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Results for “REQUITE”

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PubMed2026

Early and late CTCAE and patient-reported outcomes following lung cancer radiotherapy: A sex-stratified descriptive analysis from the REQUITE cohort.

BACKGROUND: Long-term prospective data on lung cancer patients treated with radiotherapy are limited, restricting understanding of outcomes and sex-specific characteristics. The multicentre REQUITE study provides standardized follow-up data from an international cohort. METHODS: We analysed longitudinal data from 530 lung cancer patients treated with radical radiotherapy (sequential or concurrent chemoradiotherapy, or stereotactic body radiation therapy [SBRT]) between 2014 and 2017 at 16 centres in Europe and the USA. Healthcare professionals prospectively recorded 21 pulmonary, oesophageal, neurological, cardiac, and skin adverse events using CTCAE v4.0. Patient-reported outcomes assessed symptoms, quality-of-life, fatigue, and physical activity. Adverse event incidence was stratified by sex, radiotherapy technique, chemotherapy administration, smoking status, and other clinical factors. RESULTS: At 12 months, 309 patients were evaluable, with 151 having follow-up beyond one year. Pulmonary adverse events were most frequent (40% grade ≥ 2), mainly dyspnoea and cough. Women had higher rates of oesophagitis, and more frequently reported dysphagia, and chest wall pain, while men experienced a higher frequency of cardiac adverse events. Exploratory subgroup analyses identified significant sex-related differences in grade ≥ 3 pulmonary adverse events following SBRT and in overall grade ≥ 2 oesophageal adverse events among patients with clinical stage I-II and those aged >70 years. Patient-reported outcomes showed persistent fatigue and reduced physical activity, particularly in females. Symptom prevalence and severity varied by sex, age, treatment modality, smoking status, and clinical stage. CONCLUSION: The REQUITE-Lung cohort provides prospectively collected real-world data on radiotherapy-related adverse events in lung cancer patients. This study describes patterns of adverse events and patient-reported outcomes according to sex, age, and treatment characteristics. These findings are hypothesis-generating and may support future validation in independent and pooled datasets.

Patient-reported outcomes↗

PubMed1995

Left ventricular function on exercise after surgical treatment of small aortic annuli.

To evaluate left ventricular function during exercise after aortic annular enlargement 15 patients with either aortic (group I, n = 8) or aortomitral (group II, n = 7) annuloplasty for small aortic annuli and eight patients (group III) with standard valve replacement for aortic stenosis without small aortic annuli received gated cardiac pool imagining by technetium-99m-labelled red blood cells at rest and during exercise at a mean of 23 months after operation. Left ventricular ejection fraction, preload requitable stroke work and stroke power index (preload requitable stroke work/systolic ejection period) were measured. Compared with resting values, left ventricular performance and stroke work rate on exercise after aortic annular enlargements increased significantly, as did those after standard aortic valve replacement. These results suggest that aortic annular enlargement can be indicated for surgical treatment of valvular heart diseases associated with small aortic annuli.

Adult↗

PubMed2026

Technical note: reconstructing dose distributions from manually planned electron boosts in breast radiotherapy.

PURPOSE: In breast radiotherapy, delivery of manually-calculated electron boosts limits retrospective dose-response analyses as dose distribution is unavailable. This work evaluates the feasibility of reconstructing dose distributions from manually planned electron boosts in breast-conserving radiotherapy. METHODS: Only 72 out of 198 breast cancer patients had complete stored dose distributions from sequential electron boosts in the REQUITE study. Arbitrary data from 70/72 patients were used to develop and validate dose reconstruction method. Twenty patients were used to determine optimal parameters for Monte-Carlo-based (MC) electron dose reconstruction on RayStation (v.11B-R), considering CT-calibration curve, MC-history number, andcalculation grid resolution. Remaining 50 patients were used to quantify dose reconstruction accuracy. The similarity between reconstructed and stored dose was evaluated using 3D-gamma index and dosimetric parameters extracted from breast and tumour bed contours. Dose difference location was evaluated using dose-location histogram. RESULTS: Calculation grid resolution significantly impacted electron dose distribution (p < 0.01), where the finest grid (0.15 cm) showed highest similarity to stored doses. CT-calibration curve and MC-history number had a negligible influence on dose reconstruction. Dosimetric difference between reconstructed and stored doses was < 1 Gy for breast and tumour bed. Reconstructed dose was achieved > 90% gamma passing rate in the validation set. However, around 2.5 Gy dose differences were observed at the skin and tissue interface regions. CONCLUSIONS: Retrospective electron boost dose reconstruction is feasible with acceptable accuracy, and could increase data completeness in large cohort studies. Caution is advised when assessing dose near tissue interface and further validation is needed outside the REQUITE dataset.

Electrons↗

PubMed2026

Association of Therapeutic Mammoplasty and Radiotherapy Side-effects.

