RESUMEN
OBJECTIVE: The Covid-19 pandemic led to challenging discussions between oncology clinicians and patients regarding additional risks posed by SARS-CoV-2 infection whilst receiving systemic anti-cancer therapies (SACT). We assess the potential factors affecting discontinuation of adjuvant early breast cancer treatment during the pandemic. METHODS: Data were collected on all patients with early breast cancer undergoing adjuvant SACT, between 16 March and 17 April 2020 at a single UK cancer centre. Univariate binary logistic regression analysis was performed on variables including age, recurrence risk, Index of Multiple Deprivation decile, presence of physical comorbidities, modality of treatment (neoadjuvant or adjuvant), type of treatment (cytotoxic chemotherapy or monoclonal antibodies), percentage of cycles completed and availability of alternative treatments, with a binary dependent variable on treatment discontinuation. RESULTS: Sixty-two patients with early breast cancer were identified: 18 receiving neoadjuvant and 44 adjuvant therapies. Median age was 57.5 years (range 31-75 years). Age (P = 0.02), percentage of treatment cycles completed (P = 0.014) and presence of alternative treatment options (P = 0.019) were significant factors for SACT discontinuation during the height of the Covid-19 pandemic. CONCLUSION: Factors affecting patients' decisions to discontinue SACT for early breast cancer during the Covid-19 pandemic were elucidated, which may help identify patients requiring additional support.
Asunto(s)
Neoplasias de la Mama , COVID-19 , Humanos , Adulto , Persona de Mediana Edad , Anciano , Femenino , Neoplasias de la Mama/terapia , Pandemias , SARS-CoV-2 , Terapia NeoadyuvanteRESUMEN
BACKGROUND: We validated the new European Organisation for Research and Treatment of Cancer Quality of Life Head and Neck Module (EORTC QLQ-HN43). METHODS: We enrolled 812 patients with head and neck cancer from 18 countries. Group 1 completed the questionnaire before therapy, and 3 and 6 months later. In group 2 (survivors), we determined test-retest reliability using intraclass correlation coefficients (ICC). Internal consistency was assessed using Cronbach's Alpha, the scale structure with confirmatory factor analysis, and discriminant validity with known-group comparisons. RESULTS: Cronbach's alpha was >0.70 in 10 of the 12 multi-item scales. All standardized factor loadings exceeded 0.40. The ICC was >0.70 in all but two scales. Differences in scale scores between known-groups were >10 points in 17 of the 19 scales. Sensitivity to change was found to be sufficient in 18 scales. CONCLUSIONS: Evidence supports the reliability and validity of the EORTC QLQ-HN43 as a measure of quality of life.
Asunto(s)
Neoplasias de Cabeza y Cuello/psicología , Calidad de Vida , Encuestas y Cuestionarios , Anciano , Anciano de 80 o más Años , Terapia Combinada , Europa (Continente) , Femenino , Neoplasias de Cabeza y Cuello/complicaciones , Neoplasias de Cabeza y Cuello/terapia , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Estudios Prospectivos , Psicometría , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadAsunto(s)
Síndrome de Kartagener/diagnóstico , Síndrome de Kartagener/terapia , Anciano , Femenino , HumanosRESUMEN
Scar involvement is a rare but characteristic cutaneous manifestation of sarcoidosis. The concurrent presence of FDG-avid lymphadenopathy and scar involvement (the "scar sign") is a useful finding on FDG PET/CT to suggest sarcoidosis, especially when biopsy specimens are difficult to obtain. A 46-year-old woman who presented with fever, cough, and weight loss was found to have mediastinal and hilar lymphadenopathy on chest radiography and CT scan. FDG PET/CT scan showed FDG-avid lower cervical, mediastinal, hilar, and inguinal lymphadenopathy. There was also increased FDG uptake along an old hysterectomy scar. Mediastinoscopy and nodal biopsy revealed noncaseating granulomas compatible with sarcoidosis.
Asunto(s)
Cicatriz/complicaciones , Cicatriz/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Imagen Multimodal , Tomografía de Emisión de Positrones , Sarcoidosis/complicaciones , Sarcoidosis/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana EdadAsunto(s)
Dolor Abdominal/etiología , Pólipos Adenomatosos/diagnóstico , Enfermedades Intestinales/diagnóstico , Neoplasias Intestinales/diagnóstico , Intususcepción/diagnóstico , Pólipos Adenomatosos/complicaciones , Adulto , Colonoscopía , Humanos , Enfermedades Intestinales/complicaciones , Neoplasias Intestinales/complicaciones , Intususcepción/etiología , Masculino , Tomografía Computarizada por Rayos XAsunto(s)
Adenolinfoma/diagnóstico , Ganglios Linfáticos/patología , Neoplasias Primarias Secundarias/sangre , Neoplasias Primarias Secundarias/diagnóstico , Tiroglobulina/sangre , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/diagnóstico , Adenolinfoma/patología , Anciano de 80 o más Años , Diagnóstico Diferencial , Femenino , Humanos , Radioisótopos de Yodo/uso terapéutico , Metástasis Linfática/diagnóstico , Cuello , Neoplasias Primarias Secundarias/patología , Neoplasias Primarias Secundarias/cirugía , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugíaAsunto(s)
Adenocarcinoma/complicaciones , Ceguera/etiología , Confusión/etiología , Neoplasias Primarias Desconocidas/patología , Síndrome de Leucoencefalopatía Posterior/diagnóstico , Convulsiones/etiología , Adenocarcinoma/secundario , Anticonvulsivantes/uso terapéutico , Ceguera/diagnóstico , Encéfalo/patología , Isquemia Encefálica/complicaciones , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/tratamiento farmacológico , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/secundario , Confusión/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Síndrome de Leucoencefalopatía Posterior/complicaciones , Síndrome de Leucoencefalopatía Posterior/tratamiento farmacológico , Factores de Riesgo , Convulsiones/diagnósticoRESUMEN
Metastasis to the internal auditory canal from breast carcinoma is extremely rare and difficult to diagnose. It radiologically mimics vestibular schwannoma and can occur as a first manifestation of systemic relapse after a long disease-free interval in patients previously treated for early breast cancer. The diagnosis is usually made retrospectively and the optimal management of such metastasis following complete resection remains undefined.