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Agboola O, Niu Y, Njike V. Abstract P539: Association of Metabolic Syndrome With Angina: Results From NHANES 2009 - 2020. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Background:
Metabolic syndrome (MetS) is a known risk factor for cardiovascular disease. However, there are limited data on its association with angina. We assessed the association of MetS with angina in a nationally representative sample of noninstitutionalized Americans.
Methods:
We combined data from five National Health and Nutrition Examination Survey (NHANES) data cycles from 2009 to 2020. We included participants aged 40 years or older. MetS was defined using the AHA/NHLBI criteria. Angina was ascertained based on the ROSE angina questionnaire. Multivariable logistic regression models adjusting for age, race, and sex were used to assess the association between MetS and angina.
Results:
Among the 21752 participants included in the analysis, 11381 (52.3%) met the criteria for MetS. Nine hundred and fifty-nine participants (4.4%) had angina. Angina was more prevalent among those with MetS than those without MetS (5.9% vs. 2.8%; p = <.0001). Compared with participants without MetS, Those with MetS were more than two-fold more likely to suffer from angina (adjusted Odds Ratio, 2.06; 95% CI 1.76-2.40; p = <.0001).
Conclusion:
From this nationally representative sample, participants aged 40 years or older with MetS were more likely to suffer from angina compared with those without MetS. Suggesting MetS as an independent risk factor of coronary artery disease.
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Njike VY, Kela GCM, Treu JA, Ayettey RG, Kussaga FM, Khan N, Comerford B, Agboola O. Egg Consumption in the Context of Plant-Based Diets and Diet Quality in Adults at Risk for Type 2 Diabetes: A Randomized Single Blind Cross-over Controlled Trial. J Am Nutr Assoc 2023; 42:130-139. [PMID: 35512755 DOI: 10.1080/07315724.2021.2006824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Lifestyle changes that emphasis on plant-based diets (PBD) are typically recommended for those at risk for type 2 diabetes mellitus (T2DM) to mitigate their cardo-metabolic risk. We examined the impact of the inclusion of eggs compared with their exclusion from PBD on diet quality among adults at risk for T2DM. This was a randomized, controlled, single-blind, crossover trial of 35 adults (mean age 60.7 years; 25 women, 10 men; 34 Caucasians, 1 African-American) at risk for T2DM (i.e., pre- diabetes or metabolic syndrome) assigned to one of two possible sequence permutations of two treatments (PBD with eggs and exclusively PBD), with a 4-week washout period. Participants received dietary counseling from a dietitian to exclude or to include 2 eggs daily in the context of PBD for a 6-week period. Diet quality was assessed using the Healthy Eating Index 2015 (HEI-2015) at baseline and 6 weeks. Compared with the exclusion of eggs, the inclusion of eggs in the context of PBD improved the diet quality score for intake of total protein foods (1.0 ± 1.1 vs. -0.4 ± 1.0; p <.0001); seafood and plant proteins (0.2 ± 1.2 vs. -0.4 ± 1.1; p = 0.0338); and fatty acids (0.8 ± 2.5 vs. -0.7 ± 2.7; p = 0.0260). Overall diet quality score depreciated with the adoption of exclusively PBD without eggs (-3.1 ± 8.3; p = 0.0411), while it was unaffected with the adoption of a PBD with the inclusion of eggs (-0.6 ± 7.9; p = 0.6892). Eggs could be used as an adjuvant to enhance the diet quality among those at risk for T2DM who adopt plant-based dietary patterns.
