Next Issue
Volume 23, October
Previous Issue
Volume 23, June
 
 
Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
From the start of 2016, the journal uses article numbers instead of page numbers to identify articles. If you are required to add page numbers to a citation, you can do with using a colon in the format [article number]:1–[last page], e.g. 10:1–20.

Curr. Oncol., Volume 23, Issue 4 (August 2016) – 23 articles

  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Reader to open them.
Order results
Result details
Section
Select all
Export citation of selected articles as:
65 KiB  
Correction
Corrigendum: Eastern Canadian Gastrointestinal Cancer Consensus Conference 2014
by E. Tsvetkova, S. Sud, N. Aucoin, J. Biagi, R. Burkes, B. Samson, S. Brule, C. Cripps, B. Colwell, C. Falkson, M. Dorreen, R. Goel, F. Halwani, C. Marginean, J. Maroun, N. Michaud, M. Tehfe, M. Thirlwell, M. Vickers and T. Asmis
Curr. Oncol. 2016, 23(4), 435; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3283 - 01 Aug 2016
Viewed by 458
Abstract
It came to our attention that, over the course of putting together this article[...] Full article
497 KiB  
Article
Concurrent Hypopituitarism and Leukemic Retinopathy in a Child with B-Precursor Acute Lymphoblastic Leukemia and Isolated Central Nervous System Relapse
by K.H. Wu, H.P. Wu, H.J. Lin, C.H. Wang, H.Y. Chen, T. Weng, C.T. Peng and Y.H. Chao
Curr. Oncol. 2016, 23(4), 431-434; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3006 - 01 Aug 2016
Viewed by 429
Abstract
Hypopituitarism in leukemia is very rare. In addition, central nervous system (cns) relapse and leukemic retinopathy in childhood acute lymphoblastic leukemia (all) have declined with the use of modern systemic chemotherapy that includes cns prophylaxis. Here, we report the case of a 4-year-old [...] Read more.
Hypopituitarism in leukemia is very rare. In addition, central nervous system (cns) relapse and leukemic retinopathy in childhood acute lymphoblastic leukemia (all) have declined with the use of modern systemic chemotherapy that includes cns prophylaxis. Here, we report the case of a 4-year-old girl who received chemotherapy and intrathecal therapy without cns radiation after a diagnosis of B-precursor all without cns involvement. Three months after chemotherapy completion, she presented with lower-extremity weakness and was diagnosed with an isolated cns relapse. Concurrent hypopituitarism and leukemic retinopathy were also found. After receiving craniospinal radiotherapy and systemic chemotherapy, her retinopathy and vision improved. She is now in complete remission, and she is still on chemotherapy according to the guideline from the Pediatric Oncology Group. Although rare, hypopituitarism and leukemic retinopathy should be taken into consideration in patients with cns involvement by leukemia. Full article
311 KiB  
Article
Plerixafor for Autologous Stem-Cell Mobilization and Transplantation for Patients in Ontario
by C.T. Kouroukis, N.P. Varela, C. Bredeson, J. Kuruvilla and A. Xenocostas
Curr. Oncol. 2016, 23(4), 409-430; https://doi.org/10.3747/co.23.3137 - 01 Aug 2016
Cited by 15 | Viewed by 640
Abstract
Background: High-dose chemotherapy with autologous stem-cell transplantation (ASCT) is an accepted part of standard therapy for patients with hematologic malignancies. Usually, stem-cell mobilization uses granulocyte colony–stimulating factor (G-CSF); however, some patients are not able to be mobilized with chemotherapy [...] Read more.
Background: High-dose chemotherapy with autologous stem-cell transplantation (ASCT) is an accepted part of standard therapy for patients with hematologic malignancies. Usually, stem-cell mobilization uses granulocyte colony–stimulating factor (G-CSF); however, some patients are not able to be mobilized with chemotherapy and G-CSF, and such patients could be at higher risk of failing mobilization. Plerixafor is a novel mobilization agent that is absorbed quickly after subcutaneous injection and, at the recommended dose of 0.24 mg/kg, provides a sustained increase in circulating CD34+ cells for 10–18 hours. The main purpose of the present report was to evaluate the most current evidence on the efficacy of plerixafor in enhancing hematopoietic stem-cell mobilization and collection before asct for patients in Ontario so as to make recommendations for clinical practice and to assist Cancer Care Ontario in decision-making with respect to this intervention. Methods: The MEDLINE and EMBASE databases were systematically searched for evidence from January 1996 to March 2015, and the best available evidence was used to draft recommendations relevant to the efficacy of plerixafor in enhancing hematopoietic stem-cell mobilization and collection before asct. Final approval of this practice guideline report was obtained from both the Stem Cell Transplant Steering Committee and the Report Approval Panel of the Program in Evidence-Based Care. Recommendations: These recommendations apply to adult patients considered for ASCT: (1) Adding plerixafor to G-CSF is an option for initial mobilization in patients with non-Hodgkin lymphoma or multiple myeloma who are eligible for ASCT when chemotherapy cannot be used and only G-CSF mobilization is available. (2) For patients with a low peripheral blood CD34+ cell count (for example, <10/μL) at the time of anticipated stem-cell harvesting, or with an inadequate first-day apheresis collection, it is recommended that plerixafor be added to the mobilization regimen to maximize stem-cell collection and to prevent the need for remobilization. (3) It is recommended that patients who have failed a previous mobilization attempt undergo remobilization with G-CSF and plerixafor, with or without chemotherapy. Full article
717 KiB  
Article
Radiation Costing Methods: A Systematic Review
by F. Rahman, S.J. Seung, S.Y. Cheng, H. Saherawala, C.C. Earle and N. Mittmann
Curr. Oncol. 2016, 23(4), 392-408; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3073 - 01 Aug 2016
Cited by 15 | Viewed by 549
Abstract
Objective: Costs for radiation therapy (rt) and the methods used to cost rt are highly diverse across the literature. To date, no study has compared various costing methods in detail. Our objective was to perform a thorough review of the radiation [...] Read more.
