86 research outputs found
Whole brain radiotherapy for brain metastases from breast cancer: estimation of survival using two stratification systems
BACKGROUND: Brain metastases (BM) are the most common form of intracranial cancer. The incidence of BM seems to have increased over the past decade. Recursive partitioning analysis (RPA) of data from three Radiation Therapy Oncology Group (RTOG) trials (1200 patients) has allowed three prognostic groups to be identified. More recently a simplified stratification system that uses the evaluation of three main prognostics factors for radiosurgery in BM was developed. METHODS: To analyze the overall survival rate (OS), prognostic factors affecting outcomes and to estimate the potential improvement in OS for patients with BM from breast cancer, stratified by RPA class and brain metastases score (BS-BM). From January 1996 to December 2004, 174 medical records of patients with diagnosis of BM from breast cancer, who received WBRT were analyzed. The surgery followed by WBRT was used in 15.5% of patients and 84.5% of others patients were submitted at WBRT alone; 108 patients (62.1%) received the fractionation schedule of 30 Gy in 10 fractions. Solitary BM was present in 37.9 % of patients. The prognostic factors evaluated for OS were: age, Karnofsky Performance Status (KPS), number of lesions, localization of lesions, neurosurgery, chemotherapy, absence extracranial disease, RPA class, BS-BM and radiation doses and fractionation. RESULTS: The OS in 1, 2 and 3 years was 33.4 %, 16.7%, and 8.8 %, respectively. The RPA class analysis showed strong relation with OS (p < 0.0001). The median survival time by RPA class in months was: class I 11.7, class II 6.2 and class III 3.0. The significant prognostic factors associated with better OS were: higher KPS (p < 0.0001), neurosurgery (P < 0.0001), single metastases (p = 0.003), BS-BM (p < 0.0001), control primary tumor (p = 0.002) and absence of extracranial metastases (p = 0.001). In multivariate analysis, the factors associated positively with OS were: neurosurgery (p < 0.0001), absence of extracranial metastases (p <0.0001) and RPA class I (p < 0.0001). CONCLUSION: Our data suggests that patients with BM from breast cancer classified as RPA class I may be effectively treated with local resection followed by WBRT, mainly in those patients with single BM, higher KPS and cranial extra disease controlled. RPA class was shown to be the most reliable indicators of survival
Radiotherapeutic alternatives for previously irradiated recurrent gliomas
Re-irradiation for recurrent gliomas has been discussed controversially in the past. This was mainly due to only marginal palliation while being associated with a high risk for side effects using conventional radiotherapy
Impact of therapy on quality of life, neurocognitive function and their correlates in glioblastoma multiforme: a review
The maintenance of quality of life (QoL) in patients with high-grade glioma is an important endpoint during treatment, particularly in those with glioblastoma multiforme (GBM) given its dismal prognosis despite limited advances in standard therapy. It has proven difficult to identify new therapies that extend survival in patients with recurrent GBM, so one of the primary aims of new therapies is to reduce morbidity, restore or preserve neurologic functions, and the capacity to perform daily activities. Apart from temozolomide, cytotoxic chemotherapeutic agents do not appear to significantly impact response or survival, but produce toxicity that is likely to negatively impact QoL. New biological agents, such as bevacizumab, can induce a clinically meaningful proportion of durable responses among patients with recurrent GBM with an acceptable safety profile. Emerging evidence suggests that bevacizumab produces an improvement or preservation of neurocognitive function in GBM patients, suggestive of QoL improvement, in most poor-prognosis patients who would otherwise be expected to show a sudden and rapid deterioration in QoL
Iodine-125 brachytherapy for brain tumours - a review
Iodine-125 brachytherapy has been applied to brain tumours since 1979. Even though the physical and biological characteristics make these implants particularly attractive for minimal invasive treatment, the place for stereotactic brachytherapy is still poorly defined
Antiangiogenic agents in the treatment of recurrent or newly diagnosed glioblastoma: Analysis of single-agent and combined modality approaches
Surgical resection followed by radiotherapy and temozolomide in newly diagnosed glioblastoma can prolong survival, but it is not curative. For patients with disease progression after frontline therapy, there is no standard of care, although further surgery, chemotherapy, and radiotherapy may be used. Antiangiogenic therapies may be appropriate for treating glioblastomas because angiogenesis is critical to tumor growth. In a large, noncomparative phase II trial, bevacizumab was evaluated alone and with irinotecan in patients with recurrent glioblastoma; combination treatment was associated with an estimated 6-month progression-free survival (PFS) rate of 50.3%, a median overall survival of 8.9 months, and a response rate of 37.8%. Single-agent bevacizumab also exceeded the predetermined threshold of activity for salvage chemotherapy (6-month PFS rate, 15%), achieving a 6-month PFS rate of 42.6% (p < 0.0001). On the basis of these results and those from another phase II trial, the US Food and Drug Administration granted accelerated approval of single-agent bevacizumab for the treatment of glioblastoma that has progressed following prior therapy. Potential antiangiogenic agents-such as cilengitide and XL184-also show evidence of single-agent activity in recurrent glioblastoma. Moreover, the use of antiangiogenic agents with radiation at disease progression may improve the therapeutic ratio of single-modality approaches. Overall, these agents appear to be well tolerated, with adverse event profiles similar to those reported in studies of other solid tumors. Further research is needed to determine the role of antiangiogenic therapy in frontline treatment and to identify the optimal schedule and partnering agents for use in combination therapy
Sedentary behavior among Spanish children and adolescents: findings from the ANIBES study
Background: An increase of sedentary behaviors far from the Mediterranean lifestyle is happening in spite of the
impact on health. The aims of this study were to describe sedentary behaviors in children and adolescents.
