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Gene expression profile of residual breast cancer after doxorubicin and cyclophosphamide neoadjuvant chemotherapy

FOLGUEIRA, Maria Aparecida Azevedo Koike; BRENTANI, Helena; CARRARO, Dirce Maria; BARROS FILHO, Mateus De Camargo; KATAYAMA, Maria Lucia Hirata; ABREU, Ana Paula Santana De; BARBOSA, Edson Mantovani; OLIVEIRA, Celia Tosello De; PATRAO, Diogo F. C.; MOTA,
Fonte: SPANDIDOS PUBL LTD Publicador: SPANDIDOS PUBL LTD
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
36.59%
In breast cancer patients, primary chemotherapy is associated with the same survival benefits as adjuvant chemotherapy. Residual tumors represent a clinical challenge, Lis they may be resistant to additional cycles of the same drugs. Our aim was to identify differential transcripts expressed in residual tumors, after neoadjuvant chemotherapy, that might be related with tumor resistance. Hence, 16 patients with paired tumor samples, collected before and after treatment (4 cycles doxorubicin/cyclophosphamide, AC) had their gene expression evaluated on cDNA microarray slides containing 4,608 genes. Three hundred and eighty-nine genes were differentially expressed (paired Student`s t-test, pFDR<0.01) between pre- and post-chemotherapy samples and among the regulated functions were the JNK cascade and cell death. Unsupervised hierarchical clustering identified one branch comprising exclusively, eight pre-chemotherapy samples and another branch, including the former correspondent eight post-chemotherapy samples and other 16 paired pre/post-chemotherapy samples. No differences in clinical and tumor parameters could explain this clustering. Another group of I I patients with paired samples had expression of selected genes determined by real-time RT-PCR and CTGF and DUSP1 were confirmed more expressed in post- as compared to pre-chemotherapy samples. After neoadjuvant chemotherapy some residual samples may retain their molecular signature while others present significant changes in their gene expression...

Laser de baixa potência na prevenção de mucosite em pacientes submetidos à quimioterapia com fluorouracil e ácido folínico; Low level laser therapy in oral mucositis prevention on patients submitted to fluorouracil and folinic acid chemotherapy

Gambirazi, Liane Marmo
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 11/12/2007 PT
Relevância na Pesquisa
36.59%
A mucosite oral constitui efeito colateral dose-limitante da quimioterapia, relativamente freqüente, desconfortável e potencialmente letal. O controle terapêutico é sintomático e ainda inexiste procedimento estabelecido para prevenir a sua manifestação. O objetivo deste estudo foi verificar a eficácia do laser de baixa potência na prevenção da mucosite oral e as influências de variáveis demográficas (idade e sexo), subjetivas (xerostomia e paladar) e objetivas (história médica), em pacientes portadores de adenocarcinoma de cólon, submetidos à quimioterapia com fluorouracil (5-FU) e ácido folínico (Leucovorin®). Quarenta e oito pacientes foram incluídos no estudo. 18 homens e 30 mulheres, na faixa etária dos 37 aos 78 anos com média de idade de 62,5 anos. Os pacientes foram endereçados, seqüencial e alternadamente, para dois grupos. Vinte e cinco pacientes compuseram o grupo submetido à aplicação preventiva de laser (grupo LP) e 23 pacientes receberam aplicação placebo (grupo C). A aplicação do laser, preventivo ou placebo, foi realizada na semana de infusão da quimioterapia, uma única vez, e os pacientes foram reavaliados após sete dias. O laser utilizado foi o AlGaInP, 660nm, fluência de 3J/cm2. Os graus de mucosite foram mensurados pela escala WHO...

