Showing papers by "Martine Extermann published in 2011"
TL;DR: In NHL patients, hyperglycemia correlates with NHemT, and a similar although less clear pattern is suggested in PC patients, suggesting a better glycemic control during chemotherapy can improve toxicity and outcomes.
Abstract: Background:Few data are available concerning how glycemic control can affect outcomes in cancer patients treated with chemotherapy.Methods:Charts of non-Hodgkin lymphoma (NHL) and prostate cancer (PC) patients treated at Moffitt Cancer Center between January 1999 and September 2006 were reviewed, an
78 citations
TL;DR: The rationale and general academic and public health implications of these priorities represent an expert consensus with potential to guide education, clinical practice, and research to improve the care of older cancer patients throughout the world.
42 citations
TL;DR: This article will address the recent updates in the basic assessment of the patient’s condition and their implication for clinical and research use, and recommend a two-step approach to the basic evaluation of the older cancer patient.
Abstract: Cancer is a disease of the elderly (median age 67 in the US), and this is a population with a variable health status. Therefore, treating the older half of the cancer population will present the challenge of not only addressing tumor diversity (the side often referred to in “personalized cancer care” discussions), but patient diversity as well as the interaction between these two heterogeneities. In that sense, geriatric oncology is the ultimate personalized cancer care. In this article, we will address the recent updates in the basic assessment of the patient’s condition, and their implication for clinical and research use. The main progresses reported in the last couple of years pertain to geriatric screening tests, and to prediction of the tolerance to treatment. Some important data on the impact of comorbidities on cancer behavior have emerged, but the clinical implications of these data are still being sorted out. We recommend a two-step approach to the basic evaluation of the older cancer patient. First a short screening with a tested screening instrument. Then further work-up of the geriatric findings in parallel with the oncology work-up to define an integrated treatment plan.
27 citations
TL;DR: Conurrent thoracic radiation therapy and celecoxib was well tolerated and toxicities matched those expected with thoracics radiotherapy alone, and the sample size was too small to draw conclusions regarding efficacy.
23 citations
TL;DR: The preferential over-expression of IR in the peri-tumoral microvessels suggests that hyperinsulinemia might contribute to colorectal cancer growth by enhancing angiogenesis.
23 citations
TL;DR: Elderly cancer patients with normal complete blood cell counts during the first course of chemotherapy might be unlikely to experience grade 4 neutropenia during subsequent cycles, and further weekly CBCs might be avoided.
Abstract: Elderly cancer patients with normal complete blood cell counts (CBCs) during the first course of (some types of) chemotherapy might be unlikely to experience grade 4 neutropenia during subsequent cycles. In this case, further weekly CBCs might be avoided. We used data of 223 cancer patients aged 70+ who were included in the CRASH (Chemotherapy Risk Assessment Score for High-age patients) trial between 2003 and 2007 in 7 cancer practices in the US. First cycle CBC values were compared to subsequent cycles. MAX2-score was used as a measure for toxicity of the chemotherapy regimen. Sixty-two patients (28%) experienced grade 4 neutropenia during subsequent cycles. Among patients who received chemotherapy with a MAX2-score lower than 0.20, only 4.6% of those without neutropenia during the first cycle experienced grade 4 neutropenia during subsequent cycles. Weekly CBC might be avoided in these patients receiving chemotherapy. Future prospective studies should confirm these results.
10 citations
TL;DR: Since diabetic patients did not have more side-effects of adjuvant chemotherapy, and adjUvant chemotherapy had a positive effect on survival for both patients with and without diabetes, diabetes alone should not be a reason for withholding adjuants.
Abstract: Background: With increasing prevalence of diabetes mellitus and colon cancer, the number of patients suffering from both diseases is growing, and physicians are being faced with complicated treatment decisions. Objective: To investigate the association between diabetes and treatment/course of stage III colon cancer and the association between colon cancer and course of diabetes. Materials and Methods: Additional information was collected from the medical records of all patients with both stage III colon cancer and diabetes ( n =201) and a random sample of stage III colon cancer patients without diabetes ( n =206) in the area of the population-based Eindhoven Cancer Registry (1998–2007). Results: Colon cancer patients without diabetes were more likely to receive adjuvant chemotherapy compared with diabetic colon cancer patients (OR 1.8; 95% CI 1.2–2.7). After adjustment for age, this difference was borderline significant (OR 1.6; 95% CI 1.0–2.6). Diabetic patients did not have: significantly more side-effects from surgery or adjuvant chemotherapy; more recurrence from colon cancer; significantly shorter time interval until recurrence; or a poorer disease-free survival or overall survival. Age and withholding of adjuvant chemotherapy were most predictive of all-cause mortality. After colon cancer diagnosis, the dose of antiglycaemic medications was increased in 22% of diabetic patients, resulting in significantly lower glycaemic indexes than before colon cancer diagnosis. Conclusions: Since diabetic patients did not have more side-effects of adjuvant chemotherapy, and adjuvant chemotherapy had a positive effect on survival for both patients with and without diabetes, diabetes alone should not be a reason for withholding adjuvant chemotherapy. Journal of Comorbidity 2011;1(1):19–27
3 citations