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Dyslexia and Irregular Dynamics of the Visual System
Published in Kees P. van den Bos, Linda S. Siegel, Dirk J. Bakker, David L. Share, Current Directions in Dyslexia Research, 2020
In the Averaged Evoked Potentials in the parieto-occipital region of visuo-spatial dyslexics during visual pattern recognition, N200 and P300 have lower amplitudes and longer latencies compared to normal subjects (Ciesielski, 1989). N200 is thought to reflect pattern feature discrimination. This phenomenon can be explained by the observation that in our model impaired learning, as reflected in a limited number of possible synaptic relays, shows up in reduced amplitudes and prolonged latencies due to a lower eigen frequency.
Lung Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Other important questions that remain include whether immunotherapy should be given together with radiotherapy and chemotherapy concomitantly or sequentially, and which is the optimal chemotherapy regimen to be given alongside it. Due to the significant improvements in OS observed in the PACIFIC trial, an important question is whether surgery will start to play a more niched role in the management of N2 disease.
Lung cancer
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
As is the case with most cancers, the treatment options and prognosis of lung cancer are heavily dependent on the cell type and stage. Surgical resection is the treatment of choice for suitable patients with localized (stage I and II) non-small cell lung cancer (NSCLC). The selection of patients for surgical intervention in the setting of N2 nodal disease (stage IIIA) remains controversial with differences between centres and continents. In most centres in the US, biopsy-proven N2 disease precludes immediate operative intervention, with the patient receiving either definitive chemoradiation or induction therapy. In comparison, in Europe, in single-station non-bulky N2 disease, there is an increasing tendency to proceed directly to surgery (64). The issue of single-station versus multiple-station N2 disease as separate prognosticators has been addressed in recent literature that has shown a significant difference in 5-year survival in resected single-station N2 disease compared with multiple-station N2 disease (65–67).
Targeting the epidermal growth factor receptor following complete surgical resection in patients with early-stage non-small cell lung cancer
Published in Expert Opinion on Pharmacotherapy, 2023
Khvaramze Shaverdashvili, Timothy F. Burns
Several studies are currently investigating the role of preoperative targeted therapy, including the phase III NeoADAURA trial, which is exploring neoadjuvant osimertinib as a single agent or combined with chemotherapy in patients with EGFR mutated in patients with resectable stage II-IIIB (N2) EGFR mutated NSCLC prior to surgery and adjuvant treatment per investigator this can include postoperative osimertinib up to three years versus chemotherapy or RT alone, or chemotherapy and RT followed by osimertinib [42]. The study’s primary end point is MPR, and some of the key secondary end points include event-free survival, pathological pCR, downstaging, DFS, OS, and MPR in patients with or without detectable EGFR mutations based on ctDNA testing (Table 1). Preliminary data from P1.14–58 phase II study enrolled 5 patients with EGFR mutated NSCLC (stage IA-IIIA) who received osimertinib in the perioperative settings, the MPR rate was 20% (1/5 patients) and no pCR were observed. Additionally, one patient was downstaged from N2 to N0 disease. Overall, osimertinib was well tolerated without added toxicity. However, given the small number of patients, no clear conclusions can be drawn while results from the NeoADAURA trial is pending, but early reports suggest low MPR and pCR rates with perioperative osimertinib. Furthermore, the neoadjuvant IO trials excluded patients with EGFR-activating mutation therefore no comparison can be made in the absence of randomized clinical trials [43].
Techniques for lung surgery: a review of robotic lobectomy
Published in Expert Review of Respiratory Medicine, 2018
Sophia Chen, Travis C. Geraci, Robert James Cerfolio
Perhaps, the best example of long-term value was an updated follow-up to this series was reported by Cerfolio et al. in 2017, representing the largest series with the longest follow-up after robotic lobectomy for non-small cell lung cancer (NSCLC) [39]. In review of 1330 patients after robotic lobectomy, short-term outcomes confirmed the safety of the procedure: conversion to thoracotomy was required in 9%, median length of stay was 3 days, and major morbidity occurred in 8%, with a low 30-day (0.2%) and 90-day (0.5%) mortality rate. The authors reported a stage-specific 5-year survival of 83% for patients with stage IA NSCLC and 77% for patients with stage IB NSCLC. The cumulative incidence of metastasis was 15%. The stage-specific survival was higher than in any other reported series either open or minimal invasive series. The question is why: is this because the series is only a surrogate of other cofounders of excellence such as tumor conference, more experienced surgeons and surgical teams, or just better staging? If a platform provides better staging by identification of N1 or N2 disease, and therefore, more patients receive adjuvant therapy, this may improve survival. In addition, a minimally invasive approach may be less immuno-compromising, which may help protect against the development of metastases. These concepts are theoretical until they are proven in a prospective randomized trial.
The role of adjuvant chemotherapy in locally advanced bladder cancer
Published in Acta Oncologica, 2018
Waqar Haque, Gary D. Lewis, Vivek Verma, Jorge G. Darcourt, E. Brian Butler, Bin S. Teh
This is the largest study to date to describe the practice patterns associated with adjuvant chemotherapy use for patients with LABC receiving both neoadjuvant chemotherapy and radical cystectomy. On multivariate logistic regression, receipt of treatment at a nonacademic facility was associated with a decreased likelihood of adjuvant chemotherapy use. This is most likely due to the lack of clear evidence describing the indications for adjuvant chemotherapy use for patients with LABC receiving neoadjuvant chemotherapy. In fact, the NCCN guidelines only recommend adjuvant chemotherapy use in instances where neoadjuvant chemotherapy has not been used [6]. Additionally, there was a nonsignificant trend for patients N1 or N2 disease to be predictive for chemotherapy use, likely due to the perceived increased risk for distant failure or metastasis with node positive disease. The fact that no such association was observed for patients with N3 disease may have been due to the relatively small number of patients in the study with N3 disease.