Análise do perfil de expressão gênica de sarcomas de partes moles de extremidades de adultos submetidos a quimioterapia neoadjuvante com doxorrubicina e ifosfamida; Gene expression profile of adult extremity soft tissue sarcomas submitted to neoadjuvant chemotherapy with doxorubicin and ifosphamide

Aguiar Junior, Samuel
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 09/10/2007 PT
Relevância na Pesquisa
36.57%
INTRODUÇÃO: A cirurgia associada à radioterapia proporciona altas taxas de preservação de membros e de controle local em sarcomas de partes moles de extremidade de adultos, mas ainda apresenta elevadas taxas de complicações locais e de metástases à distância. O valor da quimioterapia adjuvante ou neoadjuvante ainda é controverso e objeto de investigações clínicas. A identificação de fatores moleculares preditivos de resposta à quimioterapia pode selecionar pacientes que se beneficiem ou não da sua aplicação. OBJETIVOS: identificar perfis de expressão gênica capazes de diferenciar tumores respondedores e não respondedores a quimioterapia neoadjuvante em sarcomas de partes moles. Analisar os resultados preliminares relativos à efetividade de um esquema de quimioterapia neoadjuvante em sarcomas de partes moles. MÉTODOS: amostras foram coletadas a partir de um ensaio clínico fase II não controlado que testa um esquema de quimioterapia neoadjuvante com doxorrubicina e ifosfamida em sarcomas de alto grau histológico, localizados em extremidades de pacientes adultos. O perfil de expressão gênica foi determinado pela análise de cDNA microarrays. RESULTADOS: 14 pacientes foram incluídos no estudo clínico e 6 amostras foram utilizadas para análise molecular. 222 seqüências diferentemente expressas entre respondedores e não respondedores foram identificadas. Entre os genes com maior diferença de expressão...

Análise de conceito do diagnóstico de enfermagem náusea no tratamento quimioterápico; Concept analysis of diagnosis of nausea during chemotherapy treatment in nursing

Moysés, Aline Maria Bonini
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 11/07/2014 PT
Relevância na Pesquisa
36.57%
Este estudo trata-se de uma análise de conceito do diagnóstico de enfermagem Náusea no tratamento quimioterápico, de acordo com o modelo de Walker e Avant. Os objetivos foram: identificar e sintetizar o conceito náusea em pacientes durante o tratamento quimioterápico por meio de uma revisão integrativa; identificar os atributos, os antecedentes, as consequências e os referenciais empíricos da náusea relacionada à quimioterapia; elaborar um caso modelo, um caso-relacionado e um caso-contrário do conceito náusea em pacientes durante o tratamento quimioterápico; comparar a definição de náusea da NANDA-I, edição de 2012-2014 com as definições de náusea encontradas nos estudos da revisão integrativa; comparar os atributos definidores da náusea relacionada à quimioterapia na literatura com as características definidoras e os antecedentes com os fatores relacionados do diagnóstico de náusea da NANDA-I. Foram seguidas as oito etapas da análise de conceito de Walker e Avant: seleção do conceito, objetivos da análise conceitual, identificação dos possíveis usos do conceito, determinação dos atributos definidores, identificação do caso modelo, identificação de casos adicionais, identificação de antecedentes e consequências e definição de referenciais empíricos. Para este estudo foi selecionado o conceito de náusea em pacientes em tratamento quimioterápico e o objetivo da análise foi investigar se o diagnóstico de enfermagem náusea da NANDA-I contempla o tratamento quimioterápico como fatores relacionados. Posteriormente foi realizada uma revisão integrativa para identificar os possíveis usos do conceito...

Maternal and perinatal outcomes of first pregnancy after chemotherapy for gestational trophoblastic neoplasia in Brazilian women

