[Internet Use by Oncology Outpatients: Results of a Survey in Germany]. / Internetnutzung von Patienten in der ambulanten onkologischen Versorgung: Ergebnisse einer deutschlandweiten Patientenbefragung.

OBJECTIVE: Internet has become an important source of information for cancer patients regarding disease and treatment. A national survey was conducted to assess the importance of Internet in the routine care of cancer patients in Germany. METHOD: The cross-sectional survey included 5,984 outpatients (56.7% female, M=64.3 years, SD=12). 3 groups were identified: Internet users, non-users whose families/friends did online research for them, and "complete" non-users. The data was analyzed using descriptive statistics and group comparisons. RESULTS: 1 patient in 2 used the Internet to research health-related information. Internet users considered this research to be helpful, felt better able to participate in health-related decisions, and less alone with their disease. However, the information found online contributed to a feeling of uncertainty. 72.5% of Internet users researched treatment options and 21.3% talked to their doctor about their research. CONCLUSION: The Internet was shown to be an important source of information for cancer patients. For patients to be able to use Internet research meaningfully, it could be helpful that they receive support from their oncologist.

Electronic Patient Reported Outcome (ePRO) Measures in Patients with Soft Tissue Sarcoma (STS) Receiving Palliative Treatment.

The PazoQoL prospective, randomized, controlled, multicenter study was designed to continuously assess global health related quality of life (HRQoL) during treatment with pazopanib or physician-preferred chemotherapy over a 9-week period. The questionnaires were completed by the patients at home with great reliability during this time period. Continuous electronic patient reported outcome (ePRO) enabled early detection of the onset of deterioration and timely initiation of countermeasures. The Cancer Therapy Satisfaction Questionnaire (CTSQ) showed high interindividual variability and decline over a 9-week period, whereas the Time Trade-off (TTO) proved to be an efficient method for assessing individual benefit from cancer therapy. In our cohort, the TTO clearly demonstrated that the prolongation of life and the side effect profile of continued therapy were not as satisfactory as expected by patients when starting a new therapy. Although the study had to be stopped early due to the pandemic, our findings could translate into clinical practice without much effort and outside of a trial.

Effective treatment of pancreatic neuroendocrine tumours transfected with the sodium iodide symporter gene by 186Re-perrhenate in mice.

PURPOSE: ReO(4)(-) has similar kinetics regarding the sodium iodide symporter (NIS) to I(-) and TcO(4)(-) in NIS-expressing tissue. We investigated the therapeutic potential of (186)ReO(4)(-) in NIS-transfected neuroendocrine tumour tissue. METHODS: For experiments, the stably NIS-transfected pancreatic neuroendocrine cancer cell line Bon1C was used. NIS-mediated internalization and externalization experiments in vitro and a biodistribution study in nude mice bearing Bon1C xenografts were performed. A therapy study was also conducted consecutively in nude mice xenografted with Bon1C in which the mice were injected intravenously with Na(186)ReO(4). RESULTS: In vitro studies showed exponential internalization and efflux kinetics of (186)ReO(4)(-) in the cell line. The biodistribution study showed high uptake of (186)ReO(4)(-) in NIS-expressing tumours. Tumour growth inhibition was significant after injection of (186)ReO(4) in two groups of animals treated with activity levels below the determined maximum tolerable activity as compared to controls. CONCLUSION: These results indicate that the use of (186)ReO(4)(-) in the treatment of NIS-expressing neuroendocrine tumours is feasible and support the concept of using NIS as a therapeutic target for (186)ReO(4)(-).

Tumor Boards from the Perspective of Ambulant Oncological Care.

