1,721,026 research outputs found
Prevention of head and neck squamous cell carcinoma. integrated treatment approach with diet, pharmaco-nutritional support, antioxidants (and anti-COX-2): preliminary results of a phase II study
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Randomised phase III clinical trial of 5 different arms of treatment for patients with cancer-related anorexia/cachexia syndrome (CACS)
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Randomized phase III clinical trial of five different arms of treatment in 332 patients with cancer cachexia
No full textPurpose. A phase III, randomized study was carried out to establish the most effective and safest treatment to improve the primary endpoints of cancer cachexia - lean body mass (LBM), resting energy expenditure (REE), and fatigue - and relevant secondary endpoints: appetite, quality of life, grip strength, Glasgow Prognostic Score (GPS) and proinflammatory cytokines. Patients and Methods. Three hundred thirty-two assessable patients with cancer-related anorexia/cachexia syndrome were randomly assigned to one of five treatment arms: arm 1, medroxyprogesterone (500 mg/day) or megestrol acetate (320 mg/day); arm 2, oral supplementation with eicosapentaenoic acid; arm 3, L-carnitine (4 g/day); arm 4, thalidomide (200 mg/day); and arm 5, a combination of the above. Treatment duration was 4 months. Results. Analysis of variance showed a significant difference between treatment arms. A post hoc analysis showed the superiority of arm 5 over the others for all primary endpoints. An analysis of changes from baseline showed that LBM (by dual-energy X-ray absorptiometry and by L3 computed tomography) significantly increased in arm 5. REE decreased significantly and fatigue improved significantly in arm 5. Appetite increased significantly in arm 5; interleukin (IL)-6 decreased significantly in arm 5 and arm 4; GPS and Eastern Cooperative Oncology Group performance status (ECOG PS) score decreased significantly in arm 5, arm 4, and arm 3. Toxicity was quite negligible, and was comparable between arms. Conclusion. The most effective treatment in terms of all three primary efficacy endpoints and the secondary endpoints appetite, IL-6, GPS, and ECOG PS score was the combination regimen that included all selected agents
Association of serum IL-6 levels with comprehensive geriatric assessment variables in a population of elderly cancer patients
No full textThe primary aim of this study was to find whether any association exists between serum levels of proinflammatory cytokines, mainly IL-6, and the most important comprehensive geriatric assessment (CGA) variables such as functional status, cognitive functions and nutrition in a population of elderly cancer patients. The secondary aims were to find whether any difference existed between: i) age groups, ii) performance status scores, iii) patients who had lost weight versus those who had not. Eighty-four elderly patients with advanced cancer were included in the study (stage III 15.4%, and stage IV 72.6%). Serum levels of IL-6 and CRP were significantly higher in elderly than in the other adult cancer patients. Among the CGA variables investigated, the most affected were functional status assessed by IADL, cognitive functions by MMSE and nutrition. The ECOG PS was shown to be significantly associated with all the dimensions of CGA investigated: poor PS (>/=2) corresponded to severe disabilities. As for the relationship of serum IL-6 with CGA variables, the strongest correlations were between IL-6 and functional status assessed by both Katz ADL (p=0.0003), IADL (p=0.0070) and nutrition (p=0.0013). Moreover, we observed an association, although not statistically significant, between functional disability (ADL and IADL) and high IL-6 levels in individuals with weight loss. IL-6 levels seem to be independently associated with all CGA variables investigated in the present study in a population of elderly cancer patients. Because the most important CGA variables, in particular functional status, have been observed to be strongly associated with survival, the present study, confirming our previously reported ones, suggests that IL-6 may be a reliable marker of disease outcome and supports the feasibility of using IL-6 as a sensitive outcome marker in studies based on novel approaches aiming at modifying age- and cancer-related biologic mechanisms
Correlation between both serum osteopontin/osteonectin and bone remodelling parameters, inflammatory/metabolic variables and survival in metastatic cancer patients with tumors at different sites
No full textOsteopontin (OPN) is a secreted, integrin-binding phosphoprotein
that has been correlated with tumor grade and stage and
disease progression in several tumor types.The secreted protein, acidic and rich in cystein (SPARC)
is closely related to progression, invasion, angiogenesis and metastatic
process of several malignant tumors. The aim of the study was to verify
in a population of advanced cancer patients with tumors at different sites
whether there is a correlation between circulating levels of OPN and SPARCand clinical parameters (such as bone metastases, pain and quality of life),
circulating bone remodeling (skeletal) parameters (alkaline phosphatase,
C- and N-terminal fragments of type I collagen, osteocalcin, Vitamin D),
inflammatory (IL-8 and TNF-alpha) and metabolic parameters (BMI, serum
cholesterol and triglycerides).
Materials and Methods: From April 2010 to August 2010, we enrolled
33 metastatic cancer patients with tumors at different sites (M/F: 16/17,
mean age 66 years): 17 patients with bone metastases, 16 with metastases
not involving bone. Comparison between groups (controls vs cancer
patients and cancer patients with vs without bone metastases) was
performed by two-sided Student’s t test. Correlation between OPN/SPARC
and the other variables was performed by Spearman’s correlation analysis.
Results: OPN and SPARC in cancer patients were significantly higher
compared to controls but did not differ between patients with or without
bone metastases. OPN showed a positive significant correlation with C and
N terminal fragments of type I collagen (r = 0.390 and r = 0.410, p = 0.024
for both), IL-8 (r = 0.390, p = 0.034) and a negative significant correlation
with quality of life (r = −0.400, p = 0.025) and BMI (r = −0.300, p = 0.046).
SPARC showed a positive significant correlation with BMI (r = 0,360,
p = 0.049). Moreover, patients with 3 month survival (613.7±229.2 ng/ml
versus 195.8±165 ng/ml, p < 0.001).
Conclusion: The results of the present study show that high OPN levels
are associated with poor survival in advanced cancer patients. Further
studies are warranted to assess the role of OPN and SPARC to both
monitor the effects of antineoplastic regimens and to assess them as
potential targets of new treatment strategies
Muscle wasting in cancer and ageing: Cachexia versus sarcopenia
No full textThe aim of this chapter is to summarize and evaluate the different mechanisms and catabolic mediators involved in cancer cachexia and ageing sarcopenia since they may represent targets for future promising clinical investigations. Cancer cachexia is a syndrome characterized by a marked weight loss, anorexia, asthenia and anemia. In fact, many patients who die with advanced cancer suffer from cachexia. The degree of cachexia is inversely correlated with the survival time of the patient and it always implies a poor prognosis. Unfortunately, at the clinical level, cachexia is not treated until the patient suffers from a considerable weight loss and wasting. At this point, the cachectic syndrome is almost irreversible. The cachectic state is often associated with the presence and growth of the tumour and leads to a malnutrition status due to the induction of anorexia. In recent years, age-related diseases and disabilities have become of major health interest and importance. This holds particularly for muscle wasting, also known as sarcopenia, that decreases the quality of life of the geriatric population, increasing morbidity and decreasing life expectancy. The cachectic factors (associated with both depletion of fat stores and muscular tissue) can be divided into two categories: of tumour origin and humoural factors. In conclusion, more research should be devoted to the understanding of muscle wasting mediators, both in cancer and ageing, in particular the identification of common mediators may prove as a good therapeutic strategies for both prevention and treatment of wasting both in disease and during healthy ageing
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