Braga, Antonio; Maesta, Izildinha; Michelin, Odair Carlito; Gomes Delmanto, Lucia Regina; Consonni, Marcos; Rudge, Marilza Vieira Cunha; Belfort, Paulo
Fonte: Academic Press Inc. Elsevier B.V. Publicador: Academic Press Inc. Elsevier B.V.
Tipo: Artigo de Revista Científica Formato: 568-571
ENG
Relevância na Pesquisa
36.57%
Objective. To evaluate maternal and perinatal outcomes of first pregnancy after chemotherapy for gestational trophoblastic neoplasia (GTN) in Brazilian patients.Methods. This study included 252 subsequent pregnancies after chemotherapy for GTN treated between 1960-2005. Correlations of maternal and perinatal outcomes with chemotherapy regimen (single or multiagent) and the time interval between chemotherapy completion and first subsequent pregnancy were investigated.Results. There was a significant increase in adverse maternal outcomes in women who conceived <6 months than 6-12 months (76.2% and 19.6%; p<0.0001; OR=13.12; CI 95%=3.87-44.40) and >12 months (76.2% and 21.7%; P<0.0001; OR=11.56; CI 95%=3.98-33.55) after chemotherapy. Spontaneous abortion frequency was higher <6 months (71.4%) than 6-12 months (17.6%; p<0.0001: OR=11.66; CI 95%=3.55-38.22) and >12 months (9.4%; p<0.0001: OR=23.97: CI 95%=8.21-69.91) after chemotherapy. There was no difference in adverse perinatal outcomes (stillbirth, fetal malformation, and preterm birth) related to the interval after chemotherapy and Subsequent pregnancy. The overall occurrence of adverse maternal and perinatal outcomes did not significantly differ between patients on single or multiagent regimens.Conclusion. Adverse maternal outcomes and spontaneous abortion were more frequent among patients who conceived within 6 months of chemotherapy completion. In these cases...

Hormone therapy with tamoxifen reduces plasma levels of NT-B-type natriuretic peptide but does not change ventricular ejection fraction after chemotherapy in women with breast cancer

Silva,F.B.; Romero,W.G.; Carvalho,A.L.R.; Borgo,M.V.; Amorim,M.H.C.; Gouvea,S.A.; Abreu,G.R.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2015 EN
Relevância na Pesquisa
36.59%
The objective of this study was to evaluate the effect of tamoxifen on the plasma concentration of NT-pro-B-type natriuretic peptide (NT-proBNP) in women undergoing chemotherapy for breast cancer and to correlate changes in NT-proBNP with the left ventricular ejection fraction (LVEF). Over a period of 12 months, we followed 60 women with a diagnosis of breast cancer. The patients were separated into a group that received only chemotherapy (n=23), a group that received chemotherapy + tamoxifen (n=21), and a group that received only tamoxifen (n=16). Plasma levels of NT-proBNP were assessed at 0 (T0), 6 (T6), and 12 (T12) months of treatment, and echocardiography data were assessed at T0 and T12. Plasma NT-proBNP levels were increased in the chemotherapy-only group at T6 and T12, whereas elevated NT-proBNP levels were only found at T6 in the chemotherapy + tamoxifen group. At T12, the chemotherapy + tamoxifen group exhibited a significant reduction in the peptide to levels similar to the group that received tamoxifen alone. The chemotherapy-only group exhibited a significant decrease in LVEF at T12...

Chemotherapy beyond first-line in stage IV metastatic non-small cell lung cancer

Younes,Riad Naim; Pereira,José Rodrígues; Fares,Abdo Latif; Gross,Jefferson Luiz
Fonte: Associação Médica Brasileira Publicador: Associação Médica Brasileira
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2011 EN
Relevância na Pesquisa
36.67%
OBJECTIVE: Platinum-based doublet chemotherapy is considered the standard of care for advanced non-small cell lung cancer (NSCLC). However, prognosis after recurrent or progressive disease following first-line chemotherapy is usually poor. Maintenance chemotherapy, second line treatment and even third line chemotherapy are available for patients with advanced NSCLC. Unfortunately, few patients are candidates for chemotherapy beyond first line. The present study evaluated characteristics of patients with NSCLC and outcomes of the treatment of their metastatic disease, with emphasis on second and third-line chemotherapy. METHODS: This was a retrospective observational study of 2,673 patients with metastatic, stage IV, non-small cell lung cancer admitted for treatment in two São Paulo institutions. First-line chemotherapy was defined as the first chemotherapeutic approach administered to the patient. Second and third-line chemotherapy were defined as the systemic treatment administered after discontinuing first-line chemotherapy, either for intolerance or for progressive or recurrent disease. RESULTS: Most patients (57.9%) received first-line chemotherapy, and approximately 23.4% received second-line and 8% third-line regimens. Only 2.5% received fourth-line chemotherapy. Median overall survival (OS) was 8 months (95% CI: 8-9 months). At univariate analyses...

