共查询到20条相似文献，搜索用时 15 毫秒
1.
Marisa R. Moroney Dina Flink Jeanelle Sheeder Erin A. Blake Aakriti R. Carrubba Christine M. Fisher Saketh R. Guntupalli 《Reports of Practical Oncology and Radiotherapy》2018,23(5):331-336
Aim
To evaluate the associations of external beam radiation therapy (EBRT) and intracavitary brachytherapy (IB) with decreased sexual function.Background
There’s inconsistent evidence on whether radiation for gynecologic cancers has an impact on sexual health. IB, an underutilized treatment modality, is thought to have less adverse effects than EBRT.Materials and methods
A cross-sectional study examining decreased sexual function following radiation for gynecologic cancers. A decrease in sexual function was measured as a change in the Female Sexual Function Index (FSFI) from before to after treatment, with a significant decrease determined by Reliable Change Index Statistic (RCIS). Chi-square and t-tests were employed.Results
171 women completed the survey; 35% (n?=?60) received radiation, of whom 29 received EBRT and IB (48%), 15 EBRT alone (25%), 16 IB alone (27%). Women who received radiation had similar rates of decreased sexual function as women who did not (47% vs. 38%, P?=?0.262). EBRT and IB had similar rates of decreased sexual function compared to women with no radiation (50% vs. 38% P?=?0.166 and 47% vs. 38% P?=?0.309). Women experiencing decreased sexual function were more likely to be under 50 years old (OR 5.4, 95%CI 1.6–18.1), have received chemotherapy (OR 5.7, 95%CI 1.4–22.9), and have cervical cancer (OR 7.8, 95%CI 2.1–28.8).Conclusions
Treatment with EBRT or IB does not appear to impair sexual function in women with gynecologic cancer. Age less than 50, concurrent chemotherapy, and cervical cancer may place women with gynecologic cancer at higher risk for decreased sexual function following radiation. 相似文献2.
Wui Ann Woon Paul B. Ravindran Piyasiri Ekanayake Siti Amirah Yivonne Y.F. Lim Christopher H.S. Vun Jamsari Khalid 《Reports of Practical Oncology and Radiotherapy》2018,23(5):346-359
Aim
The aim of this study was to investigate the sensitivity of the trajectory log file based quality assurance to detect potential errors such as MLC positioning and gantry positioning by comparing it with EPID measurement using the most commonly used criteria of 3%/3?mm.Materials and methods
An in-house program was used to modified plans using information from log files, which can then be used to recalculate a new dose distribution. The recalculated dose volume histograms (DVH) were compared with the originals to assess differences in target and critical organ dose. The dose according to the differences in DVH was also compared with dosimetry from an electronic portal imaging device.Results
In all organs at risk (OARs) and planning target volumes (PTVs), there was a strong positive linear relationship between MLC positioning and dose error, in both IMRT and VMAT plans. However, gantry positioning errors exhibited little impact in VMAT delivery. For the ten clinical cases, no significant correlations were found between gamma passing rates under the criteria of 3%/3?mm for the composite dose and the mean dose error in DVH (r?<?0.3, P?>?0.05); however, a significant positive correlation was found between the gamma passing rate of 3%/3?mm (%) averaged over all fields and the mean dose error in the DVH of the VMAT plans (r?=?0.59, P?<?0.001).Conclusions
This study has successfully shown the sensitivity of the trajectory log file to detect the impact of systematic MLC errors and random errors in dose delivery and analyzed the correlation of gamma passing rates with DVH. 相似文献3.
