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Intraoperative radiotherapy combined with spinal stabilization surgery-a novel treatment strategy for spinal metastases based on a first single-center experiences.

INTRODUCTION: Current treatment of spinal metastases (SM) aims on preserving spinal stability, neurological status, and functional status as well as achieving local control. It consists of spinal surgery followed by radiotherapy and/or systemic treatment. Adjuvant therapy usually starts with a delay of a few weeks to prevent wound healing issues. Intraoperative radiotherapy (IORT) has previously been successfully applied during brain tumor, breast and colorectal carcinoma surgery but not in SM, including unstable one, to date. In our case series, we describe the feasibility, morbidity and mort

The Sarcoma-Specific Instrument to Longitudinally Assess Health-Related Outcomes of the Routine Care Cycle.

Patient-based health related quality of life (HRQoL) measurements are associated with an improvement in quality of care and outcomes. For a complex disease such as sarcoma, there is no disease-specific questionnaire available which covers all clinically relevant dimensions. Herein, we report on the development of an electronically implemented, sarcoma-specific instrument to assess health-related outcomes, which encompasses a combination of generic questionnaires tailored to the respective disease and treatment status covering the entire longitudinal care cycle. An interoperable digital platfor

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… Medical oncologists often use the widely accepted HRQoL measure EORTC-QLQ30 specifically for randomized controlled trials. It provides a holistic overview and includes other well-established PROMs such as MDASI. … The EORTC QLQ-C30 Summary Score as Prognostic Factor for Survival of Patients with Cancer in the "Real-World": Results from the Population-Based PROFILES Registry Oncologist 2020 25 e722 e732 10.1634/theoncologist.2019-0348 32297435 PMC7160310 52. Wilson D.A.J. Gazendam A. Visgauss J. Perrin D. …

An 8-step approach for the systematic development of an evidence-based exercise program for patients undergoing hematopoietic stem cell transplantation.

BackgroundA tailored and reliable intervention program developed based on evidence is necessary for patients with serious health conditions.ObjectiveWe describe the development of an exercise program for HSCT patients based on evidence from a systematic process.MethodsWe developed the exercise program for HSCT patients using eight systematic steps: (1) a literature review, (2) understanding patient characteristics, (3) first expert group discussion, (4) development of the first draft of the exercise program, (5) a pre-test, (6) second expert group discussion, (7) a pilot randomized controlled

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… Furthermore, Park et al. ( 32 ) showed that an oncologist’s exercise recommendation with an exercise motivation package significantly increased exercise participation among breast and colorectal cancer patients. … The effect of oncologists’ exercise recommendations on the level of exercise and quality of life in survivors of breast and colorectal cancer: A randomized controlled trial . Cancer ( 2015 ) 121 ( 16 ): 2740–8 . doi: 10.1002/cncr.29400 PMC5025035 25965782 …

Outcomes and Prognostic Factors in Critical Patients with Hematologic Malignancies.

Patients with hematologic malignancies (HMs) have a significantly elevated risk of mortality compared to other cancer patients treated in the intensive care unit (ICU). The prognostic impact of numerous poor outcome indicators has changed, and research has yielded conflicting results. This study aims to determine the ICU and hospital outcomes and risk factors that predict the prognosis of critically ill patients with HMs. In this retrospective study, conducted at a referral hospital in Taiwan, 213 adult patients with HMs who were admitted to the medical ICU were evaluated. We collected clinica

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… Oncologist. 2017;22:843–849. doi: 10.1634/theoncologist.2016-0367. 33. Odejide O.O., Salas Coronado D.Y., Watts C.D., Wright A.A., Abel G.A. End-of-life care for blood cancers: A series of focus groups with hematologic oncologists. J. Oncol. …

Cancer-Associated Thrombosis: Not All Low-Molecular-Weight Heparins Are the Same, Focus on Tinzaparin, A Narrative Review.