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Affiliation(s)
- Valentine Y Njike
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | | | - Judith A Treu
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | - Rockiy G Ayettey
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | | | - Nisar Khan
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | - Beth Comerford
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
| | - Olayinka Agboola
- Yale-Griffin Prevention Research Center, Griffin Hospital, Derby, CT, USA
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Muacevic A, Adler JR, Agboola O, Vajta Gomez JP, Alapati A, Alston S. Partnering With Residents on the Redesign of the Internal Medicine Resident Self-Evaluation Form. Cureus 2023; 15:e33304. [PMID: 36741634 PMCID: PMC9894636 DOI: 10.7759/cureus.33304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION The positive impact of resident-driven synthesis of assessment data has been associated with increased intrinsic motivation to learn and create an individualized strategy to improve performance. The objective of the study was to incorporate residents' recommendations for restructuring the self-assessment metric into a tool that will promote a well-organized and effective self-improvement plan. MATERIALS AND METHODS Residents and faculty collaborated on pre- and post-intervention questionnaires to assess the barriers to the timely completion of the current self-evaluation form and gather information on the tool's ability to stimulate the formation of concrete goals. The residents were also invited to provide their recommendations on the structure of the new tool and the educational domains that were assessed by the tool. The post-survey also evaluated the capacity of the proposed tool to guide residents in establishing specific goals. Results: The new form is concise and more precise in assisting the learner in developing short-term and long-term goals and the strategies and resources to achieve them. Discussion: Collaborating with the learners created an opportunity to address the faculty's and residents' most important concerns about the effectiveness of the metric. CONCLUSION In a learner-centered model, resident participation is critical in designing/redesigning a practical self-assessment tool for residents in Internal Medicine.
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Stawiarski K, Agboola O, Costantino A, Raskhe A, Bonde R, Bonde P. Performance Of The MELDXI Score In A Modern Left Ventricular Assist Device Cohort. J Card Fail 2022. [DOI: 10.1016/j.cardfail.2022.03.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Alexander R, Agboola O, Costales V. Sociodemographic characteristics associated with hepatitis C among patients admitted for medically managed opioid withdrawal in east Tennessee. J Addict Dis 2021; 40:92-95. [PMID: 34121634 DOI: 10.1080/10550887.2021.1935187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND While Opioid use disorder (OUD)-related mortality is epidemic in the United States, regions like Appalachia are disproportionately affected. Moreover, a dual epidemic of Hepatitis C virus (HCV) infections and OUD-related admissions has been observed. OBJECTIVE To evaluate sociodemographic characteristics of opioid-dependent patients admitted for medically managed withdrawal in East Tennessee and compare those with and without HCV. METHODS Cross-sectional study of patients with an OUD admitted for treatment, comparing those with and without a history of HCV. RESULTS The studied population was found to have high rates of HCV (36%), intravenous drug use (IVDU) (77%), polysubstance use (84%), previous incarceration (87%), and unemployment (80%). Patients with HCV, compared to those without, were significantly more likely to have a history of IVDU, IVDU complications, and polysubstance use. CONCLUSIONS This sample reflects the significant morbidity of OUD in East Tennessee. To prevent mortality, contributing factors such as polysubstance use and OUD treatment during incarceration need to be specifically addressed.
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Affiliation(s)
- Ryan Alexander
- Department of Preventive Medicine, Griffin Hospital, Derby, CT, USA.,Helen Ross McNabb Center, Knoxville, TN, USA
| | - Olayinka Agboola
- Department of Preventive Medicine, Griffin Hospital, Derby, CT, USA
| | - Victoria Costales
- Department of Preventive Medicine, Griffin Hospital, Derby, CT, USA.,Department of Internal Medicine, Griffin Hospital, Derby, CT, USA.,Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Stawiarski K, Agboola O, Bonde R, Bonde P. Exploring Preoperative Hypocalcemia as a Biomarker for Post Left Ventricular Assist Device Survival and Adverse Events. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Stawiarski K, Agboola O, Bonde R, Bonde P. Red Cell Distribution Width to Assess Heart Failure Post Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Stawiarski K, Agboola O, Park J, Mangi A, Geirsson A, Bellumkonda L, Lee F, Chen M, Jacoby D, Chou J, Ahmad T, Testani J, McCloskey G, Bonde P. The Effects of Less Invasive Extra-Pericardial Placement of Left Ventricular Assist Devices on Right Ventricular Failure in the Early Postoperative Period. