Trends in Systemic Inflammatory Reaction (SIR) during Paclitaxel and Carboplatin Chemotherapy in Women Suffering from Epithelial Ovarian Cancer

BACKGROUND

Epithelial ovarian cancer (EOC) is the most fatal gynaecological malignancy treated with cytoreductive surgery followed by adjuvant taxane-platinum-based chemotherapy. It has been shown that the pretreatment systemic inflammatory reaction (SIR) in women with OC can be evaluated using the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR) and systemic inflammatory index (SII), depending on the stage of disease, and has prognostic value for overall survival. The aim of this study was to evaluate the changes in NLR, LMR, PLR and SII during chemotherapy.

METHODS

A total of 107 women with EOC (23 with type I and 84 with type II tumours) were included in a retrospective single-centre analysis. The Kologomorov-Smirnoff, Kruskal-Wallis or Friedman analysis of variance tests were used for data analysis, and a p value of 0.05 was considered statistically significant.

RESULTS

A significant decrease in NLR, PLR and SII but not LMR was observed during adjuvant treatment. Pretreatment NLR, PLR and SII were dependent on disease stage and tumour grade; however, this association was lost during therapy. Additionally, strong and positive mutual correlations between NLR, LMR, PLR and SII were sustained during the whole course of chemotherapy.

CONCLUSIONS

During first-line adjuvant chemotherapy in women with EOC, a decrease in SIR is confirmed.

The Direct and Indirect Costs of Breast Cancer in Poland: Estimates for 2017-2019

BACKGROUND

In Poland, breast cancer (BC) is the most frequently diagnosed cancer in women and the second most common cause of death after lung cancer. This disease has important economic implications for patients, public payers, and the whole Polish economy. This study aimed to estimate the total National Health Fund (NHF) expenditures on the diagnosis and treatment of patients with breast cancer. In addition, the costs of productivity losses were also calculated.

METHODS

Cost estimation was prepared using a top-down approach. Direct cost calculations were based on data reported by NHF for patients with the diagnosis of breast cancer. Medical care costs included the following components: screening program, oncological package, surgical treatment, hospitalization, drug program, chemotherapy, radiotherapy, and outpatient care. Indirect costs in the form of absenteeism costs were calculated based on data from Statistics Poland (gross domestic product, number of employees) and the Social Insurance Institution database (the number of sick leave days).

RESULTS

Total expenditures for BC including direct costs and indirect costs amounted to EUR 305,371, EUR 332,998, and EUR 344,649, respectively in 2017, 2018, and 2019. Total healthcare costs in 2019 were EUR 4114 lower than in 2018, which resulted from the reduction in expenditure on the drug program (decrease of EUR 13,527), despite the observed increase in all remaining resources. From direct costs, the highest expense was spent on the drug program (nearly 50% of total direct costs), but this expense dropped significantly in 2019. For the remaining parameters, the costs increased year by year, of which the most expensive were surgical treatment (15%), radiotherapy (12%), and the screening program (10%). BC generated over EUR 120 thousand of social costs in 2019 and compared to 2017, there was an increase in productivity loss by 26%.

CONCLUSIONS

Our results from 2017-2019 demonstrated that total expenditure for BC in Poland increased from year to year. Breast cancer generated almost EUR 345 thousand expenses in 2019, which translates into a significant burden on the public payer's budget and the society in Poland.

Trends in Incidence and Mortality of Gynecological and Breast Cancers in Poland (1980-2018)

BACKGROUND

This study aimed to analyze and determine the incidence and mortality trends in gynecological and breast cancers (BCs) in Poland. The gynecological cancers assessed were cervical cancer (CC), corpus uteri cancer (CUC), ovarian cancer (OC), vaginal cancer (VAC), and vulvar cancer (VUC).

PATIENTS AND METHODS

Data concerning the incidence and mortality for the period of 1980-2018 were obtained from the Polish National Cancer Registry (PNCR). Joinpoint regression analysis was performed to identify trends, which were described using the annual percentage change (APC) and the average annual percent change (AAPC).

RESULTS

Statistically significant increases were observed in BC incidence (AAPC: 2.3; CI: 1.8 to 2.9; p<0.05), CUC incidence (AAPC: 2.3; CI: 1.9 to 2.7; p<0.05), CUC mortality (AAPC: 0.4; CI: 0.1 to 0.7; p<0.05) and VUC mortality (AAPC: 1.16, CI: 0.1 to 2.2; p<0.05). VAC mortality decreased (AAPC: -3.5, CI: -5.0 to -2.0; p<0.05), as did CC incidence and mortality (AAPC: -2.1, CI: -2.3 to -1.8; p<0.05, AAPC: -2.0, CI: -2.2 to -1.8; p<0.05, respectively). Between 1980 and 1993, OC incidence initially increased and then stabilized (AAPC: 0.9; CI: 0.7 to 1.1; p<0.05). After 2007, OC mortality decreased (AAPC: 0.0; CI: -0.2 to 0.2; p=0.8). Trends in VUC and VAC incidence and BC mortality were not statistically significant.