Expression of aldehyde dehydrogenase after neoadjuvant chemotherapy is associated with expression of hypoxia-inducible factors 1 and 2 alpha and predicts prognosis in locally advanced breast cancer

Tiezzi,Daniel Guimarães; Clagnan,Willian Simões; Mandarano,Larissa Raquel Mouro; de Sousa,Christiani Bisinoto; Marana,Heitor Ricardo Cosiski; Tiezzi,Marcelo Guimarães; de Andrade,Jurandyr Moreira
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/05/2013 EN
Relevância na Pesquisa
36.59%
OBJECTIVE: To analyze the expression of hypoxia-inducible factors (hypoxia-inducible factor 1A and hypoxia-inducible factor 2A) and aldehyde dehydrogenase proteins in patients with locally advanced breast carcinoma who were subjected to neoadjuvant chemotherapy. METHODS: We included 90 patients with histologically confirmed stage II and III breast carcinoma who were treated with neoadjuvant chemotherapy between 2000 and 2005. Immunohistochemistry for aldehyde dehydrogenase, hypoxia-inducible factor 1A, and hypoxia-inducible factor 2A was performed before and after neoadjuvant chemotherapy. We analyzed the influence of clinical and pathological features on clinical and pathological response, disease-free survival, and overall survival. RESULTS: An objective clinical response to neoadjuvant chemotherapy was observed in 80% of patients, with 12% showing a complete pathological response. Among all clinical and pathological parameters, only the expression of hypoxia-inducible factor 1A was associated with a pathological response. A positive association was found between expression of aldehyde dehydrogenase and that of hypoxia-inducible factor 1A before and after chemotherapy. Aldehyde dehydrogenase expression was associated with expression of hypoxia inducible-factor 2A in tumors after neoadjuvant treatment. In a univariate analysis...

The Evolution and Future of the Medicare Chemotherapy Concession

Zachary, Jennifer L.
Fonte: Harvard University Publicador: Harvard University
Tipo: Paper (for course/seminar/workshop)
EN_US
Relevância na Pesquisa
36.64%
Cancer is a life threatening disease that affects thousands of Americans each year. Chemotherapy is one of the most effective treatments for the disease, but its prohibitive cost makes it all but unavailable to those without health insurance. The Medicare program provides coverage for chemotherapy treatment to 40 million Americans 65 and older, those in the highest risk group for developing cancer. Last year the Medicare program spent over five billion dollars on chemotherapy treatment, with 75 percent of this money being paid to oncologists to reimburse them for the prescription drugs they administer to Medicare beneficiaries during chemotherapy treatment. Through a practice known as the “chemotherapy concession,†oncologists purchase prescription chemotherapy drugs from their manufacturers and wholesalers, administer the drugs to patients, and then bill Medicare for reimbursement. This payment from Medicare often far exceeds the actual cost of the drugs to the physicians who purchased them. Government audits have found that profit margins for doctors of 80 to 90 percent are not uncommon in these transactions. Critics contend that this practice encourages doctors to over-prescribe chemotherapy and jeopardizes the continued coverage of chemotherapy treatment by the Medicare program. Oncologists have maintained...

Diffusion of Intraperitoneal Chemotherapy in Women with Advanced Ovarian Cancer in Community Settings 2003–2008: The Effect of the NCI Clinical Recommendation