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Stawiarski K, Agboola O, Park J, Mangi A, Geirsson A, Lee F, Jacoby D, Bellumkonda L, Ahmad T, Chou J, Testani J, Chen M, McCloskey G, Bonde P. Blood Conservation Strategy at Time of Left Ventricular Assist Device Placement Improves Survival. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Stawiarski K, Agboola O, Jacoby D, Bellumkonda L, Ahmad T, Sugeng L, Chen M, McCloskey G, Geirsson A, Anwar M, Bonde P. Chloride Homeostasis in End Stage Heart Failure and LVAD Recipients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Stawiarski K, Agboola O, Jacoby D, Bellumkonda L, Sugeng L, Ahmad T, Chen M, McCloskey G, Geirsson A, Anwar M, Bonde P. LVAD Survival May Be Predicted by Preoperative Lymphopenia. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Stawiarski K, Agboola O, Jacoby D, Ali A, Bellumkonda L, Ahmad T, Sugeng L, McCloskey G, Chen M, Geirsson A, Bonde P, Anwer M. LYMPHOPENIA AS A PREDICTOR FOR SURVIVAL IN LVAD PATIENTS. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)31409-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Adeyeye OA, Sadiku ER, Babu Reddy A, Ndamase AS, Makgatho G, Sellamuthu PS, Perumal AB, Nambiar RB, Fasiku VO, Ibrahim ID, Agboola O, Kupolati WK, Daramola OO, Machane MJ, Jamiru T. The Use of Biopolymers in Food Packaging. Materials Horizons: From Nature to Nanomaterials 2019. [DOI: 10.1007/978-981-13-8063-1_6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Horgan AM, Darling G, Wong R, Guindi M, Liu G, Jonker DJ, Lister J, Xu W, MacKay HM, Dinniwell R, Kim J, Pierre A, Shargall Y, Asmis TR, Agboola O, Seely AJ, Ringash J, Wells J, Marginean EC, Haider M, Knox JJ. Adjuvant sunitinib following chemoradiotherapy and surgery for locally advanced esophageal cancer: a phase II trial. Dis Esophagus 2016; 29:1152-1158. [PMID: 26663741 DOI: 10.1111/dote.12444] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The prognosis for locally advanced esophageal cancer is poor despite the use of trimodality therapy. In this phase II study, we report the feasibility, tolerability and efficacy of adjuvant sunitinib. Included were patients with stage IIa, IIB or III cancer of the thoracic esophagus or gastroesophageal junction. Neoadjuvant therapy involved Irinotecan (65 mg/m2 ) + Cisplatin (30 mg/m2 ) on weeks 1 and 2, 4 and 5, 7 and 8 with concurrent radiation (50Gy/25 fractions) on weeks 4-8. Sunitinib was commenced 4-13 weeks after surgery and continued for one year. Sixty-one patients were included in the final analysis, 36 patients commenced adjuvant sunitinib. Fourteen patients discontinued sunitinib due to disease recurrence (39%) within the 12-month period, 12 (33%) discontinued due to toxicity, and 3 (8%) requested cessation of therapy. In the overall population, median survival was 26 months with a 2 and 3-year survival rate of 52% and 35%, respectively. The median survival for the 36 patients treated with sunitinib was 35 months and 2-year survival probability of 68%. In a historical control, a prior phase II study with the same trimodality therapy (n = 43), median survival was 36 months, with a 2-year survival of 67%. Initiation of adjuvant sunitinib is feasible, but poorly tolerated, with no signal of additional benefit over trimodality therapy for locally advanced esophageal cancer.
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Affiliation(s)
- A M Horgan
- Department of Medical Oncology, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - G Darling
- Department of Surgical Oncology, Division of Thoracic Surgery, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - R Wong
- Department of Radiation Oncology, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - M Guindi
- Department of Pathology and Laboratory Medicine, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - G Liu
- Department of Medical Oncology, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - D J Jonker
- Department of Medical Oncology, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - J Lister
- Department of Surgical Oncology, Division of Thoracic Surgery, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - W Xu
- Department of Biostatistics, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - H M MacKay
- Department of Medical Oncology, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - R Dinniwell
- Department of Radiation Oncology, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - J Kim
- Department of Radiation Oncology, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - A Pierre
- Department of Surgical Oncology, Division of Thoracic Surgery, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - Y Shargall
- Division of Thoracic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - T R Asmis
- Department of Medical Oncology, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - O Agboola
- Department of Thoracic Surgery, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - A J Seely
- Department of Pathology, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - J Ringash
- Department of Radiation Oncology, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - J Wells
- Department of Radiation Oncology, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - E C Marginean
