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MASCC 2013 Abstracts

figureat

Author index

A. &Scaron MASCC-0076

G.P. Kurita, C.N.,N.S.,H.F.,U.B.T MASCC-0113

&#350 MASCC-0232

&scaron MASCC-0076

A, M. MASCC-0515

A.R. MASCC-0159

Aapro, M. MASCC-0433

Abarca, M. MASCC-0435

Abbasi, S. MASCC-0200

Abbink, F.C.H. MASCC-0455

Abbruzzese, J. MASCC-0742

Abda, N. MASCC-0007

Abdel Kader, Y.S. MASCC-0685

Abdel Khalek, E.R.K. MASCC-0669

Abdel Salam, G.A. MASCC-0685

Abdi, F. MASCC-0105

Abdollahi, A. MASCC-0680

Abdolzade-Bavil, A. MASCC-0712, MASCC-0694

Abdul Majid, A. MASCC-0667, MASCC-0643

Abdul Majid, S. MASCC-0667

Abe, H. MASCC-0779

Abe, K. MASCC-0525

Abella, E. MASCC-0584, MASCC-0438

Abernethy, A. MASCC-0808, MASCC-0410

Abidjonova, N. MASCC-0495

Abimosleh, S.M. MASCC-0043

Abisaid Baker, R. MASCC-0579

Abraham, C. MASCC-0484

Abrahm, J.L. MASCC-0607

Abu, E. MASCC-0074

Abubakar, S. MASCC-0217

Acar, H. MASCC-0627, MASCC-0478, MASCC-0477, MASCC-0286, MASCC-0285, MASCC-0284, MASCC-0283, MASCC-0182, MASCC-0130, MASCC-0119, MASCC-0118, MASCC-0117, MASCC-0116, MASCC-0069, MASCC-0068

Acevedo, A. MASCC-0300

Achkar, S. MASCC-0553

Ackerl, M. MASCC-0063

Acklin, Y. MASCC-0640

Adams, N.B. MASCC-0293

Adamsen, L. MASCC-0443, MASCC-0158

Addington-Hall, J. MASCC-0720

Ademosun, A.O. MASCC-0110, MASCC-0084

Adibi, P. MASCC-0105

Adriana Cristina Nicolussi, A.C.N. MASCC-0273, MASCC-0272

Aertgeerts, B. MASCC-0459

Affonso Fonseca, F.L. MASCC-0107

Affronti, M. MASCC-0805

Affronti, M.L. MASCC-0777

Afshar, M. MASCC-0128

Agarwal, N. MASCC-0059

Aggarwal, G. MASCC-0353

Aghajany-Nasab, M. MASCC-0781

Agulnik, J. MASCC-0793

Ahin", T. MASCC-0232

Ahmad, S.N.A. MASCC-0214

Ahmed, M. MASCC-0193

Ahmed, R. MASCC-0450

Ahmed, S.A. MASCC-0586

Ahn, J.B. MASCC-0511

Ahn, J.S. MASCC-0647

Ahn, M. MASCC-0510

Ai, J.Z. MASCC-0465

Aiba, K. MASCC-0521

Aibar, J. MASCC-0632, MASCC-0056, MASCC-0002

Aieta, M. MASCC-0517

Aihara, Y. MASCC-0757

Aina, O.F. MASCC-0078

Aini, M.N. MASCC-0172

Aitkaci, F. MASCC-0645

Akbari, L. MASCC-0105

Akbayrak, N. MASCC-0303

Aketch, W.A. MASCC-0723

Akhtar, M. MASCC-0326, MASCC-0175

Akhter, T. MASCC-0241

Akkafan, R. MASCC-0761

Akman, T. MASCC-0339

Aktas, A. MASCC-0832, MASCC-0696, MASCC-0536, MASCC-0534, MASCC-0456, MASCC-0453

Akyol, M. MASCC-0031

Akyurek, S. MASCC-0548

Al Duhaiby, E. MASCC-0316

Al Qadire, M. MASCC-0046

Al Rawi, S. MASCC-0643

Al-Azri, A.R. MASCC-0489

Al-Dasooqi, N. MASCC-0853, MASCC-0257

Al-Habib, O. MASCC-0667

Al-Mohaya, M.A. MASCC-0154

Al-Rawi, S. MASCC-0667

Albiges, L. MASCC-0505

Alevizopoulos, N. MASCC-0589

Alevizopoulos., N. MASCC-0349

Alexander, C. MASCC-0480

Alexis, K. MASCC-0454

Alfaro, E. MASCC-0462

Ali, M. MASCC-0219, MASCC-0218, MASCC-0127

Alibay, A. MASCC-0738, MASCC-0527, MASCC-0501

Alibhai, S.M.H. MASCC-0578, MASCC-0577, MASCC-0576, MASCC-0570

Alici, S. MASCC-0339

Alimi, D. MASCC-0371

Alimohammadi, H. MASCC-0178

Alkalay, Y. MASCC-0212

Alkam, T. MASCC-0583

Allan, J.L. MASCC-0180

Allgaier, H. MASCC-0712

Allison, R.R. MASCC-0605

Allo, J.A. MASCC-0552

Alm El-Din, M.A. MASCC-0167

Almeida, A. MASCC-0835

Almeida, A.M. MASCC-0772, MASCC-0764, MASCC-0730

Almond, L. MASCC-0561

Alonzo, R. MASCC-0394, MASCC-0393, MASCC-0392

Alpert, T.E.A. MASCC-0703

Alqudihy, S. MASCC-0162

Alsirafy, S.A. MASCC-0685

Alt-Epping, B. MASCC-0671, MASCC-0670

Alterovitz, G. MASCC-0812

Altinbas, M. MASCC-0802, MASCC-0798

Altino, J. MASCC-0654

Aluma Luis, L. MASCC-0348

Alyasova, A. MASCC-0432

Amaadour, L. MASCC-0007

Amarillo, L. MASCC-0516

Amatya, B. MASCC-0104

Ambrad, A.A. MASCC-0605

Amdur, R. MASCC-0070

Amin, A. MASCC-0075

Amoiridou, S. MASCC-0644

Anagnostopoulos, N. MASCC-0769

Andersen, A. MASCC-0515

Andershed, B. MASCC-0656

Anderson, K.O. MASCC-0838

Anderson, Y. MASCC-0749

Andersson, M. MASCC-0656

Andrade, V. MASCC-0545, MASCC-0544

Andrade, V.A. MASCC-0278, MASCC-0277

Andreasen, A.G. MASCC-0265, MASCC-0264

Andreetta, L. MASCC-0137, MASCC-0327

Andresen, T. MASCC-0112

Andreyev, J. MASCC-0198

Andrikopoulos, E. MASCC-0340

Anees, M. MASCC-0509

Ang, C. MASCC-0749

Ang, N.K.E. MASCC-0014, MASCC-0013, MASCC-0006

Ang, S.F. MASCC-0599, MASCC-0598

Annunziata, M. MASCC-0687, MASCC-0684

Ansari, F. MASCC-0016

Ansari, P. MASCC-0288

Ansari, Z. MASCC-0614

Antoni, G. MASCC-0047

Antonuzzo, A. MASCC-0651

Antoun, J. MASCC-0553

Antoun, S. MASCC-0738, MASCC-0527, MASCC-0505, MASCC-0501

Antunes, H.S. MASCC-0568, MASCC-0565

Aplenc, R. MASCC-0729

Apolinar Martinez, A. MASCC-0309

Appan, P. MASCC-0016

Aprile, G. MASCC-0774, MASCC-0751

Aqil, M. MASCC-0326, MASCC-0175

Aragão Santana, T. MASCC-0608

Aranda Aguilar, E. MASCC-0678

Araneta, M. MASCC-0503

Arata, K. MASCC-0414

Araujo, C. MASCC-0568

Arellano, J. MASCC-0715, MASCC-0713, MASCC-0711, MASCC-0710, MASCC-0641

Argier, P. MASCC-0431

Arifi, S. MASCC-0018, MASCC-0007

Ariza García, A. MASCC-0439

Armer, J.M. MASCC-0027

Armes J. MASCC-0857

Armes, J. MASCC-0039

Aromataris, E. MASCC-0279

Arora, S.A. MASCC-0441

Arranz, C. MASCC-0840

Arroyo Morales, M. MASCC-0442, MASCC-0439

Arshoun, Y.M. MASCC-0605

Ashikaga, T. MASCC-0293

Ashkvari, P. MASCC-0183

Aslan, O. MASCC-0734, MASCC-0031

Assaker, L. MASCC-0247

Ata, O. MASCC-0284, MASCC-0283, MASCC-0119, MASCC-0069, MASCC-0068, MASCC-0066

Ata, O.Y. MASCC-0182, MASCC-0117, MASCC-0116

Athanasiadis, I. MASCC-0778

Athanassiadis, I. MASCC-0181

Atherton, P.J. MASCC-0807

Atia, E. MASCC-0336

Atkins, J.N. MASCC-0829

Atlani, D. MASCC-0376

Auber, M. MASCC-0114

Aubron-Olivier, C. MASCC-0672

Aung, A. MASCC-0162, MASCC-0161

Aung, M.M. MASCC-0319

Auriacombe M, M.A. MASCC-0818

Avgetidou, E. MASCC-0644

Avila, C. MASCC-0586

Avila, J. MASCC-0370

Avisar, N. MASCC-0719

Aydin, O. MASCC-0802

Ayvalioglu, D. MASCC-0770

Azevedo, R.G. MASCC-0856

Azevedo, S.J. MASCC-0654

Azhar, M. MASCC-0326

B. MASCC-0856

Baba, H. MASCC-0521

Baba, S. MASCC-0241

Bablioglu, I. MASCC-0548

Badre, S. MASCC-0541, MASCC-0539

Badros, A.Z. MASCC-0773

Badyal, D.K. MASCC-0201

Bae, D. MASCC-0416

Bafaloukos, D. MASCC-0778, MASCC-0769

Bagcivan, G. MASCC-0303

Bagnato, V.S. MASCC-0106

Bahadur, N. MASCC-0511

Baharvand, M. MASCC-0775, MASCC-0761

Bahiddin yilmaz, B.Y. MASCC-0833

Bairati, I. MASCC-0055, MASCC-0054

Bak, K. MASCC-0431

Bakitas, M. MASCC-0234

Balachandran, D. MASCC-0585

Balakan, O. MASCC-0339

Balakumaran, A. MASCC-0334

Balan, A. MASCC-0806

Ballatori, E. MASCC-0517

Bamberg, M. MASCC-0297

Bandieri, E. MASCC-0706

Banerjee, D. MASCC-0752

Baracos, V.E. MASCC-0505

Barak, F. MASCC-0212, MASCC-0211

Barasch, A. MASCC-0663

Barash, S. MASCC-0719

Barata, P. MASCC-0743, MASCC-0739, MASCC-0659

Barbeau, E. MASCC-0695

Barbosa, P.S. MASCC-0565

Barbosa, Y. MASCC-0835

Barinoff, J. MASCC-0708

Barker, P.N. MASCC-0737, MASCC-0736

Barnes, E. MASCC-0475, MASCC-0238, MASCC-0236, MASCC-0235, MASCC-0037, MASCC-0036, MASCC-0035, MASCC-0377, MASCC-0383

Baro, S. MASCC-0344

Barrault M, M.B. MASCC-0818

Barrault, M.B. MASCC-0822

Barret, A. MASCC-0753

Barroso, P.F. MASCC-0315

Barrow, K. MASCC-0390

Barsotti, D. MASCC-0462

Barthelemy V, V.B. MASCC-0822

Barthelemy, V.B. MASCC-0818

Barton, D. MASCC-0562, MASCC-0560

Bascomb, N. MASCC-0621

Bashford, J. MASCC-0469

Basso, F.G. MASCC-0106

Basso, U. MASCC-0653

Bastawisy, A. MASCC-0074

Bastian, S.E.P. MASCC-0044, MASCC-0042

Basu, B. MASCC-0397

Basu, C. MASCC-0397

Basu, S. MASCC-0621

Batarda, L. MASCC-0659

Batarda, M.L. MASCC-0743, MASCC-0739

Bateman, E. MASCC-0677, MASCC-0611, MASCC-0602, MASCC-0600, MASCC-0591

Batist, G. MASCC-0575

Bauchetet, C. MASCC-0531, MASCC-0497

Bauer, J. MASCC-0469

Baumann, S. MASCC-0629, MASCC-0071

Baumann, W. MASCC-0682

Bausa, A. MASCC-0516

Beato, C. MASCC-0632

Beato, C.A.M. MASCC-0654

Beaumont, J.L. MASCC-0011, MASCC-0009

Bechli, A. MASCC-0346, MASCC-0342, MASCC-0341, MASCC-0340, MASCC-0335

Beck, S.L. MASCC-0759

Bedard, A. MASCC-0099

Bedard, G. MASCC-0238, MASCC-0237, MASCC-0236, MASCC-0235, MASCC-0171, MASCC-0170, MASCC-0168, MASCC-0037, MASCC-0036, MASCC-0035, MASCC-0009, MASCC-0377, MASCC-0382, MASCC-0383, MASCC-0384

Beddard-Huber, E. MASCC-0099

Beekman, A.T.F. MASCC-0378

Begic, L.J. MASCC-0692

Behera, M.K. MASCC-0016

Behlendorf, T. MASCC-0418

Beijers, T. MASCC-0108

Beirne, G. MASCC-0705, MASCC-0700

Bektas, H. MASCC-0251, MASCC-0250

Bektas-Kayhan, K. MASCC-0770, MASCC-0690

Belderbos, J. MASCC-0224

Belen, F. MASCC-0028

Belka, C. MASCC-0297

Bella, V. MASCC-0134

Bellamy, P. MASCC-0040

Belum, V.R. MASCC-0763

Ben Aharon, I. MASCC-0299

Ben Ami, S. MASCC-0331

Benbrahim, Z. MASCC-0018, MASCC-0007

Bencova, V. MASCC-0134

Benesch, M. MASCC-0129

Bennani-Baiti, N. MASCC-0534, MASCC-0533

Benner, A. MASCC-0808

Bennett, B. MASCC-0715

Bennion, N. MASCC-0199

Bensadoun, R.J. MASCC-0663

Beorchia, A. MASCC-0423, MASCC-0420

Berenbaum, I.L. MASCC-0607

Berg, C. MASCC-0090

Bergamo, F. MASCC-0653

Berger, K. MASCC-0649

Bergman, H. MASCC-0575

Bernardo, M. MASCC-0587

Bernot, M. MASCC-0768

Berraquero, M.L. MASCC-0698

Berry, D.L. MASCC-0607

Bertoncello, M. MASCC-0527

Besen, A. MASCC-0748

Besser, A. MASCC-0049

Bhargava, R. MASCC-0452, MASCC-0447, MASCC-0307, MASCC-0295

Bhaskar, A. MASCC-0705, MASCC-0700

Bhatt, M.L.B. MASCC-0244

Bhattacharyya, G.S. MASCC-0621

Bhattacharyya, M. MASCC-0752

Bhushan, A.A.B. MASCC-0621

Bhushan, M. MASCC-0120

Bianchi, E. MASCC-0795

Bias, P. MASCC-0784, MASCC-0719

Biasotto, M. MASCC-0423, MASCC-0420, MASCC-0033

Bidargaddi, N. MASCC-0847

Bidet, G. MASCC-0461

Bidstrup, P. MASCC-0688

Bilici, M. MASCC-0339

Billard, D. MASCC-0484

Bilushi, Y. MASCC-0345

Bindon, K.A. MASCC-0042

Bingener, J. MASCC-0601

Birgegård, G. MASCC-0486

Birgens, H. MASCC-0158

Biswas, G. MASCC-0621

Bjarnason, G.A. MASCC-0767

Blackhall, L. MASCC-0844, MASCC-0333

Blair, S.C. MASCC-0562

Blais, M.C. MASCC-0289

Blaizac, C. MASCC-0531, MASCC-0497

Blal, K. MASCC-0842

Blazek, N. MASCC-0488

Blazeviciene, A. MASCC-0768

Blijlevens, N.M.A. MASCC-0567, MASCC-0305

Bloise, R. MASCC-0163

Bloom, B.F.B. MASCC-0703

Blum, R. MASCC-0546

Bock de, G.H. MASCC-0523

Body, J. MASCC-0640

Body, J.J. MASCC-0334

Boele, F. MASCC-0424

Boelke, E. MASCC-0297, MASCC-0288

Boers-Doets, C. MASCC-0396

Boespflug, A. MASCC-0753

Boiron, C. MASCC-0718

Boistard, B. MASCC-0718

Boll, D. MASCC-0361

Bolscher, J.G. MASCC-0321

Bomben, F. MASCC-0687

Bommier, C. MASCC-0638

Bonaventura, M. MASCC-0815

Bonfill, T. MASCC-0828

Boniface MASCC-0142

Bonnet, E. MASCC-0753

Bonneterre, J. MASCC-0645

Boot, A.M. MASCC-0419

Bopp, A. MASCC-0060

Borese, B. MASCC-0327

Bornbaum, C.C. MASCC-0790

Borod, M. MASCC-0848

Boronat, L. MASCC-0370

Borroni, M.E. MASCC-0434, MASCC-0433

Boruban, C. MASCC-0339

Bos-den Braber, J. MASCC-0305

Bosnjak, S. MASCC-0458

Bosscha, K. MASCC-0020

Bossi, P. MASCC-0724, MASCC-0668, MASCC-0664, MASCC-0663

Botana Rodriguez, C. MASCC-0462

Bouché, O. MASCC-0350

Boucher, K.M. MASCC-0059

Bouferrache, K. MASCC-0435

Bouillet, T. MASCC-0695

Bowen, J. MASCC-0853, MASCC-0677, MASCC-0611, MASCC-0600, MASCC-0591, MASCC-0502, MASCC-0483, MASCC-0464, MASCC-0257

Bowen, J.M. MASCC-0489, MASCC-0472, MASCC-0471

Bowers, J. MASCC-0199

Boyland, L. MASCC-0720

Bozza, C. MASCC-0633

Bozzetti, F. MASCC-0796

Braccia, D. MASCC-0787, MASCC-0786

Brachet, P.E. MASCC-0753

Brackett, S. MASCC-0522

Bradley, C. MASCC-0727

Braga, F.T.M.M. MASCC-0673, MASCC-0655

Brames, M. MASCC-0310

Brami, C. MASCC-0350, MASCC-0287

Brasnu, D. MASCC-0634

Braun, A. MASCC-0334

Breckons, M. MASCC-0492, MASCC-0271, MASCC-0374

Brinksma, A. MASCC-0523, MASCC-0419, MASCC-0421

Broder, M. MASCC-0756

Bronkhorst, E.M. MASCC-0305

Broto, J. MASCC-0546

Browall, M. MASCC-0095

Brown, J.E. MASCC-0334

Browne, S. MASCC-0180

Bruera, E. MASCC-0585, MASCC-0574, MASCC-0552, MASCC-0542, MASCC-0540, MASCC-0530, MASCC-0504, MASCC-0143, MASCC-0057

Brufsky, A. MASCC-0788

Brugger, W. MASCC-0569

Brundage, W. MASCC-0293

Brunello, A. MASCC-0653

Bruner, D. MASCC-0703

Brunetti, I. MASCC-0651

Buchanan, A. MASCC-0245

Buchner, A. MASCC-0784, MASCC-0719, MASCC-0694

Budach, W. MASCC-0297, MASCC-0288

Buendia, M. MASCC-0300

Buentzel, H. MASCC-0413

Bugat, R. MASCC-0701

Buhren, B.A. MASCC-0288

Büntzel, H. MASCC-0485

Büntzel, J. MASCC-0485, MASCC-0413, MASCC-0049

Buonaccorso, L. MASCC-0706

Burgerhof, J.G.M. MASCC-0419

Burlein-Hall, S. MASCC-0388, MASCC-0387

Burns, A. MASCC-0447

Bury, M.B.J. MASCC-0703

Busam, K.J. MASCC-0763

Busatto, A. MASCC-0327

Busch, S. MASCC-0726

Bussieres E, E.B. MASCC-0818

Bustreo, S. MASCC-0517

Butler, M. MASCC-0353

Butler, R. MASCC-0628

Butow, P. MASCC-0747, MASCC-0744

Buyukberber, S. MASCC-0339

Buyukyoruk, A. MASCC-0116, MASCC-0069

Buzzoni, R. MASCC-0724

Byun, S.W. MASCC-0803, MASCC-0721

C Schimanski, C. MASCC-0649

Cabral, E. MASCC-0568

Cadeddu, F. MASCC-0115

Cakir Gokce, S. MASCC-0548

Calarese, P. MASCC-0607

Caldeira, S. MASCC-0448

Calera, L. MASCC-0678

Calik M. MASCC-0089

Calik, M. MASCC-0067

Calman, L. MASCC-0498, MASCC-0492, MASCC-0271

Calsina, A. MASCC-0804

Calsina-Berna, A. MASCC-0309

Calvo, N. MASCC-0678

Camacho, M. MASCC-0300

Campbell, F. MASCC-0493

Campbell, N.C. MASCC-0180

Campo, R.A. MASCC-0059

Camps, C. MASCC-0678

Cantarero Villanueva, I. MASCC-0442, MASCC-0439

Cantoreggi, S. MASCC-0602

Cao, S. MASCC-0141

Caporusso, F. MASCC-0010

Capovilla, E. MASCC-0653, MASCC-0344

Cappai, E. MASCC-0662

Capparella, V. MASCC-0081, MASCC-0080

Carafizi, N. MASCC-0834

Caraiscos, V.B. MASCC-0467

Carayol, M. MASCC-0532

Cardellino, G.G. MASCC-0774

Cardona, A.F. MASCC-0300

Cardozo, F.M.C.C. MASCC-0278

Carelli MASCC-0856

Carlucci, V.D.S. MASCC-0655

Carmel, D.F. MASCC-0605

Carmona-Bayonas, A. MASCC-0632, MASCC-0626

Carnaby, G. MASCC-0070

Carothers, S. MASCC-0609

Carrara, H.H.A. MASCC-0811

Carvajal Reynaldo, R. MASCC-0348

Carvalho, E.C. MASCC-0675, MASCC-0673

Casagrande, M. MASCC-0774

Casas Fernandez de Tejerina, A. MASCC-0678

Cases, M. MASCC-0017

Cassel, B. MASCC-0615, MASCC-0613

Castaldi, M. MASCC-0454

Castañeda, P. MASCC-0843

Castillo-Carandang, N. MASCC-0516

Castro, A. MASCC-0659

Cattaruzza, M. MASCC-0751

Cau, M.C. MASCC-0047

Cavicchioli, L.T. MASCC-0239

Cazin, J.L. MASCC-0645

Ceccaldi, B. MASCC-0406

Celik, C. MASCC-0116, MASCC-0069

Cella, D. MASCC-0246, MASCC-0011, MASCC-0009, MASCC-0377

Cesas, A. MASCC-0584

Cetin, K. MASCC-0641

Cetingul, N. MASCC-0351

Chachaty, E. MASCC-0501

Chadi, S. MASCC-0603

Chaen, M. MASCC-0487, MASCC-0398

Chahal, K. MASCC-0203

Chair, S.Y. MASCC-0402, MASCC-0400

Chambers, C. MASCC-0572

Chan, A. MASCC-0630, MASCC-0599, MASCC-0598, MASCC-0588, MASCC-0538, MASCC-0479, MASCC-0446, MASCC-0436

Chan, C.en.W.H. MASCC-0537

Chan, C.W.H. MASCC-0606, MASCC-0402, MASCC-0400

Chan, D.N.S. MASCC-0402

Chan, N. MASCC-0014, MASCC-0013, MASCC-0006

Chan, P. MASCC-0030

Chan, R. MASCC-0030, MASCC-0029

Chan, R.J. MASCC-0402

Chan, S. MASCC-0240

Chan, S.L. MASCC-0732

Chan, Y.H. MASCC-0732

Chandía, A. MASCC-0409

Chandra, S. MASCC-0752

Chandrakumaran, K. MASCC-0463

Chang, E. MASCC-0756

Chang, H. MASCC-0510

Chang, H.H. MASCC-0222

Chang, L.-L. MASCC-0153

Chang, S.N. MASCC-0281

Chao, A. MASCC-0352

Chao, H.L. MASCC-0132

Chapman, P.B. MASCC-0763

Charalambous, A. MASCC-0355

Charalambous, M. MASCC-0355

Chargari, C. MASCC-0406

Chasen, M. MASCC-0796, MASCC-0452, MASCC-0447, MASCC-0307, MASCC-0295, MASCC-0252

Chau, N.M. MASCC-0630, MASCC-0479

Chaumard-Billotey, N. MASCC-0571

Chay, W.Y. MASCC-0599, MASCC-0598

Cheah, K.Y. MASCC-0044, MASCC-0042

Chebolu, S. MASCC-0583

Cheetham, T.C. MASCC-0586

Chen, C.H. MASCC-0281

Chen, E. MASCC-0237, MASCC-0010, MASCC-0008

Chen, L. MASCC-0476, MASCC-0474

Chen, P.B. MASCC-0785

Chen, Q. MASCC-0844

Chen, Y. MASCC-0320, MASCC-0282

Chen, Y.M. MASCC-0132

Chen, Z. MASCC-0233

Cheng, K. MASCC-0014, MASCC-0013, MASCC-0012, MASCC-0006, MASCC-0005, MASCC-0004

Cheng, S. MASCC-0681

Cheng, S.F. MASCC-0320, MASCC-0088

Cheng, Y. MASCC-0556

Chermetz, M. MASCC-0033

Cherny, N. MASCC-0164, MASCC-0109

Cheshire, S. MASCC-0805

Cheung, A. MASCC-0431

Cheung, W. MASCC-0476, MASCC-0474

Cheung, Y.T. MASCC-0599, MASCC-0598, MASCC-0588, MASCC-0436

Cheville, A. MASCC-0740

Chey, W.D. MASCC-0737

Chiara, S. MASCC-0517

Chie, W.-C. MASCC-0167

Chisholm, G. MASCC-0542, MASCC-0143

Chisholm, G.B. MASCC-0552

Chiu, K.K. MASCC-0631

Chiu, L. MASCC-0246, MASCC-0242, MASCC-0011, MASCC-0009

Chiu, N. MASCC-0246, MASCC-0242, MASCC-0011, MASCC-0009

Chivers Seymour, K. MASCC-0498

Chmielowska, E. MASCC-0658

Cho, C. MASCC-0416

Cho, I. MASCC-0262, MASCC-0261

Cho, O.H. MASCC-0255

Cho, S. MASCC-0616

Cho, S.J. MASCC-0676

Cho, Y.H. MASCC-0647

Choi, D.R. MASCC-0511

Choi, K.C. MASCC-0402, MASCC-0400

Choi, M.Y. MASCC-0511

Choi, Y.J. MASCC-0511

Chojnicki, M. MASCC-0514

Chong, X.J. MASCC-0479

Choquette, L.C. MASCC-0564

Chou, H.L. MASCC-0132

Choupay-Dessard, G. MASCC-0488

Chow, E. MASCC-0612, MASCC-0475, MASCC-0399, MASCC-0316, MASCC-0246, MASCC-0242, MASCC-0238, MASCC-0237, MASCC-0236, MASCC-0235, MASCC-0171, MASCC-0170, MASCC-0169, MASCC-0168, MASCC-0167, MASCC-0037, MASCC-0036, MASCC-0035, MASCC-0011, MASCC-0010, MASCC-0009, MASCC-0008, MASCC-0377, MASCC-0382, MASCC-0383, MASCC-0384

Chow, R. MASCC-0612, MASCC-0399, MASCC-0246, MASCC-0242, MASCC-0171, MASCC-0168, MASCC-0011, MASCC-0009, MASCC-0382

Chrisholm, G. MASCC-0530

Christensen, J. MASCC-0688, MASCC-0158

Christensen, J.C. MASCC-0441

Christensen, L. MASCC-0504

Christrup, L. MASCC-0112, MASCC-0111

Chu, C.Y. MASCC-0709

Chu, D. MASCC-0237, MASCC-0382, MASCC-0383, MASCC-0384

Chu, I. MASCC-0510

Chu, K.M. MASCC-0618

Chue, X.P. MASCC-0630, MASCC-0479

Chui, W.K. MASCC-0599, MASCC-0598, MASCC-0588

Chung, H. MASCC-0316

Chung, I.J. MASCC-0511

Chung, J. MASCC-0586

Chung, K. MASCC-0728

Cinausero, M. MASCC-0633

Cinkir, H. MASCC-0339

Ciorra, A.A. MASCC-0081

Ciriello, F. MASCC-0423, MASCC-0420

Citak, E.A. MASCC-0768

Ciuba, D.F. MASCC-0605

Claret, C. MASCC-0645

Clark, M.M. MASCC-0807

Clavier, J.B. MASCC-0376

Cleeland, C. MASCC-0546, MASCC-0334

Cleijne, W. MASCC-0424

Clerico, M. MASCC-0517

Cnossen, I.C. MASCC-0381

Cobanoglu, G. MASCC-0284, MASCC-0117, MASCC-0116, MASCC-0069

Cohen, E.E.W. MASCC-0708

Cohen, L. MASCC-0395

Colak, D. MASCC-0802, MASCC-0798

Coles, C. MASCC-0810

Colgan, V. MASCC-0620

Coll, J. MASCC-0469

Coller, J. MASCC-0483

Coller, J.K. MASCC-0472

Collini, D. MASCC-0751

Colombani S, S.C. MASCC-0822

Colombat, P. MASCC-0531, MASCC-0497, MASCC-0254

Combariza, J. MASCC-0260, MASCC-0258

Comber, H. MASCC-0428, MASCC-0427

Company, A. MASCC-0768

Cone, C. MASCC-0805

Cong, Z. MASCC-0728

Connolly, E. MASCC-0699, MASCC-0674

Conti, G. MASCC-0033

Coolbrandt, A. MASCC-0459

Cooley, M.E. MASCC-0607

Cooney, M. MASCC-0699, MASCC-0674

Cooper, A.B. MASCC-0800

Copel, L. MASCC-0718

Cordier, J.F. MASCC-0324

Cormier, J.N. MASCC-0027

Corner, J. MASCC-0498, MASCC-0492, MASCC-0271

Corrias, M. MASCC-0653

Cortizo, D.L. MASCC-0801

Cosic, J. MASCC-0692

Costa, F.O. MASCC-0654

Costa, L. MASCC-0743, MASCC-0739

Costa, M.J. MASCC-0587

Cousin, S. MASCC-0425

Cranston, C. MASCC-0452

Crary, M. MASCC-0070

Crawford, J. MASCC-0817, MASCC-0816, MASCC-0765, MASCC-0760, MASCC-0438

Crespel, C. MASCC-0287

Cristino, J. MASCC-0713, MASCC-0711

Croghan, I. MASCC-0740

Crossland, V. MASCC-0713, MASCC-0711

Cruz, F.M. MASCC-0654, MASCC-0581, MASCC-0573

Cruz, J.J. MASCC-0678

Crvenkova, S. MASCC-0038

Cubero, D. MASCC-0654, MASCC-0856

Cubero, D.I.G.C. MASCC-0581

Cucchi, M. MASCC-0645

Cui, J. MASCC-0141

Cuijpers, P. MASCC-0378

Culakova, E. MASCC-0817, MASCC-0816

Cumpston, A. MASCC-0114

Curé, H. MASCC-0287

Curley, K.F. MASCC-0564

Curran, S. MASCC-0665, MASCC-0661

Currow, D. MASCC-0410

Cusano, F. MASCC-0572

Custódio, M.P. MASCC-0743, MASCC-0739

Dabkara, D. MASCC-0850

Daehler, M.A. MASCC-0138

Daghbashyan, S. MASCC-0325

Daher, A. MASCC-0247

Dahham, S. MASCC-0643

Dai, D. MASCC-0729

Dakhil, S.R. MASCC-0560

Dale, D. MASCC-0438

Dale, D.C. MASCC-0817, MASCC-0816

Dale, O. MASCC-0111

Dalmau, E. MASCC-0828

Dalton, J.T. MASCC-0765, MASCC-0760

Dalton, S.O. MASCC-0688

DaLuz, R. MASCC-0659

Dalvad, E. MASCC-0133

Damyanov, D. MASCC-0334

Danilkina, G. MASCC-0485

Danjoux, C. MASCC-0475, MASCC-0238, MASCC-0236, MASCC-0235, MASCC-0037, MASCC-0036, MASCC-0035, MASCC-0377, MASCC-0383

Daoud, S. MASCC-0075

Daoudi, K. MASCC-0018

Daoust, L. MASCC-0461, MASCC-0460

Darmani, N. MASCC-0583

DasGupta, T. MASCC-0390

Davidowitz, T. MASCC-0412

Davies, A. MASCC-0245, MASCC-0111, MASCC-0001, MASCC-0359

Davies, M. MASCC-0847, MASCC-0493, MASCC-0391

Davies, W. MASCC-0603

Davis, C. MASCC-0720

Davis, M. MASCC-0196, MASCC-0165, MASCC-0164, MASCC-0163, MASCC-0162, MASCC-0161, MASCC-0109

Davis, R. MASCC-0194

De Angelis, C. MASCC-0475, MASCC-0463

De Botton, S. MASCC-0527

De Bree, R. MASCC-0378, MASCC-0381

De Castro Carpeño, J. MASCC-0678

De Haan, A.F.J. MASCC-0567

De Jesus Cabral, M. MASCC-0638

De La Cruz, M. MASCC-0540, MASCC-0530

De Melker, A. MASCC-0823

De Riu, G. MASCC-0263

De Serres, M. MASCC-0289

De Soet, J.J. MASCC-0321

De Souza Costa, C.A. MASCC-0106

DeAngelis, C. MASCC-0316

Deary, V. MASCC-0582

Debattista, K. MASCC-0322

Debus, J. MASCC-0686, MASCC-0680, MASCC-0496, MASCC-0297

Decaestecker, J. MASCC-0584

Decosterd, S. MASCC-0488

Degardin, M. MASCC-0425

Dégi, C.L. MASCC-0451

DeGore, L. MASCC-0815

Deguzman, C. MASCC-0767

Del Fabbro, E. MASCC-0848, MASCC-0615, MASCC-0613, MASCC-0057

Del Fiol, G. MASCC-0607

Del Giglio, A. MASCC-0581, MASCC-0573, MASCC-0573, MASCC-0239, MASCC-0856

Del Giglio, A.B. MASCC-0856, MASCC-0239

Del Giglio, A.E.R. MASCC-0654

Delaruelle, C. MASCC-0753

Delea, T.E. MASCC-0728

Deledda, A. MASCC-0263

Delgado-Guay, M.O. MASCC-0057

DelGiglio, A. MASCC-0608

Delpierre, C. MASCC-0532

Demir, E.T. MASCC-0102

Demirci, U. MASCC-0339

Den Boer, A.M. MASCC-0455

Denaro, N. MASCC-0664

Deng, J. MASCC-0149, MASCC-0027, MASCC-0558

Denicoff, A. MASCC-0543

DeNittis, A.S.D. MASCC-0703

Dennis, K. MASCC-0475, MASCC-0316, MASCC-0236

Dent, R.A. MASCC-0599, MASCC-0598, MASCC-0538

Dereumaux, N. MASCC-0645

Deryck, T. MASCC-0502

Des Bordes, J.K.A. MASCC-0800

Desbiens, J.F. MASCC-0289

Descotes, J.M. MASCC-0695

Descourt, R. MASCC-0197, MASCC-0098, MASCC-0096

Desilets, O. MASCC-0691

Desjardins, A. MASCC-0805, MASCC-0777

Despierre, E. MASCC-0328

Destro-Borgen, M. MASCC-0722

Dettino, A.A. MASCC-0654

Dev, R. MASCC-0540, MASCC-0057

Di Giovanni, J. MASCC-0237, MASCC-0010, MASCC-0008

Di Lenarda, R. MASCC-0423, MASCC-0420

Di Palma, M. MASCC-0527, MASCC-0501

Dias, B.P. MASCC-0830

Dias, F. MASCC-0568

Diasio, B. MASCC-0845

Díaz Rodríguez, D. MASCC-0698

Díaz Rodriguez, L. MASCC-0442

Dib, L.L. MASCC-0801

Didwaniya, N. MASCC-0540

Dieckmann, K. MASCC-0063

Diel, I. MASCC-0726

Dielenseger, P. MASCC-0707

Diemar, C. MASCC-0418

Dieperink, K. MASCC-0133

Dieperink, K.B. MASCC-0512, MASCC-0265, MASCC-0264

Dierckx de Casterlé, B. MASCC-0459

Dietrich, M.S. MASCC-0149, MASCC-0027, MASCC-0762, MASCC-0558

Dilek Erdem, D.E. MASCC-0833

Dimitrijevic, J. MASCC-0458

Dimitrovska, A. MASCC-0038

Dimov, A. MASCC-0657

Ding, S.-A. MASCC-0213

Dintinjana, M. MASCC-0593

DiPalma, M. MASCC-0738, MASCC-0505

Dobrila-Dintinjana, R. MASCC-0597, MASCC-0593

Doherty, G. MASCC-0746

Dolai, T. MASCC-0752

Dolbeault, S. MASCC-0718

Domen, K. MASCC-0256, MASCC-0209

Domingo, E. MASCC-0516

Dominkus, M. MASCC-0546

Donbavand, J. MASCC-0021

Dong, F. MASCC-0292, MASCC-0291

Dong, M. MASCC-0233

Donnely, J.P. MASCC-0567

Donner, C. MASCC-0413

Dorchin, M. MASCC-0174, MASCC-0173

Douw, L. MASCC-0424

Downar, J. MASCC-0603

Dowsett, R.J. MASCC-0564

Doyle, N. MASCC-0270, MASCC-0269

Doyle, P.C. MASCC-0790

Dr. Njimogu MASCC-0142

Drewes, A.M. MASCC-0112

Drobner, I. MASCC-0432

Drummond, F. MASCC-0725, MASCC-0635

Drummond, F.J. MASCC-0428, MASCC-0427

Du, Q. MASCC-0526

Dubinina, V. MASCC-0290

Dubinina, V.G. MASCC-0429

Dubreuil, J. MASCC-0753

Dubroeucq, O. MASCC-0287

Duchnowska, R. MASCC-0658

Duguey-Cachet, O. MASCC-0179

Dumitrescu, C. MASCC-0296

Dunson Jr., W.A. MASCC-0759

Dusza, S. MASCC-0763

Duval, M. MASCC-0461

Dwary, A. MASCC-0850

Dyag?l, I. MASCC-0364

Easson, A. MASCC-0603

Eastman, P. MASCC-0401

Eduardo, B. MASCC-0395

Eeckhout, G.M. MASCC-0378

Eeltink, C. MASCC-0636, MASCC-0375

Eerenstein, S.E. MASCC-0381

Egerdie, B. MASCC-0334

Ehlken, B. MASCC-0649

Einhorn, L.H. MASCC-0310

Ekema, C. MASCC-0142

Ekholm, O. MASCC-0111

El Mesbahi, O. MASCC-0018, MASCC-0007

El Osta, L. MASCC-0553, MASCC-0551

El Osta, N. MASCC-0551

El-hadad, A. MASCC-0336

Elad, S. MASCC-0313

Elangovan, V. MASCC-0704, MASCC-0619

Elayouty, H.L. MASCC-0121

Ellershaw, J.E. MASCC-0343

Elliott, L. MASCC-0857, MASCC-0039

Elmi, S. MASCC-0839

Elrafei, T. MASCC-0454

Elsaesser, R. MASCC-0784

Elsafy, E. MASCC-0336

Elsurer Afsar, R. MASCC-0066

Ely, J. MASCC-0754

Emali, F. MASCC-0723

Emmenegger, U. MASCC-0171, MASCC-0169, MASCC-0168

Engellau, J. MASCC-0546

Engin, H. MASCC-0339

England, D. MASCC-0572

Enright, P. MASCC-0447

Ensslin, C. MASCC-0024

Epstein, J.B. MASCC-0149

Erdemir, U.G.U.R. MASCC-0770

Eremin, V. MASCC-0407

Ermacora, P. MASCC-0774, MASCC-0751

Ersoy, U. MASCC-0802

Escalante, C. MASCC-0395

Escalante, C.P. MASCC-0579

Esh, A. MASCC-0314

Esme, H. MASCC-0089, MASCC-0067

Espejo, J. MASCC-0843

Espie, C.A. MASCC-0437

Espinal, R. MASCC-0194

Estfan, B. MASCC-0832, MASCC-0536, MASCC-0534

Etienne-Mastroianni, B. MASCC-0324

Eurelings, M. MASCC-0636

Evangelista, S. MASCC-0462

Eyll, B.M.V. MASCC-0654

Fabi, A. MASCC-0517

Fache, B. MASCC-0350

Faddoul, S. MASCC-0553

Faerber, J. MASCC-0729

Fairchild, A. MASCC-0167

Faith, K. MASCC-0051

Fakhrul islam, P.R.O.F. MASCC-0275

Fakiha, K. MASCC-0483

Falcone, A. MASCC-0651

Fallowfield, L.J. MASCC-0334

Faltl, L. MASCC-0390

Fan, B. MASCC-0150

Fan, G. MASCC-0599, MASCC-0598

Fansabedian, T. MASCC-0528

Faria, C. MASCC-0766, MASCC-0756

Farley, D. MASCC-0601

Farouk, M. MASCC-0569

Farsi, F. MASCC-0371

Fasola, G. MASCC-0774, MASCC-0751, MASCC-0633

Fatigoni, S. MASCC-0517

Fatigue, . MASCC-0151

Fayette, J. MASCC-0672

Fearon, K. MASCC-0796

Fee-Schroeder, K.C. MASCC-0846

Feinn, R.S. MASCC-0564

Feldman, E. MASCC-0605

Feldstain, A. MASCC-0307, MASCC-0252

Felice, M. MASCC-0462

Fendrychová, J. MASCC-0768

Feng, A. MASCC-0546

Fenlon, D. MASCC-0580, MASCC-0498, MASCC-0492, MASCC-0271

Fennelly, D. MASCC-0746

Fernanda Mara Coelho Cardozo, F.M.C.C. MASCC-0273

Fernanda Mara Coelho, F.M.C. MASCC-0272

Fernández Lao, C. MASCC-0442, MASCC-0439

Fernandez Ortega, P. MASCC-0707

Fernandez Perez, D. MASCC-0707

Fernandez, P. MASCC-0768

Fernandez-Martinez, A. MASCC-0632, MASCC-0626, MASCC-0002

Ferrand, F.R. MASCC-0753

Ferrari, L. MASCC-0774

Ferreira, C. MASCC-0568

Ferreira, E. MASCC-0568

Ferreira, E.M. MASCC-0565

Ferreira, S. MASCC-0835

Ferreira, S.M.A. MASCC-0764

Ferreira, V.T.K. MASCC-0830, MASCC-0811, MASCC-0730

Ferrer, M. MASCC-0828

Festa, A. MASCC-0695

Feudtner, C. MASCC-0729

Feyer, P. MASCC-0726

Fiduccia, P. MASCC-0653

Fieuws, S. MASCC-0023

Fijlstra, M. MASCC-0157

Filho, D.R. MASCC-0654

Fillion, L. MASCC-0289

Findler, M. MASCC-0313, MASCC-0313

Finek, J. MASCC-0640

Finkelstein, D. MASCC-0522

Finkelstein, S.E. MASCC-0605

Finn, K. MASCC-0607

Finnie, J. MASCC-0257

Fiscella, K. MASCC-0556

Fisch, M. MASCC-0559

Fisher, B.T. MASCC-0729

Fishman, M. MASCC-0017

Fitch, M. MASCC-0578, MASCC-0577, MASCC-0576, MASCC-0390, MASCC-0389, MASCC-0388, MASCC-0387, MASCC-0386

Fitch, M.I. MASCC-0449, MASCC-0445

Fitz, A. MASCC-0693, MASCC-0456, MASCC-0453

Fizazi, K. MASCC-0505

Flaiban, C. MASCC-0687, MASCC-0684

Flament, T. MASCC-0753

Flechl, B. MASCC-0063

Fleckenstein, K. MASCC-0520

Fleischmann, C. MASCC-0736

Fleming, L. MASCC-0437

Fletcher, S.W. MASCC-0586

Floquet A, A.F. MASCC-0822

Fogelman, D.R. MASCC-0800, MASCC-0742

Folkins, C. MASCC-0463

Foltran, L. MASCC-0774

Fonseca, O. MASCC-0156

Font, C. MASCC-0678, MASCC-0632, MASCC-0626, MASCC-0056, MASCC-0002

Foo, K.M. MASCC-0538

Foo, Y.L. MASCC-0588

Forges, F. MASCC-0167

Foster, C. MASCC-0720, MASCC-0498, MASCC-0492, MASCC-0271, MASCC-0374

Foster, R. MASCC-0720

Fouladi, N. MASCC-0178

fouquereau, E. MASCC-0254

Fox, A. MASCC-0569

Franklin, J. MASCC-0790

Fraquelli, L. MASCC-0462

Freedman, J.L. MASCC-0729

Freytes, C. MASCC-0392

Freytes, C.O. MASCC-0394, MASCC-0393

Friedman, H. MASCC-0777

Friedman, H.S. MASCC-0805

Friend, J. MASCC-0410

Frisbee-Hume, S. MASCC-0585, MASCC-0574, MASCC-0542, MASCC-0395

Frisbee-Hume, S.E. MASCC-0552

Fritz, G. MASCC-0062, MASCC-0060

Fryer, J. MASCC-0359

Fu, M.R. MASCC-0027

Fu, Q. MASCC-0494

Fujii, H. MASCC-0513, MASCC-0500

Fukutomi, A. MASCC-0369

Fulman, L. MASCC-0493

Fuloria, J. MASCC-0562

Fumis, R.R.L. MASCC-0654

Fundakowski, C. MASCC-0184

Fung, K. MASCC-0790

Furuse, J. MASCC-0521

Gaafar, R. MASCC-0074

Gachot, B. MASCC-0501

Gagne, H. MASCC-0293

Gagnon, P. MASCC-0691

Gaiger, A. MASCC-0063

Galiano Castillo, N. MASCC-0442, MASCC-0439

Galiti, D. MASCC-0769

Galitis, E. MASCC-0769

Gallego Zapata, S. MASCC-0348

Galli, L. MASCC-0651

Galun, D. MASCC-0555

Galvez, K. MASCC-0260, MASCC-0258

Galvin, R. MASCC-0699, MASCC-0674

Gandhavadi, R.B. MASCC-0605

Ganesan, S. MASCC-0704

Gangeri, L. MASCC-0795

Ganguly, B.B. MASCC-0752

Ganjoo, K. MASCC-0546

Ganswindt, U. MASCC-0297

Gao, S. MASCC-0579

Garavello, I. MASCC-0811

Garbin, L.M. MASCC-0655

Garcia, E. MASCC-0828

Garcia, Y. MASCC-0828

Garg, N. MASCC-0742

Garguil V, V.G. MASCC-0818

Garrett, A. MASCC-0408

Garrone, O. MASCC-0517

Garssen, A. MASCC-0563

Gasich, E.L. MASCC-0407

Gaston-Johansson, F. MASCC-0095

Gates, P. MASCC-0365

Gatou, E. MASCC-0778

Gaur, R. MASCC-0829

Gaur, S. MASCC-0215

Gauvin, F. MASCC-0461, MASCC-0460

Gavin, A. MASCC-0725, MASCC-0635

Gaya, S.A. MASCC-0217

Ge, L. MASCC-0004

Geay, J.F. MASCC-0484

George, M. MASCC-0614

Georgieva, S. MASCC-0657

Gerber, P. MASCC-0297

Gerber, P.A. MASCC-0288

Geredeli, C. MASCC-0339

Gerratana, L. MASCC-0633

Ghosh, I. MASCC-0850

Ghosh, K. MASCC-0722

Ghosh, M. MASCC-0752

Ghosh, S. MASCC-0624

Ghosn, M. MASCC-0553, MASCC-0551

Giacchetti, S. MASCC-0767

Gianello, L. MASCC-0664

Giannatempo, P. MASCC-0724

Gibson, R. MASCC-0853, MASCC-0471, MASCC-0257

Gibson, R.J. MASCC-0489, MASCC-0472

Gichini, L. MASCC-0689

Gichini, L.I. MASCC-0148

Giglio, A.D. MASCC-0107

Gijsen, B. MASCC-0323

Gillet, N. MASCC-0254

Gilmore, J. MASCC-0787

Ginocchi, L. MASCC-0651

Giotis, A. MASCC-0463

Gioules, A. MASCC-0297

Giovannini, L. MASCC-0687, MASCC-0684

Giovannoni, M. MASCC-0774

Girard, N. MASCC-0324

Girre, V. MASCC-0575, MASCC-0570

Girvent, F. MASCC-0828

Giscard, S. MASCC-0645

Giuliani, J. MASCC-0137, MASCC-0136, MASCC-0135, MASCC-0327

Given, B. MASCC-0851

Gladkov, O. MASCC-0784, MASCC-0719

Glaus, A. MASCC-0186

Glavic, Z. MASCC-0692

Glaza, I. MASCC-0831

Gleich, L. MASCC-0410

Gloria, K. MASCC-0051, MASCC-0050

Glowacka, I. MASCC-0831, MASCC-0826

Gobbo, M. MASCC-0423, MASCC-0420, MASCC-0033

Goddard, K. MASCC-0797

Godfrey, K.A. MASCC-0749

Gokcen-Röhling, B. MASCC-0770

Gokoz dogu, G. MASCC-0339

Goksel, G. MASCC-0339

Golby, C. MASCC-0322

Goldman, C.S. MASCC-0856

Gomes, A. MASCC-0528

Gomes, F. MASCC-0659

Gonçalves, G. MASCC-0587

Gong, S.J. MASCC-0511

Gonzalez-Barboteo, J. MASCC-0804, MASCC-0309

Gonzalez-Fernandez, R. MASCC-0370

Gooberman-Hill, R. MASCC-0747, MASCC-0744

Good, M. MASCC-0543

Goossens, G.A. MASCC-0328, MASCC-0023

Goswami, D. MASCC-0175

Goto, K. MASCC-0414

Gottumukala, V. MASCC-0800

Gotz, C. MASCC-0204, MASCC-0086

Govindbabu, K. MASCC-0621

Gozzo, T. MASCC-0835

Gozzo, T.O. MASCC-0811, MASCC-0772, MASCC-0764

Gralla, R. MASCC-0737, MASCC-0434, MASCC-0432

Gralla, R.J. MASCC-0765, MASCC-0760, MASCC-0454, MASCC-0312

Grané, M.C. MASCC-0056, MASCC-0002

Granot, T. MASCC-0331, MASCC-0299, MASCC-0298

Gravelle, D. MASCC-0295

Gray, N. MASCC-0180

Gregoracci, G. MASCC-0751

Grendahl, D.C. MASCC-0846

Grimmett, C. MASCC-0492, MASCC-0271

Groot de, M. MASCC-0424

Grothey, A. MASCC-0625

Grunberg, S. MASCC-0433

Grunberg, S.M. MASCC-0293

Grutsch, J. MASCC-0466, MASCC-0465

Grutsch, J.F. MASCC-0138

Guariento, R.T. MASCC-0856

Gucek, M. MASCC-0337

Guerrero, G.P. MASCC-0545

Guest, A. MASCC-0749

Guihard, S. MASCC-0376

Guinigundo, A.S. MASCC-0541, MASCC-0539

Guirro, E.C.O. MASCC-0830, MASCC-0730

Gul, O.V. MASCC-0284, MASCC-0283, MASCC-0119, MASCC-0117

Gunn, K.M. MASCC-0847

Güntsch, F. MASCC-0418

Guo-chenXing, G. MASCC-0065

Gupta, D. MASCC-0138

Gürsel, T. MASCC-0028

Gushiken, F. MASCC-0394, MASCC-0393, MASCC-0392

Guth, D. MASCC-0726

Guy-Coichard, C. MASCC-0753

Guyon F, F.G. MASCC-0822

Güzin demirag, G.D. MASCC-0833

H. MASCC-0182

H. Pedersen, J. MASCC-0716

Haak, H.R. MASCC-0052

Haas-Rassfeld, B. MASCC-0496

Habana, A. MASCC-0516

Habel, L.A. MASCC-0586

Habl, G. MASCC-0680

Hacibekiroglu, I. MASCC-0802

Hack, C. MASCC-0520

Haefner, M. MASCC-0680, MASCC-0496

Hafashimana, V. MASCC-0160

Haga, N. MASCC-0414

Hagag, P. MASCC-0187

Hagiwara, M. MASCC-0728

Hagner, W. MASCC-0831, MASCC-0826

Haid, V. MASCC-0316

Haile, D. MASCC-0394, MASCC-0393, MASCC-0392

Haislip, S. MASCC-0787

Haitz, K. MASCC-0767

Hall, S. MASCC-0329, MASCC-0180, MASCC-0001

Halpenny, B. MASCC-0607

Halpern, A.C. MASCC-0763

Hamad, A.-W.R. MASCC-0072

Hamada, K. MASCC-0757

Hamauchi, S. MASCC-0369

Hamou, A. MASCC-0644

Hancock, M.L. MASCC-0765, MASCC-0760

Handsfield, L. MASCC-0844

Hank, E. MASCC-0481

Hankins, M. MASCC-0374

Hanna, E. MASCC-0838

Hannon, B. MASCC-0820

Hans, S. MASCC-0634

Hansen, D.G. MASCC-0504

Hansen, O. MASCC-0512

Hansen, S. MASCC-0512

Hanucharurnkul, S. MASCC-0015

Haque, R. MASCC-0586

Harder, J. MASCC-0288

Hardt, J. MASCC-0570

Harle, I. MASCC-0431

Harputoglu, H. MASCC-0339

Harrison, J. MASCC-0333

Harsch, J. MASCC-0496

Hartley, B. MASCC-0270, MASCC-0269

Hartmann, I. MASCC-0133

Harvey, R.D. MASCC-0773

Hasan, A. MASCC-0394, MASCC-0393

Hasan, M. MASCC-0742

Hassali, M.A. MASCC-0085

Hassan, B.A.R. MASCC-0085

Hassan, L. MASCC-0643

Hassel, J. MASCC-0680

Hata, T. MASCC-0679

Hatake, K. MASCC-0521

Hauschild, A. MASCC-0709

Hauswald, H. MASCC-0686

Haynes, I. MASCC-0713, MASCC-0711, MASCC-0710

Hebling, J. MASCC-0106

Hechmati, G. MASCC-0715, MASCC-0713, MASCC-0711, MASCC-0710, MASCC-0640

Heckler, C. MASCC-0829, MASCC-0794

Heckler, C.E. MASCC-0810

Hedley, M.L.H. MASCC-0441

Hegarty, J. MASCC-0745, MASCC-0665, MASCC-0661

Hegde, U.P. MASCC-0564

Heike, Y. MASCC-0366

Heilmann, E. MASCC-0780

Heimans, J. MASCC-0424

Hendriksen, C. MASCC-0443

Henke, M. MASCC-0297

Hennequin, M. MASCC-0551

Hennessy, M. MASCC-0428, MASCC-0427

Henninger, C. MASCC-0062, MASCC-0060

Henry, R. MASCC-0269

Hera, M. MASCC-0342, MASCC-0340

Heras, P. MASCC-0346, MASCC-0342, MASCC-0341, MASCC-0340, MASCC-0335

Herbers, A.H.E. MASCC-0567

Herchenhorn, D. MASCC-0568

Hernández, C. MASCC-0056, MASCC-0002

Hernandez, R. MASCC-0641

Herndon II, J.E. MASCC-0805

Heron, D.E. MASCC-0605

Herve, C. MASCC-0638, MASCC-0634

Herzog, M. MASCC-0062

Hesketh, P. MASCC-0432

Hessissen, L. MASCC-0590

Hicks, K. MASCC-0037

Hiegel, C. MASCC-0718

Higa, G. MASCC-0114

Higney, K. MASCC-0727

Hindenburg, H.J. MASCC-0852, MASCC-0726

Hinke, A. MASCC-0496

Hira, N. MASCC-0610

Hirasawa, T. MASCC-0368

Hirata, K. MASCC-0521

Hirsch, B. MASCC-0808

Ho, H.K. MASCC-0630, MASCC-0598, MASCC-0479

Ho, R. MASCC-0003

Ho, S.ne.S.M. MASCC-0537

Ho, S.S.M. MASCC-0639, MASCC-0400

Hobbs, G. MASCC-0114

Hoelzer, K.L. MASCC-0810

Hof, H. MASCC-0686

Hojan, K. MASCC-0785, MASCC-0783

Højsted, J. MASCC-0112

Holcmann, M. MASCC-0288

Holden, L. MASCC-0612, MASCC-0475, MASCC-0238, MASCC-0236, MASCC-0235, MASCC-0037, MASCC-0036, MASCC-0035, MASCC-0377, MASCC-0382, MASCC-0383

Hollen, P.J. MASCC-0312

Holliday, L. MASCC-0408

Holm, M. MASCC-0198

Holmes, H. MASCC-0800, MASCC-0742

Homey, B. MASCC-0288

Honaga, K. MASCC-0379, MASCC-0380

Hong, D.S. MASCC-0511

Hong, J. MASCC-0041

Hong, W. MASCC-0405

Hong, Y.S. MASCC-0511, MASCC-0143, MASCC-0041

Honma, Y. MASCC-0414

Hoque, M. MASCC-0481

Horaiya, K. MASCC-0525

Horn, J. MASCC-0493

Horng, C.-F. MASCC-0153

Horsley, P. MASCC-0469

Hoshikawa, Y. MASCC-0508

Hosokawa, R. MASCC-0508, MASCC-0507

Hotko, Y. MASCC-0584

Hou, L. MASCC-0152

Hou, M.-F. MASCC-0167

Houghton, D. MASCC-0493

Howard, A.F. MASCC-0797

Howarth, G.S. MASCC-0044, MASCC-0043, MASCC-0042

Howell, D. MASCC-0578, MASCC-0576

Howell, J. MASCC-0786

Hoy, S. MASCC-0493

Hrushesky, W.J. MASCC-0138

Hsia, T.C. MASCC-0312

Hsiao, J. MASCC-0170

Hsu, L.Y. MASCC-0446

Huang T.-W. MASCC-0221

Huang, D. MASCC-0559

Huang, T.-W. MASCC-0144

Huang, Y.S. MASCC-0729

Hubbard, G. MASCC-0180

Hubbard, J. MASCC-0625

Huelsenbeck, J. MASCC-0062, MASCC-0060

Huelsenbeck, S. MASCC-0060

Hughes, B.G.M. MASCC-0402

Hui, D. MASCC-0552, MASCC-0542, MASCC-0540, MASCC-0143, MASCC-0057

Hulbert Williams, N. MASCC-0374

Humbert, N. MASCC-0461, MASCC-0460

Humphreys, S. MASCC-0648

Hung, C.T. MASCC-0851

Hung, H.C. MASCC-0032

Hung, Y. MASCC-0469

Hunt, J.A.N.E. MASCC-0702

Hussain, R. MASCC-0219, MASCC-0127, MASCC-0083

Hussain, S. MASCC-0275

Hussey, D. MASCC-0464

Husson, O. MASCC-0053, MASCC-0052

Huszno, J. MASCC-0026

Hutchins, R. MASCC-0540

Hutchinson, M.R. MASCC-0472

Huysmans, M.C.D.N.J.M. MASCC-0305

Hwang, J. MASCC-0559, MASCC-0510, MASCC-0262

Hwang, M. MASCC-0101, MASCC-0100

Iacono, D. MASCC-0633

Iacovelli, R. MASCC-0505

Iaiza, E. MASCC-0774

Iannacone, E. MASCC-0664

Ibáñez, B. MASCC-0056, MASCC-0002

Ibrahim, A. MASCC-0815, MASCC-0667

Ichinose, Y. MASCC-0779

Idrees, F. MASCC-0509

Idrees, J. MASCC-0509

Idrees, M. MASCC-0509

Idris yücel, I.Y. MASCC-0833

Iihara, H. MASCC-0513, MASCC-0500

Iire, L. MASCC-0064

Ikeda, M. MASCC-0368

Ikegame, K. MASCC-0256, MASCC-0209

Ikoma, K. MASCC-0524

Imamoglu, G.I. MASCC-0802, MASCC-0798

Imhof, L. MASCC-0186

Immanuel, A.S. MASCC-0702

Inal, A. MASCC-0339

Inamoto, T. MASCC-0779

Indelli, M. MASCC-0517

Innominato, P. MASCC-0791, MASCC-0767

Inocencio Vasques, C. MASCC-0332

Ionta, M.T. MASCC-0517

Iqba, H. MASCC-0127

Iqbal, H. MASCC-0219, MASCC-0218, MASCC-0083

Irfan, N. MASCC-0218

Isenring, E. MASCC-0629, MASCC-0469

Ishida, N. MASCC-0508

Ishida, T. MASCC-0617

Ishiguro, H. MASCC-0779, MASCC-0637

Ishihara, M. MASCC-0513, MASCC-0500

Ishii, S. MASCC-0256, MASCC-0209

Ishikawa, A. MASCC-0379, MASCC-0380

Ishitani, K. MASCC-0308

Isik, M. MASCC-0028

Isikdogan, A. MASCC-0339

Ismail, P. MASCC-0200

Isola, M. MASCC-0751

Israelyan, K. MASCC-0325

Ito, E. MASCC-0507

Ito, Y. MASCC-0521

Itoh, Y. MASCC-0513, MASCC-0500

Itova, Z.Z. MASCC-0076

Ivanova, D. MASCC-0657

Izoe, Y. MASCC-0519, MASCC-0468

J. MASCC-0857

Jaafari, B. MASCC-0159

Jablonka, F. MASCC-0107

Jackson, J. MASCC-0766

Jacob, J. MASCC-0771

Jacobs, I. MASCC-0546

Jacobsen, P. MASCC-0017

Jacquemin, M. MASCC-0023

Jaehde, U. MASCC-0520

Jagannath, S. MASCC-0773

Jagoe, T. MASCC-0793

Jahana, S. MASCC-0757, MASCC-0660

Jair Licio Ferreira Santos, J.L.F.S. MASCC-0273, MASCC-0272

Jakobsen, J. MASCC-0145

Jamal, N. MASCC-0463, MASCC-0244

James MASCC-0857

James, J. MASCC-0039

Jamshed, A. MASCC-0219, MASCC-0218, MASCC-0127, MASCC-0083

Jane, E. MASCC-0843, MASCC-0840

Janelsins, M. MASCC-0794, MASCC-0791, MASCC-0755

Janelsins, M.C. MASCC-0829, MASCC-0810

Jang, J. MASCC-0262

Jang, J.S. MASCC-0647, MASCC-0511

Jang, R.W. MASCC-0467

Jansen, R. MASCC-0422

Jansky, M. MASCC-0670

Janssens, C. MASCC-0023

Jarden, M. MASCC-0158, MASCC-0145

Jarlbaek, L. MASCC-0504

Jarvis, V. MASCC-0431

Jaslowski, A.J. MASCC-0562

Jatoi, A. MASCC-0796, MASCC-0311

Javle, M. MASCC-0742

Jean-Pierre, P. MASCC-0556, MASCC-0184

Jeong, H.J. MASCC-0404

Jérôme, M. MASCC-0023

Jesus-Garcia, R. MASCC-0167

Jhon, M.N. MASCC-0190

Jian, J.-M. MASCC-0153

Jim, H. MASCC-0017

Jiménez, F. MASCC-0362, MASCC-0363

Jin, J. MASCC-0255

Johansen, C. MASCC-0688

Johns, E. MASCC-0607

Johnson, C. MASCC-0620

Johnston, M. MASCC-0180

Johnston, M.A. MASCC-0765, MASCC-0760

Joly, F. MASCC-0836

Jon, F. MASCC-0475, MASCC-0383

Jones, A. MASCC-0648

Jones, P. MASCC-0707

Joo, J. MASCC-0750

Jordan, K. MASCC-0434, MASCC-0418

Jourt Pineau, C. MASCC-0406

Jovenin, N. MASCC-0350, MASCC-0287

Jreige, Y. MASCC-0247

Juhler, M. MASCC-0145

Juliana Maria De Paula, J.M.P. MASCC-0273, MASCC-0272

Julka, P.K. MASCC-0016

Jun, S. MASCC-0666

Jung, H.J. MASCC-0511

Jungberg, P. MASCC-0726

Jungyun, P. MASCC-0415

Jurczak, W. MASCC-0658

Kaasa, S. MASCC-0111

Kadakia, K.C. MASCC-0846

Kaden, B. MASCC-0792

Kahana, B. MASCC-0385, MASCC-0385

Kahana, E. MASCC-0385

Kahangi, L. MASCC-0105

Kaida, K. MASCC-0256, MASCC-0209

Kaina, B. MASCC-0062, MASCC-0060

Kakeji, Y. MASCC-0521

Kalbasi, S. MASCC-0200

Kalinka-Warzocha, E. MASCC-0658

Kalinowski, K. MASCC-0805

Kalyana, H.M. MASCC-0160

Kama, N. MASCC-0314

Kamal, A. MASCC-0314

Kamal, N. MASCC-0336

Kamen, C. MASCC-0829, MASCC-0755

Kamen, C.S. MASCC-0810

Kamizato, M. MASCC-0757, MASCC-0660

Kamps, W.A. MASCC-0419, MASCC-0421

Kamura, T. MASCC-0521

Kan, N. MASCC-0779

Kan-no, H. MASCC-0368

Kanathigoda, S. MASCC-0353, MASCC-0354

Kanda, T. MASCC-0525

Kanemaru, A. MASCC-0229

Kanesvaran, R. MASCC-0630, MASCC-0479

Kang, B.W. MASCC-0511

Kang, J.H. MASCC-0647

Kang, T.I. MASCC-0729

Kantar, M. MASCC-0351

Kaplan, I. MASCC-0412

Karagöz, G. MASCC-0770

Karahan, A. MASCC-0768

Karatsu, F. MASCC-0610

Kasera, C.A. MASCC-0723

Kaspers, G.J.L. MASCC-0455

Kassem, F. MASCC-0074

Kasymjanova, G. MASCC-0793

Kataoka, Y. MASCC-0366

Kathiresan, N. MASCC-0554

Kato, H. MASCC-0779

Katsaragakis, S. MASCC-0644

Kattan, J. MASCC-0247

Katz, M.H.G. MASCC-0800, MASCC-0742

Kaufer, H. MASCC-0212

Kaur P. MASCC-0201

Kav, S. MASCC-0768

Kawamura-Murayama, Y. MASCC-0268

Kaya, Z. MASCC-0028

Kaye, V. MASCC-0021

Kayssi, A. MASCC-0603

Kazanjian, A. MASCC-0797

Kee, Y.C. MASCC-0599, MASCC-0598

Keefe, C. MASCC-0611

Keefe, D. MASCC-0853, MASCC-0677, MASCC-0611, MASCC-0602, MASCC-0600, MASCC-0591, MASCC-0502, MASCC-0464, MASCC-0257

Keefe, D.M.K. MASCC-0489

Keilani, M. MASCC-0063

Kenne Sarenmalm, E. MASCC-0095

Kennedy, J.A. MASCC-0042

Kereena, C. MASCC-0093, MASCC-0092

Kerimoglu, O.S. MASCC-0116

Kerkhof, A.J.F.M. MASCC-0470

Kerkmann, M. MASCC-0782

Kerschaever, I. MASCC-0328

Kersh, R. MASCC-0199

Kersten, M.J. MASCC-0391

Keskin, E.Y. MASCC-0028

Khachatryan, V. MASCC-0325

Khakimova, G.J. MASCC-0249

Khalechelvam, P. MASCC-0006

Khalek, E. MASCC-0314

Khalek, R. MASCC-0336

Khalil, M.A. MASCC-0800, MASCC-0742

Khan, F. MASCC-0104

Khan, R.A. MASCC-0175

Khattab, M. MASCC-0590

Khattak, A.A. MASCC-0509

Khawaja, S. MASCC-0192, MASCC-0191

Khuroo, A.H. MASCC-0175

Kilgour, R.D. MASCC-0848

Kim, B. MASCC-0403

Kim, G.C. MASCC-0404

Kim, H.J. MASCC-0647, MASCC-0647, MASCC-0511

Kim, H.K. MASCC-0312

Kim, H.Y. MASCC-0511

Kim, J. MASCC-0510

Kim, J.S. MASCC-0647

Kim, J.Y. MASCC-0805, MASCC-0666

Kim, K. MASCC-0262

Kim, M.S. MASCC-0403

Kim, S. MASCC-0616, MASCC-0549

Kim, S.H. MASCC-0540

Kim, S.W. MASCC-0647

Kim, S.Y. MASCC-0647, MASCC-0511, MASCC-0511

Kim, Y. MASCC-0416

Kim, Y.S. MASCC-0647

Kingsley, P.A. MASCC-0201

Kinnear, H. MASCC-0725, MASCC-0635

Kinney, A.Y. MASCC-0059

Kinyanjui, D. MASCC-0689

Kirshbaum, M. MASCC-0021

Kirshner, J.J. MASCC-0829

Kirshner, J.K. MASCC-0703

Kitagawa, Y. MASCC-0521

Kitajima, M. MASCC-0521

Kittel, K. MASCC-0726

Kiwada, H. MASCC-0617

Kjeldsen, L. MASCC-0158

Klassen, O. MASCC-0686

Klein, G. MASCC-0557

Klein, M. MASCC-0424

Klepstad, P. MASCC-0111

Kligman, L. MASCC-0139

Knegjens, J. MASCC-0224

Knight, A. MASCC-0431

Knoth, R. MASCC-0766, MASCC-0756

Ko&#231 MASCC-0231, MASCC-0230

KO, Y. MASCC-0319, MASCC-0316

Ko, Y.D. MASCC-0520

Ko, Y.H. MASCC-0647

Kobayashi, M. MASCC-0679, MASCC-0487

Kobayashi, T. MASCC-0525

Koç, ". MASCC-0232

Kocak, H. MASCC-0028

Kocak, U. MASCC-0028

Kodama, N. MASCC-0256, MASCC-0209

Koehler, U. MASCC-0133

Koeppen, S. MASCC-0697

Koerber, J. MASCC-0792

Koffka, A. MASCC-0686

Koh, C. MASCC-0005, MASCC-0004

Koh, S. MASCC-0143

Koh, S.J. MASCC-0511

Köhler, J. MASCC-0708

Kohn, N. MASCC-0312

Koike, K. MASCC-0308, MASCC-0367

Kojima T. MASCC-0229

Koldehoff, M.K. MASCC-0697

Kollen, W.J.W. MASCC-0455

Kolnick, L. MASCC-0149

Komatsu, H. MASCC-0398

Kondo, E. MASCC-0268

Konias, M. MASCC-0726

Koo, K. MASCC-0384

Koopman, C. MASCC-0791

Kopecky, J. MASCC-0087

Kose, F. MASCC-0748

Kose, N. MASCC-0802

Koseki, T. MASCC-0508, MASCC-0507

Kostadinova, L. MASCC-0038

Kostanyan, M. MASCC-0253

Kostopoulou, M. MASCC-0346, MASCC-0342, MASCC-0341, MASCC-0340, MASCC-0335

Kotlinska-Lemieszek, A. MASCC-0514

Kotronoulas, G. MASCC-0440

Kottschade, L. MASCC-0562

Kouri, M. MASCC-0769

Kourie, H.R. MASCC-0553, MASCC-0551

Koyama, T. MASCC-0525

Krajcovicova, I. MASCC-0134

Krakauer, E.L. MASCC-0522

Krakowski, I. MASCC-0371, MASCC-0254

Kravchenko, S. MASCC-0364

Krcmery, V. MASCC-0134

Krebber, A.M. MASCC-0378

Kreitler, M.M. MASCC-0211

Kreitler, S. MASCC-0212, MASCC-0211

Kremer, L.C.M. MASCC-0646

Krishnasamy, M. MASCC-0365

Kristaly, K. MASCC-0464

Kroman, N. MASCC-0688

Krug, D. MASCC-0496

Krzyzanowska, M. MASCC-0577, MASCC-0576

Krzyzanowska, M.K. MASCC-0841, MASCC-0820

Kubrak, C. MASCC-0624

Kuchibhatla, R. MASCC-0557

Kucukmetin, A. MASCC-0749

Kuderer, N. MASCC-0816

Kuderer, N.M. MASCC-0817

Kumar, A. MASCC-0167

Kumar, D. MASCC-0244

Kumar, K. MASCC-0316

Kummer, E. MASCC-0187

Kunst, G. MASCC-0636

Kurachi, C. MASCC-0106

Kurahashi, S. MASCC-0513

Kurihara, M. MASCC-0525

Kurita, G.P. MASCC-0112, MASCC-0111

Kuznetsova, O. MASCC-0290

Kuznetsova, O.V. MASCC-0429

Kwan, M.L. MASCC-0586

Kwan, T. MASCC-0003

Kwan, W. MASCC-0813

Kwatra G. MASCC-0201

Kwint, M. MASCC-0223

Kwon, J.H. MASCC-0574, MASCC-0552, MASCC-0540, MASCC-0511, MASCC-0143

Kwong, J. MASCC-0389

Kyrtsonis, M.C. MASCC-0778

Lackner, H. MASCC-0129

Lacouture, M. MASCC-0024

Lacouture, M.E. MASCC-0763, MASCC-0709

Laenen, A. MASCC-0459

Laheij, A. MASCC-0321

Lai J.-H. MASCC-0221

Lai Tiong, F. MASCC-0287

Lai, C.Y. MASCC-0088

Lai, J.-H. MASCC-0144

Lai, Y. MASCC-0243, MASCC-0022

Lai, Y.-H. MASCC-0073

Lai, Y.H. MASCC-0789, MASCC-0317, MASCC-0281

Lakdja F, F.L. MASCC-0818

Lalla, R.V. MASCC-0564, MASCC-0396

Lam", Z. MASCC-0231, MASCC-0230

Lam, H. MASCC-0612, MASCC-0246, MASCC-0242, MASCC-0171, MASCC-0170, MASCC-0169, MASCC-0168, MASCC-0011, MASCC-0009, MASCC-0382, MASCC-0384