Objective: Costs for radiation therapy (rt) and the methods used to cost rt are highly diverse across the literature. To date, no study has compared various costing methods in detail. Our objective was to perform a thorough review of the radiation costing literature to identify sources of costs and methods used. Methods: A systematic review of Ovid medline, Ovid oldmedline, embase, Ovid HealthStar, and EconLit from 2005 to 23 March 2015 used search terms such as “radiation,” “radiotherapy,” “neoplasm,” “cost,” “ cost analysis,” and “cost benefit analysis” to locate relevant articles. Original papers were reviewed for detailed costing methods. Cost sources and methods were extracted for papers investigating rt modalities, including three-dimensional conformal rt (3D-crt), intensity-modulated rt (imrt), stereotactic body rt (sbrt), and brachytherapy (bt). All costs were translated into 2014 U.S. dollars. Results: Most of the studies (91%) reported in the 33 articles retrieved provided rt costs from the health system perspective. The cost of rt ranged from US$2687.87 to US$111,900.60 per treatment for imrt, followed by US$5583.28 to US$90,055 for 3D-crt, US$10,544.22 to US$78,667.40 for bt, and US$6520.58 to US$19,602.68 for sbrt. Cost drivers were professional or personnel costs and the cost of rt treatment. Most studies did not address the cost of rt equipment (85%) and institutional or facility costs (66%). Conclusions: Costing methods and sources were widely variable across studies, highlighting the need for consistency in the reporting of rt costs. More work to promote comparability and consistency across studies is needed. Full article
1028 KiB  
Article
High-Grade Glioma Management and Response Assessment—Recent Advances and Current Challenges
by M.N. Khan, A.M. Sharma, M. Pitz, S.K. Loewen, H. Quon, A. Poulin and M. Essig
Curr. Oncol. 2016, 23(4), 383-391; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3082 - 01 Aug 2016
Cited by 35 | Viewed by 723
Abstract
The management of high-grade gliomas (hggs) is complex and ever-evolving. The standard of care for the treatment of hggs consists of surgery, chemotherapy, and radiotherapy. However, treatment options are influenced by multiple factors such as patient age and performance status, extent [...] Read more.
The management of high-grade gliomas (hggs) is complex and ever-evolving. The standard of care for the treatment of hggs consists of surgery, chemotherapy, and radiotherapy. However, treatment options are influenced by multiple factors such as patient age and performance status, extent of tumour resection, biomarker profile, and tumour histology and grade. Follow-up cranial magnetic resonance imaging (mri) to differentiate treatment response from treatment effect can be challenging and affects clinical decision-making. An assortment of advanced radiologic techniques—including perfusion imaging with dynamic susceptibility contrast mri, dynamic contrast-enhanced mri, diffusion-weighted imaging, proton spectroscopy, mri subtraction imaging, and amino acid radiotracer imaging—can now incorporate novel physiologic data, providing new methods to help characterize tumour progression, pseudoprogression, and pseudoresponse. In the present review, we provide an overview of current treatment options for hgg and summarize recent advances and challenges in imaging technology. Full article
360 KiB  
Article
Comparative Efficacy of Whole-Brain Radiotherapy with and without Elemene Liposomes in Patients with Multiple Brain Metastases from Non-Small-Cell Lung Carcinoma
by Y.N. Sun, Z.Y. Zhang, Y.C. Zeng, F. Chi, X.Y. Jin and R. Wu
Curr. Oncol. 2016, 23(4), 377-382; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3183 - 01 Aug 2016
Cited by 5 | Viewed by 396
Abstract
Purpose: We explored and compared the clinical effects of whole-brain radiotherapy (WBRT) with and without elemene liposomes in patients with multiple brain metastases from non-small-cell lung carcinoma (NSCLC). Methods: We retrospectively analyzed 62 patients with multiple brain metastases from [...] Read more.
