BACKGROUND Scoring systems have not been evaluated in oncology patients.We aimed to assess the performance of Acute Physiology and Chronic Health Evaluation(APACHE)II,APACHE III,APACHE IV,Simplified Acute Physiology S...BACKGROUND Scoring systems have not been evaluated in oncology patients.We aimed to assess the performance of Acute Physiology and Chronic Health Evaluation(APACHE)II,APACHE III,APACHE IV,Simplified Acute Physiology Score(SAPS)II,SAPS III,Mortality Probability Model(MPM)II0 and Sequential Organ Failure Assessment(SOFA)score in critically ill oncology patients.AIM To compare the efficacy of seven commonly employed scoring systems to predict outcomes of critically ill cancer patients.METHODS We conducted a retrospective analysis of 400 consecutive cancer patients admitted in the medical intensive care unit over a two-year period.Primary outcome was hospital mortality and the secondary outcome measure was comparison of various scoring systems in predicting hospital mortality.RESULTS In our study,the overall intensive care unit and hospital mortality was 43.5%and 57.8%,respectively.All of the seven tested scores underestimated mortality.The mortality as predicted by MPM II0 predicted death rate(PDR)was nearest to the actual mortality followed by that predicted by APACHE II,with a standardized mortality rate(SMR)of 1.305 and 1.547,respectively.The best calibration was shown by the APACHE III score(χ^(2)=4.704,P=0.788).On the other hand,SOFA score(χ^(2)=15.966,P=0.025)had the worst calibration,although the difference was not statistically significant.All of the seven scores had acceptable discrimination with good efficacy however,SAPS III PDR and MPM II0 PDR(AUROC=0.762),had a better performance as compared to others.The correlation between the different scoring systems was significant(P<0.001).CONCLUSION All the severity scores were tested under-predicted mortality in the present study.As the difference in efficacy and performance was not statistically significant,the choice of scoring system used may depend on the ease of use and local preferences.展开更多
Invasive grade III and IV maliguant gliomas remain difficult to treat with a typical survival time post-diagnosis hovering around 16 months with only minor extension thereof seen in the past decade,whereas some improv...Invasive grade III and IV maliguant gliomas remain difficult to treat with a typical survival time post-diagnosis hovering around 16 months with only minor extension thereof seen in the past decade,whereas some improvements have been obtained towards five-year survival rates for which completeness of resection is a prerequisite.Optical techniques such as fluorescence guided resection(FGR)and photodynamic therapy(PDT)are promising adjuvant techniques to in-crease the tumor volume reduction fraction.PDT has been used in combination with surgical resection or alternatively as standalone treat ment strategy with some sucoess in extending the median survival time of patients compared to surgery alone and the current standard of care.This document reviews the outcome of past clinical trials and highlights the general shift in PDT therapeutic approaches.It also looks at the current approaches for interstitial PDT and research options into increasing PDT's glioma treatment fficacy through exploiting both physical and biological based approaches to maximize PDT selectivity and therapeutic index,particularly in brain adjacent to tumor(BAT).Potential reasons for failing to demonstrate a significant survival advantage in prior PDT clinical trials will become evident in light of the improved understanding of glioma biology and PDT dosimetry.展开更多
【目的】了解国际肿瘤学期刊的分布特点和发展规律,为我国肿瘤学期刊的发展提供启示和借鉴。【方法】以2013年度美国《科学引文索引》(SCI)影响因子前50位肿瘤学期刊为研究对象,收集每种期刊的基本资料和2004-2013年度的SCI期刊引证报...【目的】了解国际肿瘤学期刊的分布特点和发展规律,为我国肿瘤学期刊的发展提供启示和借鉴。【方法】以2013年度美国《科学引文索引》(SCI)影响因子前50位肿瘤学期刊为研究对象,收集每种期刊的基本资料和2004-2013年度的SCI期刊引证报告数据,动态分析近10年来国际高端肿瘤学期刊群体的变化,对重点期刊的变化内因进行了深入探讨。【结果】近10年之中,有13种期刊退出、13种期刊进入SCI影响因子前50。多数期刊的影响因子逐年增长,但增长幅度存在较大差异,其中CA-A Cancer Journal for Clinicians、Lancet Oncology和Journal of Clinical Oncology的影响因子增长显著,有2种期刊2013年的影响因子比2004年降低了1以上。2013年度SCI被引频次位居前2位者分别是Cancer Research和Journal of Clinical Oncology,均为极具影响的优秀肿瘤学期刊。【结论】面对国际优秀学术期刊的挑战,我国应大力推进英文版学术期刊的发展,走集团化办刊的发展道路,期刊应充分利用好学会资源,并在办刊过程中重视高被引文章的刊发。展开更多