Olga Pons-Llanas Susana Roldan-Ortega Francisco Celada-Alvarez María José Perez-Calatayud Victoria Fornes-Ferrer Alejandro Tormo-Micó José Perez-Calatayud José Luis López-Torrecilla 《Reports of Practical Oncology and Radiotherapy》2018,23(4):290-297
Aim
The present retrospective study was to compare toxicity and survival outcomes in a group of low-risk PCa patients treated with either the preoperative planning technique (145?Gy) or the real-time IoP technique (160?Gy).Background
The two most common permanent seed implantation techniques are preoperative planning (PP) with 145?Gy and real-time intraoperative planning (IoP) with 160?Gy. Although IoP has largely replaced PP at many centres in recent years, few studies have directly compared these two techniques.Materials and methods
Retrospective study of 408 patients with low-risk PCa treated with permanent seed implant brachytherapy at our institution between October 2003 and December 2014. Of these, 187 patients were treated with PP at a dose of 145?Gy while 221 received real-time IoP with 160?Gy.Results
At a median follow up of 90 months, 5- and 8-year rates of biochemical relapse-free survival (BRFS) were 94.8% and 86% with the IoP technique versus 90.8% and 83.9%, respectively, with PP. The maximum dose to the urethra was <217?Gy with both techniques. Despite the higher dose, IoP did not cause any significant increase in toxicity (p?=?0.11).Conclusions
The present study shows that real-time intraoperative brachytherapy at a dose of 160?Gy yield better biochemical control than preoperative planning at 145?Gy. In addition, urinary toxicity did not increase, despite the dose escalation, probably because the dose constraints to the urethra were met despite the increased dose escalation. These findings support the use of real-time IoP. 相似文献4.
Joana Pinheiro Darlene Rodrigues Pedro Fernandes Alexandre Pereira Lurdes Trigo 《Reports of Practical Oncology and Radiotherapy》2018,23(5):322-330
Introduction
The incidence of breast carcinoma (BC) has increased in the last years. Between 2 and 12% of patients diagnosed with BC will develop bilateral breast carcinoma (BBC). The treatment of these carcinomas is more aggressive than unilateral BC.Purpose
To perform a retrospective qualitative analysis of BBC patients whose treatment has included brachytherapy (BT) and to present a revised literature on this issue.Material and methods
The cases of BBC whose treatment included brachytherapy were revised. The literature on this issue was refreshed.Results
Five women, aged between 54 and 78 at the time of the diagnosis, submitted to conservative surgery followed by external radiotherapy (RT) with boost of BT or exclusive BT (APBI), in the IPO-P BT Service between 2003 and 2016.Discussion
The patients with BBC have slightly higher rates of local recurrences, mostly in the tumor bed, where there is a higher risk of local recurrence. Patients treated with BT had lower rates of recurrences than those treated with photons and electrons.Conclusions
BBC represents a complex challenge for doctors, because in some cases there is a tendency to use more aggressive treatments and, at the same time, it is not easy to achieve the timing for the correct treatment. 相似文献5.
Morbidity dynamics in proton–photon or photon radiation therapy for locally advanced prostate cancer
Evgeny V. Khmelevsky Irina N. Kancheli Vladimir S. Khoroshkov Andrey D. Kaprin 《Reports of Practical Oncology and Radiotherapy》2018,23(1):21-27
Aim
This study evaluated the frequency and long-term dynamics of early and late post irradiation damage after proton–photon or photon therapy for locally advanced prostate cancer.Background
The results of a randomized study of proton–photon or photon therapy using several fractionation regimes were analyzed in 272 patients with high and intermediate risk of progression.Materials and methods
Three variants of proton boost fractionation were studied sequentially: 3.0 (8 daily fractions), 4.0 (5 fractions, 3 or 5 fractions/week), and 5.5 (3 fractions, 3 fractions/week) Gy(RBE).Results
A significant decrease in the severity of both acute and late gastrointestinal injuries is achievable with a proton beam. The dynamics of late gastrointestinal and genitourinary toxicity over a 10-year period were generally characterized by a decrease in severity of morbidity by 30% and 15%, respectively.Conclusions
Local irradiation with a fractional dose of 3.0–5.5 Gy(RBE) and a cumulative dose of 28.0–28.8 Gy(RBE) for protons significantly reduces the early and late rectitis severity, but does not reduce the risk of lower urinary tract injuries. Fractionation regimens do not significantly differ in toxicity levels. 相似文献6.