Lam, Z. MASCC-0232

Lambrinou, E. MASCC-0355

Lamerato, L. MASCC-0766

Landers, M. MASCC-0733

Lane, S.C. MASCC-0605

Langberg, H. MASCC-0716

Langston B. MASCC-0857

Langston, B. MASCC-0039

Lanoy, E. MASCC-0505

Lao, N. MASCC-0612, MASCC-0399, MASCC-0171, MASCC-0169, MASCC-0011, MASCC-0009, MASCC-0382

Lapid, M.I. MASCC-0807

Lappalainen, J. MASCC-0737

Laranjeira, C. MASCC-0735, MASCC-0731

Larkin, D. MASCC-0301, MASCC-0279, MASCC-0259

Larsen, E. MASCC-0030

Larsson, B. MASCC-0079

Larsson, B.K. MASCC-0061

Larue, C. MASCC-0738

Laskarakis, A. MASCC-0589, MASCC-0349

LaStayo, P.C. MASCC-0059

Latour, J.F. MASCC-0571

Lauzon, E. MASCC-0383

Lauzon, N. MASCC-0475, MASCC-0399, MASCC-0238, MASCC-0237, MASCC-0236, MASCC-0235, MASCC-0037, MASCC-0036, MASCC-0035, MASCC-0377, MASCC-0382

Lavallière, E. MASCC-0488

Lay, H. MASCC-0805

Le Fel, J. MASCC-0836

Le Moignan, J. MASCC-0691

Le Moulec, S. MASCC-0406

Le, B.H. MASCC-0401

Le, L.W. MASCC-0841, MASCC-0467

Le, Q.H. MASCC-0350

Leal, A.D. MASCC-0846

Leal, I. MASCC-0735, MASCC-0731

Leclercq, E. MASCC-0646, MASCC-0391

Leclercq, V. MASCC-0425

Lee, A.J. MASCC-0180

Lee, C. MASCC-0261

Lee, C.S. MASCC-0746

Lee, D.J. MASCC-0403

Lee, E.M. MASCC-0511

Lee, H.H.-C. MASCC-0132

Lee, H.W. MASCC-0647

Lee, J. MASCC-0681, MASCC-0580, MASCC-0416, MASCC-0262, MASCC-0261

Lee, J.I. MASCC-0511

Lee, K. MASCC-0803, MASCC-0721, MASCC-0202

Lee, K.H. MASCC-0511, MASCC-0143

Lee, K.T. MASCC-0511

Lee, P.H. MASCC-0317

Lee, R. MASCC-0395

Lee, S. MASCC-0616, MASCC-0394, MASCC-0393

Lee, S.C. MASCC-0732

Lee, S.N. MASCC-0647, MASCC-0511

Lee, S.R. MASCC-0647

Lee, T.K. MASCC-0813

Lee, T.Y. MASCC-0222

Lee, Y.H. MASCC-0789

Leemans, C.R. MASCC-0378, MASCC-0381

Lefebvre, G. MASCC-0425

Lefebvre, M. MASCC-0645

Legeren Alvarez, M. MASCC-0439

LeGrand, S. MASCC-0195

Lehmkuhl, M. MASCC-0476

Leighl, N. MASCC-0820, MASCC-0577, MASCC-0576

Leino-Kilpi, H. MASCC-0064

Lemke, M. MASCC-0237, MASCC-0010

Lemmens, V. MASCC-0108, MASCC-0020

Lemonde, M. MASCC-0741

Lemos, L. MASCC-0717

Lennan, E. MASCC-0707

Leppert, W. MASCC-0514, MASCC-0248

Lerner, T.G. MASCC-0573, MASCC-0239, MASCC-0856

Leroy, P. MASCC-0638, MASCC-0634

Lesage, C. MASCC-0350

Lessa, A.E.R. MASCC-0654

Lesser, M. MASCC-0312

Lethan, C. MASCC-0133

Leung, D.Y.P. MASCC-0639, MASCC-0606

Leung, S.Y. MASCC-0732

Levacic, D. MASCC-0805

Levi, F. MASCC-0767

Levin, R.D. MASCC-0138

Lheureux, S. MASCC-0753

Li, D. MASCC-0045

Li, J. MASCC-0228, MASCC-0227

Li, K. MASCC-0169

Li, W.Y. MASCC-0732

Li, X. MASCC-0233

Li, Y. MASCC-0729, MASCC-0228

Li, Y.,P.,X.(. MASCC-0227

Li, Z. MASCC-0234

Liakopoulos, I. MASCC-0644

Lian, C.K. MASCC-0012

Liang, J.-T. MASCC-0073

Liang, S.-Y. MASCC-0213

Liao, W.Y. MASCC-0789

Liao, Y.C. MASCC-0789

Libert, I. MASCC-0417

Lichtenberger, B.M. MASCC-0288

Licitra, L. MASCC-0664

Liedberg, G. MASCC-0061

Liedberg, G.M. MASCC-0079

Liede, A. MASCC-0715, MASCC-0713, MASCC-0711, MASCC-0641

Liem, C. MASCC-0540

Life, q. MASCC-0225

Lifshitz S. MASCC-0212

Light, K.C. MASCC-0059

Lilien, T. MASCC-0388

Lim, G. MASCC-0691

Lim, M.Y. MASCC-0311

Lim, S.R. MASCC-0588

Lim, T. MASCC-0403

Lin, C. MASCC-0318

Lin, E. MASCC-0401

Lin, Y. MASCC-0243

Lindblad, M. MASCC-0079

Lindhorst, S. MASCC-0805

Link, H. MASCC-0782

Liru, M. MASCC-0723

Lis, C.G. MASCC-0138

Lisa, R. MASCC-0162

Liu, B. MASCC-0150

Liu, F. MASCC-0227

Liu, H. MASCC-0560, MASCC-0131

Liu, M. MASCC-0494, MASCC-0379, MASCC-0380

Liu, P. MASCC-0712, MASCC-0694

Liu, P.F. MASCC-0132

Llop, L. MASCC-0056, MASCC-0002

Llorens-Torrome, S. MASCC-0804

Lo, S.K. MASCC-0599, MASCC-0598

Lobach, D.F. MASCC-0607

Loeffen, E.A.H. MASCC-0523

Loeliger, J. MASCC-0491, MASCC-0490

Logan, R. MASCC-0853, MASCC-0483

Logan, R.M. MASCC-0489

Loi, T.T. MASCC-0240

Lok, A. MASCC-0559

Lokar, K. MASCC-0768

Lomas IV, H. MASCC-0199

Lombana, M. MASCC-0300, MASCC-0260, MASCC-0258

Lonardi, S. MASCC-0653

Longo, J.M. MASCC-0605

Lonial, S. MASCC-0773

López López, R. MASCC-0678

López Postigo, M. MASCC-0309

Lopez, G. MASCC-0395

López, J. MASCC-0843, MASCC-0840

Lopez, V. MASCC-0301, MASCC-0279, MASCC-0259

López-Millán, J. MASCC-0698

López-Romboli, E. MASCC-0804

Loprinzi, C.L. MASCC-0846, MASCC-0562, MASCC-0560

Lordick, F. MASCC-0649

Loridan, T. MASCC-0645

Loriot, Y. MASCC-0505

Lossignol, D. MASCC-0417, MASCC-0296

Lotfollahi, Z. MASCC-0044

Loucheux, M.H. MASCC-0645

Lowe, E.S. MASCC-0736

Lozach-Brugirard, M. MASCC-0753

Lu, Y.-Y. MASCC-0213

Lucchesi, M. MASCC-0651

Luci, R. MASCC-0345

Luengo-Gil, G. MASCC-0626

Lugini A. MASCC-0081

Lugini, A. MASCC-0080

Lukkahatai, N. MASCC-0337

Lukkahatai, N.L. MASCC-0503

Lukyanchuk, O.V. MASCC-0429

Lundstöm, S. MASCC-0796

Lundström, S. MASCC-0111

Lunter, S. MASCC-0323

Luo, R. MASCC-0800

Luporsi, E. MASCC-0701

Lustberg, M.B. MASCC-0609

Lutrino, E.S. MASCC-0774

Luz, R. MASCC-0743, MASCC-0739

Lyman, G. MASCC-0817

Lyman, G.H. MASCC-0816, MASCC-0438

Lynn, I. MASCC-0440

Lynnette, J. MASCC-0723

Lyss, A.P. MASCC-0562

Ma, L. MASCC-0252

Ma, Y.M. MASCC-0732

Maamoun, J. MASCC-0449, MASCC-0445

Maccio', A. MASCC-0047

Machado, M.T. MASCC-0107

Machida, N. MASCC-0369

Mack, L.A. MASCC-0603

Mackenzie, C. MASCC-0288

Macleod, U. MASCC-0180

Madeddu, C. MASCC-0047

Madhavan Sasidharan, S. MASCC-0554, MASCC-0550

Madhukumar, P. MASCC-0599, MASCC-0598

Madrid, C. MASCC-0435

Madsen, C.L. MASCC-0265, MASCC-0264

Maeda, Y. MASCC-0268

Maehara, Y. MASCC-0521

Magno, S.M. MASCC-0662

Magrin, M.E. MASCC-0795

Maguire, R. MASCC-0440

Mahadevan, R. MASCC-0214

Maher, J. MASCC-0198

Mahi, L. MASCC-0701

Mai, J.M. MASCC-0703

Mailliez, A. MASCC-0425, MASCC-0645

Mais, K. MASCC-0493

Majeed, S. MASCC-0165

Majorana, A. MASCC-0033

Mak, S.S.S. MASCC-0400

Malhotra, H. MASCC-0621

Mallaev, M. MASCC-0249

Malver, L.P. MASCC-0112

Mamzer, M.F. MASCC-0638

Manceau, F. MASCC-0793

Mandal, S. MASCC-0752

Maniadakis, N. MASCC-0640

Manicom, C. MASCC-0372

Manikowska, F. MASCC-0785

Mank, A. MASCC-0391

Mansikkamaki, P. MASCC-0082

Mantovani, G. MASCC-0047

Manzullo, E. MASCC-0579, MASCC-0395

Marete, J.G. MASCC-0148

Marghoob, A.A. MASCC-0763

Markova, M. MASCC-0768

Marosi, C. MASCC-0063

Marples, G. MASCC-0749

Marquez, M. MASCC-0454

Marshall, K. MASCC-0491, MASCC-0490

Mart?na, Z. MASCC-0364

Martin, A.A. MASCC-0565

Martin, C. MASCC-0527

Martin, T. MASCC-0773

Martin-Vasallo, P. MASCC-0370

Martins, A. MASCC-0448

Maruelli, A. MASCC-0706

Marx, G. MASCC-0334

Marzola, M. MASCC-0135

Mason, H. MASCC-0128

Masood, A. MASCC-0219, MASCC-0218, MASCC-0127, MASCC-0083

Masooma, S. MASCC-0257

Massumi, A. MASCC-0178

Masuoka, K. MASCC-0525

Masutti Sureda, B. MASCC-0678

Maté-Méndez, J. MASCC-0309

Mathias-Duarte, L. MASCC-0801

Matkovic, M. MASCC-0768

Matsui, R. MASCC-0414

Matuschek, C. MASCC-0297

Mauramo, M. MASCC-0566

Mawardi, H.H. MASCC-0154

Maxwell, C. MASCC-0541, MASCC-0539

Mayeur, D. MASCC-0484

Mayo, B. MASCC-0602

Mazanah, M. MASCC-0172

Mazurczak, M.A. MASCC-0562

Mazzaferro, V. MASCC-0795

Mazzer, M. MASCC-0774, MASCC-0751, MASCC-0668

McAllister, W. MASCC-0199

McAndrew, A. MASCC-0390, MASCC-0389, MASCC-0388, MASCC-0386

McBride, L. MASCC-0776

McCabe, R. MASCC-0466

McCabe, R.M. MASCC-0465

McCarthy, A. MASCC-0629, MASCC-0029

McCarthy, G. MASCC-0745, MASCC-0733

McColl, E. MASCC-0582

McCulloch, L. MASCC-0773

McEwen, S. MASCC-0839

McKinley, A. MASCC-0180

McPhelim, J. MASCC-0440

McQuestion, M. MASCC-0528

McVeigh, U. MASCC-0754

McWha, L. MASCC-0847

McWilliams, R. MASCC-0625

Meakin, C.J. MASCC-0605

Megalakaki, K. MASCC-0769

Mehmood, T. MASCC-0219, MASCC-0218, MASCC-0127, MASCC-0083

Meisner, I. MASCC-0299

Meißner, A. MASCC-0823

Mekelenkamp, H. MASCC-0455

Mella, S. MASCC-0687

Mellas, N. MASCC-0018, MASCC-0007

Mellstedt, H. MASCC-0569

Meloni, S.M. MASCC-0263

Meminaj, M. MASCC-0345

Menang, J.N. MASCC-0142

Mendes, M. MASCC-0156

Mendez, C. MASCC-0300

Mensah, K. MASCC-0280

Menzel, L.M. MASCC-0811

Merad, M. MASCC-0527, MASCC-0501

Merad-Taoufik, M. MASCC-0505

Merad-Toufik, M. MASCC-0738

Merani, S. MASCC-0603

Mercier-Vogel, L. MASCC-0488

Merlotti, A. MASCC-0663

Merriman, K.W. MASCC-0838

Mertz, B.G. MASCC-0688

Metcalfe, A. MASCC-0547

Mevlude, I. MASCC-0339

Meyer, F. MASCC-0055, MASCC-0054

Meyer, K. MASCC-0413

Mgren" MASCC-0113

Miao, S.J. MASCC-0132

Miccinesi, G. MASCC-0706

Miceli, R. MASCC-0664

Michel, B. MASCC-0417

Miedema, K.G.E. MASCC-0523

Migliorati, C.A. MASCC-0149

Mikami, M. MASCC-0368

Milani, A. MASCC-0768

Milanti, A. MASCC-0082

Milecki, P. MASCC-0783

Milicevic, M. MASCC-0555

Milisen, K. MASCC-0459

Milito, G. MASCC-0115

Milligan, P. MASCC-0025

Minegishi, S. MASCC-0468

Minn, H. MASCC-0064

Minnema, M. MASCC-0636

Mirabile, A. MASCC-0664

Miriam, W. MASCC-0050

Mirjalili, N. MASCC-0177

Miron, R. MASCC-0527

Mishcheniuk, O. MASCC-0364

Mishima, H. MASCC-0679

Missel, M. MASCC-0716, MASCC-0443

Mitchell, R. MASCC-0754

Mitchell, W. MASCC-0101, MASCC-0100

Miyake, M. MASCC-0679

Miyakoshi, K. MASCC-0524

Miyata, C. MASCC-0379, MASCC-0380

Mizukami, N. MASCC-0367

Mizuma, M. MASCC-0524

Mizuno, M. MASCC-0519

Mizuochi, K. MASCC-0525, MASCC-0524

Mo, M. MASCC-0584

Moattari, M. MASCC-0159

Mohammed M safhi, P.R.O.F. MASCC-0275

Mohan, M.P. MASCC-0806, MASCC-0771

Mohile, S. MASCC-0794

Mok, F. MASCC-0169

Møller, T. MASCC-0158

Mollo V, V.M. MASCC-0822

Molmans, B.H.W. MASCC-0455

Mols, F. MASCC-0108, MASCC-0053, MASCC-0052, MASCC-0020

Monette, J. MASCC-0576, MASCC-0575, MASCC-0575, MASCC-0570

Monhonval, M. MASCC-0738

Monnier, Y. MASCC-0435

Montgomery, P. MASCC-0522

Montserrat, M. MASCC-0768

Mooney, K. MASCC-0759

Moons, P. MASCC-0023

Moore, A.J. MASCC-0558

Moore, D.F. MASCC-0810

Moore, M. MASCC-0820

Morag, A. MASCC-0331

Morais, J.A. MASCC-0848

Morales, M. MASCC-0370

Moreira, M. MASCC-0654

Morere, J.F. MASCC-0701

Morero, J.A.P. MASCC-0544

Moresino, C. MASCC-0071

Morgado Gomes, F. MASCC-0743, MASCC-0739

Morgado, M. MASCC-0717, MASCC-0156

Morgado, S. MASCC-0717, MASCC-0156

Morishita, S. MASCC-0256, MASCC-0209

Morita, N. MASCC-0487

Morita, S. MASCC-0679

Morrison, D. MASCC-0437

Morrow, G. MASCC-0794, MASCC-0791, MASCC-0755

Morrow, G.R. MASCC-0829, MASCC-0810

Morrow, P.K. MASCC-0579, MASCC-0541, MASCC-0539, MASCC-0438

Mortazavi, H. MASCC-0775, MASCC-0761

Mota, A.A. MASCC-0654

Motahhary, P. MASCC-0189, MASCC-0188

Moura, S. MASCC-0390

Movahedian, A. MASCC-0781

Moya, I. MASCC-0828

Mpagiaou, O. MASCC-0644

Msefer Alaoui, F. MASCC-0590

Muallaoglu, S. MASCC-0748

Mueller, U. MASCC-0719, MASCC-0712

Muench, U. MASCC-0058

Muhammad, A. MASCC-0643

Mujeeb, M. MASCC-0326, MASCC-0175

Mukhopadhyay, S. MASCC-0201

Mulcahy, H. MASCC-0746

Mulder, R. MASCC-0391

Munga, E.W. MASCC-0103

Munhoz, B. MASCC-0573

Munier, O. MASCC-0753

Muraoka, K. MASCC-0524

Murchie, P. MASCC-0329, MASCC-0180

Murphy, B. MASCC-0663

Murphy, B.A. MASCC-0149, MASCC-0558

Murphy-Kane, T. MASCC-0431

Muscaritoli, M. MASCC-0796

Mustian, K. MASCC-0794, MASCC-0791, MASCC-0755

Mustian, K.M. MASCC-0829, MASCC-0810

Muzzatti, B. MASCC-0687, MASCC-0684

Myers, J. MASCC-0387

Nabais, I. MASCC-0587

Nacinovic-Duletic, A. MASCC-0593

Naeije, L. MASCC-0646

Nagai, S. MASCC-0366

Nagano, K. MASCC-0757

Nagl, N. MASCC-0756

Naik, R. MASCC-0749

Najib, R. MASCC-0018

Najmi, A.K. MASCC-0326, MASCC-0175

Nakanishi, Y. MASCC-0521

Nakashima, T. MASCC-0617

Nallet, G. MASCC-0531, MASCC-0497

Nam, J. MASCC-0416

Nam, S. MASCC-0403

Nam, S.-H. MASCC-0143

Namie Okino sawada, N.O.S. MASCC-0272

Namura, M. MASCC-0779

Narayama, C. MASCC-0368

Narayama, T. MASCC-0368

Narciso, B. MASCC-0672

Nariana, E. MASCC-0634

Narui, H. MASCC-0610

Nascimento, T.G. MASCC-0772

Nathanel, R. MASCC-0212

Natoli, L. MASCC-0324

Nauck, F. MASCC-0780, MASCC-0671, MASCC-0670

Naumann, P. MASCC-0496

Navari, R. MASCC-0360

Nazar G.A.T. MASCC-0072

Necchi, A. MASCC-0724

Neisi, K. MASCC-0183

Nejjari, C. MASCC-0007

Nemoto, K. MASCC-0366

Neri, E. MASCC-0791

Nestor, K. MASCC-0796

Neuman, T. MASCC-0842

Ng, A. MASCC-0824

Ng, L. MASCC-0104

Ng, Q.S. MASCC-0436

Ng, R. MASCC-0599, MASCC-0598

Ng, T. MASCC-0436

Ngai, M.I. MASCC-0319

Ngan, M.P. MASCC-0618

Nguyen, J. MASCC-0316, MASCC-0010, MASCC-0008, MASCC-0383, MASCC-0384

Ni, X. MASCC-0228, MASCC-0227

Niarou, V. MASCC-0346, MASCC-0342, MASCC-0341, MASCC-0340, MASCC-0335

Nichols, A. MASCC-0790

Nicolatou-Galitis, O. MASCC-0778, MASCC-0769, MASCC-0181

Nicolussi, A.C. MASCC-0545, MASCC-0544

Nicolussi, A.C.N. MASCC-0278, MASCC-0277

Niehoff, P. MASCC-0496

Niesvizky, R. MASCC-0773

Nietsch, J. MASCC-0782

Nieuwlaat, W.A. MASCC-0052

Nik Jaafar, N.R. MASCC-0214

Nikolaidi, A. MASCC-0181

Nilsson, U. MASCC-0656

Ninashvili, N. MASCC-0019

Ninot, G. MASCC-0532

Nirenberg, A. MASCC-0561

Nishigaki, M. MASCC-0513, MASCC-0500

Nishimoto, H. MASCC-0268

Nishioka, K. MASCC-0366

Nissar, S. MASCC-0241

Noel, G. MASCC-0376

Noel-savina, E. MASCC-0197, MASCC-0098, MASCC-0096

Noguera, A. MASCC-0530

Noh, S. MASCC-0510

Noirot, B. MASCC-0645

Nolan, B. MASCC-0746

Nolte, L. MASCC-0491, MASCC-0490

Nooka, A. MASCC-0773

Nooruddin, Z. MASCC-0540

Normal"" MASCC-0208

Novak, S. MASCC-0577, MASCC-0576

Novonty, P.J. MASCC-0562

Novotny, P. MASCC-0311

Nowacka, K. MASCC-0831, MASCC-0826

Nowacki, M. MASCC-0831, MASCC-0826

Nowara, E. MASCC-0026

Nowotnik, D.P. MASCC-0605

Numico, G. MASCC-0668

Nutakki, S. MASCC-0466

O'Brien, D. MASCC-0709, MASCC-0708

O'Brien, K. MASCC-0635

O'Connor, K.J. MASCC-0059

O'Donovan, E. MASCC-0707

O'Driscoll, D. MASCC-0727

O'Mahony, M. MASCC-0745

O'Mara, A. MASCC-0543

O'Neill, M.E. MASCC-0741

O'Sullivan, E. MASCC-0747, MASCC-0744

Oakley, C. MASCC-0529

Obiols-Portis, M. MASCC-0417

Oboh, G. MASCC-0110, MASCC-0084

Ocaña, J. MASCC-0828

ODonnell, R.L. MASCC-0749

Oelmann, J. MASCC-0686

Oerlemans, S. MASCC-0053

Ogawa, H. MASCC-0256, MASCC-0209

Ogawa, T. MASCC-0366

Oguz, A. MASCC-0798

Oh, H.S. MASCC-0511

Oh, S. MASCC-0676, MASCC-0616

Oh, S.Y. MASCC-0511

Ohlsson-Nevo, E. MASCC-0656

Ohmann, C. MASCC-0297

Oikawa, T. MASCC-0229

Oikonomou, H. MASCC-0644

Okamoto, W. MASCC-0414

Olagunju, A.T. MASCC-0078, MASCC-0077

Olcun, U. MASCC-0339

Olimova, Z.A. MASCC-0249

Oliveira, S. MASCC-0743, MASCC-0739, MASCC-0659

Oliveira, S.O. MASCC-0239

Olson, K. MASCC-0624

Olson, R. MASCC-0797

Olver, I. MASCC-0847, MASCC-0408

Omoto, I. MASCC-0047

Öner, N. MASCC-0028

Onoda, H. MASCC-0525

Onoratelli, M. MASCC-0462

Onozawa, Y. MASCC-0369

Onwuteaka-Philipsen, B.D. MASCC-0470

Ooi, W.S. MASCC-0599, MASCC-0598

Oranje, W.A. MASCC-0052

Orgiano, L. MASCC-0047

Orlandi, E. MASCC-0664

Orlando, A. MASCC-0751

Orrevall, Y. MASCC-0796

Orsey, A.D. MASCC-0799

Ortner, P. MASCC-0726

Oshan, G. MASCC-0813

Othman, S. MASCC-0085

Otmani, N. MASCC-0590

Otomo, E. MASCC-0366

Ottaviani, G. MASCC-0423, MASCC-0420, MASCC-0033

Ou, M. MASCC-0222

Ouakinin, S.R. MASCC-0587

Oudard, S. MASCC-0634

Oza, A. MASCC-0820

Ozbay, I. MASCC-0478, MASCC-0477

Özbek, C. MASCC-0690

Ozga-Majchrzak, O. MASCC-0783

Ozkan, I. MASCC-0251

Ozsoy, S. MASCC-0351

Ozturk, S. MASCC-0339

Ozyilkan, O. MASCC-0748

Pace, R. MASCC-0081, MASCC-0080

Padhye, N.S. MASCC-0585

Pais-Ribeiro, J.O.S.E. MASCC-0362, MASCC-0363

Paiva, H. MASCC-0856

Palazzo, F. MASCC-0334

Palesh, O. MASCC-0791, MASCC-0767

Palla, S. MASCC-0574, MASCC-0559, MASCC-0395

Palladino, M.A. MASCC-0517

Palliative Care MASCC-0164

Palliative Medicine MASCC-0109

Palmas, M. MASCC-0434, MASCC-0433, MASCC-0432

Palmeira de Oliveira, R. MASCC-0821

Pampols, M. MASCC-0828

Panda, P. MASCC-0190

Pang, J. MASCC-0316

Pang, K. MASCC-0386

Panjehpour, M. MASCC-0781

Panobianco, M.S. MASCC-0764

Pant, M.C. MASCC-0244

Papadopolou, C. MASCC-0440

Papadopoulos, D. MASCC-0605

Papadopoulou, E. MASCC-0778, MASCC-0769, MASCC-0181

Pappas, L.M. MASCC-0059

Parala, A. MASCC-0165

Parala-Metz, A. MASCC-0196

Pardo, J. MASCC-0828

Park, C. MASCC-0416

Park, J.S. MASCC-0803, MASCC-0721

Park, K. MASCC-0405

Park, K.U. MASCC-0666, MASCC-0647

Park, K.W. MASCC-0143

Park, S. MASCC-0416, MASCC-0416

Park, S.I. MASCC-0404

Park, S.J. MASCC-0676

Park, S.M. MASCC-0202

Park, Y. MASCC-0262, MASCC-0261

Parker, N. MASCC-0800

Parliament, M. MASCC-0624

Parreira, L. MASCC-0743, MASCC-0739

Pascoletti, G. MASCC-0751

Pasetka, M. MASCC-0475, MASCC-0463, MASCC-0316

Paskett, E. MASCC-0556

Pasquin, E. MASCC-0344

Passamonti, S. MASCC-0110, MASCC-0084

Patel, S. MASCC-0337

Patiraki, E. MASCC-0644

Patlan, J.T. MASCC-0579

Patrick, D. MASCC-0334

Patterson, J. MASCC-0582

Paul, J. MASCC-0437

Paula, J.M. MASCC-0545, MASCC-0544

Paula, J.M.P. MASCC-0278, MASCC-0277

Paulus, V. MASCC-0753

Peckham, J. MASCC-0622

Pedersen, J.H. MASCC-0443

Pediatric clients CALMEF MASCC-0142

Peerlinck, K. MASCC-0023

Peetermans, W.E. MASCC-0023

Pelicier, N. MASCC-0634

Pella, N. MASCC-0774

Pellejero, R. MASCC-0828

Pellissier, J. MASCC-0648

Pentikis, H.P. MASCC-0441

Peoples, A. MASCC-0755

Peoples, A.R. MASCC-0829, MASCC-0810

Peppone, L. MASCC-0829, MASCC-0794, MASCC-0755

Peppone, L.J. MASCC-0810

Peralta, E. MASCC-0698

Peralta, L. MASCC-0462

Pereira, J. MASCC-0640

Pereira, R. MASCC-0659

Perelman, M. MASCC-0343

Perez-Cruz, P. MASCC-0522

Peria, F.M. MASCC-0654

Peric, J. MASCC-0597

Pernet A, A.P. MASCC-0822

Pessi, M.A. MASCC-0724, MASCC-0706, MASCC-0652

Peters, K. MASCC-0777

Peters, K.B. MASCC-0805

Peterson, D.E. MASCC-0564

Petit, L. MASCC-0350

Petranovic, D. MASCC-0593, MASCC-0593

Petta, E. MASCC-0644

Pfeffer, K. MASCC-0288

Phillips, S. MASCC-0021

Pianowski, L. MASCC-0856

Pietkun, K. MASCC-0831, MASCC-0826

Pietra, C. MASCC-0602

Piil, K. MASCC-0145

Pilbeam, C.C. MASCC-0564

Pillai, K.K. MASCC-0326

Pimentel, F.L. MASCC-0448

Pimentel, L.E. MASCC-0057

Pino, L. MASCC-0300, MASCC-0260, MASCC-0258

Pinto, M. MASCC-0821

Piper, B. MASCC-0014, MASCC-0006

Pirolli, M. MASCC-0641

Piroozi MASCC-0159

Pisa, F. MASCC-0774

Pisano, M. MASCC-0263

Pishas, K. MASCC-0602

Pizzorni, N. MASCC-0664

Planinsek Rucigaj, T. MASCC-0814

Plews, E. MASCC-0611, MASCC-0602, MASCC-0600

Poillucci, V. MASCC-0805

Pokpalagon, P. MASCC-0015

Poletto, E. MASCC-0774

Polianskis, R. MASCC-0112

Poma, A. MASCC-0441

Pon, D. MASCC-0750

Ponce Leão, P. MASCC-0735, MASCC-0731

Poniedzialek, B. MASCC-0514

Poniewierski, M.S. MASCC-0817, MASCC-0816

Poon, M. MASCC-0399, MASCC-0246, MASCC-0242, MASCC-0171, MASCC-0170, MASCC-0169, MASCC-0168, MASCC-0167, MASCC-0037, MASCC-0036, MASCC-0035, MASCC-0011, MASCC-0009

Poortmans, P. MASCC-0053

Pop, M. MASCC-0376

Pope, A. MASCC-0820

Popovic, M. MASCC-0399, MASCC-0246, MASCC-0242, MASCC-0168, MASCC-0011, MASCC-0010, MASCC-0009, MASCC-0008, MASCC-0384

Porta-Sales, J. MASCC-0804

Portilla Carlos, C. MASCC-0348

Posadas Martínez, M. MASCC-0462

Poslins, E. MASCC-0389

Potthoff, K. MASCC-0686, MASCC-0680, MASCC-0496

Potting, C.M.J. MASCC-0305

Poulin, P. MASCC-0252

Poulsen, L.L. MASCC-0515

Power, K. MASCC-0741

Powers, A. MASCC-0766, MASCC-0756

Poyato Gómez, E. MASCC-0309

Prado, C.M.M. MASCC-0765, MASCC-0760

Prado, M.A.E. MASCC-0730

Prado, M.A.S. MASCC-0772

Prasanatikom, W. MASCC-0226

Préaubert, C. MASCC-0531, MASCC-0497

Presseau, J. MASCC-0180

Pritchard, M.J. MASCC-0166

Pritchard, S. MASCC-0797

Probyn, L. MASCC-0399

Pronost, A.M. MASCC-0254

Pruitt, D.E. MASCC-0605

Pruthi, S. MASCC-0740, MASCC-0722

Pugh, S.P. MASCC-0703

Puglisi, F. MASCC-0751, MASCC-0633

Pulitzer, M.P. MASCC-0763

Pulivarthi, K. MASCC-0574

Purcell, B. MASCC-0021

Purfarzi, F. MASCC-0178

Puts, M. MASCC-0578, MASCC-0577, MASCC-0576, MASCC-0575, MASCC-0570

Qian, Y. MASCC-0334

Qin, R. MASCC-0846

Quach, D. MASCC-0641

Quigley, J. MASCC-0641

Quinn, B. MASCC-0493

Quintard, B. MASCC-0179

Rabêlo, P. MASCC-0835

Raber-Durlacher, J. MASCC-0663

Raber-Durlacher, J.E. MASCC-0321

Rabin, M.S. MASCC-0607

Radbruch, L. MASCC-0343

Radina, E. MASCC-0027

Radzuan, M. MASCC-0591

Rafaqat, R. MASCC-0193, MASCC-0192, MASCC-0191, MASCC-0330

Raftopoulos, V. MASCC-0355

Raggi, D. MASCC-0724

Raha cancer center group RCCG MASCC-0174, MASCC-0173

Rahrotaban, S. MASCC-0205

Raimondou, H. MASCC-0644

Rajangam, K. MASCC-0773

Rajapaksa, I. MASCC-0104

Ralph, C. MASCC-0572

Ramadan, M.E. MASCC-0685

Ramadas, L. MASCC-0315

Raman, S.V. MASCC-0609

Ramiandrisoa, F. MASCC-0350

Rampini, M. MASCC-0568

Ranjan, T. MASCC-0805, MASCC-0777

Rao, A. MASCC-0165

Rao, J. MASCC-0494

Raphael, M.F. MASCC-0457, MASCC-0455

Rath, G.K. MASCC-0016

Rauco, A. MASCC-0081, MASCC-0080

Ray, S. MASCC-0377

Raynaud, C. MASCC-0571

Razi, E. MASCC-0778, MASCC-0769

Read, P. MASCC-0844, MASCC-0333

Ream, E. MASCC-0529, MASCC-0857, MASCC-0039

Rebollo Laserna, F.J. MASCC-0678

Rebollo, M. MASCC-0462

Reddy, A. MASCC-0574, MASCC-0395

Redzovic, A. MASCC-0597

Reed, L.J. MASCC-0454

Regan, M. MASCC-0473

Reguart, N. MASCC-0708

Reich, M. MASCC-0425

Reif, M. MASCC-0555

Reifur, L. MASCC-0239

Reijneveld, J. MASCC-0424

Reinbolt, R.E. MASCC-0609

Reiner, M. MASCC-0438

Reis, H.B. MASCC-0801

Reis, P.E.D. MASCC-0655, MASCC-0332

Remondes-Costa, S. MASCC-0362, MASCC-0363

Repousis, P. MASCC-0778

Repping, S. MASCC-0823

Resteghini, C. MASCC-0724

Reverter, J.C. MASCC-0626

Revnic, J. MASCC-0343

Rey, P. MASCC-0571

Reyes-Gibby, C. MASCC-0838

Rezk, J. MASCC-0149

Rha, S. MASCC-0262, MASCC-0261

Rho, S.Y. MASCC-0041

Ribeiro, C. MASCC-0743, MASCC-0739, MASCC-0659

Ribot-Berenguer, T. MASCC-0309

Ricci, S. MASCC-0651

Richard, C. MASCC-0063

Richard, S. MASCC-0634

Richardson, A. MASCC-0720, MASCC-0580, MASCC-0529, MASCC-0498, MASCC-0492, MASCC-0271

Richardson, C. MASCC-0307

Richardson, M. MASCC-0199

Richardson, M.N. MASCC-0579

Richter, K. MASCC-0716

Rider, A. MASCC-0713, MASCC-0711, MASCC-0710

Ridner, S. MASCC-0762, MASCC-0558

Ridner, S.H. MASCC-0027

Riese, C. MASCC-0682

Rigal, O. MASCC-0836

Riklikiene, O. MASCC-0768

Riley, E. MASCC-0493

Rings, E.H.H.M. MASCC-0157

Ripamonti, C. MASCC-0724, MASCC-0706, MASCC-0652

Ristevski, E. MASCC-0473

Rizel, S. MASCC-0299

Rizzi, G. MASCC-0434, MASCC-0433, MASCC-0432

Rj, E. MASCC-0749

Robert, G. MASCC-0529

Roberts, J. MASCC-0506, MASCC-0186, MASCC-0025

Roberts, K. MASCC-0749

Robinson, E. MASCC-0522

Robitaille, M.A. MASCC-0289

Rocha, M. MASCC-0362, MASCC-0363

Rock, H. MASCC-0780

Rodin, G. MASCC-0841, MASCC-0820

Rodrigues, M. MASCC-0371

Rodrigues, P. MASCC-0568

Rodriguez, R. MASCC-0840

Roeland, E. MASCC-0101, MASCC-0100

Rogowski, W. MASCC-0584

Rohde, L. MASCC-0566

Roila, F. MASCC-0517

Roma, A. MASCC-0653

Roman, M. MASCC-0056, MASCC-0002

Rondelli, P. MASCC-0706, MASCC-0652

Roodbol, P.F. MASCC-0419, MASCC-0421

Root, C. MASCC-0431

Ros, C. MASCC-0840

Roscoe, J.A. MASCC-0810

Rose, M. MASCC-0017

Rosello, A. MASCC-0843

Rosello, J. MASCC-0843, MASCC-0840

Rosen, A. MASCC-0024

Rosen, A.C. MASCC-0763

Rosenthal, M.A. MASCC-0401

Rossi R. MASCC-0081

Rossi, G. MASCC-0432

Rossi, R. MASCC-0080

Rotsaert, L. MASCC-0645

Rousseau, C. MASCC-0417

Rovira, K. MASCC-0836

Rovo, A. MASCC-0566

Row, M.B. MASCC-0579

Roy, V. MASCC-0836

Rubenstein, E. MASCC-0812

Ruberg, K. MASCC-0520

Rudd, J.A. MASCC-0618

Ruggeri, B. MASCC-0517

Ruijs, C.D.M. MASCC-0470

Ruiz BS, T.L. MASCC-0799

Rummans, T.A. MASCC-0807

Ruppert, A.S. MASCC-0609

Rüssel, J. MASCC-0418

Russi, E. MASCC-0668, MASCC-0664, MASCC-0663

Russo, S. MASCC-0633

Ryan, E. MASCC-0746

Ryan, N. MASCC-0572

Rybicki, L. MASCC-0536, MASCC-0456, MASCC-0453, MASCC-0165

Rybin, A. MASCC-0290

Rybin, A.I. MASCC-0429

Ryoo, H.M. MASCC-0511

Rzymski, P. MASCC-0514

S. MASCC-0159

S. Sommer, M. MASCC-0716

S., R. MASCC-0216

Sa&#287 MASCC-0232, MASCC-0231, MASCC-0230

Sa, T.H. MASCC-0654

Saada, Y. MASCC-0179

Sadhu, C. MASCC-0694

Saeed, K. MASCC-0083

Saeki, K. MASCC-0757

Saeki, T. MASCC-0521

Sahani, M.K. MASCC-0160

Sahgal, A. MASCC-0475, MASCC-0238, MASCC-0236, MASCC-0235, MASCC-0167, MASCC-0037, MASCC-0036, MASCC-0035, MASCC-0377

Saibene, G. MASCC-0668

Sakamoto, J. MASCC-0679

Sakhri, S. MASCC-0206

Sakli, I. MASCC-0645

Sakurai, K. MASCC-0617

Salameh, O. MASCC-0553

Saligan, L. MASCC-0337, MASCC-0151

Saligan, L.S. MASCC-0503

Salman, S. MASCC-0509

Salmon, H. MASCC-0565

Salner, A.L. MASCC-0564

Samadova, G. MASCC-0495

Samala, M. MASCC-0194

Samala, R. MASCC-0196, MASCC-0195

Samanta, B. MASCC-0201

Sameer, A.S. MASCC-0241

Samiee, S. MASCC-0781

Samuel, C.O. MASCC-0776

Samuel, L. MASCC-0180

San Miguel-Arregui, M. MASCC-0530

San-Miguel, M.T. MASCC-0552

Sanad, R. MASCC-0336

Sanatani, M. MASCC-0140

Sánchez Blanco, C. MASCC-0698

Sánchez Salado, C. MASCC-0442

Sani, F. MASCC-0795

Sano, M. MASCC-0414

Sant'Anna, G.R. MASCC-0565

Santacruz, J. MASCC-0300

Santak, G. MASCC-0692

Santi, P.X. MASCC-0654, MASCC-0581

Santos, A.C.F. MASCC-0675

Santos, B. MASCC-0570

Santos, J.L.F.S. MASCC-0278, MASCC-0277

Sapsford, M. MASCC-0390

Saraiva, D.A. MASCC-0545

Sargi, Z. MASCC-0184

Sargon, M.F. MASCC-0089, MASCC-0067

Sari, E. MASCC-0802

Sarimiye, F.O. MASCC-0077

Sarri, T. MASCC-0778

Sasaki, E. MASCC-0525

Satheeshkumar, P.S. MASCC-0806, MASCC-0771

Sato, M. MASCC-0617

Sato, T. MASCC-0508

Saunders, D. MASCC-0431

Saunders, T.A. MASCC-0607

Saura, R. MASCC-0524

Sauvajot, C. MASCC-0634

Savage, E. MASCC-0733

Savage-Larose, L. MASCC-0295

Sawada, N. MASCC-0545, MASCC-0544, MASCC-0278, MASCC-0273

Sawada, N.O. MASCC-0837

Sawada, N.O.S. MASCC-0277

Sax, C. MASCC-0063

Schadendorf, D. MASCC-0709

Schaller, A.K.C. MASCC-0079, MASCC-0061

Scheckermann, C. MASCC-0712

Schiller, D. MASCC-0603

Schilling, J. MASCC-0852, MASCC-0726

Schindler, A. MASCC-0664

Schindler, F. MASCC-0856

Schipper, J. MASCC-0297

Schluckebier, L. MASCC-0568

Schlundt, S. MASCC-0805

Schmidt, K. MASCC-0712, MASCC-0624

Schmidt, M. MASCC-0686

Schmoll, H.J. MASCC-0418

Schneider, D. MASCC-0394, MASCC-0393

Schneider, S.M. MASCC-0805

Schneider-Stock, R. MASCC-0075

Schorr, A. MASCC-0060

Schottinger, J. MASCC-0586

Schroeder, J.M. MASCC-0288

Schrumpf, H. MASCC-0288

Schumacher, C. MASCC-0376

Schumacher, R.F. MASCC-0033

Schumann, A. MASCC-0555

Schwartzberg, L. MASCC-0812

Schwinger, W. MASCC-0129

Sciacca, V. MASCC-0081

Scotte, F. MASCC-0638, MASCC-0701, MASCC-0634

Scrignaro, M. MASCC-0795

Secilmis Kerimoglu, O. MASCC-0069

Seckin, G. MASCC-0827

Sedano, A. MASCC-0768

Seganfredo, H.C. MASCC-0332

Seidel, M. MASCC-0129

Seijas, N. MASCC-0056, MASCC-0002

Seisler, D. MASCC-0601

Seisler, D.K. MASCC-0846

Seki, N. MASCC-0414

Selamat Din, S.H. MASCC-0214

Selvi, M. MASCC-0632, MASCC-0626, MASCC-0056

Seonghoon, S. MASCC-0552

Serna, J. MASCC-0522

Serpe, R. MASCC-0047

Serpentini, S. MASCC-0344

Seymour, J.F. MASCC-0365

Shaker, B. MASCC-0454

Shanaz M.G. MASCC-0072

Shao, C. MASCC-0556

Shapiro, C.L. MASCC-0609

Sharma, A. MASCC-0016, MASCC-0356, MASCC-0357

Sharma, D.N. MASCC-0016

Sharma, M. MASCC-0356, MASCC-0357, MASCC-0358

Sharp, L. MASCC-0747, MASCC-0744, MASCC-0727, MASCC-0725, MASCC-0635, MASCC-0428, MASCC-0427

Sharp, S. MASCC-0707

Shavdia, M. MASCC-0019

Shavdia, N. MASCC-0019

Shaw, A. MASCC-0557

Shebl, A. MASCC-0336

Sheehan, J. MASCC-0199

Shen, W. MASCC-0712

Sheng, J. MASCC-0227

Sherief, L. MASCC-0336, MASCC-0314

Sheu, J.C. MASCC-0281

Shi, G. MASCC-0131

Shi, J. MASCC-0586

Shi, Q. MASCC-0845

Shi, Y. MASCC-0152

Shibamori, M. MASCC-0617

Shibata, K. MASCC-0414

Shida, M. MASCC-0368

Shih, V. MASCC-0538

Shimizu, K. MASCC-0757

Shimoni, M. MASCC-0331

Shin, K. MASCC-0518

Shin, S. MASCC-0616

Shin, S.-W. MASCC-0143

Shin, S.W. MASCC-0647, MASCC-0511

Shindo, E. MASCC-0487, MASCC-0482, MASCC-0398

Shinkura, N. MASCC-0779

Shishkin, E.A. MASCC-0407

Shklovskiy-Kordi, N. MASCC-0499

Shokaier, F. MASCC-0842

Showalter, T. MASCC-0844

Shrotiya, S. MASCC-0832, MASCC-0693

Shrotriya, S. MASCC-0536, MASCC-0535, MASCC-0534, MASCC-0533

Shun, S.-C. MASCC-0073

Shun, S.C. MASCC-0789, MASCC-0317, MASCC-0281

Shunmugam, C. MASCC-0619

Shwe, M. MASCC-0599, MASCC-0598

Sibilia, M. MASCC-0288

Sidhu, K.S. MASCC-0703

Siegel, D. MASCC-0773

Siegelmann, N. MASCC-0212

Sigaard, L. MASCC-0265, MASCC-0264, MASCC-0133

Silva Melo Cruz, F. MASCC-0608

Silva, T. MASCC-0568

Silveira, R.C.C.P. MASCC-0675, MASCC-0673, MASCC-0655

Sim, A. MASCC-0844

Sim, J. MASCC-0683

Sim, Y.J. MASCC-0404

Sima, L. MASCC-0150

Simanek, R. MASCC-0796

Simino, G.P.R. MASCC-0332

Siminska, J. MASCC-0831, MASCC-0826

Simlesa, D. MASCC-0692

Simmons, C. MASCC-0168

Simpson, M. MASCC-0269

Simpson, M.F. MASCC-0440

Simson, L. MASCC-0044

Singh, S. MASCC-0244

Singh-Carlson, S. MASCC-0086, MASCC-0813, MASCC-0622, MASCC-0480, MASCC-0204, MASCC-0203

Sit, J.W.H. MASCC-0639

Sjøgren, P. MASCC-0112, MASCC-0111

Skerman, H. MASCC-0629

Skubitz, K. MASCC-0546

Sleeboom, H. MASCC-0640

Sloan, J. MASCC-0845, MASCC-0625, MASCC-0601, MASCC-0560

Sloan, J.A. MASCC-0807, MASCC-0562

Slovacek, L. MASCC-0147, MASCC-0087

Slovackova, B. MASCC-0147, MASCC-0087

Small, I. MASCC-0568

Small, W.J.S. MASCC-0703

Smeets, R.E.H. MASCC-0053

Smillie, K. MASCC-0797

Smit, H.F.E. MASCC-0378

Smith, K. MASCC-0359

Smith, L. MASCC-0464

Smith, P. MASCC-0498, MASCC-0492, MASCC-0271

Smith, S. MASCC-0086, MASCC-0480, MASCC-0204

Smith, S.M. MASCC-0059

Smolle, V. MASCC-0288

Snelgrove, R. MASCC-0603

So, W.K.W. MASCC-0606, MASCC-0402, MASCC-0400

Soares, L.E. MASCC-0565

Soares, L.R. MASCC-0581

Soerensen, B. MASCC-0265, MASCC-0264

Soga, Y. MASCC-0268

Soibinet, P. MASCC-0287

Soler, J. MASCC-0828

Soliman, A. MASCC-0314

Song, E.K. MASCC-0647, MASCC-0511

Song, H.S. MASCC-0511

Song, S. MASCC-0261

Sonis, S. MASCC-0181

Sonis, S.T. MASCC-0812, MASCC-0605, MASCC-0564

Sonmez, O. MASCC-0339

Sonobe, H.M. MASCC-0544

Soon Haeng, L. MASCC-0415

Soran, A. MASCC-0815

Sørbye, L.W. MASCC-0306, MASCC-0304

Sørensen, V.-A. MASCC-0158

Sorgatz, K.M. MASCC-0846

Soriano, M.L. MASCC-0370

Sostek, M. MASCC-0737, MASCC-0736

Sota, K. MASCC-0256, MASCC-0209

Sottile, R. MASCC-0633

Soumoudronga, R.F. MASCC-0672

Sousa, M. MASCC-0743, MASCC-0739

Southerland, C. MASCC-0805

Sovinz, P. MASCC-0129

Spanjaard, L. MASCC-0457

Spano, I. MASCC-0344

Spence, L. MASCC-0851

Spencer, K. MASCC-0199

Spiegel, D. MASCC-0791, MASCC-0767

Spinelli, T. MASCC-0071

Springall, E. MASCC-0578, MASCC-0576, MASCC-0570

Sprod, L. MASCC-0794

Srinivasan, V. MASCC-0554, MASCC-0550

St-Hilaire, A. MASCC-0289

St. Germain, D. MASCC-0543

Staddon, A. MASCC-0546

Stadelmaier, N. MASCC-0179

Stammberger, U. MASCC-0709, MASCC-0708

Stan, D. MASCC-0740, MASCC-0722

Stanise, B. MASCC-0454

Stankovic, N. MASCC-0555

Stas, M. MASCC-0328, MASCC-0023

Stegmaier, P. MASCC-0297

Steigerwald, S. MASCC-0603

Steinbrenner, L.M. MASCC-0605

Steindal, S. MASCC-0306, MASCC-0304

Steindorf, K. MASCC-0686

Steiner, M.S. MASCC-0765, MASCC-0760

Stella, K. MASCC-0048

Stella, R. MASCC-0051, MASCC-0050, MASCC-0048

Stella, W. MASCC-0051

Stemmer, S. MASCC-0412

Stemmer, S.M. MASCC-0331, MASCC-0299, MASCC-0298

Stensen, M. MASCC-0158

Stephens, E.K. MASCC-0311

Stewart, E. MASCC-0437

Stilos, K. MASCC-0390

Stitt, L. MASCC-0140

Stojanovic, S. MASCC-0460

Stokes, E. MASCC-0699, MASCC-0674, MASCC-0389

Stolz Baskett, P. MASCC-0025

Stolz-Baskett, P. MASCC-0186

Stone, L. MASCC-0855, MASCC-0854

Stopeck, A. MASCC-0334

Strakhan, M. MASCC-0454

Strasser, F. MASCC-0796, MASCC-0164, MASCC-0109

Strenger, V. MASCC-0129

Strik, H. MASCC-0780

Stringer, A. MASCC-0853, MASCC-0628, MASCC-0602, MASCC-0591, MASCC-0483

Stringer, A.M. MASCC-0489

Stukenborg, G. MASCC-0333

Sturt, J. MASCC-0547

Su, C. MASCC-0338, MASCC-0302

Su, C.C. MASCC-0091

Su, W. MASCC-0243, MASCC-0022

Suarez-Almazor, M. MASCC-0559

Sugie, T. MASCC-0637

Sugimori, N. MASCC-0525

Sugiura, Y. MASCC-0268

Sugiyama, T. MASCC-0521

Sulkers, E. MASCC-0419, MASCC-0421

Sulkes, A. MASCC-0331, MASCC-0299

Sung, L. MASCC-0841

Surbone, A. MASCC-0687, MASCC-0684

Surendran, V. MASCC-0554, MASCC-0550

Susnjar, S. MASCC-0458

Suwa, H. MASCC-0779

Suzuki, A. MASCC-0500

Suzuki, K. MASCC-0414

Svanberg, A. MASCC-0486

Svec, J. MASCC-0134

Swami, N. MASCC-0841, MASCC-0820

Swinton, N. MASCC-0793

Swistel, A. MASCC-0561

Sym, S.J. MASCC-0511

Symons, J. MASCC-0720

Szwarc, M. MASCC-0107

Tack, J. MASCC-0737, MASCC-0736

Tada, K. MASCC-0366

Tagbarha, M. MASCC-0155

Tahmasebi, S. MASCC-0159

Taira, M. MASCC-0757

Tajima, T. MASCC-0368

Takahashi, K. MASCC-0268

Takahashi, M. MASCC-0513

Takahashi, N. MASCC-0508

Takahashi, T. MASCC-0513

Takakura, Y. MASCC-0525

Takamiya, R. MASCC-0757

Takase, K. MASCC-0679

Takase, M. MASCC-0414

Talei MASCC-0159

Tamahara, T. MASCC-0507

Tamai, N. MASCC-0757

Tamaki, K. MASCC-0757

Tamashiro, A.S. MASCC-0581

Tamminga, R.Y.J. MASCC-0419

Tamozlu, T. MASCC-0339

Tamparon, R. MASCC-0294

Tamura, K. MASCC-0521

Tan de Bibiana, J. MASCC-0797

Tan, A. MASCC-0560

Tan, C. MASCC-0294

Tan, J. MASCC-0294

Tan, L. MASCC-0012

Tan, M.H. MASCC-0630, MASCC-0479

Tan, W. MASCC-0225

Tan, X.Y. MASCC-0319

Tan, Y.P. MASCC-0588

Tanaka, I. MASCC-0610

Tanay, M. MASCC-0506

Tanda, N. MASCC-0508, MASCC-0507

Tang, C.L. MASCC-0240

Tang, J.L. MASCC-0317

Tang, W.ie.P.Y. MASCC-0537

Tannir, N. MASCC-0395

Tanuma, A. MASCC-0524, MASCC-0379, MASCC-0380

Taphoorn, M. MASCC-0424

Tarcea, V. MASCC-0496

Tardif, F. MASCC-0691

Tarrant, R. MASCC-0580

Tasaka, A. MASCC-0549

Tasar, A. MASCC-0520

Tàssies, D. MASCC-0626

Taylor, D. MASCC-0343

Taylor, M.A. MASCC-0605

Teich, N. MASCC-0568

Teich, V. MASCC-0568

Teillet, A. MASCC-0484

Tejani, M. MASCC-0755

Temel, J.S. MASCC-0410

Teo, Y.L. MASCC-0630, MASCC-0479

Teresa, C. MASCC-0409

Terpos, E. MASCC-0640

Terstriep, S.A. MASCC-0562

Terui, T. MASCC-0308

Tetelin, F. MASCC-0634

Tetterton, J. MASCC-0805

Tewes, M. MASCC-0443

Tez, T. MASCC-0301

Thamm, C. MASCC-0849

Thavarajah, N. MASCC-0238, MASCC-0237, MASCC-0236, MASCC-0235, MASCC-0010

Thiadens, S.R.J. MASCC-0027

Thirugnanasambanthan, A.T. MASCC-0697

Thomas, R. MASCC-0198, MASCC-0040

Thomas, S. MASCC-0832, MASCC-0696, MASCC-0693, MASCC-0535, MASCC-0533

Thompson, J.O. MASCC-0001

Thompson, S. MASCC-0464

Thomson, D. MASCC-0629

Thomson, M. MASCC-0493

Thong, M.S.Y. MASCC-0020

Thongprasert, S. MASCC-0312

Thorpe, D. MASCC-0628

Thuijl van, H. MASCC-0424

Tierney, S. MASCC-0431

Timmer, W. MASCC-0071

Timmons, A. MASCC-0747, MASCC-0744

Tissing, W.J.E. MASCC-0523, MASCC-0455, MASCC-0419, MASCC-0157, MASCC-0421

Titareli Merizio Martins Braga, F. MASCC-0675

Tlaker Zunter, V. MASCC-0814

Todaka, A. MASCC-0369

Toi, M. MASCC-0779, MASCC-0637

Tokashiki, S. MASCC-0229

Tokunaga, Y. MASCC-0679

Toledano, A. MASCC-0701

Tolver, A. MASCC-0158

Toral, J. MASCC-0516

Toro, J. MASCC-0393, MASCC-0392

Toro, J.J. MASCC-0394

Torp, K. MASCC-0729

Torres, A. MASCC-0300

Torres, H. MASCC-0559

Torres, L.M. MASCC-0343

Tosker, V. MASCC-0187

Tosteson, T. MASCC-0234

Tourangeau, A. MASCC-0578, MASCC-0577

Tournigand, C. MASCC-0753

Tovstohan, A. MASCC-0364

Toy MASCC-0182

Toy, H. MASCC-0089, MASCC-0068, MASCC-0067

Toyokawa, A. MASCC-0679

Trager, S. MASCC-0531, MASCC-0497, MASCC-0371

Tramer, F. MASCC-0110, MASCC-0084

Tran, B.T. MASCC-0703

Tran, C.D. MASCC-0043

Tran, T. MASCC-0793

Treister, N.S. MASCC-0154

Treleaven, J. MASCC-0493

Tremblay, A. MASCC-0289

Trentin, L. MASCC-0653

Trier, K. MASCC-0716

Trimmer, R. MASCC-0535

Trindade, A.C. MASCC-0659

Tröger, W. MASCC-0555

Trufelli, D. MASCC-0608

Truntzer, P. MASCC-0376

Truty, M. MASCC-0601

Tsai, Y.-C. MASCC-0153

Tsao, M. MASCC-0475, MASCC-0238, MASCC-0236, MASCC-0235, MASCC-0037, MASCC-0036, MASCC-0035, MASCC-0377, MASCC-0383

Tsauo, J.-Y. MASCC-0073

Tsauo, J.Y. MASCC-0317

Tsay, S.-L. MASCC-0213

Tsay, S.L. MASCC-0032

Tseng, H. MASCC-0595, MASCC-0594, MASCC-0592

Tseng, L.-M. MASCC-0167

Tserkezoglou, A. MASCC-0644

Tsianakas, V. MASCC-0529

Tsotakos, S. MASCC-0644

Tsuda, M. MASCC-0679, MASCC-0637

Tsuji, E. MASCC-0366

Tsuji, T. MASCC-0525, MASCC-0524, MASCC-0379, MASCC-0380

Tsurukawa, T. MASCC-0524

Tsushima, T. MASCC-0369

Tsuyuki, S. MASCC-0779

Tu, H.A. MASCC-0578

Tual, V. MASCC-0531, MASCC-0497

Tubert-Jeannin, S. MASCC-0551

Tullio, A. MASCC-0263

Tuppo, C.M. MASCC-0027

Turcotte, S. MASCC-0054

Turnbull, D. MASCC-0847

Turrioni, A.P.S. MASCC-0106

Ueda, Y. MASCC-0229

Uematsu, N. MASCC-0617

Uemura, S.T. MASCC-0565

Uesugi, M. MASCC-0468

Ulas, M. MASCC-0748

Ulrich, C. MASCC-0686

Ünür, M. MASCC-0770, MASCC-0690

Urban, C. MASCC-0129

Urrego Marcela, M. MASCC-0348

Urvay, S. MASCC-0802

Uttenreuther-Fischer, M. MASCC-0709, MASCC-0708

Uwland, N.F. MASCC-0563

Uyterlinde, W. MASCC-0224, MASCC-0223

Vaartio-Rajalin, H. MASCC-0064

Vaezi, M. MASCC-0583

Vaiman, M. MASCC-0187

Vales, D. MASCC-0793

Valieva, R.M. MASCC-0249

Valls, S. MASCC-0056, MASCC-0002

Van Achterberg, T. MASCC-0459

Van Dalen, E. MASCC-0391

Van de Poll-Franse, L. MASCC-0108

Van de Poll-Franse, L.V. MASCC-0053, MASCC-0052

VAN de Velden, W.J.F.M. MASCC-0567

Van de Wetering, M. MASCC-0391

Van de Wetering, M.D. MASCC-0823, MASCC-0646, MASCC-0457

Van de Wiele, T. MASCC-0502

Van den Broek, W. MASCC-0020

Van den Heuvel, M. MASCC-0224, MASCC-0223

Van den Hurk, C. MASCC-0108

Van der Elst, E. MASCC-0459

Van der Pol, M. MASCC-0323

Van der Veen, F. MASCC-0823

Van der Venn, I. MASCC-0580

Van der Wal, G. MASCC-0470

Van Loveren, C. MASCC-0321

Van Oorschot, B. MASCC-0430

Van Pelt, A.M.M. MASCC-0823

Van Straten, A. MASCC-0378

Van Teijlingen, E. MASCC-0702

Van Uden-Kraan, C.F. MASCC-0381

Van-der Molen, L. MASCC-0663

Vandenbussche, K. MASCC-0389

Vanhoecke, B. MASCC-0502

Vanlemmens, L. MASCC-0645

Vanni, L. MASCC-0541, MASCC-0539

Vardas, E. MASCC-0778, MASCC-0769

Varenova, L. MASCC-0094

Vargas, A. MASCC-0632, MASCC-0626

Vasconcelos, T. MASCC-0821

Vasile, E. MASCC-0651

Vaskelyte, A. MASCC-0768

Vaslamatzis, M.M. MASCC-0589, MASCC-0349

Vassiliou, V. MASCC-0167

Vasumathy, N. MASCC-0550

Vazquez, D. MASCC-0604

Vazquez-Quintana, E. MASCC-0604

Védrine, L. MASCC-0406

Veeraiah, S. MASCC-0704, MASCC-0619

Veerman, E.C.I. MASCC-0321

Velthuis, M. MASCC-0323

Verdonck- de Leeuw, I. MASCC-0636

Verdonck-de Leeuw, I. MASCC-0378, MASCC-0381

Verdonck-de Leeuw, I.M. MASCC-0663

Vergeichik, G.I. MASCC-0407

Vergis, A. MASCC-0603

Verity, R. MASCC-0547, MASCC-0529

Verkade, H.J. MASCC-0157

Verschakelen, J. MASCC-0023

Viallard, M.L. MASCC-0638

Viaux, P. MASCC-0350

Vibe-Petersen, J. MASCC-0716

Viel, E. MASCC-0753

Vigano, A. MASCC-0848

Vij, R. MASCC-0773

Vilallonga, J.S. MASCC-0409

Villeneuve, E. MASCC-0460

Vinther, A. MASCC-0515

Vishnuvardhan, Z. MASCC-0093, MASCC-0092

Visser, A. MASCC-0563

Visser, O. MASCC-0375

Vithala, M. MASCC-0293

Vitori, W. MASCC-0107

Viviane Andrade, V.A. MASCC-0273, MASCC-0272

Vizzard, M.A. MASCC-0293

Vlahovic, G. MASCC-0777

Vogl, F.D. MASCC-0541, MASCC-0539

Vogt., T. MASCC-0792

Volet, J. MASCC-0350

Volovat, C. MASCC-0719

Von Dincklage, J. MASCC-0408

Von Moos, R. MASCC-0640, MASCC-0334

Von Roenn, J.H. MASCC-0736

Vredenburgh, J.J. MASCC-0805

Vreugdenhil, G. MASCC-0108

Vrouchou, P. MASCC-0713, MASCC-0711

Vujovic, A. MASCC-0458

Vuletich, C. MASCC-0408

Vulser, C. MASCC-0634

Vvedenskaia, E. MASCC-0094

Wadhawan, G.S. MASCC-0120

Wagland, R. MASCC-0720, MASCC-0580

Wagner, L. MASCC-0512

Wagner, L.I.W. MASCC-0703

Wahner-Roedler, D. MASCC-0722

Wai, M.K. MASCC-0618

Wakabayashi, G. MASCC-0521

Wakeda, T. MASCC-0366

Wakefield MS, D.B. MASCC-0799

Wales Arnold, S. MASCC-0431

Walker, H. MASCC-0620

Walpole, E. MASCC-0629

Walsh, D. MASCC-0832, MASCC-0696, MASCC-0693, MASCC-0536, MASCC-0535, MASCC-0534, MASCC-0533, MASCC-0456, MASCC-0453

Waltimo, T. MASCC-0566

Wan Mohamad Zain, W.N.I. MASCC-0677

Wan, R.W.M. MASCC-0400

Wan-Chow-Wah, D. MASCC-0576

Wang, J. MASCC-0228, MASCC-0227

Wang, X. MASCC-0579, MASCC-0574

Wang, X.S. MASCC-0579

Wardill, H.R. MASCC-0471

Wartlick, F. MASCC-0060

Wass, M. MASCC-0418

Watanabe, A. MASCC-0367

Watson, D. MASCC-0464

Watzke, H. MASCC-0796

Weaver, E.W. MASCC-0557

Webster, L. MASCC-0737

Wee, H.L. MASCC-0630, MASCC-0630, MASCC-0479

Weidner, S.M. MASCC-0812

Wein, S. MASCC-0034

Weiss, J. MASCC-0027

Weiss, M. MASCC-0187

Welz, S. MASCC-0297

Wendt, T. MASCC-0297

Wentlandt, K. MASCC-0841

Were, P. MASCC-0723

Weru, K.J. MASCC-0426

Wessels, S. MASCC-0686

Westerhof, G.J. MASCC-0563

Whang, S. MASCC-0616

Whelton, R. MASCC-0450

White, I. MASCC-0464

Whiteford, A. MASCC-0707

Wiegel, T. MASCC-0496, MASCC-0297

Wieruszewska, K. MASCC-0658

Wignall, A. MASCC-0611, MASCC-0600, MASCC-0591

Wiktorowicz, K. MASCC-0514

Wildiers, H. MASCC-0459

Wiles, L. MASCC-0707

Wilkinson, A. MASCC-0623

Wilkinson, A.M. MASCC-0620

Williams, J. MASCC-0530, MASCC-0395

Williams, J.L. MASCC-0585

Williams, J.P. MASCC-0810

Williams, M. MASCC-0040

Wilmer, A. MASCC-0520

Wilson, C. MASCC-0611

Wilson, D. MASCC-0844

Wilson, H. MASCC-0749

Winter, J. MASCC-0498

Wisbeck, W.M. MASCC-0605

Wiseman, T. MASCC-0270

Wiskemann, J. MASCC-0686

Witte, B.I. MASCC-0378

Wogu, A.F. MASCC-0817, MASCC-0816

Wojciechowska-Lampka, E. MASCC-0658

Wolf, J. MASCC-0708

Wolfson, C. MASCC-0575

Wollenberg, A. MASCC-0288

Won, J.Y. MASCC-0143

Wong, B. MASCC-0759

Wong, E. MASCC-0238, MASCC-0236, MASCC-0235, MASCC-0171, MASCC-0170, MASCC-0169, MASCC-0167, MASCC-0377, MASCC-0383, MASCC-0384

Wong, E.M.L. MASCC-0639, MASCC-0606

Wong, F. MASCC-0086, MASCC-0204

Wong, H.L. MASCC-0005

Wong, K. MASCC-0238, MASCC-0236, MASCC-0235

Wong, K.S. MASCC-0606

Wong, M. MASCC-0446

Wong, M.C. MASCC-0631

Wong, Q.X. MASCC-0446

Wong, R. MASCC-0631, MASCC-0240

Wong, S. MASCC-0715

Wong, S.M. MASCC-0732

Wong, W.H. MASCC-0004

Woo, I.S. MASCC-0511

Wood, P.A. MASCC-0138

Woodring, S. MASCC-0777

Woody, N. MASCC-0195

Worsfold, A. MASCC-0713, MASCC-0711, MASCC-0710

Wroclawski, M.L. MASCC-0107

Wu, P. MASCC-0185

Wu, S. MASCC-0024

Wu, S.-F. MASCC-0213

Wu, W. MASCC-0681

Wu, W.W. MASCC-0088

Wu, X. MASCC-0233

Wujcik, D. MASCC-0759

Wyke, S. MASCC-0180

Xie, F. MASCC-0319

Xu, A. MASCC-0542

Xu, H.-Y. MASCC-0126, MASCC-0125, MASCC-0124, MASCC-0123, MASCC-0122

Xu, L. MASCC-0152

Xu, X.L. MASCC-0526

Yacouben, K. MASCC-0738

Yakasai, I.A. MASCC-0217

Yamada, M. MASCC-0513

Yamada, N. MASCC-0268

Yamagami, K. MASCC-0779

Yamagishi, N. MASCC-0487, MASCC-0398

Yamakage, M. MASCC-0367

Yamamoto, K. MASCC-0549

Yamamoto, N. MASCC-0521, MASCC-0414

Yaman, S. MASCC-0339

Yamanaka, T. MASCC-0414

Yamatodani, A. MASCC-0549

Yamauchi, A. MASCC-0779

Yamauchi, M. MASCC-0367

Yamauchi, S. MASCC-0256, MASCC-0209

Yamazaki, K. MASCC-0369

Yanai, T. MASCC-0414

Yang, H. MASCC-0045

Yang, J.C.H. MASCC-0708

Yang, P. MASCC-0845

Yang, P.C. MASCC-0789

Yao, C.T. MASCC-0132

Yap, K. MASCC-0642, MASCC-0322

Yap, Y.S. MASCC-0599, MASCC-0598, MASCC-0538

Yardley, L. MASCC-0492, MASCC-0271

Yasaka, M. MASCC-0368

Yasoda, A. MASCC-0637

Yasui, H. MASCC-0369

Yasumori, N. MASCC-0414

Yates, P. MASCC-0629, MASCC-0029

Yavas, C. MASCC-0627, MASCC-0478, MASCC-0477, MASCC-0286, MASCC-0285, MASCC-0284, MASCC-0283, MASCC-0182, MASCC-0130, MASCC-0119, MASCC-0118, MASCC-0117, MASCC-0116, MASCC-0089, MASCC-0069, MASCC-0068, MASCC-0067, MASCC-0066

Yavas, G. MASCC-0627, MASCC-0478, MASCC-0477, MASCC-0286, MASCC-0285, MASCC-0284, MASCC-0283, MASCC-0182, MASCC-0130, MASCC-0119, MASCC-0118, MASCC-0117, MASCC-0116, MASCC-0089, MASCC-0069, MASCC-0068, MASCC-0067, MASCC-0066

Yazilitas, D. MASCC-0798

Yeh, K.-H. MASCC-0073

Yenicesu, I. MASCC-0028

Yennu, S. MASCC-0585, MASCC-0395

Yennurajalingam, S. MASCC-0574, MASCC-0552

Yerushalmi, R. MASCC-0299

Yeung, C.K. MASCC-0618

Yeung, S.J. MASCC-0579

Yigit, G. MASCC-0250

Yildirim Sari, H. MASCC-0351

Yilmaz, M. MASCC-0351

Yin, P. MASCC-0152

Yokota, T. MASCC-0369

Yong, W.S. MASCC-0599, MASCC-0598

Yoo, J. MASCC-0790

Yoo, S. MASCC-0416

Yoo, Y.S. MASCC-0255

Yoon, K.S. MASCC-0403

Yoon, S.Y. MASCC-0143

Yoon, T. MASCC-0510

Yoshibayashi, H. MASCC-0779

Yoshida, E. MASCC-0507

Yoshida, K. MASCC-0521, MASCC-0513

Yoshimi, C. MASCC-0513

Yoshizawa, R. MASCC-0757

Young, A. MASCC-0707, MASCC-0128

Younus, J. MASCC-0140, MASCC-0139

Yu, B. MASCC-0526

Yu, C.J. MASCC-0789

Yu, I. MASCC-0474

Yu, S. MASCC-0494

Yuankai, S. MASCC-0312

Yuh, G.E. MASCC-0605

Yuh, Y.J. MASCC-0511

Yuksel, S. MASCC-0548

Yun, H.J. MASCC-0647

Yun, Y. MASCC-0416

Yun, Y.H. MASCC-0683

Yunjung, Y. MASCC-0415

Yusoff, Z.M. MASCC-0085

Zacchigna, S. MASCC-0423, MASCC-0420, MASCC-0033

Zachariah, B. MASCC-0017

Zadik, Y. MASCC-0842

Zafferri, V. MASCC-0653

Zagonel, V. MASCC-0653

Zakeri, Z. MASCC-0159

Zakin, L. MASCC-0701, MASCC-0527

Zamora, I. MASCC-0300

Zanardi, O. MASCC-0327

Zandonai, A.P. MASCC-0837

Zanellato, R.M. MASCC-0239

Zaner, K. MASCC-0607

Zegarski, W. MASCC-0831, MASCC-0826

Zelek, L. MASCC-0695

Zeltser, R. MASCC-0842

Zeng, L. MASCC-0612, MASCC-0246, MASCC-0242, MASCC-0237, MASCC-0171, MASCC-0170, MASCC-0168, MASCC-0167, MASCC-0037, MASCC-0036, MASCC-0035, MASCC-0011, MASCC-0010, MASCC-0009, MASCC-0008, MASCC-0377, MASCC-0382, MASCC-0384

Zeppetella, G. MASCC-0245

Zhang, H. MASCC-0045

Zhang, L. MASCC-0246, MASCC-0242, MASCC-0238, MASCC-0236, MASCC-0235, MASCC-0171, MASCC-0170, MASCC-0169, MASCC-0168, MASCC-0167, MASCC-0037, MASCC-0036, MASCC-0035, MASCC-0011, MASCC-0009, MASCC-0377

Zhang, R. MASCC-0045

Zhao, G. MASCC-0141

Zhen, P. MASCC-0012

Zheng, L. MASCC-0228

Zheng, R. MASCC-0292, MASCC-0291

Zhong, W. MASCC-0583

Zhong, X. MASCC-0233

Zhou, K. MASCC-0732, MASCC-0631

Zhou, M. MASCC-0612, MASCC-0237, MASCC-0169, MASCC-0382

Zhou, Y. MASCC-0334

Zhu, B. MASCC-0526

Zhu, L. MASCC-0045

Zilembo, N. MASCC-0724

Zimmermann, C. MASCC-0841, MASCC-0820, MASCC-0467

Zingerman, B.V. MASCC-0499

Zirko, R. MASCC-0087

Zomer-Kooijker, K. MASCC-0455

Zou, L. MASCC-0694

MASCC-0001

An evaluation of the activity of a 7-day per week, nurse-led, face-to-face specialist palliative care service in an acute district general hospital

A. Davies 1, J.O. Thompson1, S. Hall1

1Palliative Care, St. Luke’s Cancer Centre, Guildford, United Kingdom

Introduction: UK guidelines recommend that hospital-based specialist palliative care teams should provide a 9 am to 5 pm, 7-day per week, face-to-face service.

