who have had an axillary lymph node dissection and limited node-positive disease may be candidates for treatment with APBI. Further research is ultimately needed to better define specific criteria for APBI in node-positive patients. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Breast Source Type: research

Prognostic Factors, Treatment, and Outcomes in Early Stage, Invasive Papillary Breast Cancer: A SEER Investigation of Less Aggressive Treatment in a Favorable Histology
Objectives: Invasive papillary breast cancer (IPBCA) represents 0.5% of invasive BCA, and is thought to carry a favorable prognosis. This population-based study reports on prognostic factors, treatment, and outcomes of early-stage IPBCA to explore whether there is any evidence to support less aggressive treatment. Materials and Methods: IPBCA cases from 1990 to 2009 of the recent Surveillance, Epidemiology, and End Results were analyzed. Inclusion criteria included patients with stage T1-2, N0 IPBCA. Univariate and multivariate analyses were performed using the variables of treatment, stage, race, hormone receptor sta...
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Breast Source Type: research

Evaluating Candidacy for Hypofractionated Radiation Therapy, Accelerated Partial Breast Irradiation, and Endocrine Therapy After Breast Conserving Surgery: A Surveillance Epidemiology and End Results (SEER) Analysis
Conclusions: This SEER analysis demonstrates that a substantial proportion of women with early stage breast cancer are eligible for HFRT, APBI, or ET alone after breast conserving surgery according to consensus guidelines and prospective trial criteria. With incorporation of additional pathologic, dosimetric, and chemotherapy data, quality assurance pathways may use such data to help ensure patients are receiving appropriate risk stratified treatment recommendations. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Breast Source Type: research

Social Network, Surgeon, and Media Influence on the Decision to Undergo Contralateral Prophylactic Mastectomy
Conclusions: Patients who choose CPM do so with influence and support from members of their social networks. Reversing the increasing choice of CPM will require educating these influential others, which can be accomplished by encouraging patients to include them in clinical consultations, and by providing patients with educational materials that can be shared with their social networks. Surgeons need to be perceived as having an opinion, specifically that CPM should be reserved for those patients for whom it is medically indicated. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Breast Source Type: research

Impact of Staging With Positron-emission Tomography (PET) and Comorbidities on Management and Survival of American Veterans With Stage I-III Non–Small Cell Lung Cancer
Conclusions: PET scans resulted in upstaging in 15% in CS I-III NSCLC. AAC scores dictated therapy decisions and outcomes more than PET staging. Veterans had lower 5-year survival rates (26.3%, 15.8%/13.4%) compared with 53% and 27% in age/sex/time-period matched SEER data for stage I-II/III NSCLC. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Thoracic Source Type: research

Patient-reported Adherence to Adjuvant Aromatase Inhibitor Therapy Using the Morisky Medication Adherence Scale: An Evaluation of Predictors
Conclusions: Using the MMAS, only 50% of women with stage 1 to 3 breast cancer reported high adherence to AI therapy, consistent with other reports showing suboptimal adherence to adjuvant endocrine therapy. The MMAS allows for the rapid assessment of adherence to oral adjuvant endocrine therapy and is valuable in a busy clinical setting. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Breast Source Type: research

