Radiation Duration in Women with Cervical Cancer Treated with Primary Chemoradiation: A Population-Based Analysis

<p>This study examines factors associated with prolonged radiation duration and its impact on survival in women with cervical cancer treated with primary chemoradiation. Women in the National Cancer Database with stage IB2-IVA cervical cancer from 2003 to 2011 who received radiation and chemotherapy were included. Of 7209 women, who met inclusion criteria, 3401 (47.1%) and 3808 (52.8%) completed radiation in ≤ 8 and > 8 weeks, respectively. There was no overall survival difference for radiation duration ≤ 8 vs. > 8 weeks. Sensitivity analyses showed that inferior overall survival is only seen with radiation duration of > 10–12 weeks.</p

Predictors of Interventional Treatment Use for Venous Thromboembolism in Cancer Patients

<p>Venous thromboembolic disease is a major cause of morbidity in cancer patients. The Perspective database was used to identify patients with solid tumors and a diagnosis of VTE from 2006 to 2012. We examined use of IVC filters, thrombolysis, and thrombectomy. Among 32,545 patients, 23.1% received an IVC filter, 1.9% thrombolytic therapy, and 0.4% underwent thrombectomy. Use of IVC filters decreased between 2006 and 2012 (23.4% to 21.2%, <i>p</i> = 0.012). Older patients, uninsured patients, Hispanics, and those with more comorbidities were more likely to undergo filter placement while patients at rural hospitals were less likely to receive an IVC filter (<i>p</i> < 0.05 for all).</p

Safety, Utilization, and Cost of Image-Guided Percutaneous Liver Biopsy Among Cancer Patients

<p>Image-guided percutaneous liver biopsy (PLB) is a diagnostic tool for lesions in the liver. Hemorrhage is the most common complication. We selected patients with a diagnostic claim for cancer who had undergone PLB. There were a total of 26,941 patients who underwent PLB. Hemorrhage risk was 1.43% among patients undergoing PLB. When stratified by setting, odds of hemorrhage were 4.5 times higher when biopsy was performed in an inpatient setting (<i>p</i> < .001). Risk factors associated with hemorrhage included marital status, liver cancer and comorbidity score. The use of PLB has increased over time. Reassuringly, the hemorrhage risk associated with PLB is low.</p

Statistical analysis of different protein lists using the Qlucore Omics Explorer.

<p>(A). Principal Component Analysis (PCA) of proteins identified in the serum exosome from baseline and endpoint blood draws for Group 1 (>20% increase in neuropathy) and Group 2 (no change in neuropathy). (B). PCA of proteins identified in the unique peptide-based list (left) and unsupervised hierarchical clustering of the unique peptide-based protein signature (right).</p

Pro-inflammatory signaling was identified in the exosomal proteins expressed at higher levels in the group 2 breast cancer patients (taxane treated and no change in neuropathy) based on the upstream analysis of IPA.

<p>(A). Higher levels of IL-6 targets found in the group 2 breast cancer patients compared to the group 1 breast cancer patients. P-value of the prediction is listed next to the upstream regulator, IL-6. (B). Interacting networks of C/EBPβ signaling proteins found in the group 2 breast cancer patients and their predicted physiological functions. (C). Scatter plots of representative proteins in the pro-inflammatory signaling networks in group 1 and 2 breast cancer patients and their expression in two time points (T0 and T12). T0 represents the baseline blood draws, and T12 represents the endpoint blood draws. Spectral counts of these proteins in patients were represented in the linear log scale (ln). p-values are included in the comparison between the group 1 and group 2 patients at the baseline. (D). Peak area of a peptide, HYEGSTVPEK (2+), from haptoglobin (HP) showed higher level of expression in group 2 patients than in group 1 patients. Significantly different proteins (q<0.2) were marked by *.</p

Pathway analysis of exosomal proteins expressed at higher levels in the group 2 breast cancer patients (taxane treated and no change in neuropathy) derived from Ingenuity Pathway Analysis (IPA).