Objectives: This report describes the activity of a new, 9 am to 5 pm, 7-day per week, nurse-led, face-to-face service in an acute district general hospital in the United Kingdom.

Methods: The service is based in a district general hospital, with an integral cancer centre. On the weekends, one clinical nurse specialist (CNS) is present within the hospital, with a consultant in palliative medicine providing telephone support. The data for this report was obtained by reviewing the clinical databases used by the specialist palliative care team.

Results: During the first year, the CNS’s undertook 651 face-to-face consultations on the weekends; the median number of consultations was 12, with the median number of “new” patient consultations being 1.5. Overall, 25 % total consultations, and 18 % “new” patient consultations, were undertaken on the weekends.

The primary reasons for reviewing patients on the weekends were pain (46 %), other symptoms (27.5 %), psychological support (2 %), deterioration in condition (3 %), discharge planning (4 %), patient on the Liverpool Care Pathway (17 %), and patient with malignant spinal cord compression (0.5 %). In 60 % of cases, the CNS’s identified another problem during the consultation. Overall, 23 % “new” patients died over the weekend.

Conclusions: Our data provides evidence of the value of having a 9 am to 5 pm, 7-day per week, face-to-face service in an acute district general hospital.

References: National Institute for Clinical Excellence. Improving Supportive and Palliative Care for Adults with Cancer. London: NICE; 2004.

MASCC-0002

Hospital at home in cancer patients

J. Aibar 1, A. Fernández-Martínez2, N. Seijas1, C. Font2, B. Ibáñez1, L. Llop1, S. Valls1, M. Roman1, M.C. Grané1, C. Hernández1

1Integrated Care Unit. Medical and Nursing Direction, Hospital Clinic de Barcelona, Barcelona, Spain, 2Department of oncology, Hospital Clinic de Barcelona, Barcelona, Spain

Introduction: Cancer patients often have acute complications associated or not with malignancy that require hospitalization. An approach to avoiding hospitalization even for acutely ill patients is the ‘hospital at home (HaH)’ model.

Objectives: To compare the characteristics and outcome of cancer patients with acute medical complications admitted to a HaH program with a hospitalized control group.

Methods: Three hundred sixty-six cancer patients with acute complications requiring complex medical care were included, 247 of whom were attended in HaH program and 119 received conventional hospitalization (CH).

Results: No differences were found in the proportion of tumor types, being lung cancer the most common malignancy in both groups, followed by gastrointestinal tract tumors, breast cancer and genitourinary malignancies. The most common reasons for admission were respiratory infection/pneumonia, febrile neutropenia and fever without a clear clinical focus. Patients in the CH group had higher Charlson index (p < 0.001). Patients admitted to HaH had a lower total stay than those admitted to the hospital (p = 0.04). During HaH admission 5 patients consulted the emergency room for medical complications, 11 patients required hospitalization, and 3 patients died. CH patients had a significantly higher in-hospital mortality (p < 0.05).

Conclusions: HaH for patients with cancer who require hospitalization is an acceptable alternative to hospital based treatment in selected patients with good results in terms of mortality, total stay and hospital readmissions.

References: 1. Shepperd S, Doll H, Angus RM, et al. Avoiding hospital admission through provision of hospital care at home: a systematic review and meta-analysis of individual patient data. CMAJ. 2009 Jan 20;180(2):175–82.

MASCC-0003

Complementary therapy usage in Hong Kong Chinese women with early stage breast cancer awaiting adjuvant radiotherapy

T. Kwan 1, R. Ho1

1Centre on Behavioral Health, The University of Hong Kong, Hong Kong, Hong Kong China

Introduction: In Hong Kong, it is common for patients to use complementary therapy (CMT) on their own initiative while receiving Western medical treatment.

Objectives: To assess the prevalence of CMT usage and its associations with demographic and clinical factors in Chinese women with early stage breast cancer during cancer treatment.

Methods: Ethnic Chinese breast cancer patients awaiting adjuvant radiotherapy (n = 133) were recruited from two public hospitals and three community patient support centres in Hong Kong from December 2010 onward. Self-administered questionnaires were used to collect data on demographics, clinical status and the use of these types of CMT since diagnosis: Chinese herbal medicine, dietary therapy, physical therapy and/or mental therapy

Results: Of all women (median age 49 years), 78 % had received both breast surgery and adjuvant chemotherapy. The rate of using any type of CMT was 62 %. Chinese herbal medicine was the type most commonly taken. The use of CMT was significantly associated with age (r = −0.24, p = 0.006), and education (X2 trend = 11.26, p = 0.001), but not with household income, marital status, cancer stage, breast surgery type or chemotherapy. Qualitative data showed that women had little knowledge of the herbal products they took. Women’s classifications of dietary supplements and herbal medicine varied widely, leading to misreporting or under-reporting.

Conclusions: In this study, majority of the women had used CMT. Younger age and higher education were associated with using CMT. The consumption of Chinese herbs during Western cancer treatment raised concerns for potential interactions, and disclosure of its use may be hampered by women’s limited understanding.

MASCC-0004

Perceived symptoms and unmet needs in breast cancer survivors: a comparison study between 2 and 5 years post-treatment cohorts

K. Cheng 1, W.H. Wong2, L. Ge1, C. Koh2

1Nursing, National University of Singapore, Singapore, Singapore, 2Nursing, National University Hospital, Singapore, Singapore

Introduction: Symptoms would be one of the most important aspects impeding the transition and can give rise to unmet needs for breast cancer survivors (BCS).

Objectives: To compare the range and levels of perceived symptoms and unmet needs reported by BCS between 2 and 5 years post- cancer treatment.

Methods: Two hundred BCS (mean age: 54 years) within 2 years following cancer treatment (n = 108) and at 2–5 years post-treatment period (n = 92) were enrolled for analysis. The Memorial Symptom Assessment Scale (MSAS) and the Supportive Care Needs Survey (SCNS-34) were used to assess symptom burden and unmet needs

Results: Eighty-eight percent of the survivors reported having at least one symptom, while 49 % reported at least one unmet need. Lack of energy was the most prevalent symptom (50 %) in 2 years post-treatment group, while numbness/tingling in hands/feet was the most prevalent symptom (46 %) in 5 years post-treatment group. There was a trend in 2 years group to have higher MSAS Psychological (PSYCH), Physical (PHY), Global Distress Index (GDI) scores than the 5 years group, however, the difference was not significant (p > 0.05). Most of the survivors had unmet needs in the Health care system/Information domain; with 33 % and 38 % reported at least one unmet need for help in 2 years and 5 years groups, respectively. The mean score for the Psychological needs was significantly higher in the 2 years group compared with the 5 years group (p = 0.01).

Conclusions: Survivors in the 2 to 5 years post-cancer treatment reported more perceived needs in Psychological domain than those in less than 2 years.

MASCC-0005

Factors associated with unmet supportive care needs of breast cancer survivors during the 5 years post-cancer treatment

K. Cheng 1, H.L. Wong2, C. Koh2

1Nursing, National University of Singapore, Singapore, Singapore, 2Nursing, National University Hospital, Singapore, Singapore

Introduction: There is limited study with respect to the factors that may influence the breast cancer patients’ needs in the phase of rehabilitation and survivorship.

Objectives: To examine factors associated with unmet supportive care needs of breast cancer survivors (BCS) in the half-year to 5 year post-treatment period.

Methods: Two hundred BCS (mean age: 54 ± 8 years) at the half-year to 5 year post-treatment period were enrolled for analysis. Measuring instruments included the Supportive Care Needs Survey (SCNS-34) and the Memorial Symptom Assessment Scale.

Results: About half (49 %) of the BCS reported at least one unmet need and 36 % reported having at least one moderate or high unmet need. Of these, 65 %, 16 % and 19 % of the survivors reported 1–5, 6–10, >10 unmet needs, respectively. In the multivariable model, BCS reported high symptom burden (adjusted OR = 10.29; 95 % CI = 2.25–47.12; p = 0.003), and received adjuvant chemotherapy (adjusted OR = 5.13; 95 % CI = 1.68–15.67; p = 0.004) were significantly associated with a higher probability of at least one unmet need. As for the probability of having at least one moderate or high unmet need, the adjusted OR of high symptom burden and adjuvant chemotherapy were 12.46 (95 % CI = 3.36–46.18, p < 0.001) and 3.45 (95 % CI = 1.13–10.52, p = 0.03), respectively.

Conclusions: Adjuvant chemotherapy and residual and/or late emerging symptoms long after the completion of the treatment can give rise to unmet needs for breast cancer survivors.

MASCC-0006

A longitudinal study of the effects of multimodal symptom management program on reducing symptom burden for patients with breast and colorectal cancer

K. Cheng 1, N. Chan2, N.K.E. Ang3, P. Khalechelvam1, B. Piper4

1Nursing, National University of Singapore, Singapore, Singapore, 2Oncology, National University Hospital, Singapore, Singapore, 3Nursing, National University Hospital, Singapore, Singapore, 4Nursing, University of Arizona, Singapore, Singapore

Introduction: The consequences that cancer and its treatment-related symptoms exert have negative effects on many aspects of patients.

Objectives: To determine the effects of a RCT of a multimodal program on reducing symptom occurrence and severity.

Methods: Fifty-two patients (mean age 56.7) were randomized either to an experimental or a control group. The experimental group received a multimodal structured symptom management program for 20 weeks, and standard treatment and care (n = 27). The control group received standard treatment and care (n = 25). The Memorial Symptom Assessment Scale (MSAS) was completed weekly at baseline (before adjuvant cancer therapy, time 1), at 6 weeks from time 1 (time 2), at 12 weeks from time 1 (time 3), and at 24 weeks from time 1 (time 4).

Results: Most were aged 50 or older (81 %) and had a diagnosis with breast cancer (62 %). The longitudinal pattern of symptom median intensity was very similar for both groups. There was a trend in the experimental group to have lower severity at 6 week from time point 1 than the control group, however, the difference was not significant (p > 0.05). The median scores for MSAS Physical, Global Distress Index, and total scores were lower in the experimental group at 6- and 24-week from time 1 (median 0.24 to 0.73) compared with the control group (median 0.15 to 0.93), but the differences were not significant (p > 0.05).

Conclusions: The symptom management program may reduce symptom severity at 6- and 24-week. Nevertheless, the evaluable subjects were relatively small in this analysis that would limit the statistical power of demonstrating the differences.

MASCC-0007

Albuminemia is a prognostic factor for overall and disease free survivals in metastatic non small cell lung cancer : experience of Hassan II university hospital

Z. Benbrahim 1, S. Arifi1, L. Amaadour1, N. Abda2, C. Nejjari2, N. Mellas1, O. El Mesbahi1

1Medical Oncology, Hassan II University Hospital, Fez, Morocco, 2Epidemiology, Faculty of Medicine and Pharmacy of Fez, Fez, Morocco

Introduction: Hypoalbuminemia is a frequent manifestation of advanced NSCLC which is often related with a poor survival.

Objectives: The aim of our study was to establish the correlation between hypoalbuminemia and survival (disease-free survival (DFS) and overall survival (OS)) in Moroccan patients with metastatic NSCLC.

Methods: We reviewed 115 cases of metastatic non small cell lung carcinomas diagnosed between January 2007 and June 2011 at the Medical Oncology Department of Hassan II University Hospital. Albumin level was performed at the time of diagnosis and prior to treatment. Survival curves were plotted by the Kaplan-Meier method and compared using the log-rank test.

Results: Median age was 57 ± 10 years. Forty eight per cent had albuminemia ≤35 mg/mL with a mean level of 28 mg/L. Hypoalbuminemia was more frequently associated with body mass index <18.5 kg/m2 (p = 0,008). However, it was not correlated to age, performance status, histologic type, number of metastatic sites involved, pleural effusion, liver metastasis, hypercalcemia and anemia. The median duration of follow-up was 7.4 months (range: 1–99 months). In the univariate analysis, hypoalbuminemia was significantly correlated to lower OS (mean: 15 vs 4 months, p = 0,0023) and lower DFS (mean :10,8 versus 3,8 months, p = 0,033). The response rate was shorter (10 % vs 43 %) but not significantly different (p = 0,09). In multivariate analysis, hyoalbuminemia was significantly associated with shorter OS and DFS.

Conclusions: This study suggests that hypoalbuminemia could be an independent prognostic marker to predict unfavorable OS and PFS in patients with metastatic NSCLC.

MASCC-0008

Comparison of the EORTC QLQ-BM22 and the FACT-BP for assessment of quality of life in cancer patients with bone metastases

M. Popovic 1, J. Nguyen1, E. Chen1, J. Di Giovanni1, L. Zeng1, E. Chow1

1Rapid Response Radiotherapy Program, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada

Introduction: Currently, the EORTC QLQ-BM22 and the FACT-BP are the two most widely used and validated quality of life (QOL) tools for bone metastases patients.

Objectives: The purpose of this study is to compare the development and characteristics of these two modules, as well as their current use in palliative research.

Methods: Studies detailing the development process for the QLQ-BM22 and the FACT-BP were identified and consulted. A comparison between the development, characteristics, validation and use of both questionnaires was conducted.

Results: The QLQ-BM22 was developed with collaboration from patients, health care professionals and consultation from the literature whereas the FACT-BP was created strictly through interviews with patients. The two tools have identical approaches to the types of QOL they assess, generally concerning themselves with the four fields of physical well-being, emotional well-being, social well-being and functional well-being. Scoring, organization, response options and item format are different; however, recall period is the same. Both tools serve as bone metastases supplements to core items relevant to all patients with cancer.

Conclusions: Both the QLQ-BM22 and FACT-BP are designed for assessment of QOL issues specific to cancer patients with bone metastases. Each instrument has unique strengths and weaknesses and choice between these tools is dependent on the needs of the investigators and of the study.

MASCC-0009

Quality of life in patients with advanced cancers using the functional assessment of cancer therapy-general assessment tool: a literature review

M. Popovic 1, N. Lao1, G. Bedard1, L. Zeng1, L. Zhang1, D. Cella2, J.L. Beaumont2, N. Chiu1, L. Chiu1, H. Lam1, M. Poon1, R. Chow1, E. Chow1

1Rapid Response Radiotherapy Program, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada, 2Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA

Introduction: Clinicians assess quality of life (QOL) in advanced cancer patients in order to select appropriate treatment regimens.

Objectives: The present review aims to compare QOL scores of the Functional Assessment of Cancer Therapy-General (FACT-G) assessment tool in relation to clinical and socio-demographic features in patients with advanced cancers.

Methods: A literature search was conducted using EMBASE (1994 to 2012) and MEDLINE (1994 to 2012) in the OvidSP platform. Weighted analysis of variance was conducted by using the number of patients from each study arm as a weighting variable.

Results: Thirty-three relevant studies encompassing 39 study arms were identified. Education, national per capita healthcare expenditure, admission status and previous radiation therapy were found to be statistically significant with respect to certain domains of the FACT-G. A greater percentage of patients completing post-secondary education correlated to significantly better emotional well-being and global QOL. Cohorts from countries with higher national per capita healthcare expenditures had better physical well-being, social/family well-being and improved relationships with their doctors. Patient samples comprised of purely outpatients had better levels of emotional well-being and global QOL when compared to mixed cohorts. A greater percentage of patients previously receiving radiation therapy correlated to a better relationship with doctor score.

Conclusions: Although limitations of the present review exist, clear differences in QOL scores based on socio-demographic and clinical factors are observed. Future work aimed at determining confounding parameters or cause and effect relationships is recommended.

MASCC-0010

Comparing prognostic factors in patients with spinal metastases: a literature review

M. Popovic 1, M. Lemke1, L. Zeng1, E. Chen1, J. Nguyen1, N. Thavarajah1, J. Di Giovanni1, F. Caporusso1, E. Chow1

1Rapid Response Radiotherapy Program, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada

Introduction: The expected prognosis of spinal metastases patients plays a large role in guiding treatment decisions, the outcome of which influences quality of life.

Objectives: The current study aims to review the reported factors and prognostic scoring systems that accurately predict survival of patients with spinal metastases.

Methods: A literature search was conducted to identify studies which elucidated prognostic factors in spinal metastases patients. PubMed (1966 to 2011), MEDLINE (1948 to July 2011) and EMBASE (1947 to 2011) were consulted. Articles were included if they conducted retrospective or prospective analyses on predictors of survival for patients with spinal metastases; articles validating or examining the accuracy of existing prognostic scoring systems were also included.

Results: A total of 29 studies were identified. A consensus of the literature was found with respect to three prognostic parameters: primary cancer site, extent of metastases and general condition or performance score. Further research is recommended to determine the prognostic value of age, neurological deficit, and previous treatment. The Bauer scoring system was found to be the superior prognostic model for heterogeneous populations. The Tokuhashi scoring system performed well for breast and prostate cancer patients, but poorly for renal and lung cancer patients.

Conclusions: No current prognostic scoring method was shown to be robust enough to accommodate all spinal metastases patients. Future studies are encouraged to develop.

Methods for determination of the appropriate prognostic factors and scoring systems for specific patient populations.

MASCC-0012

A longitudinal study of the prevalence and impact of symptoms in children and adolescents with cancer

K. Cheng 1, C.K. Lian2, P. Zhen2, L. Tan2

1Nursing, National University of Singapore, Singapore, Singapore, 2Paediatric Oncology, National University Hospital, Singapore, Singapore

Introduction: The consequences that cancer and its treatment-related symptoms exert have negative effects on many aspects of paediatric patients.

Objectives: To describe the symptoms reported by cancer patients who were between 10 and 18 years of age, and to explore the relationships between symptom scores and quality of life (QoL) scores.

Methods: Twenty-four patients (mean age, 14 ± 2.7 years; 63 %, was boys) diagnosed with hematological malignancy (67 %) and solid tumor (33 %) were enrolled for analysis. Data were collected before commencement of chemotherapy (time 1), at 2 months from time 1 (T2), and at 4 months from time 1 (T3). Measuring instruments included the Memorial Symptom Assessment Scale Pediatric 10–18 (MSAS) and the PedsQL4.

Results: All of the patients reported at least one symptom; with 21 %, 42 % and 37 % of them reported 1–5, 6–10, >10 symptoms, respectively, at baseline. The most common reported symptoms (>50 %) were lack of energy, weight loss, lack of appetite and feeling of sadness, and they decreased to 21 %, 25 %, 38 % and 8 %, respectively, at T3. The MSAS Psychological (PSYCH) (p = 0.08), PHY (p = 0.03), Global Distress Index (GDI) (p = 0.01), and total scores (p = 0.05) decreased over time (T1-T3). Significant strong correlations were noted between MSAS PSYCH, GDI and Total scores, and Emotional (−0.445 to −0.836, p < 0.01), Psychosocial Health (−0.522 to −0.746, p < 0.01) and Total PedsQL scores (−0.463 to −0.645, p < 0.05) at T1 and T2.

Conclusions: Symptoms are prevalent to children and adolescents after diagnosis with cancer but are in a descending pattern over time, and can cause impairments of QoL.

MASCC-0013

Trajectory of psychological morbidity and quality of life for patients receiving adjuvant cancer therapy

K. Cheng 1, N. Chan2, N.K.E. Ang2

1Nursing, National University of Singapore, Singapore, Singapore, 2Oncology, National University Hospital, Singapore, Singapore

Introduction: Cancer diagnosis and cancer therapy can give rise to psychological morbidity.

Objectives: To determine the psychological symptoms and quality of life (QoL) status reported by patients during the first three cycles of adjuvant chemotherapy until 3 months.

Methods: Seventy patients (mean age, 56.3 ± 8.1 years) diagnosed with breast (70 %) and colorectal (30 %) cancers completed the Hospital and Depression Scale (HADS) and the EORTC QLQ-C30 before commencement of chemotherapy (time 1), weekly thereafter during the chemotherapy (cycles 1–3), and at 1.5 (time 2) and 3 months (time 3) from time 1.

Results: At baseline, 7.1 % and 8.6 % of patients were probable cases (score >10) of anxiety and depression respectively, while 5.7 % and 7.1 % were possible cases (score 8–10) of anxiety and depression respectively. The probable cases of anxiety and depression increased to 11.4 % and 15.7 % at cycle 3, separately. The possible cases of anxiety went up to 17.1 % at time 3, while depression increased to 18.6 % at cycle 3. The mean anxiety score was 4.3 at baseline and in an ascending pattern at cycles 1, 3 and time 2 (p < 0.01), while the mean depression score was 3.8 at baseline and in an ascending pattern at cycle 1, times 2 and 3 (p < 0.01). All the subscale and overall QoL scores were in the descending patterns at cycles 1 and 3 (p < 0.01). The social (mean 65.1–73.6) and role functioning (median 64–73.6) spheres were those mostly compromised across time.

Conclusions: Chemotherapy may impact anxiety and depression, and thus patients’ QoL.

MASCC-0014

The effects of home-based symptom management programme to fatigue, sleep disturbance, and mood disturbance in patients with cancer undergoing adjuvant chemotherapy

K. Cheng 1, N.K.E. Ang2, N. Chan2, B. Piper3

1Nursing, National University of Singapore, Singapore, Singapore, 2Oncology, National University Hospital, Singapore, Singapore, 3Nursing, University of Arizona, Arizona, USA

Introduction: Fatigue, sleep disturbance and mood disturbance are the common symptoms reported by patients undergoing chemotherapy.

Objectives: To determine the effects of a home-based symptom management programme on reducing fatigue, sleep disturbance and mood disturbance.

Methods: Fifty-two patients (mean, 56.7; range, 37–76 years) with a diagnosis of breast (n = 32) and colorectal (n = 20) cancers were randomized either to an experimental or a control group. The experimental group received a home-based symptom management program for 20 weeks, and standard care (n = 27). The control group received standard care (n = 25). The memorial symptom assessment scale was completed weekly at baseline (before chemotherapy) and weekly thereafter during the chemotherapy (cycles 1–4).

Results: Fatigue, sleep disturbance and mood disturbance reported at baseline were 27 %, 39 % and 58 % by experimental group, and 20 %, 28 % and 56 % by control group (p > 0.05). Subjects in control group (90 %) reported a higher prevalence of fatigue than the experimental group (63 %) in cycle 4 (p = 0.045). The patterns of median frequency, intensity and distress of these three symptoms were very similar for both groups; peaked on cycle 3 for fatigue while peaked on cycle 1 for sleep disturbance and mood disturbance. There was a trend in experimental group to have lower symptom scores across the four cycles of chemotherapy than the control group, however, the difference was not significant (p = 0.05).

Conclusions: Home-based symptom management programme directed at managing fatigue, sleep disturbance and mood disturbance would be useful in reducing the symptom prevalence and severity. Nevertheless, larger population group is required to confirm our findings.

MASCC-0015

Religious organization supporting palliative care in advanced cancer in Thailand

P. Pokpalagon 1, S. Hanucharurnkul1

1Ramathibodi School of Nursing Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Introduction: The religious organizations in Thailand play an important role in palliative care for helping advanced cancer patients accepted the reality of life and meet the bio-psycho-social-spiritual needs.

Objectives: To describe the structure, process, and outcome of palliative care from a religious organization based.

Methods: This qualitative study was conducted in a religious organization in Northeastern Thailand which focusing on palliative care for cancer patients. Forty-four advanced cancer patients and five key professional carers were interviewed. Participant observation and field note were also recorded.

Results: The religious organization is a non-profit organization, provided 60 beds for cancer patients and families in natural and peaceful environment. The aims of this organization based on Buddhism is to help cancer patients accepted reality of life and enhanced physical, psychosocial, and spiritual comfort. The abbot managed the total care system and took care patients with receiving help from volunteers, patients, and families in the community with the atmosphere of mutual assistance. The organization combined Thai traditional and Western medications, natural herbal, herbal sauna, breathing practice, diet, music, sense of humor, and healing touch to help patients. Family support and spiritual wisdom from the abbot (e.g., naming individual patient, a ritual of chanting with herbal preparation, or patients/families boiling herbal preparation together) was integrated to help cancer patients. The outcomes revealed that the patients can accept the reality of life with peaceful death.

figurea
figureb

Conclusions: Religious organization was found to be helpful to the patients and their families, and should be supported by the healthcare policy makers.

MASCC-0016

Role of supportive care in the management of radiation therapy toxicities in elderly head & neck cancer patients

M.K. Behera 1, A. Sharma1, F. Ansari1, P. Appan2, D.N. Sharma2, P.K. Julka2, G.K. Rath1

1Clinical Oncology, ALL INDIA INSTITUTE OF MEDICAL SCIENCES (AIIMS), New Delhi, India, 2Surgical Oncology, ALL INDIA INSTITUTE OF MEDICAL SCIENCES (AIIMS), New Delhi, India

Introduction: Toxicities of combined-modality treatment of head and neck cancers usually associated with significant morbidity and decreased quality of life. It is necessary to provide patients with adequate supportive measures in order to decrease suffering while maintaining the ability to deliver full treatment.

Objectives: To evaluate the radiation therapy toxicities & role of supportive care and treatment compliance of elderly patients in head and neck squamous cell carcinoma.

Methods: A total of 164 elderly patients were studied. Sixty percent of the patients were subjected to either radical radiation ± chemotherapy or surgery followed by post-op RT, rest 40 % were treated with palliative radiation and/or best supportive care.

Results: Acute toxicities encountered were anemia-gr III-10 %, gr II-40 %, neutropenia-gr II-40 %, gr III-14 %, radiation dermatitis gr III-22 %, gr II-40 %, mucositis—gr III-30 %, gr II-50 %, and dysphagia- gr III-22 % and II-40 %. Gr I-II radiation dermatitis managed with topical emollients, multiagent ointments ± topical steroid ointments. Patients having gr II dysphagia or more and patients with surgery advised for ryle’s tube insertion to maintain oral feeds. Mucositis managed with regular mouth rinse with povidone iodine ± local anaesthetic solution and dispersible paracetamol/diclofenac gargles. Thirty percent of the patients were not able to complete the stipulated treatment.

Conclusions: Even after careful selection of patients in a multidisciplinary clinic more than one third of the elderly HNSCC failed to comply for the stipulated treatment. Best supportive care remains the most important aspect in the management of radiation toxicities.

References: 1.Murphy et al, Clinical Advances in Hematology & Oncology Volume 5, Issue 10 October 2007, 807–22.

MASCC-0017

Effects of androgen deprivation therapy (ADT) for prostate cancer (PC) on muscle strength and physical functioning

H. Jim 1, M. Cases1, M. Rose1, B. Zachariah2, M. Fishman3, P. Jacobsen1

1Dept. of Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, USA, 2Dept. of Radiation Oncology, James A. Haley Veterans Medical Center, Tampa, USA, 3Dept. of Genitourinary Oncology, Moffitt Cancer Center, Tampa, USA

Introduction: Loss of skeletal muscle mass is a known adverse effect of ADT used in treatment of PC.

Objectives: Although ADT-related loss of muscle mass is also likely to result in loss of muscle strength and declines in physical functioning, this possibility has not been systematically evaluated.

Methods: To address this issue, we assessed physical functioning (using the SF-12), upper body muscle strength (using a hand dynamometer), and lower body muscle strength (using the Chair Stand Test) in PC patients undergoing ADT (n = 32; M = 65 years) and PC patients previously treated with surgery but not ADT (n = 64; M = 67 years). Assessments were conducted before the start of ADT and 6 and 12 months later and at corresponding intervals in the non-ADT sample.

Results: Group (ADT, no ADT) × time (baseline, 6 months, 12 months) interactions (p < .05) were found for grip strength (dominant and non-dominant hands), chair rise, and physical functioning. In each instance, there was growing divergence between groups over time, with muscle strength and physical functioning at 12 months worse in the ADT group than in the non-ADT group.

Conclusions: Results confirm that adverse effects of ADT on muscle mass are accompanied by loss of muscle strength. Additionally, they suggest that ADT-related loss of muscle strength results in markedly poorer physical functioning within 12 months of treatment onset. Taken together, findings point to the importance of identifying interventions effective in preventing or reversing loss of muscle strength in this patient population.

MASCC-0018

Safety and efficacy of 5FU bolus in association with cisplatin: a retrospective study about 40 patients

Z. Benbrahim 1, R. Najib1, K. Daoudi1, S. Arifi1, N. Mellas1, O. El Mesbahi1

1Medical Oncology, Hassan II University Hospital, Fez, Morocco

Introduction: Combination of 5-fluorouracil in continuous infusion and cisplatin is an effective regimen for the treatment of a wide range of carcinomas. This chemotherapy often requires a long period of hospitalization and limitation of daily activity of these patients.

Objectives: The aim of this study is to evaluate safety and efficacy of cisplatin associated with 5FU bolus.

Methods: We retrospectively reviewed 40 patients treated with cisplatin and 5FU bolus between January 2009 to April 2012 at Hassan II University Hospital. Toxicities were evaluated according to the NCI-CTC version 3.0.

Results: Median age of patients was: 54.2 ± 10.2 years. 70 % were men. All patients had not receive prior chemotherapy. A total of 128 cycles of chemotherapy were administered. 51 cycles (40 %) of cisplatin-5FU bolus were received for the treatment of gastric cancers, 46 cycles (36 %) for Head and neck cancers, 16 cycles (12.5 %) for biliary tract cancers. Doses of 300 mg/m2 d1-d3 (95 cycles), 300 mg/m2 d1-d5 (17 cycles), 400 mg/m2 d1-d5 (12 cycles) were used. Toxicity was mainly hematological: overall incidence of toxicity grade 3 and 4 per cycle were: anemia 14 %, neutropenia 12 %. Non hematological toxicity was mild to moderate: overall incidence of toxicity grade 1–2 per cycle were: vomiting: 25 %, mucositis: 13 %, diarrhea: 7 %. The median duration of follow-up was 3.4 months (range: 1–9). Overall response rate was 57 %.

Conclusions: Our experience indicated the safety and some efficacy of cisplatin associated with 5FU bolus. Further studies are required to elucidate the clinical role of 5FU bolus in these cancers.

MASCC-0020

Living with the physical and mental consequences of an ostomy; a study among 1–10 year rectal cancer survivors from the population-based profiles registry

F. Mols 1, V. Lemmens2, K. Bosscha3, W. van den Broek4, M.S.Y. Thong1

1Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands, 2Department of Research, Comprehensive Cancer Centre South, Eindhoven, Netherlands, 3Department of Surgery, Jeroen Bosch Hospital, Den Bosch, Netherlands, 4Department of Surgery, Sint Anna Hospital, Geldrop, Netherlands

Introduction: Having an ostomy can have a major impact on the lives of rectal cancer patients.

Objectives: To examine the physical and mental consequences of an ostomy among 1–10 year rectal cancer survivors.

Methods: Rectal cancer patients diagnosed between 2000 and 2009, as registered in the population-based Eindhoven Cancer Registry, received a questionnaire on quality of life (QOL; EORTC QLQ-C30), disease-specific health status (EORTC QLQ-CR38), depression and anxiety (HADS), illness perceptions (B-IPQ), and health care utilization; 76 % (n = 1017) responded.

Results: Four hundred seven (43 %) rectal cancer survivors had an ostomy at time of survey. They reported a statistically significant and clinically relevant lower physical, role and social functioning, and global health status/QOL but fewer symptoms of constipation and diarrhea compared to those without an ostomy. Also they had a statistically significantly but not clinically relevant worse body image, more male sexual and fewer gastrointestinal problems. No differences regarding the prevalence of symptoms of anxiety and depression were found. Those without an ostomy believed that their illness had less serious consequences, will last shorter, they experienced less illness symptoms, and are less concerned about their illness compared to those with a permanent or those who had a temporary ostomy. Only the subscale Consequences showed clinical relevance. Patients with an ostomy visited their medical specialist, but not their general practitioner, significantly more often.

Conclusions: Rectal cancer survivors with an ostomy have a lower QOL, worse illness perceptions and a higher health care consumption compared to those without an ostomy 1–10 years after diagnosis.

MASCC-0021

Making the most out of life: the contribution of attention restorative theory as a non-pharmacological approach to manage cancer fatigue

M. Kirshbaum 1, J. Donbavand1, S. Phillips1, V. Kaye1, B. Purcell1

1Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom

Introduction: This study investigates a unique approach based on Attention Restorative Theory (ART) (Kaplan 2001) to develop a non-pharmacological intervention to help individuals manage the distressing effects of cancer fatigue.

Objectives: To: identify activities and situations identified as being enjoyable by individuals who have moderate to severe fatigue; analyze reported ‘enjoyable experiences’ by mapping emergent themes to core components of attention restoration; develop a self-management intervention tool.

Methods: A purposive sample of 25 individuals who experienced moderate to severe fatigue was selected from the local hospice and community. Focused semi-structured interviews probed the question: What do you enjoying doing? Framework analysis was used to manage responses.

Results: Seventy-five ‘enjoyable experiences’ were identified, including artistic pursuits, voluntary work, socialising and learning. These activities were organised into five conceptual themes: Belonging, Expansion, Nurturing, Purposeful and Fascination. When mapped against attributes of restorative activities specified in ART, there was some congruence and variation. It was clear that the participants expressed a great need to be safe and in a nurturing environment. Some participants placed a high value in and received great joy from contributing to the community; this was not noted in previous ART literature.

Conclusions: A self-management intervention tool was developed and due to be piloted comprising a short interview, an analysis of activities and a co-planning section. The guide is intended to be used to address fatigue through exploring, discovering and promoting experiences which engage interest, excite, nurture and challenge the person.

References: Kaplan, S. (2001) Mediation, Restoration and the Management of Mental Fatigue. Environment and Behavior, 33:480–506.

MASCC-0022

An analysis of the usage of strong opioids in the palliative care unit of a medical center-a three-year review

Y. Lai 1, W. Su1

1Hospice Palliative Care Center, Mackay Memorial Hospital, Taipei city, Taiwan

Introduction: Pain management is integral to palliative care to effectively improve patients’ quality of life.

Objectives: The aim of this study was to collect valuable data on the use of strong opioid analgesics in the management of pain in terminally ill cancer patients receiving palliative care in a Taiwanese medical center. This detailed analysis of drug usage should help in making decisions on opioid treatment in palliative care.

Methods: A retrospectively reviewed was used. Information regarding medications for pain management in the last 2 weeks before death was analyzed.

Results: In the second-last week of life, 97 (64.6 %) patients were prescribed morphine only and 43 (28.7 %) of them received two or more different opioids. In the last week, patients tended to prefer morphine to other opioids. The mean daily morphine dosage was significantly higher in the last week (96.79 mg) than in the second-last week (88.08 mg). Subcutaneous injection (76 %) was the most frequent route of opioid administration. In the second-last week before death, patients had taken a significantly higher dose of opioids to improve the breakthrough pain.

Conclusions: Generally, most intractable cancer pain could be controlled by strong opioids through appropriate dose adjustments and routes. However, breakthrough pain could not be effectively relieved immediately by morphine, the mainly opium-based drug for the sudden severe pain.

Prospectively, we initiate more research effort into breakthrough pain in Taiwan. The development of an appropriate drug with immediate-release effects is on -going. The clinical management quality with regard to BTP can then be improved gradually.

MASCC-0023

Heparin versus normal saline as locking solution in totally implantable venous ports: a randomized controlled trial in cancer patients

G.A. Goossens 1, M. Jérôme1, C. Janssens1, W.E. Peetermans2, S. Fieuws3, P. Moons4, J. Verschakelen5, K. Peerlinck6, M. Jacquemin6, M. Stas7

1Nursing Centre of Excellence, University Hospitals Leuven, Leuven, Belgium, 2Internal Medicine, University Hospitals Leuven, Leuven, Belgium, 3Interuniversity Centre for Biostatistics and Statistical Bioinformatics, KU Leuven, Leuven, Belgium, 4Public Health an Primary Care, KU Leuven, Leuven, Belgium, 5Radiology, University Hospitals Leuven, Leuven, Belgium, 6Center for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium, 7Surgical Oncology, University Hospitals Leuven, Leuven, Belgium

Introduction: Heparin is commonly used as locking solution in implantable venous access ports. However, evidence that normal saline is not inferior to heparin is lacking.

Objectives: We tested the hypothesis that locking ports with normal saline is not inferior to heparin regarding functional problems and catheter-related bacteraemia.

Methods: We conducted an open-label, parallel-group, randomized, non-inferiority trial. Eight hundred and two cancer patients with a newly inserted port were randomised either to lock their port with heparin (300U/3 ml) or with normal saline. Ports, inserted by dedicated surgeons, were accessed by specially trained nurses, according to strict protocols. The number of functional complications was the primary outcome and defined as “easy injection, impossible aspiration” at port access. Secondary outcomes comprised all functional problems and catheter-related bacteraemia.

Results: From January 2009, to December 2010, 404 patients received a normal saline lock and 398 a heparin lock. Of these patients, 382 from the normal saline group and 383 from the heparin lock group were included in the analysis. The incidence rate of “easy injection, impossible aspiration” was 3.70 % (95 % CI 2.91–4.69) of accesses in the normal saline group and 3.92 % (95 % CI 3.09–4.96) in the heparin group with a relative risk of 0.94 (95 % CI 0.67–1.32). Catheter-related bloodstream infection rate per 1,000 catheter days was 0.03 in the normal saline and 0.10 in the heparin group.

Conclusions: A normal saline lock, prior to Huber needle removal, is safe if combined with a strict protocol for port insertion and maintenance.

MASCC-0024

Pruritus in patients treated with targeted cancer therapies: systematic review and meta-analysis

C. Ensslin 1, A. Rosen1, S. Wu2, M. Lacouture1

1Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, USA, 2Division of Medical Oncology Department of Medicine, Stony Brook University, Stony Brook, USA

Introduction: Pruritus is a disabling symptom that has been anecdotally described in patients treated with targeted cancer therapies, and reports on its incidence vary. The overall risk to develop pruritus in these patients has not been systematically ascertained.

Objectives: We conducted a systematic review and meta-analysis of the literature to determine the incidence and risk of developing pruritus among patients treated with targeted therapies.

Methods: Databases from PubMed and Web of Science from January 1998 until July 2012 and abstracts presented at the American Society of Clinical Oncology annual meetings from 2004 to 2012 were searched to identify relevant studies. The incidence and relative risk (RR) of pruritus were calculated using random-effects or fixed-effects model depending on the heterogeneity of included studies

Results: Of 5,065 studies initially identified, a total of 20,532 patients from 144 studies were included for analysis. The summary incidences of all-grade and high-grade pruritus were 17.4 % (95 % confidence interval (CI): 16.0–19.0 %) and 1.4 % (95 % CI: 1.2–1.6 %). From randomized controlled trials, patients treated with targeted therapies had a significantly increased risk of developing all-grade pruritus, with an overall RR of 2.59 (95 % CI: 2.03–3.30, p < 0.001); there was a significant variation among different classes of drugs (P < 0.001)

Conclusions: There is a significant risk of developing pruritus in cancer patients receiving targeted therapies. In order to prevent suboptimal dosing and reductions in quality of life, these patients should be counseled and treated against this disabling event.

References: Balagula Y, Lacouture ME, Cotliar JA. Dermatologic toxicities of targeted anticancer therapies. The journal of supportive oncology 2010;8:149–61.

MASCC-0025

Needs assessment in caregivers of older cancer patients using the German version of the supportive care needs survey for partners and caregivers (SCNS-P&C44)

P. Stolz Baskett 1, J. Roberts2, P. Milligan2

1School of Health Professions, Institute of Nursing, Winterthur, Switzerland, 2King’s College, Florence Nightingale School of Nursing & Midwivery, London, United Kingdom

Introduction: Only few tested needs assessment instruments for informal caregivers are available in other languages than English.

Objectives: To present data on the translation, discriminatory potential, psychometric properties and none-response issues related to the SCNS-P&C44 (German version).

Methods: A consecutive sample of informal caregivers (n = 86; aged 37–85), of older chemotherapy patients were recruited from three ambulatory cancer clinics in north-eastern Switzerland. The SCNS-P&C44 was translated from its original English version into German following common procedures for cultural adaptation of research instruments, i.e. multiple forward translation, translator agreement and piloting. None response was assessed and internal consistency measured using Cronbach’s alpha for the proposed subscales.

Results: Respondents reported up to 41 moderate to high needs, with 24 participants (28 %) reporting no moderate to high needs at all. Cronbach’s alpha for the proposed underlying factors ranged from 0.91 to 0.97, indicating good reliability. Caregivers with depressed mood (p = .001) had significantly more often one or more moderate to high needs with an additional gender difference approaching significance (p = 0.55). Non-response to single items appeared at random apart from the item ‘Fertility problems in patient’, which was missing for six of the cases (7 %).

Conclusions: The German version of the SCNS-P&C44 appears to be a reliable tool to assess informal caregivers of older cancer patients’ needs indicated by high Cronbach’s alpha values. Associations of gender and mood state with need level add evidence to construct validity. Items assessing needs around fertility may be culturally or population specific and warrant further exploration in a larger study.

MASCC-0026

Cardiac side effects of trastuzumab in her 2 positive breast cancer patients – single centere experiences

J. Huszno 1, E. Nowara1

1Clinical and Experimental Oncology Department, Maria Sklodowska Curie Memorial Cancer Centere and Institut of Oncology Gliwice, Gliwice, Poland

Introduction: The expression of steroid receptors and HER2 over expression in breast cancer cells are predictive and prognostic factors. Over expression of HER2 allows to use immunotherapy which most serious side effect is cardiotoxicity.

Objectives: The aim of this study was to present our own experiences concerning well known cardiac risk factors and evaluate the influence of steroid receptor status profile on cardiotoxicity risk in HER2 breast cancer patients.

Methods: The study was performed in 166 breast cancer patients who received immunotherapy in the Clinical and Experimental Oncology Department, between 2006 and 2012.

Results: LVEF reduction >10 % of the baseline fraction was observed in 12 (8 %) patients. Due to persistent cardiotoxicity 10 patients (6 %) had to discontinue therapy prematurely. There was observed the predisposition to cardiac side effects (13 % vs 5 %) in patients with negative steroid receptor status p = 0.08. The decrease of LVEF (12 % vs 0) and cardiac adverse side effects (2 % vs 0) were detected only in ER-/PR- patients but without statistical significance. Discontinuation of therapy because of cardiotoxicity was associated with negative receptor status (33 % vs 7 %) p = 0,019. Irrespective of steroid receptor status, older age of patients (p = 0,009), higher BMI (p = 0,05), low baseline LVEF (p < 0.001), previous anthracycline based chemotherapy (p = 0.01) and radiotherapy to the left side of the chest (p = 0,02) were associated with the occurrence of cardiotoxicity and decrease of LVEF.

Conclusions: Breast cancer type containing Erb-B2 overexpresson (ER-/PR-/HER2+) was associated with predisposition to cardiac side effects. The signification of cardiac risk factors were confirmed.

MASCC-0027

Factors associated with symptoms and infection occurrence among individuals with secondary extremity lymphedema

J. Deng 1, M.R. Fu2, J.M. Armer3, J.N. Cormier4, E. Radina5, S.R.J. Thiadens6, J. Weiss7, C.M. Tuppo8, M.S. Dietrich1, S.H. Ridner1

1School of Nursing, Vanderbilt University, Nashville, USA, 2College of Nursing, New York University, New York, USA, 3Sinclair School of Nursing, University of Missouri, Columbia, USA, 4UT MD Anderson Cancer Center, The University of Texas, Houston, USA, 5Department of Family Studies & Social Work, Miami University, Oxford, USA, 6National Lymphedema Network, National Lymphedema Network, San Francisco, USA, 7CoxHealth Outpatient Rehabilitation, CoxHealth Outpatient Rehabilitation, Springfield, USA, 8Bariatric and Metabolic Weight Loss Center, Stony Brook Medicine, Stony Brook, USA

Introduction: Secondary extremity lymphedema is the most common type of lymphedema in the United States, which largely results from cancer and its treatment. Currently, a limited number of studies have been available to examine risk factors related to symptoms and infections in individuals with extremity lymphedema.

Objectives: The objective of this study was to examine factors associated with symptoms and infections among individuals with secondary extremity lymphedema.

Methods: Data were collected from a web-based survey supported by the National Lymphedema Network (NLN) from March 2006 through January 2010. A total of 1206 participants reported having secondary upper or lower extremity lymphedema. Multivariate and logistic regression analysis was used to examine the factors associated with symptoms and infection among individuals with extremity lymphedema.

Results: Distressing symptoms were more likely reported by individuals with lower income (p = .005), no insurance coverage (p = .030), history of surgery (p = .024), history of infection in the affected extremity (p = .020), no self-care (p = .011), and lower extremity lymphedema (p = .037). Individuals with a history of surgery (p < .001), radiation therapy (p = .043), reporting the symptom of heaviness of the affected extremity (p = .016), and with lower extremity lymphedema (p = .004) had an increased likelihood of episodes of infection.

Conclusions: Select factors of level of income, insurance coverage status, surgery treatment history, self-care status, and anatomical site of lymphedema were associated with symptom burden among individuals with secondary extremity lymphedema. Symptoms and infection were significantly correlated. Longitudinal studies are needed to identify causative risk factors for symptoms and infection in individuals with secondary extremity lymphedema.

MASCC-0028

Usage of low dose oral midazolam during invasive procedures of pediatric hematology patients

F. Belen 1, H. Kocak2, U. Kocak1, M. Isik1, N. Öner1, E.Y. Keskin1, Z. Kaya1, I. Yenicesu1, T. Gürsel1

1Department of Pediatric Hematology, Gazi University, Ankara, Turkey, 2Department of Pediatrics, Gazi University, Ankara, Turkey

Introduction: Children with hematological diseases (especially with leukemias) often undergo painful procedures that add more stress to their underlying illness.

Objectives: The aim of the study was to investigate whether oral midazolam can decrease fear, pain and distress when given together with usual intravenous sedoanalgesia.

Methods: A total of 47 patients 1–18 years of age who were followed at hematology inpatient setting were included at the study. The study group consisted of patients undergoing bone marrow aspiration or lumbar puncture for Acute Leukemia, Immune Thrombocytopenia, Thrombocytosis, Chronic Myleogeneous Leukemia and Aplastic Anemia. Patients were divided into placebo (n = 23) and oral midazolam (n = 24) groups in this double blind randomized study. Midazolam group received 0.1 mg/kg(maximum 10 mg) orally 30 min before the procedure. Both groups were administered 0.5 mg/kg ketamine intravenously before the procedure. Parents and children >7 years reported their fear, distress and pain with visual analogous scale (VAS) and Wong-Baker Fascies Scale. CHEOPS score was filled by the blinded pediatric hematologist performing the procedures.

Results: There was no difference of fear, pain and distress levels of placebo and midazolam groups according to VAS, Wong Baker Fascies and CHEOPS scores(p > 0.05). We found no additional effect in decreasing pain and stress of oral midazolam versus placebo when administered together with intravenous ketamine analgesia. Nausea according to analgesia was found less in the midazolam group (p < 0.05).

Conclusions: Low dose oral midazolam does not have an additional effect in decreasing pain and stress in pediatric hematology patients when administered together with intravenous ketamine analgesia. More studies to evaluate its effect when used without intravenous analgesia is warrented.

MASCC-0029

A prospective longitudinal survey of fatigue self-management behaviors in patients with advanced cancer

R. Chan 1, P. Yates2, A. McCarthy3

1Cancer Care Services, Royal Brisbane and Women’s Hospital, Herston, Australia, 2Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia, 3School of Nursing, Queensland University of Technology, Kelvin Grove, Australia

Introduction: Fatigue is a distressing symptom frequently experienced by patients with advanced cancer. Although there have been advances in managing fatigue with the use of a range of pharmacologic and non-pharmacologic strategies, fatigue is not well-managed in this population.

Objectives: For patients with advanced cancer, the aims of the study were to examine the self-management behaviors associated with fatigue, the perceived effectiveness of these behaviors, and the medical/socio-demographic factors influencing the perceived effectiveness of these behaviors.

Methods: A prospective longitudinal study was undertaken with a 152 patients with metastatic breast, lung, colorectal and prostate cancer experiencing fatigue (>3/10) recruited from oncology outpatients department at a tertiary referral cancer center. Patients were interviewed on three occasions over a two-month period. Self-management behaviors associated with fatigue, medical/socio-demographic characteristics, social support, depression, anxiety, self-efficacy and other symptoms were assessed.

Results: Findings indicate that most of the fatigue severity measures increased slightly over time. On average, participants used nine fatigue self-management behaviors at each time-point. Participants reported that the most effective self-management behaviors were ‘pacing their activities’, ‘planning activities to make the most of energy’, and ‘taking short sleeps’. General Estimating Equations were used to examine the factors associated with the increased perceived effectiveness of fatigue self-management behaviors over time. These were higher self-efficacy, higher education level, lower levels of depressive symptoms, and lower functional status.

Conclusions: Interventions which assist individuals to use selected fatigue self-management behaviors have the potential to alleviate fatigue. Further investigation of these behaviors and the factors influencing their uptake is required.

MASCC-0030

An overview of level I evidence for the management of radiation dermatitis literature

R. Chan 1, E. Larsen1, P. Chan1

1Cancer Care Services, Royal Brisbane and Women’s Hospital, Herston, Australia

Introduction: Despite the technologic advances, radiation dermatitis is still a prevalent and distressing symptom in patients with cancer undergoing radiotherapy. Systematic reviews (SRs) are regarded as level I evidence providing direction for clinical practice and guidelines.

Objectives: This overview aims to provide a critical appraisal of SRs published on interventions for the prevention/management of radiation dermatitis.

Methods: We searched the following electronic databases: MEDLINE, CINAHL, EMBASE, and the Cochrane Library (up to Feb 2012). We also hand-searched reference lists of potentially eligible articles and a number of key journals in the area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using the “A Measurement Tool to Assess Systematic Reviews” (AMSTAR).

Results: Of 1,837 potential titles, six SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/non-steroidal topical agents, systematic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews may create biases to the overall results or recommendations for clinical practice.

Conclusions: An up-to-date high quality SR in preventing/managing radiation dermatitis is needed to guide practice and direction for future research. Clinicians or guideline developers are recommended to critically evaluate the information of SRs in their decision making.

MASCC-0031

Conflict management styles among oncology nurses

O. Aslan 1, M. Akyol2

1Department of Fundamentals of Nursing, Gülhane Military Medical Academy, Ankara, Turkey, 2Department of Biostatistics, Yildirim Beyazit University, Ankara, Turkey

Introduction: Suitable conflict management in the oncology setting contributes to lead the effective decision making process during cancer care.

Objectives: The aim of this research was to determine the conflict management styles of oncology nurses with their peers.

Methods: It was planned as a descriptive study. Ninety-nine oncology nurses working at an oncology research and education hospital in Ankara were included in the study in June-July 2009. Rahim Organizational Conflict Inventory-II C (ROCI-II) and a demographic data form were used to collect data. Data were analyzed in SPSS 15.00 program.

Results: The highest mean subscale score in ROCI-II was 29.13 ± 2.90(Integrating). The lowest mean subscale score was 16.88 ± 1.67(Compromising). Mean “Integrating” and “Obliging” subscale scores of nurses in high school level were significantly higher than those of nurses with associate degree and bachelor’s degree(Z = 2.717, P = 0.007). Mean “Dominating” and “Avoiding” subscale scores didn’t differ with demographic characteristics of nurses(P > 0.05). Mean “Comprimising” subscale scores differed with duration in oncology significantly(X 2 = 8.421, P = 0.016).

Conclusions: This research revealed that mostly used conflict management style of oncology nurses was “Integrating.” Some sociodemographic factors affected conflict management styles of nurses. Educational activities may be benefical for nurses on conflict management styles according to various conditions. Because using suitable conflict management styles will provide oncology nurses with peaceful working environments during high quality supportive cancer care process.

References:

1.Vivar CG. Putting conflict management into practice: a nursing case study. J Nurs Manage 2006; Apr; 14(3):201–206.

2.Walczak MB, Absolon PL. Essentials for Effective Communication in Oncology Nursing: Assertiveness, Conflict Management, Resolution, Delegation and Motivation. J Nurses Staff Dev 2001; Mar-Apr;17(2):67–70.

MASCC-0032

Patient and clinical determinants predict treatment outcomes of health-related quality of life, pain and symptoms in colorectal cancer: a follow-up study

S.L. Tsay 1, H.C. Hung2

1School of Nursing, National Taipei University of Nursing & Health Sciences, Taipei, Taiwan, 2School of Nursing, Hung Kuang University, Taichung, Taiwan

Introduction: None

Objectives: The aim of the current study was to evaluate the changes in outcomes of health-related quality of life (HRQoL), pain and symptoms and its relationship to the demographic and clinical characteristics from diagnosis, 1 month, 3 months, and 6 months after the initial diagnosis in patients with colorectal cancer using a repeated measures framework.

Methods: A cohort study was performed in 134 colorectal cancer patients in Central Taiwan. HRQoL, pain, and symptoms were assessed at 4 points. The Functional Assessment of Cancer Therapy-colon (FACT-C) questionnaire, VAS pain, and the Memorial Symptom Assessment Scale (MSAS) were used for data collection. A generalized estimating equation (GEE) was applied for statistical analysis.

Results: The majority of the patients were male (55 %) and married (91.5 %). The mean of age was 60.39 years (SD = 11.71). 55 % of patients were diagnosed at the third and fourth stage of colorectal cancer (54.5 %). The results of GEE showed that patients’ HRQoL, pain, and symptoms significantly improved over time. Female, had comorbidity, and stage IV patients had higher pain scores overtime. Female and stage IV patients had worse physical symptoms, stage IV and II patients had worse psychological symptoms overtime. Patients with stage IV who received surgery and CCRT had the worst health-related quality of life overtime.

Conclusions: Patients’ demographic and clinical characteristics affect treatment outcomes of pain, symptoms, and health-related quality of life overtime.

MASCC-0033

High-level laser therapy in the treatment of chemotherapy-induced oral mucositis in paediatric patients

G. Ottaviani 1, M. Gobbo1, M. Chermetz1, S. Zacchigna1, R.F. Schumacher2, G. Conti3, M. Biasotto1, A. Majorana4

1Oral Medicine, University of Trieste, Trieste, Italy, 2Pediatrics, University of Brescia, Brescia, Italy, 3Oral Surgery, University of Milan, Brescia, Italy, 4Oral Medicine, University of Brescia, Brescia, Italy

Introduction: Oral mucositis is one of the most debilitating side effects of chemotherapy.

Laser Therapy has recently proven successful in the management of such affection, through a safe, non-invasive and free-of-side-effect procedure.

Objectives: To verify the success of High-Level Laser Therapy in the management of oral mucositis in children.

Methods: Eighteen paediatric oncologic patients receiving chemotherapy and/or hematopoietic stem-cell transplantation affected by oral mucositis were enrolled. Assessment of oral mucositis was performed through Common Toxicity Criteria objective scale, and through VAS. Patients were asked to fill in a validated questionnaire and photos of lesions were taken in each session.

Patients were treated through HLL Therapy through 4-minute applications twice a day over a period of 4 consecutive days. A follow up recall was performed 7 days after the last laser application.

Results: All patients referred an improvement in pain, and an objective amelioration of lesions was registered since Day 4 up to a complete regression of oral mucositis on Day 11, with no apparent side effects.

Conclusions: HLL therapy was well tolerated and may be effective in the treatment of chemotherapy-induced oral mucositis in pediatric patients, accelerating wound healing and reducing symptoms.

Being non-invasive, easy to use and free of side effects, we feel confident to affirm that HLL Therapy may become a standard protocol in the treatment of chemotherapy-induced oral mucositis in paediatric patients.

References: Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Migliorati C,et al; Mucositis Study Group of the MASCC/ISOO. Support Care Cancer. 2013 Jan;21(1):333–41.

MASCC-0034

The nature of hope and why it cannot be false

S. Wein 1

1Pain and Palliative Care Service, Institute of Oncology Davidoff Center, Petach-Tikva, Israel

Introduction: Hope is a two-edged sword. It makes one feel good and provides a stimulus to reach a goal. At the same time however, it can trap one into pursuing futile dreams.

Objectives: The Ancient Greeks thought that hope was evil and expressed this in the myth of Pandora. Later, Judeo-Christian doctrine categorized hope as good.

Methods: Hope is a hard-wired psychological process guided by beliefs, culture, and character. Medical-nursing decisions in cancer care, such as further chemotherapy, truth-telling and resuscitation are partly determined by hope.

Results: Hope has three essential characteristics: it exists only in the future; it helps to create goals, and it invariably generates good feelings for the subject. Hope is a subjective commitment to the uncertain future. Hence a 5 % chance of response to chemotherapy may be hope-generating to some, but appear ‘false’ and futile to others. Some people hope for miracles, and for them this is realistic. Thus the concept ‘false hope’ is an oxymoron since by definition hope is subjectively true.

The ‘good feeling’ associated with hoping is inherent to the process of hoping and is not part of the content of the hope. The emotional and spiritual aspects of hope commonly cited in the literature, are epiphenomena, not integral to hope itself.

Conclusions: Hope can only be considered ‘false’ if staff or family provide false information to the patient. Since hope intrinsically makes us feel good and helps create goals, people can be manipulated with hope-generating scenarios. Hope as a medicant must be used cautiously.

MASCC-0035

Minimal clinically important differences in the Edmonton symptom assessment system in patients with advanced cancer

G. Bedard 1, L. Zeng1, L. Zhang1, N. Lauzon1, L. Holden1, M. Tsao1, C. Danjoux1, E. Barnes1, A. Sahgal1, M. Poon1, E. Chow1

1Radiation Oncology, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada

Introduction: Longitudinal symptom monitoring is important in the advanced cancer patient setting. Scores over time may naturally fluctuate, though a patient may feel the same

Objectives: The purpose of this study was to determine the minimal levels of change required to be clinically relevant (the minimal clinically important difference; MCID) using the Edmonton Symptom Assessment System (ESAS)

Methods: Patients completed the ESAS prior to palliative radiotherapy and at follow-up. MCIDs were calculated using both anchor and distribution-based Methods for improvement and deterioration. Ninety-five percent confidence intervals (CI) for the differences in mean change scores between adjacent categories (i.e. ‘improved’ versus ‘no change’ and ‘no change’ versus ‘deteriorated’) were calculated.

Results: A total of 276 patients completed the ESAS at baseline and during at least one follow-up visit. MCIDs were seen at the 4 week follow-up: decreases of 1.2 units and 1.1 units in pain and depression scales, respectively, constituted clinically relevant improvement. Deterioration in the pain, tiredness, depression, anxiety, and appetite loss symptom scales showed meaningful change if increases of at least 1.4, 1.8, 1.1, 1.1 and 1.4 units were observed, respectively. Eight and twelve week follow-ups values were similar. The distribution-based method produced results that tended to be closest to the 0.5 SD estimates.

Conclusions: MCIDs can help to determine whether treatment is successful in maintaining and improving patient quality of life, and may be useful in determining whether changes in pain and other symptoms are clinically relevant. Future studies should confirm our findings with a variety of anchors.

MASCC-0036

Minimal important differences in the EORTC QLQ-C30 to determine meaningful change for patients with advanced cancer

G. Bedard 1, L. Zeng1, L. Zhang1, N. Lauzon1, L. Holden1, M. Tsao1, C. Danjoux1, E. Barnes1, A. Sahgal1, M. Poon1, E. Chow1

1Radiation Oncology, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada

Introduction: Quality of life (QOL) is an important consideration for patients with advanced cancer. The EORTC QLQ-C30 is a general QOL tool used in the cancer population. Often, with a large enough sample, statistical significance can be reached, however the clinical significance is often unknown.

Objectives: The purpose of this study was to determine the magnitude of change that is meaningful to patients in the EORTC QLQ-C30 for advanced cancer patients.

Methods: Patients completed the EORTC QLQ-C30 at baseline and 1 month later. Minimal important differences (MID) were calculated through anchor and distribution based Methods for improvement and deterioration. The two anchors of overall health and overall QOL were used to determine meaningful change.

Results: All functional scales and some symptom scales correlated at least moderately (r > 0.30) with both anchors. The overall health anchor produced a greater number of scales and symptoms that reached statistically significant meaningful change. Meaningful change for improvement with these two anchors ranged from 9.1 units (cognitive functioning) to 23.5 units (pain), and for deterioration ranged from 7.2 units (physical functioning) to 13.5 units (role functioning).

Conclusions: Knowledge of meaningful change on the EORTC QLQ-C30 allows physicians to assess patient change over time, along with evaluating the impact of treatment (or no treatment) on a patient’s quality of life. This knowledge gives insight into whether or not the treatment is effective and ultimately if it should be continued. Knowledge of MIDs may assist in sample size determination and interpretation for future trials.

MASCC-0037

Minimal important differences in the EORTC QLQ-C15-Pal to determine meaningful change in palliative advanced cancer patients

G. Bedard 1, L. Zeng1, L. Zhang1, N. Lauzon1, L. Holden1, M. Tsao1, C. Danjoux1, E. Barnes1, A. Sahgal1, M. Poon1, K. Hicks1, E. Chow1

1Radiation Oncology, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada

Introduction: Quality of life (QOL) is an important consideration for advanced cancer patients. Brief questionnaires are advantageous to reduce patient burden. In large clinical trials, statistical significance of small changes can be achieved; however whether such change is clinically relevant is unknown.

Objectives: The purpose of this study was to determine the minimal important differences (MID) of the EORTC QLQ-C15-Pal.

Methods: Patients undergoing palliative radiotherapy completed the EORTC QLQ-C15-Pal at baseline and 1 month later. Anchor and distribution-based assessments were employed to determine the MID associated with this instrument. The anchor of overall QOL (question 15) was used to determine meaningful change.

Results: Two hundred seventy-six patients were included in the calculation of MID. Mean age was 65 years and the majority of patients had primary lung, breast or prostate cancers. Statistically significant MID for improvement was seen in emotional functioning and pain (20.9 and 15.6 respectively). MID for deterioration required a change 20.4, 24.5, 17.1 and 23.0 in physical functioning, fatigue, pain, and appetite loss, respectively to constitute meaningful change. Distribution-based estimates of MID were closest to the SEM. MID for brain and bone metastases patients yielded MIDs larger than previously determined in the incorporation of all patients.

Conclusions: Meaningful change of the EORTC QLQ-C15-Pal is important for clinicians to determine the impact of treatment on QOL of patients and can also aid in determination of the sample size required for clinical trials. Future studies should investigate MID in subpopulations using symptom specific modules.

MASCC-0038

Supportive care during adjuvant interferon (IFN) alpha treatment in patients (PTS) with high-risk melanoma

A. Dimitrovska 1, S. Crvenkova1, L. Kostadinova2

1Sarcoma, Institute of Radiotherapy and Oncology, Skopje, Macedonia

2Melanoma, Institute of Radiotherapy and Oncology, Skopje, Macedonia

Introduction: The treatment with IFN is associated with side-effects and poor tolerance by pts.

Objectives: To determine IFN-induced toxicity in the adjuvant treatment of high-risk for recurrence melanoma pts.

Methods: Histories of 182 stage IIb-c and III melanoma pts were reviewed. One hundred twelve pts received intermediate dose IFN (IDI) after excisional biopsy: 9 MU/day/5 days per week for 4 weeks, followed by 48 weeks of the same dose, 3 times a week, s.c., and 70 pts received high-dose IFN (HDI): 20 MU/m2/5 days per week for 4 weeks followed by 10 MU/m2 s.c., 3 times a week, for 48 weeks maintenance therapy.

Results: The adverse effects were more prominent in the HDI group. Flu-like syndrome was the most common in the induction phase (72 % in the IDI and 82 % in the HDI group), while fatigue (53 % vs 68 %), weight loss (20 % vs 36 %), nausea (2 % vs 17 %)-in the maintenance phase. Of neuropsychiatric symptoms the most frequent were depression with apathy (18 %), insomnia (11 %), irritability (6 %). Pts were receiving concomitant supportive therapy: paracetampl before administration of IFN, increased fluid intake, antidepressants if necessary, antiemetics and were advised for proper nutrition. While hematological toxicity could be successfully managed by colono-stimulating factors and platelet transfusions, liver abnormalities seen in 57 % in the HDI group were the main reason for treatment discontinuation (31 %).

Conclusions: Successful management of adverse events of IFN alpha is very important in the adjuvant therapy of melanoma pts. Proper supportive care can ensure more pts to complete the planned therapy.

MASCC-0039

The effectiveness of a brief telephone based intervention to reduce fatigue in prostate cancer: a feasibility study

B. Langston 1, J. Armes1, L. Elliott2, J. James2, E. Ream1

1Florence Nightingale School of Nursing & Midwifery, King’s College London, London, United Kingdom, 2Services, Prostate Cancer UK, London, United Kingdom

Introduction: Cancer-related fatigue is a significant clinical symptom commonly experienced by men during and following treatment for prostate cancer. It is distressing, interferes with functioning, and is often under-acknowledged by healthcare professionals.

Objectives: To evaluate the effectiveness of a brief telephone-based intervention for fatigue delivered by Specialist Nurses at Prostate Cancer UK.

Methods: A randomised control trial design was adopted. Men experiencing fatigue during or following treatment for prostate cancer were eligible to participate and were randomly allocated between waiting list control group receiving usual care or the intervention. The intervention comprised psychological support, self-care education and goal setting for behaviour change. It was delivered using motivational interviewing via 4 telephone calls over 10 weeks. Outcomes were assessed at baseline and at trial completion using the BFI, FDS, HADS, NRS (fatigue management) and EORTC-QLQ-C30. Analysis consisted of Mann–Whitney Tests for between group comparisons.

Results: Seventy-six men were recruited. Fatigue in study groups was equivalent at baseline. Post-trial between group analysis showed the intervention group reported improved global fatigue (p = .005), fatigue severity (p = .001), fatigue management (coping with fatigue in daily life) (p = .031), social functioning (p = .028) and fatigue symptoms (p = .018).

Conclusions: The findings show the effectiveness of brief a telephone intervention at improving fatigue, fatigue management and social functioning. This represents a sustainable model of intervention delivery which is acceptable to men with prostate cancer and is effective in producing positive outcomes.

References: E Ream, A Richardson, C exander-Dann (2006) ‘Supportive intervention for fatigue in patients undergoing chemotherapy: A randomized controlled trial’ Journal of Pain and Symptom Management, 31 (2), pp. 148–161.

MASCC-0040

A polyphenol rich whole food supplement reduces PSA progression in men with prostate cancer in a double blind placebo controlled RCTthe UK national Pomi-T study

R. Thomas 1, M. Williams2, P. Bellamy3

1Oncology, Bedford and Addenbrooke’s Cambridge University Hospital trusts, Bedford, United Kingdom, 2Oncology and Lifestyle Research Unit, Bedford Hospital trusts, Bedford, United Kingdom, 3Statistics, Cranfield University, Bedford, United Kingdom

Introduction: Polyphenol rich foods, particularly pomegranate, green tea, broccoli and turmeric have demonstrated anti-neoplastic effects in laboratory models. Although, some have been investigated in small phase II studies this combination had never been evaluated within an adequately powered nationally certified RCT.

Objectives: Does a 2/day oral capsule containing a specific blend of pomegranate seed, green tea, broccoli and turmeric (Pomi-T) alter the rate of PSA progression compared to placebo?

Methods: Two hundred three men, average age 74 years, had localised prostate cancer, 59 % managed with active surveillance and 41 % with watchful waiting (progressive PSA relapse following previous radical interventions) received Pomi-T or placebo for 6 months.

Results: The median rise in PSA in the supplement group (SG) was 14.7 % (95 % CI 3.4–36.7 %) versus 78.5 % in the placebo group (PG) (95 % CI 48.1–115.5 %) (63.8 % difference, analysis of covariance, p = 0.0008). 46 % of men had stable or lower PSA at trial completion in the SG versus 14 % in the PG (32 % difference, chi2, p = 0.00001). 24 % men recorded events in the SG and 34 % in the PG (non significant). Mild gastro-intestinal effects were (17 %) in the SG but 8 % of these reported an improvement in stool quality.

Conclusions: This specific well tolerated food supplement (Pomi-T) statistically slowed PSA progression in these men managed with observation compared to placebo. Many men would see this as useful addition to their self help strategies. Future trials are planned addressing the longer term clinical benefits and its combination with hormone therapies.

MASCC-0041

Trends in the aggressiveness of end-of-life care for advanced stomach cancer patients

J. Hong 1, Y.S. Hong1, S.Y. Rho1

1Division of Medical Oncology Department of Internal Medicine, College of Medicine The Catholic University of Korea, Seoul, Korea

Introduction: It is important to balance the appropriateness of active cancer treatments and end-of-life care to improve the quality of life for terminally ill cancer patients.

Objectives: This study was performed to describe the treatment pattern and end-of-life care in terminal gastric cancer patients.

Methods: We retrospectively analyzed the records of 137 patients with advanced gastric cancer receiving chemotherapy and dying between June 1, 2006 and May 31, 2011. We recorded: 1) interval between last chemotherapy dose and death; 2) frequency of emergency room visits or admission to the intensive care unit in the last month before death; 3) rate of hospice referral and agreement with written do-not-resuscitate orders; and 4) change in laboratory values in the last 3 months before death.

Results: During the last 6 months of life, 130 (94.9 %) patients received palliative chemotherapy; 86 (62.7 %) during the final 2 months; 41 (29.9 %) during the final month. During the final month, 53 (38.7 %) patients visited an ER more than once; 21 (15.3 %) were admitted to the ICU. Hospice referral occurred in 54 % (74) of the patients; 93.4 % (128 patients) gave written do-not-resuscitate orders. Platelets, aspartate aminotransferase and creatinine changed significantly 2 weeks before death; total bilirubin, 1 month before; and C-reactive protein, between 1 month and 2 weeks before death.

Conclusions: Significant proportions of gastric cancer patients still received palliative chemotherapy to the end of life. Large prospective studies are needed to validate these results and provide guidelines for discontinuing chemotherapy in terminal gastric cancer patients.

MASCC-0042

Grape seed procyanidin fractions enhance the impact of 5-fluorouracil chemotherapy on colon cancer cells

K.Y. Cheah 1, G.S. Howarth2, K.A. Bindon3, J.A. Kennedy4, S.E.P. Bastian1

1School of Agriculture Food and Wine, The University of Adelaide, Adelaide, Australia, 2School of Animal and Veterinary Sciences, The University of Adelaide, Adelaide, Australia, 3The Australian Wine Research Institute, The Australian Wine Research Institute, Adelaide, Australia, 4Department of Viticulture and Enology, California State University, Fresno, USA

Introduction: Grape seed procyanidins (PCs) have been reported to reduce intestinal injury in rat models of intestinal mucositis and ulcerative colitis.

Objectives: We investigated the effects of purified PC fractions differing in mean degree of polymerization (mDP) combined with 5-Fluorouracil (5-FU) chemotherapy, on the viability of Caco-2 colon cancer cells

Methods: Six PC fractions were isolated from Cabernet Sauvignon seeds at two ripeness stages: pre-veraison unripe (immature) and ripe (mature). Fractions were characterized by phloroglucinolysis and gel permeation chromatography (GPC). Fractions were tested on Caco-2 cells, alone and in combination with 5-FU. Cell viability was determined by 3-(4,5-Dimethylthiazol-2yl)-2,5-diphenyl-tetrazolium bromide) (MTT) assay. p < 0.05 was considered significant

Results: All isolated fractions significantly reduced Caco-2 cell viability compared to control (p < 0.05), but F2 and F3 were the most active fractions (immature F2 = 32 %, F3 = 35 % and mature F2 = 13 % and F3 = 17 %; percentage of viable cells remaining) on Caco-2 cells. When combined with 5-FU, immature seed fractions F1-F3 and mature seed fractions F1-F4 enhanced the growth-inhibitory effects of 5-FU by 27–73 % and 60–83 % (p < 0.05; compared to 5-FU control), respectively. Moreover, some fractions alone were more potent at decreasing viability of Caco-2 cells (p < 0.05; immature = 65–68 %; mature = 83–87 %) compared to 5-FU alone (37 %)

Conclusions: PCs of mDP 2–6 (immature F1-F3 and mature F1 and F4) exhibited synergistic effects on viability of Caco-2 cells when tested in combination with 5-FU. Concomitant use of grape seed PCs and 5-FU chemotherapy could represent a promising new approach for colon cancer chemoprevention.

MASCC-0043

Emu oil expedites small intestinal repair following 5-fluorouracil-induced mucositis in rats

S.M. Abimosleh 1, C.D. Tran1, G.S. Howarth2

1Women’s and Children’s Hospital North Adelaide, Department of Gastroenterology, Adelaide, Australia, 2School of Animal and Veterinary Sciences, The University of Adelaide, Adelaide, Australia

Introduction: Mucositis resulting from cancer chemotherapy is characterized by intestinal inflammation and ulceration. Previously, Emu Oil (EO) improved intestinal architecture in a rat model of chemotherapy-induced mucositis.

Objectives: We investigated EO for its further potential to promote intestinal repair in this mucositis model.

Methods: Female Dark Agouti rats (n = 8/group) were gavaged with water, Olive Oil (OO) or EO once daily (1 ml), injected with 5-Fluorouracil (5-FU) or saline, on day 5 and euthanized on day 8, 9, 10 or 11. Intestinal villus height (VH) and crypt depth (CD), neutral mucin-secreting goblet cell [GC] count, myeloperoxidase (MPO) activity and selected cytokines were quantified. p < 0.05 was considered significant.