Malnutrition in Head and neck cancer (HNC) patients can be present at the moment of diagnosis. The nutritional status is determinant for the treatment success and quality of life of the patients. The nutritional statu...Malnutrition in Head and neck cancer (HNC) patients can be present at the moment of diagnosis. The nutritional status is determinant for the treatment success and quality of life of the patients. The nutritional status gradually declines during treatment and the majority of patients undergoing treatment will need nutritional therapy. On the other hand, HNC, like other cancers, can induce a paraneoplastic syndrome that leads to cachexia. This cachexia status is most of the times the cause of death or the cause of treatment failure. So, early identification of malnutrition high risk patients is crucial to start an adequate nutrition support intervention in HNC patients. This study aims to identify HNC patients who present malnutrition or higher risk of malnutrition;to signalize variables that support early identification of high-risk patients of becoming malnourished and to establish a dynamic relationship between malnutrition risk in these patients and Quality of Life (QoL) impacts. For six months consecutive outpatients with HNC admitted at the Head & Neck Unity of Oncology Portuguese Institute—Porto were asked to participate in the research (n = 114). The European Organisation for Research and Treatment of Cancer (EORTC) cancer-specific HRQoL questionnaire-QLQ-C30 and Malnutrition Universal Screening Tool, MUST were used. At the moment of first presentation, 32 patients (28.1%) presented high-risk of malnutrition. HNC patients with oral cavity and oropharynx tumour locations, older, with low literacy or with BMI under 18.5 at the moment of diagnosis, represent a high-risk group. When HNC is considered, a dynamic and bi-directional connection between malnutrition and QoL is observed. A significant (p Emotional and social functional scales and all symptom scales—including pain, presented significant differences between high and medium risk of malnutrition patients. Fatigue, pain, insomnia, appetite loss and financial difficulties were domains directly related to high risk of malnutrition patients. Pain scores 展开更多
本文以2008-2012年间国家自然科学基金肿瘤学领域资助的5 431个基金项目为研究对象,利用Web of Science数据平台,从肿瘤学各研究领域、项目类型、获得较高经费资助的依托单位三个方面分析科学基金项目的SCI论文产出情况,探讨合理有效地...本文以2008-2012年间国家自然科学基金肿瘤学领域资助的5 431个基金项目为研究对象,利用Web of Science数据平台,从肿瘤学各研究领域、项目类型、获得较高经费资助的依托单位三个方面分析科学基金项目的SCI论文产出情况,探讨合理有效地使用经费、努力实现低投入高产出的方法,为科研人员和科研管理部门改进工作、制定相关政策提供依据.展开更多
基金Approved by Institutional Scientific Committee of Max Super Speciality Hospital,No.1944105991.
文摘BACKGROUND Scoring systems have not been evaluated in oncology patients.We aimed to assess the performance of Acute Physiology and Chronic Health Evaluation(APACHE)II,APACHE III,APACHE IV,Simplified Acute Physiology Score(SAPS)II,SAPS III,Mortality Probability Model(MPM)II0 and Sequential Organ Failure Assessment(SOFA)score in critically ill oncology patients.AIM To compare the efficacy of seven commonly employed scoring systems to predict outcomes of critically ill cancer patients.METHODS We conducted a retrospective analysis of 400 consecutive cancer patients admitted in the medical intensive care unit over a two-year period.Primary outcome was hospital mortality and the secondary outcome measure was comparison of various scoring systems in predicting hospital mortality.RESULTS In our study,the overall intensive care unit and hospital mortality was 43.5%and 57.8%,respectively.All of the seven tested scores underestimated mortality.The mortality as predicted by MPM II0 predicted death rate(PDR)was nearest to the actual mortality followed by that predicted by APACHE II,with a standardized mortality rate(SMR)of 1.305 and 1.547,respectively.The best calibration was shown by the APACHE III score(χ^(2)=4.704,P=0.788).On the other hand,SOFA score(χ^(2)=15.966,P=0.025)had the worst calibration,although the difference was not statistically significant.All of the seven scores had acceptable discrimination with good efficacy however,SAPS III PDR and MPM II0 PDR(AUROC=0.762),had a better performance as compared to others.The correlation between the different scoring systems was significant(P<0.001).CONCLUSION All the severity scores were tested under-predicted mortality in the present study.As the difference in efficacy and performance was not statistically significant,the choice of scoring system used may depend on the ease of use and local preferences.