Purpose: We explored and compared the clinical effects of whole-brain radiotherapy (WBRT) with and without elemene liposomes in patients with multiple brain metastases from non-small-cell lung carcinoma (NSCLC). Methods: We retrospectively analyzed 62 patients with multiple brain metastases from NSCLC who received WBRT (30 Gy in 10 fractions) at Shengjing Hospital of China Medical University from January 2012 to May 2013. In 30 patients, elemene liposomes (400 mg) were injected intravenously via a peripherally inserted central catheter for 21 consecutive days from the first day of radiotherapy. Overall survival (OS) and nervous system progression-free survival (nPFS) for the two groups were compared by Kaplan–Meier analysis. Factors influencing nPFS were examined by Cox regression analysis. Chi-square or Fisher exact tests were used for group comparisons. Results: The median OS was 9.0 months in the WBRT plus elemene group and 7.8 months in the WBRT-alone group (p = 0.581); the equivalent median npfs durations were 5.2 months and 3.7 months (p = 0.005). Patient treatment plan was an independent factor associated with nPFS (p = 0.002). Tumour response and disease-control rates in the WBRT plus elemene group were 26.67% and 76.67% respectively; they were 18.75% and 62.5% in the WBRT group (p = 0.452). Compared with the patients in the WBRT-alone group, significantly fewer patients in the WBRT plus elemene group developed headaches (p = 0.04); quality of life was also significantly higher in the WBRT plus elemene group both at 1 month and at 2 months (p = 0.021 and p = 0.001 respectively). Conclusions: The addition of elemene liposomes to WBRT might prolong nPFS in patients with multiple brain metastases from NSCLC, while also reducing the incidence of headache and improving patient quality of life. Full article
195 KiB  
Article
Making Molehills out of a Mountain: Experience with a New Scheduling Strategy to Diminish Workload Variations in Response to Increased Treatment Demands
by A. Waters, M. Alizadeh, C. Filion, F. Ashbury, J. Pun, M.P. Chagnon, A. Legrain and M.A. Fortin
Curr. Oncol. 2016, 23(4), 369-376; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3090 - 01 Aug 2016
Cited by 14 | Viewed by 351
Abstract
Purpose: A new scheduling strategy was implemented. Before implementation, treatments and planning computed tomography (ct) imaging were both scheduled at the same time. Maximal wait times for treatment are defined by the Quebec Ministry of Health’s plan of action according to [...] Read more.
Purpose: A new scheduling strategy was implemented. Before implementation, treatments and planning computed tomography (ct) imaging were both scheduled at the same time. Maximal wait times for treatment are defined by the Quebec Ministry of Health’s plan of action according to treatment aim and site. After implementation, patients requiring rapid treatment (priorities 0–3) continued to have their treatments scheduled at the same time as their planning ct; treatments for priority 4 (P4) patients were scheduled only after the treatment plan was approved. That approach aims to compensate for unexpected increases in planning workload by relocating less delay-sensitive cases to other time slots. We evaluated the impact on the patient experience, workload in various sectors, the care team’s perception of care delivery, access to care, and the department’s efficiency in terms of hours worked per treatment delivered. Methods: Three periods were defined for analysis: the pre-transitional phase, for baseline evaluation; the transitional phase, during which there was an overlap in the way patients were being scheduled; and the post-transitional phase. Wait times were calculated from the date that patients were ready to treat to the date of their first treatment. Surveys were distributed to pre- and post-transitional phase patients. Care team members were asked to complete a survey evaluating their perception of how the change affected workload and patient care. Operational data were analyzed. Results: We observed a 24% increase in the number of treatments delivered in the post-transitional phase. Before implementation, priority 0–3 patients waited a mean of 7.9 days to begin treatments (n = 241); afterward, they waited 6.3 days (n = 340, p = 0.006). Before implementation, P4 patients waited a mean 15.1 days (n = 233); after implementation, they waited 16.1 days (n = 368, p = 0.22). Surveys showed that patients felt that the time it took to inform them of treatment appointments was acceptable in both phases. No significant change in overtime hours occurred in dosimetry (p = 0.7476) or globally (p = 0.4285) despite the increased number of treatments. However, departmental efficiency improved by 16% (p = 0.0001). Conclusions: This new scheduling strategy for P4 cases resulted in improved access to care for priority 0–3 patients. Departmental efficiency was improved, and overtime hours did not increase. Patient satisfaction remained high. Full article
565 KiB  
Article
Prognostic Value of Pretreatment Circulating Neutrophils, Monocytes, and Lymphocytes on Outcomes in Lung Stereotactic Body Radiotherapy
by M. Giuliani, L.R. Sampson, O. Wong, J. Gay, L.W. Le, B.C.J. Cho, A. Brade, A. Sun, A. Bezjak and A.J. Hope
Curr. Oncol. 2016, 23(4), 362-368; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3051 - 01 Aug 2016
Cited by 15 | Viewed by 560
Abstract
Purpose: In the present study, we determined the association of pretreatment circulating neutrophils, monocytes, and lymphocytes with clinical outcomes after lung stereotactic body radiotherapy (sbrt). Methods: All patients with primary lung cancer and with a complete blood count within 3 months [...] Read more.
