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Your search keyword '"Stewart, C. A."' showing total 46 results
Start Over Author "Stewart, C. A." Journal journal of clinical oncology
46 results on '"Stewart, C. A."'

2. The role of imaging in early detection of patients at risk for neuropathy during primary chemotherapy for ovarian carcinoma

Author

Liam Dalton, Sarah Bell, June A. Sullivan, Stewart C. Wang, Shitanshu Uppal, Brian D. Ross, Brian A. Derstine, and Jean Hansen Siedel

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Chemotherapy, business.industry, medicine.medical_treatment, Early detection, medicine.disease, Regimen, Ovarian carcinoma, Internal medicine, Medicine, Primary chemotherapy, Dose reduction, business, Adverse effect, Ovarian cancer
Abstract

e18071 Background: Neuropathy is a common adverse event requiring dose reduction or regimen change in patients receiving platinum-taxane chemotherapy for ovarian cancer. Our aim was to determine whether specific biomarkers, such as skeletal muscle, visceral and subcutaneous fat cross-sectional areas, measured using computerized tomography (CT), were associated with the development of neuropathy. Analytic Morphomics, a semi-automated image analysis method, has been used to predict oncologic outcomes with immunotherapy and to identify patients at higher risk for postoperative complications from major cancer surgeries. We hypothesized that patients who required dose reductions or regimen changes would have CT imaging findings that distinguished them from their counterparts who did not require dose reduction or regimen change. Methods: All patients at our institution diagnosed with high-grade ovarian carcinoma between January 1, 2014 and December 31, 2018 were identified retrospectively. Analytic Morphomics was used to extract measures of body composition from CT images at the level of the third lumbar vertebra. Demographic and clinical characteristics were abstracted from the electronic medical record. We analyzed several binary outcomes (neuropathy, delay in chemotherapy, or dose reduction by cycle 1, 3 or 6) and used unpaired, two-tailed t-tests to compare means between each outcome group at each timepoint. Results: Of 156 patients screened for the study, 138 patients were included and had pre-treatment CT scans available and completed six cycles of platinum-taxane chemotherapy. Patients who developed neuropathy in any of the six cycles, or had a change in their chemotherapy regimen by cycle six, had higher mean visceral fat area than those who did not develop neuropathy. This finding was statistically significant throughout three cycles (p = 0.023) and six cycles (p = 0.030). Conclusions: Increased visceral fat on CT imaging was significantly associated with a higher incidence of neuropathy and change in chemotherapy regimen in patients undergoing primary platinum-taxane chemotherapy for ovarian carcinoma. Weight and BMI did not have a significant association with development of neuropathy, dose reduction, or treatment delay. Further study is needed to determine if dose reductions or regimen changes due to neuropathy can be better predicted using morphomics.

Published
2020
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3. Communicating and Understanding the Purpose of Pediatric Phase I Cancer Trials

Author

Cousino, Melissa K., primary, Zyzanski, Stephen J., additional, Yamokoski, Amy D., additional, Hazen, Rebecca A., additional, Baker, Justin N., additional, Noll, Robert B., additional, Rheingold, Susan R., additional, Geyer, J. Russell, additional, Alexander, Stewart C., additional, Drotar, Dennis, additional, and Kodish, Eric D., additional

Published
2012
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5. Phase I study of vincristine, irinotecan, and 131I-MIBG for patients with relapsed or refractory neuroblastoma: A New Approach to Neuroblastoma Therapy (NANT) study.

Author

DuBois, S. G., primary, Chesler, L., additional, Groshen, S. G., additional, Hawkins, R., additional, Goodarzian, F., additional, Yanik, G. A., additional, Stewart, C. F., additional, Mosse, Y. P., additional, Maris, J. M., additional, Villablanca, J., additional, and Matthay, K. K., additional

Published
2011
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6. Phase I study of bevacizumab, sorafenib, and low-dose cyclophosphamide (CYC) in children and young adults with refractory solid tumors.