- Department of Pathology, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - M Haider
- Department of Medical Oncology, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
| | - J J Knox
- Department of Medical Oncology, Princess Margaret and Toronto General Hospitals, University Health Network, Toronto, Ontario, Canada
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AlHussain H, Malone S, Gertler S, Nguyen T, Nicholas G, Page N, Woulfe J, Agboola O, Montgomery L, Caudrelier J. Results of a Prospective Trial Evaluating Accelerated Radiation Therapy using Tomotherapy Simultaneous Integrated Boost (ARTOSIB) with Concurrent and Adjuvant Temozolomide (TMZ) Chemotherapy in the Treatment of Glioblastoma Multiforme (GBM). Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Alhussain H, Caudrelier J, Malone S, Agboola O, Nguyen T, Belec J, Carty K, Bahm J, Montgomery L. Prospective Study of Accelerated Radiation Therapy using Tomotherapy Simultaneous Integrated Boost with Concurrent and Adjuvant Temozolomide Chemotherapy in the Treatment of Glioblastoma Multiforme: Dosimetric Data. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wong R, Berry S, Spithoff K, Simunovic M, Chan K, Agboola O, Dingle B. Preoperative or Postoperative Therapy for Stage II or III Rectal Cancer: An Updated Practice Guideline. Clin Oncol (R Coll Radiol) 2010; 22:265-71. [DOI: 10.1016/j.clon.2010.03.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Revised: 02/19/2010] [Accepted: 03/04/2010] [Indexed: 10/19/2022]
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Szumacher E, Warner E, Zhang L, Kane G, Kane G, Ackerman I, Nyhof-Young J, Agboola O, Agboola O, de Metz C. Ontario Radiation Oncology Residents Needs in the PGY-1 Year–Residents' Perspective Survey. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Agboola O, Modha A, Benoit B, Girard A, Dahrouge S, Donker R. 44 Does Delayed Post-Operative Adjuvant Radiation Treatment Influence the Overall Tumor Control in Incompletely Resected Pituitary Adenoma? Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)80205-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Dale DC, Crawford J, Agboola O, Lyman GH. Febrile neutropenia and reduced dose intensity in patients with aggressive non-Hodgkin's lymphoma (NHL) treated with CHOP and CNOP. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.6599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- D. C. Dale
- University of Washington, Seattle, WA; Duke University Medical Center, Durham, NC; University of Rochester Medical Center, Rochester, NY
| | - J. Crawford
- University of Washington, Seattle, WA; Duke University Medical Center, Durham, NC; University of Rochester Medical Center, Rochester, NY
| | - O. Agboola
- University of Washington, Seattle, WA; Duke University Medical Center, Durham, NC; University of Rochester Medical Center, Rochester, NY
| | - G. H. Lyman
- University of Washington, Seattle, WA; Duke University Medical Center, Durham, NC; University of Rochester Medical Center, Rochester, NY
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Kendal WS, Lagerwaard FJ, Agboola O. Characterization of the frequency distribution for human hematogenous metastases: evidence for clustering and a power variance function. Clin Exp Metastasis 2001; 18:219-29. [PMID: 11315095 DOI: 10.1023/a:1006737100797] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
When groups of mice are injected with cells from a metastasizing tumor, a minority of individuals within a given group tends to sustain disproportionately larger numbers of metastases relative to the remaining group members. This clustering of metastases obeys a power function relationship, sigma2 = amub, between the variance sigma2 and the mean number of lung metastases per animal mu (a and b constant). To see whether such clustering occurs with human lung, brain, and liver metastases, a meta-analysis of clinical and pathological series was performed. Thirty-three published series were identified that provided data regarding the numbers of organ metastases sustained by 5582 people. The data were grouped according to the primary tumor, site of metastasis and method of detection of metastases. Clustering of metastases within individuals of each subgroup (similar to the murine systems) was demonstrated by variance to mean ratios greater than 1, and by a strong correlation to the variance to mean power function (a approximately 0.49, b approximately 2.24, r2 = 96%, p < 10(-6)). The cause of this clustering remains unclear, but it may in part relate to heterogeneities in regional blood flow. As a consequence of this clustering, limited metastases would be expected to occur more frequently than predicted from random chance-providing for some optimism in the management of limited metastasis. As well, the frequency distribution for metastases revealed certain scaling symmetries, likely reflective of the underlying mechanisms of metastasis, that could be of interest to both clinicians and experimentalists working with metastasis.
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Affiliation(s)
- W S Kendal
- Department of Radiation Oncology, The Ottawa Regional Cancer Centre, Ontario, Canada.