INTRODUCTION: Patients with larger breast size and volume are at increased risk of side-effects (toxicity) from radiotherapy. Therapeutic mammoplasty (TM) extends breast-conserving surgery by combining wide local excision of the cancer with breast reduction and mastopexy techniques. The aim of this study was to determine the effect of TM using level 2 oncoplastic techniques on the incidence of early and long-term radiotherapy side-effects. PATIENTS AND METHODS: Breast cancer patients recruited prospectively into the multicenter REQUITE cohort study (www.requite.eu) at a single institution (n = 346) were included. Radiotherapy side-effects (CTCAE v4.0) were scored at baseline, following radiotherapy, and at 2-year follow-up. The association of TM and specimen resection weight were investigated in multivariable regression models. RESULTS: At 2 years, 20.1 % of patients had grade ≥ 2 atrophy, 23.2% grade ≥ 1 tumor bed induration (fibrosis), 12.6% grade ≥ 1 breast induration, and 12.1% grade ≥ 1 telangiectasia. 22.5 % of patients (n = 78) underwent TM. TM patients had larger tumors (P = .006) and specimen resection weights (P < .001). TM but not specimen resection weight was associated with reduced tumor bed induration (Odds ratio = 0.12, 95% confidence interval [CI] 0.035-0.395, P = .001), breast induration (OR 0.19, CI 0.043-0.852, P = .03) and telangiectasia (OR 0.12, CI 0.020-0.736, P = .02). Neither TM nor specimen weight had any effect on atrophy or early radiotherapy side-effects. CONCLUSION: TM but not resected specimen weight was associated with fewer long-term radiotherapy side-effects. This implies that the incidence of side-effects is affected not by reducing the overall radiotherapy target volume but by re-shaping the breast, which is likely to reduce dose inhomogeneity.

Humans↗

PubMed2002

Systemic reperfusion injury during arm replantation requiring intraoperative amputation.

This case describes the attempted replantation of an arm following its traumatic amputation. After a five-and-a-half hour ischaemic time, perfusion of the arm was re-established. However over the ensuing hours, the patient developed hyperkalaemia, acidaemia and severe hypotension requiting high dose inotropic support. Ultimately re-amputation was necessary to treat the systemic effects of the ischaemia reperfusion syndrome.

Adult↗

PubMed2001

Role of surgery in the management of Graves' disease.

Seventy-two patients, 50 women and 22 men, were operated on for Graves' disease. Their median age was 35 years. The indications for surgery included patients with large goitre, relapse after antithyroid drug (ATD) therapy, allergic reactions to ATD, non-compliance and finally an associated nodule with suspicion of carcinoma. Patients were rendered euthyroid with ATD before surgery and were pretreated with Lugol's iodine. Standard subtotal thyroidectomy was performed in 64 patients, total thyroidectomy in 7 patients, and one patient underwent a completion thyroidectomy after an initial subtotal thyroidectomy. The weight of the thyroid remnant on either side was estimated emperically between 3 g and 5 g. There was no postoperative death or thyrotoxic crisis. There was no case of permanent recurrent laryngeal nerve damage or hypoparathyroidism. Eight patients (11.1%) had temporary unilateral vocal cord palsy and 4 patients (5.5%) had temporary hypocalcemia. One patient (1.4%) developed recurrent hyperthyroidism. Postoperative transient hypothyroidism developed in 87.5% cases, all within the first postoperative year. The functional results at 2 years were as follows: Out of 47 cases followed 31 patients (65.9%) became euthyroid while 15 (31.9%) were still hypothyroid and requited long term substitutive treatment. Ophthalmopathy worsened in only one patient. Thyroidectomy has reasonable role in the management of Graves' disease, because the patients have had their diseases rapidly terminated, were hospitalised for an average period of only 3.5 days and have had no permanent functional insult except for hypothyroidism.

Adolescent↗

PubMedDate not supplied

The mucosal immune system and HIV-1 infection.

Recent progress in HIV-1 and SIV pathogenesis has revealed that mucosal tissues, primarily the gastrointestinal tract, are major sites for early viral replication and CD4+ T-cell destruction, and may be the major viral reservoir, even in patients receiving HAART. This is likely attributable to the fact that the majority of mucosal CD4+ T-cells co-expressing chemokine receptors requited for HIV-1 entry, reside in mucosal tissues. Furthermore, the intestinal mucosal immune system is continuously bombarded by dietary antigens, resulting in continual lymphocyte activation, dissemination, and homing of these activated lymphocytes (including CCR5+CD4+ T-cells) throughout mucosal tissues. Thus, the intestinal immune system represents a very large target for HIV-infection, which is continually generating newly activated CD4+ T-cells that are the preferred target of infection. Thus, HIV-1 appears uniquely adapted to persist and thrive in the mucosal-tissue environment. The selective loss of intestinal CD4+ T-cells from immune-effector sites is also likely to explain, at least in part, the preponderance of opportunistic infections at mucosal sites. It is increasingly evident that effective therapies and vaccines must be directed towards eliminating HIV-1 in mucosal tissue reservoirs, protecting mucosal CD4+ T-cells and stimulating effective mucosal immune responses.

Animals↗

PubMedDate not supplied

Cellular parameters predictive of the clinical response of colorectal cancers to irinotecan. A preliminary study.

