5 research outputs found
Inmate cancer patients – highlighting the importance of a holistic approach to oncological care
Purpose: Inmate oncologic patients' rates increased drastically worldwide. Elderly, limited exercise, unhealthy diet, hepatitis, HIV+ status, tobacco and alcohol use, constitute the main cancer risk factors. We present an outline of practical oncological management and ethical thinking, in the specific environment of a detention facility. Methods: PubMed, Cochrane Database of Controlled Trials, SCOPUS and grey literature were extensively searched upto October 2021. Ιncarcerated oncologic patients experiencevarious everyday challenges:their confinement in high securityfacilities, the lack of access to critical care and related ethicaldilemmas inherent to the context of a correctional facility. Results: The detention facilities may be inadequate in providing early cancer diagnosis and appropriate care mainlydue to a lack of specialized personnel, b) in-house or in external specialized cancer hospitals, care variability (e.g. admissions in small local or regional hospitals), c) delays inproviding access and d) gatekeeper systems. There is a paucity of administration of a) systemic therapy(chemotherapy, targeted drug therapy etc), b) radiotherapy, c)palliative care, and d) enrollment in clinical trials. Conclusions: Correctional facilities must encourage teamwork between healthcare and correctional professionals inorder to improve the provided anticancer care
Impact of Radiation Therapy on Pain Relief of Cancer Patients Affected by on Malignant Psoas Syndrome: 26 Years of Experience
Aim: The malignant psoas syndrome (MPS) is a rare and complex
cancer-related clinical entity, with a significant impact on cancer
patients' quality of life. The literature describing malignant
infiltration of the psoas muscle as well as its management is limited.
The primary endpoint of the study was the assessment of pain relief in
symptomatic terminal-stage MPS patients. Materials and Methods: Patients
underwent hypofractionated (two- or three-dimensional conformal)
radiotherapy as palliative treatment. A dose of 42.5 Gy in 17 daily
fractions (2.5 Gy/fraction) was prescribed. Pain response was measured
before 3 and 6 months after radiation delivery. Results: Between May
1992 and April 2019, eight patients were treated. The median age was 75
years (range: 59-87 years). All patients had distant metastatic disease
at the time of treatment. We found a significant pain relief (median
duration of response of 105 days) and an improvement in health-related
quality of life. Conclusions: Radiotherapy had a favorable outcome and
can be considered an effective analgesic treatment in case of painful
MPS
Prognostic Value of MRS Metabolites in Postoperative Irradiated High Grade Gliomas
Purpose. We studied the prognostic significance of Magnetic Resonance
Spectroscopy (MRS) in operated high grade gliomas. Materials and
Methods. Twelve patients were treated with radiotherapy and
Temozolomide. The MRS data were taken four weeks after operation (before
radiotherapy) and every six months after the completion of RT. The
N-acetyl aspartate, choline, creatine, and myo-inositol parameters were
quantified, analyzed, and correlated to recurrence-free survival (RFS).
Results. The median RFS was 26.06 months. RFS was significantly worse in
elderly patients (P = 0.001) along with the higher choline/creatine
ratios at either baseline (P = 0.003) or six months post Radiotherapy (P
= 0.042). Median RFS was 23 months in high choline/creatine levels = 2
at 6 months after radiotherapy and 11 months for those with <2
choline/creatine levels. There was a significant correlation of maximum
difference of choline/creatine ratio with RFS (rho = 0.64, P = 0.045).
Conclusion. Age and choline/creatine ratio are strong independent
prognostic factors in high grade gliomas
Prognostic Significance of Serum Inflammatory Response Markers in Newly Diagnosed Non-Small Cell Lung Cancer before Chemoirradiation
Purpose. To identify whether the serum’s baseline C-reactive protein
(CRP) and albumin (Alb) levels related to clinicopathological parameters
and overall survival (OS) in non-small cell lung cancer (NSCLC).
Methods. In total, 100 consecutive patients (mean age = 68.38 +/- 10.85
years) that underwent chemoradiotherapy were studied. Measurements of
CRP and Alb were performed before any treatment. Results. Serum CRP
levels were significantly associated with histological grade (P <
0.001), TNM stage (P < 0.001), PS (P = 0.009), and Alb (P < 0.001).
Additionally CRP and Alb levels were found significantly associated with
overall survival in univariate analysis (log-rank test, P < 0.001 and P
= 0.002, resp.) and CRP remained significant after controlling for age,
alcohol, performance status, and TNM stage, whereas albumin showed a
borderline effect on the hazard rate (P = 0.052). Conclusions. CRP and
Alb are both promising biomarkers in identification of NSCLC patients
with poor prognosis and form a possible target for intensifying their
therapies