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Agboola O, Blott M. Guillain-Barre disease in pregnancy treated with intravenous immunoglobulin. J OBSTET GYNAECOL 2000; 20:535-6. [PMID: 15512646 DOI: 10.1080/014436100434794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- O Agboola
- Department of Obstetrics and Gynaecology, King's College Hospital, London, UK
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Affiliation(s)
- C Earle
- Ottawa Regional Cancer Centre, University of Ottawa, Ontario, Canada.
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Lochrin C, Goss G, Stewart DJ, Cross P, Agboola O, Dahrouge S, Tomiak E, Evans WK. Concurrent chemotherapy with hyperfractionated accelerated thoracic irradiation in stage III non-small cell lung cancer. Lung Cancer 1999; 23:19-30. [PMID: 10100143 DOI: 10.1016/s0169-5002(98)00098-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES We evaluated the effect of hyperfractionated accelerated radiotherapy combined with low dose radiosensitisers followed by standard dose chemotherapy in the treatment of unresectable stage III non small cell lung cancer (NSCLC). METHODS Forty-seven patients received thoracic radiotherapy (1.5 bid x 5 days x 4 weeks) in combination with low dose daily (3-6 mg/m2) cisplatin +/- weekly vinblastine chemotherapy (step I), followed by three cycles of standard dose chemotherapy alone consisting of cisplatin (75-80 mg/m2) and vinblastine (8-16 mg/m2) given at 3-4 week intervals (step II). RESULTS The overall response rate was 70% (21% CR). The progression free interval and the median survival duration were 10.4 months and 17.3 months, respectively. The 3 year survival rate was 21%. The site of first progression was local in 44%, distant in 41%, and simultaneous in 15% of patients. Levels of esophageal toxicity were significant but acceptable with the use of prophylactic therapy. Grade 3 or 4 esophageal toxicity was observed in 28 and 19% of patients during step I and II of the study, respectively. There were three deaths associated with esophageal toxicity. All occurred prior to the implementation of the prophylactic therapy for esophagitis. Acute pulmonary symptoms were reported in 25% of patients in step I, and pulmonary fibrosis, primarily asymptomatic, was observed in 51% of patients. Hematological toxicity was moderate. Two patients died of neutropenic sepsis/pneumonia. CONCLUSION Concurrent chemotherapy and hyperfractionated accelerated radiotherapy followed by chemotherapy appears moderately effective in controlling tumour growth as measured by response rates and survival estimates. Toxicity is considerable but manageable and compatible with results from other combined modality studies.
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Affiliation(s)
- C Lochrin
- Cancer Care Ontario, Ottawa Regional Cancer Centre, Ont, Canada
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Agboola O, Benoit B, Cross P, Da Silva V, Esche B, Lesiuk H, Gonsalves C. Prognostic factors derived from recursive partition analysis (RPA) of Radiation Therapy Oncology Group (RTOG) brain metastases trials applied to surgically resected and irradiated brain metastatic cases. Int J Radiat Oncol Biol Phys 1998; 42:155-9. [PMID: 9747833 DOI: 10.1016/s0360-3016(98)00198-9] [Citation(s) in RCA: 156] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE (a) To identify the prognostic factors that determine survival after surgical resection and irradiation of tumors metastatic to brain. (b) To determine if the prognostic factors used in the recursive partition analysis (RPA) of brain metastases cases from Radiation Therapy Oncology Group (RTOG) studies into three distinct survival classes is applicable to surgically resected and irradiated patients. METHOD The medical records of 125 patients who had surgical resection and radiotherapy for brain metastases from 1985 to 1997 were reviewed. The patients' disease and treatment related factors were analyzed to identify factors that independently determine survival after diagnosis of brain metastasis. The patients were also grouped into three classes using the RPA-derived prognostic parameters which are: age, performance status, state of the primary disease, and presence or absence of extracranial metastases. Class 1: patients < or = 65 years of age, Karnofsky performance status (KPS) of > or =70, with controlled primary disease and no extracranial metastases; Class 3: patients with KPS < 70. Patients who do not qualify for Class 1 or 3 are grouped as Class 2. The survival of these patients was determined from the time of diagnosis of brain metastases to the time of death. RESULTS The median survival of the entire group was 9.5 months. The three classes of patients as grouped had median survivals of 14.8, 9.9, and 6.0 months respectively (p=0.0002). Age of < 65 years, KPS of > or = 70, controlled primary disease, absence of extracranial metastases, complete surgical resection of the brain lesion(s) were found to be independent prognostic factors for survival; the total dose of radiation was not. CONCLUSION Based on the results of this study, the patients and disease characteristics have significant impact on the survival of patients with brain metastases treated with a combination of surgical resection and radiotherapy. These parameters could be used in selecting patients who would benefit most from such treatment.
