Acta Oncologica最新文献

{"title":"The time has come for national clinical practice guidelines for managing late effects after cancer and cancer treatment.","authors":"Robert Zachariae, Peer Christiansen, Ali Amidi, Lisa Wu, Lise Ventzel, Nina Tauber, Annika Von Heymann, Bolette Skjødt Rafn, Janne Fassov, Therese Juul, Peter Christensen, Christoffer Johansen","doi":"10.2340/1651-226X.2024.40787","DOIUrl":"10.2340/1651-226X.2024.40787","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"491-493"},"PeriodicalIF":2.7,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acta Oncologica Nordic Precision Cancer Medicine Symposium 2023 - merging clinical research and standard healthcare.","authors":"Elisa Bjørgo, Gro L Fagereng, Hege G Russnes, Sigbjørn Smeland, Kjetil Taskén, Åslaug Helland","doi":"10.2340/1651-226X.2024.24954","DOIUrl":"10.2340/1651-226X.2024.24954","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"487-490"},"PeriodicalIF":2.7,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capecitabine monotherapy as first-line treatment in advanced HER2-normal breast cancer - a nationwide, retrospective study.","authors":"Alan Celik, Tobias Berg, Magnus Gibson, Maj-Britt Jensen, Iben Kümler, Saskia Eßer-Naumann, Erik H Jakobsen, Ann Knoop, Dorte Nielsen","doi":"10.2340/1651-226X.2024.38886","DOIUrl":"10.2340/1651-226X.2024.38886","url":null,"abstract":"<p><p>Background and purpose: Capecitabine can be used as first-line treatment for advanced breast cancer. However, real-world data on efficacy of capecitabine in this setting is sparse. The purpose of the study is to evaluate outcomes of patients with Human Epidermal Growth Factor Receptor (HER2)-normal advanced breast cancer treated with capecitabine monotherapy as first-line treatment.</p><p><strong>Material and methods: </strong>The study utilized the Danish Breast Cancer Group (DBCG) database and was conducted retrospectively across all Danish oncology departments. Inclusion criteria were female patients, with HER2-normal advanced breast cancer treated with capecitabine monotherapy as the first-line treatment from 2010 to 2020. The primary endpoints were overall survival (OS) and progression-free survival (PFS).</p><p><strong>Results: </strong>A total of 494 patients were included. Median OS was 16.4 months (95% confidence interval [CI]: 14.5-18.0), and median PFS was 6.0 months (95% CI: 5.3-6.7). Patients with estrogen receptor (ER)-positive disease had significantly longer OS (median: 22.8 vs. 10.5 months, p < 0.001) and PFS (median: 7.4 vs. 4.9 months, p = 0.003), when compared to ER-negative patients. Stratifying by age, patients under 45 years displayed a median PFS of 4.1 months, while those aged 45-70 years and over 70 years had median PFS of 5.7 and 7.2 months, respectively (p = 0.01).</p><p><strong>Interpretation: </strong> In this nationwide study, the efficacy of capecitabine as a first-line treatment for HER2-normal advanced breast cancer is consistent with other, mainly retrospective, studies. However, when assessed against contemporary and newer treatments, its effectiveness appears inferior to alternative chemotherapies or targeted therapies.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"494-502"},"PeriodicalIF":2.7,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parenting under pressure: a cross-sectional questionnaire study of psychological distress, parenting concerns, self-efficacy, and emotion regulation in parents with cancer.","authors":"Maria Romare Strandh, Pia Enebrink, Karin Stålberg, Renita Sörensdotter, Lisa Ljungman, Anna Wikman","doi":"10.2340/1651-226X.2024.40404","DOIUrl":"10.2340/1651-226X.2024.40404","url":null,"abstract":"<p><strong>Background and purpose: </strong>As many as one in four adults with cancer have children under 18 years. Balancing parenting and cancer is challenging and can be a source of psychological distress. This study aimed to examine psychological distress in parents with cancer and its associations with parenting concerns, self-efficacy, and emotion regulation.</p><p><strong>Materials and methods: </strong>This was a cross-sectional questionnaire study of 406 parents (aged 25-60 years) diagnosed with cancer within the last 5 years, with at least one dependent child (≤ 18 years). Parents completed questionnaires on psychological distress (DASS-21), parenting concerns (PCQ), self-efficacy (GSE), emotion regulation (ERQ), mental and physical health, and sociodemographics. Data were analysed using multiple logistic regressions on depression (yes/no), anxiety (yes/no), and stress (yes/no).