Bowles, Erin J. Aiello; Wernli, Karen J.; Gray, Heidi J.; Bogart, Andy; Delate, Thomas; O’Keeffe-Rosetti, Maureen; Nekhlyudov, Larissa; Loggers, Elizabeth Trice
Fonte: Frontiers Media S.A. Publicador: Frontiers Media S.A.
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
36.64%
Purpose: A 2006 National Cancer Institute clinical announcement recommended the use of combined intravenous (IV) and intraperitoneal (IP) chemotherapy over IV chemotherapy alone for women with International Federation of Gynecology and Obstetrics (FIGO) stage 3 optimally debulked ovarian cancer due to significant survival benefit demonstrated in multiple randomized clinical trials. We examined uptake of IP chemotherapy in community practice before and after this recommendation. Methods: We identified 288 women with FIGO stage 2 or greater incident ovarian cancer diagnosed from 2003 to 2008 at three integrated delivery systems in the US. Administrative health plan data were used to determine patient characteristics and receipt of IV and IP chemotherapy within 12 months of diagnosis. We compared characteristics of women receiving IV chemotherapy alone vs. IP chemotherapy (with or without IV chemotherapy) and assessed temporal trends in IP chemotherapy use. Results: Overall 12.5% (n = 36) of women received IP chemotherapy during the study period. IP chemotherapy use was non-existent between 2003 and 2005. Use of IP chemotherapy occurred among 26.9% of women diagnosed in 2006 and plateaued at 20.4% of women diagnosed in 2008. IP recipients were younger (mean age 55.9 vs. 63.5 years...

The Effect of Neo-adjuvant Platinum-based Combination Chemotherapy on Pathological Down-staging and Survival of Patients with Locally Advanced Bladder Cancer

Scosyrev, Emil ; Fisher, Susan G.
Fonte: Universidade de Rochester Publicador: Universidade de Rochester
Tipo: Tese de Doutorado
ENG
Relevância na Pesquisa
36.63%
Thesis (Ph.D.)--University of Rochester. School of Medicine & Dentistry. Dept. of Community and Preventive Medicine, 2010.; Background Bladder cancer (BC) is the fifth most commonly diagnosed malignancy in the United States, with more than 70,000 new cases and more than 14,000 BC deaths reported in year 2009. The overwhelming majority of deaths from BC occur among patients with muscle-invasive disease (stages T2-T4). Standard therapy for resectable (T2-T4a) muscle-invasive BC without known metastases includes radical cystectomy. Unfortunately, 30%-50% of patients with apparently resectable muscle-invasive BC (“locally advanced” disease) in fact have undiagnosed micrometastases at the time of definitive surgery. Early treatment of micrometastatic disease with neo-adjuvant platinum-based combination chemotherapy (PBCC) administered before cystectomy has been compared to cystectomy alone in several randomized trials. A meta-analysis of these trials demonstrated that addition of a neo-adjuvant PBCC regimen to definitive surgery can substantially increase the probability of tumor down-staging to pathological stage zero (pT0) and improve survival. However, it is currently unknown whether PBCC is effective for all most commonly encountered histologic sub-types of BC...

Alimentary tract mucositis: NF-kB and pro-inflammatory cytokines in the tissues and serum following chemotherapy.

Logan, Richard Martin
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2008
Relevância na Pesquisa
36.64%
Mucositis refers to the widespread damage of mucosal surfaces throughout the length of the alimentary tract (AT) that can occur during cancer treatment. Its development is an important clinical problem that complicates and limits treatment options as well as adversely affecting the quality of life and treatment outcomes for patients. Recent studies directed at determining the pathobiology of mucositis have indicated increasing evidence for the role of transcription factors, such as nuclear factor-κB (NF-κB), and certain pro-inflammatory cytokines, for example tumour necrosis factor (TNF), interleukin-1β (IL-1β) and interleukin- 6 (IL-6), in its development. This thesis developed from an initial clinical investigation in which the expression of NF-κB and COX-2 in oral mucosa was investigated in patients undergoing chemotherapy. Increased levels of NF-κB were demonstrated in the buccal mucosa following chemotherapy. It is well established that mucositis occurs in different sites of the AT. The aims of this research, therefore, were to compare and contrast the changes that do occur at different sites of the AT following chemotherapy in an established animal model (Dark Agouti (DA) rat). Furthermore, the studies were conducted to determine whether changes in tissue and serum levels of NF-κB and pro-inflammatory cytokines occurred following chemotherapy and...

