Bleomycin-Induced Pulmonary Changes on Restaging Computed Tomography Scans in Two Thirds of Testicular Cancer Patients Show No Correlation With Fibrosis Markers

Retrospective Evaluation of a Combination of Carboplatin and Bleomycin for the Treatment of Canine Carcinomas

Carboplatin is a chemotherapy agent widely used in veterinary oncology to treat various types of tumors including carcinomas. Carboplatin has previously been used in combination with 5-Fluoro uracil (5-FU) or gemcitabine for the treatment of various carcinomas. Bleomycin is a chemotherapy drug commonly used in humans, but its use has been uncommonly reported in dogs. The combination of carboplatin and bleomycin chemotherapy treatment has never been reported in dogs. Dogs diagnosed with carcinoma and treated with a combination of carboplatin and bleomycin, at a single veterinary referral center, were retrospectively evaluated. Thirty patients met the inclusion criteria. The dose of carboplatin ranged from 200–250 mg/m2 (median 240 mg/m2) and the dose of bleomycin from 15–20 IU/m2 (median 15 IU/m2). The treatment with carboplatin and bleomycin was well tolerated, with sixteen patients (53%) developing side effects. Thirteen patients (46%) developed gastrointestinal signs and nine dogs (30%) developed hematological abnormalities. The most common side effects were grade-1 hyporexia and grade-1 neutropenia. Grade-2 neutropenia was rarely observed, and only one patient developed grade-3 neutropenia. None of the dogs developed grade-4 adverse events, or required hospitalization, or died due to the treatment. No signs of chronic side effects, including pulmonary toxicity, were observed. Objective response was observed in 24% of the cases (six partial responses) and 76% of cases achieved clinical benefit (partial response+ stable disease). Clinical signs improved in 24 of the 30 cases (80%). The main aim of this study was to evaluate the safety of bleomycin and carboplatin in combination for the treatment of various types of carcinomas. The combination of bleomycin and carboplatin appears safe and potentially effective for some types of carcinomas. Larger prospective studies are needed to confirm the safety and efficacy of combined carboplatin and bleomycin.

The Role of CT in the Staging and Follow-Up of Testicular Tumors: Baseline, Recurrence and Pitfalls

Simple Summary

Testicular cancer (TC) is an uncommon group of tumors affecting predominantly younger males between 15 and 40 years, and accounting for less than 1% of malignancies in men, albeit in the context of an increasing incidence rate over recent decades. Testicular germ cell tumors (TGCT) are the most frequent (90%), and most cases of TGCT are organ-confined at diagnosis. The majority of patients with TGCT have an excellent prognosis, with a 5-year survival rate greater than 95%, and expect to be cured thanks to different risk-adapted treatments such as cisplatin-based chemotherapy, even at advanced stages. It is for this reason that both initial staging and follow-up are essential for appropriate management in initiating adapted therapy as well as treating cases of recurrence, most frequent during the first 5 years.

Abstract

Ultrasound imaging of the testis represents the standard-of-care initial imaging for the diagnosis of TGCT, whereas computed tomography (CT) plays an integral role in the initial accurate disease staging (organ-confined, regional lymph nodes, or sites of distant metastases), in monitoring the response to therapy in patients who initially present with non-confined disease, in planning surgical approaches for residual masses, in conducting follow-up surveillance and in determining the extent of recurrence in patients who relapse after treatment completion. CT imaging has also an important place in diagnosing complications of treatments. The aims of this article are to review these different roles of CT in primary TGCT and focus on different pitfalls that radiologists need to be aware of.

The effect of EBN combined with integrated hierarchical accountability nursing on patients with severe pneumonia

OBJECTIVE

To explore the effects of evidence-based nursing (EBN) combined with integrated hierarchical accountability nursing on patients with severe pneumonia (SP).