A Pooled Analysis of Biochemical Failure in Intermediate-risk Prostate Cancer Following Definitive Stereotactic Body Radiotherapy (SBRT) or High-Dose-Rate Brachytherapy (HDR-B) Monotherapy
Conclusions: With a median follow-up period of 4 years, SBRT and HDR-B monotherapy provide excellent BRFS in intermediate-risk PC. Longer-term follow-up is necessary to determine the ultimate efficacy of these hypofractionated approaches, but they appear promising relative to standard fractionation outcomes. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Targeted Prostate Biopsy Gleason Score Heterogeneity and Implications for Risk Stratification
Conclusions: Over half of multiparametric MRI-defined targets demonstrated GS heterogeneity. The addition of high GS from TB leads to risk inflation compared with using SB alone. Further research is needed on how to integrate these findings into current risk stratification models and clinical practice. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Vulvar Recurrences After Intensity-modulated Radiation Therapy for Squamous Cell Carcinoma of the Anus
Conclusions: In a cohort of patients treated with IMRT-based chemoradiation, 2 vulvar recurrences were identified within the avoided external genitalia despite limited recurrence rates within the cohort overall. This experience suggests that for patients with a locally advanced primary tumor and bulky bilateral inguinal or pelvic disease, the in-transit vulvar dermal lymphatics may be at risk for subclinical involvement and subsequent recurrence. If substantiated by a similar pattern of recurrence at other institutions, the external genitalia may need to be reclassified from an avoidance structure to a clinical treatment...
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Comparison of Demographics, Tumor Characteristics, and Survival Between Pancreatic Adenocarcinomas and Pancreatic Neuroendocrine Tumors: A Population-based Study
Conclusions: PNETs present with favorable features such as higher proportion of early-stage tumor, higher proportion of well differentiated tumors, and younger age at diagnosis. PNETs have a significantly better survival than pancreatic adenocarcinomas even after adjusting for age, sex, race, site, grade, and stage. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Perioperative Mortality in Nonelderly Adult Patients With Cancer: A Population-based Study Evaluating Health Care Disparities in the United States According to Insurance Status
Objectives: The purpose of this study was to evaluate whether insurance status predicts for perioperative mortality (death within 30 d of cancer-directed surgery) for the 20 most common surgically treated cancers. Methods: The SEER database was examined for the 20 most common surgically resected cancers and included nonelderly adults, aged 18 to 64 years. The database was queried from 2007 to 2011, with a total of 506,722 patients included in the analysis. Results: Insurance status for all patients were the following: non-Medicaid insurance (83%), any Medicaid (10%), uninsured (4%), and unknown (3%). In univariate ...
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Health Services Source Type: research

Disparity in Outcomes for Adolescent and Young Adult Patients Diagnosed With Pediatric Solid Tumors Across 4 Decades
Objective: Cancer mortality is a leading cause of disease-related death in the adolescent and young adult (AYA) population. Compared with older and younger patients, AYA patients often experience worse cancer-specific outcomes. Here, we compare AYA and pediatric overall survival (OS) in the most common pediatric extracranial solid tumors. Materials and Methods: Using the US Surveillance, Epidemiology, and End Results database, we studied patients (age, 0 to 39 y) diagnosed with Ewing sarcoma, neuroblastoma, osteosarcoma, rhabdomyosarcoma, and Wilms tumor. Results: A total of 12,375 patients (age, 0 to 39 y) were di...
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Pediatric Source Type: research

Malignant Peripheral Nerve Sheath Tumors: A Single Institution’s Experience Using Combined Surgery and Radiation Therapy
Conclusions: Combination therapy with surgery and RT provides favorable LC. Distant recurrences, however, continue to be challenging with limited salvage success at the time of relapse. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Soft Tissue Source Type: research

Secondary Surgery Versus Chemotherapy for Recurrent Ovarian Cancer
Objective: The best course of treatment for recurrent ovarian cancer is uncertain. We sought to determine whether secondary cytoreductive surgery for first recurrence of ovarian cancer improves overall survival compared with other treatments. Materials and Methods: We assessed survival using Surveillance, Epidemiology and End Results-Medicare data for advanced stage ovarian cancer cases diagnosed from January 1, 1997 to December 31, 2007 with survival data through 2010 using multinomial propensity weighted finite mixture survival regression models to distinguish true from misclassified recurrences. Of 35,995 women age...
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gynecologic Source Type: research

Utilization of Postoperative Chemoradiotherapy Among Women in the United States With High-risk Cervical Cancer
Conclusions: Despite level I evidence supporting its use, less than half of women in this large US cohort with high-risk cervical cancer received adjuvant CRT. Use of adjuvant CRT for women did not significantly increase between 2002 and 2012. Patient age, race, and pathologic risk factors were associated with use of adjuvant CRT. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gynecologic Source Type: research

Locally Advanced Cervical Cancer: Outcomes With Variable Adherence to Treatment
Conclusions: Adherence to both optimal treatment time and radiation dose is significantly associated with improved survival. Total radiation dose is an independent predictor of survival among patients with locally advanced cervical cancer. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gynecologic Source Type: research

Phase I Trial Using Induction Ciplatin, Docetaxel, 5-FU and Erlotinib Followed by Cisplatin, Bevacizumab and Erlotinib With Concurrent Radiotherapy for Advanced Head and Neck Cancer
Conclusions: Erlotinib in combination with induction TPF followed by erlotinib, cisplatin, and bevacizumab with XRT is active but toxic. Gastrointestinal toxicities partly caused high rates of study withdrawal. All doses studied in this protocol caused unexpected toxicities and we do not recommend advancement to phase II. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Head and Neck Source Type: research