Impact of age on choice of chemotherapy and outcome in advanced colorectal cancer

Khattak, M.; Townsend, A.; Beeke, C.; Karapetis, C.; Luke, C.; Padbury, R.; Maddern, G.; Roder, D.; Price, T.
Fonte: Pergamon-Elsevier Science Ltd Publicador: Pergamon-Elsevier Science Ltd
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
36.59%
BACKGROUND: Age is a major risk factor for development of sporadic colorectal cancer but elderly patients are underrepresented in clinical trials and are potentially offered chemotherapy less often. METHODS: Data were obtained from South Australian Clinical Registry for advanced colorectal cancer between 1st February 2006 and 9th September 2010. Patients who received chemotherapy were analysed to assess the impact of single versus combination chemotherapy and to assess the outcome in two age cohorts, age < 70 years and ≥ 70 years. RESULTS: Out of a total of 1745 patients in the database during this time period, 951 (54.5%) received systemic chemotherapy. 286 (30%) received first line therapy (median age 74 years) with single agent fluoropyrimidine and 643 patients (68%) received first line combination chemotherapy (median age 64 years). The median overall survival of patients receiving first line combination chemotherapy was 23.9 months compared to 17.2 months for those who received single agent fluoropyrimidine (p<0.001). Combination chemotherapy was given to 81% of patients aged < 70 years compared to 53% of those ≥ 70 years. There was no significant difference in median overall survival of patients receiving chemotherapy by age cohort...

Liver only metastatic disease in patients with metastatic colorectal cancer: impact of surgery and chemotherapy

Padman, S.; Padbury, R.; Beeke, C.; Karapetis, C.; Bishnoi, S.; Townsend, A.; Maddern, G.; Price, T.
Fonte: Taylor & Francis As Publicador: Taylor & Francis As
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
36.59%
Background. Metastatectomy in colorectal cancer (CRC) is now a standard of care with improved survival reported. Conversion chemotherapy has increased the population who are suitable for surgery. Here we assess patterns of care and treatment outcome in liver only metastases in South Australia using the clinical registry for advanced CRC. Methods. We analysed the outcomes for patients with liver only metastatic involvement from the SA Metastatic CRC Database with the aim to investigate the role of chemotherapy on liver resection and outcome in comparison to liver resection only and chemotherapy without liver resection. Patients who had no therapy or non-surgical liver interventions were excluded for this analysis. Results. One thousand nine hundred and eight patients were available for analysis, 687 (36%) had liver only metastatic disease and 455 (24%) had active therapy as defined. In total 54.2% (247/455) had chemotherapy alone, 19.1% (87/455) had liver resection alone, and 26.6% (121/455) had combined treatment. The three-year survival for chemotherapy, resection and combined treatment subgroups is 19.5%, 73.8% and 73.7%, respectively. The addition of chemotherapy to surgery did not improve survival. Switching chemotherapy was associated with a poorer outcome; three-year overall survival for chemotherapy switch was 62.5%...

Neoadjuvant chemotherapy in ER+ HER2- breast cancer: response prediction based on immunohistochemical and molecular characteristics

Lips, E.; Mulder, L.; de Ronde, J.; Mandjes, I.; Vincent, A.; Vrancken Peeters, M.T.F.D.; Nederlof, P.; Wesseling, J.; Rodenhuis, S.
Fonte: Springer US Publicador: Springer US
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
36.6%
A pathological complete remission (pCR) is rarely achieved by neoadjuvant chemotherapy in estrogen receptor-positive (ER+) HER2-negative (HER2−) tumors. Therefore, its use might be questionable in specific groups of this tumor type. To select which patients benefit and which could be spared neoadjuvant chemotherapy, we tested standard pathology and molecular markers in ER+ HER2− breast tumors. Pretreatment biopsies were available from 211 ER+ HER2− tumors, who had been treated with neoadjuvant chemotherapy (adriamycin/cyclophosphamide). mRNA expression data were available for 132 tumors. We determined progesterone receptor expression (PR), endocrine sensitivity, HER2 expression, histology, proliferation, and molecular subtypes. We correlated these data to chemotherapy response using pCR rates and the previously published neoadjuvant response index (NRI). PR-negative tumors (n = 65, 30.8%) and luminal B type tumors (n = 43, 20.4%) responded significantly better to chemotherapy than other tumors. These associations remained significant in multivariate analysis. However, even in the subgroup of patients with the lowest response rate, comprising tumors that had both a positive-PR expression and the luminal A subtype (n = 58, 44%)...