</p><p><strong>Results: </strong>Higher parenting concerns were associated with greater odds of depression (OR = 2.33, 95% CI: 1.64-3.31), anxiety (OR = 2.30, 95% CI: 1.64-3.20), and stress (OR = 3.21, 95% CI: 2.20-4.69) when adjusting for health and sociodemographic factors. Poorer self-efficacy was associated with increased odds of anxiety (OR = 0.94, 95% CI: 0.89-0.99, p < 0.05), whereas lower use of cognitive reappraisal and higher use of expressive suppression increased the odds of depression (OR = 0.76, 95% CI: 0.59-0.98 | OR = 1.46, 95% CI: 1.18-1.80).</p><p><strong>Interpretation: </strong>The findings highlight the complexity of parental well-being in relation to parenthood and cancer, stressing the need for interventions that address relevant psychological factors to improve overall mental health in this population.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"468-476"},"PeriodicalIF":2.7,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the use of a clinically implemented deep learning segmentation model with the simulated study setting for breast cancer patients receiving radiotherapy.","authors":"Nienke Bakx, Maurice Van der Sangen, Jacqueline Theuws, Johanna Bluemink, Coen Hurkmans","doi":"10.2340/1651-226X.2024.34986","DOIUrl":"10.2340/1651-226X.2024.34986","url":null,"abstract":"<p><strong>Background: </strong>Deep learning (DL) models for auto-segmentation in radiotherapy have been extensively studied in retrospective and pilot settings. However, these studies might not reflect the clinical setting. This study compares the use of a clinically implemented in-house trained DL segmentation model for breast cancer to a previously performed pilot study to assess possible differences in performance or acceptability.</p><p><strong>Material and methods: </strong>Sixty patients with whole breast radiotherapy, with or without an indication for locoregional radiotherapy were included. Structures were qualitatively scored by radiotherapy technologists and radiation oncologists. Quantitative evaluation was performed using dice-similarity coefficient (DSC), 95th percentile of Hausdorff Distance (95%HD) and surface DSC (sDSC), and time needed for generating, checking, and correcting structures was measured.</p><p><strong>Results: </strong>Ninety-three percent of all contours in clinic were scored as clinically acceptable or usable as a starting point, comparable to 92% achieved in the pilot study. Compared to the pilot study, no significant changes in time reduction were achieved for organs at risks (OARs). For target volumes, significantly more time was needed compared to the pilot study for patients including lymph node levels 1-4, although time reduction was still 33% compared to manual segmentation. Almost all contours have better DSC and 95%HD than inter-observer variations. Only CTVn4 scored worse for both metrics, and the thyroid had a higher 95%HD value.</p><p><strong>Interpretation: </strong>The use of the DL model in clinical practice is comparable to the pilot study, showing high acceptability rates and time reduction.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"477-481"},"PeriodicalIF":2.7,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robust optimization of the Gross Tumor Volume compared to conventional Planning Target Volume-based planning in photon Stereotactic Body Radiation Therapy of lung tumors.","authors":"Thomas L Fink, Charlotte Kristiansen, Torben S Hansen, Torben F Hansen, Rune S Thing","doi":"10.2340/1651-226X.2024.40049","DOIUrl":"10.2340/1651-226X.2024.40049","url":null,"abstract":"<p><strong>Background: </strong>Robust optimization has been suggested as an approach to reduce the irradiated volume in lung Stereotactic Body Radiation Therapy (SBRT). We performed a retrospective planning study to investigate the potential benefits over Planning Target Volume (PTV)-based planning.