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Affiliation(s)
- O Agboola
- Cancer Care Ontario, Ottawa Regional Cancer Centre, The University of Ottawa Faculty of Medicine, Canada
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Aref I, Eapen L, Agboola O, Cross P. The relationship between biochemical failure and time to nadir in patients treated with external beam therapy for T1-T3 prostate carcinoma. Radiother Oncol 1998; 48:203-7. [PMID: 9783893 DOI: 10.1016/s0167-8140(98)00061-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE AND BACKGROUND To determine a prostatic-specific antigen (PSA) nadir value and time to nadir that predict a high probability of freedom from biochemical failure in men treated with external beam therapy for prostate cancer. MATERIALS AND METHODS Between January 1990 and March 1994, 228 men with T1-T3 adenocarcinoma of the prostate received a radical course of external beam irradiation with no prior or adjuvant hormonal therapy. All men had pre- and post-treatment serum PSA evaluations, and were followed up for at least 24 months, to ensure PSA nadir was reached. Biochemical failure was defined as three successive post-treatment rises in serum PSA, regardless of the magnitude of elevation. RESULTS Overall, 4-year biochemical disease-free survival (BDFS) was 42%. PSA nadir was predictive of subsequent BDFS. For those whose serum PSA nadir was < or =1 ng/ml, 4-year BDFS was 70%, versus 12% for those with serum PSA nadir > 1 ng/ml (P = < 0.001). The 4-year BDFS for patients with time to nadir < or =1 year, was 28%, versus 58% for those with time to nadir > 1 year (P < 0.001). For patients with PSA nadir < or =1 ng/ml, 4-year BDFS was 75% for those with time to nadir > 1 year, versus 61% for those with time to nadir < or =1 year (P < 0.021). In multivariate analysis, PSA nadir(< or =1 ng/ml versus >1 ng/ml, and time to nadir (< or =1 year versus > year) were independent predictors of BDFS alone with pre-treatment PSA and Gleason score. CONCLUSION Only those who achieved PSA nadir < or =1 ng/ml following external beam therapy have a favourable chance of lasting biochemical disease control, while those with nadir > 1 ng/ml have a high subsequent failure rate. The prognosis is better in patients with late time to nadir. In addition to PSA nadir, time to nadir, pretreatment PSA, and Gleason score were of independent prognostic significance.
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Affiliation(s)
- I Aref
- Ottawa Regional Cancer Centre, Civic Division, Ontario, Canada
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Abstract
In this paper we present the dosimetric data of a Therapax DTX300 kilovoltage x-ray unit for endocavitary rectal irradiation. The unit if operated at tube voltage of 40-60 kVp (30 mA) with an added filtration of 0.2-0.4 mm Al generates acceptable beam qualities comparable to those of the original Papillon technique. Relative dosimetric measurements were performed at the cone end (37.2 cm SSD) of a 3 cm diameter rectal cone using various detectors to ensure the accuracy. A Monte Carlo method was used to calculate correction factors for the diode used in the percentage depth-dose (PDD) measurement, and to study the effect of the detector size on the beam profile. The PDD data were determined using the diode measurement corrected for its energy and angular response. It was found that the PTW N23342 and Markus parallel-plate chamber can be used directly to measure the PDD for this beam quality with 2% uncertainty. Measurement and Monte Carlo results have shown that the detector size has a significant effect on the penumbral profile. Film and diode detectors have a better spatial resolution compared to ionization chambers, but they may give an incorrect profile tail due to either nonlinear response at low energy or angular dependence. This can be corrected using the ionization-chamber measurement, based on the Monte Carlo analysis. The isodose distributions for this x-ray unit are presented.
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Affiliation(s)
- X A Li
- Department of Medical Physics, Ottawa Regional Cancer Centre, Canada.