Cancer-associated thrombosis (CAT) is the second main cause of cancer death with high related mortality and morbidity, leading to anticancer agent delays and interruptions. The recommended therapy, low-molecular-weight heparin (LMWH), however, is burdensome for patients and costly for society, as treatment should last until cancer is no longer active, even indefinitely. Tinzaparin is a manageable, efficient, safe, and cost-effective option. Compared to the other LMWHs, advantages are single-daily dose and safety in the elderly and those with renal impairment (RI). The purpose of this review is

Cardiotoxicity Associated with Anti-CD19 Chimeric Antigen Receptor T-Cell (CAR-T) Therapy: Recognition, Risk Factors, and Management.

Chimeric antigen receptor T-cells (CAR-T) are improving outcomes in pediatric and adult patients with relapsed or refractory B-cell acute lymphoblastic leukemias and subtypes of non-Hodgkin Lymphoma. As this treatment is being increasingly utilized, a better understanding of the unique toxicities associated with this therapy is warranted. While there is growing knowledge on the diagnosis and treatment of cytokine release syndrome (CRS), relatively little is known about the associated cardiac events that occur with CRS that may result in prolonged length of hospital stay, admission to the inten

Incivility Is Associated with Burnout and Reduced Compassion Satisfaction: A Mixed-Method Study to Identify Causes of Burnout among Oncology Clinical Research Coordinators.

While oncology clinical research coordinators (CRCs) experience a combination of factors that are thought to put them at increased risk for burnout, very little research has been conducted to understand the risk factors associated with burnout among CRCs. We used a mixed-method approach, including self-report questionnaires to assess burnout and compassion satisfaction, as well as individual and interpersonal variables hypothesized to impact CRC well-being. We also conducted a focus group to gain a more nuanced understanding of coordinators' experiences around burnout, teamwork, resilience, an

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… Mixed-methods study of the impact of chronic patient death on oncologists’ personal and professional lives. J. Oncol. Pract. 2017;13:e1–e10. doi: 10.1200/JOP.2016.014746. 19. Shanafelt T., Dyrbye L. Oncologist burnout: Causes, consequences, and responses. J. Clin. …

The IlluminOss® photodynamic bone stabilization system for pathological osteolyses and fractures of the humerus: indications, advantages and limits in a series of 12 patients at 24 months of minimum follow-up.

BACKGROUND: Locked titanium nails are considered the reference treatment for metastatic bone lesions of the humerus in patients with aggressive histotypes, high risk of fracture or when estimated survival is lower than 6 months.Nevertheless, they are responsible for CT and MRI artifacts which interfere with postoperative radiotherapy and follow-up.The IlluminOss® is an intramedullary stabilization system which is introduced inside the humeral canal in a deflated state, and is then distended with a monomer which hardens after exposure to blue light,stabilizing the segment; it does not cause art

Management of bone health in patients with cancer: a survey of specialist nurses.

BackgroundPatients with cancer can experience bone metastases and/or cancer treatment-induced bone loss (CTIBL), and the resulting bone complications place burdens on patients and healthcare provision. Management of bone complications is becoming increasingly important as cancer survival rates improve. Advances in specialist oncology nursing practice benefit patients through better management of their bone health, which may improve quality of life and survival.MethodsAn anonymised online quantitative survey asked specialist oncology nurses about factors affecting their provision of support in

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… Therefore, bone health should be managed using a multidisciplinary approach, to include not only oncologists, orthopaedic surgeons, specialist nurses and interventional radiologists but also specialists in palliative medicine and symptom control with expertise in bone complications from cancer [ 13 , … They are also ideally placed to collaborate with other members of the multidisciplinary team, such as oncologists, pharmacists and physiotherapists, to coordinate the provision of optimal patient care. …

Subcutaneous bortezomib might be standard of care for patients with multiple myeloma: a systematic review and meta-analysis.

Background: Administration of subcutaneous (SC) bortezomib in patients with multiple myeloma (MM) has increased in recent years. Yet, it is unclear whether there is sufficient evidence to support the use of SC bortezomib as a standard of care. Methods: A systematic review of 4 randomized controlled trials and 8 retrospective trials comparing SC to intravenous (IV) bortezomib among 1,857 MM patients was performed. Embase, PubMed, Clinical Trials.gov, Cochrane Library and reference lists were searched for relevant studies from inception until August 2018. Outcomes of interest included 1-year ove

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… Given the concerns regarding the toxicity of bortezomib, there has been increasing interest from oncologists and patients in finding the optimal administration route. … Discussion The increasing interest from oncologists and patients in identifying the optimal administration route of bortezomib has been driven mainly by concerns regarding the efficacy and toxicity. 23 – 26 In phase III trials analyzed both for relapse cases 12 and for the newly diagnosed MM patients …

Ixazomib in combination with carboplatin in pretreated women with advanced triple-negative breast cancer, a phase I/II trial of the AGMT (AGMT MBC-10 trial).