Methods: A representative sample of 424 Spanish children and adolescents (38% females) involved in the ANIBES
study was analyzed regarding their sedentary behaviors, together with the availability of televisions, computers, and
consoles by means of the HELENA sedentary behavior questionnaire.
Results: For the total sample of children, 49.3% during weekdays and 84% during weekends did not meet the
recommendation of less than 2 hours of screen viewing per day. The use of TV was higher during weekdays
(p < 0.05) and there were significant differences between adolescents and children (16.9 vs. 25.1%, p < 0.05). The use
of computer, console games and of internet for non-study reasons was higher during weekends (p < 0.001).
Adolescents played more computer games and used more internet for non-study reasons than children during
both weekdays and weekends (p < 0.05 and p < 0.001, respectively). The use of internet for academic reasons was
lower in children (p < 0.001) than adolescents during weekends; however, no significant differences were found
between sexes. In addition, more than 30% of the children and adolescents had at least one electronic device in
their bedrooms.
Conclusions: Spanish children and adolescents are not meeting the recommendations regarding the maximum of
screen viewing (<2 h/day), especially during the weekend, for all of sedentary behaviors. Urgent strategies and
intervention studies are needed to reduce sedentary behavior in young people.The ANIBES study was financially supported by a grant from Coca-Cola Iberia
through an agreement with the Spanish Nutrition Foundation (FEN). The
funding sponsors had no role in the design of the study, in the collection,
analyses, or interpretation of the data; in the writing of the manuscript, and
in the decision to publish the results
Effects of an exercise program on hepatic metabolism, hepatic fat, and cardiovascular health in overweight/obese adolescents from Bogotá, Colombia (the HEPAFIT study): study protocol for a randomized controlled trial
Background: A considerable proportion of contemporary youth have a high risk of obesity-related disorders such
as cardiovascular disease, metabolic syndrome, or non-alcoholic fatty liver disease (NAFLD). Although there is consistent
evidence for the positive effects of physical activity on several health aspects, most adolescents in Colombia are
sedentary. It is, therefore, important to implement strategies that generate changes in lifestyle. The HEPAFIT study
aims to examine whether a 6-month exercise program has benefits for hepatic fat content and cardiovascular health
outcomes among overweight/obese adolescents from Bogotá, Colombia.
Methods/design: Altogether, 100 hundred overweight/obese, sedentary adolescents (aged 11–17 years) attending two
public schools in Bogotá, Colombia, will be included in a parallel-group randomized controlled trial. Adolescents will be
randomly assigned to an intervention group following one of four curricula: (1) the standard physical education
curriculum (60 min per week of physical activity, n = 25) at low-to-moderate intensity; (2) a high-intensity physical
education curriculum (HIPE, n = 25), consisting of endurance and resistance games and non-competitive activities,
such as running, gymkhanas, lifting, pushing, wrestling, or hauling, for 60-min sessions, three times per week, with
an energy expenditure goal of 300 to 500 kcal/session at 75–85% maximum heart rate (HRmax); (3) a low-to-moderate
intensity physical education curriculum (LIPE, n = 25) consisting of endurance and resistance games and non-competitive
activities (e.g., chasing, sprinting, dribbling, or hopping) for 60-min sessions, three times per week with an energy
expenditure goal of 300 kcal/session at 55–75% HRmax; and (4) a combined HIPE and LIPE curriculum (n = 25).
The HIPE, LIPE, and combined interventions were performed in addition to the standard physical education curriculum.
The primary outcome for effectiveness is liver fat content, as measured by the controlled attenuation parameter 1
week after the end of the intervention program.
Discussion: The translational focus may be suitable for collecting new information in a school setting on the
possible effects of physical activity interventions to reduce liver fat content and to improve metabolic profiles
and the cardiometabolic health of overweight/obese adolescents. This may lead to the more efficient use of
school physical education resources.The HEPAFIT study was carried out with the financial support of Instituto
Colombiano para el Desarrollo de la Ciencia y la Tecnología “Francisco José
de Caldas” COLCIENCIAS (code 59700 and no 122277757900). Katherine
González-Ruíz receive a scholarship from Universidad del Rosario, Colombia,
Escuela de Medicina y Ciencias de la Salud, to do a Doctorate. This article
presents independent research commissioned by COLCIENCIAS under its
Program Grants for Applied Research funding scheme (Convocatoria 777–2017)
- …