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Aref I, Eapen L, Agboola O, Cross P. Is prostate specific antigen density an important prognostic indicator for patients with prostate cancer treated with external beam therapy? Br J Radiol 1998; 71:868-71. [PMID: 9828800 DOI: 10.1259/bjr.71.848.9828800] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The purpose of this study was to determine if prostate specific antigen density (PSAD) is a predictor of outcome following external beam radiotherapy for prostate cancer, and to compare it with other prognostic factors. Between January 1990 and December 1993, 205 patients with T1-T3 adenocarcinoma of the prostate received a radical course of external beam irradiation, with no prior or adjuvant hormonal therapy. All patients had pre- and post-treatment serum prostate specific antigen (PSA) evaluation. They were followed up for at least 24 months. PSAD was defined as the ratio of pre-treatment serum PSA to the prostate volume, as determined from CT treatment planning scans. Prostate volumes were calculated using the prostate ellipse formula. Median PSA density was 0.37, with a range 0.01-6.7. Biochemical failure was defined as three consecutive rises in serum PSA, regardless of the magnitude of elevation. 4-year biochemical disease-free survival (BDFS) for patients with PSAD < or = 0.3 was 60%, compared with 22% for patients with PSAD > 0.3 (p = < 0.001). In a multivariate analysis, pre-treatment PSA (p = < 0.001), Gleason score (p = 0.002), and stage (p = 0.03) were independent predictors of BDFS, while PSAD was not an important prognosticator (p = 0.62). Pre-treatment serum PSA is the most important prognosticator of BDFS, following external beam radiotherapy, for patients with prostate cancer. PSA density did not predict treatment outcome.
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Affiliation(s)
- I Aref
- Department of Radiation Oncology, Ottawa Regional Cancer Centre, Ontario
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Goss G, Lochrin C, Gertler S, Stewart D, Cross P, Agboola O, Stewart D, Spadafora S, Hewitt A, Bociek G, Evans W, Yau J. 168 A pilot study of high dose chemotherapy and irradiation with NEUPOGEN (G-CSF) in limited disease small cell lung cancer (SCLC). Lung Cancer 1997. [DOI: 10.1016/s0169-5002(97)89445-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Stewart DJ, Dahrouge S, Agboola O, Girard A. Cranial radiation and concomitant cisplatin and mitomycin-C plus resistance modulators for malignant gliomas. J Neurooncol 1997; 32:161-8. [PMID: 9120546 DOI: 10.1023/a:1005788121043] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We studied the toxicity and efficacy of adding in sequence 4 resistance modulators to combination chemotherapy and radiotherapy in the treatment of glioblastoma multiforme and poor prognosis anaplastic astrocytomas. Patients received cisplatin plus mitomycin-C concurrently with and following 60 Gy of radiotherapy administered over 6 weeks. Resistance modulators were added in sequence to chemotherapy in each cohort of 6 patients as follows: metronidazole + pentoxifylline (cohort 1); + dipyridamole (cohort 2), + beta carotene (cohort 3). Central nervous system toxicity (which ranged from drowsiness to seizures and loss of consciousness) was frequent. The incidence of gastrointestinal symptoms was substantial, but was usually mild to moderate in severity. Three of 11 patients evaluable for response achieved a partial remission with treatment. The median survival duration for all patients was 26 weeks from initial diagnosis. The study was terminated prematurely because of significant toxicity (in this study as well as in parallel concurrent studies of similar design in other tumor types) and apparent lack of benefit.
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Affiliation(s)
- D J Stewart
- Ontario Cancer Treatment and Research Foundation, Ottawa Regional Cancer Centre, Canada
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Lochrin C, Goss G, Cross P, Stewart D, Tomiak E, Agboola O, Aref I, Reid K, Girard A, Logan D, Crepeau A, Dahrouge S, Evans W. 1100 Concurrent daily chemotherapy with hyperfractionated thoracic irradiation in stage IIIA & B NSCLC. Eur J Cancer 1995. [DOI: 10.1016/0959-8049(95)96346-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Affiliation(s)
- O Agboola
- Ottawa Regional Cancer Centre, Department of Radiation Oncology, University of Ottawa, Ontario, Canada
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Omigbodun AO, Ilesanmi AO, Obisesan KA, Agboola O, Adeleye JA. Invasive cervical carcinoma in two sisters. West Afr J Med 1992; 11:158-61. [PMID: 1390378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The occurrence of pre-invasive cervical carcinoma among siblings and in mother-daughter pairs has been reported previously in Europe. Invasive cervical cancer diagnosed in two Nigerian sisters within a period of three months is reported. It is suggested that sisters and daughters of patients with cervical cancer may be at a higher risk of developing the lesion because of similar socio-economic and cultural backgrounds and should therefore have regular cervical screening.