Purpose: In the present study, we determined the association of pretreatment circulating neutrophils, monocytes, and lymphocytes with clinical outcomes after lung stereotactic body radiotherapy (sbrt). Methods: All patients with primary lung cancer and with a complete blood count within 3 months of lung sbrt from 2005 to 2012 were included. Overall survival (os) was calculated using the Kaplan–Meier method. Factors associated with os were investigated using univariable and multivariable Cox proportional hazards regression. Fine–Gray competing risk regression was performed to test the association of the neutrophil:lymphocyte (nlr) and monocyte:lymphocyte (mlr) ratios with two types of failure: disease-related failure and death, and death unrelated to disease. Results: Of the 299 sbrt patients identified, 122 were eligible for analysis. The median and range of the nlr and mlr were 3.0 (0.3–22.0) and 0.4 (0.1–1.9) respectively. On multivariable analysis, sex (p = 0.02), T stage (p = 0.04), and nlr (p < 0.01) were associated with os. On multivariable analysis, T stage (p < 0.01) and mlr (p < 0.01) were associated with disease-related failure; mlr (p = 0.03), nlr (p < 0.01), and sbrt dose of 48 Gy in 4 fractions (p = 0.03) and 54 Gy or 60 Gy in 3 fractions (p = 0.02) were associated with disease-unrelated death. Median survival was 4.3 years in the nlr ≤ 3 group (95% confidence interval: 3.5 to not reached) and 2.5 years in the nlr > 3 group (95% confidence interval: 1.7 to 4.8; p < 0.01). Conclusions: In lung sbrt patients, nlr and mlr are independently associated with os and disease-unrelated death. If validated, nlr and mlr could help to identify patients who would benefit most from sbrt. Full article
540 KiB  
Article
Venous Thromboembolism Prevention During Asparaginase-Based Therapy for Acute Lymphoblastic Leukemia
by H. Sibai, J.T. Seki, T.Q. Wang, N. Sakurai, E.G. Atenafu, K.W.L. Yee, A.C. Schuh, V. Gupta, M.D. Minden, A.D. Schimmer and J.M. Brandwein
Curr. Oncol. 2016, 23(4), 355-361; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3077 - 01 Aug 2016
Cited by 28 | Viewed by 646
Abstract
Background: Venous thromboembolism (vte) is a recognized complication in patients treated with asparaginase-containing chemotherapy regimens; the optimal preventive strategy is unclear. We assessed the safety and efficacy of prophylaxis using low-dose low molecular weight heparin in adult patients with acute lymphoblastic [...] Read more.
Background: Venous thromboembolism (vte) is a recognized complication in patients treated with asparaginase-containing chemotherapy regimens; the optimal preventive strategy is unclear. We assessed the safety and efficacy of prophylaxis using low-dose low molecular weight heparin in adult patients with acute lymphoblastic leukemia in complete remission treated with an asparaginase-based post-remission chemotherapy regimen. Methods: As part of the intensification phase of the Dana-Farber Cancer Institute 91-01 regimen, asparaginase was administered weekly to 41 consecutive patients for 21–30 weeks; these patients also received prophylaxis with enoxaparin 40 mg daily (60 mg for patients ≥ 80 kg). Outcomes were assessed against outcomes in a comparable cohort of 99 patients who received the same chemotherapy regimen without anticoagulation prophylaxis. Results: The overall rate of symptomatic venous thrombosis was not significantly different in the prophylaxis and non-prophylaxis cohorts (18.92% and 21.74% respectively). Among patients receiving prophylaxis, vte occurred in higher proportion in those who weighed at least 80 kg (42.86% vs. 4.35%, p = 0.0070). No major bleeding complications occurred in the prophylaxis group (minor bleeding: 8.1%). Conclusions: Prophylaxis with low-dose enoxaparin during the intensification phase was safe, but was not associated with a lower overall proportion of vte. Full article
503 KiB  
Article
Cost-Effectiveness of Pazopanib Compared with Sunitinib in Metastatic Renal Cell Carcinoma in Canada
by J. Amdahl, J. Diaz, J. Park, H.R. Nakhaipour and T.E. Delea
Curr. Oncol. 2016, 23(4), 340-354; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.2244 - 01 Aug 2016
Cited by 38 | Viewed by 789
Abstract
Background: In Canada and elsewhere, pazopanib and sunitinib—tyrosine kinase inhibitors targeting the vascular endothelial growth factor receptors—are recommended as first-line treatment for patients with metastatic renal cell carcinoma (mrcc). A large randomized noninferiority trial of pazopanib versus sunitinib (comparz [...] Read more.
Background: In Canada and elsewhere, pazopanib and sunitinib—tyrosine kinase inhibitors targeting the vascular endothelial growth factor receptors—are recommended as first-line treatment for patients with metastatic renal cell carcinoma (mrcc). A large randomized noninferiority trial of pazopanib versus sunitinib (comparz) demonstrated that the two drugs have similar efficacy; however, patients randomized to pazopanib experienced better healthrelated quality of life (hrqol) and nominally lower rates of non-study medical resource utilization. Methods: The cost-effectiveness of pazopanib compared with sunitinib for first-line treatment of mrcc from a Canadian health care system perspective was evaluated using a partitioned-survival model that incorporated data from comparz and other secondary sources. The time horizon of 5 years was based on the maximum duration of follow-up in the final analysis of overall survival from the comparz trial. Analyses were conducted first using list prices for pazopanib and sunitinib and then by assuming that the prices of sunitinib and pazopanib would be equivalent. Results: Based on list prices, expected costs were CA$10,293 less with pazopanib than with sunitinib. Pazopanib was estimated to yield 0.059 more quality-adjusted life-years (qalys). Pazopanib was therefore dominant (more qalys and lower costs) compared with sunitinib in the base case. In probabilistic sensitivity analyses, pazopanib was dominant in 79% of simulations and was cost-effective in 90%–100% of simulations at a threshold cost-effectiveness ratio of CA$100,000. Assuming equivalent pricing, pazopanib yielded CA$917 in savings in the base case, was dominant in 36% of probabilistic sensitivity analysis simulations, and was cost-effective in 89% of simulations at a threshold cost-effectiveness ratio of CA$100,000. Conclusions: Compared with sunitinib, pazopanib is likely to be a cost-effective option for first-line treatment of mrcc from a Canadian health care perspective. Full article
915 KiB  
Article
Is Clinical Breast Examination Important for Breast Cancer Detection?
