Cancer
Sally Robinson in Priorities for Health Promotion and Public Health, 2021
Survival means the percentage of people who are still alive, after diagnosis, after a certain time. Often, this is recorded after one year (Table 14.4), five years or 10 years. Disease-free survival refers to the number of people who are not only alive but are also well with no recurrence of cancer. In the UK the number of people who have survived cancer for 10 years or more has doubled over the last 40 years to 50%, but there is significant variation across different cancer typessurvival from breast, bowel and prostate cancers is highest in middle age, but survival of other cancers is best in those under 40 years oldbetween 1971 and 2010/11, the UK saw notable improvements in the survival of cancer in prostate, malignant melanoma, non-Hodgkin lymphoma, leukaemia, bowel cancer and female breast cancerbetween 1971 and 2010/11, the UK has seen very little improvement in the survival of cancer in the brain, oesophagus and lung, and no change in pancreatic cancer(Cancer Research UK, 2020a)
The Lung and the Pleura
E. George Elias in CRC Handbook of Surgical Oncology, 2020
The primary treatment of this tumor is by chemotherapy. A combination chemotherapy of doxorubicin, cyclophosphamide, vincristine, and methyl-CCNU can result in an 80% response rate, with 40% of these patients being complete responders. A disease-free survival ranging from 12 to 24 months can sometimes be achieved with an occasional long-term survivor. However, despite the disease regression and a complete response, there is usually recurrence which can be managed by radiation therapy. In some of the programs, radiation therapy is administered to the brain at the time of the initiation of the induction chemotherapy. Another observation is that combination chemotherapy is less effective in patients with extensive disease with a median survival of less than 10 months. Again, brain metastases are common and prophylactic brain irradiation has a decreased incidence of brain metastases.
Breast Surgery
Tjun Tang, Elizabeth O'Riordan, Stewart Walsh in Cracking the Intercollegiate General Surgery FRCS Viva, 2020
What is the evidence that supports the use of sentinel node biopsy?ALMANAC trial1Level 1 evidence for use of sentinel node biopsyCompared sentinel lymph node biopsy (SLNB) with standard axillary clearanceImproved quality-of-life outcomes and arm morbidity for SLNB group. No difference in disease-free survival or overall survival.Established that SLNB should be first-line management for the clinically node-negative axilla.
Swallowing sparing intensity modulated radiotherapy versus standard parotid sparing intensity-modulated radiotherapy for treatment of head and neck cancer: a randomized clinical trial
Published in Acta Oncologica, 2022
May Gamal Ashour, Tarek Hamed Shouman, Ashraf Hamed Hassouna, Maha Hassan Mokhtar, Reem Emad El Din, Ayda Aly Youssef, Mohammed Mohammed Gomaa, Shaimaa Abdelgeleel
As appropriate, numerical data were expressed as mean and standard deviation or median and range. Frequency and percentages were used to express qualitative results. The relationship between qualitative variables was examined using Pearson's Chi-square or Fisher's exact test. For quantitative results, the t-test was used to compare two groups. The Kaplan-Meier approach was used to do the survival analysis. Overall survival was calculated from the date of diagnosis until the date of death or the last follow-up. Disease-free survival was calculated from the end of treatment till the date of recurrence, death, or last follow-up. Recurrence-free survival was calculated from the end of radiotherapy till the date of recurrence. The log-rank test was used to compare survival curves. All tests were two-tailed. A p-value < 0.05 was considered significant.
Immune checkpoint inhibitors for recurrent endometrial cancer
Published in Expert Review of Anticancer Therapy, 2022
Levent Mutlu, Justin Harold, Joan Tymon-Rosario, Alessandro D. Santin
In preclinical models, radiation treatment was shown to increase PD-L1 expression, upregulation of MHC-I molecules on tumor cells, increased proinflammatory molecules, increased leukocyte migration to the tumor cells [45,63–66]. KEYNOTE-B21/ ENGOT-en11/GOG-3053 is an ongoing phase III trial comparing addition of pembrolizumab versus placebo with chemotherapy with or without radiation therapy after curative intent surgery in newly diagnosed high risk endometrial cancer patients. The study population will include early-stage endometrial cancer with recurrence high risk as well as Stage III and IVA of any histology[67]. The primary endpoints of this study are disease free survival and overall survival. FIERCE is a phase I study, designed to evaluate feasibility and safety of adjuvant therapy pembrolizumab with chemotherapy (carboplatin and paclitaxel) and vaginal brachytherapy with surgically staged early-stage endometrial cancer patients. This trial will include patients with Stage II disease of any histology, Stage I disease that are at high risk for recurrence (i.e. positive LVSI, deep myometrial invasion, grade 2–3 tumors)[68].
Analyses of human granulosa cell vitality by fluorescence activated cell sorting after rapid cooling
Published in Human Fertility, 2022
Detlef Pietrowski, Raphaela Mladek, Maria Frank, Julia Erber, Julian Marschalek, Christian Schneeberger
The survival rate of cancer patients has increased significantly in recent years, as the diagnosis and treatment of cancer has been greatly improved. However, anticancer therapies have the potential to affect female fertility by decreasing the ovarian reserve (Anderson & Wallace, 2011; Jeong et al., 2012). Maintaining fertility by cryopreservation of ovarian tissue prior to gonadotoxic treatment is therefore an option for patients requiring urgent chemotherapy. Especially in prepubertal girls with cancer this option seems to be of particular importance (Burns et al., 2018). Cryopreservation of ovarian tissue followed by orthotopic tissue reimplantation is considered to be the most promising method for restoring fertility in these patients (Martinez & International Society for Fertility Preservation–ESHRE–ASRM Expert Working Group, 2017).
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