Low Infection Rate After Transrectal Implantation of Gold Anchor ™ Fiducial Markers in Prostate Cancer Patients After Non-broad-spectrum Antibiotic Prophylaxis.

Background In 621 consecutive prostate cancer patients, the frequency of urinary tract infections (UTI) and marker loss was evaluated. They prophylactically received a single dose of non-broad-spectrum antibiotics and transrectal implantation of three thin needle fiducial markers, Gold Anchor ™ (GA). Methods The occurrence of UTIs, sepsis, hospitalization due to infection, and marker loss after implantation was assessed from the medical records containing notes from physicians and nurses from the day of implantation to the end of 29 fractions. Results UTIs occurred in two (0.3%) of the 621 patients. Neither sepsis nor hospitalization was noted. Loss/drop-out of three markers was noted among 1,863 markers implanted. Conclusion The use of thin needles for the implantation of fiducials appears to reduce the rate of infection despite the use of a single dose of non-broad-spectrum antibiotics as prophylaxis. The marker construct appears to provide stability in the tissues.

Radiation-induced stress response in peripheral blood of breast cancer patients differs between patients with severe acute skin reactions and patients with no side effects to radiotherapy.

The aim of the study was to compare the radiation-induced oxidative stress response in blood samples from breast cancer patients that developed severe acute skin reactions during the radiotherapy, with the response in blood samples from patients with no side effects. Peripheral blood was collected from 12 breast cancer patients showing no early skin reactions after radiotherapy (RTOG grade 0) and from 14 breast cancer patients who developed acute severe skin reactions (RTOG grade 3-4). Whole blood was irradiated with 0, 5 and 2000mGy γ-radiation and serum was isolated. The biomarker for oxidative stress, 8-oxo-dG, was analyzed in the serum by a modified ELISA. While a significant radiation-induced increase of serum 8-oxo-dG levels was observed in serum of the RTOG 0 patients, no increase was seen in serum of the RTOG 3-4 patients. The radiation induced increase in serum 8-oxo-dG levels after 5mGy did not differ significantly from the increase observed for 2000mGy in the RTOG 3-4 cohort, thus no dose response relation was observed. A receiver operating characteristic (ROC) value of 0.97 was obtained from the radiation-induced increase in 8-oxo-dG indicating that the assay could be used to identify patients with severe acute adverse reactions to radiotherapy. The results show that samples of whole blood from patients, classified as highly radiosensitive (RTOG 3-4) based on their skin reactions to radiotherapy, differ significantly in their oxidative stress response to ionizing radiation compared to samples of whole blood from patients with no skin reactions (RTOG 0). Extracellular 8-oxo-dG is primarily a biomarker of nucleotide damage and the results indicate that the patients with severe acute skin reactions differ in their cellular response to ionizing radiation at the level of induction of oxidative stress or at the level of repair or both.

Care diaries: a way of increasing head and neck cancer patient's involvement in their own care and the communication between clinicians.

Head and neck (H&N) cancer patients and their families meet a large number of clinicians during their long treatment period and many of them find it difficult to understand all the information given concerning their illness, treatment, and care. We have developed a care diary for these patients and their families, used also by the clinicians involved, to improve communication and patient involvement. The present survey was an evaluation of the helpfulness of those diaries. Anonymous answered questionnaires were collected from 42 H&N cancer patients, 28 family members, and 47 clinicians of different categories. Altogether 85% of the respondents stated that the care diaries had a positive effect on information, in general, and communication. It is recommended that care diaries should be implemented in the standard care for H&N cancer patients and their families. To improve the clinical value, it is particularly important to inform the clinicians on how to use the care diaries. The content and layout of the care diaries needs to be developed according to suggestions given from the respondents in this survey.