CONCLUSION

The results of this study showed a significant increase in OC, CUC, and BC incidence, and a decrease in the incidence of CC and VAC. The VUC trends were stable. Mortality trends for BC initially fluctuated and, since 2010, has begun to increase. Throughout the observed period, mortality due to VUC and CUC increased, whereas decreased among patients with CC. OC mortality was stable, but not significant. Furthermore, the study showed a correlation between age group and rate of incidence and mortality of each assessed cancer.

Role of Systemic Inflammatory Reaction in Female Genital Organ Malignancies - State of the Art

Systemic inflammatory reaction (SIR) is an unfavorable prognostic factor in many malignancies and has a role in all stages of the neoplastic process: initiation, promotion, and disease progression. Analysis of SIR can be performed by assessing indicators (eg, lymphocyte-to-neutrophil, platelet-to-lymphocyte, and monocyte-to-neutrophil ratios) and products of neutrophils and lymphocytes (ie, the systemic immune-inflammation index), or by examining the relationship between levels of C-reactive protein and albumin (based on the Glasgow Prognostic Score, modified Glasgow Prognostic Score, and C-reactive protein-to-albumin ratio). Risk stratification is essential in the clinical management of cancer; hence, the evaluation of these factors has potential applications in the clinical management of patients with cancer and in the development of new therapeutic targets. This review summarizes the current knowledge on SIR indicators and presents their clinical utility in malignancies of the female genital organs.

Benzoxazepine-Derived Selective, Orally Bioavailable Inhibitor of Human Acidic Mammalian Chitinase

Human acidic mammalian chitinase (hAMCase) is one of two true chitinases in humans, the function of which remains elusive. In addition to the defense against highly antigenic chitin and chitin-containing pathogens in the gastric and intestinal contents, AMCase has been implicated in asthma, allergic inflammation, and ocular pathologies. Potent and selective small-molecule inhibitors of this enzyme have not been identified to date. Here we describe structural modifications of compound OAT-177, a previously developed inhibitor of mouse AMCase, leading to OAT-1441, which displays high activity and selectivity toward hAMCase. Significantly reduced off-target activity toward the human ether-à-go-go-related gene (hERG) and a good pharmacokinetic profile make OAT-1441 a potential candidate for further preclinical development as well as a useful tool compound to study the physiological role of hAMCase.

[Proton beam radiotherapy of uveal melanoma--preliminary results]

PURPOSE

Presentation of the proton beam radiotherapy (PBR) as a method of treatment of the uveal melanoma patients in the Department of Ophthalmology and Ocular Oncology and Nuclear Physics Institute in Cracow, Poland and their preliminary results.

MATERIAL AND METHODS

Nine patients with only choroidal melanoma were treated using PBR between January and April 2011. There were 4 women (44%) and 5 men (56%), a mean age 56 years (38-72). The mean tumor thickness using ultrasounds was 4.14 mm (1.4-9.6 mm).

RESULTS

The mean follow-up was 6 months (5-7). The mean tumor thickness after PBR was 2.47 mm (0-9.3 mm). In 2 patients endoresection of irradiated tumor mass was performed with final flat scar. After exclusion of these patients from analysis, the mean thickness was 3.17 mm (1.5-9.3 mm). In 6 patients the visual function was stable.

CONCLUSIONS

The preliminary results show that PBR is highly precise method of uveal melanoma treatment achieving high rates of local control. This method necessitates a close co-operation between ophthalmologist, oncologist, radiotherapists, and medical physicist as well as an elaboration of own procedures of planning and treatment. uveal melanoma, radiotherapy, proton-beam radiotherapy.

Postoperative irradiation of incompletely excised gemistocytic astrocytomas. Clinical outcome and prognostic factors

BACKGROUND AND PURPOSE

Although gemistocytic astrocytomas are considered slow-growing tumors, they often behave aggressively and carry the least favorable prognosis among low-grade astrocytomas. The aim of this study is to evaluate the outcomes and prognostic factors of patients with incompletely excised gemistocytic astrocytomas irradiated postoperatively.

PATIENTS AND METHODS

Records of 48 patients with incompletely excised gemistocytic astrocytoma, irradiated between 1976 and 1998 at the Department of Radiation Oncology, Maria Skłodowska-Curie Memorial Cancer Center, Cracow, Poland, were reviewed. The total dose ranged from 50 to 60 Gy (mean: 59.35, median: 60 Gy) delivered in daily fractions of 2 Gy, 5 days a week. The treatment volume covered the residual tumor with a margin of 1-2 cm.