Results: In 5-FU-injected rats, only EO administration increased VH in the ileum (day 8), jejunum and JI (days 8 and 9) compared to 5-FU controls (p < 0.05). GC count was reduced by 5-FU (jejunum: days 8 and 9; ileum: day 8; p < 0.05) and EO increased ileal GC on days 10 and 11 compared to 5-FU controls. MPO activity was increased in jejunum (days 8 and 9) and ileum (day 8) following 5-FU injection, compared to normal controls (p < 0.05). Both EO and OO reduced jejunal MPO on days 8 and 9, however, only EO decreased ileal MPO on day 8. Cytokine levels were not significantly affected by either oil or 5-FU administration at the day 8 time point.

Conclusions: Promotion of repair from injury could represent a new mechanism of action for Emu Oil, suggesting potential as an adjunct to conventional treatment approaches for cancer management.

MASCC-0044

Comparative effects of mistletoe extracts and 5-fluorouracil chemotherapy on viability of Caco-2 and IEC-6 intestinal epithelial cells

Z. Lotfollahi 1, G.S. Howarth2, L. Simson3, K.Y. Cheah4, S.E.P. Bastian4

1School of Medical Sciences, The University of Adelaide, Adelaide, Australia, 2School of Animal and Veterinary Sciences, The University of Adelaide, Adelaide, Australia, 3Faculty of Applied Sciences, University of Canberra, Canberra, Australia, 4School of Agriculture Food and Wine, The University of Adelaide, Adelaide, Australia

Introduction: Mistletoe Extract (ME) (Viscum album) is predominantly composed of lectins and viscotoxins with purported claims of toxicity to tumour cells. 5-Fluorouracil (5-FU) chemotherapy for cancer treatment is often accompanied by severe intestinal injury (mucositis).

Objectives: MEs from different host trees (Quercus: Oak, Fraxini: Ash and Mali: Apple) in the presence or absence of 5-FU chemotherapy, were examined for their effects on viability of colon cancer and normal intestinal cells in vitro.

Methods: MTT assay was used to determine Caco-2 (colonic cancer) and IEC-6 (non-transformed) cell viability after 48 h incubation with MEs (1–100 μg/mL) or MEs (1–100 μg/mL) combined with 5-FU (100 μM for Caco-2 and 5 μM for IEC-6). Statistical significance was assumed at p < 0.05.

Results: Fraxini; with highest levels of lectin and viscotoxin, was the most potent ME followed by Quercus and Mali with IC50 values of 42.7, 65.5 and 84.4 μg/mL, respectively, on Caco-2 cells. Fraxini (50 μg/mL) when combined with 5-FU (5 μM), significantly increased the toxicity of 5-FU on IEC-6 cells compared to Fraxini (50 μg/mL) alone (p < 0.05). None of the MEs, when combined with 5-FU, significantly increased 5-FU toxicity on Caco-2 cells compared to ME alone. Quercus and Mali did not alter the degree of 5-FU toxicity on IEC-6 cells, compared to the same concentrations of Quercus and Fraxini alone.

Conclusions: Future studies could investigate ME effects in vivo models of colon cancer to determine whether ME (particularly Quercus) inhibits the development of colonic neoplasia without exacerbating the undesirable impact of 5-FU on the normal healthy intestine.

MASCC-0045

In-depth bioinformatic analysis of lung cancer-related microRNA targets

D. Li 1, H. Yang1, R. Zhang1, H. Zhang1, L. Zhu2

1School of Life Sciences, Nanjing University, Nanjing, China, 2Institute of Discovery Biology, Jiangsu Simcere Pharmaceutical R&D Co. Ltd, Nanjing, China

Introduction: Lung cancer (LC) is the leading cause of cancer deaths worldwide, yet few studies of its specific mechanisms useful for diagnosis or treatment exist. MicroRNAs (miRNAs) present one mechanism by which genes with diverse functions on multiple pathways can be simultaneously regulated on the post-transcriptional level, and they are closely integrated with lung cancer [1,2].

Objectives: Lung cancer related pathways through which lung cancer associated miRNAs (LC-miRNAs) regulate these processes were investigated.

Methods: Gene targets of miRNAs were predicted using TargetScan. The web-based functional annotation tool DAVID was applied for disease analysis, gene ontology analysis and pathway analysis. The signaling pathways and processes were explored using the systems biology tool KEGG Mapper.

Results: The results showed that LC-miRNAs might function in the post-transcriptional level mainly through manipulating the expression of transcription factors and protein kinases, and target genes for the LC-miRNAs were most prominently predicted to function in regulation of transcription. Our analysis also highlighted the potential of these LC-miRNAs to regulate the cell differentiation, proliferation, endocytosis and migration signaling logically required to cause a lung cancer cell mainly through five canonical pathways (PI3K-Akt signaling pathway, Pathways in cancer, MAPK signaling pathway, HTLV-I infection, Focal adhesion).

Conclusions: This study may improve the understanding the regulatory role of miRNAs in lung cancer. These findings should form a useful knowledge base for potential future development of novel therapeutic treatments.

References:

1.International Journal Oncology. 2012, 41(6):2213–26.

2.International Journal Oncology. 2012, 40(6):1763–9.

MASCC-0046

Jordanian nurses’ views on adequacy of cancer pain management: a qualitative study

M. Al Qadire 1

1Faculty of Nursing, Al Albyat University, Mafraq, Jordan

Introduction: Cancer patients currently live longer than previously because of earlier diagnosis and developments in treatment medications and techniques. Although guidelines and pharmacological interventions exist to manage cancer pain, poor assessment and under-medication is well-documented. Cancer pain is a cultural-sensitive phenomenon and many barriers may hinder patients from receiving adequate pain management. No previous study explored barriers to optimal cancer pain management within the Islamic-Arabic culture communities such as Jordan.

Objectives: This study aims to exploring nurses’ views on the factors contributing to the inadequacy of pain management in Jordan.

Methods: Qualitative research method and semi-structured interviews were used to interview 20 oncology nurses who working in two referral hospitals in Jordan

Results: Nurses’ mean age was 29 years (SD 1.9) and 12 were males. They had on average 4.8 (SD 2.0) years of working experience. Thematic analysis of nurses’ interviews identified many factors that may result in ineffective cancer pain management, including the following: belief in God’s Will, doctor verses nurse tension, institutional characteristics (e.g. difficult access to pain medication, low priority to cancer pain management, absence of pain policy, healthcare providers characteristics (e.g. negative attitudes toward cancer pain, lack of knowledge and training), fear of addiction and misconceptions complex, and devaluing patients pain report.

Conclusions: Barriers to cancer pain management and misconceptions were abundant. These barriers, in general, were similar to barriers within the other cultures with some of them are related to country culture. Education, training, more financial resources, and public awareness might be possible interventions to reduce patients suffering.

MASCC-0047

Efficacy and safety of a two drug-combination regimen for cancer-related cachexia in the clinical practice

G. Mantovani 1, C. Madeddu1, L. Orgiano1, G. Antoni1, R. Serpe1, I. Omoto2, M.C. Cau1, A. Maccio’1

1Department of Internal Medical Sciences Medical Oncology, University of Cagliari, Cagliari, Italy, 2Department of Surgery, Tanoue Hospital, Kagoshima, Japan

Introduction: To test the safety and efficacy of a combination treatment (including nutraceuticals) with carnitine + celecoxib for cancer-related anorexia/cachexia syndrome (CACS) in the clinical practice.

Objectives: Primary: safety, increase of lean body mass (LBM) and improvement of quality of life.CACS) in the clinical practice. Secondary: increase of physical performance (grip strength and 6-min walk test, 6MWT) and decrease of inflammation (serum levels of IL-6 and Glasgow prognostic score, GPS)

Methods: Outpatients with CACS (i.e. loss of body weight >5 % of the pre-illness or ideal weight in the previous 3 months) were eligible. Treatment: L-carnitine 4 g/day + Celecoxib 300 mg/day. Basic treatment polyphenols 300 mg/day, lipoic acid 300 mg/day, carbocysteine 2.7 g/day, Vitamin E, A, C, all orally. Treatment duration 4 months.

Results: From 06/2011 to 04/2012, 75 patients all stage IV were enrolled: 40 completed the treatment and were evaluable (mean age 65 ± 9.6, range 32–82 years)

Results showed a significant increase of LBM (dual-energy X-ray absorptiometry and L3 computed tomography) from baseline as well as physical performance by 6MWT. Quality of life (EORTC-QLQ-C30) as well as fatigue (MFSI-SF) also improved significantly. ECOG PS and GPS decreased significantly. The treatment was safe, no grade 3–4 toxicities occurred and no patient had to discontinue the treatment due to severe adverse events.

Conclusions: Results of the present study confirm the efficacy and safety of the two-drug combination regimen1. Therefore, this simple, feasible, effective, safe, with favorable cost-benefit profile, two-drug approach could be suggested in the clinical practice as a treatment for CACS.

References: 1. Madeddu et al, Clinical Nutrition 31:176–182,2012

MASCC-0048

Are there benefits of palliative care services at home than hospice for critically ill HIV/aids patients?

K. stella1, R. Stella 2

1Palliative section-nursing, Meru palliative care unit, Meru, Kenya, 2School of Nursing, Kenya Medical Training College, Nairobi, Kenya

Introduction: Home palliative care service is becoming the choice of many patients with life limiting illness in Kenya especially in rural areas where clinics/hospitals are far away.

The care under the relative is more preferred by patients but lack professional palliative care to manage symptoms like pain.

Objectives: To assess the benefit of palliative care service at home visas hospice. The survey was done at Ongata –Ngong area about 40 km from capital city.

Methods: Six care givers and 10 patients with HIV/AIDS were invited to participate, the survey purpose was explained to the patients and caregivers.

Results: Seventy-five percent patients preferred home care with specialised palliative care 25 % hospice. 60 % referred for Hospice pain management but declined due to long distance and expenses involved, 35 % bought pain killer locally, 40 % received palliative care at the Hospice, 25 % traditional medicine 80 % had several symptoms requiring a specialist. 90 % referred the care with a specialist palliative care as a special care and human, 10 % preferred a health worker from different area. 40 % of caregiver referred home care as burden, 60 % fulfilling. They all thought they could share their problems better at home than at the Hospice.

Conclusions: There is need for incorporating home based care and palliative care for better symptom approach and involvement of other health providers, private clinics and the community at large. Training of local area health providers on palliative care hence ensuring all who need the service receives with less strain.

References: HIV/AIDS, Cancer, life limiting illness, community based, training and palliative care.

MASCC-0049

Aquafitness rehabilitation for patients with tracheostomy

J. Büntzel 1, A. Besser1

1Otolaryngology, Südharz Klinikum, Nordhausen, Germany

Introduction: Swimming and aquafitness are normally prohibited for each patient suffering from tracheostomy. The individual physical rehabilitation program is limited.

Objectives: We have introduced a combined system of tracheostomy tube and snorkel in our rehabilitation system after laryngectomy/tracheostomy in order to open aquafitness courses for these patients too.

Methods: Between 10–2011 and 1–2013 we have included 12 patients to our pilot program. We used a commercial available snorkelling system (“Lorchel”, Heimomed Frechen, Germany). 10/12 patients had got a laryngectomy, and further two patients had had a tracheostomy and partial laryngectomy because of their cancer. The aquafitness program was introduced by a specialized instructor, and the swim training was supervised by professional trainers. The launching process included 10 weekly sessions about 90 min.

Results: 10/12 patients were satisfied in using the new combined system. Two patients rejected the system after first session. All 10 positive patients were able to perform the aquafitnes program. 8/10 patients were able to swim in deep water. 2/12 patients have already used the snorkelling system during their individual holidays. We have not seen any complication of the used technique. The supervising system seems to be necessary in order to ensure the correct usage of the snorkel by the patients.

Conclusions: The usage of snorkelling systems offers new possibilities in the physical are habilitation for individuals with tracheostomy. Aquafitness as well as swimming should be included to avoid muscular late side effects due to surgery and radiotherapy of the treated body region.

MASCC-0050

Young women in Kenya are on a rough journey with breast and cervical cancers causing emotional and fears among the community

R. Stella 1, K. Gloria2, W. Miriam3

1School of Nursing, Kenya Medical Training College, Nairobi, Kenya, 2Research, University of Manitoba, Nairobi, Kenya, 3School of Nursing, KMTC, Nairobi, Kenya

Introduction: The word breast or cervical cancer is becoming common in most families in Kenya, in almost 40 % household there is a young patient diagnosed or on treatment. Young children are more affected being left without mothers.

Objectives: To find out the average age of patients admitted with breast/cervical cancer at the Hospice due to high number of orphan children.

Methods: The survey was conducted at Nairobi Hospice between March 2010–August 2010, which serves an average of 600 patients a year with 6 medical staffs and volunteers.

Results: There were 106 patients with breast cancer and 142 patients with cervical cancer a total of 248 admissions. Forty-three percent were diagnosed with breast cancer and 57 % with cervical cancer. Forty-nine percent breast cancers, 63 % cervical cancer below 50 years of age. Fifty-five percent diagnosed in late stage, 40.5 % HIV+. Forty-five percent referred for palliative care without surgery, chemotherapy or radiation, 55 % had some form of curative treatment, 20 % had recurrent and 15 % had not given birth. 65 % were from rural homes while 35 % urban towns. Forty-five percent not disclosed to children, 60 % received support from partners, 35 % abandoned by partners, 70 % had financial constrain hence stopping treatment midway.

Conclusions: There is need for health promotion programs to reduce the incidence and mortality of the two most common cancers among women. Ministry of Health and other stake holders need to avail more school and community health education. Good mechanism is needed in counseling the affected especially children and early screening of young ladies.

References: Breast cancer, cervical cervical, children, support

MASCC-0051

Does deaf community receive equal palliative care services as others? Challenges of health care providers offering the service

R. Stella 1, K. Faith2, K. Gloria3, W. stella4

1School of Nursing, Kenya Medical Training College, Nairobi, Kenya, 2Nursing, Ministry of Medical Services, Nairobi, Kenya, 3Research, University of Manitoba, Nairobi, Kenya, 4Palliative, Cancer Care Kenya, Nairobi, Kenya

Introduction: Deaf community can’t hear either speak, In Kenya they are isolated members of our society who suffers in silence when sick due to few signing health workers in our hospitals, and hence a Deaf has to bring in a relative/friend to interpret for them.

Objectives: Find out the challenges experienced by palliative care provider and the patients during care/management.

Methods: A survey was carried out at 6 hospices in Kenya in different counties, 10 palliative care providers and 5 deaf patients with life limiting illness. The survey purposes were explained and consent obtained.

Results: None of the palliative care providers trained in signing language. Only 45 nurses in the whole country trained on Kenya sign language, No record of palliative care awareness, 90 % of the patients brought in a relative to interpret, 60 % cannot read, 90 % feels they are not understood by health providers, 80 % feels their pain not well managed, 60 % their relationship with providers a challenge, 80 % feels below deal than others patients, 100 % wished for communication directly, 60 % felt went with untreated symptoms, 40 % felt health providers avoided them, 50 % health providers disinterested in learning, 60 % willing, 80 % communication a challenge and 40 % basic sign language.

Conclusions: There is a need for sign language training in ensuring quality palliative care delivery to all. Importance of on job training by already trained nurses and workshops on palliative care to the deaf community. Ministry of health fully participation and filling gaps in palliative care services.

References: Palliative, deaf, communication, nurses

MASCC-0052

Fatigue among (long-term) thyroid cancer survivors: results from the population-based profiles registry

O. Husson 1, W.A. Nieuwlaat2, W.A. Oranje3, H.R. Haak4, L.V. van de Poll-Franse1, F. Mols1

1Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands, 2Internal Medicine, Elisabeth Hospital, Tilburg, Netherlands, 3Internal Medicine, Tweesteden Hospital, Tilburg, Netherlands, 4Internal Medicine, Maxima Medical Centre, Eindhoven, Netherlands

Introduction: Fatigue is a common problem among different groups of cancer survivors. Research focusing on the levels of fatigue among thyroid cancer (TC) survivors is lacking.

Objectives: The aims of this study were 1) to obtain insight into the prevalence of fatigue among short-term and long-term TC survivors, by comparing a sample of TC survivors with an age- and sex-matched normative population; 2) to investigate which demographic, clinical, and thyroid cancer specific characteristics were associated with fatigue.

Methods: All patients diagnosed with TC between 1990 and 2008, as registered in the Eindhoven Cancer Registry, received a cross-sectional survey on fatigue (FAS) and disease-specific symptoms (THYCA-QoL). The fatigue scores were compared with those of an age- and sex-matched normative population (n = 530). Multiple linear regression analyses were conducted to investigate the independent associations between clinical and demographic variables and (TC specific) HRQoL.

Results: Eighty-six percent (n = 306) responded. TC survivors were more often classified as fatigued or very fatigued (short-term <5 years: 43 %; long-term 5–10 years: 44 %; long-term 10–15 years: 47 %; long-term >15 years: 39 %) compared to the normative population (25 %; p < 0.001). Anxiety (OR: 1.15, 95 % CI: 1.03–1.28) and depression in general (OR: 1.43, 95 % CI: 1.22–1.68) were associated with fatigue, as was also the case for TC specific neuromuscular (OR: 1.03, 95 %CI: 1.01–1.06), concentration (OR: 1.03, 95 %CI: 1.01–1.06) and psychological problems (OR: 1.06, 95 %CI: 1.02–1.10).

Conclusions: Short-term and long-term TC survivors report higher levels of fatigue compared to an age- and sex-matched normative population. Both TC specific and mental health problems were strongly associated with fatigue.

MASCC-0053

Satisfaction with information is associated with baseline and follow-up quality of life among lymphoma and multiple myeloma survivors: results from the profiles registry

O. Husson 1, S. Oerlemans1, F. Mols1, R.E.H. Smeets2, P. Poortmans3, L.V. van de Poll-Franse4

1Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands, 2Internal Medicine, St. Anna Hospital, Geldrop, Netherlands, 3Radiation Oncology, Verbeeten Institute, Tilburg, Netherlands, 4Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands

Introduction: Providing information that is congruent with patients’ needs is an important determinant for patient satisfaction.

Objectives: The aim was to insight into the relationship between information provision and HRQoL, anxiety and depression levels among lymphoma and Multiple Myeloma (MM) survivors.

Methods: All patients diagnosed with lymphoma or MM between 1999 and 2009, registered in the Eindhoven Cancer Registry, received a questionnaire including the EORTC QLQ-INFO25, EORTC QLQ-C30 and HADS on two time points. Paired sample t-tests were used to assess changes over time and multivariate linear regression analyses were used to determine independent associations of information provision with HRQoL, levels of anxiety and depression.

Results: The perceived receipt of information about medical tests, treatment and helpfulness of the received information were significantly higher at baseline compared to 2-year follow-up. The perceived level of information about the disease and other services and the HRQoL and levels of anxiety and depression did not change over time.

Higher satisfaction with the received information at T1 was associated with better physical, role, emotional and social functioning and global quality of life at T2 (ß ranging from 0.15 to 0.25; all p < 0.05). After correction for baseline functioning levels, this relationships remained only significant for role functioning (ß = 0.17, p < 0.05) and global quality of life (ß = 0.14, p < 0.05). Survivors who were satisfied at both time points (56 %) reported highest levels of mental HRQoL.

Conclusions: Satisfaction with the received information is associated with better HRQoL and lower levels of anxiety and depression. Future studies should explore strategies to optimize patient satisfaction with received information.

MASCC-0054

Mortality among cancer free survivors 3 to 7 years after treatment for early stage head and neck cancer (HNC): comparison with the general population

F. Meyer 1, S. Turcotte1, I. Bairati1

1Clinical Epidemiology, Cancer Research Center, Quebec City, Canada

Introduction: Guidelines for follow-up for HNC patients recommend fewer visits after 3 years. Overall survival is considerably better among long term cancer free survivors than among those living with cancer. Yet, there is no evidence that long term cancer free survivors have a mortality rate similar to that in the general population.

Objectives: We compared the mortality rate of HNC patients free of cancer, 3 to 7 years after therapy ended, to that in the general population.

Methods: Patients (n = 540) with early stage HNC treated with radiation therapy (RT) were recruited in all regions of the province of Quebec to participate in a randomized trial (1994–2000). We formed five cohorts with all cancer free survivors (without HNC relapse or second primary cancer) respectively three (n = 350), four (n = 279), five (n = 199), six (n = 125) and seven (n = 49) years after RT ended. Patients’ follow-up was partitioned according to age, sex and calendar year. Age and sex specific mortality rates in the Quebec population were obtained for each calendar year (1994–2009). Standardized mortality ratios (SMR) were used to compare survivors’ mortality rate to that in the general population.

Results: The SMR were 1.68, 1.65, 1.80, 1.41 and 1.86 for cancer free survivors respectively at 3, 4, 5, 6 and 7 years. The mortality rate among cancer free survivors was always higher (p < 0.05) than in the general population.

Conclusions: Despite the excellent outcome of their early stage HNC, long term cancer free survivors have a higher mortality rate than the general population presumably because of smoking and socioeconomic conditions.

MASCC-0055

Quality of life as survival predictor among survivors, cancer free or not, 3 years after radiation therapy for early stage head and neck cancer (HNC)

I. Bairati 1, F. Meyer1

1Clinical Epidemiology, Cancer Research Center, Quebec City, Canada

Introduction: Health-related quality of life (HRQOL) at the time of cancer diagnosis is a predictor of overall survival (OS). The prognostic significance of HRQOL assessed at later times is less documented.

Objectives: We assessed whether HRQOL 3 years after initial therapy was associated with OS among cancer free survivors and among those living with cancer (after relapse or second primary cancer).

Methods: In a randomized trial conducted among 540 patients treated with radiation therapy (RT) for early stage HNC, we assessed HRQOL with the EORTC QLQ-C30 3 years after RT ended. Multivariate Cox regression was used to assess, separately for cancer free survivors and for survivors living with cancer, whether HRQOL was an independent predictor of OS.

Results: Among the 340 cancer free survivors with HRQOL data, 126 deaths were observed in the follow-up (median 8.1 years). After controlling for age, nine of the 15 HRQOL variables were associated with OS (p < 0.05). When all variables were considered, age, sex, smoking, comorbidity, physical functioning (hazard ratio (HR) for a 10 point increment: 0.85) and appetite loss (HR: 1.10) were independent OS predictors (p < 0.05). Among the 76 survivors living with cancer, 39 deaths were observed in the follow-up (median 7.2 years). After controlling for age, 12 of the 15 HRQOL variables were associated with OS (p < 0.05). When all variables were considered, age, appetite loss (HR: 1.28) and pain (HR: 1.21) were independent OS predictors (p < 0.05).

Conclusions: HRQOL after initial therapy remains a survival predictor both for cancer free survivors and for survivors living with cancer.

MASCC-0056

Hospital at home in patients with febrile neutropenia

J. Aibar 1, M. Selvi2, N. Seijas1, C. Font2, B. Ibáñez1, S. Valls1, L. Llop1, M. Roman1, M.C. Grané1, C. Hernández1

1Integrated Care Unit. Medical and Nursing Direction, Hospital Clinic de Barcelona, Barcelona, Spain, 2Department of oncology, Hospital Clinic de Barcelona, Barcelona, Spain

Introduction: Patients with febrile neutropenia traditionally require in-hospital treatment because of the risk of serious complications and associated mortality. In a subgroup of these patients who are considered ‘low risk’, however, treatment in the outpatient setting may be considered. One of such alternatives to hospital admission is the hospital-at-home program (HaH).

Objectives: To evaluate the efficacy and safety of HaH program in patients with febrile neutropenia.

Methods: Sixty cases of patients with febrile neutropenia included in our HaH program were revised.

Results: Twenty patients had lung cancer, 22 had breast cancer, 9 had cancer of the urogenital aparatus, 3 had lymphoma and 6 had others. At admission median C-reactive protein (CRP) level was 6.5 mg/dl and mean absolute neutrophil count (ANC) was 581.3 cells/μL; at discharge these values were 2.7 mg/dl and 5011,9 cells/μL respectively. 91.7 % of the patients received intravenous antibiotic. Microbiological evidence of infection was found in 11 cases. Median length of HaH stay was 6 days. Fourteen patients had to consult again at the ED and/or needed hospitalization within 30 days after HaH discharge, one of whom died during hospital stay. By logistic regression analysis we found that a higher CRP level at HaH admission is a factor independently associated to this clinical course.

Conclusions: Hospital-at-home is a good alternative to hospitalizatión in the management of patients with low-risk febrile neutropenia.

References: Beguin Y, Benoit Y, Crokaert F, et al. Outpatient and home parenteral antibiotic therapy (OHPAT) in low-risk febrile neutropenia: consensus statement of a Belgian panel. Acta Clin Belg 2002;57(6):309–16

MASCC-0057

The association between hypogonadism, symptom burden, and survival in male patients with advanced cancer

R. Dev 1, D. Hui1, E. Del Fabbro2, M.O. Delgado-Guay1, L.E. Pimentel1, E. Bruera1

1Supportive Care and Palliative Medicine, University of Texas MD Anderson Cancer Center, Houston, USA, 2Palliative Medicine, Virginia Commonwealth University, Richmond, USA

Introduction: Our group has previously reported the high frequency of hypogonadism in advanced cancer patients compared to the general population. Low testosterone is associated with opioid use and cachexia.

Objectives: To evaluate the association between the hypogonadism, symptom burden, and survival in advanced cancer patients.

Methods: 119/131 (91 %) consecutive male cancer patients had an endocrine evaluation (total/free testosterone, c-reactive protein, thyroid stimulating hormone, and morning cortisol level) when presenting with symptoms of fatigue or anorexia-cachexia. Symptoms were evaluated by the Edmonton Symptom Assessment Scale. We examined the correlation with Spearman test and survival with log rank test and Cox-regression analysis.

Results: The median age was 64; majority were white 85 (71 %). Median total testosterone was 209 ng/dL (normal ≥240 ng/dL) and free testosterone 4 ng/dL (normal ≥9 ng/dL). Decreased total testosterone was associated with elevated CRP (r = 0.40; p < 0.001), increase white blood cell count (r = 0.20; p = 0.03), worse Eastern Cooperative Oncology Group (ECOG) performance status (r = 0.20; p = 0.03), >5 % weight loss (r = 0.27; p = 0.003), and opioid use (r = 0.36; p < 0.001). Low total and free testosterone were significantly associated with worse fatigue (p ≤ 0.02), increased anxiety (p ≤ 0.04), decreased feeling of well-being (p ≤ 0.04), and increased dyspnea (p ≤ 0.05). On multivariate analysis, decreased survival was associated with low total testosterone (HR 1.7; p = 0.03), worsening ECOG status (HR 1.6; p < 0.01), high c-reactive protein (HR 3.3; p < 0.001), and decreased albumin (HR 2.6; p < 0.001)

Conclusions: Systemic inflammation, weight loss, and opioid use were associated with decreased testosterone in cancer patients. Low testosterone is associated with a symptom burden and may have prognostic value independent of c-reactive protein, albumin, and performance status.

MASCC-0058

The status and importance of communication in physiotherapy – do physiotherapists need skills in professional communication?

U. Muench 1

1Klinik für Allgemein- und Viszeralchirurgie Darmzentrum Westend, DRK Kliniken Berlin | Westend, Berlin, Germany

Introduction: Patients have significantly less inhibitions towards physiotherapists compared to physicians and/or psycho-oncologists in terms of telling them about experiences, questions, fears and troubles in their everyday language. In addition, physiotherapists are regularly faced with the challenge of having to motivate fatigued cancer patients to do exercises to reduce their symptoms of weakness.

Objectives: As part of a ‘Sport for cancer patients’ curriculum organized by the ‘Cancer and Sports’ team from the Tumor Center Berlin eV module on ‘Communication with cancer patients’ was developed and carried out first time 2011, repeated 2012 at a level of 15 h. 2011 the module was planned with a length of 1 h. Feedback from the evaluation showed a strong desire to gain more knowledge about communication and psychosocial oncology. In 2012, the module planned with 2 h time.

Methods: The evaluation itself contained five questions/statements concerning the module itself and importance of communication skills.

Two measurement points were planned. First point immediately after taking part at the module itself, the second one two months later by mail.

Results: Participation: about 50 %.

Feedback showed a very strong need to gain knowledge about communication and communication skills, and deepen this, also more and better knowledge about self-care and keeping up mental health.

Conclusions: This small sample shows a need for training in communication from the perspective of physiotherapists. It may require a study to review the evaluation results scientifically.

References: Hermann, A., Rosenbaum, M., Hoppe, S., Hohenberger, P. (2002), Physiotherapeutische und psychoonkologische Betreuung von Patienten mit Sarkomen, Der Onkologe 4/2002, 366–377

MASCC-0059

An eccentrically-biased qigong intervention in prostate cancer survivors: effects on fatigue and psychological distress

A.Y. Kinney 1, R.A. Campo2, L.M. Pappas2, K.J. O’Connor2, P.C. LaStayo3, S.M. Smith2, K.M. Boucher4, K.C. Light5, N. Agarwal6

1Department of Medicine, University of Utah Huntsman Cancer Institute, Salt Lake City, USA, 2Huntsman Cancer Institute, University of Utah, Salt Lake City, USA, 3Physical Therapy, University of Utah, Salt Lake City, USA, 4Oncologic Sciences, University of Utah, Salt Lake City, USA, 5Department of Anesthesiology, University of Utah, Salt Lake City, USA, 6Department of Medicine, University of Utah, Salt Lake City, USA

Introduction: Fatigue is one of the most commonly reported and least understood cancer-related symptoms among prostate cancer survivors. It has been associated with psychological distress and a sedentary lifestyle.

Objectives: To determine the feasibility and preliminary efficacy of an eccentrically-biased Qigong intervention in fatigued prostate cancer survivors.

Methods: We conducted a single-blind, randomized feasibility trial of an eccentrically-biased Qigong intervention as compared with a control intervention consisting of non-aerobic stretching among 41 men (mean age = 72.8, sd = 9.4). Sessions lasted 60 min each and took place twice a week for 12 weeks for each of the study groups. The primary end point was a change in the FACIT-Fatigue. The secondary endpoints included changes in BSI-18 global severity index and subscale scores at the end of 12 weeks. The study groups were compared on their changes (post-baseline) with Wilcoxon tests. The analysis includes 29 men who completed the post-intervention measures.

Results: The study groups did not differ significantly with regard to baseline FACIT-Fatigue and the BSI-18 scores. Men in the Qigong condition, compared with the stretching condition, demonstrated clinically and statistically significant improvements in FACIT fatigue (p = 0.016), global severity index (p = 0.002), somatization (p = 0.048) and anxiety (p = 0.003) scores. 69 % of the qigong group had improved depression scores, but there was not a significant difference in change between groups (0.092). No adverse events were observed.

Conclusions: Qigong that is eccentrically biased may be a useful treatment for fatigued prostate cancer survivors and merits implementation of a larger definitive trial.

MASCC-0060

Multiple beneficial effects of statins and Rac1-inhibitors on cardio- and hepatotoxicity induced by the anthracycline derivative doxorubicin

G. Fritz 1, C. Henninger1, A. Schorr1, A. Bopp1, F. Wartlick1, J. Huelsenbeck2, S. Huelsenbeck2, B. Kaina2

1Toxicology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany, 2Toxicology, Johannes Gutenberg University, Mainz, Germany

Introduction: The lipid lowering drug lovastatin (Lova) exhibits pleiotropic effects, which mainly rest on the inhibition of Ras-homologous (Rho) GTPases. Pharmacological inhibition of Rho GTPases potentiates the antitumor efficacy of various anticancer drugs. The influence of statins on normal tissue damage provoked by anticancer drugs is hitherto only poorly investigated.

Objectives: We aim to elucidate the consequences of pharmacological inhibition of Rac1 signaling on stress responses and cell death of non-malignant cells treated with the anthracycline derivative doxorubicin (Doxo).

Methods: Human endothelial cells (HUVEC) and rat cardiomyoblasts (H9c2) were pretreated with Lova or a Rac1-specific small-molecule inhibitor. Following Doxo exposure, DNA damage response (DDR) and cytotoxicity were monitored. Besides these in vitro studies, the influence of Lova was analyzed on Doxo-induced acute and subacute cardio- and hepatotoxicity in vivo (Balb/c mice).

Results: Lovastatin blocked the DDR and promoted survival of HUVEC and H9c2 cells following Doxo treatment1. Protection by Lova rests on inhibition of Rac1 signaling, which is required for DNA double-strand break formation resulting from inhibition of topoisomerases by Doxo. Moreover, Lova protected Balb/c mice against acute and subacute cardio- and hepatotoxic effects of Doxo1,2. Taken together we suggest that the cytoprotective effect of Lova against Doxo-induced injury is due to a reduced DNA damage induction, attenuated DDR and reduction of cell death.

Conclusions: Lova attenuates dose-limiting adverse effects of Doxo-based anticancer therapy, thereby widening its therapeutic window.

References: 1Huelsenbeck et al (2011) Cell Death Dis 2:e190; 2Henninger et al (2012) Tox Appl Pharm 261, 66–73.

MASCC-0061

Relatives’ perception of head and neck cancer patients’ pain

A.K.C. Schaller 1, G. Liedberg2, B.K. Larsson1

1Department of Medical and Health Sciences Faculty of Health Sciences Linköping University, Rehabilitation Medicine, Linköping, Sweden, 2Faculty of Health Sciences Linköping University, Department of Social and Welfare studies, Linköping, Sweden

Introduction: When a family member suffers from cancer, there is a risk that their family members’ quality of life and everyday life will be negatively affected.

Objectives: The aim was to describe how family members experience their ill relative’s situation especially with respect to various dimensions of pain due to head and neck cancer (HNC) and radiotherapy. Furthermore, this study aims to describe the family members’ own experiences.

Methods: This qualitative interview study involved 21 relatives of HNC patients.

Results: Relatives reported that patients suffered from severe pain in their oral cavity region and frequently saw that the patient’s pain relief was insufficient. Nevertheless, relatives noted that the patients were long-suffering and were experienced at coping with the difficult situation. It was hard for the relatives to see their loved ones in such a difficult situation, which included treatment-related side effects such as fatigue, obstipation, nausea, and weight loss. Both relatives and patients experienced anxiety and fear about the prognosis.

Family members experienced difficulties managing household chores, providing care, and accompanying their sick relative to medical visits. Moreover, many relatives were employed and were expected to work. This demanding situation resulted in feelings of loneliness and abandonment that sometimes led to sleeping difficulties. More information was desired regarding treatment and prognosis and the relatives thought a nurse could help facilitate contact with healthcare would be helpful. In all, a dark picture was reported.

Conclusions: Caregiving relatives to HNC patients need extensive psychological and practical support to optimize mutual wellbeing during the disease period.

MASCC-0062

Statins protect against ionizing radiation-induced adverse normal tissue responses

G. Fritz 1, C. Henninger1, J. Huelsenbeck2, M. Herzog2, B. Kaina2

1Toxicology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany, 2Toxicology, Johannes Gutenberg University Mainz, Mainz, Germany

Introduction: Radiotherapy plays a key role in anticancer therapy. However, ionizing radiation (IR) also damages normal tissue. HMG-CoA-reductase inhibitors (statins) block the function of Ras and Ras-homologous (Rho) GTPases, which are involved in the regulation of IR-induced stress responses and apoptosis.

Objectives: We aim to examine the usefulness of statins to protect normal tissue from the side effects of IR.

Methods: Early IR-induced DNA damage response (DDR) and cell death were comparatively analyzed in human endothelial cells (HUVEC; EA.hy926) pretreated or not with lovastatin (Lova). Moreover, we investigated the effect of Lova on acute and subacute normal tissue damage induced by total body irradiation (TBI) of Balb/c mice.

Results: Lovastatin inhibited the IR-stimulated activation of the DDR (i.e p53) in endothelial cells1 without affecting the level of DNA strand breaks. The statin also increased the survival of irradiated endothelial cells in vitro. TBI of Balb/c mice (1 × 6 Gy) revealed that Lova reduces acute proinflammatory and profibrotic stress responses of liver and intestine2. Lova also attenuated the mRNA expression of proinflammatory and profibrotic cytokines observed 3 weeks after TBI (2 × 2.5 Gy) in the lung. TBI promoted the extravasation of circulating tumor cells and subsequent formation of lung metastases. Again, this pro-metastatic IR effect was blocked by Lova3.

Conclusions: Lova counteracts multiple adverse normal tissue responses caused by irradiation, pointing to a radioprophylactic potency of statins.

References: 1Nübel et al. (2006) Clin Cancer Res 12, 933–39; 2Ostrau et al (2009) Radiotherapy Oncology 9, 492–99; 3Hamalukic et al (2011) PLOSone 6(19)e26413.

MASCC-0063

The prognostic value of cognition in patients with glioblastoma multiforme

B. Flechl 1, M. Ackerl1, C. Sax1, C. Richard2, M. Keilani2, A. Gaiger1, K. Dieckmann3, C. Marosi1

1Internal Medicine, Medical University, Vienna, Austria, 2Physical Medicine and Rehabilitation, Medical University, Vienna, Austria, 3Radiotherapy, Medical University, Vienna, Austria

Introduction: In patients with Glioblastoma multiforme (GBM) progressive disease leads sooner or later to cognitive decline

Objectives: In this study we evaluated if two cognitive assessments performed early in the treatment course have a prognostic significance for predicting progression free survival (PFS).

Methods: We assessed the cognition of 35 patients with GBM using the program NeuroCogFX with four subscales (working memory, attention, verbal and figural memory, verbal fluency) and summary scale. Baseline evaluation was done at initiation of radiotherapy (11–57 days after diagnosis) and second evaluation 3 months later (82–117 days after baseline).

Results in subscales were categorized in ‘declined’, ‘stable’ and ‘improved’. Tumor progression was based on MRI scans

Results: The patients (12 women, 23 men) were in median 54 years old (21–75 years). The majority (61 %) showed stable cognitive results, 22 % improved and 14 % decreased in the summary scale of cognition. The median PFS was 11 months (2.6–27.4 months). An improvement of attention correlated significantly with longer PFS (p = 0.015, see Fig 1) whereas the other three cognitive subscales were not associated with PFS.

figurec

Conclusions: The present study shows evidence, that an increase or decrease of attention scales measured within the first 5 months of disease has prognostic value for PFS.

MASCC-0064

Empowering patient education—model development

H. Vaartio-Rajalin 1, H. Leino-Kilpi1, H. Minn2, L. Iire2

1Nursing Science, University of Turku, Turku, Finland, 2Oncologic, Turku University Hospital, Turku, Finland

Introduction: Oncologic patients are a heterogeneous group of individuals with a vast range of cognitive needs and informational expectations during their illness trajectory. The cognitive resources of these patients may be affected due to illness and its care, and should be continuously analyzed in order to coordinate well-targeted patient counseling in inter-professional collaboration.

Objectives: The goal of this international multicenter study is to develop a model of empowering counseling praxis for cancer patients during illness trajectory. This model will contain a diagnostic instrument for self-identification of adult cancer patients’ cognitive needs and a collaborative counseling checklist for health care professionals at clinical specialties during cancer management.

Methods: The process of establishing the model will be presented at conference. There will be altogether six datasets to be obtained in Finland, Sweden, Norway and Spain from oncological clinics. At the first phase of study the focus is in identification of the cognitive needs of adult oncologic patients during the whole illness trajectory, and identification of the significant factors affecting these cognitive needs. From the base of this phase, a diagnostic instrument for self- identification of one’s cognitive needs will be developed and validated. At second phase there will be an exploration of the cancer nurses’ and physicians’ Methods to identify, analyze and response to the cognitive needs of their patients, and nurses’ activities as counseling patient advocates. Finally, the third phase focuses on validation of a collaborative counseling checklist for health care professionals during cancer management.

Results: Not available yet.

Conclusions: Not available yet.

MASCC-0065

The prediction of the TS?ERCC1 mRNA levels to the clinical outcome of patients with esophageal squamous cell carcinoma treated with CDDP/5-FU chemotherapy

G. Guo-chenXing 1

1Cancer, Zhengzhou University Affiliated Zhengzhou Central Hospital, Zhengzhou, China

Introduction: Oesophageal cancer is the eight most frequent malignancy and the fourth highest cause of cancer-related mortality, with almost 500,000 new patients diagnosed annually worldwide.

Objectives: The aim of this study was to determine whether the expressions of excision repair cross-complementation group 1 (ERCC1) and thymidylate synthase (TS) predict the clinical outcome of patients with esophageal squamous cell carcinoma treated with CDDP/5-FU chemotherapy.

Methods: The mRNA levels of TS/β-actin and ERCC1/β-actin in esophageal cancer tissue were determined by semi-quantitative reverse-transcription polymerase chain reaction(RT-PCR) and their correlations to the chemotherapy results were studied.

Results: Twenty esophageal cancer patients were divided into two groups by the mean TS mRNA level, and all 8 patients in low level group were responsers to chemotherapy, whereas only 3 in12 patients in high level group responded to chemotherapy. There was a significant difference between the two groups(Fisher’s exact test, P = 0.001)?7 patients with TS and ERCC1 mRNA level lower than or equal to their respective means were all responsers to chemotherapy, however only 4 in 13 patients with TS and ERCC1 mRNA level higher than their respective means responded to chemotherapy. The difference between the two groups for response has a statistical significance (Fisher’s exact test, P = 0.005).

Conclusions: This study indicates that TS?ERCC1 mRNA levels may be predictive markers for response in patients with oesophageal squamous cell cancer receiving CDDP/5-FU chemotherapy.

MASCC-0066

Renal function analyses in patients with stomach cancer who underwent adjuvant chemoradiotherapy

G. Yavas 1, R. Elsurer Afsar2, C. Yavas3, O. Ata4

1Radiation Oncology, Selcuk University, Konya, Turkey, 2Nephrology, Selcuk University, Konya, Turkey, 3R, Konya Training and Research Hospital, Konya, Turkey, 4Medical Oncology, Selcuk University, Konya, Turkey

Introduction: Chemoradiotherapy is an important part of stomach cancer treatment.

Objectives: We aimed to evaluate renal functions in patients with stomach cancer who underwent adjuvant chemoradiotherapy.

Methods: Fifty-nine stomach cancer patients who underwent total gastrectomy and lymph node dissection and adjuvant chemoradiotherapy were included. Demographic parameters (age, gender), and basal and 12th month biochemical parameters were recorded. Mean kidney dose (MKD) administered during radiotherapy (RT) was determined. Basal and 12th month estimated glomerular filtration rate (eGFR) was calculated by MDRD formula.

Results: There were 25 female (42,4 %) and 34 male (57,6 %) patients. The mean age of the patients was 60,8 ± 11,9 years. Mean follow-up period was 15,6 ± 9,8 months. Twenty-three (39 %) patients were ≥65 years of age and 21 patients (%35.6) had basal eGFR <90 ml/min/1.73 m2. When the basal and 12th month eGFR was compared, eGFR decreased in 27 patients (45,8 %), whereas eGFR remained stable in 32 (54,2 %) patients. We performed cox regression analyses in order to define the relationship between a decreased eGFR and age, gender, MKD, basal MKD and albumin. Cox regression analyses revealed that a MKD >1,500 cGy and basal eGFR <90 ml/min/1.73 m2 significantly increased the risk of a decreased eGFR at 12th month (HR = 2,288, 95 % CI (1,009–5,188), p = 0,048 and HR = 2,854, 95 % CI (1,121–7,262), p = 0,028, respectively).

Conclusions: Our results suggested that a basal eGFR <90 ml/min/1.73 m2 and MKD >1,500 cGy significantly increased the risk of a decreased 12th month eGFR.

References: 1. Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725–30.

MASCC-0067

The effect of halofuginone on radiation induced cardiovascular damage

C. Yavas 1, M. Calik2, G. Yavas3, H. Toy4, H. Esme2, M.F. Sargon5

1Radiation Oncology, Konya Training and Research Hospital, Konya, Turkey, 2Thoracic Surgery, Konya Training and Research Hospital, Konya, Turkey, 3Radiation Oncology, Selcuk University, Konya, Turkey, 4Pathology, Necmettin Erbakan University, Konya, Turkey, 5Anatomy, Hacettepe University, Ankara, Turkey

Introduction: Cardiovascular toxicity is a major dose limiting factor during mediastinal irradiation.

Objectives: To evaluate the effects of two different doses of Halofuginone (H) on radiation induced cardiovascular damage.

Methods: Sixty rats were divided into 6 groups. Group (G) 1 was defined as control group. G2 was radiotherapy (RT) only group. Group 3 and 4 were 2.5 and 5 μg H groups respectively. Group 5 and 6 were RT plus 2.5 and 5 μg H groups respectively. A single dose of 12 Gy RT was given with 6 MV photon beams. H was applied intraperitoneally with daily doses, started immediately after administration radiotherapy and continued until the animals were sacrificed.

Results: The endocardial thickness of all study groups was significantly differed at 6th and 16th week of RT (p < 0.001 for each). The maximum thickness was observed in G2. There were significant differences between G2 and G5 (p < 0.001); G2 and G6 (p < 0.001) and; G5 and G6 (p = 0.001) regarding to endocardial thickness at 16th week of RT. There were significant differences within the study groups in terms of thoracic aorta fibrosis scores (p = 0.002). When the RT groups were compared there were significant differences between G2-G5, G2-G6 (p = 0,007 and =0,002 respectively). There weren’t any difference between the control and H groups.

Conclusions: Our results suggested that H may improve radiation induced cardiovascular damage. The most prominent improvement was observed in 5 μg H + RT group at 16th week of RT.

References: 1. Adams MJ, Hardenbergh PH, Constine SL, Liphultz SE. Radiation-associated cardiovascular disease, Critical reviews in oncology/Hematology2003;45: 55–75.

MASCC-0068

The morphological effects of tamoxifen, letrozole, anastrozole and radiotherapy in cardiac tissue of rats

O. Ata 1, G. Yavas2, C. Yavas3, H. Acar2, H. Toy4

1Medical Oncology, Selcuk University, Konya, Turkey, 2Radiation Oncology, Selcuk University, Konya, Turkey, 3Radiation Oncology, Konya Training and Research Hospital, Konya, Turkey, 4Pathology, Necmettin Erbakan University, Konya, Turkey

Introduction: There is limited data regarding the cardiac toxicity profile of hormonal therapy when used alone and concurrent with radiotherapy.

Objectives: We aimed to evaluate the morphological effects of Anastrozole (A), Letrozole (L) and Tamoxifen (T) on cardiac tissue, when used alone or combination with radiotherapy in rats.

Methods: Eighty rats were divided into 8 groups. Group (G) 1 was defined as control group. G2 was RT only group. Group 3, 4 and 6 were T, A and L control groups respectively. Group 6, 7 and 8 were RT plus T, A and L groups respectively. A single dose of 12 Gy RT was given. The drugs were started 1 week before the RT and continued until the animals were sacrificed 16 weeks after the RT. As an end point the extent of cardiac toxicity for each rat was quantified with image analysis of histological sections of the heart.

Results: RT increased both endocardial thickness (p < 0.001) and cardiac fibrosis scores (p < 0.001), whereas A and L did not. As for T, only significant change was observed in endocardial thickness (p < 0.001). RT combined with T or A or L did not increase endocardial thickness (p: 0.739, p:<0.99, p: 0.280, respectively) and cardiac fibrosis scores (p:0.089, p: 0.796, p: 0.796:, respectively) when compared with RT alone.

Conclusions: Our results suggested that unlike A and L, RT and T may be cardiotoxic in rats, as measured by increased endocardial thickness and cardiac fibrosis score. However, concurrent T with RT did not further increase carditoxicity.

MASCC-0069

Dosimetric comparison of 3-dimensional conformal and field in field radiotherapy techniques for the adjuvant treatment of early stage endometrial cancer

G. Yavas 1, C. Yavas2, H. Acar1, A. Buyukyoruk1, G. Cobanoglu1, O. Secilmis Kerimoglu3, O. Ata4, C. Celik3

1Radiation Oncology, Selcuk University, Konya, Turkey, 2Radiation Oncology, Konya Training and Research Hospital, Konya, Turkey, 3Obstetrics and Gynecology, Selcuk University, Konya, Turkey, 4Medical Oncology, Selcuk University, Konya, Turkey

Introduction: Adjuvant radiotherapy has been shown to improve loco-regional control rates in endometrial cancer patients.

Objectives: To compare field-in-field radiotherapy (FIF) with conformal radiotherapy (CRT) in terms of dosimetric benefits for early stage endometrial cancer patients.

Methods: Ten consecutive early stage endometrial cancer patients who underwent adjuvant external beam radiotherapy were included to the study. For each patient, two different treatment plans were created. FIF and CRT plans were compared for doses in the planning target volume (PTV), the organ at risk (OAR) volume including rectum, bladder, bowel, bilateral femurs and bone marrow, the dose homogeneity index, and the monitor unit counts required for the treatment.

Results: The FIF technique significantly reduced the maximum dose of the PTV, rectum, bladder, bowel, left femur, right femur and bone marrow (p values were: <0.001, 0.031, 0.003, <0.001, 0.001, 0.001 and <0.001 respectively). When the OAR volumes irradiated with 30 and 45 Gy were compared, the results were in favor of the FIF technique. The volumes of rectum, bladder, bowel, left femur, right femur and bone marrow receiving more than the prescription dose of 45 Gy were significantly reduced with FIF technique (p values were 0.016, 0.039, 0.01, 0.04, 0.037 and 0.01 respectively). The dose homogeneity index (DHI) was significantly improved with FIF technique (p < 0.001)

Conclusions: FIF technique seems to be more advantageous than CRT during adjuvant radiotherapy for early stage endometrial cancer patients.

References: Chan P, Yeo I, Perkins G, Fyles A, Milosevic M. Dosimetric comparison of intensity modulated, conformal, and fourfield pelvic radiotherapy boost plans for gynecologic cancer: a retrospective planning study. Radiat Oncol 2006;4:13–21.

MASCC-0070

Role of fear and pain avoidance on adherence to prophylactic swallowing exercises in head and neck cancer patients

G. Carnaby 1, R. Amdur2, M. Crary3

1Behavioral Science & Community Health, University of Florida, Gainesville, USA, 2Radiation Oncology, University of Florida, Gainesville, USA, 3Speech Hearing & Language Science, University of Florida, Gainesville, USA

Introduction: Participation in preventative swallowing exercise during HNC treatment improves functional swallowing and maintains muscle structure. Despite these benefits, patient adherence to exercise programs is not always optimal. One possible factor associated with lower exercise adherence is pain-related fear.

Objectives: This study sought to identify behavioral reactions to pain during HNC treatment and the impact of Pain-fear avoidance on swallowing exercise adherence.

Methods: One hundred thirty HNC subjects enrolled in a trial of swallowing intervention, completed Pain Disability Index (PDI), Pain-Interference visual analogue (VAS) and pain related-swallowing quality of life scales(SWALQOL) at baseline, post radiotherapy, 3-months following treatment. Repeated measures ANOVA explored relationships between psychosocial pain/avoidance factors and swallowing exercise adherence.

Results: Data was available on 127 subjects. Swallowing function was normal across subjects at baseline. No difference between group baseline scores for PDI, VAS or SWALQOL scores was observed. A strong relationship between pain intensity (VAS) and deterioration in swallowing ability at 6 weeks (post treatment) and 3 months (p < .0008) was identified. Withdrawal from dysphagia intervention was significantly associated with higher pain intensity across time points (p < .002). Fear of choking reported at baseline was linearly related to amount of swallowing exercise performed during CRT (F (4, 83) = 3.26, p < .016), and to pain/disability ratings post treatment F (4,105) =4.69, P < .002) and 3 months following CRT (F (4, 74) = 3.03, P < .023).

Conclusions: Findings suggest the pain experience and psychologic factors (emotional reaction to pain) interact to influence and maintain swallowing avoidant behavior, reducing adherence to prophylactic swallowing exercise.

MASCC-0071

A randomized, controlled, thorough ECG trial to investigate the effects of netupitant and palonosetron (NEPA) combinations on ECG of healthy volunteers

T. Spinelli 1, C. Moresino1, S. Baumann2, W. Timmer2

1Research and Development, Helsinn Healthcare SA, Lugano, Switzerland, 2CRS, Clinical Research Services Mannheim GmbH, Mannheim, Germany

Introduction: Chemotherapy-induced nausea and vomiting is ranked among the worst side effects of chemotherapy. NEPA, a new antiemetic under development, is a fixed-dose combination of the highly selective NK1 receptor antagonist (RA) netupitant (300 mg), and the pharmacologically distinct 5-HT3 RA palonosetron (0.5 mg). NEPA targets 2 important emetic pathways with a single oral dose.

Objectives: This randomized, double-blind, placebo- and positive-controlled study aimed to determine the individually heart rate (HR)-corrected QT interval (QTcI) after different doses of NEPA treatments.

Methods: The study included 197 volunteers in 4 treatment groups: placebo, 200 mg netupitant + 0.5 mg palonosetron (NEPA200/0.5), 600 mg netupitant + 1.5 mg palonosetron (NEPA600/1.5), and 400 mg moxifloxacin. Treatment involved a 24-h baseline ECG, a single dose of treatment, followed by ECG measurements for 2 days. Cardiovascular safety and tolerability were assessed.

Results: Mean placebo-corrected QTcI change from baseline for NEPA200/0.5 and NEPA600/1.5 was +5 and +4 ms, respectively. Moxifloxacin showed an expected 8/9 ms increase in QTcI vs placebo. Mean placebo-corrected change from baseline for HR was -3 bpm for both NEPA groups. Placebo-corrected changes in pulse rate (PR) and QRS durations were comparable in both NEPA groups (0–1 ms). The frequency of treatment-related AEs (TRAEs) in the NEPA200/0.5 was similar to the placebo and moxifloxacin groups but slightly higher in the NEPA600/1.5. Constipation, upper abdominal pain, and headache were commonly reported TRAEs after different NEPA doses administration.

Conclusions: No significant effects on QTcI, HR, PR, or QRS duration were observed after different NEPA doses administration.

MASCC-0072

Serum and salivary levels of polyamines as potential biomarkers in the diagnosis of oral squamous cell carcinoma

S.G.Al-Talabani A.-W.R. Hamad 1,2

1Medical Allied Sciences, Al-Balqa Applied University, Salt, 2Al-Balqa Applied University, Amman, Jordan

Background: Oral cancer is one of the prevalent cancers of the body and is one of the 10 most common causes of death. Oral squamous cell carcinoma (OSCC) accounts for over 90 % of these tumors. The aim of this study was designed to detect biochemical markers in serum and saliva of oral squamous cell carcinoma patients and to evaluate their validity in monitoring and diagnosis.

Patients and Methods: The level of polyamines in the serum and saliva of (30) patients with OSCC and (20) healthy individuals as control group was measured. Polyamines (spermidine and spermine)were determined by high performance liquid chromatography (HPLC) in both serum and saliva of patients with OSCC and control group.

Results and Discussion: The total serum and salivary polyamines level of OSCC were significantly higher than the control group (P < 0.001). Both salivary and serum polyamines level were reliably accurate test in separating between OSCC patients and control group since the area under the ROC curve for both serum and salivary polyamines was one which is significantly higher (different) from that of an equivocal test of 0.5. There was significant difference in salivary spermine level among OSCC patients in relation to lesion status. Spermine levels were reduced in recurrent lesion especially with metastases. There were significant differences in serum polyamines level among OSCC patients in relation to duration of the disease (P < 0.05).

MASCC-0073

Fatigue characteristics and physical fitness in colorectal cancer survivors

Y.-H.L.,K.-H.Y.,J.-Y.T.,J.-T. S.-C. Shun 1

1Department of nursing, College of Medicine/National Taiwan University, 2National Taiwan University, 3Depatment of medicine, 4Department of Physical Therapy, 5Department of Medicine, National Taiwan University, Taipei, Taiwan R.O.C.

Introduction: Enhancing activity has been proved as the best strategy to improve cancer-related fatigue. Exercise behavior should be understood before conducting exercise program. Fatigue is current measured by self-report but objective reporting method should be explored to measure the exactly change of fatigue.

Objective: To (1) explore exercise behavior and level of physical fitness and domains of fatigue, and (2) identify associations between physical fitness and domains of fatigue in colorectal cancer survivors.

Methods: A cross-sectional design was used, with participants recruited from the outpatient clinics in Northern Taiwan. A set of structured questionnaires was used to assess participants’ exercise behavior, fatigue characteristics (intensity, duration and its interference), anxiety, and depression. Physical fitness was measured by 6-minutes walking test (6MWT), 30-second sit and up (30-SU), hand grip strength, and low leg muscle strength.

Results: One hundred and sixty-one patients were included in this study. About 72.7 % (n = 117) patients reported taking regular exercise, but the level of loving to take exercise was 6.5 points based on a 0 to 10 scale. Around 59.6 % of survivors reported experiencing fatigue. Duration of fatigue and the level of interference in daily life caused fatigue and overall fatigue were associated with hand grip strength.

Conclusions: Healthcare providers should understand the cancer survivors’ exercise preferences before conducting exercise program to improve their fatigue. Hand grip strength may be the good objective indicator for fatigue in colorectal cancer survivors. Larger sample size is suggested to confirm the results for the future studies.

MASCC-0074

Mistletoe preparation (Viscum Fraxini2) as palliative treatment of malignant pleural effusion

R. Gaafar1, F.A. Kassem1, A.E. Bastawisy 1

1Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt

Background: Malignant pleural effusion is a common finding in patients with solid tumors with significant impact on quality of life hence there is a strong need to investigate new agents in this entity.

Patients and Methods: This is a prospective randomized controlled study including patients with symptomatic recurrent malignant pleural effusion of different primaries. Patients were randomized into 2 groups : the 1stgroup received 5 ampoules of Mistletoe preparation with defined lectin content(Viscum Fraxini2) diluted in 10 cc glucose 5 % solution. Re-instillation was repeated every week till complete dryness of the pleural fluid (maximum duration of therapy 8 weeks). 2nd group received 60 units of Bleomycin once intrapleurally. The primary aim of this study was to evaluate the efficacy of Mistletoe preparation as a palliative treatment of malignant pleural effusions in comparison to Bleomycin. Secondary aim was to evaluate the tolerability of the Mistletoe preparation.

Results: A total of 23 patients were included and followed up during the study from Dec.2007 till Jan.2012.13 patients received Mistletoe preparation and 10 patients received Bleomycin. Overall clinical response (drytap) was reported in 61.5 % of Mistletoe preparation arm versus 30 % in Bleomycinarm (p = 0.2138), 95 % CI = (-0.1203, 0.6325). Toxicity of both arms was mild admanageable and included in Mistletoe preparation arm: fever, chills, headache, malaise and in 2 cases allergic reaction which was controlled by discontinuation of the drug and steroid injection.

Conclusions: Mistletoe preparation is an efficient and well tolerated sclerosant agent and needs further investigations.

MASCC-0075

Preventive effect of saffron’s bioactive ingredient “crocin” against liver cancer: a preclinical study

R.S.-S.,S.D. A. Amin 1,2

1Biology, UAE University, Al-Ain, United Arab Emirates, 2Zoology, Cairo University, Cairo, Egypt, 3Institute of Pathology, University of Erlangen, Erlangen, Germany, 4Histopathology, Tawam Hospital, Al-Ain, United Arab Emirates

Introduction: This is a follow up of our study published in September issue of Hepatology and featured in October issue of Science News that documented the antic-cancer potential of saffron.

Objectives: To investigate both chemopreventive actions and mechanisms of saffron-based bioactive ingredient; crocin, against diethylnitrosamine (DEN)-induced liver cancer in rats.

Methods: Administration of crocin at two doses of 100 and 200 mg/kg body wt per day was started 2 weeks prior to the DEN injection and was continued for 22 weeks.

Results: Crocin decreased the placental glutathione-S-transferase positive foci in livers of DEN-treated rats. Furthermore, crocin counteracted DEN-induced oxidative stress in rats as assessed by restoration of superoxide dismutase, catalase, and glutathione-S-transferase levels and diminishing of myeloperoxidase activity, malondialdehyde and protein carbonyl formation in liver. The results of immunohistochemical staining of rat liver showed that crocin inhibited the DEN-mediated elevations in numbers of cells positive for Ki-67, cyclooxygenase 2, inducible nitric oxide synthase, nuclear factor-kappa Bp-65 and the phosphorylated tumor necrosis factor receptor. Crocin also blocked the depletion in the number of cells positive for TUNEL and M30 CytoDeath in liver tissues of DEN-treated rats. In vitro experiments also confirmed these findings and showed inhibition of NFkB activation, increased cleavage of caspase-3, as well as DNA damage upon saffron treatment.

Conclusions: The present study provides evidence that crocin protects against liver cancer through inhibition of cell proliferation and induction of apoptosis and that crocin’s anti-cancer effect is manifested via modulating oxidative damage and suppressing inflammatory response.

MASCC-0076

Food sources of vitamin d and its deficiency in Latvian males

1The sanatorium ‘Jantarnij Bereg’, Riga Stradins University, 2Riga Stradins University, Faculty of Rehabilitation Sports, Nutrition and Education Department, Riga, Latvia

Background and objectives: Over50 % of population is found to suffer from vitamin D deficiency. Vitamin D deficiency in Europe, Northern Europe, Asia and Africa, especially in elderly people was revealed by many epidemiological researches.

Methods: There were included 134 males aged 45–80. None of the research participants have taken any vitamin D supplements or supplements containing vitamin D. Serum vitamin D level was detected in all the participants((25 hydroxyl vitamin D: 25(OH)D) and the amount of the consumed vitamin D was determined. The survey was conducted to acquire information about the amount of vitamin D consumed with food.

Results: Insufficient Vitamin D intake was detected in 78,4 %, vitamin D deficiency with consequent low vitamin D serum level in 94,1 %. Mean data: vitamin Din food—6,9 μg, 25(OH)D—16,9 ng/mL, BMI—28,1 kg/m2, age–59,4 years. The amount of vitamin D in food statistically reliably directly correlate with serum vitamin D level (r = 0,961; p = 0,01), and there is an inverse correlation with age (r = 0,226; p = 0,009). No statistical reliable correlation was found between serum 25 (OH) Dlevels and BMI. Major food sources of Vitamin D are fat-rich seafish, eggs, dairy product.

Conclusions: Insufficient intake of vitamin D with food and low serum level is marked in males of advancing age. Vitamin D levels directly correlate with vitamin D intake. Not found statistically significant correlation between vitamin D levels, vitamin D diet and BMI, but indirectly correlates with age.

MASCC-0077

The burden of unidentified depression in breast cancer patients in a Nigerian oncological clinic: evidence for scaling up services to bridge mental health gap

F.O.S. A.T. Olagunju 1

1Department of Neuropsychiatry (psychooncology), Lagos University Teaching Hospital/College of Medicine, University of Lagos, Lagos, 2Department of Oncology/Radiotherapy, University College Hospital, Ibadan, Ibadan, Nigeria

Introduction: The diagnosis, course and treatment of breast cancer are frequently not without emotional distress in the affected people. Common emotional related problems include fear, anger, shock, low self esteem, anxiety, impaired social functioning and depression (perhaps the commonest). Unfortunately, emotional disorders, especially depression in people with breast cancer are poorly dealt with, despite the linkage of their co-morbidity with poor treatment compliance; worsen disease progression and poorer quality of life.

Objectives: This abstract aims at illustrating the burden of unidentified depressive illness in people with breast cancer in a treatment facility in Lagos.

Methods: A total of 96 consenting adults with histological diagnosis of breast cancer recruited using systematic random sampling were interviewed with sociodemographic/clinical profile questionnaire and Centre for Epidemiological Studies Depression Scale Revised (CES-DR) by the researchers. Data obtained were analysed using SPSS-15.

Results: In this study, a significant proportion of individuals with breast cancer had depressive symptomatology (CES-DR score of 16 and above) made up of 46(47.9 %) of the total participants. In addition, none of these depressed participants have been identified or treated previously for depression.

Conclusions: Overall, the finding in this study exemplifies the existing mental health gap among people with breast cancer, thus underscores the need to either develop or scale up comprehensive mental health services targeted towards prompt identification and treatment of emotional disorders using a holistic approach. Furthermore, key stakeholders in the management of breast cancer need to be engaged in order to translate research evidence to policy formulation and development of treatment programmes.

MASCC-0078

Assessment of prevalence, psychosocial correlates and psychometrics of a screening instrument of depression among oncology outpatients in Sub-Saharan Africa

A.T. Olagunju 1, O.F. Aina1

1Department of Neuropsychiatry, Lagos University Teaching Hospital/College of Medicine, University of Lagos, Lagos, Nigeria

Introduction: Depression in cancer subjects has been linked with grave consequences if unattended, however, poorly diagnosed due to paucity of information and absence of screening modalities.

Objectives: This study aims to determine the prevalence with correlates of depression and evaluate the diagnostic validity of Centre for Epidemiological Studies Depression Scale Revised (CES-DR) for screening in cancer subjects.

Methods: The participants were recruited using systematic random sampling, made up of 200 cancer patients and 200 age and sex matched controls that consented and met the inclusion criteria. A designed socio-demographic, clinical profile questionnaire, CES-DR and the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) were used to interview participants.

Results: One-half of all cancer patients presented with advanced stage cancer and 98 (49.0 %) of them compared with 40 (20.0 %) controls had significant depressive symptomatology using CES-DR scores of ≥16. The prevalence of depression based on SCAN in cancer subjects was 27.5 % with 9.5 % in controls and the difference was statistically significant (p = < 0.001). A substantial proportion of cancer patients with depression 36(65.5 %, n = 55) had moderate depression, while 7.2 % (n = 55) had severe depression. Unemployment status, being unmarried and duration of cancer were predictive of depression in cancer participants (p = ≤0.005). The sensitivity and specificity of CES-DR was 96.4 % and 68.7 % respectively

Conclusions: Prompt identification and treatment of cancer, mental disorders like depression should be integrated into cancer care in this part of the world. Furthermore, availability of screening tools like CES-DR for cancer patients in local languages in primary care settings is warranted.

MASCC-0079

Experiences of pain—a longitudinal qualitative study of patients with head and neck cancer recently treated with radiotherapy

B.L.,2.,M.L.,G.M.L. A.K.C. Schaller 1,2

1“Rehabilitation Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, 2Pain and Rehabilitation Centre, County Council of Östergötland, 3Department of Social and Welfare studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden”

It is not unusual for Patients with Head and Neck Cancer (HNC) often suffer from both tumour and treatment-related pain that is difficult to alleviate. This longitudinal, qualitative study aims to describe how HNC patients experience existential, psychological, physical and social pain and how these dimensions of pain influence the well-being of HNC patients treated with radiotherapy (RT).

Twenty-six patients were invited to participate in two interviews after RT had been completed. These interviews were analysed using content analysis. The effects of pain on the well-being of HNC patients emerged as a main category within the results. Besides, five additional categories were found: the preoccupied mind, the altered mood, overwhelming fatigue, bodily pain and decreased participation and changed relations. For the first time, this study demonstrated that a patient group in the treatment phase suffers from existential pain in the form of fear of death, meaninglessness and guilt. Psychological, physical and social pain were also prominent. In all likelihood, the different dimensions of pain influence one another. Health care staff should consider a patient’s overall pain situation from the time cancer treatment begins, so that the depression, anxiety, fatigue, pain, nutritional difficulties and social withdrawal experienced by patients will decrease.

MASCC-0080

Phase II clinical trial using aminotrofic in the prevention of anorexia and cachexia in cancer patients receiving chemotherapy: evaluation of the efficacy and safety

R.P.,A.R.,V.C.,R.R. A. Lugini 1

1Medical Oncology, Hospital ‘San Camillo de Lellis’, 2medical Oncology, Hospital ‘San Camillo de Lellis’, Rieti, 3medical Oncology, Hospital ‘Santa Maria Goretti’, Latina, Italy

Introduction: Food shortage in cancer patients is associated with poor prognosis. Treatments and disease have a major impact on nutritional status. An improvement of the nutritional status of patients with cancer can change the prognosis, quality of life and functional status, facilitating improved tolerance to treatment. Aminotrofic is a supplement of amino acids with vitamins B6 and B1, shown to provide useful nutrients for muscle trophism.

Methods: From November 2011 to April 2012, 30 cancer patients received Aminotrofic at a dose of 2 sachet/day. All patients included in the study performed chemotherapy: 70 % of the patients performed a treatment for metastatic disease. The treatment duration was at least 4 months. The following variables were evaluated: 1) nutritional status; 2) clinical status; 3) quality of life; 4) adherence to the chemotherapy.

Results: Of 30 patients, 28 completed the treatment and were assessable. All evaluable patients did not show a significant reduction in body weight, appetite and quality of life. The 28 evaluable patients also completed the chemotherapy program.

Conclusions: Aminotrofic found to be safe and effective in this setting of the study. The relevant data is represented by adherence of patients to chemotherapy treatment in relation to the maintenance of an adequate performance status. A randomized phase III study is warranted.

MASCC-0081

Quality of life of elderly patients receiving weekly carboplatin and paclitaxel chemotherapy plus cetuximab first line for metastatic squamous carcinoma of the head and neck

R.R.,R.P.,V.S.,A.R. A. Lugini 1

1medical Oncology, San Camillo de Lellis, General Hospital, Rieti, 2Medical Oncology, Santa Maria Goretti, General Hospital, Latina, Italy

Background: A phase III trial demonstrated that Cetuximab is the first agent to improve survival when added tho platinum-based chemotherapy for metastatic squamous cell carcinoma of the head and neck. The safety and tolerability of a combination of weekly Paclitaxel and Carboplatin and Cetuximab for the first line treatment for metastatic squamous cell carcinoma of the head and neck in elderly population were investigated.

Patients and Methods: Patients >70 years of age with histologically confirmed metastatic squamous cell carcinoma were enrolled. Other eligibility criteria included: measurable disease, Karnofsky performance status >60 % and adequate hematologic, hepatic and renal functions. Patients receiving Paclitaxel (80 mg/mq), Carboplatin AUC 2 and Cetuximab (400/250 mg/mq) weekly. Treatment was continued for a maximum of six cycles of chemotherapy. After six cycles, patients in the who had at least stable disease received cetuximab monotherapy until disease progression or unacceptable toxicity. The European Organisation for Research and Treatment of Cancer QoL Questionnaire-Core 30 and QLQ-Head and Neck 35 module were used to assess QoL.

Results: From September 2010 to September 2012 were evaluated 40 patients with metastatic squamous carcinoma of the head and neck. Patients were scheduled to complete the questionnaires on day 1 of every cycle. The analysis of the responses to the questionnaires from patients shows that the pattern of chemotherapy used provides excellent control of symptoms related to the disease.

Conclusion: This analysis shows an important clinical benefit of chemotherapy regimen proposed in the population included in the study.

MASCC-0082

The quality improvement of palliative care in the intensive care unit

P.M. A. Milanti 1

1Maternity and women’s health nursing, University of Indonesia, Depok, Indonesia, 2Faculty of Health Care and Nursing, Helsinki Metropolia University, Helsinki, Finland

Introduction: There are evidences of failure and challenges to incorporate a holistic palliative care into the nursing care plan in the critical care setting.

Objectives: The objective of this study was to assess the interventions to improve the quality of palliative care in the intensive care unit.

Methods: Online search of electronic nursing databases were conducted. Five studies met the inclusion criteria. The data were then extracted and analyzed by using content analysis

Results: The thematic analysis revealed some interventions aimed for quality improvement of palliative care in the ICU are integrating palliative care into the intensive care, promoting palliative care consultation and enhancing collaboration between the palliative care by the ICU team and the palliative team.

Conclusions: Quality improvement of the palliative care in the intensive care unit is a collaborative work that can be implemented in several approaches. A strong nursing leadership and managerial ability is needed to address the common challenges of the group change process in the quality improvement.

MASCC-0083

Outcome of intravenous methotrexate in recurrent or persistent squamous cell carcinoma of head and neck

1Radiation Oncology, 2Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

Introduction: Recurrent or progressive disease in head and neck cancers is considered to have poor prognosis. Although various chemotherapeutic agents have been tried in palliative setting but there is a lack of definitive standard protocol.

Objectives: The aim of this retrospective study is to evaluate the outcome of intravenous methotrexate in recurrent or persistent squamous cell carcinoma of head and neck in our institution.

Methods: Between January 2006 and December 2009, 103 patients with recurrent or persistent head and neck cancers were identified from Head and Neck Database at Shaukat Khanum Memorial Cancer Hospital and Research Center. All the patients had good performance status (ECOG 0–1) prior to the start of palliative chemotherapy and received intravenous methotrexate 40 mg/m2 weekly. Response, toxicity and mean time to progression were determined.

Results: Response to methotrexate; complete response (CR) in 10 %, partial response (PR) in 11 11 %, stable disease (SD) in 60 % and progressive disease (PD) in 19 % of patients respectively. Chemotherapy related toxicities includes; grade 4 neutropenia and mucositis in 6 (5 %) and 8 (7 %) respectively and deranged liver functions in 17 (16 %) patients. Mean time to progression was 7.5 months (range 1–39 months).

Conclusions: The disease control in our study is comparable with already published literature. Although various drug regimens have been employed in the past very little has been gained in slowing the progression of the disease.

