- 作者列表："Acharya PP","Sarma D","McKinnon B
OBJECTIVE:This retrospective review aims to analyze epidemiological trends related to temporal bone cancer, and primarily of the squamous cell subtype. Potential trends analyzed included age, gender, and geographical location. DATA SOURCES:This retrospective review analyzed data found in the National Cancer Institute's SEER Database for cases of carcinomas of the middle ear. Cases were selected between 1975 and 2016 and using the primary site of Middle Ear (Site code C30.1), and then narrowed using additional variables, which included age, sex, and state-county. Languages covered included English. DATA EXTRACTION:The extracted data was entered into an Excel spreadsheet for further analysis in SPSS Version 25. DATA SYNTHESIS:An Analysis of Covariance (ANCOVA) and a Bonferroni correction were applied to the data for further analysis of significant trends. The data was then placed into tables outlining the distribution of cases among select patient characteristics of age and sex, and significant age group pairwise comparisons. CONCLUSIONS:Age at diagnosis of temporal bone cancer is strongly associated with the prevalence of temporal bone cancer. We urge providers to consider subtypes of temporal bone cancer, including squamous cell carcinoma, when evaluating older adults with risk factors for temporal bone cancer and an abnormal physical exam.
目的: 本回顾性综述旨在分析与颞骨癌相关的流行病学趋势，主要是鳞状细胞亚型。分析的潜在趋势包括年龄、性别和地理位置。 数据来源: 本回顾性综述分析了美国国家癌症研究所SEER数据库中发现的中耳癌病例的数据。在 1975 年至 2016 年之间选择病例，使用中耳的原发部位 (部位代码C30.1)，然后使用其他变量缩小范围，包括年龄、性别和州县。涵盖的语言包括英语。 数据提取: 将提取的数据输入Excel电子表格，以便在SPSS版本 25 中进一步分析。 数据综合: 对数据进行协方差分析 (ANCOVA) 和Bonferroni校正，以进一步分析显著趋势。然后将数据放入表格中，概述年龄和性别的选定患者特征之间的病例分布，以及显著的年龄组成对比较。 结论: 诊断为颞骨癌的年龄与颞骨癌的患病率密切相关。我们敦促提供者在评估有颞骨癌危险因素和体检异常的老年人时，考虑颞骨癌的亚型，包括鳞状细胞癌。
METHODS:OBJECTIVE:Large inoperable sacral chordomas show unsatisfactory local control rates even when treated with high dose proton therapy (PT). The aim of this study is assessing feasibility and reporting early results of patients treated with PT and concomitant hyperthermia (HT). METHODS: :Patients had histologically proven unresectable sacral chordomas and received 70 Gy (relative biological effectiveness) in 2.5 Gy fractions with concomitant weekly HT. Toxicity was assessed according to CTCAE_v4. A volumetric tumor response analysis was performed. RESULTS: :Five patients were treated with the combined approach. Median baseline tumor volume was 735 cc (range, 369-1142). All patients completed PT and received a median of 5 HT sessions (range, 2-6). Median follow-up was 18 months (range, 9-26). The volumetric analysis showed an objective response of all tumors (median shrinkage 46%; range, 9-72). All patients experienced acute Grade 2-3 local pain. One patient presented with a late Grade 3 iliac fracture. CONCLUSION:Combining PT and HT in large inoperable sacral chordomas is feasible and causes acceptable toxicity. Volumetric analysis shows promising early results, warranting confirmation in the framework of a prospective trial. ADVANCES IN KNOWLEDGE: :This is an encouraging first report of the feasibility and early results of concomitant HT and PT in treating inoperable sacral chordoma.
METHODS:BACKGROUND:National guidelines recommend screening and treatment for cancer-related bone disease and continued monitoring of bone-modifying agents. It is unclear whether a standardized screening tool is utilized to identify eligible patients and ensure appropriate supportive care is implemented. The purpose of this study was to evaluate current prescribing practices and optimize management of bone-modifying agents. METHODS:A retrospective chart review was performed to identify patients who received hormone deprivation therapy or had bone metastases through Hematology/Oncology or Urology clinics from 1 November 2016 to 31 October 2017. The primary endpoints of this study were the incidence of completed baseline dual-energy X-ray absorptiometry (DEXA) scan for patients on hormone deprivation therapy and percent of patients started on a bone-modifying agent for the prevention of skeletal-related events secondary to bone metastasis. Secondary endpoints included percent of patients with dental examinations prior to initiation, adequate calcium and vitamin D supplementation, incidence of osteonecrosis of the jaw or flu-like symptoms and education, and percent of bisphosphonate doses appropriately adjusted based on renal function. RESULTS:A total of 375 patients were assessed for baseline DEXA scans and bone-modifying therapy. Of the 226 patients on hormone deprivation therapy, 111 (49%) patients were appropriately screened with a DEXA scan prior to initiation of hormone deprivation therapy. Among the 149 patients with bone metastases, only 94 (63.1%) patients were started on a bone-modifying agent. CONCLUSIONS:Opportunities have been identified to optimize management of patients with cancer-related bone disease. Implementation of standardized tools may increase the rate of appropriate screening and initiation of bone-modifying therapy when warranted.
METHODS:PURPOSE:Low skeletal muscle mass has been associated with poor prognosis in patients with advanced lung cancer. However, little is known about the relationship between skeletal muscle mass and overall survival in patients with bone metastases from lung cancer. The objective of the present study was to evaluate the prognostic value of low trunk muscle mass in predicting overall survival in these patients. METHODS:The data from 198 patients who were diagnosed with bone metastases from lung cancer from April 2009 to May 2017 were retrospectively reviewed. The areas of the psoas and paravertebral muscles were measured at the level of the third lumbar vertebra on computed tomography scans taken at the time nearest to the diagnosis of bone metastasis. Muscle area was evaluated for male and female cohorts separately using different cutoff points. Cox proportional hazards analysis was performed to evaluate the factors independently associated with overall survival. RESULTS:The overall survival of patients in the lowest quartile for psoas muscle area or paravertebral muscle area was significantly shorter than that of patients above the 25th percentile for muscle area (p < 0.001). Multivariate analyses showed that paravertebral muscle mass (hazard ratio, 1.73; 95% confidence interval, 1.17-2.56; p = 0.006), epidermal growth factor receptor-targeted therapy, and performance status were independent prognostic factors. CONCLUSIONS:Low paravertebral muscle mass was associated with shorter survival, independently of known prognostic factors.