BACKGROUND: Triple-negative breast cancer (TNBC) comprises a heterogeneous group of diseases which are generally associated with poor prognosis. Up to now, no targeted treatment beyond anti-VEGF therapy has been approved for TNBC and cytotoxic agents remain the mainstay of treatment. Ixazomib is a selective and reversible inhibitor of the proteasome, which has been mainly investigated in the treatment of multiple myeloma. In a preclinical study TNBC cells were treated with the first-generation proteasome inhibitor bortezomib in combination with cisplatin and synergistic efficacy was demonstrat

The influence of fractionated radiotherapy on the stability of spinal bone metastases: a retrospective analysis from 1047 cases.

BACKGROUND: The effect of radiotherapy, in particular the application of different multi-fraction schedules in the management of unstable spinal bone metastases (SBM), is incompletely understood. This study aims to compare the radiological response regarding various dose and fractionation schedules of radiotherapy in the palliative treatment of SBM. METHODS: We retrospectively assessed 1047 patients with osteolytic SBM, treated with palliative radiotherapy at our department between 2000 and 2015. Lung cancer (40.2%), breast (16.7%) and renal cancer (15.2%) were the most common solid tumors in

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… Statistically, a significant percentage of patients was alive in LRT group at the time of the survey, which indirectly reflects the common practice, particularly the influence of subjective life expectancy estimation (KPS, extra osseous disease extent) on the choice of multi-fraction regime by radio-oncologists … Klimo P Jr Schmidt MH Surgical management of spinal metastases Oncologist 2004 9 2 188 196 10.1634/theoncologist.9-2-188 15047923 5. …

Pursuing equity in cancer care: implementation, challenges and preliminary findings of a public cancer referral center in rural Rwanda.

BackgroundCancer services are inaccessible in many low-income countries, and few published examples describe oncology programs within the public sector. In 2011, the Rwanda Ministry of Health (RMOH) established Butaro Cancer Center of Excellence (BCCOE) to expand cancer services nationally. In hopes of informing cancer care delivery in similar settings, we describe program-level experience implementing BCCOE, patient characteristics, and challenges encountered.MethodsButaro Cancer Center of Excellence was founded on diverse partnerships that emphasize capacity building. Services available incl

Osteonecrosis of the Jaws (ONJ) after Bisphosphonate Treatment in Patients with Multiple Myeloma: Decreasing ONJ Incidence after Adoption of Preventive Measures.

Bisphosphonates (BPs) are administered to Multiple Myeloma (MM) patients with bone lytic lesion. Osteonecrosis of the Jaw (ONJ) is a complication reported since 2003 in patients treated with intravenous (IV) BPs such as zoledronic acid and pamidronate, with 6%-26.3% frequency in early literature series, before some preventive measures were recommended. We evaluated the occurrence of ONJ with and without dental preventive measures in MM patients treated with BPs in our centre between 1996 and 2015. Since 2005, MM patients (already under treatment or before treatment) underwent a baseline mouth

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… On December 2005, after observation of first cases of ONJ at our centre, the Alessandria Hospital Oncology-Haematology Department created a multidisciplinary team to manage the emergence and future risk of ONJ, including dentists, maxillofacial surgeons, haematologists, oncologists, nurses, radiologists … After our hospital oncologists and haematologists prompted the establishment of a multidisciplinary team at the end of 2005, the oral health of MM patients was more strictly followed. …

Lymphedema Associated With Primary Amyloidosis: A Case Study.

