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  • 1
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    Effects of a structured counselling-based intervention to improve physical activity behaviour of adolescents and young adult cancer survivors – the randomized phase II Motivate AYA – MAYA trial
    SAGE Publications ; 2021
    In:  Clinical Rehabilitation Vol. 35, No. 8 ( 2021-08), p. 1164-1174
    Details
    In: Clinical Rehabilitation, SAGE Publications, Vol. 35, No. 8 ( 2021-08), p. 1164-1174
    Abstract: To explore whether a structured counselling-based intervention increases vigorous physical activity behaviour of adolescent and young adult cancer survivors. Design: Randomized controlled phase II trial. Setting: University Cancer Center Hamburg, Germany. Subjects: Eighty-nine participants (mean age 24.1 ± 6.3) were randomized to control ( n = 44) or intervention group ( n = 45). Interventions: The intervention group was consulted about physical activity behaviour via interview (week 0), and telephone counselling (weeks 1, 3 and 12). The control group only received general physical activity guidelines for cancer survivors (week 0). Main measures: The primary outcome was the rate of participants with ⩾9 metabolic equivalent (MET)-hours per week of vigorous activity post-intervention, measured with the International Physical Activity Questionnaire. Secondary outcomes included assessing physical activity behaviour (e.g. amount and type of physical activity) and quality of life. Assessments were completed in weeks 0 (baseline), 12 (post-intervention) and 52 (follow-up). Results: Sixty-nine participants completed the post-intervention- and 47 the follow-up-assessment. The rate of participants performing vigorous physical activity increased from baseline to post-intervention for both without differing significantly ( P = 0.541). Both increased their total metabolic equivalent from baseline to post-intervention (intervention group from 55.2 ± 43.7 to 61.7 ± 29.4, control group from 75.3 ± 81.4 to 88.3 ± 80.2). At follow-up the intervention group (73.7 ± 80.2) was more active than baseline when compared to the control group (78.5 ± 50.0). Conclusions: A structured counselling-based physical activity intervention did not significantly impact the level of vigorous physical activity behaviour in adolescent and young adult cancer survivors.
    Type of Medium: Online Resource
    ISSN: 0269-2155 , 1477-0873
    URL: Article
    DOI: 10.1177/0269215521997974
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2028323-4
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  • 2
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    Severe and irreversible myelopathy after concurrent systemic and intrathecal nucleoside analogue treatment for refractory diffuse large B-cell lymphoma: A case report and review of the literature
    SAGE Publications ; 2016
    In:  Journal of Oncology Pharmacy Practice Vol. 22, No. 3 ( 2016-06), p. 523-527
    Details
    In: Journal of Oncology Pharmacy Practice, SAGE Publications, Vol. 22, No. 3 ( 2016-06), p. 523-527
    Abstract: We report a patient with refractory diffuse large B-cell lymphoma who developed irreversible, severe spinal neurotoxicity after concurrent treatment with intrathecal and systemic cytarabine. Shortly after concomitant administration of intrathecal triple therapy (MTX, dexamethasone and cytarabine) and high-dose systemic cytarabin (R-DHAP protocol) the patient lost control of bowel and bladder function and developed an ascending, irreversible paraplegia. Infectious or neoplastic diseases of the spinal cord were ruled out. A magnetic resonance imaging scan of the spine resulted in a diagnosis of toxic myelitis. Previously observed cases of spinal neurotoxicity after cytarabine treatment are reviewed as well as current guidelines for the use of intrathecal chemotherapy in high-grade non-Hodgkin lymphoma. In summary, severe spinal neurotoxicity of intrathecal chemotherapy is a rare side-effect, however several studies suggest that the neurotoxicity of cytarabine is significantly enhanced by concurrent intrathecal and high-dose systemic administration. Simultaneous high-dose systemic and intrathecal chemotherapy with cytarabine should therefore be avoided.