<p>(A). Top 10 canonical pathways emerged after IPA core analysis. Threshold indicates the minimal significance level [scored as–log (B-H p-value) from Benjamini-Hochberg procedure for multiple testing correction]. (B). Overlapping canonical pathways that were significantly enriched in this dataset. B-H p-value was listed below each pathway. (C). Network #1 from significantly enriched canonical pathways displaying proteins involved in the network. Proteins identified in the network were colored in red. Blue lines connected interacting proteins in the Coagulation System. (D). Network #1 from significantly enriched canonical pathways displaying proteins involved in the network. Proteins identified in the network were colored in red. Blue lines connected interacting proteins in the Acute Phase Response Signaling. (E). Network #2 from significantly enriched canonical pathways displaying proteins involved in the network. Proteins identified in the network were colored in red. Blue lines connected interacting proteins in the Acute Phase Response Signaling. (F). Network #2 from significantly enriched canonical pathways displaying proteins involved in the network. Proteins identified in the network were colored in red. Blue lines connected interacting proteins in the IL-12 signaling and production in macrophages. Significantly different proteins (q<0.2) were marked by *.</p

Baseline characteristics in relation to any fracture before breast cancer (BC) diagnosis in aromatase inhibitor (AI) users.

<p>NOTE: Pharmacy data through December 31, 2013.</p>1<p> Logistic regression adjusted for age, race/ethnicity, menopausal status, and year of breast cancer diagnosis.</p>2<p> Median (physical activity) = 20.9 metabolic equivalent (MET)-hours/week; median (alcohol intake) = 3.1 g/day.</p><p>Baseline characteristics in relation to any fracture before breast cancer (BC) diagnosis in aromatase inhibitor (AI) users.</p

Baseline characteristics of study cohort by initial use of aromatase inhibitor (AI) or tamoxifen (TAM).

<p>NOTE: Pharmacy data through December 31, 2013; Missing data for entire cohort: menopausal status (n = 9), BMI (n = 28), smoking (n = 13), alcohol (n = 552), vitamin supplements (n = 37).</p>1<p> Logistic regression adjusted for age at breast cancer diagnosis as a continuous variable.</p>2<p> Median (overall) = 3.10 g/day, median (postmenopausal women) = 2.90 g/day.</p>3<p> Osteoporosis defined by ICD-9 code (733.00–733.09) or any prior bisphosphonate prescription.</p>4<p> Major fracture includes fracture of spine, humerus, wrist, or hip.</p><p>Baseline characteristics of study cohort by initial use of aromatase inhibitor (AI) or tamoxifen (TAM).</p

Baseline characteristics in relation to osteoporosis¹ before breast cancer diagnosis (BC) in aromatase inhibitor (AI) users.

<p>NOTE: Pharmacy data through December 31, 2013.</p>1<p> Osteoporosis defined by ICD-9 code (733.00–733.09) or any prior bisphosphonate prescription.</p>2<p> Logistic regression adjusted for age, race/ethnicity, menopausal status, and year of breast cancer diagnosis.</p>3<p> Median (physical activity) = 20.9 metabolic equivalent (MET)-hours/week; median (alcohol intake) = 3.1 g/day.</p><p>Baseline characteristics in relation to osteoporosis^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0111477#nt107" target="_blank">1</a>} before breast cancer diagnosis (BC) in aromatase inhibitor (AI) users.</p

Baseline characteristics in relation to major fracture¹ before breast cancer (BC) diagnosis in aromatase inhibitor (AI) users.

<p>NOTE: Pharmacy data through December 31, 2013.</p>1<p> Major fracture includes fracture of spine, humerus, wrist, or hip.</p>2<p> Logistic regression adjusted for age, race/ethnicity, menopausal status, and year of breast cancer diagnosis.</p>3<p> Median (physical activity) = 20.9 metabolic equivalent (MET)-hours/week; median (alcohol intake) = 3.1 g/day.</p><p>Baseline characteristics in relation to major fracture^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0111477#nt114" target="_blank">1</a>} before breast cancer (BC) diagnosis in aromatase inhibitor (AI) users.</p