Gianluca Ingrosso Alessandra Carosi Daniela di Cristino Elisabetta Ponti Andrea Lancia Marta Bottero Alessandro Cancelli Alessandra Murgia Irene Turturici Riccardo Santoni 《Reports of Practical Oncology and Radiotherapy》2018,23(5):315-321
Aim
To identify factors influencing toxicity in patients affected by localized prostate cancer treated with conformal image-guided radiotherapy.Background
Image guidance in combination with conformal techniques is the standard of care in localized prostate cancer, but factors affecting toxicity are still under investigation.Materials and methods
294 patients were analyzed. Median age at diagnosis was 71?year. 76?Gy (38?×?2?Gy) were delivered to the target volume. We used the χ2 test to analyse associations between toxicity and dosimetric and clinical parameters. Multivariate analysis was performed using binary logistic regression. Kaplan–Meier method was used for survival analysis.Results
Median follow-up was 62.9 months. Acute grade ≥2 gastro-intestinal toxicity (GI) was 12.1%. Acute genito-urinary (GU) toxicity of grade ≥2 was 33.9%. Actuarial 4 and 5 years late grade ≥2 GI was 3% and 4%, respectively. Four and 5-year late grade ≥2 GU toxicity was 6% and 10%. At multivariate analysis for acute toxicity rectal V70 was correlated with GI toxicity (p?=?0.01, HR 2.73 CI 1.19–6.26), and smoking habit with GU toxicity (p?<?0.01, HR 2.50 CI 1.51–4.14). For late toxicity, rectal V70 was correlated with gastro-intestinal toxicity (p?=?0.04, HR 4.76 CI 1.07–21.13), and pre-radiotherapy urinary symptoms with genito-urinary toxicity (p?=?0.01, HR 2.84 CI 1.29–6.22).Discussion
Conformal image-guided radiotherapy shows low rates of toxicity. Smoking should be avoided during radiotherapy. Besides the evaluation of high doses received by the organs at risk, individual factors, such as co-morbidities and lifestyle choices, have an impact on normal-tissue complication risk. 相似文献7.
Tomohei Nakao Hiroko Fukushima Takashi Fukushima Ryoko Suzuki Sho Hosaka Yuni Yamaki Chie Kobayashi Atsushi Iwabuchi Kazuo Imagawa Aiko Sakai Toko Shinkai Kouji Masumoto Shingo Sakashita Tomohiko Masumoto Masashi Mizumoto Ryo Sumazaki Hideyuki Sakurai 《Reports of Practical Oncology and Radiotherapy》2018,23(5):442-450
Aim
To assess the feasibility of transferring to the University of Tsukuba Hospital for proton beam therapy (PBT) during intensive chemotherapy in children with Ewing sarcoma family of tumors (ESFT) who had been diagnosed and started their first-line treatment at prefectural or regional centers for pediatric oncology.Background
The treatment of ESFT relies on a multidisciplinary approach using intensive neoadjuvant and adjuvant chemotherapies with surgery and radiotherapy. Multi-agent chemotherapy comprising vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide (VDC-IE) is widely used for ESFT, and the interval between each course is very important for maintaining the intensity and effect of chemotherapy.Materials and methods
Clinical information of patients who received PBT and VDC-IE between April 2009 and May 2016 was collected retrospectively. The intervals between each course of VDC-IE and adverse events were assessed.Results
Fifteen patients were evaluated. No delays in the intervals of chemotherapy due to transfer were observed. There were no adverse events caused during/just after transfer and no increases in adverse events. The estimated 4-year overall and event-free survival rates were 94.6% and 84.8%, respectively.Discussion
Although the results of efficacy are preliminary, survival rates were comparable with past studies. More experience and follow-up are required to further assess the efficacy of PBT for patients with ESFT.Conclusion
Multidisciplinary therapy for children with ESFT involving transfer to our hospital for PBT during VDC-IE was feasible without treatment delay or an increase in adverse events. 相似文献8.