by L. Provencher, J.C. Hogue, C. Desbiens, B. Poirier, E. Poirier, D. Boudreau, M. Joyal, C. Diorio, N. Duchesne and J. Chiquette
Curr. Oncol. 2016, 23(4), 332-339; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.2881 - 01 Aug 2016
Cited by 51 | Viewed by 1877
Abstract
Background: Screening clinical breast examination (CBE) is controversial; the use of CBE is declining not only as a screening tool, but also as a diagnostic tool. In the present study, we aimed to assess the value of CBE in breast [...] Read more.
Background: Screening clinical breast examination (CBE) is controversial; the use of CBE is declining not only as a screening tool, but also as a diagnostic tool. In the present study, we aimed to assess the value of CBE in breast cancer detection in a tertiary care centre for breast diseases. Methods: This retrospective study of all breast cancers diagnosed between July 1999 and December 2010 at our centre categorized cases according to the mean of detection (CBE, mammography, or both). A CBE was considered “abnormal” in the presence of a mass, nipple discharge, skin or nipple retraction, edema, erythema, peau d’orange, or ulcers. Results: During the study period, a complete dataset was available for 6333 treated primary breast cancers. Cancer types were ductal carcinoma in situ (15.3%), invasive ductal carcinoma (75.7%), invasive lobular carcinoma (9.0%), or others (2.2%). Of the 6333 cancers, 36.5% (n = 2312) were detected by mammography alone, 54.8% (n = 3470) by mammography and CBE, and 8.7% (n = 551) by physician-performed CBE alone (or 5.3% if considering ultrasonography). Invasive tumours diagnosed by CBE alone were more often triple-negative, HER2-positive, node-positive, and larger than those diagnosed by mammography alone (p < 0.05). Conclusions: A significant number of cancers would have been missed if CBE had not been performed. Compared with cancers detected by mammography alone, those detected by CBE had more aggressive features. Clinical breast examination is a very low-cost test that could improve the detection of breast cancer and could prompt breast ultrasonography in the case of a negative mammogram. Full article
108 KiB  
Commentary
HPV Vaccines? Still Needed
by L.Z.G. Touyz
Curr. Oncol. 2016, 23(4), 330-331; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3034 - 01 Aug 2016
Cited by 2 | Viewed by 291
Abstract
The human papilloma virus (HPV) was at one time deemed benign, with few variants [...]
Full article
121 KiB  
Editorial
Cost-Effectiveness of Pazopanib: An Example of Improved Transparency and Accessibility of Industry-Sponsored Economic Evaluations through Publication in Peer-Reviewed Journals
by J. Beca and K.K.W. Chan
Curr. Oncol. 2016, 23(4), 327-329; https://0-doi-org.brum.beds.ac.uk/10.3747/co.22.2741 - 01 Aug 2016
Cited by 1 | Viewed by 329
Abstract
We congratulate Amdahl et al. on publishing their paper about the cost-effectiveness of pazopanib compared with sunitinib in metastatic renal cell carcinoma (mrcc) in Canada. [...] Full article
369 KiB  
Guidelines
Approach to Fever Assessment in Ambulatory Cancer Patients Receiving Chemotherapy: A Clinical Practice Guideline
by M.K. Krzyzanowska, C. Walker-Dilks, C. Atzema, A. Morris, R. Gupta, R. Halligan, T. Kouroukis and K. McCann
Curr. Oncol. 2016, 23(4), 280-285; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3098 - 01 Aug 2016
Cited by 2 | Viewed by 604
Abstract
Background: This guideline was prepared by the Fever Assessment Guideline Development Group, a group organized by the Program in Evidence-Based Care at the request of the Cancer Care Ontario Systemic Treatment Program. The mandate was to develop a standardized approach (in terms of [...] Read more.
Background: This guideline was prepared by the Fever Assessment Guideline Development Group, a group organized by the Program in Evidence-Based Care at the request of the Cancer Care Ontario Systemic Treatment Program. The mandate was to develop a standardized approach (in terms of definitions, information, and education) for the assessment of fever in cancer patients receiving chemotherapy. Methods: The guideline development methods included a search for existing guidelines, literature searches in medline and embase for systematic reviews and primary studies, internal review by content and methodology experts, and external review by targeted experts and intended users. Results: The search identified eight guidelines that had partial relevance to the topic of the present guideline and thirty-eight primary studies. The studies were mostly noncomparative prospective or retrospective studies. Few studies directly addressed the topic of fever except as one among many symptoms or adverse effects associated with chemotherapy. The recommendations concerning fever definition are supported mainly by other existing guidelines. No evidence was found that directly pertained to the assessment of fever before a diagnosis of febrile neutropenia was made. However, some studies evaluated approaches to symptom management that included fever among the symptoms. Few studies directly addressed information needs and resources for managing fever in cancer patients. Conclusions: Fever in patients with cancer who are receiving systemic therapy is a common and potentially serious symptom that requires prompt assessment, but currently, evidence to inform best practices concerning when, where, and by whom that assessment is done is very limited. Full article
306 KiB  
Article
Negative Predictive Value of Preoperative Computed Tomography in Determining Pathologic Local Invasion, Nodal Disease, and Abdominal Metastases in Gastric Cancer
by D.J. Kagedan, F. Frankul, A. El-Sedfy, C. McGregor, M. Elmi, B. Zagorski, M.E. Dixon, A.L. Mahar, J. Vasilevska-Ristovska, L. Helyer, C. Rowsell, C.J. Swallow, C.H. Law and N.G. Coburn
Curr. Oncol. 2016, 23(4), 273-279; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3124 - 01 Aug 2016
Cited by 3 | Viewed by 410
Abstract
Background: Before undergoing curative-intent resection of gastric adenocarcinoma (GA), most patients undergo abdominal computed tomography (CT) imaging to determine contraindications to resection (local invasion, distant metastases). However, the ability to detect contraindications is variable, and the literature is limited [...] Read more.