MASCC-0084

Inhibition of proteasome and metalloproteinase activities in CACO2 cells by phenolic-rich extracts from some citrus peels

G.O.,S.p.,F.T. A.O. Ademosun 1

1Biochemistry Department, Federal University of Technology, 2Department of Biochemistry, Federal University of Technology, Akure, Nigeria, 3Department of Life Sciences, University of Trieste, Trieste, Italy

This study sought to investigate the effect of free and bound phenolic extracts from some citrus[grapefruit (Citrus paradisii), orange(Citrus sinensis) and shaddock (Citrus maxima)] peels on the proteasome and matrix metalloproteinase (MMP) activities in primary colon cancer cells(Caco-2). The free phenolics were extracted with 80 % acetone, while the bound phenolics were extracted from the alkaline and acid hydrolyzed residues withethyl acetate. The results revealed that free and bound phenolic extracts from orange peels had significantly (P < 0.05) higher inhibition of proteasome activity in extract-treated cell lysates, while free and bound phenolics from shaddock peels had the least inhibition. Both phenolic extracts from orange peels and bound phenolics from grapefruit peels had significantly (P < 0.05)higher inhibition of proteasome activity in intact cells after 24 h treatment with the extracts. Furthermore, the dose-dependent inhibition of MMP activity in Caco-2 cells by the extracts showed that free phenolic extracts had significantly (P < 0.05) higher inhibition than the bound phenolics in the three peels. The inhibition of proteasome and MMP activity in primary colon cancer cell line by phenolic extracts from these citrus peels showed that they could potentially be used in the management of colorectal cancer. However, bound phenolics exhibited stronger inhibition of proteasome activity, while free phenolics showed a stronger inhibition of MMP activity.

MASCC-0085

Impact of chemotherapy (regimens and doses) onthrombocytopenia in solid cancer patients

Z.M.Y.,M.A.H.,S.O. B.A.R. Hassan 1

1Clinical Pharmacy, 2Social and Administrative Pharmacy, Universiti Sains Malaysia, Penang, Malaysia

Introduction: Thrombocytopenia denotes abnormal decreases in platelet numbers and is a major detrimental side effect of the chemotherapy or cancer disease itself which can lead to hemorrhage from vital organ. This is particularly a problem for the brain specifically within solid cancer patients and has a great negative effect on cancer patients quality of life (QOL). This present study tries to find the association between thrombocytopenia onset and severity with different chemotherapeutics regimens and doses used in the treatment of several solid cancers.

Methods: This retrospective observational study was conducted in Penang General Hospital on 341 thrombocytopenic solid cancer patients who were admitted between 2003 and 2009. The main statistical tests used were Chi-square test and Logistic regression test for categorical data. While for continues data the main statistical tests were Linear regression and correlation test. The significance of the result will be when the P < 0.05, while the confidence interval for this study was 95 %.

Results: FEC and 5-FU + 5-FU have the strong association and correlation with thrombocytopenia onset and severity. However the associations and correlations with thrombocytopenia severity were stronger than those with the onset. Different doses of 5-FU and cyclophosphamide play a critical role in thrombocytopeniaonset and severity.

Conclusion: Monitoring and determination of platelet levels for cancer patients treated with FEC and 5-FU + 5-FU specifically with high doses must be emphasized and afocus of particular attention i.e., palliative and supportive care.

MASCC-0086

Comparison of the impact of breast cancer treatment within two different healthcare systems

S. Singh-Carlson1, C. gotz2, S. Smith3, F. Wong4

1Nursing, California State University Long beach, 2Rehabilitation, Todd Cancer Centre, Long Beach, USA, 3Radiation Oncology British Columbia Cancer Agency, Victoria, Victoria, 4Radiation Oncology British Columbia Cancer Agency, Surrey, Surrey, Canada

Introduction: Breast cancer survivors? (BCS) experiences and concerns of treatment impacts and perceptions of survivorship care plan (SCP) content and benefit seem to resonate for women regardless of different populations or healthcare structuring.

Objectives: This paper will compare how BCS of different ethnic background, residing in unlike healthcare systems report of the impact of breast cancer treatment. Discussions will include thematic findings from 4 studies that explored experiences/concerns of BCS post-treatment at different life-stages conducted in Southern California with American Caucasian/Hispanic and in British Columbia with Canadian Caucasians and South Asian (SA) BCS.

Methods: All studies utilized qualitative methodology and interviewed women ranging from 19 to 80 years old, 3–60 months post-treatment, with non-metastatic breast cancer. Canadian BCS were discharged from cancer-agency settings to family physicians, whereas American counterparts were followed by oncologists or family-physicians, dependent on types of medical insurance coverage. Comparison of themes will identify treatment-impacts variation among BCS in different healthcare-structuring.

Results: Some universal effects were fatigue-loss of physical energy/strength, fear/uncertainty, cognitive changes, and need to normalize post-treatment. Financial concerns due to loss of wages were common among BCS; however BCS in American healthcare system would seem to experience higher rates of mental distress due to medical insurance costs. Themes such as accessing inner strength and experiencing losses had different cultural and social nuances for BCS from all settings.

Conclusions: Comparison of these populations show need for development and implementation of appropriate SCP, that focus on varying ages, being mindful of different healthcare systems, social and cultural nuances.

MASCC-0087

Glioblastoma multiforme and neurocognitive functioning: own experience

B. Slovackova 1, L. Slovacek1, R. Zirko1, J. Kopecky1

1Charles University Hospital, Hradec Kralove, Czech Republic

Background: The authors evaluate in a pilot study the neurocognitive function of patients with GBM.

Patients and Methods: The evaluation of neurocognitive function had been performed during 2009–2010 in 11 patients with GBM (9 women, 2 men) with a mean age of 56.8 years (age range 45–72). The assessment of neurocognitive functions was performed by clinical neuropsychologist using the Methods sensitive for cognitive deficit

Results: Because of a limited set of patients and an insufficient number of scheduled check-ups (caused by severe tumour progression) the results could not be statistically evaluated. Due to these circumstances, the results of a pilot study are presented in the form of case reports. There are presented the results of three patients with different localization of GBM and with different type of neurosurgical intervention (total resection, subtotal resection and stereobiopsy).

Conclusion: The diagnosis of cognitive deficit can be based on careful assessment of personal medical history, present symptoms and physical examination. Laboratory tests and imaging technique help by the detection of secondary cognitive changes. Targeted examination of cognitive function relies in use of various neuropsychological tests. To monitor developments and changes in cognitive functions in patients with GBM the following battery of neuropsychological tests has shown helpful information: Addenbrooke’s Cognitive Examination, Trail Making Test, Rey-Osterrieth Complex Figure and Verbal Fluency Test. It seems that this battery of neuropsychological tests is suitable for repeated long-term monitoring of cognitive function in cancer patients undergoing radiotherapy of brain.

MASCC-0088

The effectiveness of innovative integrated teaching method on female adolescents’ knowledge of cervical cancer, health belief, and the intention of HPV vaccination

C.Y. Lai 1, W.W. Wu1, S.F. Cheng1

1National Taipei University of Nursing and Health Sciences (NTUNHS), Taipei, Taiwan R.O.C.

Introduction: Cervical cancer is not only the second leading cause of the death in the world, but also ranked as the second most prevalent cancer among women in Taiwan.

Objectives: The purpose of this study was to explore the effectiveness of innovative integrated teaching strategies on female adolescents’ knowledge of cervical cancer, health belief, and the intention of HPV vaccination.

Methods: A quasi-experimental pre-and post-test research design with two groups was used. A purposive sample of 200 female adolescents from a regional high school in Taipei were recruited. The research instruments used in this study included the structured demographic questionnaire, the scale of female adolescents’ knowledge of cervical cancer and health belief, and the acceptability scale. The innovative integrated teaching strategies were including: (1) the video CD provided by the Department of Health, Executive Yuan ROC (Taiwan) for the prevention of cervical cancer;(2) the teaching material’s Power Point made by authors according to their clinical experiences; and (3) Facebook used as a platform to facilitate students’ discussion and learning with the lecturer and classmates.

Results: GEE(Generalized estimating equations)was used to test the effectiveness of the innovative integrated teaching method were on promoting female adolescents’ knowledge of cervical cancer, health belief, and the intention of HPV vaccination.

Conclusions: The teaching method can be applied to Taiwan’s high school on promoting promoting women’s health.

MASCC-0089

The effect of halofuginone on radiation induced cardiovascular damage

M.C.,G.Y.,H.T.,H.E., C. Yavas 1

1Radiation Oncology, 2Thoracic Surgery, Konya Training and Research Hospital, 3Radiation Oncology, Selcuk University, 4Pathology, Necmettin Erbakan University, Konya, 5Anatomy, Hacettepe University, Ankara, Turkey

Purpose: We aimed to evaluate the effects of two different doses of Halofuginone (H) on radiation induced cardiovascular damage.

Methods: Sixty female rats were divided into 6 groups. Group (G) 1 was defined as control group. G2 was radiotherapy (RT) only group. Group 3 and 4 were 2.5 and 5 μg H groups respectively. Group 5 and 6 were RT plus 2.5 and 5 μg H groups respectively. A single dose of 12 Gy RT was given with 6 MV photon beams. H was applied intraperitoneally with daily doses, started immediately after administration radiotherapy and continued until the animals were sacrificed. Kruskal-Wallis and Mann–Whitney U tests were used for statistical analyses.

Results: The endocardial thickness of all study groups was significantly differed at 6th and 16th week of RT (p < 0.001 for each). The maximum thickness was observed in G2. There were significant differences between G2 and G5 (p < 0.001); G2 and G6 (p < 0.001) and; G5 and G6 (p = 0.001) regarding to endocardial thickness at 16th week of RT. There were significant differences within the study groups in terms of thoracic aorta fibrosis scores (p = 0.002). When the RT groups were compared there were significant differences between G2-G5, G2-G6 (p = 0,007 and = 0,002 respectively). There weren’t any difference between the control and H groups.

Conclusion: Our results suggested that H may improve radiation induced cardiovascular damage. The most prominent improvement was observed in 5 μg H + RT group at 16th week of RT.

MASCC-0090

Young adult cancer survivors: health behaviors and related discussions with healthcare providers

C. Berg 1

1Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA

The increased incidence and decreased mortality of pediatric cancer has resulted in a growing population of survivors at risk for health problems and early mortality. We examined health behaviors and recent interactions with healthcare providers regarding health behaviors among 102 young adult survivors of pediatric cancers identified from medical records in the Southeastern US. We then conducted qualitative interviews with30 survivors and 20 healthcare providers. Our survey sample was on average22.22 (SD = 3.21) years old, 50 % female, and 19.4 % Black. In the past 30 days,14.0 % had smoked cigarettes, 11.1 % had used marijuana, and 59.2 % had used alcohol, with 22.2 % binge drank. Nearly a quarter (24.0 %) was sedentary. Predictors of engaging in positive health behaviors included greater health-related locus of control and social support (p’s < .05). Regarding interactions with healthcare providers during their last clinic visit, 59.0 %were asked about smoking, 56.0 % were asked about alcohol use, 46.5 % were asked about illicit drug use, 70.0 % were asked about nutrition, and 71.7 % were asked about physical activity. Qualitative interviews with young adults indicated that participants were rarely told about the specific need to engage in positive health behaviors for pediatric cancer survivors. Moreover, participants indicated that, while these factors were sometimes assessed, minimal intervention was delivered. Similarly, healthcare provider interviews indicated that, while many assessed tobacco use and weight-related factors, these assessments were not systematically done, and little support for interventions existed. Thus, increased resources to support healthcare providers in tertiary cancer prevention efforts are needed.

MASCC-0091

Tanshinone IIA could inhibit human hepatocellular carcinoma HA59T/VGH cells through ER stress in vitro

C.C. Su 1

1Surgery, Changhua Christian Hospital/China Medical University, Changhua, Taiwan R.O.C.

Introduction: Malignant tumor is the leading cause of death in Taiwan at recent 20 years. The 5-year survival rate is only 5 % in un-resectable patient. Looking for more effective medicine is necessary. DanShen (Salviae miltiorrhizae Radix) is a widely prescribed traditional herbal medicine for cardiovascular diseases. Tanshinone IIA (Tan-IIA) is one of the diterpene quinone extracted from DanShen.

Purpose: Our previous study showed that TanshinoneIIA (Tan-IIA) can inhibit human hepatic cancer cells HepJ5 through inducing endoplasmic reticulum stress (ER stress) in vivo and in vitro. For further evaluated the efficacy of Tan-IIA, the other human hepatic cancer cell line HA59T/VGH was used to study.

Material and method: The cytotoxicity of Tan-IIA in HA59T/VGH cells was measured by MTT assay. The ER stress related protein expressions (PERK, IRE1, Bip, PDI, Calnexin, Calreticulin, p38, ERK, TCTP and Mcl-1) in HA59T/VGH cells were treated with different concentrations of Tan-IIA for different durations by western blotting. Result: The results showed Tan-IIA could inhibit the HA59T/VGH cells with time and dose dependent. The concentrations of IC50 were 20.12, 16.66 and 10.30 μM for 24, 48 and 72 h, respectively. The protein expressions of ATF6, p38, Caspase-12, Caspase-9, Cleaved Caspase8 and Bax were up-regulated, but pERK, JNK, Bcl-xL, Bcl-2, Mcl-1 and TCTP were down-regulated when compare with control group.

Conclusion: Tan-IIA could inhibit the HA59T/VGH cells in vitro through inducing ER stress. These finding indicate that Tan-IIA could inhibit H.C.C through inducing ER stress in vitro.

MASCC-0092

Review on methods, risks & benefits of enteral nutrition in patients with head and neck cancers being treated with radiotherapy or chemotherapy

Z.v.,h.a.n.c.p. C. kereena 1

1Biotechnology, 2Botany & Microbiology, Acharya Nagarjuna University, Guntur, India

Background: Patients with head and neck cancer are at high risk of malnutrition due to dysphagia from the tumor and treatment. 40–50 % of head and neck cancer patients have a markedly impaired nutritional status at the time of their initial presentation. Despite difficulty with oral intake, these patients usually have a normal stomach and lower gastrointestinal tract. The preferred route of nutritional support for these patients is enteral nutrition. Two commonly used Methods for enteral feedings are nasoenteric and percutaneous endoscopic gastrostomy.

Objectives: To determine the Methods, risks and benefits of enteral feeding used in the nutritional management of patients with head and neck cancer receiving radiotherapy or Chemo radiotherapy using the clinical outcomes, nutritional status, quality of life and rates of complications.

Methods: Data were collected on demographics, diagnosis, types, nutritional status, management, benefits, risks and duration of enteral feeding.

Results: Malnutrition occurs frequently in head and neck cancer and may be overlooked in patients who do not look ‘underweight’ despite significant weight loss. Early and intensive nutrition intervention however has been shown to prevent or minimise nutritional deficits. Based on our findings, nutrition support should be indicated for cancer patients considering the potential effects to improve the quality of life.

Conclusions: Both baseline and treatment-induced malnutrition need to be addressed, and aggressive nutritional support can decrease the weight loss during the treatment and improve quality of life in patients with head and neck cancer.

MASCC-0093

Effect of soya and red kidney bean supplementation on lipid peroxidation and antioxidant levels of head and neck cancer patients

Z.V. C. kereena 1

1Biotechnology, 2Botany & Microbiology, Acharya Nagarjuna University, Guntur, India

Objectives: * To investigate whether supplementation with Soya and Red Kidney Bean recipe can improve biochemical status of enzymatic and non enzymatic antioxidants in head and neck cancer patients during treatment.

Methods and Materials: A total of 120 head and neck cancer patients were divided into three groups, each group consisting of 40patients Group A (GA) supplemented with Soy bean (SB), Group B (GB) supplemented with red kidney bean (RKB), Group C (GC) supplemented with SB & RKB combination. The serum was analyzed for enzymatic & non enzymatic antioxidants.

Results: There is no significant difference between cases before and after supplementation in SOD values. There is a significant difference between GA & GC cases and no significant difference in GB before and after supplementation in catalase values. There is a significant difference of MDA levels between the supplemental groups. There is a significant difference of vitamin A values in groups between GA & GC before and after supplementation and no significant difference in GB. The difference between GA, GB & GC for vitamin E values is significant. Vitamin C value is increased and significant in GA and GC and insignificant in GB. Soya bean showed positive antioxidant activity that may contribute to enhance the effect of antioxidant defense. Conclusion: The present study revealed that, Soya bean and red kidney bean, and combination of soy and red kidney bean supplementation has effectively reduced lipid peroxidation (LPO) and oxidative stress through increased antioxidant status in the head and neck cancer patients.

MASCC-0094

Home versus hospital cancer mortality (2006–2011) and palliative care

L.V. E. Vvedenskaia 1

1State Medical University, 2Regional Medical Statistics Center, Nizhny Novgorod, Russia

Objectives: Our aim was to examine the proportion of home versus hospital cancer mortality in a large Russian region in relation to demographic factors and to identify 5 year trends in home deaths from cancer.

Materials and Methods: The data on the place of death were derived from death registrations for all cancer deaths in the region between the years of 2006–2011.We examined 5 year trend in home and hospital cancer mortality for the whole region, for the city and for the rural area.

Results: Within this period the percentage of home deaths from all causes significantly increased: in the region from 55.67 % to 73.68 %, in rural areas from 60.10 % to 82.12 % and in the city from 30.32 % to 66.37 %. The number of deaths from cancer was consistently high and the rate of home cancer deaths was 85.0–89.0 % - 87.52 % on average for these years. Older people with cancer were more likely to die at home (85.16 % of all cancer deaths). Among all women and men died from cancer respectively 90.62 % and 79.60 % died at home. The proportion of homeland hospital deaths from cancer was 87.52 and 7.48 %, respectively.

Conclusions: High proportion of home cancer deaths is the result of reducing the hospital care supply and demonstrates low availability of inpatient palliative care. These findings today highlight the need for a palliative care service establishment for cancer patients and special attention should be paid to home care services and palliative care education of primarily care medical specialists.

MASCC-0095

Sense of coherence and symptom burden in women with breast cancer

M.B.,4.,5.,F.G.-J. E. Kenne Sarenmalm 1,2,3

1“Research and Development Centre, Skaraborg Hospital, Skövde, 2Institute of Health and Caring Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, 3Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, MD, USA, 4School of Life Sciences, University of Skövde, Skövde, 5Institute of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden”

Introduction: Less is known about personal factors such as sense of coherence (SOC) that could interfere with the management of a variety of burdensome symptoms that challenge the patient from the moment of a breast cancer diagnosis through the treatment and its aftermath.

Objectives: To examine symptom burden and SOC in a cohort of 206 patients with breast cancer.

Methods: In this prospective and longitudinal study, the Memorial Symptom Assessment Scale, and SOC-scale were used to evaluate symptom burden and SOC at the diagnosis of primary or recurrent breast cancer, and 1 month, 3, and 6 months follow-ups. A two-step cluster analysis was used to categorize participants into clusters of individuals.

Results: The cluster analysis resulted in two clusters. Cluster I (61.1 %) included individuals who generally experienced fewer symptoms and lower levels of symptom burden. In contrast, cluster II (39.9 %) included individuals who experienced more symptoms and higher levels of symptom burden. There was a significant correlation between SOC and clusters, showing that cluster I had higher SOC mean level (mean SOC = 75 with 95 % CI 73–76) than cluster II (mean SOC = 69 with 95 % CI 67.5–71), p-value < 0.001.

Conclusion: Subgroups of patients are in need of targeted interventions. Patients, who reported high levels of symptom burden, differed distinctly in their symptom experience regarding symptom prevalence (frequency, severity and distress). These patients also differed in their coping capacities, and patients who reported lower SOC also experienced higher levels of symptom burden. Study findings suggest that SOC is an antecedent to symptom burden.

MASCC-0096

Percutaneous implantable port: infectious and thrombosis

R.d. E. noel-savina 1

1Chu Brest, Brest, 2Chu Brest, Brest, France

Taking care of patients in oncology needs safety venous access, as Percutaneous implantable port. These venous devices are sometimes responsible for serious adverse events. Infection and thrombosis are the two main complications that can occur early or be delayed. Clinical examination and especially, evaluation of the severity are very important keys to manage the patients. They both can lead to the ablation of the central venous device which is an option to keep always in mind. However, whatever the clinical situation is, the oncologic context such as life expectancy and the need for a venous access is also a data to counterbalance.

MASCC-0098

Delayed non invasive reduction of large bullae following thoracic irradiation

E. Noel-savina 1, R. Descourt1

1Chu-Brest, Brest, France

Abstract: Chest radiotherapy is a mainstay of management of thoracic oncology patients. Radiotherapy also injures non target tissues such as the lungs, coronary arteries, and esophagus and safe limits to the doses that can be delivered to tumors have been determined empirically. Patients afflicted with lung cancer due to smoking often have concomitant COPD which on occasion manifests as bullous emphysema. We describe a case and course of treatment of lung cancer found incidentally in a patient followed for severe pulmonary emphysema. Treatment consisted of radio-chemotherapy after induction chemotherapy. Three years after the end of anti-neoplastic treatment a follow-up CT scan revealed complete retraction a large emphysematous bulla that had been present prior to treatment.

MASCC-0099

Supporting advance care planning for patients through oncology professional education

A.B. E. Beddard-Huber 1

1Pain and Symptom Management/Palliative Care, 2Survivorship, BC Cancer Agency, Vancouver, BC, Canada

In Canada there is a growing aging population, and at the same time the incidence of cancer is also increasing. Advance care planning is a process of reflection and communication to identify the values, wishes and beliefs of an individual’s future healthcare plans, for if a time comes when they cannot speak for themselves.

In British Columbia, the Ministry of Health announced Advance Care Planning as new legislation on September 1, 2011. The legislation allows for a process that may result in an Advance Directive and/or Representation Agreement.

The BC Cancer Agency has implemented an Advance Care Planning education program for physicians, nurses and allied healthcare providers. Simultaneously the PRISM (Patient-Reported Information and Symptom Measurement) questionnaire was introduced which assesses multiple domains for all patients including their knowledge of advance care planning.

The education program includes both a compulsory introductory eLearning module and an advanced module consisting of in-person facilitated group sessions on enhancing communication skills. Staff will evaluate their knowledge and skills discussing advance care planning with patients and families. Along with staff performance, patient-reported outcomes will be analyzed. Through education our hope is to increase comfort and capacity to address advance care planning with patients and their families.

MASCC-0100

Octreotide prescribing patterns in the palliation of symptomatic inoperable malignant bowel obstruction patients at a single us academic hospital

E. Roeland 1, M. Hwang1, W. Mitchell1

1Medicine, University of California San Diego, La Jolla, CA, USA

Background: Medical management is the cornerstone of malignant bowel obstruction (MBO) therapy and includes antisecretory agents such as octreotide. Currently, little data exist regarding octreotide prescribing patterns in US academic hospitals in the palliation of inoperable MBO.

Methods: This retrospective chart review identified inpatients that received octreotide for palliation of inoperable MBO at a single academic US hospital (2008–2011). The prescribing primary service (medical vs. surgical), days to initiation, daily dose, cumulative dose, length of stay (LOS), and overall survival (OS) were analyzed. Multiple linear regression was used to assess if the association between dose and LOS was significant. Kaplan-Meier curves and log rank test were used to evaluate OS.

Results: A total of 767 patients received octreotide and 134 had a diagnosis of cancer. Thirty-seven (24 female, 13 male; mean age 56.7 years) had a radiographically confirmed inoperable MBO. The mean LOS was equivalent on both services (17 days). The mean octreotide dose was 201.2-μg on the medical service vs. 119-μg on the surgical service. Mean time to initiation was 8.4 days (7.9 medical vs. 8.8 surgical). Earlier initiation was associated with a shorter LOS (Spearman’s correlation = 0.76, p < 0.0001). No statistically significant association between average daily dose, cumulative dose, and OS was demonstrated.

Limitations: The data are retrospective from a single institution.

Conclusion: Early initiation of octreotide may lead to shorter LOS; the association remains after adjustment for patient age. Timing and dose of octreotide was not significantly associated with survival.

MASCC-0101

Octreotide prescribing patterns in the palliation of symptomatic inoperable malignant bowel obstruction patients at a single us academic hospital

E. Roeland 1, M. Hwang1, W. Mitchell1

1Medicine, University of California San Diego, La Jolla, CA, USA

Background: Medical management is the cornerstone of malignant bowel obstruction (MBO) therapy and includes antisecretory agents such as octreotide. Currently, little data exist regarding octreotide prescribing patterns in US academic hospitals in the palliation of inoperable MBO.

Methods: This retrospective chart review identified inpatients that received octreotide for palliation of inoperable MBO at a single academic US hospital (2008–2011). The prescribing primary service (medical vs. surgical), days to initiation, daily dose, cumulative dose, length of stay (LOS), and overall survival (OS) were analyzed. Multiple linear regression was used to assess if the association between dose and LOS was significant. Kaplan-Meier curves and log rank test were used to evaluate OS.

Results: A total of 767 patients received octreotide and 134 had a diagnosis of cancer. Thirty-seven (24 female, 13 male; mean age 56.7 years) had a radiographically confirmed inoperable MBO. The mean LOS was equivalent on both services (17 days). The mean octreotide dose was 201.2-μg on the medical service vs. 119-μg on the surgical service. Mean time to initiation was 8.4 days (7.9 medical vs. 8.8 surgical). Earlier initiation was associated with a shorter LOS (Spearman’s correlation = 0.76, p < 0.0001). No statistically significant association between average daily dose, cumulative dose, and OS was demonstrated.

Limitations: The data are retrospective from a single institution.

Conclusion: Early initiation of octreotide may lead to shorter LOS; the association remains after adjustment for patient age. Timing and dose of octreotide was not significantly associated with survival.

MASCC-0102

The prevalence of different HPV types in Turkish women with a normal pap smear

E.T. Demir 1

1Obstetric and gynecology, Private Yasam Hospital, Antalya, Turkey

Introduction: Human papillomavirus (HPV) infection is one of the most common sexually transmitted diseases in women and cause of cervical cancer and genital warts.

Objectives: We studied cervical smear samples of women from different regions of Turkey for investigate age-specific HPV prevalence, HPV type distribution, and the relationship between HPV positivity and several risk factors.

Methods: Between February 2010 and January 2011, 582 cervical smear samples from sexually active women aged between 15 and 68 years, admitted for regular examination at the departments of Obstetrics and Gynecology of five different centers were studied. Samples were analyzed for the presence of HPVby AmpliTaq. Positive samples were typed further for 37 different HPV genotypes by a line blot assay.

Results: HPV was positive in 17.9 % of the women. HPV prevalence was highest in the age group of 25–29 years (31.8 %), and decreased with increasing age. HPV 16 was the most common type (3.6 %) followed by type 6 (2.6 %) and type 45 (2.2 %). Types 11 and 18 were rare (0.6 % and 0.4 %, respectively). Among the risk factors, number of sexual partners and parity were positively correlated with HPV positivity.

Conclusions: HPV prevalence is frequent in Turkish women with normal cervical cytology contrary to the belief about the rarity of this virus in Islamic countries. The prevalence of HPV was 17.9 %. HPV positivity was reported between 12.8 % and 32.1 % in the recent regional studies performed in Turkey. Therefore, implementing the HPV vaccine into the national immunization program seems to be beneficial.

MASCC-0103

Communication the backbone of care to patients with life limiting illness

E.W. MUNGA 1

1Oncology, Aga Khan University Hospital Nairobi, Nairobi, Kenya

Introduction: Communication is the act of conveying information through exchange of thoughts, messages or information.

Communication to patients with life limiting illness is vital and rarely practiced by most physicians and health care providers during their contact with patients mainly due to time limitation or frequency of care to patients with the same illness hence they tend to overlook some very important aspects. During my clinical placement today 22/01/2013 I witnessed a patient breakdown in an outburst in tears 2 years later after a mastectomy done yet she was at the oncologist office having not yet accepted her diagnosis probably due to lack of understanding thoroughly to her nature of illness. Many times I have been approached by patients, relatives to explain further the discussed elements during their session with the physician.

Objective: Create the awareness to health care givers on the importance of thorougher communication to the patient, relatives of the patient who are suffering from a life limiting illness.

Methods:

Workshop forum

Conference

Practical example

Conclusion: Any time an individual is diagnosed with a life limiting illness e.g. cancer all the patient and relatives think about is death hence they are very sensitive and should be handled with the atmost care, the only people they can fully entrust their lives on for hope and improvement in condition is the health care givers hence they should be well trained and practise proper communication to patients with life limiting illness.

MASCC-0104

Outcomes of social support programs in brain cancer survivors in an Australian Community cohort

B.A.,I.R.,L.N.,3. F. Khan 1,2,3

1Department of Rehabilitation Medicine, Royal Melbourne Hospital, Parkville, 2School of Public Health and Preventive Medicine, Monash University, Clayton, 3Department of Medicine, Dentistry & Health Sciences, University of Melbourne, Parkville, VIC, Australia

Introduction: Persons with primary brain tumour (BT) need continuing support to deal with their physical and psychosocial concerns after treatment.

Objectives: To evaluate the impact of social support programs on improving cancer related disability, neuro-cognitive dysfunction and enhancing participation in BT survivors.

Methods: Participants (n = 43) received an individualised social support program: face-to-face interview for education/counselling plus peer-support program or community education/counselling sessions. The assessments were at baseline (T1), 6-week (T2) and 6-month (T3) post-intervention using validated questionnaires: Depression Anxiety Stress Scale (DASS), Functional Independence Measure (FIM), Perceived Impact Problem Profile (PIPP), Cancer Rehabilitation Evaluation System–Short Form (CARES-SF), Cancer Survivor Unmet Needs Measure, McGill Quality of life questionnaire (MQOL) and Brief COPE.

Results: Participants’ mean age was 53 years (range 31–72 years), majority were female (72 %); median time since BT diagnosis was 2.3 years and almost half (47 %) had high grade tumours. At T2, participants reported higher emotional wellbeing (DASS ‘anxiety’ and ‘stress’ subscales, p < 0.05; FIM ‘cognition’ subscale, p < 0.01), improved function (FIM ‘motor’ subscale, p < 0.01) and higher QoL (CARES-SF ‘global’ score, p < 0.05; MQOL ‘physical symptom’ subscale, p < 0.05). At the T3 follow-up, most of these effects were maintained. The intervention effect for BT specific coping strategies emerged for the Brief COPE ‘self-distraction’ and ‘behavioural disengagement’ domains, (p < 0.05 for both). No adverse effects was reported.

Conclusion: Post-treatment social-support programs can improve physical and cognitive function, and enhance QoL of BT survivors. Social support programs need further evaluation and should be encouraged by clinicians within cancer rehabilitative services.

MASCC-0105

Health-state utilities in liver cirrhosis: a cross-sectional study

P. Adibi1, F. Abdi 1, L. Akbari1, L. Kahangi1

1Isfahan University of medical sciences, Isfahan, Iran

Objectives: Liver cirrhosis is a serious disease which can change many aspects of life of the patients and their family and effects society. Health-related quality of life (HRQL) in patients with cirrhosis can be evaluated using utility assessment techniques. We aimed to study the utility of cirrhosis from the point of view of the patients, their family, and their caretakers to find appropriate interventions, and training and counselling programmes to support patients.

Methods: In this cross-sectional study with a purposive sampling, 66 subjects constructed of 30 patients with decompensated cirrhosis (all of whom were on the liver transplant waiting list), 21 family caregiver and 15 caretakers, were included. We administered data collection in face to face interviews, through paper-based questionnaire. We also elicited utilities using formal approaches; standard gamble (SG), time trade-off (TTO), rating scale (RS) and willingness to pay(WTP).

Results: There were statistically significant differences in utilities assigned by three groups in all preference-based measures (P < 0.05). The total utility score of patients was lower in comparison to their family members and caretakers. The Spearman’s correlation coefficient showed that the three Methods of TTO, RS, and SG were convergent in the caretaker group and divergent in the patient group. The only significant correlations between utilities were between TTO and WTP in patient group and between TTO and RS in family caregiver group (P < 0.05).

Conclusions: utility assessments indicate that HRQL is compromised in patients with cirrhosis. These data can be the basis for cost-effectiveness analyses in studies of patients with chronic liver disease.

MASCC-0106

VEGF gene expression byzoledronic acid-treated keratinocytes and gingival fibroblasts submitted to lowlevel laser therapy

A.P.S.T.,C.K.,V.S.B. F.G. Basso 1

1State University of Campinas, 2Universidade Estadual Paulista, Araraquara, 3Universidade de São Paulo, São Carlos, Brazil

Bisphosphonate-induced osteonecrosis has been associated with the cytotoxicity of this drug on oral mucosa cells. Low-level laser therapy (LLLT) has been proposed as an adjuvant therapy for this condition. However, data about the effects of LLLT on bisphosphonate-treated cells are missing. The aim of this study was to evaluate the effects of LLLT on gene expression of vascular endothelial growth factor (VEGF) by gingival fibroblasts and keratinocytes previously treated with Zoledronic Acid (ZA). Cells were seeded using complete culturemedium (cDMEM) for 48 h. Then, cDMEM was replaced by free-serum culturemedium for 24 h, followed by addition of ZA (5 μM). After 48 h, fresh cDMEM was applied on the cells which were subjected to LLLT for 3 times (every 24 h) using a LaserTable (InGaAsP – 780 nm + −3 nm, 25 mW), at 0 (control group), 0.5, 1.5, 3, 5 and 7 J/cm2, associated or not to ZA. After 24 h of the last irradiation, gene expression of VEGF was assessed by Real Time PCR. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests, considering 5 % of significance level. ZA caused significant decrease on VEGF expression by keratinocytes, but not for fibroblasts. LLLT increased VEGF expression by keratinocytes for all energy doses. For ZA-treated keratinocytes an increased VEGF expression was observed at 5 and 7 J/cm2. For gingival fibroblasts, all energy doses maintained a gene expression similar to control group. Specific parameters of LLLT could promote VEGF expression which may increase cell proliferation and accelerate oral mucosa healing.

MASCC-0107

Serum crosslinked-N-terminal telopeptide of type I collagen (NTX) has prognostic implications for patients with initial prostate carcinoma

M.L.W.,F.L.A.F.,M.S. F. Jablonka 1

1“Department of Oncology,) ABC Medical School, Department of Oncology - Santo André - Brazil, 2ABC Medical School, Department of Urology - Santo André - Brazil, ABC Medical School, Department of Urology - Santo André - Brazil, Santo André, Brazil”

Introduction: NTx is a metabolite of type I collagen, the main constituent of bone matrix, which has been previously shown to be increased in patients with bone metastasis. We wanted to evaluate NTx role in sample PCa patients at diagnosis when most of them have no overt bone involvement

Methods: Men with a histologic diagnosis of PCa at diagnosis were included. Serum Ntx was measured serially every 3 months up to 2 years by ELISA with the osteomark® NTx Serum kit

Results: Fifty-five PCa patients with a median age of 67 years (51 ? 83), 86 % with stage I, 4 % with stage II, 2 % with stage III and 10 % with stage IV were included. At entry median NTx was of 14.65 nM and it did not correlate with age, Gleason score or PSA but we observed a significant direct correlation with stage (p = 0.0094). With a median follow up of 23 months, at diagnosis, Seum Ntx correlated significantly with biochemical recurrence (p = 0.012) as did Gleason score (p = 0.00056), Stage (p = 0.012) and PSA (p < 0.0001). By multivariate analysis the only 2 independent variables significantly correlated with biochemical recurrence were PSA (p = 0.046) and NTx (p = 0.021).

Conclusion: We conclude that Serum Ntx has potential prognostic value in PCa patients at diagnosis and may improve current prognostic models. These data stress the potential prognostic importance of bone metabolism biomarkers for PCa patients even in the absence of overt bone involvement.

Supported by: FAPESP

MASCC-0108

Chemotherapy-induced neuropathy and its association with quality of life among 2–11 year colorectal cancer survivors; results from the population-based profiles registry

T.B.,V.L.,C.v.d.H., F. Mols 1,2

1Department of Medical Psychology, Tilburg University, Tilburg, 2Department of research, Comprehensive Cancer Centre South, Eindhoven, 3Department of internal medicine, Maxima Medical Centre, Veldhoven, The Netherlands

Aim: To gain insight into the prevalence and severity of chemotherapy-induced neuropathy and its influence on quality of life (QOL) among a population-based sample of CRC survivors, 2–11 years after diagnosis.

Methods: All currently alive individuals diagnosed with CRC between 2000 and 2009 as registered in the Dutch population-based Eindhoven Cancer Registry were eligible for participation. Eighty-three percent (n = 1648) of patients filled out the EORTC-QLQ-C30 and the EORTC-QLQ-CIPN20.

Results: The five neuropathy-related symptoms that bothered patients the most during the past week were erectile problems (42 % of men),trouble hearing (11.5 %), trouble opening a jars or bottles (11.1 %), tingling toes or feet (9.6 %), and trouble walking stairs or standing up (9.1 %). Also, patients who received oxaliplatin more often reported tingling (29 vs. 8.4 %;p = 0.001), numbness (17 vs. 5.2 %; p = 0.0047), and aching or burning pain (13 vs.5.9 %; p = 0.0293) in toes or feet compared to those not treated with chemotherapy and these symptoms were indeed significantly associated with oxaliplatin. Those with many neuropathy symptoms reported statistically significant and clinically relevant worse QOL scores on all subscales of the EORTC QLQ-C30.

Conclusion: 2–11 years after diagnosis of CRC, neuropathy-related symptoms are still reported, especially sensory symptoms in the lower extremities among those treated with oxaliplatin. Since neuropathy symptoms have a negative influence on health-related QOL, more attention should be paid to screen for these symptoms and to alleviate these symptoms in those that report them. Future studies should focus on possible ways to effectively prevent and treat chemotherapy-induced neuropathy.

MASCC-0109

MASCC palliative care leadership survey: palliative care program structure

N.C.,M.D.,P.M. F. Strasser 1

1Palliative Care Center, Cantonal Hospital St.Gallen, Switzerland Center, The Cleveland Clinic, Cantonal Hospital, St.Gallen, Switzerland, 2Shaare Zedek Medical Center, Jerusalem, Israel, 3Cleveland Clinic, Cleveland, OH, USA

Background: Palliative care (PC) program structure is evolving. This MASCC survey queried palliative care leaders regarding program structure.

Methods: A survey adapted from Hui et al(1) queried MASCC,ESMO and EAPC palliative care leaders through the MASCC website

Results: Sixty-two program leaders completed surveys. Most services included outpatient clinics (82 %), inpatient consultation (80 %) and inpatient palliative services (62 %). Programs were small, with 2 physician FTEs. Leaders were from Med Oncol, Int. Med, Anestheics and family medicine. All services incorporated inpatient and outpatient nursing. Paramedical staffing were: dieticians 66 %, pharmacist 46 %, psychologists 88 %, social workers 84 %. 75 % indicated had most referrals >4 weeks before death, 25 % reported referrals < i month prior to death. Symptoms were the most reason for referral to inpatient PC, other reasons incuded terminal, psychosocial care and respite. Average LOS 10 days and mortality 40 %. Half had weekly grand rounds; half rotations for medical oncology-hematology fellows.

Discussion: PC programs incorporate inpatient consultation services, outpatient clinic services and inpatient palliative care beds. A minority do not have acute palliative inpatient services. Staffing is low with small and constricted teams carrying very large clinical loads. Protected time for research and teaching is limited.

Conclusion: Characteristics and services anticipated from a palliative care service is still developing. Program development is hampered by inadequate allocation of resources to effectively staff interdisciplinary academic and clinical services.

1. Hui D, et al. Availability and integration of palliative care at US cancer centers. JAMA. 2010 Mar 17;303(11):1054–61.

MASCC-0110

Phenolic-rich extracts from orange peels (Citrussinensis) inhibit proteasome and metalloproteinase activities in metastatic (LoVo and loVo/ADR) cell lines

G.O.,S.p.,F.T. A.O. Ademosun 1

1Biochemistry Department, 2Department of Biochemistry, Federal University of Technology, Akure, Nigeria, 3Department of Life Sciences, University of Trieste, Trieste, Italy

This study sought to investigate the effect of free and bound phenolic extracts from orange (Citrus sinensis) peels on the activities of two contemporary anti-cancer therapeutic targets [proteasome and matrix metalloproteinase (MMP)]in metastatic (LoVo and LoVo/ADR) colon cancer cell lines. The free phenolics were extracted with 80 % acetone, while the bound phenolics were extracted from the alkaline and acid hydrolyzed residues with ethyl acetate. The results revealed that bound phenolic extracts had significantly (P < 0.05) higher inhibition of proteasome activity than free phenolics in extract-treated celllysates from the two cell lines. However, there was stronger inhibition of proteasome activity in LoVo/ADR cell lysates than the LoVo cell lysate. Furthermore, bound phenolics had significantly (P < 0.05) higher inhibition of proteasome activity in intact cells after 24 h treatment with the extracts. Free phenolics had a stronger dose-dependent inhibition of MMP activity in the cell lines, though there was no significant difference in the MMP inhibition by both free and bound phenolics in LoVo/ADR cells. Based on the ability of the phenolics to inhibit proteasome and MMP activity in both metastatic colon cancer cell lines, they could potentially be used in the management of the malignancy and in further anti-cancer drug development research. However, bound phenolics exhibited stronger inhibition of proteasome activity, while free phenolics showed stronger inhibition of MMP activities.

MASCC-0111

Patients with cancer in opioid treatment: renal function and symptoms/adverse effects

S.L. "G.P. Kurita 1,2, P.S.,4.,O.E.,L.C.,A. m3

1Section of Palliative Medicine, 2Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark, 3Stockholms Sjukhem Foundation and Dept. Oncology Pathology, Karolinska Institute, Stockholm, Sweden, 4Dept. Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 5National Institute of Public Health, University of Southern Denmark, 6Dept. Drug Design and Pharmacology, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark, 7The Royal Surrey County Hospital, NHS Foundation Trust, Guilford, UK, 8Dept. Oncology, St. Olavs Hospital, Trondheim University Hospital, 9Dept. Cancer Research and Molecular Biology, Faculty of Medicine Norwegian University of Science and Technology, 10European Palliative Care Research Centre, 11Dept. Intensive Care Medicine, St Olavs Hospital, Trondheim University Hospital, 12Dept. Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway

Introduction: Renal impairment and the risk of toxicity due to accumulation of active metabolites or the opioid per se have raised the awareness of associations with symptoms/adverse effects.

Objective: To analyze if symptoms/adverse effects were associated with renal function in patients with cancer in opioid treatment.

Methods: Cross-sectional multicenter study (European Pharmacogenetic Opioid Study, 2005–2008). Inclusion criteria: cancer, age ≥18y and regular scheduled treatment for ≥3 days exclusively with only one of the most reported opioids (morphine/oxycodone/fentanyl) for moderate/severe cancer pain. 1154 patients were analyzed. Fatigue, nausea and vomiting, pain, loss of appetite, constipation and cognitive dysfunction were assessed (EORTC QLQ-C30). Renal function was analysed through Cockcroft-Gault formula (cutoffs: < 60 ml/min impaired function and < 30 ml/min severe impairment). Multiple logistic regressions were adjusted for age, sex, opioids and other medications.

Results: The three opioid groups had similar mean age (≈ 60y) and proportions between sexes. Renal impairment was observed in 48.0 % of morphine, 50.0 % oxycodone and 57.6 % fentanyl groups. Patients with mild and those with moderate/severe renal impairment in morphine treatment had higher odds of having severe constipation (OR: 2.16, 95 % CI: 1.37–3.39, P < 0.01) and loss of appetite (OR: 2.31, 95 % CI: 1.29–4.13, P = 0.02), respectively. No other significant associations.

Conclusion: Severe constipation and loss of appetite were the only symptoms/adverse effects associated with renal impairment in patients in morphine treatment. The use of oxycodone and fentanyl, in relation to the six symptoms studied, seems to be safe.

Study supported by EU Palliative Care Research Collaborative 6th Programme.

MASCC-0112

The effects of pain and opioids on cognitive function: an experimental model in cancer pain

L.P.M.,4.,T.A.,R.P. G.P. Kurita 1,2

1Section of Palliative Medicine, 2Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, 3Mech-Sense and Dept. Gastroenterology, 4Multidisciplinary Pain Centre, Aalborg Hospital, Aalborg, 5Dept. Drug Design and Pharmacology, Faculty of Health and Medical Sciences University of Copenhagen, 6Dept. Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

Introduction: Pain and opioids are frequent in cancer, but their interference on patients’ cognitive function is not clear.

Objective: To study the effects of pain and opioids on sustained attention (SA).

Methods: Randomized, double-blind, placebo controlled, crossover study with 22 healthy Caucasian male volunteers (20–28y). SA, the ability to respond rapidly to external stimuli for an extend period of time, was evaluated by Continuous Reaction Times (CRT) software

Results were presented in percentiles. Three sessions for each participant were conducted. 1st session: CRT was tested under the influence of experimental pain of mild and moderate intensities induced by an electronic pneumatic tourniquet cuff; 2nd session: CRT was tested under the influence of placebo (saline) or remifentanil; 3rd session: CRT was tested under pain relief with remifentanil or placebo as well as breakthrough pain. Assessments occurred when the volunteers reported stable pain or 10 min after steady-state infusion. Study approved by Ethics Committee.

Results: 1st session: moderate and mild pain slowed CRT significantly from baseline, but no differences when comparing pain intensities. 2nd session: slower performance on remifentanil when compared to placebo (50th: P = 0.007; 90th: P < 0.001). 3rd session: decrease in pain intensity with remifentanil; placebo effect was minimal (P < 0.001); volunteers had slower CRT when receiving remifentanil (10th: P = 0.02; 50th and 90th: P < 0.001). When pain was increased (breakthrough pain), only a minor effect was noted prolonging CRT (50th: P = 0.045).

Conclusion: The results suggest that opioids interfere more with cognitive function than pain itself.

Study supported by The Danish Cancer Society.

MASCC-0113

Quality of life and symptoms in patients admitted to a comprehensive cancer centre

C.N.,N.S.,H.F.,U.B.T. “G.P. Kurita 1,2, mgren”4

1Section of Palliative Medicine, 2Multidisciplinary Pain Centre, 3Dept. Haematology, 4Dept. Oncology, Rigshospitalet, Copenhagen University Hospital, 5Dept. Palliative Medicine, Bispebjerg Hospital, Copenhagen University Hospital, 6Dept. Drug Design and Pharmacology, Faculty of Health and Medical Sciences University of Copenhagen, 7Dept. Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

Introduction: Quality of life (QoL) and symptomatology in patients with malignancies admitted to comprehensive cancer centres are rarely investigated.

Objective: To investigate QoL and symptoms of inpatients at the departments of haematology and oncology.

Methods: Cross-sectional study, in which 124 cancer inpatients were assessed in May/June 2011. Inclusion criteria: Age ≥ 18 years. Exclusion criteria: absence at assessments, not able to complete the questionnaire or unwilling to give informed consent. Demographic data, diagnoses, symptoms, and health-related quality of life (EORTC QLQ-C30) were assessed. EORTC QLQ-C30 scores were converted into 0–100. Comparisons were analyzed using Wilcoxon two-sample, rank tests, and Fisher’s exact test.

Results: One hundred twenty-four patients were analysed, mean age = 59y (SD = 13.7), 42 % admitted to haematological department (14 % had allogenic stem cell transplantation), lung cancer was the most frequent diagnosis (15 %). Role functioning scale was the most severely impaired (mean score = 35), whereas cognitive function showed the best score (mean = 70). The mean overall QoL/global health score was 43 (SD = 25.6). The symptom burden of the inpatients was strikingly severe and especially fatigue and appetite loss were pronounced. Role and social functions appeared to be more impaired in oncology patients than in those admitted to haematology (P = 0.0372 and 0.0167, respectively). On the other hand, pain and constipation were more severely affected in haematology patients (P = 0.0194 and 0.0064, respectively).

Conclusions: Inpatients in a comprehensive cancer centre had low quality of life and a severe symptom burden. Fatigue and appetite loss were the most severe symptoms reported.

MASCC-0114

Further evidence supporting the association between a novel marker and delayed chemotherapy-induced vomiting (CIV)

A.C.,M.A.,G.H. G. Higa 1

1West Virginia University, 2West Virginia University Hospitals, Morgantown, WV, USA

Objective: The emetogenic classification of individual chemotherapy drugs is still the most important risk factor for developing CIV. Nonetheless, the classification system does not distinguish the phase in which emesis occurs following chemotherapy. We evaluated additional data to determine the association between a recently identified biomarker and delayed vomiting.

Methods: Pretreatment values of substance P (SP), the serotonin metabolite, 5-HIAA, and urine creatinine (Cr) were determined in 23 patients, all of who were treated with a high-dose melphalan-conditioning regimen. Emetic prophylaxis consisted of two daily doses of ondansetron and dexamethasone. The median duration of follow up was 116 h (range 72–144). Measured SP and 5-HIAA/Cr values and calculated ratios of SP to 5-HIAA/Cr were grouped according to the presence (+) or absence (-) of delayed vomiting. The data were analyzed by Wilcoxon’s Rank Sum Test.

Results: Delayed emesis occurred in seven patients, frequently beginning approximately 72 h after chemotherapy; the other 16 had no vomiting symptoms (although five of these patients complained of nausea). Neither neurotransmitter alone was associated with delayed symptoms as the between-group variance was not significantly different. However, the ratio of SP to 5-HIAA/Cr was significantly different between the (+), median 73.5 and (-), median 12, emesis groups, p = 0.0108.

Conclusions: The data obtained from this relatively homogenous cohort of patients are in accord with the recent publication and further suggest that the pretreatment SP to 5-HIAA/Cr ratio ≥70 is associated with the development of delayed vomiting. We are currently testing the predictability of this biomarker prospectively.

MASCC-0115

Endosponge treatment of anastomotic leaks

G. Milito 1, F. Cadeddu1

1General Surgery, Policlinico Tor Vergata Roma, Roma, Italy

Background: Endoluminal vacuum therapy using Endosponge is a new endoscopic method to treat extraperitoneal anastomotic leakage following low anterior resections or Hartmann’s stump leakage in the lesser pelvis, at an early stage and with no reintervention. This tool consists of an open-pored sponge inserted into the cavity. A drainage tube fixed to a low vacuum drainage system is then connected to the sponge through the anus. Thus, it is realized a continuous drainage of the secretion and the sponge cleans away the fibrin coatings, reduces in size and cleans the cavity.

Methods: Between January 2003 and December 2012, 12patients with anastomotic leakage following low anterior resection and neoadjuvant radiochemotherapy were treated with transrectal VAC. They were prospectively evaluated.

Results: Stapled straight end to end colorectal anastomoses were performed in all patients between 3 and 7 cm above the anal verge, a protective loop ileostomy was performed in every patients. The diagnosis of anastomotic leakage was performed after a median interval of 15 days (range 7–22) the median size of the cavity was 81 × 46 mm. Fluid collection was drained, percutaneosly in 10 cases, surgically in 2 patients who presented with a cavity of 80 × 55 mm and 85 × 50 respectively. The median duration of therapy was 35 days (range 16–51), with a 8–15 sponge exchanges for patient. Median healing time was 59 days (range 32–65). Nointraoperative complications were recorded. We found 5 cases of mild anal pain successfully treated medically

Conclusion: The Endosponge seems an effective minimally invasive procedure to treat extraperitoneal anastomotic leakage without reintervention reducing morbidity and mortality.

MASCC-0116

Dosimetric comparison of 3-dimensional conformal and field in field radiotherapy techniques for the adjuvant treatment of early stage endometrial cancer

C.Y.,H.A.,A.B.,G.C. G. Yavas 1

1Radiation Oncology, Selcuk University, 2Radiation Oncology, Konya Training and Research Hospital, 3Obstetrics and Gynecology, 4Medical Oncology, Selcuk University, Konya, Turkey

Background: We aimed to compare field-in-field radiotherapy (FIF) with conformal radiotherapy (CRT) in terms of dosimetric benefits for early stage endometrial cancer patients.

Materials and Methods: Ten consecutive early stage endometrial cancer patients who underwent adjuvant external beam radiotherapy were included to the study. For each patient, two different treatment plans were created. FIF and CRT plans were compared for doses in the planning target volume (PTV), the organ at risk (OAR) volume including rectum, bladder, bowel, bilateral femurs and bone marrow, the dose homogeneity index, and the monitor unit counts required for the treatment.

Results: The FIF technique significantly reduced the maximum dose of the PTV, rectum, bladder, bowel, left femur, right femur and bone marrow (p values were: < 0.001, 0.031, 0.003, < 0.001, 0.001, 0.001 and <0.001 respectively). When the OAR volumes irradiated with 30 and 45 Gy were compared, the results were in favor of the FIF technique. The volumes of rectum, bladder, bowel, left femur, right femur and bone marrow receiving more than the prescription dose of 45 Gy were significantly reduced with FIF technique (p values were 0.016, 0.039, 0.01, 0.04, 0.037 and 0.01 respectively). The dose homogeneity index (DHI) was significantly improved with FIF technique (p < 0.001).

Conclusions: FIF allowed more homogeneous dose distribution in the PTV and reduced the doses received by OAR. Considering the lower maximum doses in the OAR and PTV, FIF technique seems to be more advantageous than CRT during adjuvant radiotherapy for early stage endome

MASCC-0117

Comparison of two different radiotherapy techniques in stomach cancer patients who underwent concomitant chemoradiotherapy

C.Y.,G.C.,O.V.G.,H.A. G. Yavas 1

1Radiation Oncology, Selcuk University, 2Radiation Oncology, Konya Training and Research Hospital, 3Medical Oncology, Selcuk University, Konya, Turkey

Background: We aimed to compare four field radiotherapy technique (4 F) with three field technique with enhanced dynamic wedges (3F)in patients with stomach cancer who underwent postoperative chemo-radiotherapy.

Material and Methods: Ten stomach cancer patients who underwent total gastrectomy and lymph node dissection were included. For each patient, two different treatment plans were created for the tumor bed and regional lymph nodes. Three-field and 4F plans were compared for the doses in the planning target volume (PTV), the organ at risk (OAR) volumes (including kidneys, liver, spleen and spinal cord), the dose homogeneity index (DHI), and the monitor unit counts (MU) required for the treatment. Student-t test was used for statistical analysis.

Results: There was no difference between two techniques in terms of DHI (p:0.576). The mean dose received by the liver was significantly reduced with 3 F technique (p < 0.001);whereas the mean doses of the kidneys, spleen and spinal cord were decreased with 4Ftechnique (p values were 0.007, 0.021 and <0.001 respectively) (Table 1). The dose to %10, %30, %40 and %50 of the total liver volume were significantly reduced with 3Ftechnique (p values were 0.026, 0.009, 0.001 and <0.001 respectively). The MU counts required for the treatment was significantly lower with 4F technique (p < 0.001).

Conclusion: Four-field technique was found to be more advantageous than the 3F technique, with respect to the OAR, other than the liver, and monitor units required for treatment in patients with stomach cancer without any known liver disease.

MASCC-0118

Evaluation of doses in the Wernicke and Broca’s areas using two different radiotherapy techniques in patients with right frontal glioblastoma multiforme

C.Y.,H.A. G. Yavas 1

1Radiation Oncology, Selcuk University, 2Radiation Oncology, Konya Training and Research Hospital, Konya, Turkey

Purpose: We aimed to evaluate the doses in the Broca’s and Wernicke’s areas using parallel opposed two field and three field technique in patients with right frontal glioblastoma multiforme (GBM).

Materials and Methods: The standard Rando phantom (Alderson) was used in this study for measuring of the Broca’s and Wernicke’s areas doses. Prior to the dose measurements, thermoluminesans dosimetry (TLD) were sorted into groups of equal sensitivity. The whole brain was scanned with 5 mm slice thickness and intervals. The PTV, Broca’s and Wernicke’s areas contours were delineated. Two different plans using parallel opposed field and parallel opposed fields and vertex field were compared. The doses measued in TLD and calculated by TPS were compared.

Results: The three field technique allowed the lower doses in the Broca’s and Wernickes’s areas when compared to two field technique. The doses calculated in the Broca’s area and Wernicke’s area were % 0.98 ± 0.03 and %0.09 ± 0.06 of the isocenter dose with three field and % 1.06 ± 0.04 and % 0.133 ± 0.03 of the isocenter dose with two field techniques respectively. When we compared the doses measured by TLD and calculated with TPS; for Broca’s area TLD was compatible with TPS % 3.23 and % 2.92 and for Wernicke’s area TLD was compatible with TPS % 4.12 ve % 3.95 in two field and three field techniques respectively.

Conclusion: In right frontal hemisphere tumors regarding to doses of Broca’s and Wernicke’s areas three field technique is superior.

MASCC-0119

How to decrease lens dose in patients with brain metastasis who underwent palliative whole brain radiotherapy?

C.Y.,H.A.,O.V.G.,O.A. G. Yavas 1

1Radiation Oncology, Selcuk University, 2Radiation Oncology, Konya Training and Research Hospital, 3Medical Oncology, Selcuk University, Konya, Turkey

Purpose: Palliative whole brain radiotherapy (WBRT) has been the standard treatment for brain metastases. Ionizing radiation is known to be one of the most potent cataractogenic agents. For a single treatment, the lowest cataractogenic dose was reported to be 2 Gy. We aimed to evaluate the lens, optic nerve and eye doses with two different radiotherapy techniques in patients with brain metastasis who undergone WBRT.

Materials and Methods: Ten patients with brain metastasis were included. The planned dose was 3,000 cGy in 10 fractions. For each patient, two different treatment plans were created for whole brain. Helmet-field (HF) (inferior border was the bottom of C2 vertebra) and classical technique with collimation (CT)(anterior border was defined as skin fall of, inferior border was the bottom of cranial base) were generated for all patients. Two techniques were compared with respect to the lens doses, the dose homogeneity index (DHI), and the monitor unit counts (MU) required for the treatment. Student-t test was used for statistical analysis.

Results: There was no difference between two techniques in terms of both DHI(p: 0.182) and MU counts (p: 0,167). The maximum and mean doses received by the right lens, left lens and right eye were significantly reduced with CT (p values for maximum doses 0,007, 0,012 and 0,010; for median doses 0,027, 0,046 and0,002 respectively).

Conclusion: CT with collimation was found to be more advantageous, with respect to the lens doses in addition the dose received by the right eye during WBRT.

MASCC-0120

Experience with adaptive IGRT at RGCI & RC, India

G.S. Wadhawan 1, M. Bhushan1

1Radiation Oncology, Rajiv Gandhi Cancer Institute& Research Centre, New Delhi, India

Purpose: Accurate image guided radiotherapy (IGRT) using MVCBCT is essential prerequisite to practice IMRT or 3DCRT and forms an important factor in the quality of actual radiation delivery. The capability of generating an entire volumetric MV-CBCT data set in a single-gantry rotation, allows 3D visualization of the tumor prior to the delivery of treatment and correlation with reference plan CT data. This permits corrections of shifts beyond an acceptable limit.

Material and Methods: Prior to treatment, 2D and/or CBCT on ARTISTE (M/s Siemens) was acquired and setup errors with reference to X, Y, Z were corrected online in 20 patients of breast, head & neck (H&N) and prostate. A second CBCT was acquired after the correction process and coordinates for daily set-up and images were obtained.

Results: A total number of 211 CBCT or 2D images were performed in 20 patients. The sites included—breast (n = 10), H&N (n = 6) and prostate (n = 4). Images were evaluated for 95, 58 and 58 fractions respectively. The shifts observed in X, Y and Z axes are summarized below: In addition, rotational errors were observed in 7 % (15/211 images). These include breast (2 %), H&N (1 %) and prostate (4 %), which were also corrected by IGRT.

Conclusion: Despite immobilization devices, shifts beyond the acceptable limits of 2 mm were observed during online CBCT or 2D with IGRT in breast (79.9 %), H&N (49.2 %) and prostate (96.6 %). IGRT permits detection and online corrections of these shifts which would have been otherwise gone unnoticed leading to dosimetric errors during radiation therapy

MASCC-0121

Peri-operative chemo-radio-therapy versus radiotherapy treatment in NSC-Lung cancer

H.L. Elayouty 1

1Cardiothoracic Surgery, Suez Canal University, Ismailia, Egypt

Objectives: A randomized prospective study designed to compare radio-therapy alone with concomitant chemo-radio-therapy in patients who have undergone lung-resection for non-small cell lung cancer. The goals are to assess the feasibility and reproducibility of the combined regimen and to evaluate its ability to improve local control and quality of life.

Methods: Forty two patients (25 men, 17 women) had. stage II or IIIA disease,. Their median age was 54 years (range 33–63 years.). All had experienced no weight loss. Group A (21 patients): Patients with marginally resectable disease received two cycles of chemotherapy pre-operatively and a maximum of four cycles post-operatively. Patients with initially resectable tumors received four cycles postoperatively. Radiation therapy was begun on day 1 or 2 concomitantly with chemotherapy. Group B (21 patients) received radiotherapy alone.

Results During chemo-radiotherapy two developed toxicity and were shifted to group B. Eighteen out of 19 remain alive at the end of chemo-radio-therapy and recorded median :survival of 51.3 months compared with 16 out of 23 in group B who had median :survival of 42.9 months (p = 0.001). Conclusion: Concomitant chemo-radio-therapy is feasible and reproducible as adjuvant treatment in non small- cell lung cancer.

MASCC-0122

Genome-wide association study, carcinogenesis, and the possibility to create drugs

H.-Y. Xu 1

1Department of Emergency Medicine, Clinical Institute, Clinical Institute, Workers Hospital of Nanyang Textile Corporation, Nanyang City, Henan Province, Nanyang City, China

The genome-wide association study has emerged as a powerful and successful tool to identify common disease alleles, including cancer. These research projects and results have further proved that genome-wide association and genome-wide gene-environment interaction of cancer has more than two susceptibility loci of genome association. Which have further supported the new theory of carcinogenesis, the carcinogenesis theory of gene multiple hits.

The gene susceptibility loci of cancer may be caused by environmental agents, chronic infection, et al., including alcohol drinking. The risk factors attributable fraction of susceptibility loci should be calculated. We should create the new way to prevent the cancer from the view points of the genetic etiology of multiple hits and susceptibility loci.

Preventing cancer caused by environmental agents and other risk factors of cancer could result in possible creation of drugs when they are the highest risk factors of cancer attributable fraction of susceptibility loci.

MASCC-0123

Washing the foodstuffs of seeds, promoting the health level, a proposal for legislation of national standard of food safety

H.-Y. Xu 1

1Department of Emergency Medicine, Clinical Institute, Clinical Institute, Workers Hospital of Nanyang Textile Corporation, Nanyang City, Henan Province, Nanyang City, China

Background and objectives: As the bad situation of pollution in the foodstuffs of seeds in and outside of China is more and more serious and critical. There is not any concrete regulation or national process standard of food safety to eliminate or reduce the pollution in the foodstuffs of seeds round the world. It is imperative to eliminate the danger pollution factors in the foodstuffs of seeds for promoting people’ health around the world before the pollution factors are eat and harm the human-being.

Methods: Summarize the bad situation of pollution in the foodstuffs of seeds around the world.

Results: Washing the foodstuffs of seeds to eliminate the danger pollution factors in the foodstuffs of seeds, promoting the health level, and a proposal for legislation of national standard of food safety was created.

Conclusions: The proposal for washing the foodstuffs of seeds, promoting the health level, a legislation of national standard of food safety was suggested to promote health food and health people around the world.

MASCC-0124

Revision of law of environmental protection to promote health and development of mankind, the strategy

H.-Y. Xu 1

1Department of Emergency Medicine, Clinical Institute, Clinical Institute, Workers Hospital of Nanyang Textile Corporation, Nanyang City, Henan Province, Nanyang City, China

Objective: In order to protect the health of mankind from worse environmental harming, the law must be addressed.

Methods: Summarize the bad conditions of environmental situation and the environmental protection law in China. The strategies to revise the law of environmental protection in China are suggested.

Results: The first proposal is to concretely build the law for campaign of educational, propagandistic publicity of environmental protection and health for all people. The second proposal is to create the law for building the department of prevention and treatment for environmental medicine in all the hospitals and health organizations. The third proposal is to create the law for building the national system to monitor, report and forecast the environmental situation like what the weather forecasting system does. The fourth proposal is to create the law for building the administration departments of environmental protection at the grass levels of villages. The fifth proposal is to create the law for building the administration departments of environmental protection at any unit. The sixth proposal is to create the law for building the administration departments of environmental protection for foreign units or investment in China. The six kinds of lawmaking proposals were suggested can be also for promotion of environmental protection and health all over the world.

Conclusion: The research is very good for environmental protection and health promotion if the proposals are adapted into laws and regulations by China. The proposals are much too worthwhile to be referenced by all related people and countries around the world.

MASCC-0125

Health policy needed immediately to administrate the patient ward of respiratory system far from pollution circle and polluted streets

H.-Y. Xu 1

1Department of Emergency Medicine, Clinical Institute, Clinical Institute, Workers Hospital of Nanyang Textile Corporation, Nanyang City, Henan Province, Nanyang City, China

Objective: In order to promote and enhance the results of treatment and prevention for respiratory diseases in the hospital, this research project has been done.

Methods: Summarizing the problems and shortcomings of the patient wards of respiratory system presented at some hospitals and the pollution bad situation in China. Which the patient wards of respiratory system are under pollution circle and polluted street. The environmental pollution can cause respiratory diseases. And so arouses the creation of proposals for curing them.

Results: There are 6 points of proposals have been suggested. Which the main principles are that the patient ward of respiratory system should be far from pollution circle and polluted street.

Conclusion: At the modern ecological environment or the present environmental pollution situation, the pollution can cause diseases. Especially the respiratory patients are more easy to suffering from the environmental pollution by the streets. In order to promote and enhance the results of treatment and prevention for respiratory diseases in the hospital, the proposals that the patient ward of respiratory system should be far from pollution circle and polluted street and its concrete 6 application points are suggested which are very useful. It is much too imperative to create the law or regulations of health policy according to the proposals to apply them at once and well. The proposals are worth to be referenced by China and foreign countries.

MASCC-0126

Recognizing and recording the tone of people’ and others’ language, to promote development of work, life and science, and promote administration of social security

H.-Y. Xu 1

1Department of Emergency Medicine, Clinical Institute, Clinical Institute, Workers Hospital of Nanyang Textile Corporation, Nanyang City, Henan Province, Nanyang City, China

Objective: In this paper, the author uses the modern information and computer science to solve the present problem which the computer has not recorded all the tone and the words at the same time when the people are speaking.

Method: Summarize the modern information and computer science. Create the new breakthroughs project of computer science.

Results: The author outlines, transmit the recognizing into computer with their tone and characters and store the tone and characters of the speaking information. Therefore, any people’s speaking could be recorded into the computer with their characters of tone at the same time.

Conclusion: This is a breakthrough creation project for information and computer science. The life, work, and security and other active things of mankind could be more easy and wonderful. There were much too harvesting in economical and practical gaining. And there were also much too harvesting in social development. So there are lots of chances waiting us to make her true in the near future when the paper of the new breakthrough creation for information and computer science is published and accepted for application. Because recognizing and recording the tone of people’ language and his characters of the speaking information are different from each other. Like the fingerprint, the public security and other practical gaining could be great.

The breakthrough technology project of computer science can be used for recognizing and recording the tone of language of other biology, and their characters of the speaking or voice information, apart from people’.

MASCC-0127

Outcome of palliative chemotherapy in recurrent head and neck cancer

T.M.,M.A.,A.M.,R.H. H. Iqbal 1

1Surgical Oncology, 2Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

Purpose: The aim of this retrospective study is to evaluate the outcome of palliative chemotherapy in recurrent head and neck cancer in our institution.

Methods: Between September 2005 and August 2009, 146 patients received palliative chemotherapy either due to recurrent or persistent disease after completion of radical treatment. With a median age of 48 years (range 18–70), there were 111 (76 %) males and 35 (24 %) females. Site distribution; Oral cavity 100 (68 %), Hypopharynx 3 (2 %), Nasopharynx 14 (10 %), Larynx 7 (5 %), Oropharynx 3 (2 %), Paranasal sinuses 14 (10 %) and others 5 (1 %). Patterns of recurrence included: local 65 (44 %), regional 32 (23 %), distant 8 (5 %) and persistent disease 41 (28 %) respectively. 106 (73 %) of patients already received cisplatin based chemotherapy either in neo-adjuvant or concurrent chemoradiation setting. Various first line palliative chemotherapeutic agents given included: Methotraxate (10 mg x 4 days/week PO or 40 mg/m2 weekly I/V), Cyclophosphamide (50 mg OD PO), Paclitaxel (80 mg/m2 weekly I/V) and Cisplatin (75 mg/m2 3 weekly I/V) respectively.

Results: One hundred sixteen patients (79 %) received Methotraxate, 19 (13 %) Cyclophosphamide, 4 (3 %) Paclitaxel, and 7 (5 %) received Cisplatin. A total of 9 (6 %) patients had toxicity related hospital admissions. One patient died due to drug toxicity. Mean time to progression; Methotrexate 7, Cyclophosphamide 9, Paclitaxel 10 and Cisplatin 7.8 months respectively. Overall mean time to progression was 7.8 months (range 1–39).

Conclusions: The disease control in our study is comparable with already published literature but very little has been gained in slowing the progression of the disease.

MASCC-0128

Acute management of neutropenic sepsis: a 12 month prospective analysis of 320 acute admissions in a large cancer centre in the UK

H. Mason 1, M. Afshar1, A. Young1

1Oncology, St James University Hospital, Leeds, UK

Introduction: Febrile neutropenia (FN) secondary to chemotherapy is well reported, but lacks consensus on management. Few prospective studies report ratios of suspected FN to confirmed FN, and their subsequent management. These data have fiscal implications for healthcare resource allocation, and patient management.

Objectives: To evaluate acute management of FN in a tertiary centre over a 12 month period, compare current practice against guidelines, and review subsequent outcomes.

Method: Data were collected from suspected FN patients (admitted 2011–2012). Variables analysed included chemotherapy regimen, neutropenic status, antibiotic prescription and reasons for deviation from guidelines.

Fifty admissions were sub-analysed retrospectively. Appropriateness of cultures, imaging, prescription/timing of antibiotics and MASCC scores were reviewed and statistical analyses performed. Treatment was compared to current guidelines.

Results: Of 319 patients admitted with suspected FN, 117(37 %) patients had confirmed FN. Mean time to administration of antibiotics from first contact was 130 min (range = 5–510 mins), and 48 min from arrival to the ward (range = 5–420 mins).

Of 50 patients sub-analysed, 4(8 %) received inappropriate antibiotics, 45(90 %) patients had blood cultures sent, not always adhering to local guidelines. CXR’s were requested in 47/50, with 11(22 %) considered unnecessary.

MASCC scores were calculated in 5/50(10 %) patients. Retrospectively calculated scores found mean duration of antibiotics in high risk patients was 8.3 days. 50 % of low risk patients met criteria to switch to oral antibiotics at 48 h; 30 % of these continued IV antibiotics longer than deemed clinically necessary.

Conclusion: FN management is variable in our centre. The development of a clerking proforma, incorporating national guidelines, aims to improve standards.

MASCC-0129

Hemophagocytosis/hyperferritinemia syndrome in children with acute monoblastic leukemia

H. Lackner 1, V. Strenger1, P. Sovinz1, W. Schwinger1, M. Seidel1, M. Benesch1, C. Urban1

1Medical University Graz, Graz, Austria

Background: Intensification of antileukemic treatment and progress in supportive management have improved the survival rates of children with acute myeloid leukemia (AML). However, mobidity and early mortality in these patients are still very high, especially in children with M5 subtypes of AML.

Patients: Over the last 2 decades we observed an inflammatory syndrome with fever, elevation of C-reactive protein (CRP), hyperferritinemia and hemophagocytosis in absence of any proven infections in 3 of 10 children treated for AML FAB M5. They were treated according the international protocol AML-BFM 2004. During prolonged aplasia following the first block of chemotherapy, all children developed high fever and elevation of CRP not responding to broad spectrum antibiotics and antimycotics. No infectious agents could be identified, serum levels of ferritin and soluble interleukin 2 (s-IL2) were extremely elevated, and hemophagocytosis was identified in bone marrow. Treatment with dexamethasone (DXM) was initiated, and the children immediately responded to DXM, however, the same syndrome was observed again after the second and third block of chemotherapy.

Discussion: Supportive care of children treated for AML is still an enormous challenge. Inflammatory syndromes complicating the management of these children have been reported after application of chemotherapy and due to hyperleukocytosis. Our patients clinically showed the symptoms of an inflammatory syndrome without evidence of acute infections and, additionally, fulfilled the criteria for hemophagocytosis. The co-incidence of AML FAB M5 with HLH might be explained by cytokines released from the monoblastic leukemic cells itself. Treating physicians should be aware of this possible complication.

MASCC-0130

The impact of dose calculation algorithms for peripheral dose distributions of enhanced dynamic and physical wedges

G.Y.,C.Y. H. Acar 1

1Radiation Oncology, Selcuk University, 2Radiation Oncology, Konya Training and Research Hospital, Konya, Turkey

Background: The peripheral dose is important when anatomical structures with very low dose tolerances are involved. In this study, the two available calculation algorithms of the Varian Eclipse 8.6 treatment planning system(TPS), the anisotropic analytic algorithm(AAA) and pencil-beam convolution(PBC) was used to compare measured and calculated peripheral dose distribution of physical wedged(PW) and enhanced dynamic wedged fields(EDW).

Methods: Peripheral dose measurements were carried out for 6 and 18 MV photons using a 0.6 cc Farmer-type ionization chamber in the slab phantom. Measurements were performed using 15°, 30°, 45° and 60° PW and EDW for three different field sizes at dmax and up to a maximum distance of 50 cm beyond the field edges. Peripheral dose was further computed using two different algorithms of a TPS. The measured and calculated datas were then compared to find which algorithm calculates peripheral dose distribution more accurately.