    Type of Medium: Online Resource
    ISSN: 1078-1552 , 1477-092X
    URL: Article
    DOI: 10.1177/1078155214562268
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2026590-6
    SSG: 15,3
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  • 3
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    Chylothorax in a Patient with Hodgkin's Lymphoma: A Case Report and Review of the Literature
    SAGE Publications ; 2013
    In:  Tumori Journal Vol. 99, No. 3 ( 2013-05), p. e96-e99
    Details
    In: Tumori Journal, SAGE Publications, Vol. 99, No. 3 ( 2013-05), p. e96-e99
    Abstract: Chylothorax is defined as chyle entering the pleural space. The most common causes of chylothorax are lymphoma followed by bronchogenic carcinoma and trauma. Case report We report a case of chylothorax in a patient with Hodgkin's lymphoma. A 28-year old man was admitted to the hospital with exertional dyspnea and dry cough. A chest X-ray showed the large opacity on the left side suggesting to the presence of pleural effusion. Methods The effusion was drained, and biochemical tests of the pleural fluid revealed high contents of triglycerides and, hence, confirmed the diagnosis of chylothorax. Cytology of the pleural fluid showed no evidence of Hodgkin's cells. Computer tomography scans of the chest and abdomen exhibited the presence of a soft tissue mass located in the left mediastinum. Mediastinal mass biopsy led to diagnosis of Hodgkin's lymphoma of the nodular sclerosis subtype. The patient received the standard treatment with two cycles of chemotherapy with prednisolone, doxorubicin, cyclophosphamide, vincristine, bleomycin, procarbazine, and etoposide (BEACOPP), followed by an additional two cycles of therapy with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Results After one cycle of chemotherapy, chylothorax initially decreased. Unfortunately, during the following courses of chemotherapy, the pleural effusion reoccurred and repeated pleural taps were necessary. According to the treatment protocol, radiation of the mediastinal bulk was performed after chemotherapy. Now, nearly one year after completion of radiotherapy, the chylothorax has significantly regressed and no further thoracocenteses were necessary. Conclusion The case reveals an example of left-sided chylothorax as the first manifestation of Hodgkin's lymphoma in a young patient. In this case, radiotherapy was shown to be an effective treatment option for lymphoma-associated chylothorax unresponsive to chemotherapy.
    Type of Medium: Online Resource
    ISSN: 0300-8916 , 2038-2529
    URL: Article
    DOI: 10.1177/030089161309900324
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 280962-X
    detail.hit.zdb_id: 2267832-3
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  • 4
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    Tolerance to Chemotherapy in Elderly Patients with Cancer
    SAGE Publications ; 2007
    In:  Cancer Control Vol. 14, No. 1 ( 2007-01), p. 44-56
    Details
    In: Cancer Control, SAGE Publications, Vol. 14, No. 1 ( 2007-01), p. 44-56
    Abstract: Due to demographic changes, the number of elderly people with cancer will increase in the next decades. In the past, elderly patients with cancer were often excluded from clinical trials. Chronological age has been considered a risk factor for increased toxicity and reduced tolerance to chemotherapy. Methods We present a review on toxicity of chemotherapy and factors associated with toxicity in elderly patients with cancer, and we discuss chemotherapeutic agents and treatment options in treating this patient population. Results Age is a risk factor for increased toxicity to chemotherapy and decreased tolerance. However, few trials have been reported with adjustment for age-associated changes such as impairment of functional status and increased comorbidity, which also show an independent association with increased toxicity. Published data may include several biases, such as referral and publication bias. Conclusions Decision making in elderly cancer patients should be based on the results of a geriatric assessment. Patients with few or no limitations should be treated as younger patients are treated. Data with a high level of evidence are unavailable for patients showing moderate or severe limitations in a geriatric assessment.