BACKGROUND: We have examined, in this study, the feasibility of determining cellular factors contributing to irinotecan activity in colorectal cancers. Irinotecan is a camptothecin derivative requiting carboxylesterase activation to SN-38, which interacts with its target enzyme, topoisomerase I. MATERIALS AND METHODS: In 9 surgical or biopsy samples of colorectal tumours and corresponding normal tissue, kept in a tumour bank, we evaluated topoisomerase I expression and activity, respectively by Western blotting and DNA relaxation assay, carboxylesterase activity using two different substrates and p53 status by immunohistochenistry. RESULTS: Topoisomerase I expression and activity were significantly correlated, as were the two types of determinations for carboxylesterase activity. Topoisomerase I was significantly more active in tumours than in corresponding normal tissue. The three samples presenting the highest topoisomerase I expression and activity originated from the patients who responded to irinotecan treatment. No such features were apparent for carboxylesterase activity and p53 staining. CONCLUSION: Topoisomerase I expression appeared as the parameter most likely to predict response to irinotecan therapy in the clinical setting.

Adult↗

PubMed1994

Phase I clinical trial of irinotecan (CPT-11), 7-ethyl-10-[4-(1-piperidino)-1-piperidino]carbonyloxy-camptothecin, and cisplatin in combination with fixed dose of vindesine in advanced non-small cell lung cancer.

Irinotecan hydrochloride (CPT-11), a semisynthetic derivative of camptothecin, has been demonstrated to be active against solid tumors such as non-small cell lung cancer and colorectal cancer. Two combination phase I trials were undertaken to determine the maximum tolerated dose of CPT-11 in combination with cisplatin and vindesine in patients with advanced non-small cell lung cancer. All 46 patients (age 32-73 years) entered into these trials had a good performance status (Eastern Cooperative Oncology Group score, 0-1) and had received no prior chemotherapy or radiotherapy. In the first trial, 14 stage IV and 2 stage IIIb patients were studied; in the second trial 30 patients with stage IV disease were accrued. In the first trial, CPT-11 was given as a 90-min i.v. infusion on days 1 and 8 in combination with a fixed dose of cisplatin (100 mg/m2, i.v., on day 1) and vindesine (3 mg/m2, i.v., on days 1 and 8), every 4 weeks. The starting dose of CPT-11 was 25 mg/m2, and the dose was increased in increments of 25 mg/m2. In the second trial, the doses of either CPT-11 (days 1 and 8) or cisplatin (day 1) were escalated with a fixed dose of vindesine (same dose as the first study) given in a 4-week cycle. The starting doses of CPT-11 and cisplatin were 20 and 60 mg/m2, respectively, and the dose of either CPT-11 or cisplatin was increased in increments of 20 mg/m2. At least 3 patients were entered at each dose level in both trials. Use of granulocyte colony-stimulating factor or granulocyte-macrophage colony-stimulating factor was not permitted in this trial. In the first trial, grade 4 granulocytopenia and grade > or = 3 diarrhea were dose limiting at 50 mg/m2 CPT-11, which represented the maximum tolerated dose. At the subsequent dose of CPT-11, 7 new patients were requited at the 50% reduced dose level of 37.5 mg/m2 on days 1 and 8. Nine patients were evaluated for response, and 4 of them achieved a partial response. In spite of a low dose of CPT-11 (25-37.5 mg/m2), the maximum concentration in plasma of CPT-11 (> 0.4 micrograms/ml) reached > 10-fold the in vitro concentration of CPT-11 required for 50% inhibition of growth. In the second trial, the dose-limiting toxicities were grade 4 granulocytopenia lasting for > or = 7 days and grade > or = 3 diarrhea.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1995

[Parental communication and support perceived in families of suicidal and non-suicidal adolescents].

This study focuses on two family-related variables linked to the issue of teenage suicide, namely communication and parental support. The purpose of the study is to compare the perceptions of suicidal and non-suicidal teenagers with those of their parents in order to better understand the relation between these variables and the issue of teenage suicide. Results confirm that communication and parental support represents a problem in families with suicidal teenagers. These dimensions are perceived more negatively by the latter subjects in comparison to the control group. In addition, the variations in perception between the adolescent and his or her parents are much greater in families with suicidal teens. This data supports the usefulness of family interventions when family problems are identified during detection measures or when counseling is requited by a suicidal teenager.

Adolescent↗

PubMedDate not supplied

[Methane in cadaver blood--homicide by natural gas or postmortem formation?].

A man had a quarrel with his wife. Suddenly he collapsed and became cyanotic. The woman supposed him to be dead. Because she was afraid of familiar requital, she opened the gas-cock of the cooking-range to pretend a suicide; methane emitted. The autopsy revealed a fresh cardiac infarction. Postmortem chemical analysis established methane in the blood. The question was, whether the methane had any importance for the death. By experimental inhalation of a methane-air-mixture (3%) we could expose, that the methane concentration in postmortem blood didn't have any relevance for the death.

Adult↗