Clinical Oncology and Research

Journal Information
ISSN / EISSN : 2613-4942 / 2613-4942
Published by: Science Repository OU (10.31487)
Total articles ≅ 234
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Jorge Mario Molina Díaz, Luis Guillermo Martínez Domínguez, Karla Eugenia Hernández Trejo
Published: 1 October 2022
Clinical Oncology and Research, Volume 2022, pp 1-4; https://doi.org/10.31487/j.cor.2022.04.01

Abstract:
Introduction: DSD are congenital alterations in which either sexual chromosomes, gonadal or anatomical development are atypical. It is estimated that about 1 in every 4500 live births has some type of DSD, ovotesticular DSD representing around 3-10% of the cases. Given the rarity of DSD, it is an underexplored area, and little is known of ovotesticular DSD. Materials and Methods: A retrospective study on patients diagnosed with Ovotesticular DSD in a tertiary medical center from 2009 to 2018. The clinical presentation, phenotype, gonadal features, gender assignment and medical management were evaluated. Results: A total of 184 cases matched the initial search criteria. Only 9 patients with confirmed histopathological diagnosis were selected. Eight out of the nine cases evaluated presented ambiguous genitalia at birth, and only one was detected until pubertal age with presence of bilateral gynecomastia. A female 46 XX karyotype was reported in six patients, whereas the remaining three patients had mosaicism. Four patients were at pubertal age at the time of the study, and three of them required induction of puberty due to lack of sexual steroid production due to loss of gonadal organs. Discussion: Ovotesticular DSD is a rare finding with a heterogeneous spectrum concerning its genetic etiology, clinical presentation, and surgical findings. Most patients are diagnosed during infancy or childhood; few are diagnosed at pubertal age. Conclusion: Actual management and decision on gender assigning and treatment is challenging and debatable; therefore, a scrupulous clinical examination, as well as hormonal, imaging, genetic and molecular investigation is needed for a correct diagnosis. Further investigation is required to fully understand the disease.
Nadine Magy-Bertrand, Andréa Pastissier, Jérôme Razanamahery, Sébastien Humbert, Thibaud Soumagne, Etienne Daguindau, Catherine Chirouze, Gaël Piton
Published: 12 August 2022
Clinical Oncology and Research, Volume 2022, pp 1-4; https://doi.org/10.31487/j.cor.2022.03.04

Abstract:
Hemophagocytic lymphohistiocytosis (HLH) may be secondary to cancer or other conditions in adults. We aimed to compare characteristics and outcomes of secondary HLH depending on cancer status among adults. Weight loss over 10 %, headache and enlarged lymph nodes were more frequent in malignant- HLH (M-HLH). Higher phosphatase alkaline level and CRP level were present in M-HLH. Mortality rate tended to be higher in M-HLH group in the first month and during the two years follow-up. Some clinical features and biological abnormalities are associated with an increased probability of malignancy in secondary HLH among adults.
Catherine Roy, Minault Quentin, Philippe Barthelemy, Marie Mielcarek, Pierre Leyendecker, Mickael Ohana
Published: 5 August 2022
Clinical Oncology and Research, Volume 2022, pp 1-8; https://doi.org/10.31487/j.cor.2022.03.03