Background: Before undergoing curative-intent resection of gastric adenocarcinoma (GA), most patients undergo abdominal computed tomography (CT) imaging to determine contraindications to resection (local invasion, distant metastases). However, the ability to detect contraindications is variable, and the literature is limited to single-institution studies. We sought to assess, on a population level, the clinical relevance of preoperative CT in evaluating the resectability of GA tumours in patients undergoing surgery. Methods: In a provincial cancer registry, 2414 patients with ga diagnosed during 2005–2008 at 116 institutions were identified, and a primary chart review of radiology, operative, and pathology reports was performed for all patients. Preoperative abdominal ct reports were compared with intraoperative findings and final pathology reports (reference standard) to determine the negative predictive value (NPV) of ct in assessing local invasion, nodal involvement, and intra-abdominal metastases. Results: Among patients undergoing gastrectomy, the NPV of CT imaging in detecting local invasion was 86.9% (n = 536). For nodal metastasis, the NPV of CT was 43.3% (n = 450). Among patients undergoing surgical exploration, the npv of ct for intra-abdominal metastases was 52.3% (n = 407). Conclusions: Preoperative abdominal CT imaging reported as negative is most accurate in determining local invasion and least accurate in nodal assessment. The poor NPV of CT should be taken into account when selecting patients for staging laparoscopy. Full article
1063 KiB  
Article
Did the Addition of Concomitant Chemotherapy to Radiotherapy Improve Outcomes in Hypopharyngeal Cancer? A Population-Based Study
by S.F. Hall and R. Griffiths
Curr. Oncol. 2016, 23(4), 266-272; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3085 - 01 Aug 2016
Cited by 13 | Viewed by 371
Abstract
Background: For oncologists and for patients, no site-specific clinical trial evidence has emerged for the use of concurrent chemotherapy with radiotherapy (ccrt) over radiotherapy (rt) alone for cancer of the hypopharynx (hpc) or for other human papilloma [...] Read more.
Background: For oncologists and for patients, no site-specific clinical trial evidence has emerged for the use of concurrent chemotherapy with radiotherapy (ccrt) over radiotherapy (rt) alone for cancer of the hypopharynx (hpc) or for other human papilloma virus–negative head-and-neck cancers. Methods: This retrospective population-based cohort study using administrative data compared treatments over time (1990–2000 vs. 2000–2010), treatment outcomes, and outcomes over time in 1333 cases of hpc diagnosed in Ontario between January 1990 and December 2010. Results: The incidence of hpc is declining; the use of ccrt that began in 2001 is increasing; and the 3-year overall survival for all patients remains poor at 34.6%. No difference in overall survival was observed in a comparison of patients treated in the decade before ccrt and of patients treated in the decade during the uptake of ccrt. Conclusions: The addition of ccrt to the armamentarium of treatment options for oncologists treating head-and-neck patients did not improve outcomes for hpc at the population level. Full article
252 KiB  
Article
The Prevalence and Nature of Supportive Care Needs in Lung Cancer Patients
by M.E. Giuliani, R.A. Milne, M. Puts, L.R. Sampson, J.Y.Y. Kwan, L.W. Le, S.M.H. Alibhai, D. Howell, N. Abdelmutti, G. Liu, J. Papadakos, P. Catton and J. Jones
Curr. Oncol. 2016, 23(4), 258-265; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3012 - 01 Aug 2016
Cited by 53 | Viewed by 1072
Abstract
Purpose: In the present work, we set out to comprehensively describe the unmet supportive care and information needs of lung cancer patients. Methods: This cross-sectional study used the Supportive Care Needs Survey Short Form 34 (34 items) and an informational needs survey (8 [...] Read more.