Felipe F.B. Tuon Khaiany Lino Florencio Clóvis Arns da Cunha Jaime Luis Lopes Rocha 《Revista iberoamericana de micología》2018,35(2):63-67
Background
Posaconazole is used for the prophylaxis of invasive fungal disease (IFD). Previous studies have shown it to be cost-effective compared to fluconazole/itraconazole. However, posaconazole has never been economically evaluated in developing countries.Aims
The aim of the present study was to perform a cost-effectiveness analysis of posaconazole compared to fluconazole in public (SUS) and private hospitals (PHS) in Brazil.Methods
A cost-effectiveness simulation was conducted on the basis of a pivotal study on the use of posaconazole in acute myeloid leukemia (AML) patients, adjusting the costs to Brazilian data.Results
A pharmacoeconomic analysis was performed on a hypothetical sample of 100 patients in each drug group. The total cost of posaconazole use alone was USD$ 220,656.31, whereas that for fluconazole was USD$ 83,875.00. Our results showed that patients with IFD remain hospitalized for an additional 12 days, at an average cost of USD$ 850.85 per patient per day. The total money spent by PHS for 100 patients for 100 days was USD$ 342,318.00 for the posaconazole group and USD$ 302,039.00 for the fluconazole group. An analysis of sensitivity (10%) revealed no intergroup difference.Conclusions
In Brazil posaconazole is cost-effective, and should be considered for the prophylaxis of patients with AMD/myelodysplasia (AML/MDS) undergoing chemotherapy. 相似文献9.
Ramya Rangarajan 《Reports of Practical Oncology and Radiotherapy》2018,23(1):57-60
Aim
The aim of the study is to evaluate the differences in dosimetry between tandem-ovoid and tandem-ring gynaecologic brachytherapy applicators in image based brachytherapy.Background
Traditionally, tandem ovoid applicators were used to deliver dose to tumor in intracavitary brachytherapy. Tandem-ring, tandem-cylinder and hybrid intracavitary, interstitial applicators are also used nowadays in cervical cancer brachytherapy.Methods and materials
100 CT datasets of cervical cancer patients (stage IB2 – IIIB) receiving HDR application (50 tandem-ovoid and 50 tandem-ring) were studied. Brachytherapy was delivered using a CT-MRI compatible tandem-ovoid (50 patients) and a tandem-ring applicator (50 patients). DVHs were calculated and D2cc was recorded for the bladder and rectum and compared with the corresponding ICRU point doses. The point B dose, the treated volume, high dose volume and the treatment time were recorded and compared for the two applicators.Results
The mean D2cc of the bladder with TR applicator was 6.746 Gy. TO applicator delivered a mean D2cc of 7.160 Gy to the bladder. The mean ICRU bladder points were 5.60 and 5.63 Gy for TR and TO applicator, respectively. The mean D2cc of the rectum was 4.04 Gy and 4.79 Gy for TR and TO applicators, respectively. The corresponding ICRU point doses were 5.10 Gy and 5.66 Gy, respectively.Conclusions
The results indicate that the OAR doses assessed by DVH criteria were higher than ICRU point doses for the bladder with both tandem-ovoid and tandem-ring applicators whereas DVH based dose was lower than ICRU dose for the rectum. The point B dose, the treated volume and high dose volume was found to be slightly higher with the tandem-ovoid applicator. The mean D2cc dose for the bladder and rectum was lower with tandem-ring applicators. The clinical implication of the above dosimetric differences needs to be evaluated further. 相似文献10.