    Type of Medium: Online Resource
    ISSN: 1073-2748 , 1073-2748
    URL: Article
    DOI: 10.1177/107327480701400106
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2004182-2
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  • 5
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    Fulminant blast crisis with de novo 11q23 rearrangement in a Philadelphia-positive CML patient undergoing treatment with dasatinib
    SAGE Publications ; 2019
    In:  Tumori Journal Vol. 105, No. 6 ( 2019-12), p. NP8-NP11
    Details
    In: Tumori Journal, SAGE Publications, Vol. 105, No. 6 ( 2019-12), p. NP8-NP11
    Abstract: Progression of chronic myeloid leukemia (CML) is frequently accompanied by cytogenetic evolution, with an extra copy of the Philadelphia chromosome, trisomy 8 and 19, and isochromosome (17p) commonly detected. Translocations involving 11q23 chromosomal region have been rarely reported in CML. The few reported patients with blast crisis (BC) of CML carrying an 11q rearrangement have insufficient responses to tyrosine kinase inhibitors (TKIs) and possess a poor prognosis. Case report: We report the case of a 30-year-old man with CML who had a fulminant myeloid BC 4 months after initiation of first-line therapy with the TKI dasatinib, despite showing an optimal response at the 3-month timepoint. Despite cytoreductive therapy with hydroxyurea and 3rd-generation TKI ponatinib, the patient died within 10 days after the diagnosis of BC. Cytogenetic analyses revealed additional genetic aberrations including trisomy 8 and t(9;11)(p21;q23) involving the mixed lineage leukemia ( MLL) gene. Conclusion: The presence of 11q23 rearrangements in the relapse clone in BC of CML most likely accounts for the adverse clinical outcome. Thus, in the case of rapid and unexpected BC, the presence of 11q rearrangements should be tested together with other additional chromosomal alterations, and immediate addition of chemotherapy to the TKIs should be evaluated.
    Type of Medium: Online Resource
    ISSN: 0300-8916 , 2038-2529
    URL: Article
    DOI: 10.1177/0300891619839473
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 280962-X
    detail.hit.zdb_id: 2267832-3
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  • 6
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    Impact of geography on prognostic outcomes of 21,509 patients with metastatic colorectal cancer enrolled in clinical trials: an ARCAD database analysis
    SAGE Publications ; 2021
    In:  Therapeutic Advances in Medical Oncology Vol. 13 ( 2021-01), p. 175883592110205-
    Details
    In: Therapeutic Advances in Medical Oncology, SAGE Publications, Vol. 13 ( 2021-01), p. 175883592110205-
    Abstract: Benchmarking international cancer survival differences is necessary to evaluate and improve healthcare systems. Our aim was to assess the potential regional differences in outcomes among patients with metastatic colorectal cancer (mCRC) participating in international randomized clinical trials (RCTs). Design: Countries were grouped into 11 regions according to the World Health Organization and the EUROCARE model. Meta-analyses based on individual patient data were used to synthesize data across studies and regions and to conduct comparisons for outcomes in a two-stage random-effects model after adjusting for age, sex, performance status, and time period. We used mCRC patients enrolled in the first-line RCTs from the ARCAD database, which provided enrolling country information. There were 21,509 patients in 27 RCTs included across the 11 regions. Results: Main outcomes were overall survival (OS) and progression-free survival (PFS). Compared with other regions, patients from the United Kingdom (UK) and Ireland were proportionaly over-represented, older, with higher performance status, more frequently male, and more commonly not treated with biological therapies. Cohorts from central Europe and the United States (USA) had significantly longer OS compared with those from UK and Ireland ( p = 0.0034 and p  〈  0.001, respectively), with median difference of 3–4 months. The survival deficits in the UK and Ireland cohorts were, at most, 15% at 1 year. No evidence of a regional disparity was observed for PFS. Among those treated without biological therapies, patients from the UK and Ireland had shorter OS than central Europe patients ( p  〈  0.001). Conclusions: Significant international disparities in the OS of cohorts of mCRC patients enrolled in RCTs were found. Survival of mCRC patients included in RCTs was consistently lower in the UK and Ireland regions than in central Europe, southern Europe, and the USA, potentially attributed to greater overall population representation, delayed diagnosis, and reduced availability of therapies.
