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Pandit PN, Patil RA, Palwe VS, Tambade SH, Wagh SY, Gavit MK, Nagarkar RV. Patterns of blood pressure changes in patients with head and neck cancer receiving radiotherapy or chemo-radiotherapy at a tertiary cancer centre. Head Neck 2020; 43:1280-1288. [PMID: 33372394 DOI: 10.1002/hed.26590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/05/2020] [Accepted: 12/17/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To evaluate patterns of blood pressure (BP) changes in patients with head and neck cancer (HNC) receiving radiation (RT)/chemo-radiation (CRT) METHODS: This study included data collection, compilation, and analysis of 451 consecutive HNC patients who underwent RT/CRT. RESULTS Out of 451 patients, 376 (82%) were male and 75 (18%) were female with a median age of 52 years. Patients receiving 3DCRT experienced greater fall in BP, including for SBP and MAP, compared to those receiving IMRT-IGRT. Female patients experienced greater fall in diastolic BP as compared to male patients (p: 0.03). At the end of treatment, we observed a significant association between a fall in systolic BP (decrease by 10% of baseline) and weight loss of more than 10% of baseline weight (p: 0.03). CONCLUSION Fall in BP during RT/CRT is significantly affected by treatment technique and sex and is strongly associated with significant weight loss.
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Affiliation(s)
- Prakash N Pandit
- Department of Radiation Oncology, HCG Manavata Cancer Centre, Nashik, India
| | | | - Vijay S Palwe
- Department of Radiation Oncology, HCG Manavata Cancer Centre, Nashik, India
| | - Suwarna H Tambade
- Department of Internal Medicine, HCG Manavata Cancer Centre, Nashik, India
| | - Sameer Y Wagh
- Department of Internal Medicine, HCG Manavata Cancer Centre, Nashik, India
| | - Majula K Gavit
- Department of Nursing, HCG Manavata Cancer Centre, Nashik, India
| | - Raj V Nagarkar
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, India
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Karlan BY, Oza AM, Richardson GE, Provencher DM, Hansen VL, Buck M, Chambers SK, Ghatage P, Pippitt CH, Brown JV, Covens A, Nagarkar RV, Davy M, Leath CA, Nguyen H, Stepan DE, Weinreich DM, Tassoudji M, Sun YN, Vergote IB. Randomized, Double-Blind, Placebo-Controlled Phase II Study of AMG 386 Combined With Weekly Paclitaxel in Patients With Recurrent Ovarian Cancer. J Clin Oncol 2012; 30:362-71. [DOI: 10.1200/jco.2010.34.3178] [Citation(s) in RCA: 181] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To estimate the efficacy and toxicity of AMG 386, an investigational peptide-Fc fusion protein that neutralizes the interaction between the Tie2 receptor and angiopoietin-1/2, plus weekly paclitaxel in patients with recurrent ovarian cancer. Patients and Methods Patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer were randomly assigned 1:1:1 to receive paclitaxel (80 mg/m2 once weekly [QW], 3 weeks on/1 week off) plus intravenous AMG 386 10 mg/kg QW (arm A), AMG 386 3 mg/kg QW (arm B), or placebo QW (arm C). The primary end point was progression-free survival (PFS). Secondary end points included overall survival, objective response, CA-125 response, safety, and pharmacokinetics. Results One hundred sixty-one patients were randomly assigned. Median PFS was 7.2 months (95% CI, 5.3 to 8.1 months) in arm A, 5.7 months (95% CI, 4.6 to 8.0 months) in arm B, and 4.6 months (95% CI, 1.9 to 6.7 months) in arm C. The hazard ratio for arms A and B combined versus arm C was 0.76 (95% CI, 0.52 to 1.12; P = .165). Further analyses suggested an exploratory dose-response effect for PFS across arms (Tarone's test, P = .037). Objective response rates for arms A, B, and C were 37%, 19%, and 27%, respectively. The incidence of grade ≥ 3 adverse events (AEs) in arms A, B, and C was 65%, 55%, and 64%, respectively. Frequent AEs included hypertension (8%, 6%, and 5% in arms A, B, and C, respectively), peripheral edema (71%, 51%, and 22% in arms A, B, and C, respectively), and hypokalemia (21%, 15%, and 5% in arms A, B, and C, respectively). AMG 386 exhibited linear pharmacokinetic properties at the tested doses. Conclusion AMG 386 combined with weekly paclitaxel was tolerable, with a manageable and distinct toxicity profile. The data suggest evidence of antitumor activity and a dose-response effect, warranting further studies in ovarian cancer.
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Affiliation(s)
| | - Amit M. Oza
- Author affiliations appear at the end of this article
| | | | | | | | - Martin Buck
- Author affiliations appear at the end of this article
| | | | | | | | - John V. Brown
- Author affiliations appear at the end of this article
| | - Allan Covens
- Author affiliations appear at the end of this article
| | | | - Margaret Davy
- Author affiliations appear at the end of this article
| | | | - Hoa Nguyen
- Author affiliations appear at the end of this article
| | | | | | | | - Yu-Nien Sun
- Author affiliations appear at the end of this article
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