Purpose: In the present work, we set out to comprehensively describe the unmet supportive care and information needs of lung cancer patients. Methods: This cross-sectional study used the Supportive Care Needs Survey Short Form 34 (34 items) and an informational needs survey (8 items). Patients with primary lung cancer in any phase of survivorship were included. Demographic data and treatment details were collected from the medical charts of participants. The unmet needs were determined overall and by domain. Univariable and multivariable regression analyses were performed to determine factors associated with greater unmet needs. Results: From August 2013 to February 2014, 89 patients [44 (49%) men; median age: 71 years (range: 44–89 years)] were recruited. The mean number of unmet needs was 8 (range: 0–34), and 69 patients (78%) reported at least 1 unmet need. The need proportions by domain were 52% health system and information, 66% psychological, 58% physical, 24% patient care, and 20% sexuality. The top 2 unmet needs were “fears of the cancer spreading” [n = 44 of 84 (52%)] and “lack of energy/tiredness” [n = 42 of 88 (48%)]. On multivariable analysis, more advanced disease and higher MD Anderson Symptom Inventory scores were associated with increased unmet needs. Patients reported that the most desired information needs were those for information on managing symptoms such as fatigue (78%), shortness of breath (77%), and cough (63%). Conclusions: Unmet supportive care needs are common in lung cancer patients, with some patients experiencing a very high number of unmet needs. Further work is needed to develop resources to address those needs. Full article
196 KiB  
Article
Regional Variation in the Management of Metastatic Gastric Cancer in Ontario
by A.L. Mahar, N.G. Coburn, D.J. Kagedan, R. Viola and A.P. Johnson
Curr. Oncol. 2016, 23(4), 250-257; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3123 - 01 Aug 2016
Cited by 10 | Viewed by 464
Abstract
Background: Geographic variation in cancer care is common when clear clinical management guidelines do not exist. In the present study, we sought to describe health care resource consumption by patients with metastatic gastric cancer (gc) and to investigate the possibility of [...] Read more.
Background: Geographic variation in cancer care is common when clear clinical management guidelines do not exist. In the present study, we sought to describe health care resource consumption by patients with metastatic gastric cancer (gc) and to investigate the possibility of regional variation. Methods: In this population-based cohort study of patients with stage iv gastric adenocarcinoma diagnosed between 1 April 2005 and 31 March 2008, chart review and administrative health care data were linked to study resource utilization outcomes (for example, clinical investigations, treatments) in the province of Ontario. The study took a health care system perspective with a 2-year time frame. Chi-square tests were used to compare proportions of resource utilization, and analysis of variance compared mean per-patient resource consumption between geographic regions. Results: A cohort of 1433 patients received 4690 endoscopic investigations, 12,033 computed tomography exams, 12,774 radiography exams, and 5059 ultrasonography exams. Nearly all patients were seen by a general practitioner (98%) and a specialist (99%), and were hospitalized (95%) or visited the emergency department (87%). Fewer than half received chemotherapy (43%), gastrectomy (37%), or radiotherapy (28%). The mean number of clinical investigations, physician visits, hospitalizations, and instances of patient accessing the emergency department or receiving radiotherapy or stent placement varied significantly by region. Conclusions: Variations in health care resource utilization for metastatic gc patients are observed across the regions of Ontario. Whether those differences reflect differential access to resources, patient preference, or physician preference is not known. The observed variation might reflect a lack of guidelines based on high-quality evidence and could partly be ameliorated with regionalization of gc care to high-volume centres. Full article
220 KiB  
Article
The Economic Burden of Cancers Attributable to Tobacco Smoking, Excess Weight, Alcohol Use, and Physical Inactivity in Canada
by H. Krueger, E.N. Andres, J.M. Koot and B.D. Reilly
Curr. Oncol. 2016, 23(4), 241-249; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.2952 - 01 Aug 2016
Cited by 23 | Viewed by 764
Abstract
Objectives: The purpose of the present study was to calculate the proportion of cancers in Canada attributable to tobacco smoking (TS), alcohol use (AU), excess weight (EW), and physical inactivity (PIA); to explore variation in [...] Read more.
Objectives: The purpose of the present study was to calculate the proportion of cancers in Canada attributable to tobacco smoking (TS), alcohol use (AU), excess weight (EW), and physical inactivity (PIA); to explore variation in the proportions of those risk factors (RFS) over time by sex and province; to estimate the economic burden of cancer attributable to the 4 RFS; and to calculate the potential reduction in cancers and economic burden if all provinces achieved rf prevalence rates equivalent to the best in Canada. Methods: We used a previously developed approach based on population-attributable fractions (PAFS) to estimate the cancer-related economic burden associated with the four RFS. Sex-specific relative risk and age- and sex-specific prevalence data were used in the modelling. The economic burden was adjusted for potential double counting of cases and costs. Results: In Canada, 27.7% of incident cancer cases [95% confidence interval (CI): 22.6% to 32.9%] in 2013 [47,000 of 170,000 (95% CI:38,400–55,900)] were attributable to the four RFS: TS, 15.2% (95% CI: 13.7% to 16.9%); EW, 5.1% (95% CI: 3.8% to 6.4%); AU, 3.9% (95% CI: 2.4% to 5.3%); and PIA, 3.5% (95% CI: 2.7% to 4.3%). The annual economic burden attributable to the 47,000 total cancers was $9.6 billion (95% CI: $7.8 billion to $11.3 billion): consisting of $1.7 billion in direct and $8.0 billion in indirect costs. Applying the lowest rf rates to each province would result in an annual reduction of 6204 cancers (13.2% of the potentially avoidable cancers) and a reduction in economic burden of $1.2 billion. Conclusions: Despite substantial reductions in the prevalence and intensity of TS, TS remains the dominant risk factor from the perspective of cancer prevention in Canada, although EW and AU are becoming increasingly important RFS. Full article
511 KiB  
Article
Fee-for-Service Cancer Rehabilitation Programs Improve Health-Related Quality of Life
by A.A. Kirkham, S.E. Neil-Sztramko, J. Morgan, S. Hodson, S. Weller, T. McRae and K.L. Campbell
Curr. Oncol. 2016, 23(4), 233-240; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3038 - 01 Aug 2016
Cited by 8 | Viewed by 558
Abstract
Background: Rigorously applied exercise interventions undertaken in a research setting result in improved health-related quality of life (HRQOL) in cancer survivors, but research to demonstrate effective translation of that research to practice is needed. The objective of the present study was to determine [...] Read more.