Nayana Damiani Macedo Aline Rodrigues Buzin Isabela Bastos Binotti Abreu de Araujo Breno Valentim Nogueira Tadeu Uggere de Andrade Denise Coutinho Endringer Dominik Lenz 《Tissue & cell》2017,49(1):22-27
Objective
The current study proposes an automated machine learning approach for the quantification of cells in cell death pathways according to DNA fragmentation.Methods
A total of 17 images of kidney histological slide samples from male Wistar rats were used. The slides were photographed using an Axio Zeiss Vert.A1 microscope with a 40x objective lens coupled with an Axio Cam MRC Zeiss camera and Zen 2012 software. The images were analyzed using CellProfiler (version 2.1.1) and CellProfiler Analyst open-source software.Results
Out of the 10,378 objects, 4970 (47,9%) were identified as TUNEL positive, and 5408 (52,1%) were identified as TUNEL negative. On average, the sensitivity and specificity values of the machine learning approach were 0.80 and 0.77, respectively.Conclusion
Image cytometry provides a quantitative analytical alternative to the more traditional qualitative methods more commonly used in studies. 相似文献11.
Rosa Belén Mohedano del Pozo Margarita Rubio Alonso Mª Soledad Cuétara García 《Revista iberoamericana de micología》2018,35(3):117-122
Background
The role of culture-independent techniques (galactomannan, (1-3)-β-d-glucan) in the early diagnosis of invasive fungal diseases (IFD) is well assessed in hematological patients, but there are no clear conclusions in patients with chronic obstructive pulmonary disease (COPD).Aims
To study the usefulness of nonculture-based techniques in the diagnosis of IFD in COPD-patients at risk for IFD.Methods
A prospective observational study based on monitoring COPD patients at risk for IFD during 2007–2010 was carried out. The presence of galactomannan, (1-3)-β-d-glucan and an indirect immunofluorescence of Candida albicans germ tube specific antibodies (CAGTA) were performed.Results
Among 43 COPD patients, 16 (37.2%) were diagnosed with IFD: seven cases were proven IFD (five invasive candidemia – IC, one invasive aspergillosis – IA and a rhinocerebral zygomycosis) and nine probable IFD (seven IA and two IC). In the diagnosis of IC and IA, the negative predictive value (NPV) of (1-3)-β-d-glucan was 100%. Regarding CAGTA in IC, NPV was 96.2%. Finally, NPV of galactomannan in IA was 91.2%. The area under the ROC curve for (1-3)-β-d-glucan in IC and for the rest of the IFD cases was 0.86 (95% CI, 0.79–0.93) and 0.60 (95% CI, 0.43–0.77), for CAGTA in IC was 0.83 (95% CI, 0.74–0.91) and for galactomannan in IA was 0.71 (95% CI, 0.56–0.85). Positive (1-3)-β-d-glucan preceded the growth of Candida (average of 1.7 days) in blood culture.Conclusions
In COPD patients at risk for IFD the assayed techniques are especially useful to rule out the presence of IFD. 相似文献12.
Jesus Fortún Francesca Gioia Patricia Muñoz Javier Graus Elia Gómez-García de la Pedrosa Pilar Martín-Dávila Ana Saiz Antonio Vena Santiago Moreno 《Revista iberoamericana de micología》2018,35(3):159-161
Background
T2 magnetic resonance imaging (T2MR) is a new method for the diagnosis of invasive candidiasis, although most studies have analyzed its role in patients with candidemia or not infection.Case report
We present the case of a patient with arteritis and thrombosis of the hepatic graft resulted from an undocumented fungal infection in the explanted liver.T2MR in serum was a suitable diagnostic tool for the diagnosis of the deep-seated invasive candidiasis in the absence of candidemia or the isolation of the yeast in culture.Conclusions
T2MR allowed the diagnosis of deep-seated invasive candidiasis in an immunodepressed patient without candidemia, even before the onset of symptoms. 相似文献13.