Retrospective Analysis of Cisplatin Nephrotoxicity in Patients With Head and Neck Cancer Receiving Outpatient Treatment With Concurrent High-dose Cisplatin and Radiotherapy
Objectives: Cisplatin remains the pivotal chemotherapy in squamous cell carcinoma of the head and neck (SCCHN), with nephrotoxicity considered the dose-limiting toxicity. The purpose of our study was to propose an outpatient high-dose cisplatin protocol aimed at preventing nephrotoxicity and to analyze the results of its utilization in patients with SCCHN treated with concurrent radiotherapy. Materials and Methods: We retrospectively evaluated 82 SCCHN patients treated with outpatient high-dose cisplatin concurrent with radiotherapy at our institution. Acute kidney injury (AKI) and chronic kidney disease were defined ...
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Head and Neck Source Type: research

Survival of Patients With Multiple Intracranial Metastases Treated With Stereotactic Radiosurgery: Does the Number of Tumors Matter?
Background: Defining prognostic factors is a crucial initial step for determining the management of patients with brain metastases. Randomized trials assessing radiosurgery have commonly limited inclusion criteria to 1 to 4 brain metastases, in part due to multiple retrospective studies reporting on the number of brain metastases as a prognostic indicator. The present study reports on the survival of patients with 1 to 4 versus ≥5 brain metastases treated with radiosurgery. Methods: We evaluated a retrospective multi-institutional database of 1523 brain metastases in 507 patients who were treated with radiosurgery ...
Source: American Journal of Clinical Oncology - April 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Central Nervous System Source Type: research

Thyroid Paraganglioma: Our Experience and Systematic Review of the Literature on a Rare Tumor
We describe 2 cases of thyroid PG, suggest a possible diagnostic and therapeutic management strategy, and present a systematic review of the literature. Case Reports: Two 67-year-old women presented similarly with asymptomatic but rapidly growing thyroid nodules in which malignancy was suspected after fine needle aspiration biopsy, “THY 4” according to the 2014 SIAPEC classification, both undergoing total thyroidectomy. Unexpectedly, immunohistochemistry showed neuroendocrine cellular architecture that was negative for common markers of well-differentiated follicular neoplasms, thyroglobulin, thyroid transcr...
Source: American Journal of Clinical Oncology - March 23, 2018 Category: Cancer & Oncology Tags: Original Articles: Endocrine Source Type: research

Impact of Radiation Therapy Dose Escalation on Prostate Cancer Outcomes and Toxicities
Objectives: Freedom from biochemical failure (FFBF) is a common primary outcome of randomized-controlled trials of prostate cancer (PCa). We aimed to determine how increasing the PCa biologically equivalent dose (BED) of external radiation therapy (RT) is correlated with FFBF and overall patient outcomes: overall survival (OS), distant metastasis (DM), and cancer-specific mortality (CSM); as well as genitourinary (GU), and gastrointestinal toxicities. Materials and Methods: We performed a meta-analysis of 6884 PCa patients from 12 randomized-controlled trials of external beam RT. Mixed effects regression models were u...
Source: American Journal of Clinical Oncology - March 23, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Age Bias in Time From Diagnosis Comparisons of Prostate Cancer Treatment
Conclusions: The survival benefit apparent to prostatectomy in conventional observational cohort studies could reflect an age-related bias attributable to their use of TFD analysis. Care is warranted in the choice of timescale in observational analysis if large age differences exist between treatment cohorts. Randomized controlled trials remain the most reliable means to compare prostate cancer treatments. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - March 23, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Utility of the ACE Inhibitor Captopril in Mitigating Radiation-associated Pulmonary Toxicity in Lung Cancer: Results From NRG Oncology RTOG 0123
Conclusions: Despite significant resources and multiple amendments, NRG Oncology Radiation Therapy Oncology Group 0123 was unable to test the hypothesis that captopril mitigates radiation-induced pulmonary toxicity. It did show the safety of such an approach and the use of newer angiotensin-converting enzyme inhibitors started during radiotherapy may solve the accrual problems. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - March 23, 2018 Category: Cancer & Oncology Tags: Original Articles: Thoracic Source Type: research