Results: Both algorithms from the TPS adequately model the peripheral dose distribution up to 45°. For large field sizes with 60° EDW, the largest deviation between calculated and measured dose distribution is less than 3.5 % using the AAA, but can increase up to 9.7 % of the distribution using PBC.

Conclusion: The AAA models wedged peripheral dose distributions more accurately than the PBC does for all studied conditions; the differences between the algorithms are more significant for large wedge angles and large field sizes. It must be emphasized that the use of PBC for planning large-field treatments with 60° EDW could lead to inaccuracies of clinical significance.

MASCC-0131

Ovarian masses in children and adolescents in China: analysis of 203 cases

H. Liu 1, G. Shi1

1Department of Obstetric and Gynecologic, West China Second University Hospital, Sichuan University, Chengdu, China

Objective: The true incidence of ovarian tumors in children is unknown. Few studies beyond case reports and case series have been published concerning pediatric ovarian tumors. Herein we review a large number of ovarian tumor cases.

Methods: The charts of 203 patients who presented with adnexal masses were reviewed.

Results: The patient’s ranged in age from 2 to 18 years (mean = 15.6 years), with 30 being premenarchal (14.8 %). The main complaint was abdominal pain or abdominal distension in 117 patients (57.7 %). A high AFP level in a pre-pubic girl with an adnexal mass is indicative of a malignant ovarian tumor. The 214 adnexal masses (11 patients had bilateral cysts) consisted of benign tumorous oophoropathy (107 masses, 50.0 %), borderline and malignant tumors (29 masses, 13.6 %), and nontumorous oophoropathy (78 masses, 36.5 %). Of the 136 neoplasia, germ cell tumors accounted for 71.5 %. Surgical intervention was performed in 98.5 % of cases. There were decreased blood loss, surgery duration and days of hospitalization with the laparoscopic procedure when compared with an open surgery.

Conclusions: The incidence of ovarian tumor increases with age, especially in patients older than 14 years. Abdominal pain is the most common complaint in young patients with adnexal masses. AFP is the most useful diagnostic biomarker of ovarian tumors in young females. Laparoscopic resection of ovarian cysts is a safe operative approach

MASCC-0132

The beneficial effect of Zusanli (stomach-36) acupressure on postoperative gastrointestinal function of colorectal cancer patients

H.L.C.,S.J.M.,P.F.L.,H.H.-C. H.L. Chou 1

1Nursing, Far Eastern Memorial Hospital & Oriental Institute of Technology, New Taipei City, 2Nursing, 3Surgery, Cathay General Hospital, Taipei, Taiwan R.O.C.

Introduction: A loss of bowel peristalsis is common after abdominal surgery, and can lead to abdominal distention, pain, reduced bowel sounds, emesis, or other discomforts. If patients do not have bowel sounds or bowel movement by the fourth day postoperation, they are considered to be at risk for postoperative ileus (POI).

Objectives: To evaluate the effectiveness of Zusanli (ST-36) acupressure on recovery of postoperative gastrointestinal function in colorectal cancer patients.

Methods: Sixty colorectal cancer patients who had undergone abdominal surgery. Patients were randomly assigned to two groups: ST-36 acupressure group (n = 30) and a sham acupressure group (n = 30). Patients in the experimental group received acupressure procedure in a 3-minute cycle performed3 times per day during the 5 days after surgery. Generalized Estimating Equations were used to estimate longitudinal effects of the two groups of patients.

Results: Patients who received acupressure had significantly earlier flatus passage and time to liquid intake as compared to patients in the control group. Other main variables, including the first time to solid intake and defecation, did not show significant difference between the two groups. The GEE model revealed that all patients had increasing bowel sounds over time, and the experimental group had higher improvement than the control group of bowel motility within the period of 2–3 days postoperatively.

Conclusions: ST-36 acupressure was able to shorten the time to first flatus passage, oral liquid intake, and improve gastrointestinal function in patients after abdominal surgery.

MASCC-0133

Fatigue in breast cancer patients undergoing curative radiatherapy treatment

I. Hartmann 1, C. Lethan1, E. Dalvad1, U. Koehler1, L. Sigaard1, K. Dieperink1

1Department of Oncology. Odense University Hospital, Odense, Denmark

Background: Breast cancer patients undergoing radiotherapy often suffer from fatigue. Effectiveness of exercise in groups in the management of fatigue has been shown in studies. However, there is a lack of evidence to whether personal interview and motivation to home based exercise will have the same effect.

Objective: To investigate whether a personal interview combined with an easy accessible self-elected individual type of exercise improve the patients self-evaluated level of fatigue.

Methods: Breast cancer patients (n = 78) were randomized to intervention or control. All patients were previously treated with either lumpectomy or mastectomy followed by chemotherapy, and was undergoing curative radiotherapy.

Within 5 days after starting radiotherapy, all patients were baseline scored on a 1–5 scale, with 5 representing the maximum score for fatigue. In the intervention group individual agreements on type of exercise were made, followed by personal interviews after 14 and 30 days. Final score was conducted by telephone after 60 days. The control group achieved personal interviews but no motivation to exercise.

Results were descriptively analysed and differences in groups tested by non-parametric Mann–Whitney test.

Results: Average age was 50 years (21–78). A number of 60 patients were randomized to the intervention group and 18 patients to the control group. Average improvement was 1.32 in score in intervention group whereas average improvement in score was 0.67 (p = .004) in control group.

Conclusion: An intervention with motivation to exercise in patients suffering from fatigue have significant effect on patients self evaluated level of fatigue.

MASCC-0134

Psychosocial distress development among young Slovak early-stage breast cancer patients surviving 3 years after early breastconserving surgery

J.S.,I.K.,V.B.,V.K. V. Bencova 1

1Ist Clinic of Oncology, Faculty of Health and Medical Sciences University of Copenhagen Medicine, Comenius University, 2Ist Clinic of Oncology, Faculty of Medicine, Comenius University Bratislava, 3Ist. Clinic of Oncology, Faculty of Health and Medical Sciences University of Copenhagen Medicine, Comenius University Comenius University Bratislava, 4Department of Mammology, St. Elisabeth Cancer Institute, 5Faculty of Public Health, St. Elisabeth University of Health and Social Sciences, Bratislava, Slovak Republic

Objective: The objective of this study was to evaluate the age-related long-term psychosocial morbidity development and health-related quality of life outcomes among disease-free outdoor breast cancer patients previously treated for early-stage breast cancer by breast conserving surgery (BCS).

Methods: One hundred twenty-eight eligible disease-free breast cancer patients previously treated by BCS or modified radical mastectomy (MRM) and surviving without tumor recurrence and any serious comorbidity were recruted for the survey. The assessment of the psychosocial morbidity was conducted 1 and 3 years after surgery using the standardised EORTC Quality of Life QLQ C3O.3 questionaire, the breast cancer specific module QLQ BR-23 and the Hospital Anxiety and Depression Scale (HADS) questionaire.

Results: Scoring cancer-specific quality of life and psychosocial morbidity over the time between 1 and 3 years after surgery have shown that nearly 70 % of breast cancer patients treated by BCS were surviving without profound impact onto psychosocial status and health-related quality of life. However, even 3 years after BCS, more than 30 % patients were suffering from emotional distress due to increasing anxiosity, nervousness, uncertainty and fear about future. Patients with higher psychosocial burden mainly belong to younger population aging between 35 and 50 years. The low quality of life and increased psychosocial distress seems not to be related to physical symptoms caused by cancer treatment.

Conclusion: The need to pay more attention to psychosocial care of outdoor breast cancer survivors being under long-term clinical control and suffering from emotional distress after each clinical check-up is emphasized.

MASCC-0135

The management of skin toxicity during erlotinib in advanced non-small cell lung cancer: how much does it cost?

M.M. J. Giuliani 1

1Palliative Care Unit - Mater Salutis Hospital, U.L.S.S. 21, Legnago (VR), 2Clinical Oncology Unit - St. Anna University Hospital, Ferrara, Italy

Objectives: The aim of this study is to estimate the costs for the foreseesable management of skintoxicity in patients treated with erlotinib for NSCLC in order to value the direct medical economical impact. No economical assessment has been published for management of skin toxicity during erlotinib for NSCLC.

Materials and Methods: We retrospectively analyzed all consecutive patients with NSCLC treated with erlotinib at Clinical Oncology Unit of University-Hospital of Ferrara (Italy) from June 2007 to May 2011. We evaluated severity and median duration of skin rash for each grade and we identified costs for the different therapeutic interventions.

Results: We evaluated 25 patients. Median time follow-up was 18.65 months (range5.69–88.36). At last follow-up 7 patients (28.0 %) were alive with metastases and 18 patients (72.0 %) were deceased. Nineteen patients(76.0 %) developed skin toxicities: 2 patients (10.5 %) mild rash, 11 patients(57.9 %) moderate rash and 6 patients (31.6 %) severe rash; no case of hospitalization was observed. Median duration of mild rash was 97 days (costs-range: 157.7–452.2 €), median duration of moderate rash was 89 days (costs-range: 438.7–1035.6 €) and median duration of severe rash was 34 days (costs-range: 460.3–1057.2 €).

Conclusions: Our experience showed that management of skin toxicities related to erlotinib is not so expensive, especially for low grade; therefore we also recommended to give particularly attention to low grade of toxicities for reducing progression to high grade and consequent risk of hospitalization, that really impact on costs.

MASCC-0136

Pain control of cancer patients in homecare setting: which role for the palliative homecare specialist?

J. Giuliani 1

1Palliative Care Unit - Mater Salutis Hospital, U.L.S.S. 21, Legnago (VR), Italy

Background: The aim of this study was to evaluate the pain management and control before and after intervention of a palliative home care specialist (second subgroup) compared with patients managed only by the General Practitioner (first sbgroup).

Materials and Methods: A retrospective analysis of homecare patients with advanced cancer disease and with an issue of pain management, in treatment with strong opioids, referred to our Local Unit Social Health was examined by 01/08/2012 to 31/10/2012.

Results: Eighteen patients were evaluated: 9 patients (50.0 %) were directly managed by a palliative home care specialist and 9 patients (50.0 %) were managed only by the General Practitioner. Generally, in the second subgroup ECOG PS was worse and patients had a worst pain control at the beginning of taking care in comparison with first subgroup both for frequency (3 vs 2) and intensity (3 vs 4). Considering second subgroup, after the intervention of the palliative homecare specialist, there was a decrease of both frequency (3 vs 2) and intensity (4 vs 2) of pain. Instead, in first subgroup, there was a substantial stationarity of frequency(2 vs 2) and a less decreasing in intensity of pain (3 vs 2) after the intervention of the General Practitioner compared with the intervention of the palliative homecare specialist.

Conclusions: Finally we can consider how useful the intervention of the palliative homecare specialist and we encourage the hope intervention in all cases where pain control is particularly difficult.

MASCC-0137

Which clinical impact of intravenous midline catheter usage in homecare patients?

J. Giuliani 1, L. Andreetta1

1Palliative Care Unit, Mater Salutis Hospital- U.L.S.S. 21, Legnago (VR), Italy

Introduction: Midline catheters are peripheral intravascular catheters commonly used in the home health care setting. The aim of this study is to evaluate the complications and durations of use of midline catheters in daily clinical practice referring to home care patients follow at our Local Unit Social Health. No results like the above have been published until now.

Materials and Methods: A retrospective analysis of homecare patients with positioning of midline at home referred to our Local Unit Social Health (catchment area of approximately 150,000 inhabitants) was examined by 01/09/2011 to 15/10/2012.

Results: Among 390 homecare patients with ongoing periodic medical care, 92 patients (23.6 %) have placed a midline at home. At last follow-up, 70 patients (76.1 %) were alive and 22 patients (23.9 %) were deceased. Thirty-six patients (39.1 %) had advanced cancer in best supportive care (BSC). In 7 patients (7.6 %) the midline has been removed: in 4 cases (4.3 %) for obstruction, in 1 (1.1 %) to damage of the catheter and in 2 (2.2 %) has marched accidentally. In any case, there were infectious complications. The median duration of catheter was 85 days (range 1–365 days). There was no statistical significance concerning a possible relationship between the positioning seat of the midline with the onset of complications and the presence of an advanced cancer with the onset of complications.

Conclusions: Midline catheters fill an important niche in the homecare patients. Better prospective studies of sufficient size to address all potential risk factors, insertion technique and details of follow-up care are needed.

MASCC-0138

Patient satisfaction with quality of life is a more powerful predictor of survival than symptom burden and functioning in advanced non-small cell lung cancer patients

D.G.,C.G.L.,R.D.L.,M.A.D. J.F. Grutsch 1

1Cancer Treatment Centers of America, Schaumburg, IL, 2Oncology Analytics Corporation, Plantation, FL, USA

Introduction: While there are data linking specific quality of life (QoL) symptom and functioning domains to improved survival, there are no data investigating the prognostic power of patient satisfaction with QoL in cancer.

Objectives: We investigated the relative prognostic power of these approaches in patients with advanced non-small cell lung cancer(NSCLC) participating in a clinical trial of concurrent chronotherapy with melatonin.

Methods:84 NSCLC patients (65 males, 19 females; 64 stage IV, 20 stage IIIB; mean age61.3) were randomized to receive placebo (n = 29), AM melatonin (n = 27), and PM melatonin(n = 28) in addition to cisplatin and etoposide chemotherapy. QoL was evaluated using EORTC-QLQ-C30 while patient satisfaction with QoL was measured using Quality of Life Index (QLI), incorporating four subscales: health & physical, social & economic, psychological &spiritual, and family. Cox regression evaluated the relationship between QoL and survival.

Results: Variables associated with survival on univariate analysis included age, ECOG, EORTC global, physical, role, social, fatigue, pain, QLI health & physical, psychological & spiritual(p < 0.05 for all). On multivariate analysis after adjusting for age and ECOG, while all EORTC scales lost their statistical significance, QLI health & physical functioning emerged as the most powerful prognostic indicator of survival (HR:0.94; 95 % CI:0.90–0.98, p = 0.003).

Conclusions: In this study, we found that patient satisfaction with health & physical functioning superseded all EORTCQoL variables. We suggest that patient satisfaction with their health might be used as a stratification as well as an outcome variable in future supportive care oncology trials.

MASCC-0139

Caphosol for mucositis: a case series

L.K. J. Younus 1

1Medical Oncology, London Regional Cancer Program, 2Nurse Practitioner, London Regional Cancer Program Regional Cancer Program, London, ON, Canada

Introduction: Mucositis is a common side effects due to chemo and/radiation therapy. Caphosol is a proven preventive strategy in randomized clinical trials. However, its efficacy to treat active mucositis is unknown.

Objectives: To evaluate the efficacy of Caphosol to treat mucositis by comparing the grade of mucositis before and after treatment (NCIC-CTG criteria) and documenting the duration of treatment.

Methods: A retrospective review was conducted on consecutive adult patients treated at London Regional Cancer Program who developed mucositis and were treated with Caphosol. This study was approved by ethics committee at University of Western Ontario.

Results: A total of 21 patients, two males (one with cancer esophagus and another with lung cancer) and 19 females (all with breast cancer), with a median age of 59 years were evaluated. Grade 3 mucositis was present in 4 patients which completely resolved with Caphosol in an average of 5 days of treatment, without needing any hospitalization. Fifteen patients with grade 2 mucositis reverted back to grade 0 by using Caphosol for an average of 3.5 days. One patient with no effect had grade 1 mucositis dating prior to chemotherapy and remained as such. Another patient with no initial improvement had oral candidiasis and once treated with Fluconozole and Caphosol had a complete resolution. No obvious side effects were reported by patients.

Conclusion: Our case series, for the first time, shows that Caphosol is potentially effective treatment against mucositis.

MASCC-0140

A pilot study of gentiana lutea (radix), zingiber officinalis, and curcuma longa for the treatment of anorexia in cancer patients

J.Y.,L.S. M. Sanatani 1

1Medical Oncology, Western University, 2Clinical Research Unit, London Regional Cancer Program, London, ON, Canada

Introduction: Anorexia is a common symptom for patients with cancer. Gentian, ginger, and turmeric have traditionally been used to stimulate appetite.

Objectives: We tested these agents in combination, in a pilot study to assess tolerability in patients not currently on chemotherapy, indicating 4/10 or worse anorexia on the Edmonton Symptom Assessment System. We collected exploratory data on the patient’s appetite using a visual analogue scale.

Methods: Between 2009 and 2012, 17 patients were enrolled in arm 1 (turmeric 1 g and ginger 1 g orally twice daily, and gentiana lutea tincture 1 ml three times a day, for 14 days). The three patients enrolled in arm 2 received the same doses of ginger and turmeric but no gentian. All patients completed a daily appetite diary, and weekly symptom assessment.

Results: In arm 1, 7 patients (41 %, 95 % CI 18 %–65 %) completed treatment. Seven patients (41 %) stopped early because of unacceptable toxicity or patient-initiated discontinuation, and 3 stopped because of other reasons. All patients in arm 2 stopped taking the study medication within a few days of starting treatment, leading the study committee to recommend stopping the trial. The most common adverse effects attributed to study drug were nausea (6 patients), vomiting (3), fatigue (3), diarrhea (2) and bloating (2). There was no significant effect seen on appetite.

Conclusions: At the doses used in this study, the combination of ginger, turmeric, and gentian is not tolerated well in cancer patients. Future studies should use fewer agents or lower doses.

MASCC-0141

Effect of fast track surgery on insulin resistance indexes of esophageal cancer patients

G. Zhao 1, S. Cao1, J. Cui1

1Department of Thoracic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China

Objective: To investigate the influence of fast track surgery (FTS) on insulin resistance indexes in esophageal cancer patients.

Methods: A total of 68 esophageal cancer patients receiving radical operation in our hospital from November 2009 to March 2011 were randomly divided into 2 groups by envelope method: FTS group(n = 34) and control group(n = 34). The postoperative first passage of gas by anus and defecation, postoperative hospital stay, hospitalization expenditure, and postoperative complications were recorded. Insulin resistance indexes were measured before operation as well as on the 1st,3rd,and 7th postoperative days, including fasting blood-glucose(FBG),fasting insulin(FINS),serum level of interleukin-6(IL-6),and C-reactive protein(CRP). The insulin resistance index(HOMA-IR) was calculated at the flame time points.

Results: The postoperative time of first passage of gas[(1.91 ± 1.13)d vs.(2.95 ± 1.25)d, P = 0.000] and defecation [(3.75 ± 1.54)d vs.(4.84 ± 1.76)d, P = 0.007] in FTS group were significantly shorter compared with control group, and the total hospitalization expenditure was significantly lower in FTS group [(31.9 ± 4.2) thousand yuan vs. (39.8 ± 3.6) thousand yuan, P = 0.000]. The preoperative insulin resistance indexes showed no significant differences between the two groups (all P > 0.05). One day after operation, the levels of log-HOMA-IR(0.97 ± 0.52 vs.1.54 ± 0.57, P = 0.000), FINS[(11.87 ± 4.55)μU/ml vs. (17.16 ± 6.90) μU/ml, P = 0.000], IL-6[(124.15 ± 21.39)ng/L vs. (138.78 ± 23.60)ng/L, P = 0.009], and CRP[(62.92 ± 14.78)mg/L vs. (71.07 ± 14.51)mg/L, P = 0.025] in FTS group were significantly lower than those in control group. Three days after operation, the levels of log-HOMA-IR(0.86 ± 0.47 vs. 1.27 ± 0.58, P = 0.002), FINS[(9.56 ± 4.37) μU/ml vs. (14.91 ± 6.54) μU/ml, P = 0.000], IL-6[(140.94 ± 25.12)ng/L vs. (153.89 ± 24.06)ng/L, P = 0.035], and CRP[(138.59 ± 21.61)mg/L vs. (153.17 ± 25.20)mg/L, P = 0.019] in FTS group were significantly lower than those in control group. Seven days after operation, the level of CRP in FTS group was significantly lower than that in control group [(53.07 ± 15.84)mg/L vs. (61.59 ±16.28)mg/L, P = 0.032].

Conclusion: FTS may promote the early recovery of gastrointestinal function, reduce stress reaction and postoperative insulin, thus being conducive to fast rehabilitation of esophageal cancer patients.

MASCC-0142

Paediatric pain approach in Cameroon

C.E.,P.c.C.,D.N. J.N. Menang 1

1“Pediatric ward, Baptist Hospital Mutengene, 2Administration, CALMEF Health Center, Yaoundé, Cameroon”

Background: Generally, children and infants are either unable to express themselves verbally or adequately give medical history. They often cry in their pain, hunger, thirst and other discomforts. Unfortunately, carers on most children’s wards in Cameroon often scold at them and in some cases, nurses also threaten kids since the general conception is that children always cry unnecessarily.

Method: Two combined retrospective case studies of a 9 year old osteomylitis case and 3 year 5 month burn cases of 2008–2009. Visits to CALMEF Health Centre and 4 other pediatric clinics, survey questionnaires to carers and nurses, observation of approach to child pain and interviews are the approached considered.

Results: Study revealed that, about 50 % of infants and children hospitalized, crying probably from pain are either scolded by carer or visitors and neighbours, 30 % are threatened to stop crying by nurses and about 20 % managed to keep silent or are supported by carers to bear the pain successfully. Many nurses stick to time interval prescription even when the child is in pain. Most pain cases are not identified and most practices lack opiates or appropriate analgesics; often without pain control protocol.

Conclusion: Overall view of study reveal that child pain management approach in Cameroon is still full of challenges and available professionals. This therefore calls for partnership and net-working with international institutions like ASCO, MASCC IASP-PAIN and others. Active involvement in forums like conferences, training or discussion for available professionals is very vital.

MASCC-0143

Validation of a Korean translation of the Edmonton symptom assessment scale

S.-H.N.,S.K.,Y.S.H.,K.H.L. J.H. Kwon 1

1Internal Medicine, Hallym University, Kangdong Sacred Heart hospital, 2Internal Medicine, VHS medical Center, Seoul, 3Internal Medicine, Good Samaritan Hospital, Gyeongsanbuk-do, 4Division of Oncology, Department of Internal Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, 5Internal Medicine, Yeoungnam Medical Center, Yeoungnam University Medical School, Taegu, 6Internal Medicine, Korea University Medical Center, Seoul, 7Hematooncology, Daegu Fatima hospital, Daegu, 8Hematooncology, Kokuk University Medical Center, Seoul, Republic of Korea, 9Palliative Care and Rehabilitation Medicine, 10Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Aim: We developed a Korean version of the Edmonton Symptom Assessment Scale (K-ESAS), a brief, widely adopted multidimensional questionnaire to evaluate patient-reported symptoms, and performed a psychometric analysis in Korean patients undergoing treatment for advanced cancer.

Methods: We tested the K-ESAS in 2 pilot studies with 15 patients each. We assessed internal consistency, test-retest reliability, and concurrent validity in 163 Korean patients, who completed the K-ESAS along with Korean versions of the MDAnderson Symptom Inventory (K-MDASI) and the Hospital Anxiety and Depression Scale (K-HADS) twice. Thirty-eight patients repeated the questionnaires again 7 days later to assess responsiveness.

Results: K-ESAS scores had good internal consistency, with a Cronbach alpha coefficient of 0.88, indicating that no questions had undue influence on the score. Pearson correlation coefficients for K-ESAS symptom scores between baseline and after 2–4 h ranged from 0.72 (95 % CI:0.64–0.79) to 0.87 (95 % CI: 0.82–0.90), indicating strong test-retest reliability. For concurrent validity, Pearson correlation coefficients between K-ESAS symptom scores and corresponding K-MDASI symptom scores ranged from 0.70(95 % CI: 0.62–0.77) to 0.83 (95 % CI: 0.77–0.87), indicating good concurrent validity. For K-HADS, concurrent validity was good for anxiety (r = 0.73, 95 %CI: 0.65–0.79) but moderate for depression (r = 0.4, 95 % CI: 0.26–0.52). For responsiveness, changes in K-ESAS scores after 7 days were moderately correlated with changes in K-MDASI scores but weakly correlated with changes in K-HADS scores.

Conclusion: The K-ESAS is a valid and reliable tool for measuring multidimensional symptoms in Korean cancer patients.

MASCC-0144

Circadian activity rhythms and quality of life in hepatocellular carcinoma patients

T.-W.H. J.-H. Lai 1,2

1Department of Internal Medicine, Erlin Branch of Changhua Christian Hospital, Changhua, 2Department of Nursing, Hung Kuang University, Taichung, Taiwan R.O.C.

Introduction: Little is known about the relationships between circadian activity rhythms and quality of life inhepatocellular carcinoma patients.

Objectives: The objectives of this study were to describe values for nocturnal sleep/rest, daytime wake/activity, and circadian activity rhythm parameters measured using actigraphy and to evaluate the relationships between these subjective and objective measures of sleep disturbance and quality of life in HCC patients.

Methods: The patients (n = 71) completed self-report measures for sleep disturbance (ie, Pittsburgh Sleep Quality Index, PSQI) and quality of Life (the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, EORTC QLQC30) and wore wrist actigraphs for 72 h. Pearson correlations were calculated between variables.

Results: Based on the patients’ subjective responses to the PSQI, 87 % had a global PSQI score greater than 5. In addition, the mean global quality of life was poor. An actigraphy-sleep efficiency revealed percent wake at night and total sleep time were worsen than normal adult ranges, and data of daytime activity and rest parameters were deteriorate than healthy adult values; the data on Circadian Activity Rhythms were also worsen than healthy adult values, all the above results indicated that patients with HCC experienced clinically significant levels of sleep disturbance.

Conclusions: According to our results, most of the HCC patients experienced clinically significant levels of sleep disturbance and poor QOL. Physicians, nurses and family caregivers need to be assessed, along with patients, for sleep disturbance, and appropriate interventions initiated for improving the QOL for HCC patients.

MASCC-0145

Rehabilitation for patients with high grade gliomas and their relativesa feasibility study

M.J.,3.,J.J.,M.J. K. Piil 1,2,3

1“Neurosurgery Dep., 2The Center for Integrated Rehabilitation of Cancer Patients (CIRE), 3The University Hospitals Centre for Nursing and Care Research, 4The Neuroscience Centre, 5Dept. of Neurosurgery, The University Hospital of Copenhagen Rigshospitalet, Copenhagen, Denmark”

Background: In Denmark approximately 500–600 patients are diagnosed annually with a malignant brain tumor of the type glioblastoma. High grade glioma occurs most frequently between 45 and 70 years of age. Median survival time is 12–15 months and 5 year survival is 10 %. Patients with gliomas have a symptom burden that leads to numerous complications and high mortality.

We lack evidence based knowledge about how disease-and treatment related symptoms and complications are experienced by and affects the patients and their relatives during and after treatment. The literature confirms that there is a need for a systematic evaluation of patients and relative’s needs in order to recommend national/international and disease-specific rehabilitative interventions for patients with gliomas and their relatives.

Aim: The project aims to elucidate patients and relatives life situation, needs, wishes and preferences for rehabilitative interventions during and after surgical and medical treatment for high grade glioma. Furthermore, the aim is to develop and test a rehabilitative intervention based on patient and family perspectives and research literature.

Design: The study will be conducted in 2 parts from 2012 to 2015. Part 1 is a longitudinal, qualitative, explorative, and descriptive interview study of patients and their relatives’ life situation and rehabilitation needs and a quantitative evaluation of the patients health related quality of life. Part 2 is a pilot study with a pre experimental one-group design testing a rehabilitative intervention program. The intervention program will be developed from existing intervention literature and the findings from part 1 of the study.

MASCC-0147

Chemotherapy-induced bipolar disorder in a female patient with breast cancer: a case report

B.S. L. Slovacek 1

1Department of Clinical Oncology and Radiation Therapy, Charles University Hospital, 2Department of Psychiatry, Charles University Hospital University Hospital, Hradec Kralove, Czech Republic

The authors report on a case of chemotherapy-induced bipolar disorder after non-adjuvant chemotherapy AC-TH in a 45-year-old woman with breast carcinoma. This case report highlights the potential risk of chemotherapy causing bipolar disorder. At the same time it indicates the need to cooperate with the psychiatrist. Early symptomatic psychopharmacological intervention enabled the smooth completion of non-adjuvant chemotherapy followed by partial mastectomy and axilla exenteration including adjuvant therapy (radiation therapy, biotherapy, hormonal therapy).

MASCC-0148

Quality of life analysis in colorectal cancer ostomates in Kenya

L.I. Gichini 1, J.G. Marete1

1Oncology, Aga Khan University Hospital, Nairobi, Nairobi, Kenya

Background

Introduction: Fashioning of a stoma is often done in colorectal cancer patients. Ostomates face many challenges. Anxiety over a stoma causes alteration in life-style, including: work, desire to travel and staying away from home overnight, overall Self image. Sexuality is greatly affected. This change of lifestyle and a challenging adaptation that needs to be made has not yet been documented in colorectal ostomates in Kenya.

Objectives: The aim of this study was to document the impact of stoma on the QOL of colorectal cancer ostomates, Document the impact of physical and psychosocial impact of a stoma on a colorectal cancer patient, Trigger the mechanism for improving QOL for such patients

Methods: The study was conducted amongst patients in the colorectal cancer support group that meets at the Aga Khan University, Hospital Nairobi. The inclusion criteria were colorectal cancer ostomates. Forty ostomates were included in the study. The Coloplast(R) QoL Questionnaire was used to survey all possible areas of changes in QOL after surgery. Statistical analyses: all data were entered and analysed using SPSS software

Results: This study confirms that having a stoma significantly diminishes QOL in Kenyan ostomates. There is a definite correlation between the impact of stoma on the lifestyle, self perception, relationship with others, sexuality and QOL.

Conclusion: Institutionalising stoma clinics, rehabilitation of colorectal cancer patients by formation and streghtening of colorectal cancer survivors support groups and quality ostomy appliances are factors that will improve QOL in colorectal cancer patients with stoma in Kenya

MASCC-0149

Validation of late oral health outcomes, an oral health subscale of the Vanderbilt head and neck symptom survey in post-radiotherapy head and neck cancer patients

J.D.,J.B.E.,C.A.M., L. Kolnick 1

1Department of Medicine, 2School of Nursing, Vanderbilt University Medical Center, Nashville, TN, 3Oral Medicine Services, Otolaryngology and Head and Neck Surgery, City of Hope National Medical Center, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 4Department of Diagnostic Sciences and Oral Medicine, College of Dentistry, University of Tennessee Health Sciences Center, Memphis, 5Division of Dentistry, Department of Oral and Maxillofacial Surgery, 6Department of Biostatistics, Schools of Medicine and Nursing, Vanderbilt University Medical Center, Nashville, TN, USA

Introduction: The Vanderbilt Head and Neck Symptom Survey (VHNSS) version 2.0 oral symptom subscale was developed to address potentially overlooked and underreported oral health issues.

Objectives: To report the validation of questions pertaining to xerostomia (4 items), dental health (4 teeth), dentures (1 item) and trismus (1 item).

Methods: Between May 2011 and April 2012, 50 patients treated with chemoradiotherapy for head and neck cancer completed the 50-item VHNSS survey, underwent an oral health assessment by a dentist, salivary flow and inter-incisal opening (IIO) measurements.

Results: Patient reported problems with dry mouth correlated with unstimulated salivary flow rates (−.43, p = .002). Cracked teeth (−.55, p = < .001) or difficulty chewing due to teeth (−.43, p = .004) correlated with urgent or emergent dental care issues identified on exam. Using a cut off of >4 on any of four the dental questions, we identified 83 % of patients with urgent or emergent dental issues. The ROC curve was useful (.89, p < .001) for separating patients with and without urgent/emergent dental issues. Limitations in jaw movement correlated with IIO (−.43, p = .002). Small numbers of patients with dentures precluded meaningful analysis of this subsample.

Conclusions: Clinically significant oral health issues pertaining to xerostomia, dental health and trismus may be identified using the oral health subscale of the VHNSS version 2.0. Patients who score >4 on any of the teeth related items should be referred for immediate dental evaluation; and for trismus should be referred for physical therapy.

MASCC-0150

Prevalence and treatment of neuropathic cancer pain

L. Sima 1, B. Fan1, B. Liu1

1National Pain Management an Research Center, China-Japan Friendship Hospital, Beijing, China

Objective: Neuropathic pain is defined as pain arising as a direct consequence of a lesion or disease affecting the somatosensory system. 19 % to 39 % of patients with cancer pain have concurrent neuropathic pain. We investigated the characteristics and prevalence of neuropathic cancer pain (NCP) in China, prospectively to assess current management.

Methods: A cross-sectional and prospective follow-up survey was performed. Cancer patients met NP define and with a score of ID-Pain Scale ≥1 were diagnosed NCP. Pain management was according to NCCN guideline. The main outcome measures were 24-h NRS, five symptoms indicated in ID-Pain scale (prickling, burning, electric shock, numbness and allodynia) by a 10-point score, and SF-6D quality of life scale.

Results: Six hundred fifty-eight patients were recruited from National Pain Management and Research Center. One hundred forty-seven patients met NCP diagnosis. One hundred eighteen patients completed the questionnaire and first treatment and enrolled ITT analysis. The common symptoms of NCP included numbness, prickling, burning, allodynia and electric shock by turns. The most involved nerves were lumbosacral plexus, cervical plexus, brachial plexus and sciatic nerve. NRS score was reduced to 3.7 ± 1.5 (P < 0.001) on d3 and 2.9 ± 1.4 (P < 0.001) on d21. Relief began on d3 for allodynia (P = 0.020), and on d7 for burning and electric shock (P = 0.003 and 0.018, respectively). The intensity of prickling and numbness remained unchanged. The quality of life was improved from d3 (P = 0.002).

Conclusion: NCP has a high incidence in China. NCP can be rapidly relieved in a majority patients. The symptoms of numbness and prickling are difficult to control.

MASCC-0151

Neurometabolic activities of arginine, apoliprotein e, and alpha-synuclein: implications for the development of fatigue during localized radiation therapy

L. Saligan 1,. Fatigue1

1National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA

Introduction: The etiology behind fatigue development during radiation therapy remains unknown.

Objectives: This study investigated the differential gene/protein expressions during the development of fatigue while receiving external beam radiation therapy (EBRT).

Methods: Thirty, Caucasian men (meanage = 65.5 ± 6.9) with non-metastatic prostate cancer scheduled for EBRT were enrolled. Fatigue (FACIT-F; lower scores mean higher fatigue) and blood were collected pre-treatment (baseline), and at midpoint of EBRT (day21). Microarray analysis was performed from whole blood RNA using the filtering criteria (foldchange >2.0 or <2.0, p < .05). Proteins were identified from depletedsera using 2-dimensional gel electrophoresis. Fatigue phenotype was maximized by categorizing subjects into high (HF: N = 20 [66 %], mean age = 66.6 ± 7.4) and low fatigue (LF: N = 10, mean age = 62.8 ± 5.4), based on a 3-point change in FACIT-F score from baseline to day21 of EBRT

Results: Fatigue changed from baseline (HF = 44.5 ± 6.9, LF = 44.4 ± 11.1) to midpoint (HF = 35.6 ± 6.9, LF = 45.3 ± 10.2) of EBRT. Microarray results from all subjects showed α-synuclein upregulation (fold changes >2.9, p < .001) from baseline to midpoint of EBRT. In subgroup analysis between the 2 time points, the HF group showed upregulation of ARG1 (arginase1; foldchange =2.41, p < .05) and significantly increased serum apolipoprotein (ApoE, fold change >1.5, p < .001).

Conclusion: Injury increases astrocytesecretion of ApoE instigated by α-synuclein overexpression. Increased ARG1 expression induces argininedeficiency altering ApoE-related metabolic activities during synaptogenesis. The neurometabolic activities of arginine, ApoE, and α-synuclein during synaptogenesis may provide information of the etiology of EBRT-related fatigue.

MASCC-0152

Effects of electric stimulation to acupoints on gastrointestinal hormones and motility among old postoperative patients with gastrointestinal tumors

L.X.,Y.S.,P.Y. L. Hou 1

1“Department of Nursing, Shanghai Pulmonary Hospital, 2Department of Nursing, Putuo Hospital, Shanghai University of Traditional Chinese Medicine,, 3Department of Nursing, Tenth People’s Hospital of Tongji University, 4Department of General Surgery, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China”

Objective: To evaluate the effects of electric stimulation to acupoints on gastrointestinal hormones and motility among old postoperative patients with gastrointestinal tumors and explore an efficient and noninvasive method for postoperative recovery of bowl functions.

Methods: We selected 40 old patients with gastrointestinal tumors receiving surgeries between January 2009 and December 2010 and evenly randomly assigned them into regular nursing care group(RNC) and acupoint electric stimulation group(AES) group each with 20 cases. Patients in the RNC group received regular nursing care and patients in the AES group received regular nursing care plus electric stimulation on acupoints. We evaluated the serum concentration of gastrin(GAS), motilin(MOT), cholecystokinin(CCK) and electrogastrogram(EGG) on the first, third and fifth day after surgery. We also recorded the anal exhaust time and the number of cases with such gastrointestinal function disorders as abdominal pain, abdominal distention and diarrhea

Results: Comparison between two groups in GAS, MOT, EGG, the anal exhaust time, abdominal pain, abdominal distention and diarrhea showed significant statistical difference(P < 0.05). Conclusion: Electric stimulation on acupoints could increase postoperative GAS, MOT levels, promote recovery of gastrointestinal functions and decrease complications among senile patients with gastrointestinal tumors.

MASCC-0153

A randomized clinical comparison of a non-alcohol barrier film and standard care for radiotherapy skin protection in nasopharyngeal cancer patients

J.-M.J.,Y.-C.T.,C.-F.H. L.-L. Chang 1

1Center for Advancement of Nursing Education, 2Department of Radiation Therapy, 3Department of Clinical Research, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan R.O.C.

Purpose: The aim of this study is to evaluate the efficacy of using a non-alcohol barrier film to prevent or reduce the incidence of radiation-induced moist desquamation among nasopharyngeal cancer (NPC) patients.

Methods: This study was prospective, randomized, open label, paired comparison of a radiotherapy skincare standards with and without the use of a non-alcohol barrier film skinprotectant. The barrier film was randomized to the left and right areas of theradiation field twice per week during the 7 weeks of radiotherapy. No other prophylactic skin care products were allowed within the radiation field of treatment during the study. A modified version of the RTOG radiation morbidity scoring index was used to quantify the degree of skin damage.

Results: Thirty-eight patients were included in the final analysis. The incidence of moist desquamation was 26 % of the total study population. Treatment effects between the experimental and control sides were compared using the GEE method. The average in RTOG scores for both sides changed significantly with time effects at 3, 4, 5, 6, and 7 weeks with estimate beta of 0.185,0.638, 1.064, 1.559, and 1.806 respectively. The experimental sides had significantly lower RTOG scores than the control sides at 6 and 7 weeks (estimate beta = –0.129 and –0.213 respectively, P value < .05).

Conclusions: The non-alcohol barrier film reduced both the duration and frequency of RT-induced moist desquamation better than no treatment. This skin care strategy has shown promise to prevent moist desquamation in this population.

MASCC-0154

Oral health considerations among cancer survivors

H.H.M.,N.S.T. M.A. Al-Mohaya 1

1Dentistry, Prince Sultan Military Medical City, Riyadh, 2Faculty of Dentistry/Division of Oral Medicine, King Abdulaziz University, Jeddah, Saudi Arabia, 3Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA

Usually, patients with cancer encounter assaults on their oral health from both the disease and the treatment option. While most of these are manageable, complications can have a profound impact on quality of life. Compromised oral health prior to, during, and following cancer therapy can affect treatment outcomes.

Despite the significant advances in the cancer therapy which had a great impact on prolonging the survival rate, these patients are potentially at high risk for developing a number of oral complications, ranging from acute oral complications including mucositis and infections, to late complications including hyposalivation, caries, taste changes, trismus and jaw osteonecrosis.

Cancer survivors, depending on the specific cancer and modalities of therapy, may remain at life-long risk of developing oral complications which require increased awareness and recognition to promote prevention and appropriate intervention as well as long-term dental follow-up after completion of cancer therapy.

It is therefore important for the primary oncologist and the dentist to be aware of these complications. Prevention and management is best provided via multidisciplinary health care teams, which must be integrated and communicate effectively in order to provide the best patient care in a coordinated manner at the appropriate time. Patients should typically undergo thorough oral examination prior to initiation of therapy, during and after therapy to identify any active infection. The aim of this presentation is to discuss potential oral complications as a result of cancer therapy and their management and what are certain precautions we should be aware of for these patients.

MASCC-0155

The beliefs, knowledge, understanding, attitudes and treatment access to breast cancer amongst rural women in Northern Nigeria

M. Tagbarha 1

1Community Health and Policy, University of Abuja, Abuja, Nigeria

Goal: The goal of this study is to ascertain the beliefs, knowledge, understanding, attitudes and treatment access to breast cancer among rural women in Nigeria.

Background: Breast cancer has become a popular topic in recent years with several thousands of women diagnosed to be positive every year. The availability of care/treatment upon early detection is key to survival.

Methods: An interview guide was designed specifically for this study in which 200 women, age 45 and over took part in. It contained questions about beliefs, knowledge, understanding and attitudes about Breast Self-Examination (BSE), Clinical Breast Examination(CBE) and mammogram. The data were obtained during face-to-face interviews in the primary language of the participating woman.

Results: Out of the 200 women who participated, only 1 % of the participants practiced BSE monthly, 8 % had undergone at least one CBE during their lives, and 91 % had never had a mammogram. There were little or no access to treatment even at early detection in these rural areas causing thereby vulnerability to loss of life. Majority of these rural women (95 %) said they knew little or nothing about breast cancer. While 15 % of the women said detecting cancer early was important, only 3 % reported that cancer could be cured.

Conclusions: The level of awareness and treatment access to breast cancer amongst Northern Nigeria’s rural women is extremely low. This alarming situation calls for urgent intervention of health organizations to provide immediate breast cancer awareness, screening and care so as to reduce incidences at early detection.

MASCC-0156

Extravasation of vinca alkaloids: development of an action algorithm for quick and effective treatment

S.M.,2.,M.M.,2.,O.F. M. Mendes 1

1Health Sciences Faculty, University of Beira Interior, 2Pharmaceutical Services, Hospital Centre of Cova da Beira, Covilhã, Portugal

Introduction: Due to the increase of cytotoxic infusions given, healthcare professionals endeavour to minimize chemotherapy complications. A potential complication is vesicant chemotherapy extravasation, such as vinca alkaloids (VA). The extravasation may affect the quality of life of patients and their survival. Therefore, fast acting and effective treatment are essential.

Objectives: To develop an algorithm for management of extravasation of VA.

Methods: A literature review was performed, through research and analysis of guidelines and articles obtained from PubMed since January/2000 to December/2012, intersecting the terms chemotherapy extravasation and extravasation treatment.

Results: The first course of action is to stop the infusion immediately, not remove the cannula, disconnect the infusion, and with a new syringe aspirate as much of the infusate as possible. The medical staff on service is then notified, the extravasation kit is collected and the extravasated drug is identified. Thereafter, the extravasation area is marked and photographed and the cannulais removed. Warm compresses should be applied to the affected area for 20 min, 4 times/daily for 1–3 days, with minimal pressure, and the antidotehyaluronidase 150 IU/mL must be administrated (several subcutaneous injections of 1–6 mL of hyaluronidase into the extravasation area in a clockwise manner). Analgesia should be provided if required. Each incident of extravasation must be thoroughly documented and the follow-up and long term management is central.

Conclusions: The developed algorithm is a valuable tool for all hospital services that prepare and administrate VA, contributing to a quick and effective response to episodes of extravasation.

MASCC-0157

Parenteral feeding during methotrexate-induced gastrointestinal mucositis prevents weight loss in the rat

M. Fijlstra 1, W.J.E. Tissing1, H.J. Verkade1, E.H.H.M. Rings1

1Department of Pediatrics, Beatrix Children’s Hospital/University Medical Center Groningen, Groningen, The Netherlands

Background: It is unknown what feeding strategy to use to prevent weight loss in patients with chemotherapy-induced gastrointestinal mucositis. When possible, enteral nutrition is preferred to parenteral nutrition because of negative side effects. In a mucositis rat model, we demonstrated disaccharide maldigestion and fat malabsorption but up to normal absorption of glucose and amino acids upon their continuous enteral administration. We now determined the effects of4 different (par)enteral feeding strategies during mucositis on body weight and intestinal recovery.

Methods: From day 2–5 after injection with methotrexate (MTX, 60 mg/kg), rats continued ad libitum purified diet (AIN-93G, strategy 1), received continuous enteral feeding [force-feeding, normal daily amounts] with glucose and amino acids (Nutriflex®, strategy 2) or with standard formula (Nutrini®, strategy 3), or received continuous parenteral feeding with standard formula (NuTRIflex®Lipid, strategy 4). Saline-treated controls continued ad libitum purified diet

Results: From day2 on, MTX-treated ad libitum-fed rats showed a reduced food intake and bodyweight (P < 0.05), as seen before. Most continuously enterally-fed rats (88 %) were terminated early because of severe abdominal distention. Parenterally-fedrats grew similarly like controls. On day 5, the jejunum of MTX-treated adlibitum-fed rats showed hypertrophic crypts and a normal villus length. In contrast, parenterally-fed rats showed no increase in crypt length and a reduced villuslength, compared with controls (P < 0.05).

Conclusion: Continuous enteral feeding in normal daily amounts during mucositis is poorly tolerated in rats. Parenteral feeding prevents weight loss during mucositis while enteral feeding in limited amounts accelerates intestinal recovery.

MASCC-0158

The emerging role of exercise and health counseling in patients with acute leukemia undergoing chemotherapy during outpatient management

L.A.,3.,L.K.,H.B.,A. M. Jarden 1,2

1Center for Integrated Rehabilitation of Cancer Patients and The University Hospital’s Centre for Health Care Research, 2Department of Hematology, Rigshospitalet, Copenhagen University Hospital, 3Faculty of Health Sciences, Copenhagen University, Copenhagen, 4Department of Hematology, Herlev Hospital, Herlev, 5Department of Basic Sciences and Environment, Faculty of Life Sciences, Copenhagen University, Copenhagen, Denmark

Objective: The primary objective of the study was to determine the feasibility and safety of a supervised, structured and combined exercise intervention in patients with acute leukemia undergoing treatment in the outpatient setting. The secondary objectives were to investigate the effect of the intervention unphysical and functional capacity, physical activity levels, symptom burden and health-related QOL.

Method: This pilot study is a prospective, single group trial of an exercise and health counseling intervention in patients with acute leukemia during the course of consolidation treatment in the outpatient clinic.

Results: Seventeen of 20 patients completed study requirements (85 %), adherence to exercise was 73 % and for health counseling 92 %. There were improvements in the 6-minute-walk-distance (p = 0.0013), sit-to-stand test (p = 0.0062), the right and left biceps arm-curl tests p = 0.0002 and p = 0.0002, respectively; health-related quality of life (p = 0.0209) (FACT-An), vitality (p = 0.0015), mental health (p = 0.0471) and physical component scale (p = 0.0295) (SF36). Significant reduction in the symptom burden (p = 0.0021) and symptom interference on daily life activities (p = 0.0069) (MDASI). No adverse reactions were observed.

Conclusions: This 6 week supervised and structured exercise and health counseling intervention proved feasible, safe and well tolerated with physical, functional, psychosocial and symptom benefits in a small sample of patients with acute leukemia undergoing intensive chemotherapy during outpatient management. The intervention proved to be well fitted to the outpatient clinical setting and addresses the concerns associated with exercising patients during treatment for acute leukemia, i.e. low hemoglobin and platelet counts, infections, frequent visits to the hospital and the long term treatment trajectory.

MASCC-0159

The effect of combined decongestive therapy and pneumatic compression pump on lymphedema indicators in patients with lymphedema secondary to breast cancer treatment

B.J.,A.R.T.,S.P.,S.T. M. Moattari 1

1"Nursing, 2Surgery, 35.

Background: Lymphedema treatment is difficult and there is no consensus on the best treatment. This study evaluated the effect of combined decongestive therapy (CDT) and pneumatic compression pump on lymphedema indicators in patients with lymphedema secondary to breast cancer treatment.

Methods: Forty-two women with breast cancer related lymphedema participated. The volume difference of upper limbs, the circumference at 9 areas and shoulder joint range of motion were measured in all patients. Then, they were divided randomly into an intervention or control group. The intervention of the study performed for the intervention group for 8 weeks At the end of 4 and 8 weeks the same primary measurements were done for both groups. Data were analyzed using SPSS.

Results: The mean volume difference of the upper limbs and mean difference in circumference in all areas measured at different phases in the intervention group decreased significantly. However, there were no significant differences between the groups for these two variables. Mean flexion, extension, abduction and external rotation (in degrees) at different phases increased significantly in the intervention group and decreased significantly in the control group, and the changes in mean values differed significantly between the two groups.

Conclusions: CDT significantly increased shoulder joint range of motion. The finding support the effects of CDT in the treatment of secondary lymphedema of upper extremity.

MASCC-0160

Level of understanding of nurses from Goma city of breast self examination (BSE) ASA breast cancer prevention method

H.M.K.,2.,V.H. M.K. Sahani 1

1Health Department, Agir Ensemble, Goma, The Democratic Republic of the Congo, 2Gynecology, Rwamagana Hospital, Rwamagana, Rwanda

Background: Breast cancer is major public health problem in DRC and is among the leading cause of death by cancer in our country. Almost all sicks arrive at hospital at late stage of disease while health professionals can’t do anything. In this study we want to know if nurses who are supposed to inform people and sick about BSE to prevent this disease know well this method to give message that can save lives of women in community.

Method: For data collection, we used questionnaire of enquiry completed by nurses. Sample size has been determined using EPI-INFO setup calculation. We have used EPI-INFO setup for analysis of data. Tests used: T test of Student, Kruskal-Wallis test.

Results: -32 nurses know that breast cancer is public health issue (74.4 %) and 11 don’t know (25.6 %); n = 43, Khi2 = 20.5, p = 0.000006. -25nurses (58.1 %) know that BSE is a method to prevent breast cancer and 18 (41.9 %) don’t know; n = 43, Khi2 = 2.28, p = 0.131130; -6 nurses (14 %) know the procedure of BSE and 37 (86 %) don’t know; n = 43, Khi2 = 44.70, p = 0.000000. -There is no implication of the duration in career as nurse to the knowledge of BSE. -The level of study has influence on knowing that breast cancer is a public health issue: people with level know well than people with low level. -The sex does not have any influence on knowledge of nurses of BSE.

Conclusions: More nurses in Goma know that breast cancer is a public health problem and they know what mean BSE but they don’t know how to proceed and what elements to look for during BSE. Training is a need for nurse focusing on breast cancer prevention Methods. Hospital-based training can help nurses to increase their skills.

MASCC-0161

The incidence of adverse opioid events on an inpatient palliative unit requiring naloxone

M. Davis 1, A. Aung1

1Cleveland Clinic, Cleveland, OH, USA

Background: Opioids are the most common medication use in palliative care setting. Opioid toxicity in terminally ill patients may be multifactorial. Naloxone, pure opioid antagonist especially at mu opioid receptor sites in the CNS is useful for reversal of sedation and respiratory depression due to opioid toxicity but little has been report about naloxone usage in palliative care.

Method: A retrospective chart review of 1,814 adult patient admitted to palliative medicine unit over a 2 year period was performed to determine the incidence and reason of naloxone usage.

Result: Among 1,814 patients admitted to palliative medicine unit and who are on opioid, 25 patients (1.37 %) received naloxone to reverse opioid side effect. Circumstances surrounding naloxone usage were as follows: 7 overmedicated, 10 received simultaneous benzodiazepines, 2 underwent procedural sedation within 12 h, 2 received haloperidol, 1 received chlorpromazine, 3 could not be determined. There were no medication errors or equipment failures. 23 patients had their opioid dose decreased/held and 2 patients experienced adverse effects from withdrawal. The effective naloxone dose did not correlated with the opioid dose 24 h before respiratory depression. Naloxone dose varied based on practitioners. Palliative medicine physician used lower dose of naloxone relative to covering physicians.

Conclusion: The need for naloxone to reverse opioid-induced respiratory depression is less than 2 % of individuals on opioids who are treated on an acute palliative care inpatient unit. The combination of a benzodiazepine and opioid are significant contributing factors to adverse respiratory events with opioids.

MASCC-0162

Can initial admission serum creatinine and albumin help in predicting symptoms, in arranging appropriate discharges, and predict survival on a palliative unit?

M. Davis 1, A. Aung1, S. Alqudihy1, R. Lisa1

1Cleveland Clinic, Cleveland, OH, USA

Background: Low albumin and creatinine are common among patients with advance illnesses and probably reflect low muscle mass and cachexia. The presences of both a low creatinine, and albumin upon admission could predict a lower survival.

Method: This was a retrospective review of patients admitted to the palliative medicine unit over 2 month’s period, November and December 2011. Patient diagnosis and SSN (for purposes of survival information): (a) Age, (b) Gender, (c) Admission albumin and creatinine used for survival. Analysis was based on 81 patients. Recursive partitioning analysis with a log-rank splitting method was used to identify cut points in albumin or creatinine that predict survival. Cox proportional hazards analysis was used to identify prognostic factors.

Results: Variables found prognostic for worse survival in univariable analysis included male gender, lower albumin, and higher creatinine. Every variation of albumin was significant (continuous, median, RPA, tertiles). For creatinine, only by RPA was significant. In multivariable analysis, only two variables were prognostic for worse survival: albumin <3.1 and creatinine >0.91. Albumin (n = 80) per 1 unit increase HR 0.51 (0.34−0.77), p < 0.001: > 3.1/< 3.1 HR 0.28 (0.15−0.50) p < 0.001, overall HR 0.28 (0.15−0.52), p < 0.001. Creatinine >0.91/< 0.91 HR 1.83 1.03−3.25 p = 0.038, overall HR 1.80 (1.01–3.21), p = 0.046.

Discussion: Hypoalbuminemia is an adverse prognostic factor. Albumin has not been used in standard prognostic scales except for the Glasgow Prognostic Scale. Determining if albumin adds to the Palliative Prognostic Score will follow.

Conclusion: Hypoalbuminemia is a prognostic factor.

MASCC-0163

Cannabinoids for dysgeusia and metallic taste

M. Davis 1, R. Bloise1

1Cleveland Clinic, Cleveland, OH, USA

Background: Delta-9-tetrahydrocannabinol, (THC) is used for nausea and as an appetite stimulant. A recent study suggested that THC relieves dysgeusia and metallic taste.

Patient histories: An 80 year old Caucasian female presented to the outpatient supportive clinic with diabetes, coronary artery disease, and multiple myeloma. She was on a number of treatment regimens for myeloma with partial response and poor tolerance, having severe peripheral neuropathic pain. She was seen for odynophagia and metallic taste. Treatment for thrush failed to relieve her metallic taste. She was admitted through the emergency department for nausea and metallic taste. THC 2.5 mg daily completely resolved the symptom. A 56 year old Caucasian female with rheumatoid arthritis on study (Tocilizumab vs. placebo + methotrexate) was admitted with histoplasmosis complicated by respiratory failure, liver and kidney injury from antifungal therapy. She was discharged on amphotericin B 300 mg. Amphotericin B was stopped doses for severe nausea and vomiting and itraconazole started. She was readmitted and a palliative care consultation was initiated for nutritional failure, food aversion, metallic taste and nausea. THC, 2.5 mg, twice daily resolved her metallic taste and food aversion by day 4.

Discussion: Chemosensory abnormalities are under recognized leading to nutritional failure. THC increases food intake by stimulating orosensory reward pathways, increasing the motivation to eat. CB1R located in CNS reward-related and olfactory epithelium and bulb modulate odor perception and taste.

Conclusion: THC effectively treats metallic taste

MASCC-0164

MASCC Palliative Care (PC) survey: integration into cancer care

N.C.,F.S.,P.C. M. Davis 1

1Cleveland Clinic, Cleveland, OH, USA, 2Shaare Zedek Cancer Center, Jerusalem, Israel, 3Palliative Care Center, Cantonal Hospital, St Gallen, Switzerland

Background: The purpose of this survey was to determine palliative care service integration into cancer care.

Method: A survey, from Hui et al. by permission of the authors (1) was completed by MASCC, ESMO and EAPC members on the MASCC website. Questions were scored on 0–10, low scores 0–3 indicating a negative response.

Results: 183 respondents, 19 NCI, 34 ESMO designated centers, completed the survey. 83 % had PC, 93 % under M.D. leadership. 72 % had consult teams, 64 % outpatient clinics, 39 % acute inpatient units, 21 % hospices. Barriers to PC were; funding (55 %), lack of trained M.Ds or RNs (40 %), reimbursement (32 %). Over 5 years PC effectiveness increased in 63 % and quality improved in 69 %. Most agreed PC should be integrated into oncology and PC research funding should increase, only 17 % indicated their institution was likely to increase funding. <50 % were planning to increase PC personnel or beds. NCI and ESMO centers were more likely to have PC services during the past 10 years, have PC physicians on staff, and offer PC services more frequently than urban hospitals. ESMO and NCI centers scored PC quality higher, were more likelihood to increase PC physicians and inpatient beds than other centers.

Discussion: PC is important to cancer care, but a lack of interest in increasing PC funding is a barrier. NCI and ESMO centers have more interested in resourcing PC.

Conclusion: PC integration into cancer care is highly regarded but in funding and development lags behind.

1. Hui D, et al. JAMA. 2010 Mar 17;303(11):1054–61.

MASCC-0165

Does hope correlate with symptom burden in advanced cancer?

M. Davis 1, A. Rao1, S. Majeed1, A. Parala1, L. Rybicki1

1Cleveland Clinic, Cleveland, OH, USA

Introduction: Symptom burden may be detrimental to a sense of hope in patients with advanced illnesses. We did a feasibility study comparing hope to symptom burden and to patient and cancer characteristics.

Method: The Herth Hope Scale was compared to symptom burden measured by the ESAS[lr1] and to ESAS fatigue and depression scores. Herth Hope Scale was compared by gender, marital status, and duration of illness. We determined completion rate and explored associations with Herth Hope Scale using Spearman correlation (r) or Wilcoxon rank sum test.

Results: Twenty-five advanced cancer patients were surveyed using the Herth Hope Scale and ESAS with nearly 100 % completion rate. Hope[lr2] was not correlated with total ESAS score (r = −0.01; P = 0.98) or fatigue (r = 0.16; P = 0.45) but it was weakly and negatively correlated with depression (r = −0.27; P = 0.19). There was a weak association with marital status (median hope 41 if married vs. 38 not married; P = 0.11). There was no association between hope and duration of illness (median 40 <1 year of illness vs. 39 >1 year; P = 0.34) or gender (median 40 female vs. 40 male; P = 0.98)

Discussion: Hope appears to be independent of symptom burden in this small feasibility trial. This trial allowed us to power a definitive study which is in progress and will survey 198 patients to confirm this independence.

Conclusions: There is preliminary evidence that there is no association between a sense of hope and symptom burden.

MASCC-0166

The silent cancermale breast cancer

M.J. Pritchard 1

1Surgery, Wirral University Teaching Hospital NHS Foundation Trust, Liverpool, UK

Breast cancer is considered by the general public as a women’s illness. In 2008 some 1.38 million women were diagnosed with breast cancer that’s nearly a quarter of all female cancer cases. As health professionals our role is to offer hope and support to both the patient and their family members as they undergo cancer treatment. So when we talk about breast cancer we inevitably talk about women’s breast cancer. Issues of gender appear not to be at the forefront of the health professionals mind. Consequently we as health professionals have devoted both time and energy to develop sophisticated support systems to aid the patient’s physical and emotional well being. Speciality clinics, access to breast care nurses and of course the option to undergo re-constructive surgery. However what happens to this support mechanism when the patient’s gender short circuits this network? What if the cancer suffer is a man? Where does a male breast cancer patient go for support and treatment?. Male breast cancer makes up only 1 % of the total number of breast cancers worldwide. In the United Kingdom approximately 300 men are diagnosed with breast cancer each year. The aim of this paper is to raise the profile of this particular group of patients who have been diagnosed with this disease.

MASCC-0167

Comparison of baseline quality of life scores in patients with bone and brain metastases as assessed using the EORTC QLQ-C30

L.Z.,L.Z.,L.-M.T.,M.-F.H. M. Poon 1

1Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, 2Department of Surgery, Taipei Veterans General Hospital, Taipei, 3Department of Gastroenterologic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan R.O.C., 4Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada, 5Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus, 6Department of Orthopedic Oncology, Federal University of Sao Paulo, Sao Paulo, Brazil, 7Department of Clinical Oncology, Tanta University Hospital, Tanta, Egypt, 8Division of Gynaecology and Genitourinary Oncology, Department of Radiation Oncology, Regional Cancer Center, Trivandrum, India, 9Unit of Clinical Research, Innovation, and Pharmacology, Saint-Etienne University Hospital, Saint-Etienne, France, 10Department of Public Health and Institute of Epidemiology and Preventative Medicine, National Taiwan University, Taipei, Taiwan R.O.C., 11Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON, Canada

Introduction: In advanced cancer patients, quality of life (QOL) as a clinical endpoint is of utmost importance as patients have shorter life expectancies and treatment intent is palliative in nature. Since 1993, the European Organization for Research and Treatment of Cancer Core 30 Questionnaire (EORTC QLQ-C30) has been widely used to study cancer-specific health-related QOL.

Objectives: To compare baseline EORTC QLQ-C30 scores in patients with bone and brain metastases internationally.

Methods: The EORTC QLQ-C30 was used to assess QOL in bone metastases patients with histological confirmation of their primary cancer and patients with brain metastases with documented single or multiple metastases. A univariate linear regression model was applied to detect significant differences between both groups on each QLQ-C30 subscale at baseline. To normalize the distribution, natural log-transformations were applied for each C30 summary scale.

Results: Karnofsky performance status, gender, marital status, and primary cancer site were significantly different between groups (p < 0.005). After accounting for these confounding factors, three EORTC-C30 scales significantly differed between the two patient groups: physical functioning (p < 0.0001), role functioning (p < 0.0004), and pain scale (p < 0.0001). Bone metastases patients reported worse pain and physical functioning, while brain metastases exhibited greater role functioning deficits.

Conclusions: Patients with bone metastases have more pain and reduced physical functioning. However, patients with brain metastases have more severe role functioning deficits. The use of disease-specific assessment modules such as the QLQ-BM22 and QLQ-BN20 will enhance the capture of relevant QOL in these populations.

MASCC-0168

Skeletal morbidity rates over time in patients with bone metastases from solid tumors reported in bone modifying agents randomised trials

L.Z.,L.Z.,M.P.,R.C. M. Poon 1

1Rapid Response Radiotherapy Program, Department of Radiation Oncology, 2Department of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 3Department of Medical Oncology, St. Michael’s Hospital, Toronto, ON, Canada

Introduction: Skeletal related events (SREs) in patients with bone metastases decrease patients’ quality of life and functional status. While bone-modifying agents have been found to reduce the time to first on-trial SRE and decrease the total incidence of SREs, standard practice in the management of bone metastases has changed concurrently.

Objective: The purpose of this review was to investigate if advances in bone-targeted therapies have decreased the incidence of individual types of SREs and to delineate the trend of SREs.

Methods: A literature review was conducted to identify phase III, randomized bone-targeted therapy trials. For all studies, a mean year of enrolment ([start of enrolment + end of enrolment]/2) was calculated. Incidences of skeletal related events were tabulated and expressed as percentages of on-trial patients. Generalized linear mixed models were used to search for the trends of SRE over time for all placebo and intervention arms.

Results: A total of 20 eligible studies were identified which reported SRE data from phase III trials, of which 11 were suitable for the quantitative analysis. Enrolment periods for all included data ranged from 1990 to 2009. Statistically significant overall downward trends in pathological fractures and need for surgery were seen over time. Also significant differences between intervention and placebo were seen with all SREs.

Conclusion: The decrease in SREs over time may not only be a result of the development of new generation bone-modifying agents, but also due to better systemic management and awareness of events associated with bone metastases.

MASCC-0169

Adverse events across generations of bone-modifying agents in patients with solid tumor cancers reported in phase III randomized trials

L.Z.,F.M.,K.L.,U.E. M. Poon 1

1Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, 2Pamela Youde Nethersole Eastern Hospital, 3Queen Elizabeth Hospital, Hong Kong, China, 4Department of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

Introduction: Treatments of advanced cancers that have metastasized to bone are palliative in nature. Therefore, treatment tolerability with minimal adverse effects is of primary importance. Many adverse effects of bone-modifying agents have been documented. However, no study has previously attempted to compare individual adverse events experienced while taking bone modifying agents or placebos.

Objective: The objective of this study is to compare adverse events experienced among different bone-modifying agents.

Methods: A literature search was conducted to identify phase III bisphosphonate and bone-modifying agent trials reporting adverse effects. Thirty-seven adverse events of interest were identified for six different treatment options. Weighted linear regression modeling was performed on the adverse event proportions with treatment groups, normalized through applying natural log-transformations.

Results: There were significant differences on the single item events of vomiting (p = 0.045) and osteonecrosis of the jaw (p = 0.017), and combined item events of nausea/vomiting (p = 0.048), hematological and lymphatic system toxicities (p = 0.020), and any respiratory system problem (p = 0.023) between bone-modifying agent and placebo trials. The significant toxicities were observed even after adjusting for the two confounding factors of age and primary cancer site.

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Conclusion: While adverse effects are consistently experienced more frequently in patients receiving bone-modifying agents when compared to placebos, we find that the majority of individual side effects are not significantly more frequent inpatients receiving bone-modifying agents as compared to placebo.

MASCC-0170

Incidence of skeletal morbidity rates over time in patients with multiplemyeloma-related bone disease as reported in randomised trials employing bone-modifying agents

L.Z.,L.Z.,J.H.,E.W., M. Poon 1

1Rapid Response Radiotherapy Program, Department of Radiation Oncology, 2Department of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

Introduction: Patients with progressive osteolytic bone lesions are at a high risk of developing skeletal related events. Bisphosphonates have been found to inhibit osteoclast recruitment and activity and have been used for prophylaxis of SREs resulting from multiplemyeloma.

Objective: The purpose of this review was to investigate if advances in bone-targeted therapies have decreased the incidence of skeletal morbidity rate (SMR) over time in patients with multiple myeloma related bone disease.

Methods: A literature search was conducted over the OvidSP platform in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials to identify phase III results from bone-targeted therapy trials in patients with multiple myeloma. The SMR was the endpoint of interest and for each study, a mean year of enrolment ([start of enrolment + end of enrolment]/2) was calculated.

Results: A total of 8 study arms were identified, with only 2placebo arms, therefore a weighted linear regression was not feasible, and only intervention treatment arms were analyzed. A statistically significant downward trend in the SMR was observed in all intervention arms.

[pic_01]

Conclusion: The incidence of skeletal morbidity rates has decreased significantly over time in patients with multiple myeloma over the years of 1994–2007.

MASCC-0171

Incidence of skeletal related events over time from solid tumor bone metastases reported in randomised trials employing bonemodifying agents

M. Poon 1, L. Zeng1, L. Zhang1, H. Lam1, U. Emmenegger1, E. Wong1, G. Bedard1, N. Lao1, R. Chow1, E. Chow1

1Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

Introduction: Skeletal related events (SREs) in patients with bone metastases decrease patients’ quality of life and functional status. While bone-modifying agents have been found to reduce the time to first on-trial SRE and decrease the total incidence of SREs, standard practice in the management of bone metastases has changed concurrently.

Objective: The purpose of this review was to investigate if advances in bone-targeted therapies have decreased the incidence of individual types of SREs and to delineate the trend of SREs.

Methods: A literature review was conducted to identify phase III, randomized bone-targeted therapy trials. For all studies, a mean year of enrolment ([start of enrolment + end of enrolment]/2) was calculated. Incidences of skeletal related events were tabulated and expressed as percentages of on-trial patients. Generalized linear mixed models were used to search for the trends of SRE over time for all placebo and intervention arms.

Results: A total of 20 eligible studies were identified which reported SRE data from phase III trials, of which 11 were suitable for the quantitative analysis. Enrolment periods for all included data ranged from 1990 to 2009. Statistically significant overall downward trends in pathological fractures and need for surgery were seen over time. Also significant differences between intervention and placebo were seen with all SREs.

Conclusion: The decrease in SREs over time may not only be a result of the development of new generation bone-modifying agents, but also due to better systemic management and awareness of events associated with bone metastases.

MASCC-0172

Cancer caregiver information seeking behavior

1Cancer Resource and Education Center, Universiti Putra Malaysia, Serdang, Malaysia

A report by the Malaysian National Cancer Registry (NCR) has published that in between 2003–2005, a total of 67,792 new cases were diagnosed among 29,596(43.7 %) males and 38,196 (56.3 %) females in Peninsular Malaysia. Nearly all these patients have or will have family members involved in their care. Family caregivers face numerous challenges when providing care for their loved ones. Thus, they need to have knowledge and skills pertaining to all aspects in cancer care and survivorship. To achieve this, they need to search for information. Generally, this study aims to explore the information seeking behavior among cancer care giver. This include to identify their source of information and type of information needed, and also to understand the reason why they seek these information. Besides that, this study also targets To explore other information needed by the care giver to cope with their responsibility. This research will employ a qualitative approach, using in depth interviews technique with 30 cancer care givers. The interviews will be guided by interview protocol developed from literature review. Ethical clearance will be obtained for the study protocol and consent to participate in the study will be elicited from subjects. The findings from this study will provide guidelines in the development of the intervention module or educational program to the cancer care giver and also the most effective strategies to disseminate reliable information regarding the disease.

MASCC-0173

Monitoring of radiotherapy results using 3DCRT technique for local prostate cancer with PSA

R.c.c.g. M. dorchin 1,2

1Oncology, Ganjavian Hospital, Dezfoul, Iran, 2Al-Bairouni hospital, Damascus University, Damascus, Syria

Patients and methods: Between 1.6.2006 and 1.6.2008, a total of 135 patients were treated with Three Dimensional Conformal Radiation Therapy (3DCRT) for clinical stages T1–T3 Adenocarcinoma of the prostate. The median age was 67 years (50–83), 10 % had family history. 81 % were smokers. The median PSA level was17.5 ng/ml (3.1–95). 32 % were T2a and 50 % T2b. The median Gleason score was 6 (3–7). 34 % received the treatment after radical surgery for biochemical relapse and 64 % as primary treatment. 60 % received 66–70 Gy and 40 % received 72–76 Gy. Patients were followed with PSA 3 monthly for 24 months. The median follow up was 12 months. 39 patients didn’t follow and therefore cancelled from the study. Only 96 patients ended the treatment

Results: The Bone scan was positive (bone metastases)in the 27 cases that PSA level had increased.24 cases from these patients received 66–70 GY XRT (low dose) and their median age was more than 70 years and18 cases/27cases were directly treated with EBRT.

Conclusion: Recurrence after RPR was good controlled by RT, but primary RT was not sufficient in the majority of our patients. Those patients received only 66–70 Gy, therefore Patients should receive a maximum dose of RT, and however more complications are expected. Measurement of Prostatic Specific Antigen (PSA) after Radiation Therapy is a good marker for specificity and sensitivity of the treatment. PSA was a powerful predictor of local relapse and distant metastases (DM) and Patients who develop biochemical relapse should be considered for systemic therapy as distant metastases are expected.

MASCC-0174

Sentinel-node biopsy comparison with routine axillary dissection in breast cancer in Al-Bairouni Hospital in Damascus City

R.c.c.g. M. dorchin RCCG

Al-Bairouni Hospital, Damascus University, Damascus, Syria

Methods: From July 2007 to November 2009, we randomly assigned 423 patients with primary breast cancer (PBC) in whom the tumor was less than or equal to 2 cm in diameter (T1) either to sentinel-node biopsy and total axillary dissection (the axillary-dissection group) or to sentinel-node biopsy followed by axillary dissection only if the sentinel node contained metastases (the sentinel-node group).

Results: The number of sentinel nodes found was the same in the two groups. A sentinel node was positive in 69 of the 208 patients in the Axillary -dissection group (33.17 %), and in 74 of the 186 patients in the sentinel-node group (39.78 %). In the Axillary dissection group, the overall accuracy of the sentinel-node status was 96.9 %, the Sensitivity 91.2 % and the specificity 100 %. There was less pain and better arm mobility in the patients who underwent sentinel-node biopsy only than in those who also underwent Axillary dissection. There were 16 events associated with breast cancer in the Axillary -dissection group and 9 such events in the sentinel-node group. Among the 112 patients who did not undergo axillary dissection, there were no cases of overt axillary metastasis during follow-up.

Conclusions: Sentinel-node biopsy is a safe and accurate method of screening the axillary nodes for metastasis in women with a small breast cancer.

MASCC-0175

Role of thymoquinone in animal models of schizophrenia

R.A.K.,A.K.N.,M.A.,M.M. M. Akhtar 1

1Pharmacology, Faculty of Pharmacy, 2Pharmaceutics, 3Pharmacognosy and Phytochemistry, Jamia Hamdard (Hamdard University), New Delhi, 4Clinical Pharmacology and Pharmacokinetics (CPP), Ranbaxy Research Laboratories., Gurgoan, India

Purpose: The present study evaluated the possible role of thymoquinone (TQ, a major constituent of Nigella sativa plant) in animal models of schizophrenia (SCZ).