‘I know the difference it has made in people’s lives’: Perceptions of Rural South Australian Nurses Extending Their Role to Administer Chemotherapy.

Alnasser, Qasem
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2014
Relevância na Pesquisa
36.59%
Nurses in rural Australia are currently administering chemotherapy in centres where this was not previously the case. This has resulted from an Australian Government and metropolitan residents in Australia. One initiative has been education of rural health care professionals who work with cancer patients. In South Australia (SA) a State-wide Chemotherapy Education and Assessment Program was implemented using the Antineoplastic Drug Administration Course (ADAC) developed by the Cancer Institute of New South Wales (NSW). This research project explored the perceptions of nurses working in level-one rural centres administering low risk chemotherapy protocols in SA. Critical social theory was used to explore the hidden constraints, conscientize and empower participants. Through individual interviews a dialectic process was developed to collect the data from eight participants who were rural registered nurses working in low risk chemotherapy centres. The data analysis revealed four main categories of findings. These were; 1) role extension, preparedness and self-confidence; 2) chemotherapy services in rural areas; 3) power relationship, referrals and sustainability; and 4) communication with other cancer settings and professionals. These four categories represent the participants’ perceptions of their role and the provision of chemotherapy services in rural areas. Participants valued the service highly but identified areas that they find problematic including maintenance of knowledge and skills. It was also perceived that rural nurses do not have input into the referral process and fear that the service is being underutilised due to low referral rates from metropolitan centres. Based on the findings...

Relationship between race and clinical characteristics, extent of disease, and response to chemotherapy in patients with low-risk gestational trophoblastic neoplasia

Maesta, Izildinha; Berkowitz, Ross S.; Goldstein, Donald P.; Bernstein, Marilyn R.; Ramirez, Luz Angela C.; Horowitz, Neil S.
Fonte: Elsevier B.V. Publicador: Elsevier B.V.
Tipo: Artigo de Revista Científica Formato: 50-54
ENG
Relevância na Pesquisa
36.59%
Objective. To evaluate the potential effects of race on clinical characteristics, extent of disease, and response to chemotherapy in women with postmolar low-risk gestational trophoblastic neoplasia (GTN).Methods. This non-concurrent cohort study was undertaken including patients with FIGO-defined postmolar low-risk GTN treated with comparable doses and schedules of chemotherapy at the New England Trophoblastic Disease Center (NETDC) between 1973 and 2012. Racial groups investigated included whites, African American and Asians. Information on patient characteristics and response to chemotherapy (need for second line chemotherapy, reason for changing to an alternative chemotherapy, number of cycles/regimens, need for combination chemotherapy, and time to hCG remission) was obtained.Results. Of 316 women, 274 (86.7%) were white, 19 (6%) African American, and 23 (7.3%) Asian. African Americans were significantly younger than white and Asian women (p = 0.008). Disease presentation, and extent of disease, including antecedent molar histology, median time to persistence, median hCG level at persistence, rate of D&C at persistence, presence of metastatic disease, and FIGO stage and risk score were similar among races. Need for second line chemotherapy (p = 0.023)...