RESULTS

Toxicity was acceptable. The overall actuarial survival rates at 5 and 10 years were 30% and 17%, respectively. Age and gender had an influence on overall survival by univariate and multivariate analysis (p < 0.05). Patients < or = 35 years of age and female patients carried the best prognosis.

CONCLUSION

In most patients with gemistocytic astrocytoma, combined surgery and postoperative radiotherapy result in only short-term survival. Older age is the most important unfavorable prognostic factor in patients with gemistocytic astrocytoma.

Relationship between succinate transport and production of extracellular poly(3-hydroxybutyrate) depolymerase in Pseudomonas lemoignei

The relationship between extracellular poly(3-hydroxybutyrate) (PHB) depolymerase synthesis and the unusual properties of a succinate uptake system was investigated in Pseudomonas lemoignei. Growth on and uptake of succinate were highly pH dependent, with optima at pH 5.6. Above pH 7, growth on and uptake of succinate were strongly reduced with concomitant derepression of PHB depolymerase synthesis. The specific succinate uptake rates were saturable by high concentrations of succinate, and maximal transport rates of 110 nmol/mg of cell protein per min were determined between pH 5.6 and 6. 8. The apparent KS0.5 values increased with increasing pH from 0.2 mM succinate at pH 5.6 to more than 10 mM succinate at pH 7.6. The uptake of [14C]succinate was strongly inhibited by several monocarboxylates. Dicarboxylates also inhibited the uptake of succinate but only at pH values near the dissociation constant of the second carboxylate function (pKa2). We conclude that the succinate carrier is specific for the monocarboxylate forms of various carboxylic acids and is not able to utilize the dicarboxylic forms. The inability to take up succinate2- accounts for the carbon starvation of P. lemoignei observed during growth on succinate at pH values above 7. As a consequence the bacteria produce high levels of extracellular PHB depolymerase activity in an effort to escape carbon starvation by utilization of PHB hydrolysis products.

Dynamics of high-frequency hearing loss of operators of industrial ultrasonic devices

This investigation was aimed at elucidating the dynamics of hearing loss in the range of 500 Hz to 20 kHz of 26 Ultrasonic (Uls)-operators exposed to high-frequency noise exceeding known hygienic limits. Results of audiometric tests performed twice, before and after a period of three years, were compared. The determined hearing-threshold-shift in the range of 500 Hz to 13 kHz could be explained as the effect of aging, whereas in the range of 13 to 17 kHz the stated mean threshold elevation of 2-5 dB, beyond the hearing loss connected with aging within three years, is the consequence of high-frequency noise exposure. On this basis the dynamics of high-frequency hearing loss of 1 dB/year in the case of continued exposure to high-frequency noise could be calculated. Apart from the observed threshold elevation, the fraction of ears responding to acoustic stimuli at the highest frequencies decreases by about 10% with frequency increase of 1 kHz in the range of 13 to 19 kHz. This indicates that the hearing organ is more susceptible to high-frequency noise at the highest hearing frequencies.

High-frequency-noise-induced hearing loss: a field study on the role of intensity level and accumulated noise dose

Based on audiometric tests in the range of 10 to 20 kHz, of 106 ultrasound operators, as well as on measurements of high-frequency noise, the problem of safety limits for high-frequency noise exposure was investigated. Analyzing the relation between noise levels of 1/3 octave bands at center frequencies of 10, 12.5 and 16 kHz and the accumulated noise dose on the one hand, and changes of hearing at 10 to 12, 11 to 13 and 14 to 16 kHz respectively, on the other hand, a harmless level up to 80 dB and a harmless noise dose up to 1 unit for people not older than 40 years have been found. For older people this level and this noise dose can be dangerous.

High-frequency hearing risk of operators of industrial ultrasonic devices

Sound and ultrasound emitted by industrial ultrasonic (Uls) devices exceed the known proposed hygienic limits, especially for frequencies 10-20 kHz. The consequence of this may be a negative influence of this energy on the auditory function in the high-frequency hearing range. To determine the hearing risk to Uls operators, an adequate method for testing the hearing threshold from 10-20 kHz has been developed. In order to get reference values, 189 non-exposed persons were tested. On this basis, the hearing thresholds of 55 operators for frequencies 500-20,000 Hz were evaluated. In addition to threshold elevations in the range 10-20 kHz, a decreasing number of subjects responding to stimuli at the highest audible frequencies was observed. The threshold shift at 10-20 kHz of subjects exposed to sound and ultrasound emitted by Uls-devices depends upon the physical parameters of the sound spectrum, time on the job and daily exposure time. No abnormalities were found in the hearing range 500-8000 Hz.