Method: TQ (20 mg/kg i.p) was administered daily for 28 days in mice. Different models of SCZ like haloperidol-induced catalepsy, apomorphine-induced climbing behaviour and elevated plus maze test were used. After the last dose of TQ on 28th day, behavioural tests were performed followed by biochemical estimations

Results: Pre-treatment of TQ alone and in combination with haloperidol observed cataleptic behaviour. Administration of TQ in apomorphine induced climbing behaviour reduced maximum time of single climb and climbing index (p < 0.001). Scopolamine-induced prolongation of transfer latency (TL) was suppressed by TQ (p < 0.001). There was no change in the percentage alternation of animals in TQ treated group. However, a significant possible alternation was observed (p < 0.001), suggested its anti-amnesic effect. The anti-amnesic effect of TQ was associated with decrease in acetyl cholinesterase (AChE) activity in mice brain. A decrease in TBARS levels and increase in glutathione (GSH) and Catalase levels were observed in all models used, thus, confirming its antioxidant properties. TQ administration also showed reduction in dopamine levels indicating the involvement of dopamine receptors in all three models thus, suggesting its antipsychotic like activities.

Conclusion: The present study observed antipsychotic like profile of TQ. However, our results are preliminary, further studies are required using specific animal models of positive and negative symptoms of SCZ in understanding the possible role of TQ in SCZ.

MASCC-0177

Introducing a new cost-effective alternative method preventing post-radiotherapy hyposalivation

N. Mirjalili 1

1Shahid Sadoughi University of medical sciences, Yazd, Iran

Introduction: Salivary gland dysfunction is one of the debilitating complications of head and neck radiation therapy. Depending on radiation schedule, salivary gland hypofunction may range from absolute lack of saliva to severely reduced excretion. Ideally, there are some modern measures, such as prescribing Amifostin or shielding the major glands that enable health-care providers to reduce the extent of hyposalivation. However, a considerable number of patients particularly in developing countries can barely tackle the costs.

Objective: Introducing a new cost-effective alternative method preventing post-radiotherapy hyposalivation.

Methods: A 27-year-old female with carcinoma of nasopharynx was referred for oral health evaluations. As she was not capable of paying for Amifostin, and couldn’t tolerate the side effects of Pilocarpin, a combination of hydration and topical saliva stimulation including salivary gland massage and gum chewing was instructed. During the radiotherapy sessions gum chewing was omitted due to dry mouth and she continued with massage only. Her unstimulated whole saliva flow rate and severity of oral dryness feeling were measured before, during and after the radiotherapy.

Results: The flow rate at first visit was 6.2 ml/min which fell to a minimum of 0.81 ml/min during the radiotherapy and rose to 1.3 ml/min after the first month of radiotherapy. The severity of oral dryness feeling, according to Tompson’s score, at the first visit was 15 which increased to a maximum value of 45 and then decreased to 24 1 month after the last radiotherapy session.

Conclusion: Salivary gland massage is a promising low-cost method in reducing post-radiotherapy hyposalivation.

MASCC-0178

Study of the relationship between individual and social factors of women on screening of breast cancer by using health belief model

N. Fouladi 1, F. Purfarzi1, H. Alimohammadi1, A. Massumi1

1Ardebil University of Medical Sciences, Ardebil, Iran

Breast cancer is the most common cancer in women. More than 90 % of the patients can be cured by early recognition. Breast self-examination and mammography can be useful in this case.

Materials and methods: In this study 380 women aged 30 and older who had gone to health centers of Ardabil were choose to measure their use of breast cancer screening in the last year. HBM questioner that was reliable and valid for Iranian women was used in this case. Logistic regression was used to identify leading independent predictors of breast cancer screening.

Results: In this study 27 % of the women performed BSE in the last year but only 6/8 % of them used mammography as a way of screening during the last year.

There was a significant difference in all parts of model unless in perceived severity between women that had performed BSE in the last year and who did not performed this behavior. The regression analysis revealed that intentions to perform BSE were predicted by perceived self-efficacy and perceived barriers for BSE and intentions to perform mammography were predicted by perceived barriers for mammography.

Conclusion: This study indicates that self-efficacy can cause performing BSE and perceived barriers can cause not performing BSE and mammography.

MASCC-0179

A screening tool to identify patients’ psychosocial difficulties and to establish a supportive relationship at cancer diagnosis

O.D.-C.,B.Q.,Y.S. N. Stadelmaier 1

1“Institut Bergonié, 2Laboratoire de Recherche ‘Santé et Qualité de Vie’ EA 4139, Université Victor Segalen Bordeaux 2, Bordeaux, France”

Context: In France, following all cancer diagnoses, nurses offer a consultation dedicated to providing information, listening, and identifying supportive care needs. To assist nurses in structuring these consultations and to enable them to approach any psychosocial difficulties encountered with the patient, in a Cancer Centre we introduced The Basic Documentation for PsychoOncology (Po-Bado), a semi-directive interview guide validated in Germany.

Hypothesis: We tested the hypothesis that, above and beyond it capacity for screening, the Po-Bado would encourage the establishment of supportive relationships and improve satisfaction of nurses regarding their relational competencies with patients and the structure of consultations.

Method: We retranscribed and analysed (NVIVO8) 62 consultations, carried out by 15 nurses divided into two groups. The first consisted of four nurses already experienced with the use of the Po-Bado (20 consultations), and the second consisted of 11 trained on the tool during the study (21 before training and 21 after training). Satisfaction of the 15 nurses was evaluated by semi-directive interviews.

Results: There was a significantly greater use of techniques encouraging the expression of patients’ experiences and significantly less use of non-encouraging techniques in consultations using the Po-Bado (inexperienced after training and experienced). Healthcare professionals felt more competent after training on the Po-Bado and stated that they felt more legitimate, particularly in their referrals to psychologists.

Conclusion: The PO-Bado is beneficial for the quality of the supportive relationship with the patient, consultation structure, and the satisfaction of healthcare professionals with regard their relational skills.

MASCC-0180

Developing a community-based complex intervention to improve quality of life in people with colorectal cancer: evidence, theory and acceptability

J.L.A.,P.M.,S.B.,S.H. N. Gray 1

1Division of Applied Health Sciences, University of Aberdeen, Aberdeen, 2General Practice and Primary Care, University of Glasgow, Glasgow, 3Cancer Care Research Centre, University of Stirling, Stirling, 4Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, 5Hull York Medical School, Hull York Medical School, Hull/York, 6Institute of Health and Society, University of Newcastle, Newcastle upon Tyne, 7Department of Oncology, Aberdeen Royal Infirmary, Aberdeen, 8Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK

Background: People with colorectal cancer report significantly impaired quality of life (QoL). Many physical, psychological, and social factors associated with lower QoL are modifiable, and therefore amenable to intervention. The present study reports the development of a theory-based intervention to improve QoL in people with colorectal cancer.

Methods: MRC complex intervention guidelines informed four development activities; (a) literature review of existing evidence of modifiable predictors of QoL in people with cancer, (b) development of a theoretical basis and causal model for the intervention, (c) modelling of processes and outcomes and identification of appropriate behaviour change techniques by a multi-disciplinary group, and (d) assessment of feasibility and acceptability through semi-structured interviews with people with colorectal cancer (n = 28), cancer specialists (n = 16), and primary care health professionals (n = 14) and pilot testing with patients (n = 12).

Results: Modifiable predictors of QoL identified were: symptoms (fatigue, pain, diarrhoea, shortness of breath, insomnia, anorexia/cachexia, poor psychological well-being, sexual problems); and impaired activities. To modify these symptoms and activities, an intervention based on Control Theory was developed to help participants identify personally important symptoms and activities; set appropriate goals; use action planning to progress towards goals; self-monitor progress; and identify (and tackle) barriers limiting progress. Interview responses were generally favourable and included recommendations about timing and style of delivery that were incorporated into the intervention. The pilot study demonstrated the feasibility of intervention delivery.

Conclusions: Through multi-disciplinary collaboration, a theory-based, acceptable and feasible intervention to improve QoL in colorectal cancer patients was developed, and can now be evaluated.

MASCC-0181

Oral ulcers in patients with advanced breast cancer receiving everolimus: clinical presentation and management.

A.N.,I.A.,E.P. O. Nicolatou-Galitis 1

1Dental School, University of Athens, 2Oncology Department, Mitera Hospital-Ygeia, Athens, Greece, 3Divisions of Oral Medicine Brigham and Women’s Hospital and the Dana-Farber Cancer Institute, Dana-Farber Cancer Institute, Boston, MA, USA

Purpose: Oral aphthous-like ulcers, referred to as «stomatitis» or «oral mucositis» represent a frequent dose-limiting toxicity related to mTOR inhibitors in oncology. The aim of this study was to report the clinical features and management outcomes in patients with everolimus-related stomatitis.

Patients and methods: Fifteen women with hormone-receptor-positive advanced breast cancer received everolimus combined with exemestane. Patients reporting the occurrence of oral pain during the course of antitumor therapy were referred to trained assessors for oral assessment

Results: Seven of 15 patients (46.6 %) were evaluated with stomatitis. Presenting pain was severe in 6 patients. The median time to development of pain was 13 days. Ulcers affected the non-keratinized mucosa, while the keratinized gingival mucosa was also affected in one patient. Topical dexamethasone solution was an effective intervention in all 7 patients. Everolimus was temporarily discontinued for a median time of 2 weeks in 4 patients. Two of those 4 patients developed a second event of stomatitis and everolimus was again discontinued and resumed after 2 weeks. At present all 7 patients continue everolimus therapy without any further toxicity; 5 receive full dose and 2 receive reduced dose

Conclusions: Everolimus-related oral ulcers were frequent and led to temporary discontinuation to 4 (57.1 %) and permanent dose modifications to 2 (28.6 %) patients. Topical dexamethasone was effective in managing stomatitis. Well-designed prospective trials, endorsing a consensus in terminology and an appropriate grading scale are needed to evaluate measures on prevention and management of this unique toxicity, aiming at improving overall cancer treatment outcomes.

MASCC-0182

The effects of concomitant hormonotherapy on radiation induced cardiac toxicity

G.Y.,C.Y.,H.A.,H.T. O.Y. Ata 1

1Medical Oncology, 2Radiation Oncology, Selcuk University, 3Pathology, Necmettin Erbakan University, Konya, Turkey

Background: We aimed to evaluate the effects of Anastrozole(A), Letrozole (L) and Tamoxifen (T) on radiation induced cardiac toxicity.

Methods: Eighty female rats were divided into 8 groups. Group (G) 1 was defined as control group. G2 was radiation therapy (RT) only group. Group 3, 4 and 6 were T, A and L control groups respectively. Group 6, 7 and 8 were RT plus T, A and L groups respectively. A single dose of 12 Gy RT was given to thorax with an anterior field. T, A and L were started 1 week before the RT and continued until animals were sacrificed 16 weeks after the RT. The extent of cardiactoxicity for each rat was quantified with image analysis of histological sections of the lung.

Results: The endocardial thickness and cardiac fibrosis scores were significantly differed between all the study groups (p values were <0.001 and 0.001 respectively). Endocardial thickness was significantly higher in RT + T group when compared to the other RT groups (p < 0.001 for each). The medianendocardial thickness was 1233, 5 micron RT + L group and 986, 5 micron for RT + Agroup (p < 0.001). When compared to RT groups with respect to fibrosis scores to there was a significant difference only in between RT + T and RT + A groups (p:0.008).

Conclusion: When used with concomitant RT, A is the safeties whereas T seems to be the most toxic drug regarding to radiation induced cardiac toxicity. This finding should be clarified with further clinical studies.

MASCC-0183

Compritive knowledge of breast self examination in midwifery and nursing students

K.N. P. Ashkvari 1

1Islamic Azad University of Iran Karaj Branch, 2Islamic Azad University, Karaj, Iran

Introduction: Breast cancer is the most common type of cancer among women world wide ranking second in mortality from cancer. Bse is a screaning method that should be taught at an early age so as to educate women about the importance of early detection of breast cancer.

Aim: the aim of this study was to evaluate the level of knowledge of midwifery and nursing student regarding breast self-examination.

Materials and methods: This study is descriptive on 23 midwifery and 69 nursing student. Data collection tool was a questionnaire the included 6 questions about demographic characteristics, and 14 question about knowledge breast self examination. Data analyzed by descriptive statistics.

Result: Our results show that the average age being (21–35), majority of them are single (%67/4) and (%29/3) twin. Our result showed no significant differences in midwifery and nursing knowledge. (p > 5 %). Our result showed the students of midwifery and nursing have mild knowledge.

Conclusion: It seems that despite of the importance of the bse in early diagnosis of breast cancer the majority of women have poor knowledge and practice about BSE. Based on the positive attitude of most women about BSE, it is that increasing the knowledge of women by education ways of breast cancer, especially BSE, this will be available by more attention of public health centers, TV and newspaper for increasing women awareness.

MASCC-0184

Psychological and demographic predictors of negative self-perception in a culturally diverse sample of head and neck cancer patients

1Psychology, University of Notre Dame, Notre Dame, IN, 2University of Miami School of Medicine, Miami, FL, USA

Background: Head and neck squamous cell carcinomas (HNC) and their various treatments are associated with psychological distress and negative self-perception that can impact patients’ psychosocial functioning and quality of life (QoL). Identifying factors that lead to psychological distress and negative self-perception is essential to the development and testing of interventions to improve QoL for HNC patients.

Methods: This study included 150 English-fluent HNC patients between 20 and 88 years old (Mean = 64, SD = 14). Fifty-six percent were US-born and 44 % were foreign-born from Cuba, Haiti, Dominican Republic, Jamaica, Puerto Rico, Nicaragua, and Peru. These patients provided demographic data and completed psychometrically valid measures of anxiety, depression, and self-perception. We conducted a standard multiple regression (MR) analysis, using scores on measures of anxiety and depression, age, sex, race, education, income, and employment status to predict self-perception.

Results: We found a statistically significant MR model (p < .001). Education (Standardized Coefficient Beta (SCB) = −.20, t = −2.39, p = .02), race (SCB = .156, t = 2.084, p = .04) and anxiety (SCB = .199, t = 2.078, p = .04) statistically significantly predicted self-perception. However, age, sex, employment status, income and depression did not make a statistically significant contribution to the prediction of self-perception (all ps > .05).

Conclusion: Race, education, and anxiety can negatively influence patients’ self-perception. Demographics and psychological distress data need to be integrated in the development and testing of interventions to improve QoL for HNC patients.

MASCC-0185

Struggling through a difficult time: experiences from patients with larynx cancer during active treatment phase

P. Wu 1

1Nursing Dept, Eye & ENT Hospital, Fudan University, Shanghai, China

Aim: To explore laryngeal cancer patients’ experiences during the active treatment phase.

Methods: A qualitative methodology was adopted. A purposive sample of 11 people with advanced-stage laryngeal cancer was included. Participants were recruited from Eye and Ear Nose Throat hospital in Shanghai. Data were collected over a 3-month period through open-ended interviews (in which some patients mainly using writing) and informal observations. Data collection occurred between postoperative Day 5 and discharge day to ensure the participants were medically stable enough to participate. A thematic analysis of the data was performed.

Findings: The core theme identified during interpretation of data was demonstrated in four interwoven themes: (1) A strong sense of life threat; (2) Perceived a great deal of pain; (3) Loss of control due to unable to communicate orally; and (4) Moving between hope and despair. Ways to cope with these disturbances were captured in one theme: ‘Keep thinking of survive’.

Conclusion: This study extends a nuanced understanding of laryngeal cancer patients’ experiences during the active treatment phase. Our results address the experience or problem of voicelessness immediately after surgery. Our data indicates that the patients had been struggling through a difficult time. Patients have episodes of substantial pain and psychosocial distress. Despite advances in symptom management, the distress relief is incomplete. However, patients seemed to minimize these problems and instead focused on gaining control of the situation, relying on the support of their family and healthercare givers. Hence, there is a great need for support for this population.

MASCC-0186

Qualitative exploration of experience and needs of informal caregivers of geronto-oncology patients undergoing ambulatory chemotherapy

J.R.,A.G.,L.I. P. Stolz-Baskett 1

1Zurich University of Applied Sciences, Institute of Nursing, Winterthur, Switzerland, 2FNSNM, King’s College, London, UK, 3Tumor- und Brustzentrum ZeTuP, St. Gallen, Switzerland

Objectives: To understand and describe experiences and needs of informal caregivers of older cancer patients receiving parenteral chemotherapy.

Methods: Semi-structured face-to-face interviews were conducted with informal caregivers (n = 19) of patients 70 years and older receiving chemotherapy. Interviews were transcribed verbatim and analysed using the Framework approach to thematic analysis.

Setting: Three ambulatory cancer clinics in the German speaking part of Switzerland, during 2011–2012.

Results: Caregivers experienced manifold negative and positive emotional, spiritual, physical and social needs. Frequent issues of concern were the psychological impact of diagnosis, such as shock or disbelief, treatment side-effects, difficulties communicating with health care professionals, including the perception of long waits between tests and being told results, and thoughts about death/dying or loss respectively. Positive experiences included, for example, a sense of gaining valuable life experience and deepening of relationships. The patient’s age made some experiences appear normal to caregivers rather than cancer dependent. Caregivers were subsequently categorised: caregivers with needs that have been met by the Health Care Team (HCT); caregivers with unmet needs; and caregivers declining support from the HCT; as well as caregivers for whom more than one of these scenarios applied.

Conclusions: Caregiver needs were mostly articulated around emotional, social and spiritual issues. Not all caregivers accepted support for their needs from the health care team. In summary, caregivers of older cancer patients vary in the level of support needed and individual and on-going assessment of informal caregivers needs is required in order to ensure the provision of adequate and appropriate support.”

MASCC-0187

Long term outcome in thyroid cancer with intermediate differentiation following systematic total or near-total thyroidectomy plus high dose radioactive iodine therapy

P. Hagag 1, M. Vaiman1, E. Kummer1, V. Tosker1, M. Weiss1

1Assaf Harofeh Medical Center, Zerifin, Israel

Aim: To determine the long-term outcome of thyroid cancer with intermediate differentiation following standardized therapy.

Methods: Thirty patients (study group) with palpable tall-cell, columnar cell, diffuse sclerosing, insular and Hurthle cell variants of thyroid carcinoma, as well as 45 follicular and 99 pure papillary controls, underwent systematic total or near-total thyroidectomy followed by at least one high dose of radioactive iodine. Patients with poorly differentiated thyroid carcinoma according to the Turin consensus conference criteria were excluded from the study.

Results: After a mean follow-up of 12 years, the recurrence rate was very elevated (37 %) in the study group (p < 0.001 versus controls), even in Stage I or Stage II subjects (p < 0.001), but the disease-specific mortality in the same cohort (7 %) was comparable to that of the follicular carcinoma group (p > 0.28) and better than that of previous studies. Essentially, insular histology was associated with a poor outcome (recurrence 83 %, mortality 33 %). The mean interval between thyroidectomy and onset of new metastases was 4 years in the study group. The recurrence was only locoregional in diffuse sclerosing carcinoma, whereas distant metastases (lung, mediastinum, bone, brain) were observed in all cases of recurrent insular, tall-cell and Hurthle cell carcinoma. In all metastatic cases, the iodophile status was permanent and no cases of dedifferentiation of metastases were described.

Conclusions: Despite the aggressive behavior of thyroid cancer with intermediate differentiation, intensive surgical and isotopic therapy may ameliorate the prognosis. However, in insular thyroid carcinoma, thyrosin kinase inhibitor treatment should be early prescribed, even in cases of iodophile tumor.

MASCC-0188

The assessment of tissue eosinophiliain head and neck squamouscell carcinoma by luna staining

P. Motahhary 1

1Tehran Dental School, Tehran, Iran

Introduction: Tumor associated tissue eosinophilia (TATE) has been described in a variety of neoplasms, but it’s role in tumors has not yet been defined, SCC is the most common malignancy of the head and neck. The aim of this study was to evaluate the association between TATE and histopathologic grading in HNSCC with luna staining.

Method: Out of 83 cases 67 paraffin blocked of HNSCC were selected, hematoxylinand eosin stained sections were reviewed for histopathologicgrading according to Broderssystem and divided to three groups: well, moderate and poor differentiated. 4 μ sections were stained with lunafor detection of eosinophilic infiltration within the tumor. A blind pathologist counted eosinophilsin 10HPF in each slide and categorized as: none (0), low (1–4), medium (5–19), high (≥20). Clinic opathologic factors including: age, sex, location and histopathologicgrading were tested statistically.

Results: TATE was negative in one (1.5 %) case, which was moderately differentiated and was positive in 66 (98.5 %) There was no correlation between TATE and age, sex, location, and histopathologicgrading (P > 0.05).

Conclusion: TATE has no correlation with histopathologic factors, but TATE was lower in poorly differentiated group than two others.

MASCC-0189

The assessment of tissue eosinophiliain head and neck squamouscell carcinoma by luna staining

P. Motahhary 1

1Tehran Dental School, Tehran, Iran

Introduction: Tumor associated tissue eosinophilia (TATE) has been described in a variety of neoplasms, but it’s role in tumors has not yet been defined, SCC is the most common malignancy of the head and neck. The aim of this study was to evaluate the association between TATE and histopathologic grading in HNSCC with luna staining.

Method: Out of 83 cases 67 paraffin blocked of HNSCC were selected, hematoxylinand eosin stained sections were reviewed for histopathologicgrading according to Broderssystem and divided to three groups: well, moderate and poor differentiated. 4 μ sections were stained with lunafor detection of eosinophilic infiltration within the tumor. A blind pathologist counted eosinophilsin 10HPF in each slide and categorized as: none (0), low (1–4), medium (5–19), high (≥20). Clinic opathologic factors including: age, sex, location and histopathologicgrading were tested statistically.

Results: TATE was negative in one (1.5 %) case, which was moderately differentiated and was positive in 66 (98.5 %) There was no correlation between TATE and age, sex, location, and histopathologic grading (P > 0.05).

Conclusion: TATE has no correlation with histopathologic factors, but TATE was lower in poorly differentiated group than two others. "

MASCC-0190

Evaluation of dengue and dengue like illness in a place of 15–20 lackcs population by serological methods

M.N.J.,M.H.D.,M.K.,M.D. P. Panda 1

1Microbiology, T.N. Medical College, Mumbai, India, Rourkela, 2Microbiology, Apollo Hospitals, Bilaspur, India

We are 300 beded tertiary care hospital. Situated in central India. We had many cases of fever with rashes and some of them were with severe hypotension and shock. The lab investigations included IgG, IgM and NS1 Antigen for Dengue virus, Hemaptological parameters and Liver function test. Many cases were found to have raised SGOT and SGPT with severe depletion of platelet count.

MASCC-0191

Frequency of hepatitis B and C in surgical patients, Civil Hospital Karachi

R. Rafaqat 1, S. Khawaja1

1Dow Medical College, Karachi, Pakistan

Background: Hepatitis B and C is a serious health problem worldwide. Infections with hepatitis B and C virus have been escalating in Pakistan and it has reached in endemic state. This study was carried out to determine the frequency of hepatitis B and C in surgical patients.

Methods: This cross-sectional study was conducted in Civil Hospital Karachi. Total 662 patients admitted in surgical department were approached. All patients were screened for HBsAg and anti-HCV using immunochromatography ICT. The information about risk factors was also assessed. The data was analyzed on SPSS 17.

Results: Out of 662, 325 (49.1 %) were males and 337 (50.9 %) were females. Mean age of patients was 37.52. Hepatitis B surface antigen (HBsAg) was positive in 19 (2.9 %) and Hepatitis C (anti-HCV) in 45 (6.8 %) patients. HBsAg was positive in 12 (63.15 %) males and 7 (36.84 %) females. Whereas anti-HCV was positive in 21 (46.66 %) males and 24 (53.33 %) females. The results show that out of 19 positive patients for HbsAg, 17 (89.47 %) have history of intravenous injections and out of 45 anti-HCV, 44 (97.77 %) have the same history. The other major risk factors found were blood transfusion, blood donation, ear-nose piercing, dental procedure and barber shave.

Conclusion: The study suggests a moderate to high prevalence of hepatitis B and hepatitis C in surgical patients. Routine serological screening prior to surgery should be made mandatory so that health care workers especially surgeons can take precaution before surgery.

MASCC-0192

Skin cancer knowledge and sun protection behaviors in medical and non-medical university students in Karachi, Pakistan

R. Rafaqat 1, S. Khawaja1

1Dow Medical College, Karachi, Pakistan

Objective: To examine skin cancer knowledge and sun protection behaviors in Medical and Non-Medical university students in Karachi, Pakistan

Methods: We surveyed 768 students (16–27 years) at two large public sector universities (401 Medical Students and 367 Non-Medical Students) in Karachi, Pakistan. Survey data were collected regarding skin cancer knowledge and sun protection behaviors. Differences between the 2 groups were compared with chi-squared test.

Results: Of all the respondents, sun exposure as a risk factor for skin cancer was identified by 77.7 %, genetics by 44 %, ultraviolet radiation by 87.1 %, multiple skin moles by 19.1 % and fair complexion by 27.7 %. Knowledge of risk factors was greater among the Medical Students as compared to the Non-Medical Students. Of the total, 56 % of the participants ‘always’ wears sun-protective clothing, 41.4 %‘always’ wears hat/dupatta, 13.2 % ‘always’ seeks shade, 10.5 % ‘always’ wears sun glasses, and 27.9 % ‘always or most of times’ apply sunscreen with sun protection factor of ≥15. The most frequent method of sun protection was found to be wearing sun-protective clothing, which was significantly more common among the Medical Students (64.1 % vs. 47.1, p < .001); while wearing of sun-glasses was significantly more common among the Non-Medical Students (15.8 % vs. 5.7 %, p < .001). In terms of the wearing of hat/dupatta, seeking shade and wearing sunscreen, no significant difference was evident between Medical and Non-Medical students.

Conclusion: University programs for increasing knowledge of skin cancer risk are warranted. Changing attitude and behaviors regarding exposure and protective measures is increasingly important.

MASCC-0193

Knowledge & self-perceived practice regarding infection control among nursing students of Civil Hospital Karachi.

R. Rafaqat 1, M. Ahmed1

1Dow Medical College, Karachi, Pakistan

Introduction: Health-care associated infections cover all clinically evident infections that are not the part of patient’s original illness for which patient is admitted. Most of these infections clinically become evident after 48 h of admission. In all settings, nurses can play a dominant role in infection prevention and control by using their knowledge, skill and judgment. This reflects the importance and need of such type of study among nursing students.

Methods: A cross-sectional study was conducted at Civil Hospital Karachi. Nursing students practicing in Civil Hospital Karachi were approached for the study. A pre-designed interview based questionnaire was used for data collection. The collected data was analyzed using SPSS version 17.

Results: Total 241 students were interviewed including 41.5 % males and 58.5 % females. Of all students, 71.4 % had received guidelines about infection control from their seniors nursing staff. Hand hygiene facility was available in 78.8 % of wards. Among all students 80.9 %were aware of WHO guidelines on hand washing but only 20.3 % performed complete steps. Only 128 students (53.1 %) were aware of the term Health-care Associated Infections. Overall half of the students of this study reported lack of proper practice such as washing hand before and after procedure, using gloves and applying proper alcohol.

Conclusion: There is lack of proper practice among nursing students and lack of knowledge regarding health care associated infections. This study warrants the health associated education programs to fill the gap in knowledge as well as in practice.

MASCC-0194

Efficacy and safety of a 6-hour continuous overlap method for converting intravenous to transdermal fentanyl in cancer pain

Samala1, R. Espinal1, 1, R.(. M.1, Davis1

1(1) Cleveland Clinic, Cleveland, OH, USA

Objective: To determine the efficacy and safety of a 6-hour continuous overlap method for converting intravenous to transdermal fentanyl (TF) in patients with cancer pain.

Background: Cancer pain requires opioids like fentanyl, which is used parenterally (intravenous or subcutaneous), then converted to TF once pain is controlled. Little evidence exists to guide conversion. We determined the efficacy of a 6-hour continuous overlap when converting intravenous to transdermal fentanyl.

Method: We switched from IV fentanyl to TF, using a 1:1 (IV:TF) conversion and overlapped by 6 h without tapering IV fentanyl dose starting with the first transdermal fentanyl dose. Pain intensity by numerical rating scale, rescue analgesic doses, and presence and severity of opioid-related adverse events were assessed immediately before TF placement, and at 6, 12, 18, and 24 h thereafter.

Result: Seventeen consecutive patients with cancer pain controlled by IV fentanyl were converted to TF. Median age was 65 years, 10 were female. Pain intensity at 6 and 24 h and number of rescue doses remained stable following TF placement. At 12 and 18 h there was a statistically pain was significantly but not clinically significantly increased (p = 0.01 and 0.02, respectively).

Conclusion: A continuous 6-hour overlap is safe and effective when converting from IV fentanyl to TF. A slight increase in pain intensity may occur but does not lead to increased rescue dosing. A 6 h IV to TF conversion strategy rather than a 12 h stepped dose reduction strategy is simpler, and reduces care burden.

MASCC-0195

A man with pancoast syndrome: lessons from his painful journey to disease discovery and palliative care

N.W.,S.L. R. Samala 1

1Center for Home Care and Community Rehabilitation, 2Radiation Oncology, 3The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA

Introduction: Over 80 years have passed since Henry Khunrath Pancoast described growths in the thoracic cavity apex that present with misleading symptoms.

Objectives:

1. Describe a case of Pancoast syndrome.

2. Understand the historical background, clinical characteristics, and diagnostic challenges of superior sulcus tumors.

3. Discuss the management of superior sulcus tumors, focusing on palliative care.

Case description: A 60-year-old man was transferred to our hospital for further management of a newly detected right apical lung mass. His painful journey began 7 months prior with a constant tearing pain between his shoulder blades radiating to his entire right upper extremity, and accompanied by progressive hand weakness. Three months into his disease, the patient had seen several specialists, found little relief from assorted pain regimens, and undergone surgery for suspected carpal tunnel syndrome. By the time he sought treatment at the hospital which discovered the lung mass, he had lost use of his right hand, as well as 41 lb of weight. On assessment at our institution, the patient exhibited right-sided ptosis and miosis, and right claw hand. Biopsy revealed non-small cell lung cancer. He was moved to our palliative care unit where optimal pain control was achieved using multiple medications, a course of radiotherapy, and various interventions delivered by an interdisciplinary team.

Conclusions: Being mindful of the clinical features of superior sulcus tumors, including the classic attributes of Pancoast Syndrome, may lead to earlier disease discovery. Providing effective palliative care is crucial as patients sail through multiple treatment alternatives.

MASCC-0196

Nonconvulsive status epilepticus in a palliative care unit: a crucial consideration

A.P.-M.,M.D. R. Samala 1

1Center for Home Care and Community Rehabilitation, 2The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, OH, USA

Introduction: In patients with impaired mental state, discovering an underlying cause can vary from being clear-cut to nebulous.

Objectives:

1. Recognize nonconvulsive status epilepticus as an important consideration in patients with altered mental status.

2. Review the clinical presentation, differential diagnoses, and management of nonconvulsive status epilepticus.

3. Discuss the implications of nonconvulsive status epilepticus in addressing goals of care and prognosis.

Case description: A 66-year-old man was admitted to our palliative care unit with severe lower back pain and muscle spasms of a few weeks duration. He was diagnosed with prostate cancer 5 years prior, which metastasized to bone. Pain control was subsequently achieved with transdermal fentanyl, oxycodone, diazepam, diclofenac, and gabapentin. During hospitalization, his consciousness fluctuated between unresponsiveness and brief wakefulness. Attempted remedies—naloxone, empiric antibiotics, and careful revision of opioid regimen—were unsuccessful. Magnetic resonance imaging of his brain showed leptomeningeal disease, and an electroencephalogram demonstrated nonconvulsive status epilepticus (NCSE). He was placed on multiple anticonvulsants with significant improvement in mental state. NCSE is a rarely implicated cause of impaired consciousness. It is worsened by neuroleptics, which are used for delirium, and reversed by anticonvulsants. In the setting of a serious medical illness, such as leptomeningeal disease, which is rare in prostate cancer, NCSE bears a poor prognosis.

Conclusions: Discerning the cause of mental status change can be frustrating and not beneficial at times. NCSE, however, should be considered, especially for patients with diseases that potentially affect the brain.

MASCC-0197

Osteoporotic vertebral compression fractures: a rare complication of radiotherapy in a patient with lung cancer

E.n.-s. R. descourt 1

1Chu Brest, Brest, 2Chu Brest, Brest, France

The development of bone fractures after radiotherapy is a rare event which mainly concerns the pelvis or the long bones. This complication is unusual in the vertebrae. We describe the case of a 66-year-old male patient with lung cancer who was treated with combined radio-chemotherapy and developed dorsal pain secondary to vertebral compression 4 months after the end of radiotherapy. Investigations led to a diagnosis of post-radiotherapy vertebral osteonecrosis. It is important to differentiate metastatic lesions from radiological complications. It is not possible to differentiate a metastasis from a recent osteoporotic compression fracture by imaging. A bone biopsy may therefore be necessary. Metastatic bone involvement is common in patients with lung cancer. When images are not typical of secondary progression, however, and there is no change in the general state of the patient, evidence of thoracic progression of the tumour or distal progression other than bone, vertebral osteoporotic complications should be considered. It is important that a wrong diagnosis is not made without histological proof of metastasis which has a poor prognosis.

MASCC-0198

Exercise after radical prostatic radiotherapy linked to better sexual function and reduced late toxicity

M.H.,J.A.,J.M. R. Thomas 1,2,3

1Oncology, Cambridge University, Cambridge, 2Post graduate Medicine, Cranfield University, 3Oncology, Bedford Hospital, Bedford, 4Medicine, The Royal Marsden Hospital, 5Oncology, Mount Vernon Hospital, London, UK

Introduction and objectives: More and more men are surviving prostate cancer yet living with the consequences of their disease and treatments. This retrospective study evaluated a link between exercise, smoking and obesity with the symptoms of late pelvic toxicity post radiotherapy.

Methods: 440 (94 %) of an entire cohort of 470 alive men who were treated with radical radiotherapy at Addenbrooke’s/Bedford Hospital between 2000 and 2010 completed a questionnaire consisting of the Vaizey Rectal Toxicity score, theNCI common toxicity scores for rectal bleeding, erectile function and urinary incontinence, a General Practical Physical Activity Questionnaire and questions concerning BMI and smoking. The effect of each lifestyle criteria on erectile function, urinary and rectal symptoms was investigated using a non-parametric ANOVA (Kruskal–Wallis) test or chi-squared test (significance level α = 0.05).

Results: At the time of the survey, 63 % were over-weight or obese (BMI >25); 58 % were inactive, 27 % moderately inactiveand 15 % active. Active men had significantlybetter erectile and urinary function and lower rectal toxicity. Men smoking >5/day had significantly worserectal toxicity as did overweight men.

Conclusion: This is the first comprehensive evaluation of exercise and lifestyle habits duringand after radical radiotherapy for prostate cancer. Although a retrospective analysis, the data strongly suggests higher late toxicity among smokers, inactive and overweight men. We recommend that men should receive, written information, lifestyle counselling before and after radiotherapy and if necessary referral to smoking cessation clinics, dieticians and local gyms via the national exercise referral scheme.

MASCC-0199

Palliation of of cervical spine metastases with stereotactic body radiosurgery

R.K.,2.,N.B.,J.B.,K.S. H. Lomas IV 1

1Department of Radiation Oncology & Radiosurgery, Riverside Regional Medical Center, Newport News, 2Department of Radiation Oncology, University Of Virginia, Charlottesville, 3Department of Neurosurgery, Riverside Regional Medical Center, Newport News, 4Department of Neurosurgery, University Of Virginia, Charlottesville, VA, USA

Objectives: Stereotactic body radiosurgery for progressive spinal metastases provides excellent palliation in well selected patients. The authors examine a series of spinal metastasis patients treated with stereotactic body radiosurgery (SBRT).

Methods: Using our institutional database we collected data from 253 cases of spinal radiation for metastasis. There were 37 cases of cervical spine radiation for metastasis treated between 2007 and 2011. There were 26 patients who were treated with radiosurgery initially and 11 patients had previously received external beam therapy. The primary indication for intervention was pain (35/37 patients). Spinal MRI was performed before treatment initiation and CT or MRI at regular follow-up intervals to evaluate for disease progression, and clinical follow-up visits were examined for improvement in pain. The National Cancer Institute Common Toxicity Criteria version 3.0 was used to evaluate toxicity.

Results: Mean and median follow-up was 18.36 months and 15 months respectively with a range of 4 to 60 months. None of the patients experienced myelitis, progression of fracture or a new fracture. Radiographic local control was 100 %. Palliation of pain was observed in 33/35 patients (94.3 %). Toxicity was limited to 3 patients with grade 1 dysphasia and1 patient with grade 1 dermatitis. The cumulative doses for the SBRT ranged from 15 to 24 Gy with a mean dose of 20.45 Gy given in 3 or 4 treatment fractions with one treatment per week.

Conclusion: Treatment of progressive cervical spinal metastases with stereotactic body radiosurgery results in excellent palliation and local control with minimal toxicity.

MASCC-0200

Gene polymorphism in estrogen receptor-b (exon 7) and breast cancer risk in women

S.K.,P.I. S. Abbasi 1

1Dept. Medical biotechnology, School of Allied Medicine, Tehran University of Medical Sciences, 2School of Veterinary Medicine, University of Tehran, Tehran, Iran, 3Department of Biomedical Science, Faculty of Medicine and Health Sciences Universiti Putra Malaysia, Sedang, Malaysia

Gene polymorphism in estrogen receptor-b (exon 7) and breast cancer risk in women

Sakineh Abbasi 1, Samira Kalbasi2, Patimah Ismail3

Abstract

Background: Evidence suggests that alterations in estrogen signaling pathways, including estrogen receptor-a (ER-a) and -b (ER-b) occur during breast cancer development. Epidemiologic studies have revealed that age–incidence patterns of breast cancer in Middle East differ from those in Caucasians. Genomic data for ER-b is therefore of value in the clinical setting for that ethnic group and we have investigated whether polymorphisms in the ER-b gene are associated with breast cancer risk among Iranian women

Methods: Two selected coding regions in ER-b gene (exons 3 and 7) were scanned in Iranian women with breast cancer referred to Imam Khomeini Hospital Complex clinical breast cancer group (150 patients) and in healthy individuals (147 healthy control individuals). PCR single-strand conformation polymorphism technology was performed

Results: A site of silent single nucleotide polymorphism (SNP) on exon 7 was found, but, we did not found any variation on exon 3. The frequency of allele 1 in codon 392 (CTC → CTG was found only in breast cancer patients (5.7 %) (X2 = 17.122, P = 001). We found that allele 1 in codon 392 (C1176G) had direct association with the occurrence of lymph node metastasis

Conclusions: Our data suggest that ER-b polymorphisms in exon 47 codon 392 is correlated with various aspects of breast cancer in Iran. ER-b genotype, as determined during presurgical evaluation, might represent a surrogate marker for predicting breast cancer lymph node metastasis.

MASCC-0201

Olanzapine for post-chemotherapy dysgeusia and anorexia: the unidentified saviour?

G.K.,D.K.B.,P.A.K.,P. S. Mukhopadhyay 1

1Pharmacology, Christian Medical College, Ludhiana, 2Radiation Oncology, Christian Medical College & Hospital, Ludhiana, 3Preventive & Social Medicine, 4Biochemistry, Christian Medical College, Ludhiana, Ludhiana, India

Introduction: Patients on chemotherapy with some anticancer drugs experience dysgeusia and anorexia after chemotherapy. Secretion of the agent in saliva, cytotoxic action on the test buds, radiation in the head-neck region causing damage the taste buds and associated nausea-vomiting are considered contributory.

Objective: To find out the efficacy of olanzapine in protection from anorexia in patients with head and neck cancer on chemotherapy.

Method: In this prospective, randomized, controlled, open label study total 60 chemotherapy naïve patients undergoing cisplatin chemotherapy with or without radiation for head and neck cancer were enrolled. They were divided into control and study groups. Treatment offered to these groups and assessment schedule is summarized in the figure.[pic_01] A four point categorical scale (1–4) was used to assess anorexia on day1 and day 10.[pic_02] Higher score was suggestive of more anorexia. Anorexia was compared and analysed within the groups and in between groups before and after chemotherapy, p value less than 0.05 was considered statistically significant

Results: Total 51 patients (26 in control and 25 in the test) were enrolled till analysis of data. Anorexia, though noted after chemotherapy in both the groups, was less in olanzapine group and was statistically significant (post-chemotherapy median score 1 vs. 2.5). Progression to higher anorexia after chemotherapy was less in olanzapine group.[pic_03]

Conclusion: Olanzapine offers protection from anorexia after chemotherapy.

MASCC-0202

Prevalence and associated factors of metabolic syndrome in Korean cancer survivors

K.L. S.M. Park 1

1Seoul National University, College of Medicine, 2Department of Family Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea

Purpose: This study was designed to evaluate the prevalence of metabolic syndrome among cancer survivors compared to non-cancer controls from a population-based sample and to identify risk factors associated with metabolic syndrome among cancer survivors.

Methods: Data from the fourth Korean National Health and Nutrition Examination Survey were analyzed to compare the prevalence of metabolic syndrome, as defined by 2009 consensus criteria. Factors associated with metabolic syndrome were identified using multiple logistic regression analysis among cancer survivors.

Results: The prevalence of metabolic syndrome in cancer survivors (n = 335) was similar to non-cancer population (n = 10,671). Age of more than 60 years (adjusted odds ratio [aOR] 4.83, 95 % confidence interval [CI] 1.94–12.03), BMI between 23 and 25 (aOR 6.71, 95 %CI 2.90–15.57), BMI more than 25 (aOR 12.23, 95 % CI 5.20–28.77) were significantly associated with metabolic syndrome in cancer survivors. Gastric cancer survivors showed lower risk of metabolic syndrome than other cancer survivors (aOR 0.36, 95 % CI 0.14–0.94).

Conclusions: Cancer survivors were not more likely to have higher risk for metabolic syndrome than non-cancer control in Korea. These findings may be due to higher proportions of gastric cancer survivors among Korean cancer survivors. The risk for metabolic syndrome among cancer survivors varies according to oncological and non-oncological factors.

Implications for cancer survivors: Cancer survivors who are elderly and obese had increased risks for metabolic syndrome. Healthcare providers should assess and screen the metabolic syndrome, especially for vulnerable groups.

MASCC-0203

Exploring post-treatment experiences and concerns of south Asian breast cancer survivors residing in California

S.s.-c. K. Chahal 1

1Nursing, City of Hope, 2Nursing, California State University Long beach, Long Beach, CA, USA

Methods: The purpose of this study was to explore theexperiences and concerns of South Asian women breast cancer survivors post-treatment. Qualitative research methodology was used to collect data through semi structured interviews. Data was coded and categorized into themes using qualitative analysis Methods. The sample included five South Asian women breast cancer survivors, ages 54–68, who were 3 months to 5 years post-treatment. This pilot study was done as part of my Masters in Nursing thesis project.

Findings indicated that all these women had a fear of cancer recurrence which resulted in changing their lifestyle, especially with being more active in search for information on nutrition, exercise, and side effects. Some of the side effects included feelings of depression, fear of the uncertainty, and physical muscle and nerve pain. Most reported support from spouses, family, and/or friends; whereas others reported strain on their relationship with their spouses. Most women wanted the following information included in survivorship careplans: diagnosis, treatment, prognosis, and potential acute and late toxicities as well as statistical, psychological, sexual, spiritual, social, nutritional, and exercise information. They wanted each area customized to their needs.

Health care professionals can incorporate these findings in designing culturally appropriate survivorship care plans for South Asian women breast cancer survivors. Because of language and cultural barriers it was hard for them to speak to their oncologists or their family physicians. Most women felt isolated since they did not have any peer support from others who had gone through through breast cancer.

MASCC-0204

Concerns and perceptions of breast cancer survivors’impact of treatment from differing geographical populations and ethnicity

C.g.,S.S.,F.W. S. Singh-Carlson 1

1Nursing, California State University Long beach, 2Rehabilitation, Todd Cancer Centre, Long Beach, CA, USA, 3Radiation Oncology, British Columbia Cancer Agency, Victora, Victoria, 4Radiation Oncology, British Columbia Cancer Agency, Surrey, Surrey, BC, Canada

Introduction: Breast cancer survivors’ (BCS) experiences and concerns of treatment impacts and perceptions of survivorship care plan (SCP) content and benefit seem to resonate for women regardless of different populations or healthcare structuring.

Objectives: This paper will compare how BCS of different ethnic background, residing in unlike healthcare systems report of the impact of breast cancer treatment. Discussions will include thematic findings from 4 studies that explored experiences/concerns of BCS post-treatment at different life-stages conducted in Southern California with American Caucasian/Hispanic and in British Columbia with Canadian Caucasians and South Asian (SA) BCS.

Methods: All studies utilized qualitative methodology and interviewed women ranging from 19 to 80 years old, 3–60 months post-treatment, with non-metastatic breast cancer. Canadian BCS were discharged from cancer-agency settings to family physicians, whereas American counterparts were followed by oncologists or family-physicians, dependent on types of medical insurance coverage. Comparison of themes will identify treatment-impacts variation among BCS in different healthcare-structuring.

Results: Some universal effects were fatigue-loss of physical energy/strength, fear/uncertainty, cognitive changes, and need to normalize post-treatment. Financial concerns due to loss of wages were common among BCS; however BCS in American healthcare system would seem to experience higher rates of mental distress due to medical insurance costs. Themes such as accessing inner strength and experiencing losses had different cultural and social nuances for BCS from all settings.

Conclusions: Comparison of these populations show need for development and implementation of appropriate SCP, that focus on varying ages, being mindful of different healthcare systems, social a

MASCC-0205

Fascin expression in pleomorphic adenoma and mucoepidermoid carcinoma

S. Rahrotaban 1

1Tehran Dental School, Tehran, Iran

Abstract

Background: Salivary gland tumors constitute an important part of oral and maxillofacial pathology. Pleomorphic adenoma (PA) and mucoepidermoid carcinoma (MEC) are the most common benign and malignant salivary gland tumors. Fascin is an actin-bundling protein that increases the motility of normal and transformed epithelial cells. The aims of the study was to determine the expression of fascin in these tumors to determine its role in their progression.

Materials and methods: Forty formalin fixed paraffin embedded tissue blocks of PA, and 20 blocks of MEC were included in this study. Diagnostic confirmation was performed through examination of hematoxylin and eosin sections. Both tumors were immunohistochemically analyzed for the presence of Fascin using Avidin-Biotin complex method and evaluated via light microscope by 2 independent observers.

Results: In both tumors the percentage of stained cells was significantly correlated with intensity of staining (p = 0.01 in PA and p = 0.00 in MEC). In pleomorphic adenoma, statistical analysis showed a significant direct correlation between percentage of stained cells and recurrence (p = 0.00). There was no significant difference between intensity and percentage of staining with clinicopathologic factors in mucoepidermoid carcinoma.

Conclusion: Fascin might be a useful marker for recurrence of pleomorphic adenomas and patients with high fascin expression in primary PA should be fallowed up periodically to detect potential recurrence as soon as possible.

MASCC-0206

Epithelial ovarian cancer in young women is an 8 cases report

S. Sakhri 1,2

1Algiers, CHU Tizi Ouzou, Algiers, 2Algiers, CHU Tizi Ouzou, Algeria, Algeria

Background: As the most lethal of the gynaecologic malignancies, ovarian cancer remain the sixtieth most common cause of cancer related death for women in Algeria. Epithelial ovarian cancer mostly appears in aged women, but rarely in young women.

Methods: Retrospective study [January 2010–December 2011], O8 medical records were analyzed; the young patients were aged under than 40 years old. We have evaluated the clinical pathologic features such as the histological type, stage, and the follow up.

Result: Followed it after 34 month showed that the mean age was 37 years (range: 30–40), the average time of diagnosis was 6 months. The majority were stage III, cystadenocarcinome were the most commonpathologic types. The recurrence was observed in one case (pleural and bone metastasis) due to platinum-resistance

Conclusion: Our study showed that the majority of cases weresplatinum- sensitivity those who confirms with the literature or the good prognosis.

MASCC-0208

The effectiveness of group hope therapy on hope and depression of mothers with children suffering from cancer in Tehran

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Background: Researches mainly focus on patients who suffer from cancer. Families and parents have been neglected in these researches although they experience levels of stress, depression and anxiety. This research aims at studying the effectiveness of Hope Therapy based on group therapy on hope and depression of mothers with children suffering from cancer in Aliasghar Children’s Hospital, Tehran (2010).

Methods: In this applied and semi-experimental research, 20 mothers were selected based on Snyder Hope Scale and Beck Depression Inventory (pre-test). They were randomly assigned into two groups of experimental and control. Intervention based on Hope Therapy protocol was executed on the experimental group for 8 weeks (eight sessions, each lasted for 2 h). Afterwards, posttest was performed for both groups. After 8 weeks, the experimental group completed questionnaires and the follow up phase.

Results: Results demonstrated that Hope Therapy increases hope (p < 0.05), and decreases depression in mothers of children with cancer (p < 0.001).

Conclusion: Covariance analysis indicated that Hope Therapy significantly decreases depression and increases hope of mothers whose children suffer from cancer. Follow up results showed no significant changes in hope of this group of mothers in the 2 months after post-test, but depression was decreased significantly during this period. It was concluded that effectiveness of Hope Therapy may be continued during the follow up phase

MASCC-0209

Higher corticosteroid dose declines physical function, but does not affect psychosocial function among allogeneic hematopoietic stem-cell transplantation patients

K.K.,S.Y.,K.S.,S.I. S. Morishita 1

1Department of Rehabilitation, Hyogo College of Medicine Hospital, 2Division of Haematology, Department of Internal Medicine, 3Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan

Purpose: The aim of this study was to investigate the effect of corticosteroid dose toward degree of physical and psychosocial function in allogeneic hematopoietic stem-cell transplantation (allo-HSCT) patients during the early period.

Methods: The study included 113 patients who underwent allo-HSCT between July 2007 and April 2012 at Hyogo College of Medicine Hospital in Japan. The evaluation was performed up to 3 weeks before and 6 weeks after transplantation. Physical function was evaluated using tests for hand-grip strength and knee-extensor strength, and the 6-min walk test (6MWT). Psychosocial function was measured using Hospital Anxiety and Depression Scale (HADS). Total corticosteroid dose was collected from medical records.

Results: Significant decrease was observed inhand-grip strength, knee-extensor strength, and the 6-min walk test (6MWT) after transplantation (22 % in handgrip, 25 % knee-extensor strength and 15 % in 6MWT, P < 0.01). Total corticosteroid dose was correlated with decrease of hand-grip and knee-extensors strength (r = 0.3 ~ 0.4. P < 0.01) but was not correlated with 6MWT performance (r = 0.1. P > 0.05). There were no differences in anxiety and depression scale between transplantation times. The anxiety and depression scale was not different before and after HSCT both in patients with and without corticosteroid.

Conclusions: This study showed the relationship between corticosteroid dose and declines in physical function among allo-HSCT patients. The results of this study suggest that muscle strengthening of allo-HSCT patients could be adjusted according to the corticosteroid dose administered to the patient.

MASCC-0211

The effects of illness conceptions on the patients’ quality of life

M.M.K.,F.B. S. Kreitler 1,2

1Pediatric Hemato-Oncology, Sheba Medical Center, Tel Aviv, 2Psychology, Tel-Aviv University, Tel-Aviv, 3Psychology, Tel-Aviv UniversityAviv University, Tel Aviv, 4Oncology, Barzilai Medical Center, Ashkelon, Israel

Illness conceptions (ICs) are opinions and attitudes about medical diagnoses and states, e.g. concerning the origin, course, and effects of diseases. ICs reflect socially prevalent ideas rather than medical facts. They have gained in importance in view of increased emphasis on patients’ empowerment and on the need to consider the patients’ cultural background. ICs are important for cancer patients since they are often concerned with the meaning of their disease and suffering. The purpose was to explore whether and to what extent the ICs of cancer patients are correlated with their quality of life (QOL). The participants were 230 patients of both genders (mean age 56 years), with different cancer diagnoses in different stages and mean disease duration 3.4 years. All were administered the ICs Inventory, which assesses attitudes concerning attribution of diseases, its manifestations and effects, and the Multidimensional QOL of Adults questionnaire. Both tools have satisfactory reliability and validity. The findings showed that some conceptions were related negatively to QOL, e.g., the disease affects many domains, its origin depends on the individual’s personality, it is a total systemic phenomenon and persists beyond symptoms. Some conceptions were related positively to QOL, e.g., disease course is affected by psychological factors, its origin depends on one’s life style, recovery is possible, and the doctor is the major healing agent. The finding that patients’ beliefs affect their QOL indicates the importance of communicating to patients evidence-based beliefs and information that correct misconceptions and contribute to enhancing positive effects on their QOL.

MASCC-0212

Where to die? Factors affecting the place of death

S.K.,3.,S.L.,H.K.,R. F. Barak 1

1Oncology, Barzilai Medical Center, Ashkelon, 2Pediatric Hemato-Oncology, Sheba Medical Center, Tel-Hashomer, 3Psychology, 4Faculty of Social Sciences, Tel-Aviv University, 5Oncology, Macabi Sick Fund, Tel-Aviv, Israel

Most patients prefer to die at home but barely 30 % do so. The study deals with examining the variables contributing to dying at home. The participants were 326 cancer patients, of both genders, with a mean age of 63.25 years, who have died in 2000–2008 and have been treated by the palliative care unit of the Barzilai Hospital. 65.7 % died at home and 33.4 % in the hospital. The data was extracted from the patients’ files. The examined variables were demographic (age, gender, marital status, ethnic background, number of years in Israel until death), medical (age at diagnosis, diagnosis, nature of last treatment one got, patient having got nursing care, patient having got care of social worker, patient having got care of a psychologist, family got care of a social worker, patient had a special caregiver) and sociological (having insurance, having worked in Israel, living alone or with family, living with one’s children, living in self-owned or rented house, family members working). The findings indicate that the chances of dying at home are higher if the patient is non-Ashkenazi, the family got social worker care, the patient lived in a self-owned house, the patient lived with his family, the family members worked, and the patient’s stay in Israel since immigration was longer. Logistic regression showed that all the predictors together yielded a significant model accounting for 10.9–12.3 % of the variance. The findings suggest that dying at home requires maintaining continued care for the patient and family in the community context.

MASCC-0213

The relationship between opioid-taking self-efficacy and quality of life in Taiwanese oncology outpatients

S.-Y. Liang 1, S.-A. Ding1, S.-L. Tsay1, S.-F. Wu1, Y.-Y. Lu1

1National Taipei University of Nursing and Health Sciences (NTUNHS), Taipei, Taiwan R.O.C.

Social and behavioral scientists have proposed that a person’s belief system crucially influences his or her behaviour, and therefore may affect outcomes of pain management. The purpose of this study was to explore the relationship between opioid-taking self-efficacy and quality of life amongst Taiwanese cancer outpatients. The cross-sectional study included 109 oncology outpatients in one cancer center in the Taipei area of Taiwan. The research instruments included the Opioid-Taking Self-Efficacy-Cancer (OTSES-Ca.) and the Chinese version of European Organization for Research Treatment of Cancer Quality of Life Group Questionnaire Core 30, EORTC QOL-C30 (version 3.0). Opioid-taking self-efficacy demonstrated a significant relationship with patients’ functional status of quality of life (r = 0.30, p < .01) and symptom problem of quality of life (r = −0.22, p < .05). The higher perceived opioid-taking self-efficacy was related to a good functional status and a lower level of symptom problem. However, there was no significant correlation between opioid-taking self-efficacy and patients’ global health status of quality of life (r = 0.12, p > .05). This study highlights the potential importance of a patient’s confidence in their ability to manage their prescribed opioid regimen in their quality of life.

MASCC-0214

Depressive and anxiety disorders among family caregivers of breast cancer patients receiving oncologic treatment in Kuala Lumpur Hospital

1Department of Psychiatry and Mental Health, Tuanku Jaafar Hospital, Seremban, 2Department of Psychiatry, Universiti Kebangsaan Malaysia, 3Department of Psychiatry and Mental Health, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia

Introduction: Caring for a family member diagnosed with cancer can be highly stressful thus rendering the caregivers vulnerable to psychological morbidities.

Objectives: To determine the rates of depressive and anxiety disorders among the caregivers of breast cancer patients undergoing oncologic treatment and their predictive factors.

Methods: A total of 130 caregiver-patient dyads attending the oncology center for breast cancer treatment participated in this cross-sectional study. Data on the patients’ socio-demographic and illness characteristics were obtained from their medical record while the caregivers completed three self-report measures: 1) socio-demography and the caregiving factor questionnaire, 2) Multi-dimensional Perceived Social Support (MSPSS) and 3) Depression, Anxiety and Stress Scale (DASS-21). Subsequently, those who met the cut-off points in DASS-21 were interviewed using The Mini-International Neuropsychiatric Interview (MINI) to diagnose depressive and anxiety disorders.

Results: There were 49.2 % (n = 64) caregivers who scored positively in DASS-21where 17.7 % (n = 23) were diagnosed to have depressive disorders while 11.5 % (n = 15) had anxiety disorders. Patients’ functional status (p < 0.05, OR = 12.78, CI = 3.76–83.49) and the caregivers’ education level (p < 0.05, CI = 9.30, CI = 1.82–47.57) significantly predict depressive disorders while shared caregiving (p < 0.05, OR = 6.29, CI = 1.91–20.77) and patient’s treatment type (p < 0.05, OR = 4.55, CI = 1.12–18.44) significantly predict anxiety disorders among the caregivers in this study.

Conclusions: A significant proportion of family caregivers were psychologically affected while caring for the breast cancer patients. The predictive factors for depressive and anxiety disorders found in this study may guide in identification and prevention of these c

MASCC-0215

Quality of life in cancer patients due to disfigurement

S. Gaur 1

1Barnard Institute Of Radiation Oncology, Madras Medical College and Government General Hospital, Chennai, India

Introduction: Majority of cancers/cancer treatments lead to some disfigurement, like-removal of body part, scarring, swelling, ulceroproliferative lesions, alopecia, skin changes, permanent feeding/breathing interventions. Changes in the appearance can have far reaching effects, reduced self confidence, self esteem, difficulty in social interactions and ultimately social withdrawal. It is necessary that psychological and social effects of appearance are studied in order to assess what can be done to improve the quality of life in such patients.

Objectives: To assess the effect of disfigurement in patients because of cancer or cancer treatment, and its importance in the wholesome management of the patient.

Methods: Study type—Cross-sectional study

Study population—100. Patients suffering from cancer and undergoing/completed cancer treatment,with disfigurement

Study tool—WHOQOL-BREF questionnaire,which was filled by personal interviewing.

Data analysis—to determine the psychosocial impact of disfigurement and assess QOL in mainly 4 domains-Physical, Psychosocial,Social relations,environmental health

Results: •Total QOL score range was 30–70 (41.88). Most people rated their quality of life as poor. Younger age group and women were more affected by, in all spheres. People were not able to accept their bodily appearance and had negative feelings quite often.

Conclusions: Disfigurement has clearly been found to be stressful. It is imperative that the quality of life is given its due importance, especially in a developing nation like India, which can be achieved by multiprofessional involvement at individual &community level.

References: Quality of Life in Cancer Patients with Disfigurement due to Cancer and its Treatments; Duraipandi Arunachalam. Indian J Palliat Care. 2011 Sep–Dec; 17(3)

Scarring, disfigurement,quality of life in long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor study: Kinahan kE.JC

MASCC-0216

Has nurses been avoiding palliative-end of life care seminars/workshop/training in Kenya? Is it morphine, death, burn out, burden of work?

S. Rithara 1,2

1Kenya Medical Training College, Nairobi, 2Ongata Ngong Palliative Care, Kajiado, Kenya

Introduction: Palliative care is an expert care and has potential to greatly reduce burden and distress of those facing life limiting illness and ability to offer support. Nurses stay with palliation patients 90 % of their life hence increasing need for palliative care services.

Purpose: To explore the challenges and fear the nurses have.

Method: A survey done September 2010–September 2011, after explaining the purpose of the study, a total of 36 subjects were given questionnaire to complete t he survey between 20 and 45 years old nurses.

Outcome: Majority of nurses are willing to do other specialty away from palliative care. There has been increasing palliative awareness in the country and short courses. 80 % fear of breaking bad news, 55 % it consume time, 65 % burn out, 50 % fear of prescribing morphine and addiction, 70 % family dependant, 45 % fear of dealing with death after work, 40 % course very expensive, 45 % lack of motivation, 80 % work in rural with no idea of palliative care, 55 % not visited hospices which are located in big towns, 30 % willing to do home care than hospital care, student nurses less aware of the palliative care, less trained tutors on palliative care and clinical instructors.

Conclusion: Palliative awareness especially in the rural set-up, encouragement and financial support for course. Need Government active participation in palliative care delivery. Majority of the nurses’ work in government sector at the rural set-up who are willing to work in the palliative field hence supported. Community awareness in support of the nurses.

MASCC-0217

Medico-social factors associated with late presentation in women with cancer of the cervix in northern Nigeria

I.A.Y.,S.A. S.A. Gaya 1,2

1Obstetrics and Gynaecology, Bayero University Kano, 2Obsterics and Gynaecology, Bayero University/Aminu Kano Teaching Hospital Nigeria, Kano, 3Obsterics and Gynaecology, Bayero University/Aminu Kano Teaching Hospital Nigeria, 4Community Medicine, Bayero University Kano/Aminu Kano Teaching Hospital Kano, Kano, Nigeria

Background: Cancer of the cervix is one of the commonest types of cancer afflicting women globally. Most prevalent in developing countries amongst socially disadvantaged women. Comprehensive and multidisciplinary medical care for cancer of the cervix is generally unavailable in Nigeria. Purpose Identify risk factors amongst women with late presentation of cervical cancer and interventions to reduce their vulnerability.

Methods: Review of medico-social and histo-pathologic patterns of cases of cancer of the cervix at the Gynae-Oncology Unit, Aminu Kano Teaching Hospital, Kano Nigeria from January 2006 to December 2010. Information extracted and analyzed on Epi-Info statistical software, using the mean for quantitative data, frequencies and percentages to summarize categorical data. Associations between categorical variables tested using chi squared test and significance levels set at ≥0.05.

Results: Ninety-one cases of cancer of the cervix were retrieved. Mean age 49 years, SD 10.8 years. 86.8 % had advanced stage disease, were grand multiparous married more than once. Majority were unemployed over half had no formal education. Commonest presenting complaint and complication was vaginal bleeding (72.5 %), anemia (45.1 %). Only 18 had undergone HIV testing, 28 % tested positive. Commonest histological type (85.7 %) squamous cell carcinoma. There were statistically significant associations between advanced disease and age, parity and number of lifetime marriages.

Conclusions: Majority of the women present with advanced disease. Complications appear most commonly amongst severally married, poor, uneducated women in their fourth and fifth decades of life. Government and non-governmental health agencies should design community-based health education and screening programs targeting this vulnerable group.

MASCC-0218

Efficacy of single fraction palliative radiotherapy in bone metastases

M.A.,A.M.,H.I.,N.I. T. Mehmood 1

1Radiation Oncology, 2Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

Introduction: Bone metastases (BM) is a major complication of many solid tumors like breast, prostate, thyroid and lung cancers. Radiotherapy has established role in relieving pain caused by BM. Worldwide different radiotherapy schedule are being used for BM.

Objective: Aim of this study is to determine the efficacy of single fraction palliative radiotherapy for painful bone metastases.

Methods: Between March 2010 and September 2010, 120 patients with pathologically proven breast or prostate cancer with radiological evidence of bone metastases were treated with 8Gy in single fraction palliative radiotherapy in our institution. There were 56 (46.7 %) males and 64 (53.3 %) females. All patients had pain score of more than five on Brief Pain Inventory (BPI). Response was evaluated as complete response (CR) if no pain, partial response (PR) if 2 or more points decrease in pain, Stable disease (SD) no improvement in BPI score and progressive disease (PD) as increase in BPI score, after 3 months of treatment.

Results: The median age was 56 years (range 25–84 years). Fifty six (46.7 %) patients had prostate cancer and sixty four (53.3 %) had breast cancer. The response of pain after 3 months of radiotherapy was CR in 25 (20.8 %) patients, PR in 48 (40 %), SD in 29 (24.2 %) and PD in 18 (15 %) patients. The efficacy of treatment was 60.8 % with CR 20.8 % and PR 40 %.

Conclusions: Single fraction palliative radiotherapy of 8Gy has shown significant efficacy in painful bone metastases in our setting and merits further investigation in our population.

MASCC-0219

Outcome of palliative chemotherapy in recurrent head and neck cancer

T.M.,M.A.,A.M.,R.H. H. Iqbal 1

1Surgical Oncology, 2Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

Purpose: The aim of this retrospective study is to evaluate the outcome of palliative chemotherapy in recurrent head and neck cancer in our institution.

Methods: Between September 2005 to August 2009, 146 patients received palliative chemotherapy either due to recurrent or persistent disease after completion of radical treatment. With a median age of 48 years (range 18–70), there were 111 (76 %) males and 35 (24 %) females. Site distribution; Oral cavity 100 (68 %), Hypopharynx 3 (2 %), Nasopharynx 14 (10 %), Larynx 7 (5 %), Oropharynx 3 (2 %), Paranasal sinuses 14 (10 %) and others 5 (1 %). Patterns of recurrence included: local 65 (44 %), regional 32 (23 %), distant 8 (5 %) and persistent disease 41 (28 %) respectively. 106 (73 %) of patients already received cisplatin based chemotherapy either in neo-adjuvant or concurrent chemoradiation setting. Various first line palliative chemotherapeutic agents given included: Methotraxate (10 mg × 4 days/week PO or 40 mg/m2 weekly I/V), Cyclophosphamide (50 mg OD PO), Paclitaxel (80 mg/m2 weekly I/V) and Cisplatin (75 mg/m2 3 weekly I/V) respectively.

Results: 116 patients (79 %) received Methotraxate, 19 (13 %) Cyclophosphamide, 4 (3 %) Paclitaxel, and 7 (5 %) received Cisplatin. A total of 9 (6 %) patients had toxicity related hospital admissions. One patient died due to drug toxicity. Mean time to progression; Methotrexate 7, Cyclophosphamide 9, Paclitaxel 10 and Cisplatin 7.8 months respectively. Overall mean time to progression was 7.8 months (range 1–39).

Conclusions: The disease control in our study is comparable with already published literature but very little has been gained in slowing the progression of the disease.

MASCC-0221

Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials

J.-H.L.,2. T.-W. Huang 1

1Department of nursing, Hung Kuang University, Taichung, 2Department of Internal Medicine, Erlin Branch of Changhua Christian Hospital, Changhua, Taiwan R.O.C.

Introduction: Lymphedema is a common complication ofaxillary dissection for breast cancer. We investigated whether manual lymphaticdrainage (MLD) could prevent or manage limb edema in women after breast cancersurgery.

Methods: We performed a systematic review andmeta-analysis of published randomized controlled trials (RCTs) to evaluate theeffectiveness of MLD in the prevention and treatment of breast-cancer-relatedlymphedema. The PubMed, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro),SCOPUS, and Cochrane Central Register of Controlled Trials electronic databaseswere searched for articles on MLD published before December 2012, with nolanguage restrictions. The primary outcome for prevention was the incidence ofpostoperative lymphedema. The outcome for management of lymphedema was a reductionin edema volume.

Results: Ten RCTs were identified with 566 patients. Two studies evaluating thepreventive outcome of MLD found no significant differences in the incidence oflymphedema between the MLD and standard treatment groups, with a risk ratio of0.63 and a 95 % confidence interval (CI) of 0.14–2.82. Seven studies assessedthe reduction in arm volume, and found no significant difference between the MLDand standard treatment groups, with a weighted mean difference of 75.12 (95 % CI, −9.34 to 159.58).

Conclusion: The current evidence from RCTs does not support the use of MLD to prevent or treat lymphedema. However, clinical and statistical inconsistencies between the various studies confounded our evaluation of the effect of MLD on breast-cancer-related lymphedema.

MASCC-0222

Facing the other: transformation of palliative nurses in reflective group

H.H.C.,M.O. T.Y. Lee 1

1Nursing, Cheng Hsin General Hospital, 2Yang Ming University, 3Yang Ming UniversityMing, Taipei, Taiwan R.O.C.

Reserch aim: The purpose of this study was to explore the personal and professional transformation of the nursing group members during the process of group dialogues.

Research method: Qualitative research method was adopted. Data collection was through theparticipatory observation of the non-structured experiencial group of the 15 nurses. Twelve times of vertibatim transcribed group process recording was analyzed by thematic analysis method.

Research finding: Three themes were found: (A) The reality beyond imaginations—impeacefulness in hospice care and uncaring in taking care; (B) Facing the other—among the nursing colleagues and among patients/families; (C) Cultivating self to comfort the other—letting-go self and being co-existence with the other.

Research implications: Mirroring from the research finding, Nurses can reflect, gain more self-awareness, respect and empathize the others, self-adapt and then enhance the quality of palliative care for patients and also families. On the other hand, it offers some possible clue for nursing facaulties’ in-service growth for nursing educators and administraters.

MASCC-0223

Concurrent chemoradiation for locally advanced non-small cell lung cancer: results of 2 focus group interviews

M.v.d.h.,M.k.,n.a.v. W. uyterlinde 1

1NKI-AVL, Amsterdam, 2Thoracic Oncology, 3Radiation Oncology, NKI-AVL, Amsterdam, The Netherlands

Purpose: To evaluate Quality of care topics in patients treated with concurrent chemoradiation (CCRT) for non-small cell lung cancer.

Patients and methods: Two focus group interviews (I–II) were performed with a 2 year interval. Randomly assigned patients with stage 3 NSCLC treated with CCRT were asked to participate. Inclusion criteria were: non progressive disease; treatment finished between 3 months and 1 year. Topics included screening, -treatment and follow up care. The focus group interviews were performed conform format with an educated and experienced interviewer and a 20 multi-disciplinary audience

Results of interview I were embedded in a clinical pathway and were evaluated in interview II. The interviews were taped and written out. Qualitative statistics included descriptive analysis and labelling of clusters.

Results: Interview I included 9 patients; 2 female; 7 male with a median age of 61 (49–73). Main clusters were poor logistics and lacking supportive care management. In interview II, 15 patients participated; 5 male, 10 female with a median age of 63 (36–81). In this group problems with reintegration was the main cluster. Logistics and supportive care management were not recorded.

Conclusions: The focus group interview is an important tool for Quality of Care measurement and evaluation. Between interview I and II, a clinical pathway was developed which led to improved logistics and supportive care management. Follow up care and reintegration is addressed and will be reported on later.

MASCC-0224

Safety and health related quality of life of concurrent chemo radiotherapy for locally advanced non-small cell lung carcinoma

J.k.,J.b.,M.v.d.h. W. uyterlinde 1

1NKI-AVL, Amsterdam, 2NKI-AVL, Amsterdam, The Netherlands

Purpose: To report on the relation between toxicity, lung function and health related quality of life (HRQL) of radiotherapy and concurrent chemotherapy with or without Cetuximab in patients with locally advanced non-small cell lung cancer (NSCLC).

Patients and methods: Patients with locally advanced NSCLC received daily Cisplatin 6 mg/m2 followed by radiotherapy (66 Gyin 24 days) with or without additional weekly Cetuximab. Toxicity was scored weekly during treatment and thereafter at 8 weeks, 13 weeks, 3, 6 and 12 months from randomization. Pulmonary function and HRQL was assessed at baseline, at the end of treatment and after 1 year.

Results: Between Feb 2009 and May2011, 102 patients with locally advanced NSCLC were included. Twelve percent ofthe population was unable to complete treatment because of toxicity. Overall toxicity grade ≥3 was seen in 71 % of the Cetuximab and in 49 % in the control arm (P = 0.04). HRQL was completed in 50 %. For both arms, dyspnea and coughing was increased at week 59 reported by patients and doctors and the median FEV1 was decreased by 11 % (p = <0.001).

Conclusions: Although more grade ≥3toxicity was seen in the Cetuximab arm, toxicity was manageable. Patient reported outcomes on coughing and dyspnoea corresponded with toxicity and decreased pulmonary function. This study displays the advantage of combining HRQL and toxicity in objectivising side effects and can be used for management and patient education as well as further research.

MASCC-0225

Improving quality of life in patients with kidney cancer through a patient organized support group

W. Tan 1, Q. Life1

1Hematology Oncology, Mayo Clinic, Jacksonville, FL, USA

Background: There are no kidney cancer (KC) specific support groups in the Southeastern United States. A family of a kidney cancer patient based on their personal experience of not being able to get information regarding her cancer, saw the need to improve information access, get emotional and social support to patients and families with KC through the formation of a support group

Methods: Patients and family members were recruited through personal referral from friends, relatives, physicians and through an online website to The Judy Nicholson Foundation.

Results: Nineteen patients with kidney cancer or relatives of kidney cancer cancer were willing to participate in the support group over a year period (2011–2012). 5/19 (26 %) of the patients had early stage cancer and were in remission., 5/19 (26 %) had a friend or relative that had KC, 9/19 (47 %) patients had stage 4 kidney cancer, 2 had lung metastectomy and are in complete remission, and 7 were actively receiving treatment. The monthly meetings were attended by 3–5 patients/relatives. The positive benefits of the support group included emotional and psychological support during periods of difficulty, able to ask others about the side effects of medications from a person who actually had been taking the medication and additional information regarding their disease and resources available. 7/19 (36 %) patients reported a positive improvement in their quality of life based on their experience with the support group. Conclusion: Initial experince with a patient formed/run support group showed positive improvement of quality of life in some patients.