基金supported by the Ontario Ministry of Health and Long-term Care and a grant from the Canadian Institute of Health Research grant number MOP-93567.
文摘Invasive grade III and IV maliguant gliomas remain difficult to treat with a typical survival time post-diagnosis hovering around 16 months with only minor extension thereof seen in the past decade,whereas some improvements have been obtained towards five-year survival rates for which completeness of resection is a prerequisite.Optical techniques such as fluorescence guided resection(FGR)and photodynamic therapy(PDT)are promising adjuvant techniques to in-crease the tumor volume reduction fraction.PDT has been used in combination with surgical resection or alternatively as standalone treat ment strategy with some sucoess in extending the median survival time of patients compared to surgery alone and the current standard of care.This document reviews the outcome of past clinical trials and highlights the general shift in PDT therapeutic approaches.It also looks at the current approaches for interstitial PDT and research options into increasing PDT's glioma treatment fficacy through exploiting both physical and biological based approaches to maximize PDT selectivity and therapeutic index,particularly in brain adjacent to tumor(BAT).Potential reasons for failing to demonstrate a significant survival advantage in prior PDT clinical trials will become evident in light of the improved understanding of glioma biology and PDT dosimetry.
文摘【目的】了解国际肿瘤学期刊的分布特点和发展规律,为我国肿瘤学期刊的发展提供启示和借鉴。【方法】以2013年度美国《科学引文索引》(SCI)影响因子前50位肿瘤学期刊为研究对象,收集每种期刊的基本资料和2004-2013年度的SCI期刊引证报告数据,动态分析近10年来国际高端肿瘤学期刊群体的变化,对重点期刊的变化内因进行了深入探讨。【结果】近10年之中,有13种期刊退出、13种期刊进入SCI影响因子前50。多数期刊的影响因子逐年增长,但增长幅度存在较大差异,其中CA-A Cancer Journal for Clinicians、Lancet Oncology和Journal of Clinical Oncology的影响因子增长显著,有2种期刊2013年的影响因子比2004年降低了1以上。2013年度SCI被引频次位居前2位者分别是Cancer Research和Journal of Clinical Oncology,均为极具影响的优秀肿瘤学期刊。【结论】面对国际优秀学术期刊的挑战,我国应大力推进英文版学术期刊的发展,走集团化办刊的发展道路,期刊应充分利用好学会资源,并在办刊过程中重视高被引文章的刊发。
文摘Malnutrition in Head and neck cancer (HNC) patients can be present at the moment of diagnosis. The nutritional status is determinant for the treatment success and quality of life of the patients. The nutritional status gradually declines during treatment and the majority of patients undergoing treatment will need nutritional therapy. On the other hand, HNC, like other cancers, can induce a paraneoplastic syndrome that leads to cachexia. This cachexia status is most of the times the cause of death or the cause of treatment failure. So, early identification of malnutrition high risk patients is crucial to start an adequate nutrition support intervention in HNC patients. This study aims to identify HNC patients who present malnutrition or higher risk of malnutrition;to signalize variables that support early identification of high-risk patients of becoming malnourished and to establish a dynamic relationship between malnutrition risk in these patients and Quality of Life (QoL) impacts. For six months consecutive outpatients with HNC admitted at the Head & Neck Unity of Oncology Portuguese Institute—Porto were asked to participate in the research (n = 114). The European Organisation for Research and Treatment of Cancer (EORTC) cancer-specific HRQoL questionnaire-QLQ-C30 and Malnutrition Universal Screening Tool, MUST were used. At the moment of first presentation, 32 patients (28.1%) presented high-risk of malnutrition. HNC patients with oral cavity and oropharynx tumour locations, older, with low literacy or with BMI under 18.5 at the moment of diagnosis, represent a high-risk group. When HNC is considered, a dynamic and bi-directional connection between malnutrition and QoL is observed. A significant (p Emotional and social functional scales and all symptom scales—including pain, presented significant differences between high and medium risk of malnutrition patients. Fatigue, pain, insomnia, appetite loss and financial difficulties were domains directly related to high risk of malnutrition patients. Pain scores
文摘本文以2008-2012年间国家自然科学基金肿瘤学领域资助的5 431个基金项目为研究对象,利用Web of Science数据平台,从肿瘤学各研究领域、项目类型、获得较高经费资助的依托单位三个方面分析科学基金项目的SCI论文产出情况,探讨合理有效地使用经费、努力实现低投入高产出的方法,为科研人员和科研管理部门改进工作、制定相关政策提供依据.
