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Yang E, Deutsch E, Mehmet A, Fayette J, Nabell L, Spencer S, Dobelbower M, Willey C, Bonner J, Wang X, Lin A, William W. A phase 1b trial of prexasertib in combination with chemoradiation in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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77
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Kotarska M, Vogelzang R, Glaser L, Lin A. 3:09 PM Abstract No. 166 Comparison of reproductive outcomes following uterine fibroid embolization versus robotic assisted laparoscopic myomectomy in patients with symptomatic uterine fibroids. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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78
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Qiu J, Yang G, Lin A, Shen Z. Rectal bleeding caused by iatrogenic ulceration after hemorrhoid ligation. Tech Coloproctol 2020; 24:395-396. [PMID: 32107683 DOI: 10.1007/s10151-020-02177-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 02/12/2020] [Indexed: 10/25/2022]
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79
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Yuvaraj J, Lin A, Nerlekar N, Munnur R, Cameron J, Nicholls S, Wong D. 402 Role of Coronary Inflammation in High-Risk Plaque and Acute Coronary Syndrome in Patients With Stable Coronary Artery Disease: Insights from Pericoronary Adipose Tissue Attenuation (PCAT) on CTCA. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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80
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Imber B, Wild A, Neal B, Lin A, Darwish H, Cahlon O, Tsai H, Chon B, Yamada Y, Yang T. Clinical Outcomes of Proton Beam Re-Irradiation for Recurrent Gliomas. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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81
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Smith G, Ning M, Shah A, Fu S, Busse P, Cantor S, Dagan R, Foote R, Fuller C, Garden A, Gunn G, Katz S, Lin A, Mohammed N, Morrison W, Patel S, Phan J, Reddy J, Rosenthal D, Snider J, Frank S. Impact of Intensity-Modulated Proton Therapy vs. Intensity-Modulated Photon Therapy on Preserving Work and Productivity in Oropharyngeal Cancer Patients: Outcomes of a Multi-Institution Randomized Trial. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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82
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Baumann B, Vachani C, Freedman G, Verginadis I, Lin A, Hill-Kayser C, Zeng C, MacArthur K, Solberg T, Koumenis C, Metz J. Management Strategies for Severe Acute Radiation Dermatitis and the Use of Bolus during Radiation Therapy for Breast and Head and Neck Cancer: Results of a Patient and Provider Survey. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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83
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Carmona R, Venigalla S, Reddy V, Williams G, Lukens J, Swisher-McClure S, Ghiam AF, Lin A, Mell L. Development and Validation of a Clinical and Genomic Generalized Competing Event Model in HPV-Negative Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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84
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Lukens J, Pustylnikov S, Montone K, Lin A, Swisher-McClure S, Ghiam AF, Weinstein G, Cohen R, Facciabene A. Tumor Infiltrating Lymphocytes in Occult Primary HPV+ Oropharyngeal Squamous Cell Carcinoma (OPSCC): Comparison of the Primary Tumor and Regional Lymph Node Metastases. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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85
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Wojcieszynski A, La Cava W, Baumann B, Lukens J, Ghiam AF, Urbanowicz R, Swisher-McClure S, Doucette A, Gabriel P, Lin A, Xiao Y, Moore J, Metz J. Machine Learning to Predict Toxicity in Head and Neck Cancer Patients Treated with Definitive Chemoradiation. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lin A, Tran H, Hsu J, Hoffmayer K, Feld G, Adler E, Pretorius V, Krummen D, Ho G. Ventricular Arrhythmias in Patients with Biventricular Assist Devices. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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88
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Leong WL, Battiston K, Cheung F, Fulton C, Lin A, Levin W, Done S, Santerre P. Abstract P3-13-11: The outcomes of ReFilx soft tissue filler as an immediate reconstruction technique for lumpectomy followed by radiotherapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-13-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Lumpectomy for breast cancer can often result in poor cosmetic outcomes which can lead to long-lasting impairment of quality of life. ReFilx is a synthetic porous degradable polyurethane scaffold that has mechanical properties comparable to that of native healthy breast tissue. It has been shown in two previous porcine studies to preserve breast shape and volume over 9 months when inserted into the cavities immediately after lumpectomy. We observed minimal foreign body reaction with good integration of the host tissue while the material degraded over time. In this study, we examined the healing process of lumpectomy treated with radiation. Radiotherapy is currently a standard adjuvant therapy after lumpectomy for breast cancers; and radiation is known to affect the healing process in general. Objective: To evaluate ReFilx, as soft tissue fillers for lumpectomy cavities in combination with standard radiotherapy. Hypothesis: ReFilx will preserve breast shape and volume by supporting tissue infiltration with minimal inflammation in the presence of clinically relevant radiotherapy. Methods: 3 female Yucatan minipigs received lumpectomies carried out using electrocautery to remove normal breast tissue of approximately 2 cm diameter, after which the cavities were filled with (case) or without ReFilx (sham control) (n=3 for each condition, each pig has 12-13 breasts). 