    Type of Medium: Online Resource
    ISSN: 1758-8359 , 1758-8359
    URL: Article
    DOI: 10.1177/17588359211020547
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2503443-1
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  • 7
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    Primary NK/T cell lymphoma nasal type of the stomach with skin involvement: a case report
    SAGE Publications ; 2009
    In:  Rare Tumors Vol. 1, No. 2 ( 2009-12-28), p. 173-175
    Details
    In: Rare Tumors, SAGE Publications, Vol. 1, No. 2 ( 2009-12-28), p. 173-175
    Abstract: Since nasal NK/T cell lymphoma and NK/T cell lymphoma nasal type are rare diseases, gastric involvement has seldom been seen. We report a unique case of a patient with a primary NK/T cell lymphoma nasal type of the stomach with skin involvement. The patient had no history of malignant diseases and was diagnosed with hematemesis and intense bleeding from his gastric primary site. Shortly after this event, exanthemic skin lesions appeared with concordant histology to the primary site. Despite chemotherapy, the patient died one month after the first symptomatic appearance of disease.
    Type of Medium: Online Resource
    ISSN: 2036-3613 , 2036-3613
    URL: Article
    DOI: 10.4081/rt.2009.e58
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2009
    detail.hit.zdb_id: 2514363-3
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  • 8
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    Novel Algorithm for More Accurate Calculation of Renal Function in Adults with Cancer
    SAGE Publications ; 2008
    In:  Annals of Pharmacotherapy Vol. 42, No. 12 ( 2008-12), p. 1749-1757
    Details
    In: Annals of Pharmacotherapy, SAGE Publications, Vol. 42, No. 12 ( 2008-12), p. 1749-1757
    Abstract: Cytotoxic agents have a narrow therapeutic window. A high percentage of some of them is renally excreted in unchanged form. Accurate assessment of an individual's glomerular filtration rate (GFR) helps to predict the pharmacokinetic behavior of those drugs more precisely. GFR calculations, however, have their limitations. Objective: To establish a more accurate calculation of renal function over a broad range of constitutive GFR values. Methods: Patients with cancer were included in the analysis. Serum levels of cystatin C, creatinine, urea, albumin, and β-trace protein were measured, and GFR was calculated by 8 mathematical formulas. The results were compared with creatinine clearance (CrCI) calculated from timed urine specimens. Results: One hundred two patients were evaluated: median age, 57.5 years (range 20–91); females, 52; males, 50; and mean urinary CrCI, 77.0 mL/min. The bias (mean percentage error) was -2% and the precision (mean absolute percentage error) was 23% for the Modification of Diet in Renal Disease (MDRD) estimation of GFR. All equations significantly overestimated CrCI in patients with measured clearance less than 50 mL/min (p 〈 0.05), with the exception of the modified Salazar-Corcoran formula. All equations underestimated CrCI in patients with measured clearance greater than 100 mL/min. The Wright formula was the least biased and most precise (–5%, 16%, respectively). In patients with measured CrCI 50–100 mL/min, the MDRD calculation had a bias of -4% and a precision of 17%. The Jelliffe and Larsson equations were associated with significant sex bias (p 〈 0.05). Conclusions: These observations suggest that individual GFR values over a broad range cannot be calculated accurately enough with only one selected formula. It may be useful to classify renal function of patients with cancer according to the novel algorithm by using MDRD first and then to subsequently calculate GFR in higher and lower ranges with the Wright and modified Salazar-Corcoran formulas, respectively. This algorithm should be validated using larger numbers of patients.
