ABSTRACT
Purpose: Despite the burgeoning geriatric population with cancer and the importance of understanding how age may be related to mental adjustment and quality of life so far, differences in coping strategies and psychological harm between the elderly and adults are hardly being taken into account to modify the approach to this population. The aim of this prospective study is to describe the differences in psychological characteristics between older and adult cancer patients and examine dissimilarities in their psychological evolution during adjuvant chemotherapy. Methods: Adults (18-69 years old) and older patients (≥ 70) with newly diagnosed non-metastatic resected cancer admitted to receive adjuvant chemotherapy were recruited. Patients completed the following questionnaires: mini-mental adjustment to cancer, brief symptom inventory, shared decision-making questionnaire-patients version, multidimensional scale of perceived social support, EORTC quality-of-life instrument, life orientation test-revised, and satisfaction with life scale. Results: 500 cancer patients (394 adults and 106 older) were evaluated. The impact of the diagnosis was less negative among older patients, with no differences in coping strategies, quality of life, or search for support. Regarding psychological changes from the beginning to the end of the adjuvant treatment, both age groups reported more somatic symptoms, increased psychological difficulty, reduced coping strategies, and a significant decrease in quality of life at the end of postoperative chemotherapy. Conclusion: Although there were clear psychological differences between adults and senior cancer patients, their evolution during adjuvant chemotherapy was similar, with deterioration in quality of life and coping. This negative psychological impact of adjuvant chemotherapy should be taken into account when considering interventions
No disponible
Subject(s)
Humans , Adult , Aged , Adaptation, Psychological , Neoplasms/psychology , Chemotherapy, Adjuvant/psychology , Age Distribution , Social Support , Quality of Life/psychology , Sickness Impact Profile , Decision Making , Postoperative PeriodABSTRACT
Aim. To explore the relationship between basal 18F-FDG uptake in breast tumors and survival in patients with breast cancer (BC) using a molecular phenotype approach. Material and Methods. This prospective and multicentre study included 193 women diagnosed with BC. All patients underwent an 18F-FDG PET/CT prior to treatment. Maximum standardized uptake value (SUVmax) in tumor (T), lymph nodes (N), and the N/T index was obtained in all the cases. Metabolic stage was established. As regards biological prognostic parameters, tumors were classified into molecular sub-types and risk categories. Overall survival (OS) and disease free survival (DFS) were obtained. An analysis was performed on the relationship between semi-quantitative metabolic parameters with molecular phenotypes and risk categories. The effect of molecular sub-type and risk categories in prognosis was analyzed using Kaplan-Meier and univariate and multivariate tests. Results. Statistical differences were found in both SUVT and SUVN, according to the molecular sub-types and risk classifications, with higher semi-quantitative values in more biologically aggressive tumors. No statistical differences were observed with respect to the N/T index. KaplanMeier analysis revealed that risk categories were significantly related to DFS and OS. In the multivariate analysis, metabolic stage and risk phenotype showed a significant association with DFS. Conclusion. High-risk phenotype category showed a worst prognosis with respect to the other categories with higher SUVmax in primary tumor and lymph nodes (AU)
Objetivo. Analizar la relación entre la captación basal de 18F-FDG en tumores mamarios y la supervivencia en pacientes con cancer de mama (CM) bajo la aproximación del fenotipo molecular. Material y métodos. Este estudio prospectivo y multicentrico incluyó 193 mujeres diagnosticadas de CM. Todas las pacientes fueron sometidas a una 18F-FDG PET/TC previa al tratamiento. Se obtuvo el SUVmax en el tumor (T), ganglios linfáticos (N) así como el índice N/T en todos los casos. Además se determinó el estadio metabólico. Atendiendo a los factores biológicos pronósticos, los tumores fueron clasificados en subtipos moleculares y categorias de riesgo. Se obtuvo tanto la supervivencia