6 weeks post-implantation, 2 of the pigs received radiation directed at the right half of their bodies (6 breasts per pig) for a total dose of 42.4 Gy delivered over 15 fractions using a clinical linear accelerator. The delivered doses to target sites and the adjacent tissue were confirmed with optically stimulated luminescent dosimeters (OSLDs). A third pig was maintained as a non-irradiated control. Ultrasound examinations were performed every 3 weeks post-implantation. At week 24 and 36, samples consisted of n=3 for irradiated and non-irradiated ReFilx and sham sites for the half-irradiated pigs, and n=3 for non-irradiated ReFilx and sham sites for the non-irradiated control pig were excised by mastecomy, the tissue samples were fixed in 10% buffered formalin for subsequent histological (H&E, Masson's Trichrome) studies. Potential side effects were monitored by vital signs, pain control, wound checks, ultrasound and blood tests. Necropsies were performed at the conclusion of the study. Results: Ultrasound examination indicated no difference between ReFilx's ability to maintain breast shape and volume with or without the presence of radiation treatment, in contrast to the collapse of the sham sites by 24 weeks. Similarly, the histology of irradiated and non-irradiated ReFilx samples showed similar levels of tissue infiltration, inflammatory changes and degradation of ReFilx. There was no significant side effects observed. Conclusions: ReFilx's ability to act as a soft tissue filler for breast volume restoration post-lumpectomy does not appear to be significantly impacted by the presence of clinically relevant radiation treatment. Longer-term follow-up is currently in progress for this study. Acknowledgements: Connaught Innovation Award (University of Toronto) and Joule Innovation Fund (Canadian Medical Association).
Citation Format: Leong WL, Battiston K, Cheung F, Fulton C, Lin A, Levin W, Done S, Santerre P. The outcomes of ReFilx soft tissue filler as an immediate reconstruction technique for lumpectomy followed by radiotherapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-13-11.
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Accordino MK, Lin A, Wright JD, Trivedi MS, Kalinsky K, Crew KD, Hershman DL. Abstract P1-20-02: Incidence of hyperglycemia in non-diabetic patients with early-stage breast cancer treated with chemotherapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-20-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: There are shared risk factors between breast cancer (BC) and diabetes mellitus (DM). BC treatments including chemotherapy given in combination with glucocorticoids can induce hyperglycemia and steroid related DM. Patients with DM are at increased risk of developing chemotherapy related toxicities such as chemotherapy induced peripheral neuropathy (CIPN) compared to those without DM. The incidence of hyperglycemia during chemotherapy in non-diabetic patients with early-stage breast cancer is unknown.
Methods: We performed a retrospective analysis of non-diabetic women with stage I-III breast cancer treated with chemotherapy at Columbia University Medical Center from 9/1/2016-8/31/2017 to evaluate hyperglycemia incidence during chemotherapy and up to six months after chemotherapy completion. Eligible patients were identified in the electronic health record (EHR) by ICD9 and 10 codes (ICD9 174.x and ICD10 C50.x) and a record of chemotherapy administration. Non-diabetic patients were defined by chart review as no recorded history of diabetes and no receipt of a diabetes medication in the EHR. Breast cancer stage was determined by chart review. Glucose values were recorded prior to chemotherapy, during chemotherapy, and for six-months after chemotherapy completion. We defined hyperglycemia as a glucose value of ≥200 mg/dl. Median time to hyperglycemia was also calculated.
Results: We identified 82 eligible patients. The majority of patients received dexamethasone during their chemotherapy course (79 patients, 96.3%). The most frequent chemotherapy regimen was doxorubicin/cyclophosphamide and paclitaxel (32 patients, 39.0%). At baseline, 20 patients (24.4%) had a normal body mass index (BMI), 27 patients (32.9%) were overweight, and 31 patients (37.8%) were obese. Hyperglycemia occurred in 8 patients (9.8%) after initiation of chemotherapy. Among patients with hyperglycemia, the maximum blood glucose was between 200-299 mg/dl in seven patients (87.5%), and between 500-599 in one patient (12.5%). The median time to hyperglycemia was 84 days. Among patients who did not experience hyperglycemia, the maximum blood glucose was between 140-159 mg/dl in six patients (8.1%), between 160-179 mg/dl in eight patients (10.8%), and between 180-199 mg/dl in three patients (4.1%). Three patients were diagnosed with DM following chemotherapy completion.