    Type of Medium: Online Resource
    ISSN: 1060-0280 , 1542-6270
    URL: Article
    DOI: 10.1345/aph.1L216
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
    detail.hit.zdb_id: 2053518-1
    SSG: 15,3
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  • 9
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    Prevalence and Predictors of Distress, Anxiety, Depression, and Quality of Life in Bereaved Family Caregivers of Patients With Advanced Cancer
    SAGE Publications ; 2020
    In:  American Journal of Hospice and Palliative Medicine® Vol. 37, No. 3 ( 2020-03), p. 201-213
    Details
    In: American Journal of Hospice and Palliative Medicine®, SAGE Publications, Vol. 37, No. 3 ( 2020-03), p. 201-213
    Abstract: To investigate prevalence and predictors of postloss distress, depressive and anxiety symptoms, and quality of life among bereaved family caregivers of patients with advanced cancer. Methods: Prospective multicenter study. Family caregivers (N = 160, mean age 56.8 years, 66% female) completed validated outcome measures (Distress Thermometer, Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire depression module 9-item scale, SF-8 Health Survey Questionnaire) 6 months after patient’s discharge or death at specialist inpatient palliative care ward. Results: Clinically relevant distress was observed in 82% with sadness (89%), exhaustion (74%), sleeping problems (68%), loneliness (53%), and sorrows (52%) being the most common distress-causing problems. Moderate/severe anxiety and depressive symptoms were observed in 27% and 35%, respectively. Compared to an adjusted norm sample, quality of life was significantly impaired with exception of “bodily pain” and physical component score. Preloss caregiving (odds ratio [OR] 2.195) and higher preloss distress (OR 1.345) predicted high postloss distress. Utilization of psychosocial support services (OR 2.936) and higher preloss anxiety symptoms (OR 1.292) predicted moderate/severe anxiety symptoms, lower preloss physical quality of life (OR 0.952), and higher preloss depressive symptoms (OR 1.115) predicted moderate/severe depressive symptoms. Conclusion: Preloss mental burden showed to be a consistent predictor for postloss burden and should be addressed during palliative care. Future research should examine specific caregiver-directed interventions during specialist palliative care.
    Type of Medium: Online Resource
    ISSN: 1049-9091 , 1938-2715
    URL: Article
    DOI: 10.1177/1049909119872755
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2236674-X
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  • 10
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    Treatment approach in patients with hyperbilirubinemia secondary to liver metastases in gastrointestinal malignancies: a case series and review of literature
    SAGE Publications ; 2016
    In:  Therapeutic Advances in Medical Oncology Vol. 8, No. 3 ( 2016-05), p. 144-152
    Details
    In: Therapeutic Advances in Medical Oncology, SAGE Publications, Vol. 8, No. 3 ( 2016-05), p. 144-152
    Abstract: Treatment of patients with severe liver dysfunction including hyperbilirubinemia secondary to liver metastases of gastrointestinal (GI) cancer is challenging. Regimen of oxaliplatin and fluoropyrimidine (FP)/folinic acid (FA) ± a monoclonal antibody (moAb), represents a feasible option considering the pharmacokinetics. Clinical data on the respective dosage and tolerability are limited and no recommendations are available. Methods: Consecutive patients with severe hyperbilirubinemia [ 〉 2 × upper limit of the normal range (ULN) and 〉 2.4 mg/dl] due to liver metastases of GI cancer without options for drainage receiving oxaliplatin, FP/FA ± moAb were analyzed. To collect further data a review of the literature was performed. Results: A total of 12 patients were identified between 2011 and 2015. At treatment start, median bilirubin level was 6.1 mg/dl ( 〉 5 × ULN, range 2.7–13.6). The majority of patients ( n = 11) received dose-reduced regimen with oxaliplatin (60–76%) and FP/FA (0–77%), rapidly escalating to full dose regimen. During treatment, bilirubin levels dropped more than 50% within 8 weeks or normalized within 12 weeks in 6 patients (responders). Median overall survival was 5.75 months (range 1.0–16.0 months) but was significantly prolonged in responders compared to nonresponders [9.7 and 3.0 months, p = 0.026 (two-sided test); 95% confidence interval (CI): 1.10–10.22]. In addition, case reports or series comprising a further 26 patients could be identified. Based on the obtained data a treatment algorithm was developed. Conclusion: Treatment with oxaliplatin, FP/FA ± moAb is feasible and may derive relevant benefits in patients with severe liver dysfunction caused by GI cancer liver metastases without further options of drainage.
    Type of Medium: Online Resource
    ISSN: 1758-8359 , 1758-8359
    URL: Article
    DOI: 10.1177/1758834016637585
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2503443-1
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