Abstract:
Objective: Assessment of a volumetric method versus gold standard unidimensional measurement based on RECIST 1.1 in advanced renal clear cell carcinoma (RCC) treated by immunotherapy. Materials and Methods: We retrospectively recorded the CT data of 14 adult patients treated with immunotherapy for metastatic RCC from February 2016 to January 2018. Follow-up CT scanners were independently reviewed by two radiologists. Unidimensional RECIST 1.1 and volumetric measurements were compared at each time point, with a total of 810 measurements performed for statistical analysis. The main criterion was the inter-observer agreement for each method. The secondary criterion was the tumoral response assessment based on three different items: RECIST 1.1, spherical volumetric method, ellipsoidal volumetric method. Results: Intraclass coefficient correlation in volumetric method (0.986 [95% CI: 0.980, 0.990]) was higher than in RECIST (0.903 [95% CI: 0.861, 0.928]). Relative measurement differences with Bland and Altman plot were lower in the volumetric method with shorter limits of agreement (0.8%; upper LOA95%: 36.5; lower LOA95%: −35), versus those in RECIST (-5.1 % (upper LOA95%: 46; lower LOA95%: −57). The volumetric method (especially the ellipsoidal one) assesses the progression disease earlier than RECIST for 57% of patients, but there is no formal difference for partial response assessment. Conclusion: Volumetric assessment for tumoral response in metastatic RCC compared to unidimensional measurements had a higher inter-observer agreement and might predict disease progression earlier.
Satadal Das, Debasmita Chatterjee, Banhishikha Singh, Ashoke Kumar Pradhan, Krishnendu Paira
Published: 8 July 2022
Clinical Oncology and Research, Volume 2022, pp 1-8; https://doi.org/10.31487/j.cor.2022.03.02

Abstract:
Hepatocellular carcinoma (HCC) is a common cancer with high incidence rate, and 5-year survival rate in HCC is less than 20%. Thus, in search of newer anticancer agents effective in HCC, we have explored possible usefulness of an alternative medicine Lycopodium against the human liver cancer cell line, HepG2 along with its clinical efficacy. The HepG2 cell line was challenged with Lycopodium 6C (diluted Lycopodium <1pg /mL available as alternative medicine) along with vehicle alcohol control in 24 hours. The cytopathic effect and viability test with methylene blue stain were observed. The cells were harvested for total RNA extraction, and gene expression levels of targeted cytokines -Interferon gamma (IFN γ); Interleukins - IL-6, IL-8, IL-10, IL-1β, Transforming Growth Factor- TGF-β1, TGF-β3 and Tumor Necrosis Factor alpha (TNF-α) by RT-PCR were studied. DNA fragmentation assay and cell viability assay by MTT method were also tested. After ethical permission we applied this medicine as adjunct therapy to observe any beneficial role of the medicine. Statistically significant changes of IL-10, IL-1β and TGF-β3 were observed after challenge with Lycopodium 6C. The IL-10 gene expression in malignant cells was significantly reduced with Lycopodium 6C; however, the expression is more with vehicle alcohol compared to normal control set. Thus, the medicine could decrease the excessive IL-10 gene expression to a moderate level. IL-1β and TGF-β3 gene up-regulation by the vehicle alcohol were also mitigated by the medicine Lycopodium 6C. Mild DNA fragmentation was also seen in cancer cells after challenge with the medicine. Two cases suffering from hepatocellular carcinoma showed much clinical improvement after therapy with this medicine. Lycopodium 6C may act as a supporting alternative medication for treating HCC.
Anita Vallacha, Afshan Asghar Rasheed, Narjis Muzaffar, Najeeb Niamatullah, Babar Malik, Chandu Mal, Lubna Gul
Published: 22 June 2022
Clinical Oncology and Research, Volume 2022, pp 1-6; https://doi.org/10.31487/j.cor.2022.03.01

Abstract:
Background: Coronavirus disease (COVID-19) was declared as pandemic by World Health Organization (WHO) on 30th January 2020. Cancer patients are a vulnerable population with increased risk for mortality associated with COVID-19 infection. In this study, we report the impact of education for acceptance of COVID-19 vaccination in our cancer patients. Methods: This was a cross-sectional study between 1st August 2021 and 31st October 2021. All patients with diagnosis of cancer who presented to the oncology clinic were asked whether they received COVID-19 vaccine or planning to get vaccinated. Patients, who had refused the vaccine, were educated to get vaccinated. Post counseling, they were again asked if they would agree to get vaccinated. Results: Out of 512 cancer patients, 274 (53.5%) were male. Of total, 456 (89.1%) were diagnosed cases of solid malignancy. Patients who were on active oncological treatment were 406 (79.3%). Of total 512, 396 (77.3%) patients agreed for the COVID-19 vaccine while 116 (22.7%) had refused to get vaccinated. Of those 116, 75 (64.7%) patients accepted to get vaccinated post counseling. Conclusion: COVID-19 vaccine acceptance is higher among cancer patients at our institute compared to reported data. Oncologists should play a key role in encouraging their patients to get vaccine in order to reduce COVID-19 related mortality.
Toshiko Kato, Kosaku Yamada
Published: 4 May 2022
Clinical Oncology and Research, Volume 2022, pp 1-5; https://doi.org/10.31487/j.cor.2022.02.02