</p><p><strong>Material and methods: </strong>Thirty-nine patients had additional plans using robust optimization with 5-mm isocenter shifts of the Gross Tumor Volume (GTV) created in addition to the PTV-based plan used for treatment. The optimization included the mid-position phase and the extreme breathing phases of the 4D-CT planning scan. The plans were compared for tumor coverage, isodose volumes, and doses to Organs At Risk (OAR). Additionally, we evaluated both plans with respect to observed tumor motion using the peak tumor motion seen on the planning scan and cone-beam CTs.</p><p><strong>Results: </strong>Statistically significant reductions in irradiated isodose volumes and doses to OAR were achieved with robust optimization, while preserving tumor dose. The reductions were largest for the low-dose volumes and reductions up to 188 ccm was observed. The robust evaluation based on observed peak tumor motion showed comparable target doses between the two planning methods. Accumulated mean GTV-dose was increased by a median of 4.46 Gy and a non-significant increase of 100 Monitor Units (MU) was seen in the robust optimized plans.</p><p><strong>Interpretation: </strong>The robust plans required more time to prepare, and while it might not be a feasible planning strategy for all lung SBRT patients, we suggest it might be useful for selected patients.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"448-455"},"PeriodicalIF":2.7,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study of microRNAs as new prognostic biomarkers in anal cancer patients.","authors":"Olav Dahl, Mette Pernille Myklebust","doi":"10.2340/1651-226X.2024.27976","DOIUrl":"10.2340/1651-226X.2024.27976","url":null,"abstract":"<p><strong>Background: </strong>MicroRNA (MiR) influences the growth of cancer by regulation of mRNA for 50-60% of all genes. We present as per our knowledge the first global analysis of microRNA expression in anal cancer patients and their prognostic impact.</p><p><strong>Methods: </strong>Twenty-nine patients with T1-4 N0-3 M0 anal cancer treated with curative intent from September 2003 to April 2011 were included in the study. RNA was extracted from fresh frozen tissue and sequenced using NGS. Differentially expressed microRNAs were identified using the R-package DEseq2 and the endpoints were time to progression (TTP) and cancer specific survival (CSS).</p><p><strong>Results: </strong>Five microRNAs were significantly associated with 5-year progression free survival (PFS): Low expression of two microRNAs was associated with higher PFS, miR-1246 (100% vs. 55.6%, p = 0.008), and miR-135b-5p (92.9% vs. 59.3%, p = 0.041). On the other hand, high expressions of three microRNAs were associated with higher PFS, miR-148a-3p (93.3% vs. 53.6%, p = 0.025), miR-99a-5p (92.9% vs. 57.1%, p = 0.016), and let-7c-3p (92.9% vs. 57.1%, p = 0.016). Corresponding findings were documented for CSS.</p><p><strong>Interpretation: </strong>Our study identified five microRNAs as prognostic markers in anal cancer. MiR-1246 and microRNA-135b-5p were oncoMiRs (miRs with oncogene effects), while miR-148a-3p, miR- 99a-5p, and let-7c-3p acted as tumour suppressors in anal cancer patients.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"456-465"},"PeriodicalIF":2.7,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary to 'Incidence of vestibular schwannoma in Finland, 1990-2017' Pediatric vestibular schwannomas: an overlooked epidemiological aspect?","authors":"Gabriele Gaggero","doi":"10.2340/1651-226X.2024.40652","DOIUrl":"10.2340/1651-226X.2024.40652","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"466-467"},"PeriodicalIF":2.7,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical trials in older patients with cancer - typical challenges, possible solutions, and a paradigm of study design in breast cancer.","authors":"Peeter Karihtala, Aglaia Schiza, Elena Fountzilas, Jürgen Geisler, Icro Meattini, Emanuela Risi, Laura Biganzoli, Antonios Valachis","doi":"10.2340/1651-226X.2023.40365","DOIUrl":"10.2340/1651-226X.2023.40365","url":null,"abstract":"<p><strong>Background and purpose: </strong>While the prevalence of older breast cancer patients is rapidly increasing, these patients are greatly underrepresented in clinical trials. We discuss barriers to recruitment of older patients to clinical trials and propose solutions on how to mitigate these challenges and design optimal clinical trials through the paradigm of IMPORTANT trial.