BACKGROUND: Cancer therapy requires the cooperation of physicians from different disciplines. At the core of the collaboration are 'tumor boards' (also known as 'multidisciplinary team meetings' and 'tumor conferences'). However, there is limited health care research that addresses the multiple facets of such meetings. MATERIAL AND METHODS: Data were analyzed from 3 routinely conducted surveys comprising information from (i) office-based hematologists and oncologists, (ii) their patients, and (iii) quality indicators. RESULTS: Most office-based oncologists stated that they participate in tumor boards taking place in hospitals. Although tumor boards are viewed as time intensive and lack financial compensation, they are considered as beneficial for patient care. Less than half of patients knew that their cases were discussed at a tumor board; those who knew rated the collaboration between their treating doctors as more positive, but also experienced slightly higher distress levels. The quality indicators showed that tumor board meetings were documented in three-quarters of the patient charts, but only half included the tumor board's recommendation. CONCLUSIONS: Participation in tumor boards is perceived as beneficial by oncologists and not just considered as a fulfillment of societies' recommendations or guidelines. The higher distress levels in patients who knew that their case was discussed at a tumor board may have occurred because more difficult cases are discussed at tumor boards and since the oncologists spend more time explaining the therapy process in complex cases, including the tumor board results.

Mandible reconstruction with patient-specific pre-bent reconstruction plates: comparison of a transfer key method to the standard method--results of an in vitro study.

PURPOSE: Patient-specific mandible reconstruction plates may be pre-bent to facilitate the surgical procedure. A method using transfer keys (TK) for repositioning pre-bent plates was compared with the standard method on mandibular models to evaluate its feasibility. METHOD: Ten mandible models were used to pre-bend reconstruction plates. After plate fixing on the models, TK were fabricated. Plates and TK were removed and segmental resections were performed. The plates were replaced on the models by the standard method of determining the plate position using previous screw holes. Plates were removed and then relocated by use of the TK. To compare the accuracy of both methods, the distances between four corresponding points of the condyles and the mandibular rami were measured. RESULTS: The mean deviation of the absolute values from the initial values for the models between the condyles and the rami was 0.964 mm for the standard method and 0.821 mm for the TK method. To determine whether there was enlargement or shrinkage between the rami or the condyles, we analysed the relative values of the data. For the standard method, the mean deviation from the initial values was +0.178 mm; for the TK method, it was +0.080 mm. In both cases, the differences were not significant. CONCLUSION: Pre-bent reconstruction plates using patient-specific 3D models can be useful in mandible reconstruction. The TK method was tested in vitro and shown to be as accurate as the standard method. The TK method may shorten the procedure and may be useful for secondary cases and cases where the pathology involves the outer corte of the mandible.

Efficacy of 99mTc pertechnetate and 131I radioisotope therapy in sodium/iodide symporter (NIS)-expressing neuroendocrine tumors in vivo.

PURPOSE: There is growing interest in the human sodium/iodide symporter (NIS) gene both as a molecular imaging reporter gene and as a therapeutic gene. Here, we show the feasibility of radioisotope therapy of neuroendocrine tumors. As a separate application of NIS gene transfer, we image NIS-expressing tumors with pinhole SPECT in living subjects. METHODS: Biodistribution studies and in vivo therapy experiments were performed in nude mice carrying stably NIS-expressing neuroendocrine tumor xenografts following i.v. injection of (131)I and (99m)Tc pertechnetate. To show the usefulness of NIS as an imaging reporter gene, (99m)Tc pertechnetate uptake was imaged in vivo using a clinical gamma camera in combination with a custom-made single pinhole collimator, followed by SPECT/small animal MRI data coregistration. RESULTS: NIS-expressing neuroendocrine tumors strongly accumulated (131)I and (99m)Tc pertechnetate, as did thyroid, stomach, and salivary gland. The volume of NIS-expressing neuroendocrine tumors decreased significantly after therapeutic administration of (131)I or (99m)Tc pertechnetate, whereas control tumors continued to grow. NIS-mediated uptake of (99m)Tc pertechnetate could be imaged in vivo at high resolution with a clinical gamma camera equipped with a custom-made single pinhole collimator. High-resolution functional and morphologic information could be combined in a single three-dimensional data set by coregistration of SPECT and small animal MRI data. Lastly, we demonstrated a therapeutic effect of (99m)Tc pertechnetate on NIS-expressing neuroendocrine tumors in cell culture and, for the first time, in vivo, thought to be due to emitted Auger and conversion electrons. CONCLUSIONS: NIS-expressing neuroendocrine tumors efficiently concentrate radioisotopes, allowing for in vivo high-resolution small animal SPECT imaging as well as rendering possible successful radioisotope therapy of neuroendocrine tumors.