METHODS

72 SP patients admitted to our hospital from March 2019 to March 2020 were recruited as the study cohort and randomly divided into control group (36 patients) or research group (36 patients). The control group underwent conventional nursing, and the research group underwent EBN combined with integrated hierarchical accountability nursing plus. The patients' respiratory function, inflammatory factor levels, hospital stay durations, mechanical ventilation times, complication rates, and nursing satisfaction levels were compared between the two groups.

RESULTS

Before the nursing, there were no significant differences in the FVC, TLC, MVV, or VC levels between the two groups (P>0.05). After the nursing, the FVC, TLC, MVV, and VC levels in the research group were all lower than they were in the control group (all P<0.05). Before the nursing, the WBC, CRP, and PCT levels in the two groups were similar (P>0.05). After the nursing, the WBC, CRP, and PCT levels in the research group were significantly lower than they were in the control group (P<0.05). The hospital stay durations and mechanical ventilation times in the research group were shorter than they were in the control group (P<0.05). The complication rate in the research group was lower than it was in the control group (5.56% vs. 27.78% P<0.05). The nursing satisfaction level in the research group was higher than it was in the control group (97.22% vs. 77.78% P<0.05).

CONCLUSION

EBN combined with integrated hierarchical accountability nursing has a good application effect on patients with SP. It can significantly improve patients' respiratory function and inflammatory factor levels, reduce the duration of patient hospital stays, reduce their mechanical ventilation times, and complication rate, and enhance their satisfaction with the nursing. Thus, it is worthy of further promotion.

Alpha-fetoprotein (AFP)-producing epithelial ovarian carcinoma (EOC): a retrospective study of 27 cases

Objective

The aim of the study was to investigate the relative risk factors associated with the prognosis and effective treatments of alpha-fetoprotein (AFP)-producing epithelial ovarian carcinoma (EOC).

Method

We presented three cases of AFP-producing EOC and performed a brief review to summarize the clinicopathological features and prognostic factors of 24 cases that have been previously reported. We evaluated the correlations among prognostic and clinical parameters, such as stage, pathology and chemotherapy regimens. In addition, a retrospective review of these 27 cases was conducted, and survival curves were estimated using the Kaplan–Meier method.

Results

The patients were aged between 23 and 77 years. The median overall survival was 10 months, and ten (37.04%) patients died within 18 months. We compared the overall mean survival times of all patients in different stages, and the results suggest that the postoperative pathological staging is hardly correlated with prognosis (P = 0.76). There was a correlation between pathology and prognosis (P = 0.0018). The mean survival time was longer for patients who had undergone chemotherapy than for those without chemotherapy (14.88 vs 0.65 months) (P < 0.0001). Moreover, although patients had a good response to the regimens for PEB and TC (P = 0.004), there was no significant difference between PEB and TC (P = 0.386).

Conclusions

AFP-producing EOC is uncommon and regarded as an extremely malignant type of tumor. Patients with chemotherapy may have a longer survival time; additionally, PEB and TC may be an optimal selection for this kind of tumor. Further large-scale studies are needed to confirm our findings.

Late respiratory effects of cancer treatment

PURPOSE OF REVIEW

The aim of this article is to examine significant advances in our understanding of the late respiratory effects of cancer treatment, including surgery, radiotherapy, chemotherapy, biological therapies and haematopoietic stem cell transplant, and to provide a framework for assessing such patients.

RECENT FINDINGS

Oncology therapies have advanced considerably over recent years but pulmonary toxicity remains a concern. Advances have been made in our understanding of the risk factors, including genetic ones that lead to toxicity from radiotherapy and chemotherapy and risk stratification models are being developed to aid treatment planning. Targeted biological treatments are continuously being developed and consequently the Pneumotox database of pulmonary toxicity continues to be an essential resource. Early detection of bronchiolitis obliterans in haematopoietic stem cell transplant patients has been found to be critical, with some positive results from intervention trials.

SUMMARY

Pulmonary toxicity is a common unwanted consequence of life enhancing or saving cancer treatments which remain difficult to treat. Developments in these fields are mainly in the areas of prevention, early detection and monitoring of unwanted side effects. We discuss some of these developments within this review.