Taolan Zhang*
Hillary Fitzgerald*, Harkiran Sandhu, Claudio Tombazzi, Danika Paulo, Stacey Tillman, Sumathi Misra, Hamid Shah and Mohana Karlekar
Purpose: Poorly controlled pain is a significant quality of life issue for patients with advanced cancer. Patients often suffer from uncontrolled pain or intolerable side effects of treatment despite receiving multi-modal care with stepwise escalation of opioids. Interventional procedures impacting central pain pathways have demonstrated promise in treating pharmacologically intractable cancer pain and may be underutilized, especially in patients with escalating opioid use. The aim of this study was to assess effectiveness of bilateral anterior cingulotomy a minimally invasive neurosurgical procedure in patients with refractory malignant cancer pain through describing opioid use trends pre- and post-procedure and by comparing pain scores.
Methods: This is a retrospective review of a case series of six patients with refractory malignant pain who underwent bilateral anterior cingulotomy. Response to procedure was measured by percent change of pain scores and average daily opioid dose reduction. In addition, demographics, oncologic history, discharge disposition, survival time post-procedure, and complications were reported.
Results: Six unique patients underwent seven total procedures between 2019-2022. Average daily OME (oral morphine equivalent) dose 48 hours prior to procedure was 4411 mg. At discharge, average daily OME dose was 250 mg, an 89% dose reduction from 48 hours prior to procedure. Pain scores reduced by 43% during this same time period.
Conclusion: Cingulotomy effectively reduced pain scores with a concurrent reduction in opioid dosing in our cohort of patients with medically refractory malignant cancer pain. Further research is warranted to identify advanced cancer patients who may benefit most from this procedure and inform clinical adoption.
Colorectal malignancy (CRC) is the third driving reason for disease related demise in the United States, with an expected 135 430 new cases and 50 260 malignancy related passings yearly. Albeit the occurrence and infection explicit mortality has bit by bit declined in the course of recent many years, late investigations depict an upsetting pattern of an expanded frequency in more youthful (<50 years) people [1]. Most of patients determined to have metastatic colorectal malignant growth (mCRC) have serious sickness, except for those with oligometastatic illness, for which fruitful careful or ablative intercessions and foundational treatment has yielded 5-year and 10-year endurance paces of around 40% and 20%, individually. For any remaining patients with mCRC, the utilization of blend foundational treatments and ideal steady consideration has created significant enhancements in mortality, with the middle generally endurance (OS) presently surpassing 30 months. Notwithstanding, with a general 5-year endurance of just around 20%, there stays a lot of opportunity to get better with restorative strategies.In late years, there have been considerable headways in our comprehension of the convergence between have insusceptible reconnaissance and tumorigenesis.
Pembrolizumab, an enemy of customized passing 1 (PD-1) monoclonal neutralizer, has been supported as a first-line treatment for metastatic non-little cell cellular breakdown in the lungs (NSCLC), both as monotherapy [in patients with NSCLC communicating modified demise ligand 1 (PD-L1) and without sharpening EGFR/ALK genomic aberrations] and joined with platinum-based chemotherapy (pemetrexed–platinum in patients with metastatic nonsquamous NSCLC without sharpening EGFR/ALK genomic abnormalities; carboplatin and paclitaxel or grab paclitaxel protein-bound in patients with metastatic squamous NSCLC)
Yassine Smiti*, Brahim El Ahmadi, Zakaria Belkhadir, and Abdelilah Ghannam
Introduction: The installation of brachyherapy applicator is a painful invasive procedure requiring anesthesia. In this study, we propose to compare intravenous anesthesia with spontaneous ventilation to an intrathecal analgesic protocol with local anesthetics and fentanyl. The main objective was to demonstrate the superiority of spinal analgesia in terms of per and postoperative analgesia during patient mobilization for CT scan. We performed a randomized clinical trial for women patients ASA 1 and 2 programmed for brachytherapy, then we divided them into 2 groups. Group 1: Have benefited from intravenous anesthesia by propofol titration with fentanyl. Group 2: Benefited from spinal analgesia with bupivacaine 5 mg and fentanyl 25 mg. Then we collected demographic data, quality of anesthesia (Ramsay score for level of sedation, analgesia level by analogical visual scale score), hemodynamic and respiratory parameters, anesthetics events , duration of anesthetic acts, pain during mobilization.
Prostate malignant growth is the most widely recognized disease in men in the United Realm (UK), with more than 42,000 men being determined to have the condition each year. It is the second most normal malignant growth in men around the world. More than 1.1 million instances of prostate disease were analyzed in 2012. Ðe utilization of 3rostDte-6 Antigen (PSA) testing has prompted a general expansion in the frequency of prostate malignant growth rates. Its utilization has likewise brought about the early location of a huge number of limited prostate disease cases, which don't represent a danger to patients' wellbeing or lives.
Shaina Sedighim, Alexander Gaidarski, Talia Kamdjou, Simon Dadoun, Samantha Linhares*, Andrew Rosenberg and Mecker G. Möller
Maira Zia*, Elin Lundström, Johanna Mårtensson, Mark Lubberink, Aglaia Schiza and Anders Sundin
DOI: 10.37421/2577-0535.2022.7.006
RECIST 1.1 tumour size measurements on CT/MRI are the mainstay of cancer therapy monitoring. However, bone metastases are consistently difficult to evaluate for hormonal therapy response often escaping CT detection. This study aimed to assess dynamic and static [18F]sodium fluoride-([18F]NaF)-PET/MRI by combining standardized uptake value (SUV) and net influx rate (Ki) from PET with the apparent diffusion coefficient (ADC), proton density fat fraction (PDFF) and effective transverse relaxation rate (R2*) from MRI for monitoring hormonal therapy effect on bone metastases. In this prospective study, three breast cancer patients underwent a 60-minute dynamic whole-body [18F]NaF-PET/MRI before and after hormonal therapy. In PET images, pelvic and spine metastases (approx. n=10/patient) with high/intermediate uptake were delineated by applying an adaptive threshold algorithm to provide SUVmean and SUVmax. Pharmacokinetic modeling was performed and Ki was calculated using a two-tissue reversible model. VOI measurements of ADC, PDFF and R2* utilized the OLEA medical software. The changes between baseline and follow-up data were calculated, statistically analysed and utilized linear regression. [18F]NaF-PET/MRI provided a powerful method for monitoring hormonal therapy response in breast cancer bone metastases as reflected by decreases in SUV and Ki. MRI parameters showed changes consistent with therapy response, although only R2* reached statistical significance.
Quint Ela
Journal of Cancer Clinical Trials received 95 citations as per Google Scholar report
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