</p><p><strong>Patients and methods: </strong>This is a narrative review of the current literature evaluating barriers to including older breast cancer patients in clinical trials and how mitigating strategies can be implemented in a pragmatic clinical trial.</p><p><strong>Results: </strong>The recognized barriers can be roughly divided into trial design-related (e.g. the adoption of strict inclusion criteria, the lack of pre-specified age-specific analysis), patient-related (e.g. lack of knowledge, valuation of the quality-of-life instead of survival, transportation issues), or physician-related (e.g. concern for toxicity). Several strategies to mitigate barriers have been identified and should be considered when designing a clinical trial dedicated to older patients with cancer. The pragmatic, de-centralized IMPORTANT trial focusing on dose optimization of CDK4/6 -inhibitors in older breast cancer patients is a paradigm of a study design where different mitigating strategies have been adopted.</p><p><strong>Interpretation: </strong>Because of the existing barriers, older adults in clinical trials are considerably healthier than the average older patients treated in clinical practice. Thus, the study results cannot be generalized to the older population seen in daily clinical practice. Broader inclusion/exclusion criteria, offering telehealth visits, and inclusion of patient-reported, instead of physician-reported outcomes may increase older patient participation in clinical trials.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"441-447"},"PeriodicalIF":2.7,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Quality of Life in Danish Cancer Survivors Referred to a Late Effects Clinic: A Prospective Cohort Study.","authors":"Lærke Kjær Tolstrup, Karin B Dieperink, Marieke Van Leeuwen, Sören Möller, Linnea Fechner, Line Helene Clausen, Thea Otto Mattsson","doi":"10.2340/1651-226X.2024.39937","DOIUrl":"10.2340/1651-226X.2024.39937","url":null,"abstract":"<p><strong>Purpose: </strong>The Region of Southern Denmark has recently established four late effects clinics to help cancer survivors suffering from complex and severe late effects. This study aimed to capture and analyze the full range of physical, mental, and psychosocial issues using patient-reported outcomes. Moreover, we aimed to describe demographic data and the type and severity of the late effects.</p><p><strong>Methods: </strong>A prospective cohort study was conducted among cancer survivors referred to a late effects clinic. Before their first appointment, patients completed the European Organization for Research and Treatment of Cancer Quality of Life cancer survivorship core questionnaire (EORTC QLQ-SURV100). We compared mean scores of the EORTC QLQ-SURV100 scales that were comparable to the scales/items from the EORTC QLQ-C30 questionnaire with norm data for the Danish population and EORTC reference values.</p><p><strong>Results: </strong>All patients referred to the clinic within its first 2 years were included (n = 247). The mean age was 57 [23-85] years and 74% were females. The most common cancer diagnoses was breast cancer (39%). The five most commonly reported late effects were fatigue (66%), pain (51%), cognitive impairment (53%), sleep problems (42%), and neuropathy (40%). A total of 236 of the patients entering the clinic completed QLQ-SURV100. They reported significantly worse mean scores on all scales compared to the Danish norm population and EORTC reference values for pretreatment cancer patients, p < 0.001. Effect sizes were moderate or large for all scales.</p><p><strong>Interpretation: </strong>In this study, we collected demographic data and described the late effects presented by the patents referred to the clinic. Moreover, we captured and analyzed the full range of physical, mental, and psychosocial issues using QLQ-SURV100. Patients referred to the Late Effects Clinic (LEC) had a number of late effects and reported a significantly lower health-related quality of life compared to the general Danish population and patients who have just been diagnosed with cancer, suggesting the aim of helping patients suffering from late effects gain a better quality of life is in dire need.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"63 ","pages":"426-432"},"PeriodicalIF":2.7,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11332500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}