We reported on a 60-year-old man presenting lymphedema of both lower extremities and scrotum for 3 years with unknown cause. We took a computed tomography scan of the lower extremities as a follow-up. There were diffuse subcutaneous edema in both lower extremities and multiple enlarged lymph nodes along the para-aortic and bilateral inguinal areas. For further evaluation, biopsy of an enlarged inguinal lymph node was taken, yielding a diagnosis of primary amyloidosis. A treatment of chemotherapy for amyloidosis was recommended for him. To our knowledge, this is the first report of lymphedema p

Is It Time to Inform This Patient that Further Antineoplastic Drug Therapy Will Not Be of Clinical Value?

A woman with heavy pre-treated ovarian cancer sought consultation regarding additional treatments. The case raises the vexing question of whether there may be a time in the course of the disease process where it is most appropriate to state further anti-neoplastic therapy will not be of clinical utility.

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… While it is not possible to provide a simple roadmap for oncologists as to when they need to definitively declare, or at least strongly state, that further treatment directed toward shrinking the tumor or preventing an established pattern of progression is futile, it is also reasonable to conclude that …

Heterogeneous tissue-specific macrophages orchestrate metastatic organotropism of breast cancer: implications for promising therapeutics.

Compelling evidences have manifested that breast cancer cells prefer to metastasize to certain distant organs, including brain, lung, bone and liver. According to the canonical "seed and soil" theory, this prominent biological behavior, termed as metastatic organotropism, involves intricate interactions between breast cancer cells (the "seeds") and specific residents in the tumor microenvironment (the "soil"), initiating from pre-metastatic niche formation to metastatic outgrowth. Recently, multifaceted heterogeneity of tissue-specific macrophages (TSMs) and their roles played in organotropic

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… BCBrM poses a remarkable therapeutic challenge for oncologists due to the presence of blood–brain barrier (BBB), the natural obstacle that restricts most drugs and immune cells from entry, thus providing a permissive sanctuary for MBC cells to develop rampantly in the CNS [ 39 ]. …

Existing and emerging strategies for fertility preservation in female patients with leukemia.

Leukemia, the most common malignancy in childhood, affects individuals from prepubertal girl to women of reproductive age. It originates from immature hematopoietic cells in the bone marrow and disseminates systemically via the blood and lymphatic circulations. Although survival rates have improved substantially, standard treatments, including intensive chemotherapy and hematopoietic stem cell transplantation, often combined with total body irradiation, are highly gonadotoxic. Consequently, a significant proportion of survivors experience long-term endocrine dysfunction and infertility, with f

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… By integrating recent advances in the field, this review aims to inform both oncologists and reproductive specialists and to support the development of safer and more effective fertility preservation strategies for female leukemia patients and survivors. … Addressing these gaps will require coordinated efforts among oncologists, reproductive specialists, and basic scientists. …

Прогресс в оказании поддержки в проведении обзора по множественным болезням, связанным с миеломой.

Множественная миелома (ММ) — неизлечимая порча плазменных клеток, характеризующаяся увеличением производства моноклонального иммуноглобулина. Пациенты с ММ подвержены высокому риску возникновения осложнений, связанных с заболеваниями. Остеолитическая болезнь костей one - из наиболее распространенных осложнений, связанных с заболеваниями, которые приводят к хронической боли и патологии скелета, что в значительной степени способствует высоким уровням заболеваемости и смертности среди пациентов с ОМ. Помимо стандартной антиММ-терапии, для улучшения качества жизни пациентов, страдающих ММ, необход

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… To minimize the risk of ONJ and other related complications, a multidisciplinary approach involving oncologists, dentists, and oral surgeons is ideal. … Oncologist. 2023;28:e1268–e1278. doi: 10.1093/oncolo/oyad188. 122. Abonour R., Rifkin R.M., Gasparetto C., Toomey K., Durie B.G.M., Hardin J.W., Terebelo H.R., Jagannath S., Narang M., Ailawadhi S., et al. …

Poster Presentation

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… Results: Of the 80 patients admitted for EOL in DNSH between July 21 to Oct21, it was found that Oncologists, who were directly in care of patients have communicated the patients n family members about the Prognosis but still continued For ICU shifting, Ventilatory requirement (if patient family wishes … Conclusion: A trained oral physician shall be a necessary team member for the oncologist or radiotherapist or other doctors of the palliative care team of head and neck malignancies for management of surgically created defect. …