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Affiliation(s)
- A O Omigbodun
- Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria
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Urtasun R, Feldstein ML, Partington J, Tanasichuk H, Miller JD, Russell DB, Agboola O, Mielke B. Radiation and nitroimidazoles in supratentorial high grade gliomas: a second clinical trial. Br J Cancer 1982; 46:101-8. [PMID: 6285947 PMCID: PMC2011055 DOI: 10.1038/bjc.1982.171] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
As a continuation of a previous controlled trial using "high-dose" metronidazole as a specific sensitizer of hypoxic cells, we used a more efficient nitroimidazole derivative (misonidazole, MISO) in combination with higher doses of radiation in patients with supratentorial high-grade astrocytomas. Sixty-six patients were stratified according to functional level and histological grading, and randomly allocated within 2 weeks of operation of 1 of 3 therapeutic groups: 1, conventional radiation alone; 2, large fractions of radiation with high-dose metronidazole; and 3, radiation as in Group 2 but with equitoxic doses of MISO. We examined survival as the principal end-point of the study. Neither by increasing the dose of radiation over the previous study, nor by using a more efficient sensitizer, were we able to improve survival over the current conventional daily fractionated radiation.
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Urtasun RC, Tanasichuk H, Fulton D, Agboola O, Turner AR, Koziol D, Raleigh J. High dose misonidazole with dexamethasone rescue: a possible approach to circumvent neurotoxicity. Int J Radiat Oncol Biol Phys 1982; 8:365-9. [PMID: 7107353 DOI: 10.1016/0360-3016(82)90641-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
With a view to modifying misonidazole (MISO) neurotoxicity, we initiated a randomized clinical study to assess a possible drug interaction and toxicity protection when dexamethasone (DXM) is administered concomittantly with MISO. The ongoing study consists of: 1. Pharmacokinetic evaluation; 2. Assessment of toxicity. Fourteen patients undergoing radiation therapy for different types of malignant neoplasia (excluding brain tumors) have been randomized to receive either MISO alone, or DXM one week prior and during treatment with MISO. Five of seven patients receiving MISO alone developed peripheral neuropathies while only one out of 7 patients that received MISO with DXM coverage developed a transient and mild neuropathy. Pharmacokinetic evaluation of MISO in plasma and urine of those patients receiving DXM has shown no evidence of drug interaction. It is postulated that the mechanism of action of DXM is at the nerve cell membrane level, restoring and stabilizing cell surface properties. In future studies we will investigate the use of DXM with increasing doses of MISO above the recommended maximum dose of 12 gm/m2, hoping to achieve a higher tumor tissue level of MISO while avoiding unacceptable toxicity. The effect of Allopurinol on the plasma kinetics of MISO was studied in four additional patients, observing also no evidence of drug interaction.
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Urtasun RC, Tanasichuk H, Fulton D, Raleigh J, Rabin HR, Turner R, Koziol D, Agboola O. Pharmacokinetic interaction of BCNU and misonidazole in humans. Int J Radiat Oncol Biol Phys 1982; 8:381-6. [PMID: 7107356 DOI: 10.1016/0360-3016(82)90644-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Although considerable laboratory in vitro and in vivo evidence is now available suggesting that misonidazole (MISO) enhances chemotherapy tumor responses, experience with human tumors is limited. Further, the mechanism of this enhancement is not definitely known. One possible mechanism is that MISO alters the pharmacokinetics of the chemotherapeutic agent, vice versa or both. We studied a group of patients with recurrent malignant gliomas, following radiotherapy. After proven recurrence, they were treated with i.v. BCNU in combination with oral MISO in an 8 week cycle. Our aims were: 1. To obtain a second remission; 2. To assess the toxicity of this combination; 3. To assess the plasma pharmacokinetics of each drug alone and in combination. Six patients entered the protocol. Four of six patients obtained either a partial or subpartial response. Prolonged moderate myelosuppression was observed in 2/6 patients after 3 cycles; 2/6 patients experienced seizures after the first cycle of chemotherapy for the first time in the course of their disease. The plasma pharmacokinetic data indicates no evidence of a MISO-BCNU drug interaction.
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