Abstract:
Background: After the Fukushima Nuclear Power Plant accident in 2011, thyroid ultrasound screening was carried out as part of the Fukushima health management survey (FHMS) on all residents of ages≤18 years at the accident. The results of the 1st (2011-2013) and 2nd (2014-2015) round screening showed dozens of times excess thyroid cancer detection compared to the expected from the cancer registry. Both FHMS and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) summarized that thyroid cancer cases detected in Fukushima were unlikely to be attributed to radiation exposure from the absence of dose-response relation. We elucidated the response of thyroid cancer incidence to individual external doses and found the dominant radiation effect on the increased thyroid cancer incidence after the accident. Method: Association between average individual external dose based on FHMS basic survey and thyroid cancer incidence rate of dose groups was analysed by the linear regression analysis. Thyroid dose estimated in UNSCEAR 2020/2021 for 10-year-old children was used for comparison. Results: Incidence proportions of dose groups in the 2nd round showed a linear response to mean individual external dose under 2.5 mSv range. A rough estimate of the excess relative risk per gray (Gy) was ERR/Gy =213 (95%CI: 129, 297) (p=0.02). Conclusion: Childhood and adolescent thyroid cancer in Fukushima was associated with individual external dose estimated in FHMS basic survey. Increased childhood and adolescent thyroid cancer in Fukushima could most probably be attributed to radiation exposure from the nuclear accident.
Fernanda De Oliveira Mota, Natalia Dassi, Ioná Grossman, Flávio Augusto Vercillo Luisi, Ricardo Antônio Bertacchi Uvo, Eliana Maria Monteiro Caran
Published: 21 April 2022
Clinical Oncology and Research, Volume 2022, pp 1-4; https://doi.org/10.31487/j.cor.2022.02.01

Abstract:
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children. It is located mainly in the head and neck, extremities and trunk, rarely achieving the biliary tract (1%). The clinical presentation is characterized by obstructive jaundice, abdominal pain and palpable mass. The prognosis is favourable when being early diagnosed. The main differential diagnosis is the choledochal cyst. We bring a case report about a patient with biliary tract rhabdomyosarcoma, diagnosed and treated for 1 year as choledochal cyst, presenting obstructive jaundice for one year. A hepatic biopsy was done, showing hepatic fibrosis. He presented clinical worsening and was referred for liver transplant. An exploratory laparotomy was done before planning the transplant, which showed a biliary tract mass, followed by a biopsy. The anatomopathological result was RMS. Biliary tract RMS is a rare entity that should be included in the differential diagnosis of obstructive jaundice in children. Because of its similarity with choledochal cyst, pediatricians and surgeons should consider this hypothesis, for adequate investigation and treatment.
Ruihua Shi, Zhihong Duan, Qingxia Wang
Published: 9 February 2022
Clinical Oncology and Research, Volume 2022, pp 1-6; https://doi.org/10.31487/j.cor.2022.01.03

Abstract:
Gastric cancer still threatens the health of people, which is the fifth most common cancer and the fourth leading cancer-related death worldwide. The stage of the disease is critical for the 5-year survival of gastric cancer; the 5-year survival rates could reach 90% for gastric cancer detected at early stages. At present, endoscopic submucosal dissection (ESD) is the main treatment for early gastric cancer. Referring to the treatment guideline of the Japan Gastric Cancer Association, the indications for ESD mainly include absolute indications, expanded indications, and relative indications. Many studies have reported favourable long-term outcomes after undergoing ESD, and compared with surgery, ESD preserves the entire stomach and improves the quality of life of patients. However, it has also been reported that the recurrence rate of gastric cancer after ESD is high, so regular follow-up and careful examination are needed, even for patients with early gastric cancer who met absolute indications.
Bao-An Chen, Zhongshu Yuan, Jing Zhang, Xue Wu, Li Yin
Published: 31 January 2022
Clinical Oncology and Research, Volume 2022, pp 1-6; https://doi.org/10.31487/j.cor.2022.01.02