global (SG) como la supervivencia libre de enfermedad (SLE). Se estudió la relación entre los parámetros metabólicos semicuantitativos con los fenotipos moleculares y las categorías de riesgo. Se analizó el efecto del subtipo molecular y las categorías de riesgo en el pronóstico mediante análisis de KaplanMeier y test uni y multivariantes. Resultados. Se encontraron diferencias estadísticamente significativas en tanto el SUVT como el SUVN, deacuerdo a los fenotipos moleculares y las categorías de riesgo, con valores mayores en los tumores biológicamente más agresivos. No se observaron diferencias con respecto al índice N/T. El análisis de KaplanMeier reveló que las categorías de riesgo se relacionaron de forma significativa con la SG y SLE. En el análisis multivariante, el estadio metabólico y la categoría de riesgo mostraron asociación significativa con la SLE. Conclusion. La categoría de alto riesgo manifestó un peor pronóstico con respecto a las otras categorías, con mayores valores de SUVmax tanto en el tumor primario como en ganglios linfáticos (AU)
Subject(s)
Humans , Female , Breast Neoplasms , Fluorodeoxyglucose F18/analysis , Survivorship/physiology , Disease-Free Survival , Lymph Nodes/pathology , Lymph Nodes , Prognosis , Biological Factors/metabolism , Biological Factors/physiology , Prospective Studies , Molecular Medicine/methods , Molecular Medicine/trends , Kaplan-Meier EstimateABSTRACT
Purpose. To explore the relation between tumor kinetic assessed by 18F-FDG PET and final neoadjuvant chemotherapy (NC) response within a molecular phenotype perspective. Material and Methods. Prospective study included 144 women with breast cancer. All patients underwent a dual-time point 18F-FDG PET/CT previous to NC. The retention index (RI), between SUV-1 and SUV-2 was calculated. Molecular subtypes were re-grouped in low, intermediate and high-risk biological phenotypes. After NC, all residual primary tumor specimens were histopathologically classified in tumor regression grades (TRG) and response groups. The relation between SUV-1, SUV-2 and RI with the TRG and response groups was evaluated in all molecular subtypes and in accordance with the risk categories. Results. Responder's lesions showed significant greater SUVmax compared to non-responders. The RI value did not show any significant relation with response. Attending to molecular phenotypes, statistical differences were observed with greater SUV for responders having high-risk molecular subtypes. Conclusion. Glycolytic tumor characteristics showed a significant correlation with NC response and dependence of risk phenotype (AU)
Objetivo. Estudiar la relación entre la cinética tumoral valorada por 18F-FDG PET y la respuesta final al tratamiento neoadyuvante (TN) bajo la perspectiva del fenotipo molecular. Material y métodos. Estudio prospectivo que incluye 144 mujeres con cáncer de mama. A todas las pacientes se les realizó una 18F-FDG PET/CT de doble fase previa al TN. El índice de retención (IR) entre el SUV-1 y el SUV-2 fue calculado. Los subtipos moleculares se agruparon en bajo, intermedio y alto riesgo. Tras el TN, los especímenes residuales tumorales se clasificaron histológicamente en grados de regresión tumoral (GRT) y grupos de respuesta. La relación entre el SUV-1, SUV-2 y el IR con los GRT y los grupos de respuesta se evaluó para todos los subtipos moleculares y las categorías de riesgo. Resultados. Las lesiones que experimentaron respuesta mostraron mayores valores de SUVmax comparadas con las no respondedoras. El IR no mostró ninguna relación significativa con la respuesta. De acuerdo con los fenotipos moleculares, se observaron diferencias significativas con mayores valores de SUV en los respondedores pertenecientes a los subtipos moleculares de alto riesgo. Conclusión. Las características glucolíticas tumorales mostraron una relación significativa con la respuesta al TN y dependencia del fenotipo de riesgo (AU)
Subject(s)
Humans , Female , Middle Aged , Breast Neoplasms , Fluorodeoxyglucose F18 , Positron-Emission Tomography/instrumentation , Positron-Emission Tomography/methods , Neoadjuvant Therapy/methods , Neoadjuvant Therapy , Prospective Studies , Breast/cytology , Breast/pathology , Ultrasonography, MammaryABSTRACT
No disponible
Subject(s)
Aged , Female , Humans , Antimetabolites, Antineoplastic , Coronary Vasospasm , Fluorouracil , Hemochromatosis , HemochromatosisABSTRACT
No disponible