Randa Bittar Élisabeth Aslangul Philippe Giral Lambert Assoumou Marc-Antoine Valantin Olga Kalmykova Marie-Christine Federspiel Corinne Cherfils Dominique Costagliola Dominique Bonnefont-Rousselot 《Comptes rendus biologies》2017,340(2):109-113
Background
We evaluated the effect of 45 days of rosuvastatin or pravastatin treatment on the distribution of HDL subfractions in HIV-1-infected individuals receiving boosted protease inhibitors (PIs) with cardiovascular risk.Methods
The distribution of HDL subclasses by gradient gel electrophoresis was blindly assessed in 74 HIV-1-infected individuals receiving boosted PIs at baseline and at day 45 of statin treatment, and compared with the distribution obtained in 63 healthy normolipidemic individuals taken as controls.Results
No significant modification appeared in HDL distribution between the two arms of statins for the HIV-1-infected individuals. Nevertheless, when compared to controls, HDL subfractions showed a significantly lower HDL2b proportion and significantly higher proportions of HDL2a and HDL3b (P < 0.001).Conclusion
No difference was observed in HDL distribution between pravastatin and rosuvastatin after 45 days treatment, in HIV-1-infected individuals under PIs. Nevertheless, when compared to healthy normolipidemic subjects, HDL distribution is clearly different, with a distribution in HIV-infected individuals under PIs associated with an increased cardiovascular risk. 相似文献14.
Carlos Ruiz de Alegría Puig Jesús Agüero-Balbín Carlos Fernández-Mazarrasa Luis Martínez-Martínez 《Revista iberoamericana de micología》2018,35(3):130-133
Background
Matrix-assisted laser desorption-time of flight mass spectrometry (MALDI-TOF-MS) represents a revolution in the identification of microorganisms of clinical interest. Many studies have confirmed the accuracy and fastness of this tool with routine strains.Aims
To identify clinical isolates of Candida from patients diagnosed with candidemia.Methods
Vitek-MS? system was used with a collection of 298 blood isolates of the genus Candida represented by 9 different species. Sequencing of the internal transcribed spacer (ITS) region of ribosomal DNA cluster was used as the reference method.Results
The results of Vitek-MS? were concordant with those obtained with the reference method for 279 (93.62%) isolates (Kappa coefficient (κ) = 0.91). Vitek-MS? misidentified 10 (3.36%) isolates and did not identify 9 (3.02%) isolates.Conclusions
This study determines the potential of Vitek-MS? in yeast identification, being a reliable and fast alternative in the clinical laboratory, with an acceptable sensitivity of 82% (IC 95%: 70–90.6%), in comparison with a 100% (IC 95%: 92.9–100%) sensitivity of the conventional methods. 相似文献15.
Background
Transforming growth factor beta (TGF-β) is a multipurpose cytokine, which plays a role in many cellular functions such as proliferation, differentiation, migration, apoptosis, cell adhesion and regulation of epithelial to mesenchymal transition. Despite many studies having observed the effect that TGF-β plays in colorectal cancer, its role in the colorectal stem cell population has not been widely observed.Method
This systematic review will analyse the role of TGF-β in the stem cell population of colorectal cancer.Results
The effects on the stem cell phenotype are through the downstream proteins involved in activation of the TGF-β pathway. Its involvement in the initiation of the epithelial to mesenchymal transition (EMT), the effect of colorectal invasion and metastasis regulated through the Smad protein involvement in the EMT, initiation of angiogenesis, promotion of metastasis of colorectal cancer to the liver and its ability to cross-talk with other pathways.Conclusion
TGF-β is a key player in angiogenesis, tumour growth and metastasis in colon cancer. 相似文献16.
Objective
A new method was presented to prepare clinical-grade human adipose-derived stromal stem cells (ASCs) and its safety in vitro, such as biological characteristics and genetic features alteration were investigated.Methods
The morphology of the ASCs which were cultured in vitro using serum-free medium was observed. Cell cycle and CD markers profile were tested by flow cytometry, while karyotype was analyzed by the chromosome G-banding technology. Growth factors expression was tested by ELISA and tumor-related genes were analyzed by the real-time PCR, respectively.Results
ASCs were adult stem cells with spindle shape. The proliferation ratio of ASCs began to slow down after 10 passages, and was significant after 15 passages. Cell cycle analysis revealed that the percentage of G2 phase and S phase cells was stable. There was no obvious missing, translocation or dislocation in terms of karyotype. Expression level of tumor relevant genes and cytokines at different passages had no significant difference.Conclusions
The clinical-grade ASCs prepared with this new method, less than ten passages, was safe for clinical trials. 相似文献17.