Abstract:
As a highly heterogeneous disease, diffuse large B-cell lymphoma shows different clinical presentations, molecular and immunophenotypic characteristics, International Prognostic Index (IPI score) and response to therapy, which consequently brings about different prognoses and survival results. In addition to surgery and chemotherapy, radiation is also one important modality to treat diffuse large B-cell lymphoma. Over the past few decades, radiation therapy has stepped forward because of technological revolutions. The role of radiation in treating diffuse large B-cell lymphoma is discussed, including: i) advances in modern-day radiation technology ii) potential toxicity from radiation, iii) indications for radiation, and iv) available studies about the efficacy of radiation.
John M. Baust, Kimberly L. Santucci, Kristi K. Snyder, Anthony Robilotto, Robert G. Van Buskirk, Thomas J. Polascik
Published: 24 January 2022
Clinical Oncology and Research, Volume 2022, pp 1-13; https://doi.org/10.31487/j.cor.2022.01.01

Abstract:
The 5-year survival rate for localized kidney cancer is 93%, but only 13% for those presenting with metastatic disease (2019 SEER data). Cryosurgery is an established treatment modality for renal cell cancer (RCC), with outcomes showing equipoise to radiofrequency ablation (RFA) and partial nephrectomy. Sorafenib is a targeted therapy for RCC utilized in more advanced stage diseases. Given the success of both cryoablation and sorafenib as monotherapies for RCC, in this study, we investigated the cellular response of RCC to combinatorial sorafenib pre-treatment and cryoablation in vitro using cell culture and tissue-engineered tumor models. In vitro samples were exposed to a single or repeat (double) 5-minute freeze at -10°C, -15°C, or -20°C representing temperatures within the periphery of a cryolesion. A repeat freeze to -20°C was necessary to fully ablate samples yielding day 1 viability of 2.9% (±0.2) with no recovery observed over the 7 days post-treatment culture. These findings were consistent with published data on the lethal temperature in RCC, suggesting that -25°C is necessary to destroy RCC following a single freeze event. Pre-treatment of samples with sorafenib at concentrations of 10.61 and 21.21 µM (½ clinical and clinical dose, respectively) was combined with a single or repeat 5-minute freeze to -10°C, -15°C, or -20°C. At the time of drug removal (day 0/pre-freeze), 10.61 µM sorafenib treated samples yielded 25.3% (±0.4) viability, yet samples regrew to control levels by day 7. Following combination freeze and sorafenib exposure, sample viability was found to be 27.5% (±0.7), 2.9% (±0.4), and 0.2% (±0.02) following a single freeze and 15.6% (±0.5), 0.7% (±0.1), and 0.1% (±0.01) following a repeat (double freeze), respectively. Regrowth was observed over the 7-day assessment period in samples exposed to a -10°C single or double freeze and a -15°C single freeze, but not in the -20°C single freeze or -15°C double freeze conditions. Thus, pre-treatment with 10.61 µM sorafenib was found to increase the minimum lethal temperature from the reported -25°C to -20°C following a single freeze event and from -20°C to -15°C following a double freeze. Results of the cell culture studies were confirmed in the 3D tissue-engineered tumor model, wherein the combination of 10.61 µM sorafenib and freezing was found to further increase the lethal temperature from <-20°C to -15°C following a single freeze event. This increased freeze susceptibility yielded a 32% improvement in the overall ablative volume of the ice ball following combinatorial treatment versus freezing alone. These in vitro results suggest that the combination of sorafenib and cryoablation may provide a possible combinatorial treatment path for RCC.
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