Background: Rigorously applied exercise interventions undertaken in a research setting result in improved health-related quality of life (HRQOL) in cancer survivors, but research to demonstrate effective translation of that research to practice is needed. The objective of the present study was to determine the effect of fee-for-service cancer rehabilitation programs in the community on hrqol and on self-reported physical activity and its correlates. Methods: After enrolment and 17 ± 4 weeks later, new clients (n = 48) to two fee-for-service cancer rehabilitation programs completed the 36-Item Short Form Health Survey (RAND-36: rand Corporation, Santa Monica, CA, U.S.A.), the Godin Leisure-Time Exercise Questionnaire, and questions about physical activity correlates. Normal fee-for-service operations were maintained, including a fitness assessment and individualized exercise programs supervised in a group or one-on-one setting, with no minimum attendance required. Fees were associated with the assessment and with each exercise session. Results: Of the 48 participants, 36 (75%) completed both questionnaires. Improvements in the physical functioning, role physical, pain, and energy/fatigue scales on the RAND-36 exceeded minimally important differences and were of a magnitude similar to improvements reported in structured, rigorously applied, and free research interventions. Self-reported levels of vigorous-intensity (p = 0.021), but not moderate-intensity (p = 0.831) physical activity increased. The number of perceived barriers to exercise (p = 0.035) and the prevalence of fatigue as a barrier (p = 0.003) decreased. Exercise self-efficacy improved only in participants who attended 11 or more sessions (p = 0.002). Exercise enjoyment did not change (p = 0.629). Conclusions: Enrolment in fee-for-service cancer rehabilitation programs results in meaningful improvements in HRQOL comparable to those reported by research interventions, among other benefits. The fee-for-service model could be an effective model for delivery of exercise to more cancer survivors. Full article
521 KiB  
Article
Cancer Incidence, Mortality, and Stage at Diagnosis in First Nations Living in Manitoba
by K.M. Decker, E.V. Kliewer, A.A. Demers, K. Fradette, N. Biswanger, G. Musto, B. Elias and D. Turner
Curr. Oncol. 2016, 23(4), 225-232; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.2906 - 01 Aug 2016
Cited by 19 | Viewed by 656
Abstract
Background: In the present study, we examined breast (BCa) and colorectal cancer (CRC) incidence and mortality and stage at diagnosis for First Nations (FN) individuals and all other Manitobans (AOMS). Methods: Several population-based [...] Read more.
Background: In the present study, we examined breast (BCa) and colorectal cancer (CRC) incidence and mortality and stage at diagnosis for First Nations (FN) individuals and all other Manitobans (AOMS). Methods: Several population-based databases were linked to determine ethnicity and to calculate age-standardized incidence and mortality rates. Logistic regression was used to compare BCa and CRC stage at diagnosis. Results: From 1984–1988 to 2004–2008, the incidence of BCa increased for FN and aom women. Breast cancer mortality increased for fn women and decreased for AOM women. First Nations women were significantly more likely than aom women to be diagnosed at stages IIIIV than at stage I [odds ratio (OR) for women ≤50 years of age: 3.11; 95% confidence limits (CL): 1.20, 8.06; OR for women 50–69 years of age: 1.72; 95% CL: 1.03, 2.88). The incidence and mortality of CRC increased for FN individuals, but decreased for AOMS. First Nations status was not significantly associated with CRC stage at diagnosis (OR for stages III compared with stages IIIIV: 0.98; 95% CL: 0.68, 1.41; OR for stages IIII compared with stage IV: 0.91; 95% CL: 0.59, 1.40). Conclusions: Our results underscore the need for improved cancer screening participation and targeted initiatives that emphasis collaboration with fn communities to reduce barriers to screening and to promote healthy lifestyles. Full article
102 KiB  
Editorial
Will Oncologists Applaud the Paris Accord? Time to Rethink Global Mega-Conferences
by C. Jacobs, A.A. Joy and M. Clemons
Curr. Oncol. 2016, 23(4), 223-224; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3169 - 01 Aug 2016
Cited by 5 | Viewed by 362
Abstract
It is ironic that the signing of the Paris Accord1,2, [...]
Full article
110 KiB  
Editorial
Hypopharyngeal Cancer: Looking Back, Moving Forward
by D. Day, A.R. Hansen and L.L. Siu
Curr. Oncol. 2016, 23(4), 221-222; https://0-doi-org.brum.beds.ac.uk/10.3747/co.23.3242 - 01 Aug 2016
Cited by 10 | Viewed by 375
Abstract
Population-based datasets can provide observational insights into cancer incidence, [...] Full article
Previous Issue
Next Issue
Back to TopTop