Author

Santana, V. M., primary, Baker, S. D., additional, McCarville, B., additional, Stewart, C. F., additional, Wu, J., additional, Billups, C., additional, Spunt, S. L., additional, Furman, W. L., additional, McGregor, L. M., additional, Hu, S., additional, Panetta, J. C., additional, Reddick, W. E., additional, Davidoff, A., additional, Leung, W. H., additional, and Navid, F., additional

Published
2011
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7. Sarcopenia to predict tolerance of adjuvant breast cancer chemotherapy

Author

Michael J. Englesbe, Anna Conlon, Stewart C. Wang, Michael S. Sabel, and Kent A. Griffith

Subjects
Bone mineral, Oncology, Cancer Research, medicine.medical_specialty, Chemotherapy, business.industry, medicine.medical_treatment, medicine.disease, Surgery, Breast cancer chemotherapy, medicine.anatomical_structure, Breast cancer, Internal medicine, Sarcopenia, medicine, Abdomen, business, Adjuvant, Pelvis
Abstract

138 Background: Despite improved survival with adjuvant chemotherapy among older women, it is less often recommended for fear they cannot complete therapy or will have excessive toxicity. Analytic morphometrics uses objective imaging measurements such as muscle size, bone mineral density (BMD) and body composition to improve risk stratification. We examined whether morphometrics might help predict toxicity of chemotherapy in breast cancer patients. Methods: Our prospective IRB-approved breast cancer database was queried for all patients who underwent adjuvant or neoadjuvant chemotherapy and had CT scans of the chest, abdomen and pelvis prior to chemo. Complications of chemotherapy were graded according to the NCI-CTC. CT scans were processed using semi-automated algorithms (MATLAB v13.0) to measure psoas area (PA) and density (PD), BMD and subcutaneous fat (SF), visceral fat (VF), and total body area (TBA. Outcome (DFS and OS) was assessed by K-M, and logistic regression models and ANOVA were used for toxicity events. Results: We identified 129 patients, ranging in age from 24 to 83 (median 52). 105 (81%) received AC/T while 19% received alternate regimens, all full weight based. T-stage, nodal status and HER2 expression were significantly associated with measures of obesity, except BMI, but not sarcopenia. After adjusting for stage and Her-2, BMI remained a significant predictor of DFS (OR 1.07 (95%CI 1.01, 1.13)) and OS (OR 1.06 (95% CI 1.00, 1.12)).After controlling for age, PD and VF were predictors of chemotherapy completion. The OR for completing chemotherapy decreased 0.95 (95% CI: 0.90, 1.01, p=0.08) for every increase of 1000 in VF and increased 1.08 (95% CI: 1.01, 1.15, p=0.03) for every unit increase in PD. Sarcopenia was associated with an increased risk of pulmonary complications (p=0.01) and anemia (p=0.06). Conclusions: Although age is a significant predictor of increased toxicity and inability to complete chemotherapy, sarcopenia is an objective, independent predictor of chemotherapy completion. Psoas density, easily obtainable from a pre-treatment CT scan, can help the clinician older breast cancer patients for adjuvant chemotherapy.

Published
2012
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8. A phase I pharmacokinetic trial of sonic hedgehog (SHH) antagonist GDC-0449 in pediatric patients with recurrent or refractory medulloblastoma: A Pediatric Brain Tumor Consortium study (PBTC 25).

Author

Gajjar, A. J., primary, Stewart, C. F., additional, Ellison, D. W., additional, Curran, T., additional, Phillips, P., additional, Goldman, S., additional, Packer, R., additional, Kun, L. E., additional, Boyett, J. M., additional, and Gilbertson, R. J., additional

Published
2010
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16. A phase I trial and pharmacokinetic (PK) study of vorinostat (SAHA) in combination with 13 cis-retinoic acid (13cRA) in children with refractory neuroblastomas, medulloblastomas, primitive neuroectodermal tumors (PNETs), and atypical teratoid rhabdoid tumor

Author

Fouladi, M., primary, Park, J. R., additional, Sun, J., additional, Ingle, A. M., additional, Ames, M. M., additional, Stewart, C. F., additional, Gilbertson, R., additional, Zwiebel, J. A., additional, Adamson, P. C., additional, and Blaney, S. M., additional

Published
2008
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28. Role of amifostine as a cytoprotectant in children ≥ 3 years with average risk (AR) medulloblastoma (MB) treated with craniospinal irradiation (CSI) and 4 courses of cisplatin (CDDP)-based high dose chemotherapy

Author

Fouladi, M., primary, Chintagumpala, M., additional, Ashley, D., additional, Kellie, S., additional, Broniscer, A., additional, Merchant, T. E., additional, Kun, L. E., additional, Stewart, C., additional, Wallace, D., additional, and Gajjar, A., additional

Published
2006
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