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Summary of Experience in Radiation Litigation
Published in Kenneth L. Miller, Handbook of Management of Radiation Protection Programs, 2020
On October 25, he obtained an X-ray for a complaint for backache noting an injury while moving furniture. On November 11, he reported a back strain that occurred in the alleged work incident on October 15, 1979 and was seen at the local hospital. Over the next 2 months he became ill and lost weight. On January 11, 1980, a bone marrow aspirate was obtained and a diagnosis of acute myelogenous leukemia was made. He was transferred to Hershey Medical Center. There, a diagnosis of metastatic cancer of unknown primary origin was made with metastasis to bone and liver. He did improve with chemotherapy and returned to work temporarily but the cancer progressed. He died on July 21, 1982.
CANCER OF UNKNOWN PRIMARY ORIGIN
Published in James Bishop, Cancer Facts, 1999
Patients with cancer of unknown primary origin have atypical clinical presentations with sites of metastatic disease often differing from those with an obvious primary. Careful evaluation of these patients is indicated with an emphasis on histological characterisation, including use of special and immunocytochemical stains, electron microscopy and cytogenetics. Appropriate assessment of metastatic sites may define subgroups with potential for significant benefit from active therapy. Clinical investigations should be selective, with an emphasis on defining these specific subgroups of patients with responsive malignancies. An extensive search for the primary site of origin of the malignancy is rarely indicated. Surgery and radiotherapy is indicated for patients with metastatic disease localised to peripheral lymph nodes or with isolated lung and liver lesions. Chemotherapy is indicated for recog- nised sensitive histologies, including poorly differentiated malignant neoplasm and poorly differentiated carcinoma in selected clinical settings.
Predicting response to radiotherapy of head and neck squamous cell carcinoma using radiomics from cone-beam CT images
Published in Acta Oncologica, 2022
S. Sellami, V. Bourbonne, M. Hatt, F. Tixier, D. Bouzid, F. Lucia, O. Pradier, G. Goasduff, D. Visvikis, U. Schick
Patients with stage III–IV HNSCC following the 8th TNM classification treated with curative intent with definitive RT guided by weekly CBCTs, with or without chemotherapy (depending on age, performance status as well as comorbidities) between January 2014 and May 2017 were considered in this retrospective study. Among them, those with at least four CBCTs during treatment, including CBCT at week 1 were included. Patients who benefited from surgery of the primary tumor or those treated with palliative intent were excluded, as were patients with nasopharyngeal carcinoma, thyroid and salivary glands tumors or a different histology (melanoma and lymphoma). Patients with a cancer of unknown primary origin were also excluded. Patients who benefited from a neck dissection without surgical treatment on their primary tumor were considered.
Mental Disorders and Suicide Risk among Cancer Patients: A Nationwide Cohort Study
Published in Archives of Suicide Research, 2022
Jae Woo Choi, Eun-Cheol Park, Tae Hyun Kim, Euna Han
Data obtained at the time of cancer diagnosis (sex, age, diagnosis year, Charlson comorbidity index, residential area, household income, disability, insurance type, and subtype of cancer) were used as potential confounding factors. The cancer patients were divided into young (20–39 years), middle-aged (40–64 years), and older adults (≥65 years). This study measured the Charlson comorbidity index through screening the year before the index date of study participant’s claims data. The index date was defined as first diagnosis date of cancer in this study. Household income was categorized into high income (81th–100th percentile), middle income (41th–80th percentile), and low income (below the 40th percentile). We classified residential area as (1) metropolitan (capital), (2) urban (local government where >1 million people live), and (3) rural (elsewhere). The insurance type was divided by the National Health Insurance or Medical Aid, which are public medical assistance programs for low income group. Subtypes of cancer in this study were bladder, breast, cancer of unknown primary origin, central nervous system, colorectal, cervical, Hodgkin’s lymphoma, head and neck, kidney and unspecified urinary organs, liver, leukemia, lung, mesothelioma, melanoma, non‐Hodgkin’s lymphoma, multiple myeloma, esophageal, other malignant neoplasms, ovary, pancreatic, prostate, sarcoma, stomach, testicular, and uterine.
Real-world utilization of molecular diagnostic testing and matched drug therapies in the treatment of metastatic cancers
Published in Journal of Medical Economics, 2018
Anita Chawla, Miranda Peeples, Nanxin Li, Rachel Anhorn, Jason Ryan, James Signorovitch
This retrospective claims analysis included US adults with six selected metastatic cancers (breast, NSCLC, colorectal, head and neck, ovarian, and uterine). These cancers were selected to comprise frequently encountered solid tumors with multiple approved targeted therapies and guideline recommendations for molecular diagnostic testing. Patients were eligible for inclusion in the study if they had: (1) claims with diagnosis codes for breast, NSCLC, colorectal, head and neck, ovarian, or uterine cancer on two different dates; and (2) claims with diagnosis codes for metastasis on two different dates between January 1, 2010 and March 31, 2015 and following their first observed claim for the primary cancer. The first such claim for metastatic disease was defined as the index date. Diagnoses were identified using International Classification of Disease-9th revision, Clinical Modification (ICD-9-CM) codes, listed in Supplementary Appendix A. Head and neck cancer included cancers of the oral cavity, pharynx, larynx, paranasal sinuses and nasal cavity, and salivary glands; cancers of the brain, esophagus, eye, parathyroid, or thyroid were not included. Eligible patients were also required to be ≥18 years old as of the index date, and to have continuous eligibility for at least 1 month after the index date. Patients were excluded if they had diagnoses of other cancers, such as sarcoma, melanoma, brain cancer, thyroid cancer, renal cancer, or cancer of unknown primary origin.