A preliminary analysis of the reduction of chemotherapy waste in the treatment of cancer with centralization of drug preparation

Hyeda,Adriano; Costa,Elide Sbardellotto Mariano da
Fonte: Associação Médica Brasileira Publicador: Associação Médica Brasileira
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2015 EN
Relevância na Pesquisa
36.61%
SummaryIntroduction:chemotherapy is essential to treat most types of cancer. Often, there is chemotherapy waste in the preparation of drugs prescribed to the patient. Leftover doses result in toxic waste production.Objective:the aim of the study was to analyze chemotherapy waste reduction at a centralized drug preparation unit.Methods:the study was cross-sectional, observational and descriptive, conducted between 2010 and 2012. The data were obtained from chemotherapy prescriptions made by oncologists linked to a health insurance plan in Curitiba, capital of the state of Paraná, in southern Brazil. Dose and the cost of chemotherapy waste were calculated in each application, considering the dose prescribed by the doctor and the drug dosages available for sale. The variables were then calculated considering a hypothetical centralized drug preparation unit.Results:there were 176 patients with a cancer diagnosis, 106 of which underwent treatment with intravenous chemotherapy. There were 1,284 applications for intravenous anticancer medications. There was a total of 63,824mg in chemotherapy waste, the cost of which was BRL 448,397.00. The average cost of chemotherapy waste per patient was BRL 4,607.00. In the centralized model, there was 971.80mg of chemotherapy waste...

Chemotherapy - induced intestinal mucositis : the role of apoptosis regulators

Bowen, Joanne M
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado Formato: 130554 bytes; 2544783 bytes; 64416 bytes; application/pdf; application/pdf; application/pdf
Publicado em //2006 EN
Relevância na Pesquisa
36.59%
Mucositis is the damage that occurs to the alimentary canal from anti - cancer therapies. It is caused by chemotherapy, radiotherapy and combination therapy and affects a large proportion of patients. Despite its prevalence, an effective anti - mucositis agent has yet to be developed that protects the whole tube, although the use of keratinocyte growth factor ( Amgen ' s Palifermin ) has recently been approved for the prevention of oral mucositis. It is important to understand mechanisms controlling mucositis so that treatment can be targeted appropriately. This thesis has investigated some of the key components identified as being involved in mucositis as well as identifying new genes which contribute to chemotherapy - induced intestinal injury. The research chapters investigated : 1 ) Gene expression of the apoptosis - regulating Bcl - 2 family, p53 and caspase - 3, and the changes which occur in the intestine following chemotherapy treatment for cancer. 2 ) The effect of different chemotherapeutic agents on intestinal cells in vitro and the role p53 plays. 3 ) The mucositis caused by single dose irinotecan in the rat with breast cancer and the role of p53 in induction of intestinal damage. 4 ) The early gene changes that occur in the small intestine of the rat with breast cancer following irinotecan treatment. Firstly...

Variations in the body mass index in Brazilian women undergoing adjuvant chemotherapy for breast cancer

Ricci,Marcos Desídérío; Formigoni,Maria Carolina; Zuliani,Lucia Maria Martins; Aoki,Denis Seiiti; Mota,Bruna Salani; Filassi,José Roberto; Piato,José Roberto Morales; Baracat,Edmund Chada
Fonte: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia Publicador: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2014 EN
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PURPOSE: To evaluate variations in the body mass index in patients undergoing adjuvant chemotherapy for breast cancer, and to associate these changes with patient's age and adjuvant chemotherapy regimen. METHODS: We performed a retrospective cohort study in order to correlate any variation in the body mass index before and after adjuvant chemotherapy with patient's age and adjuvant chemotherapy regimen. Patients who received any form of prior hormone therapy, such as tamoxifen or aromatase inhibitors, were excluded. We selected data for 196 patients with stage I to III breast cancer who were treated by radical or conservative surgery and received adjuvant chemotherapy at the Cancer Institute of the State of São Paulo, Brazil. RESULTS: Before adjuvant chemotherapy, 67.8% of patients were classified as overweight or obese according to their body mass indices. Around 66.3% (95% CI 59.7–73.0) of the patients exhibited an increase in the body mass index after adjuvant chemotherapy. The average age of all patients was 56.3±11.3 years. Participants whose body mass index increased were younger than those with no increase (54.7±11.1 versus 59.3±11.2 years; p=0.007). Patients were treated with the following adjuvant chemotherapy regimens: doxorubicin...