Conclusion: Hyperglycemia occurred in almost 10% of non-diabetic patients who received chemotherapy for early-stage breast cancer. Additionally, over 30% of patients had a blood glucose of 140 mg/dl or higher after chemotherapy initiation. The impact of hyperglycemia on the development of chemotherapy related toxicities in this group is unknown. Future research is needed to identify effective interventions for glucose control during chemotherapy, and to determine if glucose control during treatment can reduce the risk of chemotherapy related toxicities, specifically CIPN.
Citation Format: Accordino MK, Lin A, Wright JD, Trivedi MS, Kalinsky K, Crew KD, Hershman DL. Incidence of hyperglycemia in non-diabetic patients with early-stage breast cancer treated with chemotherapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-20-02.
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Mirzaee S, Lin A, Isa M, Cameron J, Alison J, Zaman S, Nicholls S. The Incidence of Fatal Arrhythmia Among Patients with Early Onset Acute Coronary Syndrome and Familial Hypercholesterolaemia. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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91
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Scherer D, Abdelmalak J, Nerlekar N, Jiang C, Fernandes K, Lin A, Munnur K, Psaltis P, Cameron J, Senevirantne S, Nicholls S, Wong D. Quantitative but not Qualitative Computed Tomography Coronary Angiography High Risk Plaque Characteristics are Associated with Major Adverse Cardiovascular Events in Patients with Non-Significant Invasive Fractional Flow Reserve. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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92
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Scherer D, Fernandes K, Nerlekar N, Jiang C, Abdelmalak J, Lin A, Munnur K, Psaltis P, Cameron J, Senevirantne S, Nicholls S, Wong D. Computed Tomography Coronary Angiography (CTCA) Detected High Risk Plaques are a Predictor of Future Coronary Events – Insights from a Propensity Matched Study of Patients who have Undergone Invasive Coronary Angiography, Fractional Flow Reserve and CTCA. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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93
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Mirzaee S, Lin A, Isa M, Thakur U, Nerlekar N, Cameron J, Nasis A, Nicholls S, Wong D. Coronary Artery Disease and Pericoronary Adipose Tissue Attenuation by Computed Tomography in Familial Hypercholesterolemia. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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94
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Yuvaraj J, Lin A, Rashid H, Nerlekar N, Cameron J, Seneviratne S, Nicholls S, Psaltis P, Wong D. Is Spontaneous Coronary Artery Dissection (SCAD) Related to Vascular Inflammation and Epicardial Fat? Insights from Novel Markers of Computed Tomography Coronary Angiography. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schonewolf C, Chao H, Guttmann D, Swisher-McClure S, Fotouhi Ghiam A, Lin A, Lukens J. Margin Status, Lymphovascular Invasion, and Number of Neck Levels Involved Predict Distant Failure in p16+ Oropharyngeal Squamous Cell Carcinoma (OPSCC) Following Transoral Robotic Surgery (TORS). Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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96
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Glaser L, Friedman J, King N, Lin A. Miscarriage Following Different Routes of Fertility-Sparing Treatment of Uterine Fibroids. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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97
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King N, Friedman J, Glaser L, Lin A. Pregnancy Outcomes after Vaginal Trial of Labor Following Myomectomy. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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98
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Huang S, Souris K, Li S, Kang M, Janssens G, Lin A, Garver E, Ainsley C, Xiao Y, Lin L. Assessment of Clinical Impact of Analytical Dose Calculation in TPS for Proton PBS Treatment Using Fast Monte Carlo Simulation. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Imber B, Yang T, Zhigang Z, Beal K, Cohen M, Tabar V, Geer E, Lin A, Young R. Comparison of Radiographic Approaches to Assess Treatment Response in Pituitary Adenomas: Are RECIST/Rano Good Enough? Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ying L, Zou R, Du L, Shi L, Zhang N, Jin J, Wu J, Zhang F, Chen K, Huang M, Zhang Y, Lin A, Yu H, Zhou L, Mao W, Su D. A serum miRNA biomarker panel for the detection of early stage non-small cell lung cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy290.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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