18.
Marta Liszka Włodzimierz Samborski 《Reports of Practical Oncology and Radiotherapy》2018,23(5):378-383
Aim
Isokinetic assessment of biomechanical parameters of the shoulder joint at the operated side versus non-operated side in patients treated surgically for breast cancer according to the type of surgery performed.Background
Despite significant progress in medicine, comprehensive cancer therapy may still cause a number of undesired structural and functional effects. The most frequent complications include long-term weakening of muscles within the shoulder and upper extremity at the operated side.Materials and methods
The study enrolled 57 patient, divided into two groups: mastectomy and BCT. Diagnostic tests were carried out on the groups to assess biomechanical parameters (peak torque, power, total work) of the shoulder joint in internal and external rotation.Results
The results of the isokinetic test revealed a considerable reduction of dynamic properties of the muscle groups responsible for the function of the shoulder joint at the operated side. The deficits observed, depending on the angular speed and plane of rotation, were from 22.3% to 32.7% and from 23.1% to 29.4% for muscle power and total work, respectively. The least noticeable loss was that of muscular torque, ranging from 6.5% to 18.3%.Conclusion
None of the treatment methods applied ensured a full release of the restriction within the shoulder and upper limb. The deficits observed may constitute a serious disorder of the musculoskeletal system; therefore, a clinical study of biomechanical parameters of the shoulder joint may be an important control of patients’ functional status after breast cancer treatment. 相似文献19.
Aparna Gangopadhyay 《Reports of Practical Oncology and Radiotherapy》2018,23(3):228-231
Aim
To identify risk factors that lower efficacy of antibiotic prophylaxis of febrile neutropenia among older patients on chemoradiation.Background
Audit of institutional data showed that older adults are at higher risk of febrile neutropenia during chemoradiation. In limited resource settings widespread use of Granulocyte-Colony Stimulating Factor (G-CSF) is not economically feasible and antibiotics are used commonly. Despite compliance with antibiotics, prophylaxis is inadequate in many patients owing to patient and tumor related factors.Materials and methods
Data from records of 219 older patients receiving antibiotic prophylaxis during chemoradiation were studied. Baseline assessment data and predisposing factors for febrile neutropenia were recorded. All patients received prophylactic fluoroquinolones. Incidence of febrile neutropenia and association with predisposing factors at baseline was analyzed by multiple logistic regression.Results
38.4% developed febrile neutropenia despite compliance. Multiple logistic regression revealed geriatric assessment (G8) score and tumor stage to be significant predictors of febrile neutropenia while on antibiotics (p < 0.0001). Odds ratios for two significant predictors G8 score and tumor stage, respectively, were 2.9 (95% CI 1.8036–4.6815) and 2.7 (95% CI 1.7501–4.1318). Correlation between these two significant predictors was found to be low in our cohort (Spearman's coefficient of rank correlation (rho) – 0.431, p < 0.0001).Conclusion
G8 score and tumor burden are significant predictors of efficacy of antibiotic prophylaxis among older adults receiving chemoradiation. In older patients having poor G8 scores and advanced tumors, antibiotic prophylaxis is unsuitable. Interestingly, co-morbidities and poor performance status did not impact efficacy of antibiotic prophylaxis among our elderly patients. 相似文献20.
Agata Karklelyte Konstantinas Povilas Valuckas Romas Griskevicius Ernestas Janulionis Eduardas Aleknavicius 《Reports of Practical Oncology and Radiotherapy》2018,23(4):284-289