MASCC-0226

Hospital utilization of patients with cervical cancer

W. Prasanatikom 1

1Utilization Management, Faculty of Medicine Ramathibodi Hospital Mahidol University, Bangkok, Thailand

Utilization review is a part of nurses’ role in case management. Since the Diagnostic Related Groups introduced in the health economic, financial indicators such as length of stay, readmission, and cost-effectiveness have been studied. Cervical cancer is one of the high-cost-high-volume diseases that has consumed large amount of hospital resources. Though data of this disease have been collected in the hospital data base, transforming these data to evidence-based has never been done. The retrospective study was to explore hospital utilization of patients with cervical cancer. The sample was 2,804 cases of patients with principle diagnosis of cervical cancer from 2006 to 2011. The data were extracted from the Hospital Information System at the Faculty of Medicine Ramathibodi Hospital, Mahidol University in Bangkok, Thailand. The results showed that the number of patients with cervical cancer increased from 211 cases in 2005 to 423 cases in 2011. An average age was 52 ± 10.10 years. Admission assessment showed that only 2.6 % were unplanned readmission with the same disease within 28 days. The length of stay (los) varied from 1 to 89 days with the mean of 3 ± 5.47 days. Patients with total abdominal hysterectomy and/or operation on ovary had longer los than those with chemotherapy. Eighty percents of the sample had los 1 day for chemotherapy. In conclusion though hospital utilization depended on patients’ needs, effective case management and ambulatory care would help to decrease los.

MASCC-0227

Comparison of biomarkers for assessment of mucosal barrier injury induced by chemotherapy

X.P.,J.W.,J.S.,X.N.,F. Y. Li 1

1Department of Surgery, 2Jinling Hospital, Nanjing University School of Medicine, Nanjing, China

Mucosal barrier injury induced by chemotherapy has come to clinical attention. Oral mucositis can be easily assessed by direct inspection, however, the assessment of intestinal mucositis still pose challenges. The aim is to compare different biomarkers to dual sugar gut permeability test on assessment of intestinal permeability during chemotherapy. Forty-two patients with gastric or colorectal cancer underwent chemotherapy including FAM or FOLFOX4 regimens. Patients were asked to grade and record symptoms of gastrointestinal toxicity daily. Intestinal permeability was assessed by measuring urinary lactulose-mannitol ratio. Plasma levels of citrulline, diamine oxidase (DAO), D-lactic acid, and endotoxin were also measured. Intestinal permeability was observed in the subgroup of patients with diarrhea or constipation. The urinary lactulose-mannitol ratio and plasma citrulline levels increased on 3rd, 6th post-chemotherapy day, respectively. There were no significant difference in plasma levels of D-lactic acid, endotoxin and DAO activity compared to pre-chemotherapy. The urinary lactulose-mannitol ratio in diarrhea patients was significant higher than that of constipation patients. These results indicated that urinary lactulose-mannitol ratio and plasma citrulline level were proper biomarkers for assessment of intestinal permeability in patients receiving chemotherapy. Intestinal permeability in diarrhea patients was significant higher than that of constipation patients.

MASCC-0228

Nutritional assessment and perioperative nutrition support in patients with chronic radiation intestinal injury

Y. Li 1, L. Zheng1, J. Wang1, X. Ni1, J. Li1

1Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China

Objective: To investigate the potential role of perioperative nutritional support in the management of patients with chronic radiation intestinal injury (CRII).

Methods: From the 2000 to 2010, 206 patients with CRII underwent operations were analyzed, retrospectively. The nutritional status was evaluated using SGA sheet. The information of perioperative nutrition support was collected.

Result: 206 CRII patients received 229 surgical therapies. Malnutrition evaluated by the SGA sheet was 86.16 % on admission. Perioperative nutrition support and surgery improved nutrition status, however, the incidence of malnutrition was still very high.

Conclusion: The rate of malnutrition in CRII patients is much high. The patients needed more time for perioperative nutrition support. Perioperative nutrition support and sugery improved the nutritional status in CRII patients.

MASCC-0229

Global gene network analysis about the relationship between the bio-functional food “coral calcium hydride” and the antioxidant effect on the rat brain

S.T.,A.K.,T.K.,3., Y. Ueda 1

1BIOTH, Co.Ltd., Miyazaki, 2Research Equipment Center, Hamamatsu University School of Medicine, Hamamatsu, 3Computational Systems Biology Research Group, Advanced Science Institute, RIKEN, Yokohama, 4TAANE, Co. Ltd., Sendai, Japan

In our previous study, we reported that a diet rich in antioxidants, such as coral calcium hydride (CCH), increased the endogenous antioxidant ability in the hippocampus of rat. In order to test the hypothesis that antioxidant CCH supplementation to rat would change the gene expression and understand how CCH enhances antioxidant ability. In the current study, we used a DNA array to compare the expression levels in the rat hippocampus fed with CCH for 2 weeks. Immune response-related and tumor-related genes were modulated, while Nrf-2 and ALDH3A promoting endogenous antioxidant ability were up regulated. Our findings about changes in these mRNA well explain the physiological finding of enhanced antioxidant ability in rat brain.

MASCC-0230

The determination of life quality and satisfaction and pain perception in cancer patients

Koç, ". 1, Sağ, Z. lam"1

1"Ondokuz Mayıs University, Samsun, Turkey"

Introduction: Life quality is an expression of individual wellness and on the other hand is an important result measurement in evaluation of health condition of the individual and the effects of the medical treatments applied to the individual.

Objectives: This study was made descriptively to determine the life quality and satisfaction and pain perception in cancer patients.

Methods: One hundred forty-seven patients that are under treatment in the oncology service of a hospital between 10.01.2012 and 20.04.2012 have been taken under the scope of the study. Data was collected by using survey form consisting of 31 questions aiming to determine the socio-demographical and clinical properties of the patients, EORTC QLQ-C30 Life Quality Scale, Satisfaction with Life Scale and verbal numerical scale.

Results: The age average of the patients is 53.2 ± 10.7. It was determined that 27.2 % of the patients were diagnosed with gastrointestinal system, that 32.7 % are in 2nd stage, that 95.2 % of them have fatigue, 85.0 % of them have pain and 72.8 % of them have nausea-vomiting symptoms due to the illness. It was determined that the Life Satisfaction Scale total score average of patients is 18.2 ± 7.8 and their verbal numerical scale score average is 6.4 ± 2.3. The EORTC QLQ-C30 life quality subscales (general wellness and functional status) are respectively determined as 8.7 ± 3.0 and 46.7 ± 9.0.

Conclusions: It was determined that patients evaluate their life quality as a whole, that their general wellness is very low, that they are partially not happy with their life satisfaction and that they have more than average pain perception.

MASCC-0231

Determination of selfcare power of cancer patients receiving chemotherapy

Koç, ". 1, Sağ, Z. lam"1

1 Ondokuz Mayıs University, Samsun, Turkey”

Introduction: Self care power is a combination of action and power components which determine the self care performance related with the maintenance and development of health.

Objectives: This study was made descriptively to determine selfcare power of cancer patients receiving chemotherapy.

Methods: One hundred forty-four patients that are under treatment in the chemo-therapy unit of a hospital between 01.05.2012 and30.08.2012 have been taken under the scope of the study. Data was collected by using survey form consisting of 22 questions aiming to determine the socio-demographical and clinical properties of the patients and self care agency scale. The lowest score that can be obtained from the scale is 35 and the highest score is 140. High score is an indicator of greatest self-care degree.

Results: The age average of the patients is 53.7 ± 14.5. It was determined that 38.2 % of the patients were diagnosed with hematological cancer, that 27.8 % are in 1st stage, that 78.5 % of them have fatigue, 69.4 % of them have alopesia and 61.8 % of them have nausea–vomiting symptoms due to the chemo-therapy. It was determined that 42.4 % of them express their health level as average, that 96.5 % of them are satisfied with the treatment they receive. The self care agency scale score average of the patients was determined as 112.3 ± 13.3.

Conclusions: In light of the obtained findings, it was determined that self care power score average is high in young people, in people whose income is equal or higher than their expenses and in people who perceive their health as good.

MASCC-0232

Determination of factors effecting the care takingload of care takers for individuals diagnosed with cancer

“. Koç 1, Sağ, Z. lam1, Ş, T. ahin”1

1 Ondokuz Mayıs University, Samsun, Turkey”

Introduction: The physical and psychological effects occurring in care taker during care taking cause the situation to occur which is named as load.

Objectives: This study is made descriptively to determine the factors effecting the care taking load of care takers for individuals diagnosed with cancer.

Methods: One hundred seventy patients that are under treatment in the chemo-therapy unit of a hospital between 18.09.2012 and 31.12.2012 and patient relatives have been taken under the scope of the study. Data was collected by using survey form consisting of 37 questions and care taking load scale. This scale is a likert type scale consisting of 22 expressions. The lowest score that can be taken from care taking load scale is 0 and the highest score is 88. The high scale score shows that the nuisance is high.

Results: The age average of the patients is 58.0 ± 13.8 while the age average of the care takers is 45.0 ± 13.2. It was determined that 20.6 % of the patients were diagnosed with breast cancer, that 37.1 % are in 1st stage, that 71.2 % of them have fatigue and 48.2 % of them have nausea symptoms due to the illness and that 24.7 % of the patients are dependent to others for discharge activities. It was determined that the care taking load scale average of care takers was 55.6 ± 13.0 and that 48.8 % of them have medium care load and38.8 % of them have heavy care load.

Conclusions: It was determined that care takers have medium and heavy social and emotional nuisance.

MASCC-0233

Establishment of a new prognostic system for advanced hepatocellular carcinoma

Z. Chen 1, X. Li1, X. Wu1, M. Dong1, X. Zhong1

1Oncology Department, the Third Affiliated Hospital of Sun Yat-Sen University, Canton, China

Aim: To establish a new prognostic system for Advanced hepatocellular carcinoma (HCC)

Methods: We analyzed a prospective cohort of patients with newly diagnosed HCC from 2008 to 2010. All the patients were staged with Advanced Liver Cancer Prognostic System (ALCPS), which is now the best predictive system for 3-month survival and overall survival for HCC. And all the patients were staged with our new system.

Results: A total of 253 patients (87.4 % with chronic Hepatitis B virus infection) were analyzed. The median follow-up is 38.5 months and the median survival is 7 months. Multivariate analyses identified alfa-fetoprotein, Blood Urea Nitrogen, Child-pugh stage, vascular involvement and tumor size to be independent prognostic factor. We give different scores to these five factors and establish a new prognostic system. Using the new system, we scored the patients by 0–8 and the patients were classified as high-risk (6–8), intermediate risk (3–5) and low risk groups (0–2). When predicting 3-month survival, ROC analysis show AUC of ALCPS and our new system is similar (0.822 VS 0.821, p = 0.98). When predicting overall survival, likelihood ratio test show χ 2 of our new system is higher than that of ALCPS (98.65 vs 85.02, p < 0.01) and AIC of our new system is lower than that of ALCPS (1939 vs 1953, p < 0.01), Our new system has better performance in terms of discriminatory ability, homogeneity and monotonicity.

Conclusion: Our new system is an appropriate prognostic system for advanced HBV-related HCC.

MASCC-0234

Joint modeling quality of life and survival using a terminal decline model in palliative care studies

T.T.,M.B. Z. Li 1

1Department of Community and Family Medicine, 2Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA

Palliative medicine is a relatively new specialty that focuses on preventing and relieving the suffering of patients facing life-threatening illness. For cancer patients, clinical trials have been carried out to compare concurrent palliative care with usual cancer care in terms of longitudinal measurements of quality of life (QOL) until death, and overall survival is usually treated as a secondary endpoint. It is known that QOL of patients with advanced cancer decreases as death approaches; however, in previous clinical trials, this association has generally not been taken into account when inferences about the effect of an intervention on QOL or survival have been made. We developed a new joint modeling approach, a terminal decline model, to study the trajectory of repeated measurements and survival in a recently completed palliative care study. This approach takes the association of survival and QOL into account by modeling QOL retrospectively from death. For those patients whose death times are censored, marginal likelihood is used to incorporate them into the analysis. Our approach has two submodels: a piecewise linear random intercept model with serial correlation and measurement error for the retrospective trajectory of QOL and a piecewise exponential model for the survival distribution. Maximum likelihood esti-mators of the parameters are obtained by maximizing the closed-form expression of log-likelihood function. An explicit expression of quality-adjusted life years can also be derived from our approach. We present a detailed data analysis of our previously reported palliative care randomized clinical trial.

MASCC-0235

Patterns of practice in the prescription of palliative radiotherapy for bone metastases at the rapid response radiotherapy program from 2005 to 2012

N. Thavarajah 1, L. Zhang1, K. Wong1, G. Bedard1, E. Wong1, M. Tsao1, C. Danjoux1, E. Barnes1, A. Sahgal1, L. Holden1, N. Lauzon1, E. Chow1

1Radiation Oncology, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada

Introduction: Radiation therapy (RT) has been used for the palliation of painful bone metastases with partial pain relief seen in 50 to 80 % of patients, and complete relief in one third of patients [1].

Objectives: To examine whether the patterns of practice in the prescription of palliative RT for bone metastases has changed over time in the Rapid Response Radiotherapy Program (RRRP). Secondary outcomes include examining factors that may have influenced the treatment regimen prescribed.

Methods: A review between August 1, 2005 and April 30, 2012 was conducted. Patient demographics, disease, and organizational factors, and reasons for prescribing RT fractionation schedules were analyzed. The chi-square test, univariate logistic regression analysis, and the simple Fisher exact test were used to conduct the statistical analyses.

Results: A total of 2,549 cases of RT were prescribed during the study period. Sixty-five percent of cases were prescribed a single fraction of RT, while 35 % of cases were prescribed multiple fractions. A single fraction was more frequently prescribed in older patients, patients with a history of previous RT, with a prostate primary and by radiation oncologists who were qualified before 1990.

Conclusions: There was a significantly greater frequency in the prescription of a single fraction of radiation therapy for patients with bone metastases.

References: [1] Chow E, Harris K, Fan G, Tsao M, Sze WM. Palliative radiotherapy trials for bone metastases: a systematic review. Journal of Clinical Oncology 2007 Apr 10;25(11):1423–1436.

MASCC-0236

Continued success in providing timely palliative radiation therapy at the rapid response radiotherapy program: a review of 2008–2012

N. Thavarajah 1, K. Wong1, L. Zhang1, G. Bedard1, E. Wong1, M. Tsao1, C. Danjoux1, E. Barnes1, A. Sahgal1, K. Dennis2, L. Holden1, N. Lauzon1, E. Chow1

1Radiation Oncology, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada, 2Radiation Oncology, The Ottawa Hospital Cancer Centre University of Ottawa, Ottawa, Canada

Introduction: The Rapid Response Radiotherapy Program (RRRP) at the Odette Cancer Centre (OCC) in Toronto, Canada is an outpatient palliative radiation therapy (RT) clinic with the primary goal of providing timely RT for symptom relief in patients with locally advanced or metastatic cancers.

Objectives: To review and evaluate the clinical activity of the RRRP over the past 4 years.

Methods: A retrospective review of a prospective database of patients referred to the RRRP between August 1, 2008 and June 30, 2012 was conducted with patient demographics, case dispositions and wait times in days from referral to consultation and from consultation to treatment.

Results: A total of 2,742 cases were referred to the RRRP. Of the total cases, 1,458 (53 %) were males and 1,284 (47 %) were females. The median age was 64 years. The most prevalent primary cancer sites were lung (33 %), breast (21 %), and prostate (17 %). The most common reasons for referral were for bone metastases (53 %) and brain metastases (21 %). A total of 1,890 cases received palliative RT. The median wait time from referral to consultation was 3 days. Sixty percent of patients were treated on the same day of consultation and 33 % within 1 to 6 days.

Conclusions: The RRRP continues to deliver timely palliative RT to patients and remains comparable to our previous reviews. The continued success of the RRRP will serve as a model for future rapid access palliative RT clinics.

MASCC-0237

Symptom clusters in patients with metastatic cancer: a literature review

N. Thavarajah 1, E. Chen1, L. Zeng1, G. Bedard1, J. Di Giovanni1, M. Lemke1, N. Lauzon1, M. Zhou1, D. Chu1, E. Chow1

1Radiation Oncology, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada

Introduction: A symptom cluster is commonly defined as two or more concurrent symptoms experienced by a patient [1].

Objectives: To present a review of the literature reporting empirically determined symptom clusters in patients with metastatic cancer.

Methods: A literature search was conducted on symptom clusters within heterogeneous metastatic cancer patient populations using MEDLINE, EMBASE, and CINAHL. Studies examining predetermined symptom clusters were excluded.

Results: A total of eight relevant studies published between 2005 and 2011 were identified. The majority of studies were cross-sectional in nature, with the exception of one study, observing baseline symptom data within inpatients and outpatients. The most common cancer sites include lung, breast, colorectal, and prostate. The number of symptom clusters extracted varied from two to eight clusters per study, comprising of two to eight symptoms per cluster. There were no clusters consistently identified within all eight studies. However, four out of eight studies utilized the Edmonton Symptom Assessment Scale (ESAS), revealing anxiety and depression to cluster together in all four studies. Differences in symptoms assessed, assessment tools, statistical analysis, patient demographics can account for discrepancies between the studies.

Conclusions: Controlling for factors that introduce variation in symptom cluster analysis may enable the development of more consistent, defined symptom clusters to facilitate efficient and effective symptom management in future clinical practice and ideally improve patient outcomes.

References: [1] Dodd MJ, Miaskowski C, Paul SM. Symptom clusters and their effect on the functional status of patients with cancer. Semin Oncol Nurs 2010;26(3):168–74.

MASCC-0238

Patterns of practice in the prescription of palliative radiotherapy for the treatment of thoracic symptoms at the rapid response radiotherapy program between 2006 and 2012

N. Thavarajah 1, K. Wong1, L. Zhang1, E. Wong1, G. Bedard1, N. Lauzon1, L. Holden1, M. Tsao1, C. Danjoux1, E. Barnes1, A. Sahgal1, E. Chow1

1Radiation Oncology, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada

Introduction: Radiation therapy can often be used for the palliation of thoracic symptoms in patients presenting with locally advanced lung cancer or lung metastases.

Objectives: The aim of this study was to examine whether the patterns of practice in the prescription of palliative thoracic radiation therapy has changed over time in the Rapid Response Radiotherapy Program (RRRP). Secondary outcomes included factors that may have influenced the treatment regimen prescribed including patient, disease, and organizational factors.

Methods: A retrospective review conducted for patients with locally advanced lung cancer or lung metastases referred to the RRRP for thoracic symptoms between July 1, 2006 and April 30, 2012. Patient demographics, organizational, and disease factors were descriptively analyzed. Differences in proportions between unordered categorical variables were examined using a chi-square test. Univariate logistic regression analysis and backward stepwise selection procedure were also used to determine the most significant factors in the prescription practice.

Results: A total of 175 courses of palliative thoracic radiation therapy were prescribed. The median age of patients overall was 71 years, and the median Karnofsky Performance Status (KPS) was 60. The most commonly prescribed treatment regimen was 20 Gy in 5 fractions (20 Gy/5) which made up 64 % of all courses prescribed. There has been a significant increase in frequency of the prescription of 20 Gy/5 over time.

Conclusions: A significant increase in the prescription of 20 Gy/5 was observed over time. However, the prescription of a higher dose fractionation schedule prescribed for patients with a higher performance status, as seen in other clinical trials and guidelines, was not observed.

MASCC-0239

Paulinia Cupana (Pc) (Guaraná) dry extract for breast cancer (bc) women with hot flashes (hfs): results of a pilot study.

A.B. del Giglio 1, T.G. Lerner1, S.O. Oliveira1, L. Reifur1, L.T. Cavicchioli1, R.M. Zanellato1, A. del Giglio1

1Oncology, Faculdade de Medicina do ABC, Sao Paulo, Brazil

Introduction: HFs are a very disturbing for BC patients, affecting about two thirds of them. PC is an amazonic plant that has show to have anti-fatigue activity for BC women undergoing chemotherapy.

Objectives: Evaluate efecness of PC fo HFs control in women with BC

Methods: We included BC women at least 3 months after finishing their treatment with at least 14 HFs per week. Patients recived 50 mg PO of PC dry extract twice daily for 6 weeks. We assessed both HF frequency and its severity and patients graded their own toxicities weekly. We employed a phase II Simon design in which 9 out of 15 patients would be required to have at least 50 % decrease in their HF severity score.

Results: We included 24 women with median age of 50.2 (36–65). Only 18 started Pc and 15 completed the 6 weeks of the study. Three patients declined participation right after starting PC for difficulty in participation and for noncompliance. Ten out of 15 patients had more than 50 % decrease in their HF severity score. Throughout the 6 weeks of treatment we observed statistically significant decreases in HFs number (p = 0.0331) and Severity Scores (p = 0.0039). As compared to week 0, patients reported worsening of anorexia (1), insomnia (1), nausea (1), fatigue (1), sweating (1), constipation (1), anxiety (1), humor change (1), and headache (1). None of these toxicities warranted discontinuation of the study.

Conclusions: We conclude that PC was effective for HF control achieving the pre-specified threshold with acceptable toxicity and warrants further confirmatory studies

MASCC-0240

Exploring the quality of life and the impact of the disease among patients with colorectal cancer

T.T. Loi 1, S. Chan2, R. Wong3, C.L. Tang1

1Colorectal Surgery, Singapore General Hospital, Singapore, Singapore, 2Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore, 3Gastroenterology & Hepatology, National University Health System, Singapore, Singapore

Introduction: Colorectal cancer has emerged as the most common cancer in Singapore. The quality of life (QoL) has become increasing important in measuring the outcomes of colorectal cancer patients and the impact of the disease on a person’s life

Objectives: To explore the range of factors that affect patient QoL and to identify patient who are at risk for adverse psychological distress.

Methods: The targeted population for the study were recruited 1 year after diagnosed with colorectal cancer at Singapore General Hospital. Subjects were assessed using the EORTC QLQ-C30, EORTC QLQ-CR29 and Hospital Anxiety and Depression Scale.

Results: The analysis was based on 300 subjects. One hundred and seventy-nine (59.7 %) patients were males and 121 (40.3 %) were females. Only 31(10.3 %) patients had stomas. Most of the patients perceived some worsening of physical functioning, role functioning, cognitive functioning and social functioning after colorectal surgery. The majority of patients reported having satisfactory global health status and overall QoL. However, 158 (53 %) of them reported having elevated level of anxiety and 127 (42 %) of the patients worried about their weight.

Many patients suffered from symptoms such as fatigue (n = 127, 42 %), constipation (n = 106, 35 %), insomnia (n = 97, 32 %) and approximately 23 % (n = 68) of them were still having pain, dyspnoea and diarrhoea symptoms. One hundred and thirty-two (44 %) patients reported having financial difficulties

Conclusions: This study found that the most important factor affecting the patient’s QoL was anxiety score which account for 53 % of the patients.

MASCC-0241

RAD51 (G135C) gene polymorphism and the modulation of risk in colorectal cancer patients of Kashmir

A.S. Sameer 1, S. Nissar2, S. Baba2, T. Akhter2

1Biochemistry, SKIMS Medical College, Srinagar, India, 2Immunology and Molecular Medicine, Sher I Kashmir Institute of Medical Sciences, Srinagar, India

Introduction: Colorectal cancer (CRC) is the third most common cancer in men and the second most common cancer in women worldwide. In the Kashmir valley, CRC represents the third most common GIT cancer after oesophageal and gastric cancer. RAD51 plays an important role in the homologous recombination, the process frequently involved in cancer transformation.

Objectives: The main objective was to find the modulation of the colorectal risk in the ethnic Kashmiri population by the three polymorphic forms of RAD51 gene.

Methods: We tested the association between the 135G>C polymorphism of the RAD51 gene and colorectal cancer risk and various clinicopathological parameters. Polymorphism was evaluated by restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR) in 100 CRC patients and 120 sex, age matched cancer-free controls

Results: There was a significant association between RAD51 genotypes and the CRC (p < 0.05) and the GC genotype was associated with the elevated risk of CRC (OR > 3.84) and CC variant genotype was associated with an increased risk of CRC in various clinic-pathological parameters.

Conclusions: We conclude that there is a significant relationship between the polymorphism of RAD51 (G>135C) gene and the risk of CRC in the ethnic Kashmiri population.

References:Thacker J. The RAD51 gene family, genetic instability and cancer. Cancer Letters 2005; 219:125–135

Krupa R, Sliwinski T, Wisniewska-Jarosinska M, et al. Polymorphisms in RAD51, XRCC2 and XRCC3 genes of the homologous recombination repair in colorectal cancer--a case control study. Mol Biol Rep 2011; 38:2849–2854.

Romanowicz-Makowska H, Samulak D, Michalska M, et al. RAD51 gene polymorphisms and sporadic colorectal cancer risk in Poland. Pol J Pathol 2012; 63:193–198.

MASCC-0242

Quality of life in patients with primary and metastatic brain cancers as reported in the literature using the EORTC QLQ-BN20 and QLQ-C30

L. Chiu 1, N. Chiu1, L. Zeng1, L. Zhang1, M. Popovic1, R. Chow1, H. Lam1, M. Poon1, E. Chow1

1Department of Radiation Oncology, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada

Introduction: Primary brain cancer and metastatic brain cancer are both associated with poor prognoses. Therefore, quality of life (QOL) becomes more of a priority than traditional endpoints such as survival.

Objectives: The objective of this review is to compare the differences in QOL as assessed by the EORTC QLQ-BN20 and the EORTC QLQ-C30 in patients with primary and metastatic brain neoplasms.

Methods: A systematic literature search was conducted over the OvidSP platform in MEDLINE (1980 to July 2012), and EMBASE (1980 to July 2012). Articles were included if they reported scores of at least one subscale of the QLQ-C30 and QLQ-BN20 for patients with either metastatic or primary malignant brain tumors. Weighted analysis of variance was conducted to compare scores in these patients.

Results: A total of 14 studies (16 arms: 3 brain metastases, 13 primary brain tumors) were included in data analysis. Performance status of patients in both cohorts was similar: of all subscale scores, only cognitive functioning from the QLQ-C30 was significantly worse in patients with primary brain tumors when compared to metastatic brain patients (p = 0.0199).

Conclusions: Despite cognitive function being significantly worse in patients with primary brain tumors, there is reason to suggest that patients with metastatic brain tumors and patients with primary brain tumors have similar QOL profiles. This study is limited by the large discrepancy in cohort sizes and the lack of clinical data. More research in assessing QOL in brain metastatic populations with the QLQ-BN20 should be conducted to confirm and validate the present findings.

MASCC-0243

Innovation of pharmacotherapy to cancer-related fatigue

Y. Lai 1, W. Su1, Y. Lin1

1Hospice Palliative Care Center, Mackay Memorial Hospital, Taipei city, Taiwan

Introduction: Cancer-related fatigue (CRF) has not been properly treated by physicians. It is still an unmet medical need to provide proper treatment for relieving fatigue and improving quality of life among cancer patients. In traditional Chinese medicine, Astragalus membranaceus (AM) is commonly used to treat the deficiency of qi (vital energy), which manifests as fatigue and lack of appetite. Studies have shown that AM-based Chinese herbal remedies improve quality of life, alleviate chemotherapy toxicity, and boost immune functions in cancer patients.

Objectives: To investigate the efficacy of the botanical-derived drug, PG2, a partially purified extract of AM for cancer-related fatigue.

Methods: A randomized, double-blind, placebo-controlled phase III trial was used. Patients with advanced cancer and moderate to severe CRF were randomized to receive either PG2 or a placebo.

Results: PG2 was shown to be safe and effective in relieving cancer-related fatigue. The fatigue improvement response rates of PG2 revealed a much stronger effect up to 29 %, better than the placebo, and this result was statistically significant. In addition, approximately 82 % of patients who reported an improvement of fatigue symptoms following the first cycle of PG2 experienced sustained benefits after administration of the second treatment cycle. Among patients treated with PG2 who did not report an improvement in symptoms throughout the first treatment cycle, approximately 71 % showed significant improvement after the second treatment cycle. No major or irreversible toxicities were observed with PG2 treatment.

figured
  Treatment N = 44 Control N = 40
All AEs 226 195
AEs in severity
 “Mild” 91 (40.27) 69 (35.38 %)
 “Moderate” 121 (53.54 %) 109 (55.90 %)
 “Severe” 14 (6.19 %) 17 (8.72 %)
Patients with AEs 41 (93.18 %) 40 (100.00 %)
Patients with SAEs 8 (18.18 %) 9 (22.50 %)
Patients discontinued due to AE 2 (4.55 %) 1 (2.50 %)
Patients with treatment-related AEs 8 (18.18 %) 8 (20.00 %)

Conclusions: PG2 might be an effective and safe treatment to such an unmet medical need.

MASCC-0244

Analytical study to see the effect of nandrolone decanoate in patients of advanced stage oral cavity cancer undergoing treatment (CCRT)

D. kumar 1, M.C. Pant1, N. Jamal1, S. Singh1, M.L.B. Bhatt1

1Radiotherapy, CSMMU, Lucknow, India

Introduction: A study comprising of 75 male pts and 75 control of adv stage oral cancer conducted at CSMMU, India (Jan 2010–Jan 2011).

Objectives: To study the effect of N.decanoate in pts undergoing chemoradiotherapy

Methods: Inj N.decanoate 50 mg IM injected wkly for 5 week in pts while control group received placebo. Included pts- KPS >=60, n.blood parameters. Excluded pts-postop, stage I & II, with comorbid conditions and derranged testosterone levels

Results: Pr.end point- to analyse mucosal toxicity, pain, hemoglobin level, well being and, weight changes, if any. The secondary end point- to measure hormonal changes, if any. Nandrolone decreased mucosal toxicity, pain, frequent breaks during the treatment and also there was a feeling of wellness among the patients. Weight and Hb levels remained static in the majority of patients in whom the drug was administered, which was in contrast to their counterparts, who experienced a significant weight loss and required frequent blood transfusions. Statistical analysis was done using Chi square test The results were found to be statistically significant. Also serum testosterone levels were assessed at 3 monthly interval post treatment for desired period of time. No hormonal imbalances were detected on follow up

Conclusions: Nandrolone reduces chemoradiation induced complications with no major side effects.

References:

1. Hormonal treatment of advanced breast cancer. A randomized trial of tamoxifen versus nandrolone decanoate. Kellokumpu-Lehtinen

2 Cyclophosphamide and n.decanoate in the treatment of adv ca of the breast results of a comparative controlled trial of the agents used singly and in combination. M. P. COLE

3. Nandrolone decanoate treatment in anemia of patients with cancer: Phase II clinical study.

Citation:J Clin Oncol 29: 2011

MASCC-0245

Acceptability of alternative routes of administration of rescue (“breakthrough”) medication: an observational study of 840 European oncology patients

A. Davies 1, A. Buchanan1, G. Zeppetella2

1Palliative Care, St. Luke’s Cancer Centre, Guildford, United Kingdom, 2Palliative Care, St. Clare Hospice, Hastingwood, United Kingdom

Introduction: Rescue (‘breakthrough’) medication can be given via a number of different routes (e.g. oral transmucosal, intranasal).

Objectives: To determine the acceptability of alternative routes of administration, and identify factors associated with/reasons for unacceptability.

Methods: Eight hundred forty cancer patients with breakthrough pain from 11 European countries were asked about the acceptability of four routes of administration (oral transmucosal, intranasal, intrapulmonary, subcutaneous), and all/main reasons for unacceptability. They were also asked about adherence with current rescue medication, and all/main reasons for non-adherence.

Results: 70 % patients reported the oral transmucosal route acceptable, with only country of origin being statistically significant; 53 % patients reported the intranasal route acceptable, with age, country of origin, and previous use of route being statistically significant; 51 % patients reported intrapulmonary route acceptable, with only country of origin being statistically significant; 61 % patients reported the subcutaneous route acceptable, with ECOG performance status, country of origin, and previous use of route being statistically significant. Only 53 % patients took medication every time they experienced pain, with the most common reasons being pain not always severe, and pain not always long lasting.

Conclusions: The acceptability of alternative routes of administration is affected by numerous factors, but especially by the country of origin and previous experience of the route of administration.

References: Davies AN, Dickman A, Reid C et al. The management of cancer-related breakthrough pain: recommendations of a task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland. European Journal of Pain 2009; 13: 331–8.

MASCC-0246

Quality of life in patients with primary and metastatic brain tumors as assessed by the FACT-Br: a literature review

N. Chiu 1, L. Chiu1, L. Zeng1, L. Zhang1, D. Cella2, M. Popovic1, R. Chow1, H. Lam1, M. Poon1, E. Chow1

1Department of Radiation Oncology, Odette Cancer Centre Sunnybrook Health Sciences Centre University of Toronto, Toronto, Canada, 2Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA

Introduction: The FACT-Br is a quality of life (QOL) assessment tool originally developed for use in patients with primary brain tumors. However, the tool has also been used to assess QOL in patients with metastatic brain tumors.

Objectives: The current review compares the differences in QOL responses as assessed by the FACT-Br in primary and metastatic brain neoplasm patient populations

Methods: A literature search was conducted using the OvidSP platform in MEDLINE (1946 to July 2012) and EMBASE (1980 to July 2012). Studies using at least one FACT-Br subscale for QOL assessment in either primary or metastatic brain tumor patients were included. The weighted means of FACT-Br subscale and overall scores were calculated for the studies. To compare scores, weighted analysis of variance was conducted and PROC GLM was performed.

Results: Twenty-three studies using the FACT-Br were identified (4 in brain metastases, 18 in primary brain tumors and 1 in a mixed sample). Social and functional well-being were significantly better in patients with primary brain tumors (weighted mean score of 22.2 vs. 10.7, P = 0.0026, and 16.9 vs. 6.2, P = 0.0025, respectively). Other FACT-Br scales and performance statuses of patients in both groups were similar.

Conclusions: Primary brain cancer patients seemed to have better social and functional well-being scores than metastatic brain tumor patients while other QOL domains were similar. The heterogeneity in the studies and the low sample size of metastatic brain tumor studies could have confounded our findings. As such, further investigation is recommended.

MASCC-0247

CAP program (circumvent anxiety of patients) during chemotherapy delivery at one-day hospital.

J. Kattan 1, A. Daher1, L. Assaker1, Y. Jreige1

1Department of Hematology/Oncology, Saint Joseph Hospital/Raymond and Aida Najjar Medical Center, Beyrouth, Lebanon

Introduction: Transforming patient anxiety to comfort during chemotherapy delivery is the desire of every cancer care giver. For the first time, a beauty care clinic services are offered to adult cancer patients, while receiving one-day chemotherapy

Objectives: To evaluate the impact of the beauty clinic services on the patient anxiety and on the department atmosphere

Methods: Professional physiotherapists in beauty care and relaxation massage offer their services for every patient during 15 min session at his own bed. CAP program was approved by Saint Joseph ethical committee and supported by Jane Nassar Institute. Evaluation questionnaires were filled by randomly selected patients.

Results: CAP program was initiated in August 2012. Around 10 patients per day were included. 90 % of our patients welcome the program and participate. Men choose hands or feet relaxation massage and women usually face beauty care. 22 patients were randomly selected to fill the CAP-evaluation questionnaire. Among these 22 patients, only 2 (9 %) refused to participate in the program. Among these 20 patients, 90 % had at least two sessions, 100 % would advise other patients to participate, 95 % of them believe that this service adds an advantage to delivered care and provides a restful atmosphere, and all of them encourage the department to continue to provide this service.

Conclusions: Psychosocial support is almost lacking in the management of our patients leading to increase their anxiety while receiving chemotherapy. CAP program represents an innovative intervention that improves patient apprehension and soften chemotherapy atmosphere.

MASCC-0248

Quality of life assessment in advanced cancer patients treated at home, a day care centre and a palliative care unit

W. Leppert 1

1Chair and Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland

Introduction: Quality of life (QOL) assessment is paramount in advanced cancer patients.

Objectives: QOL assessment is crucial in patients with advanced cancer. The aim of the study was to compare QOL in advanced cancer patients treated at home, at a day care centre (DCC) and at a palliative care unit (PCU).

Methods: QOL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire—Core 15—Palliative Care (EORTC QLQ-C15-PAL) along with the modified ESAS (Edmonton Symptom Assessment System) and the Karnofsky performance status (KPS). Two measurements were performed at baseline and after 7 days of symptomatic treatment.

Results: A total of 129 patients completed two QOL measurements with 51 patients treated at home and at PCU each and 27 patients treated at DCC. In the EORTC QLQ-C15-PAL significant improvement in functional and symptom scales was observed except for physical functioning and fatigue; patients at DCC had better physical functioning, global QOL, appetite and less fatigue. KPS scores were better at DCC comparing to patients treated at home and at PCU, and in the latter group deteriorated. ESAS results demonstrated improvement in all items except for drowsiness, which was stable in DCC and deteriorated in patients staying at home and at PCU. Higher activity, better appetite, well-being and less drowsiness were observed in patients treated at DCC.

Conclusions: QOL improved in all patients comparing the baseline and follow-up assessments, with better results observed in those treated at DCC and similar scores in patients staying at home and at PCU

MASCC-0249

Palliative chemotherapy in terminal stage of patients with ovarian cancer

M. Mallaev1, Z.A. Olimova 1, R.M. Valieva1, G.J. Khakimova1

1Chemotherapy, National Cancer Research Center, Tashkent, Uzbekistan

Introduction

Background: We conducted trial to evaluate the therapeutic efficacy and toxicity of paclitaxel with albumin in patients with terminal stage of ovarian cancer. It’s known that normal concentration of albumin in blood considerably increased the efficiency of chemotherapeutic agents.

Objectives: We selected 12 patients with terminal stage of ovarian cancer T4N2M1with ascites.

Methods

Methods: We carried out to all patients Paclitaxel 50 mg/m2 in 5 % 500 ml of dextrose during 180 min with albumin 20 %–100 ml during 5 h intravenously, simultaneously and repeated that course each 7 days during 2 month depending on common condition of the patient and laboratory analysis

Results

Results: After appropriate postchemotherapeutic and symptomatic therapy we took normal blood tests and decreasing of tumor. Common condition of patients improved after 4th course, decreased ascites and observed less toxicity of paclitaxel.

Conclusions

Conclusions: As we showed above we selected patients at the stage of T4N2M1, by ECOG standard 3 points conducted micro dose long term chemotherapy with albumin and took expected results. We observed patients that by ECOG points decreased even to 1, disappeared ascites, and improved quality of life.

MASCC-0250

Quality of life of family caregivers in hematologic cancer

H. Bektas 1, G. Yigit2

1Medical Nursing, Akdeniz University Antalya School of Health, Antalya, Turkey, 2Hematology Unit, Akdeniz University Hospital, Antalya, Turkey

Introduction: Cancer is a chronic illness that affects the entire family and deteriorates the quality of life (QoL) of family caregivers.

Objectives: The objective of this descriptive study was to assess the QoL of family caregivers in hematologic cancer

Methods: Fifty family caregivers of the hematologic cancer patients were interviewed. Data were collected with a demographic questionnaire and QoL was assessed using the Turkish version of The Caregiver Quality of Life Index-Cancer (CQOLC) scale. Descriptive statistics, multivariate regression, internal consistency analyses were utilized in the data analyses

Results: The majority of the patients were male (56 %), housewife (38 %) and retired (36 %). The median age (range) for caregivers was 42.5 years (20–68 years), the majority of family caregivers were female (64 %), married (82 %), housewifes (58 %), spouses (44 %), and children (30 %). The majority of family caregivers (62 %) had at least one chronic illness including diabetes, hypertension, arthritis, and depression. The CQOLC score of the family caregivers was 72.63 ± 16.08, (Min.32, Max.114), and scores of the four subscales were as follows: Burden 14.29 ± 7.26, distruptiveness 11.09 ± 5.61, positive adaptation 14.82 ± 5.43, and financial concerns 6.48 ± 3.94. Hematologic cancer caregivers had lower QoL scores. The mean CQOLC score differed with age, gender, education levels and marital status (p < 0.05). The Cronbach’s alpha value of the CQOLC was 0.88

Conclusions: Evidenced-based supportive programs for family caregivers of hematologic cancer patients should be developed and tested to meet their needs and support caregiving roles. The health team can plan more efficient interventions, with a view of enhancing the QoL of family caregivers.

MASCC-0251

Sexual dysfunction in patients with breast cancer

H. Bektas 1, I. Ozkan2

1Medical Nursing, Akdeniz University Antalya School of Health, Antalya, Turkey, 2Maternal Nursing, Akdeniz University Antalya School of Health, Antalya, Turkey

Introduction: All women diagnosed with breast cancer, regardless of ethnicity, have concerns regarding sexuality and body image

Objectives: The objective of this descriptive study was to assess the sexual function in patients with breast cancer

Methods: This research was carried out on 230 patients diagnosed with breast cancer. Personal information forms developed by the researcher and the Female Sexual Function Index were used as the data tools. Data were collected through personal interviews with the patients

Results: The breast cancer patients in the sample averaged 48.9 years of age (range 26–78) and included most patients who were married (79.6 %), housewife (76.0 %) and had completed primary education (53.9 %). According to the results of the research, 94.3 % of patients had chemotherapy, 48.2 % had radiotherapy, 93.9 % had surgical treatment. Also 68.7 % of the patients were satisfied with their sexual functions before they had diagnosed with cancer, 49.6 % of the patients sexual functions were affected after receiving the cancer diagnosis, 39.1 % of patients had no sexual activity. Female Sexual Function Index scores of the patients with an average were 26.3 (Min.6, Max.83) and found to be low. The Cronbach’s alpha value of the Female Sexual Function Index was 0.97

Conclusions: Patients with sexual dysfunction in individuals affected by negative body image, especially in patients who were diagnosed with breast cancer evaluated with caution, sexual dysfunction, the level of reliability and validity of assessment scales were to be made using the appropriate interventions to individuals in planning and directing the units is recommended.

MASCC-0252

The association between malnutrition and psychological distress in patients with advanced head and neck cancer

L. Ma 1, P. Poulin2, A. Feldstain3, M. Chasen4

1Division of Palliative Care, Ottawa Hospital Research Institute The Ottawa Hospital Cnacer Certre, Ottawa, Canada, 2Psychosocial Oncology Program, The Ottawa Hospital Health Institute, Ottawa, Canada, 3School of Psychology, University of Ottawa, Ottawa, Canada, 4Division of Palliative Care, The Ottawa Hospital Cnacer Certre Ottawa Hospital Research Institute, Ottawa, Canada

Introduction: Malnutrition and psychological distress are often seen in patients with head and neck cancer, but little is known about their interrelationships.

Objectives

This study aims to examine the relationship between malnutrition and psychological distress in patients with advanced head and neck cancer.

Methods: One hundred patients with advanced stage head and neck cancer were screened for nutritional status, using the Patient-Generated Subjective Global Assessment, for psychosocial distress, using the Distress Thermometer, and for psychosocial issues, using the Problem Checklist. The relationship between malnutrition and psychosocial distress was determined by regression and correlation analysis. We also used t-tests to compare distress levels among patients with or without specific nutrition-related symptoms.

Results: There were 80 male and 20 female patients; the mean age was 58.4 ± 10.9 years (range 23 to 85). The correlation between poorer nutritional status and levels of psychological distress was significant r = 0.37 (p < .001). Specifically, reduced food intake, symptoms, and greater disability were all positively associated with distress (respectively r = .27, r = .29, and r = .56, all significant at p < .01). After controlling for the effects of psychosocial problems and pain, nutritional status remained a significant predictor of distress, explaining 3.8 % of the variance in patients’ distress scores (p < .05)

Conclusions: Malnutrition and disability were strongly related to distress in patients with advanced head and neck cancer. Our results suggest the need for further research into the complex relationship between nutritional status and distress, as well as into their management in cancer care.

MASCC-0253

Intercostobrachial syndrome after nerve-sparing axillary lymph node dissection

M. Kostanyan 1

1Mammology-1, National Centre of Oncology, Yerevan, Armenia

Introduction: Intercostobrachial nerve syndrome is the most frequent postoperative complication of axillary lymph node dissection (ALND) due to surgical injury of intercostobrachial nerve (ICBN). Intercostobrachial neuralgia represents neuropapthic pain typically accompanied by remarkable sensory abnormalities in the distribution of the ICBN.

Objectives: We conducted a prospective study to evaluate the frequency, character and location of sensory disturbances of upper extremity in two consecutive groups of women who underwent level-2 ALND for operable breast cancer at National Centre of Oncology in the period of 2005–2010 years.

Methods: In group I (experimental group—110 patients) besides of motor nerves (long thoracic and thoracodorsal nerves) the ICBN was preserved. In group II (control or nerve-sacrificed group—110 patients) the ICBN was transsected. Tactile sensitivity was assessed after 3 months from the surgery by special questionnaire and using standard neurological Methods.

Results: The analyses of results showed, that prevalence rate of sensory disturbances of upper extremity was 12.7 % in the experimental group, which was significantly different from that of the control group (88.2 %, p < 0.01). In the nerve-preserved group sensory changes had character of hypesthesia (5/14) or paresthesia (9/14). Meantime, in the control group, sensory changes had more severe character in the form of dysesthesia (37/97) or anesthesia (60/97), and in 5 patients the phenomenon of allodynia (painful response to innocuous stimulus) was observed.

Conclusions: Our study demonstrates, the preservation of the ICBN during ALND produces minimal postoperative alterations in sensitivity significantly improving quality of life of operated patients.

MASCC-0254

General review: influence of managerial practices on caregivers’ quality of working life in oncology wards

P. Colombat 1, N. Gillet2, E. Fouquereau2, A.M. Pronost3, I. Krakowski4

1Haematology, CHU Tours, Tours, France, 2Psychology, University Tours, Tours, France, 3Psychology, Clinique Pasteur, Toulouse, France, 4Oncology, Centre Alexis Vautrin, Nancy, France

Introduction: Several studies have examined stress and professional burnout among healthcare workers in oncology wards. Although researchers have for a long time targeted their analyses on the negative indicators of health at work (e.g. stress, burnout, emotional distress), recent studies propose a more holistic approach to work quality of life of caregivers.

Objectives: In 2008, we demonstrated in a sample of 574 caregivers in oncology a significant relationship between several characteristics of onco-hematology services and health indicators, as the need for time and recognition, the importance of training (in palliative care, pain management, and help relationship), the care of patients and their families, the interdisciplinary efficiency

Methods: Specifically, results showed that participative management (e.g. implementation of service projects and of multidisciplinary staff) has a positive influence on health professionals’ quality of working life.

Results: Then we have looked at the impact of the proximal leadership of the nurse supervisor, i.e. transformational leadership and organizational justice on quality of working life and work engagement of 343 nurses. We observed that distributive justice and interactional justice fully mediate the relationship between transformational leadership and nurses’ quality of working life. In addition, nurses’ quality of working life positively related to their work engagement

Conclusions: We thus encourage health organizations to develop and offer to their proximal managers professional trainings aiming at strengthening transformational leadership and organizational justice.

MASCC-0255

Psychosocial adjustment, marital intimacy and family support of post-mastectomy patients

J. Jin 1, O.H. Cho2, Y.S. Yoo3

1Internal Medicine Bucheon St.Mary’s Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea, 2Department of Nursing, Hyechon University, Daejeon, Korea, 3Department of Nursing, The Catholic University of Korea, Seoul, Korea

Introduction: After mastectomy due to breast cancer patients experience lots of physical and psychosocial stress. Necessary factors should find out to support and reduce the psychosocial stress.

Objectives: This study was to explore the psychosocial adjustment, marital intimacy and family support of post-mastectomy patients

Methods: The subjects were 90 post-mastectomy patients (stage I or II) who were eligible and agreed to participate in the study. Subjects completed a survey including demographics, psychosocial adjustment scale by Lee (a 4-point Likert scale), marital intimacy scale by Kim (a 4-point Likert scale), and family support by Shim (a 5-point Likert scale). Data were analyzed using SAS (ver 9.0) program and frequency, mean (SD) t-test, ANOVA and Pearson correlation coefficients were used.

Results: The mean scores of the psychosocial adjustment and marital intimacy were 2.8 (±0.4) and 2.5 (±0.5). Also, the mean score of the family support was 3.6 (±0.7). Regarding the correlation between the psychosocial adjustment, marital intimacy and family support, there was a positive correlation.

Conclusions: These results showed that subjects who had higher marital intimacy and family support showed better in psychosocial adjustment. To improve psychosocial adjustment of post-mastectomy patients for breast cancer more effectively, there is an necessity to provide various strategic supports and intervention for effective communication with spouse and family.

References: Ginzburg K, Wrensch W, Rice T, Farren G, Spiegel D. Breast cancer and psychosocial factors: early stressful life event, social support, and well-being. Psychosomatics 2008;49:407–12.

MASCC-0256

Higher corticosteroid dose declines physical function, but does not affect psychosocial function among allogeneic hematopoietic stem-cell transplantation patients

S. Morishita 1, K. Kaida2, S. Yamauchi1, K. Sota1, S. Ishii2, K. Ikegame2, N. Kodama3, H. Ogawa2, K. Domen3

1Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan, 2Division of Haematology Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan, 3Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine, Nishinomiya, Japan

Introduction: We hypothesized that total corticosteroid dose is associated with muscle weakness in allo-HSCT patients

Objectives: The aim of this study was to investigate the effect of corticosteroid dose toward degree of physical and psychosocial function in allo-HSCT patients during the early period

Methods: The study included 113 patients who underwent allo-HSCT between July 2007 and April 2012. The evaluation was performed up to 3 weeks before and 6 weeks after transplantation. Physical function was evaluated using tests for hand-grip strength and knee-extensor strength, and the 6-min walk test (6MWT). Psychosocial function was measured using Hospital Anxiety and Depression Scale (HADS). Total corticosteroid dose was collected from medical records

Results: Significant decrease was observed in hand-grip strength, knee-extensor strength, and the 6-min walk test (6MWT) after transplantation (22 % in handgrip, 25 % knee-extensor strength and 15 % in 6MWT, P < 0.01). Total corticosteroid dose was correlated with decrease of hand-grip and knee-extensors strength (r = 0.3 ~ 0.4. P < 0.01) but was not correlated with 6MWT performance (r = 0.1. P > 0.05). There were no differences in anxiety and depression scale between transplantation times. The anxiety and depression scale was not different before and after HSCT both in patients with and without corticosteroid

Conclusions: This study showed the relationship between corticosteroid dose and declines in physical function among allo-HSCT patients. The results of this study suggest that muscle strengthening of allo-HSCT patients could be adjusted according to the corticosteroid dose administered to the patient.

MASCC-0257

Cell adhesion protein expression is altered during chemotherapy-induced mucositis: a histopathological study

N. Al-dasooqi 1, S. Masooma2, J. Bowen3, J. Finnie4, D. Keefe5, R. Gibson2

1Medicine, University of Adelaide, Adelaide, Australia, 2School of Medical Sciences, University of Adelaide, Adelaide, Australia, 3Discipline of Physiology, University of Adelaide, Adelaide, Australia, 4Pathology, Institute of Medical and Veterinary Science, Adelaide, Australia, 5Cancer centre, Royal Adelaide hospital, Adelaide, Australia

Introduction: Chemotherapy-induced mucositis is characterised by damage of mucous membranes throughout the AT. Extracellular matrix (ECM) components play a vital role in maintaining mucosal barrier integrity by regulating cellular apoptosis, proliferation and differentiation of overlying epithelium. However, tissue expression of adhesion molecules which mediate the activity of ECM during mucositis is not known.

Objectives: This study aims to investigate the expression of a number of adhesion molecules which are vital for ECM component signalling

Methods: Dark agouti rats were treated with irinotecan and killed at various timepoints after treatment. Picosirius red staining was used to illustrate expression of ECM components, and immunohistochemistry was used to assess integrins α1, integrin α4, E-selectin, P-selectin and E-Cadherin expression in these tissues

Results: Picosirius red staining indicated a substantial increase in collagen and other basement membrane components around crypts from 24 h in both regions and this diminished at the later time-points. Intergrin α1 and 4 significantly decreased early on after treatment and correlated with maximum apoptosis at 6 h. E-Cadherin expression peaked at 48 h in villi but decreased significantly in the crypt region in a delayed fashion. E-selectin was absent in crypts of untreated animals but increased at 24–72 h. P-selectin expression significantly increased in the submucosa at 24–48 h after irinotecan administration. These changes correlated with diarrhoea scores recorded

Conclusions: Irinotecan induced a significant alteration adhesion protein expression in both the jejunum and colon. These changes correlated with diarrhoea scores recorded. Changes in adhesion molecule expression may have a direct impact on the loss of mucosal layer integrity seen in mucositis.

MASCC-0258

MASCC score and prognostic factors in patients with febrile neutropenia in Colombia

J. Combariza 1, M. Lombana2, L. Pino2, K. Galvez1

1Hematology, Pablo Tobon Uribe Hospital, Medellin, Colombia, 2Hematology and Oncology, Nueva Granada University, Bogotá, Colombia

Introduction: There are no studies evaluating the utility of the MASCC score in colombian patients with febrile neutropenia

Objectives: To determine the prognostic value in overall survival at 30 days of MASCC score, clinical variables and CRP in patients with febrile neutropenia in a Colombian population

Methods: Retrospective prognostic cohort study of patients with febrile neutropenia in Pablo Tobon Uribe Hospital from Medellin, Colombia. It was determined using information from the medical records. Survival analysis was performed by Kaplan–Meier method. We used STATA 11.2 for statistical analysis

Results: We included 237 patients. Infection was documented in 59 % of cases, bacterial infection in 96.4 %, fungal infections in 2.9 % and 0.7 % for Tuberculosis. Gram negative infection occurred in 83 % of cases. MASCC score was significantly associated with serious outcomes such as the need for admission to ICU for severe infections (RR 3.55, 95 % CI 2.73–6.62 p < 0.00001) and death (RR 2.21, 95 % CI 1.74–2.79 p < 0.00001). Multivariate survival analysis demonstrated the strong association of MASCC score (HR 3.0 95 %CI 1.12–13.54; P = 0.032), and mean PCR >15 (Day 1 to 5) (HR 17 95 %CI 2.21–136.48; P = 0.007). Survival at 30 days was 100 % in patients with MASCC risk-low and mean CRP ≤ 15 mg/dL, but only 51 % in patients with high-risk MASCC score, mean CRP > 15 mg/dL and need ICU

figuree

Conclusions: The MASCC score is a useful tool for the prognostic stratification of patients with febrile neutropenia in a Colombian population. Using the mean PCR could help improve this prognostic stratification and should be confirmed in prospective studies.

MASCC-0259

Supportive care needs of patients with lung cancer: a longitudinal study

V. Lopez 1, D. Larkin2

1School of Medicine and Health Sciences, Australian National University, Canberra, Australia, 2Research Centre for Nursing and Midwifery, Canberra Hospital, Canberra, Australia

Introduction: The burden experienced by patients with lung cancer is well described in the literature. Research on needs of patients with cancer has identified high level of unmet needs depending on the cancer population. However, none has been done to assess lung cancer patients’ needs across four time points

Objectives: The aim of this study was to determine the support care needs of patients with lung cancer at four time points

Methods: Sixty consecutive patients with lung care were recruited from the oncology units in two states in Australia. The Supportive Care Needs Survey (SCNS) was used to collect patients’ perceived needs in five areas: Physical and daily living, psychological, health system and information, patients care and support and sexuality. Patients were asked to respond to the SCNS at baseline and after two, four six months

Results: The participants consisted of 52 % female and 48 % male lung cancer patients with a mean age of 64.34 years. Majority of them were married and living with their spouse. Fifty seven percent had NSCLC and 45 % were undergoing chemotherapy. Patients’ perceived supportive care needs was mostly related to psychological needs followed by health system and information needs. Sexuality needs were the least needed type of support. There were no significant differences in supportive care needs across the four time points

Conclusions: The study provides information that may be valuable in identifying areas where interventions could be implemented and evaluated to address the unmet needs of patients with lung cancer.

MASCC-0260

Diagnostic performance of C-Reactive Protein in patients with febrile neutropenia in Colombia

J. Combariza 1, M. Lombana2, L. Pino2, K. Galvez1

1Hematology, Pablo Tobon Uribe Hospital, Medellin, Colombia, 2Hematology and Oncology, Universidad Nueva Granada, Bogotá, Colombia

Introduction: There are no studies about the diagnostic value of CRP (C-Reactive Protein) in Colombian patients with febrile neutropenia

Objectives: To determine the diagnostic performance of PCR in patients with febrile neutropenia for determination of infections, bacteremia or severe infections.

Methods: Retrospective cohort type validation of diagnostic tests for patients with febrile neutropenia. It was determined using information from the medical records. The CRP was measured in all patients at the time of the episode of febrile neutropenia. The analysis of the diagnostic performance of PCR was performed using ROC curves. We used STATA 11.2 for statistical analysis.

Results: We included 237 episodes of febrile neutropenia at the Hospital Pablo Tobon Uribe in Medellin, Colombia. Infection was documented in 59 % and bacteremia in 34 % of episodes. The ROC curve for documented infection and bacteremia, showed that basal CRP was not useful as a diagnostic method. In multivariate analysis, severe neutropenia (<100/mm3) (RR 1.77, 95 % CI 1.00–3.14 P = 0.049) and the MASCC score (RR 1.87, 95 % CI 1.07–3.25 P = 0.026) were the only preditors of infection and bacteremia. For severe infections MASCC score (OR 30 95 %CI 11.33–83.75; P < 0.00001) and bacteremia (OR 3.44 95 %CI 1.55–7.64; P = 0.002) were the only significant predictors.

figuref

Conclusions: Baseline CRP is not useful as a diagnostic method in patients with hematologic diseases and febrile neutropenia in our population. The severity of neutropenia and the MASCC score were the only determinants significantly associated with documentation of infection or bacteremia

MASCC-0261

Clinicians’ awareness about CINV: risk factors, symptom experience and the goals of care

S. Rha1, J. Lee 2, I. Cho3, Y. Park2, S. Song4, C. Lee4

1College of Medicine, Yonsei University, Seoul, Korea, 2College of Nursing, Eulji University, Daejeon, Korea, 3College of Medicine, Eulji University, Daejeon, Korea, 4Yonsei Cancer Center, Severance Hospital, Seoul, Korea

Introduction: Corresponding clinicians’ understanding about symptom experience and the goals of care with that of patients’ would contribute improving symptom management

Objectives: To measure clinicians’ awareness about Chemotherapy-Induced Nausea and Vomiting (CINV), risk factors and the goals for symptom management.

Methods: A descriptive survey was conducted at two university hospitals including clinicians with at least 2 years of oncology care experience. The MAT items and lists of CINV risk factors were utilized to generate survey questions. Descriptive statistics and T-test were used to analyze the data.

Results: A total of 60 clinicians (MD: 47 % and RN: 53 %) with mean oncology care experience of 7 years. participated in the study. With moderately to highly emetogenic chemotherapy, clinicians estimated patients would vomit 1 ~ 2 times in acute phase, and 2 ~ 3 times during delayed phase. The mean intensity nausea of both phases was estimated as 6/10 after highly emetogenic chemotherapy, and 4/10 after moderately emetoegenic chemotherapy. Previous CINV experience was considered as the most contributing factor for symptom development. Clinicians aimed to control vomiting to occur once and the nausea intensity of 3/10. RNs estimated more delayed symptoms than MDs (p < .01), however, MDs’ goals for delayed symptom control were significantly tighter than that of RNs (p < .05).

Conclusions: This study provides detailed estimation about clinicians’ understanding about CINV experience, risk factors, and the goals of care. CINV are considered as significant symptom with room for further improvement. Further study is warranted to compare the findings of this study to the actual symptom experience of patients.

References

Keywords: Chemotherapy, Nausea, Vomiting

MASCC-0262

The influence of caregiving burden on health promoting behaviors and quality of life of family caregivers of cancer patients

J. Lee 1, S. Rha2, I. Cho3, K. Kim3, J. Hwang3, J. Jang3, Y. Park1

1College of Nursing, Eulji University, Daejeon, Korea, 2College of Medicine, Yonsei University, Seoul, Korea, 3College of Medicine, Eulji University, Daejeon, Korea

Introduction: Family caregivers’ role in cancer care are continued to expand with transition of care environment more towards home.

Objectives: To describe the influence of caregiving burden on health promoting behaviors and quality of life of family caregivers of cancer patients

Methods: A descriptive survey was conducted at two university hospitals including family caregivers of adult cancer patients. K-ZBI, questionnaires about health promoting behaviors, and Korean version of WHOQOL-BREF were used to collect data. Descriptive statistics, T-test and Pearson correlation were utilized to analyze data

Results: A total of 227 family caregivers of patients with various cancer diagnoses participated in the study. The caregivers were mostly middle aged (mean age = 46 year) and female (80.1 %) either spouse or children of patients. Caregivers with burden (K-ZBI score > 44) had become physical inactive and had experienced difficulty in keeping healthy diet (p < .01). Fatigue was the most troublesome symptom. With regards to cancer screening tests, 69.4 % received EGD, whereas 38.1 % received colonoscopy. Female caregivers reported high rate of receiving mammography (80 %) and PAP smear (71.6 %). Caregivers with less burden were having higher quality of life (p < .01).

Conclusions: Staying physically active and maintaining healthy diet were challenging subjects for caregivers of cancer patients. Fatigue would be the symptom of interest for caregiver intervention. Caregivers were attentive in receiving cancer screening tests except for colorectal cancer screening. More emphasis needs to be provided to identify caregivers with high caregiving burden to support them to engage in healthy life style and maintain quality life.

References

Keywords: Caregiver, Caregiving burden, Health promoting behavior, Quality of Life

MASCC-0263

Computer aided implant surgery in oncologic patients reconstructed with free-flaps. Two years follow-up results of a prospective clinical study

S.M. Meloni 1, G. De Riu1, M. Pisano1, A. Deledda1, A. Tullio1

1Surgical Microsurgical and Medicine, University of Sassari, Sassari, Italy

Introduction: Bone continuity defects following ablation for tumours, may generate a large series of problems. The osseous free-flap, has become the gold-standard for reconstructing these defects. Implant-supported prosthetic rehabilitation is enabled with this microvascular reconstructive option, although it still represents a major challenge.

Objectives: The aim of this prospective clinical study is to present the assets of implants restorations performed according to a modified computer-assisted surgical NobelGuide protocol in patients reconstructed with free-flaps.

Methods: Ten consecutive patients has been treated. Computer assisted, flapless dental implant placement was based on accurate prosthetic and aesthetic analysis. A total of 56 fixtures were installed Replace Tapered Groovy (Nobel Biocare).In order to assess the success of treatment were examined the following parameters: survival of implants; marginal bone-level changes; prosthetic complications; biological complications; implants abscesses; swelling implants mucosa; bleeding; soft tissue aspects (PPD, and BOP index) and patient satisfaction.

Results: All the cases have at least 24 months follow-up, 3 implants were lost (CSR 94.6 %). Every patient received a correct prosthetic rehabilitation with high degree of satisfaction when it comes function. Radiological examination showed a mean marginal bone loss of 1.12 mm ± 0.50 mm. All of the patients present healthy soft tissues with stable probing depth (PPD) and good bleeding on probing (BOP) values after 24 months, with values of their 4.85 ± 0.82 and on 13 % ± 5.2 %.

Conclusions: From these preliminary findings this approach seems valuable when it comes to function, improving prosthetic restorations and aesthetics in challenging patients.

MASCC-0264

Cervical canceruse of vaginal dilator

L. Sigaard 1, A.G. Andreasen1, K.B. Dieperink1, C.L. Madsen1, B. Soerensen1

1Department of Oncology, University Hospital Odense, Odense, Denmark

Introduction: Prevention of agglutination after radiotherapy for cervical cancer is required to maintain a normal functioning sexual life, which can be seen as an element in patient’s overall quality of life. Use of vaginal dilator after radiotherapy is recommended in most guidelines in Western countries. Reviews show that evidence and compliance in relation to use of the dilator are uncertain and imprecise.

Objectives: To identify the use of vaginal dilator in patients with cervical cancer who have been treated with external and internal radiotherapy.

Methods: Out of 60 invited patients with cervical cancer, 42 (70 %) accepted and completed a self-administered questionnaire.

Results: The average age was 50.9 years (range: 30–80) and 29 (69 %) were in permanent relationships. The average disease duration was 2.9 years (range: 1–6) and 13 (31 %) patients had furthermore undergone surgery. A total of 32 (76 %) patients reported that they had received a vaginal dilator; of these patients 17 (40 %) used the vaginal dilator in accordance with recommendations. Eighteen women (56 %) reported discomfort with dilator such as: pain, bleeding, reduced vaginal size and discomfort with the idea of ?? using it.

Conclusions: There was no correlation between use of dilator and age, marital status, surgery, abdominal problems and stage of disease. In this study less than half of the patients used the vaginal dilator despite recommendations. This is explained by physiological as well as psychological causes. Increased use of vaginal dilator requires special educational abilities in the clinical staff.

MASCC-0265

Cervical cancer—unpleasant vaginal smell—a neglected problem?

L. Sigaard 1, A.G. Andreasen1, K.B. Dieperink1, C.L. Madsen1, B. Soerensen1

1Department of Oncology, University Hospital Odense, Odense, Denmark

Introduction: Many side effects have been identified after radiotherapy of cervical cancer which have an impact on the overall quality of life. We find that there neither in literature nor in the clinic has been a major focus on unpleasant vaginal smell. And we wonder is it a neglected problem?

Objectives: To examine whether unpleasant vaginal smell is a problem compared to the more well-known long-term problems after external and internal radiotherapy.

Methods: Out of 60 invited patients with cervical cancer, 42 (70 %) accepted and completed a self-administered questionnaire.

Results: The average age was 50.9 years (range: 30–80). In all 29 (69 %) were in permanent relationships. The average disease duration was 2.9 years (range: 1–6) and 13 (31 %) patients had furthermore undergone surgery.

After treatment patients had the following problems:

Gastrointestinal (72 %),

Unpleasant smell from the vagina (56 %)

Urinary (53 %)

Mental health (41 %)

Pain (41 %)

Emotional (28 %)

Nausea (25 %)

Conclusions: The majority of patients suffered from unpleasant vaginal smell. Also in this study, patients had many gastrointestinal and urinary tract problems. It is relevant to examine how all these abdominal problems affect women’s experience of femininity, sexuality and quality of life. Unpleasant vaginal smell is a relevant topic in supportive care and for clinical development.

MASCC-0268

Risk factors for oral mucositis in patients after hematopoietic stem cell transplantation under intensive oral care

N. Yamada1, Y. Soga 2, K. Takahashi1, Y. Kawamura-Murayama1, H. Nishimoto1, Y. Sugiura3, E. Kondo4, Y. Maeda4

1Department of Nursing, Okayama University Hospital, Okayama, Japan, 2Division of Hospital Dentistry Central Clinical Department, Okayama University Hospital, Okayama, Japan, 3Division of Dental Hygienist Clinical Support Department, Okayama University Hospital, Okayama, Japan, 4Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan

Introduction: We reported previously that oral mucositis in hematopoietic stem cell transplantation (HCT) patients can be alleviated by intensive oral care starting prior to HCT and aimed at keeping the oral cavity clean and moist in the immediate post-transplant phase (Soga Y et al. Support Care Cancer 2010). We have been performing such oral management, while risk factors other than oral hygiene could be determined more clearly by investigating our patients.

Objectives: This study was performed to determine the risk factors for oral mucositis in patients HCT under intensive oral care.

Methods: A total of 209 consecutive patients (2006–2011) receiving HCT in our hospital were enrolled. All patients received intensive oral management as in our previous report, and oral mucositis was scored daily (CTCAE v3.0). Subjects were divided into two groups by peak score until 14 days after HCT: (A) without ulcer (grade 0–1); (B) with ulcer (grade 2–4). Statistical analysis were performed for the following factors between groups A and B: age, sex, donor type, intensity of conditioning regimen (conventional or reduced intensity), with/without total body irradiation, use of methotrexate, source of hematopoietic cells, renal dysfunction, and malnutrition.

Results: Intensity of conditioning regimen and use of methotrexate were significantly different between groups A and B (χ2 test, P < 0.05).

Conclusions: Conditioning regimen (conventional or reduced intensity) and use of methotrexate were revealed as risk factors of more severe oral mucositis in HCT. Patients with these factors should receive intensive care with prediction of severe oral mucositis.

MASCC-0269

Development of a pioneering holistic needs assessment (HNA) and care planning e-learning package for international nurses at www.hnaforcancer.com

N. Doyle 1, R. Henry1, M. Simpson1, B. Hartley1

1Living With and Beyond Cancer Forum, United Kingdom Oncology Nursing Society, London, United Kingdom

Introduction: A nurse-led project team initiated by the United Kingdom Oncology Nursing Society developed a blended e-learning website to facilitate nurses to further develop their confidence and competencies in a range of skills related to assessing holistic needs, thus enabling and empowering members to lead change at a local level.

Objectives: Development of a Holistic HNA and care planning e-learning package for nurses, via a web portal.

Methods: The project team identified three areas which were integral to an HNA implementation project. These were project support information, project management skills and practical competencies delivered in a blended e-learning package containing a series of accessible video presentations, supporting documents and practical activities. The team worked with internal and external partners to ensure that a robust and inspiring programme was created.

Results: http://www.hnaforcancer.com/ was launched in October 2012 as a blended learning programme that incorporates e-learning on core subjects. These are videoed presentations with supporting learning material accessed via the Members section of the UKONS website. Participants are additionally offered free UKONS membership for 1 year.

Conclusions

By the end of the programme the majority of participants reported improved skills in identifying and exploring holistic needs and initiating care to prevent or minimise the risk of complications. Participants had also developed their confidence and competency in new skills, including basic project management.

References: National Cancer Action Team (2011) Holistic Needs Assessment for people with cancer. A practical guide for healthcare professionals NCAT: London

MASCC-0270

Make a change, live well" events to capture the teachable moment for those living with and beyond cancer in an NHS Trust (UK)

N. Doyle 1, T. Wiseman1, B. Hartley1

1Living With And Beyond Cancer, The Royal Marsden NHS Foundation Trust, London, United Kingdom

Introduction: The Royal Marsden NHS Foundation Trust designed health and wellbeing events to raise awareness of the benefits of healthy living, and to support patients to make healthy lifestyle choices.

Objectives: Evidence suggests that adopting a healthy lifestyle helps patients to live well after treatment for cancer. We aimed to develop interactive events to benefit from the ‘teachable moment’ at the end of patients’ initial treatment for cancer.

Methods: The intervention comprised:

* an interactive event with short presentations from health care professionals

* a quiz using electronic voting pads, participants were encouraged to use a self-management tool to set personal goals for improving their lifestyle.

* an opportunity for the attendees to meet informally, talk to relevant health care professionals and visit information stands for further input

The event was evaluated by questionnaire at T1 (on the day) and T2 (3 months post-intervention)

Results: 95 % of respondents (n = 120) reported learning new information, 83 % found the day helpful and 85 % found the information stands helpful. Three month data suggests that 65 % of attendees have increased their exercise, and 40 % intend making further lifestyle changes.

Conclusions: The proposed service built on findings of the pilot National Cancer Survivorship Initiative Health and Well-being clinics by offering a different model with a focus on healthy living and lifestyle change

Results showed that this was a timely intervention to make use of a teachable moment. Further research will determine if change is sustained. Several more events are planned for the future.

MASCC-0271

Restore: an online intervention to enhance self-efficacy to self manage cancer related fatigue; an exploratory trial protocol

C. Grimmett 1, M. Breckons1, L. Calman1, L. Yardley1, A. Richardson1, P. Smith1, D. Fenlon1, J. Corner1, C. Foster1

1Faculty of Health Sciences, Macmillan Survivorship Reserch Group, Southampton, United Kingdom

Introduction: The majority of cancer survivors will experience some adverse effects as a result of their cancer and its treatment. Lack of information and support can make managing these problems challenging for survivors. Here we describe an exploratory trial protocol of the RESTORE online intervention to support self-management of cancer related fatigue

Objectives: The primary objective is to test the value (provide ‘proof of concept’) of an online intervention to increase self-efficacy to self manage problems related to cancer related fatigue. Secondary aims include impact on the perception and experience of fatigue, and quality of life

Methods: A two-armed randomised controlled trial (RCT) will compare the RESTORE intervention with the Macmillan Cancer Backup ‘Coping with Fatigue’ leaflet. The intervention includes five weekly sessions with components and activities informed by self-efficacy theory. The study population consists of cancer survivors within 5 years of completion of treatment with curative intent (target sample size N = 125). An initial pilot phase determined feasibility and acceptability of proposed recruitment

Methods: Outcome measures will be collected at baseline, 6 weeks (completion of intervention) and 3 months. Process evaluation (including telephone interviews) will also be conducted. This will explore participant’s experiences of using RESTORE, and clinician’s experience of recruitment and attitudes towards the online intervention

Results: Expected early 2014

Conclusions: Data from this trial will be used to refine the intervention and conduct a full-scale RCT. We hope to roll out the intervention in clinical practice and expand it to address other cancer related problems important to survivors following primary cancer treatment.

MASCC-0272

Relaxation with guided imagery improves health-related quality of life of cancer patients during chemotherapy: a quasi-experimental study

A.C.N. Adriana Cristina Nicolussi 1, N.O.S. Namie Okino sawada1, J.L.F.S. Jair Licio Ferreira Santos2, F.M.C. Fernanda Mara Coelho3, V.A. Viviane Andrade3, J.M.P. Juliana Maria de Paula3

1General of specialized, College of Nursing at ribeirão Preto at University of São Paulo, Ribeirão Preto São Paulo, Brazil, 2Medicina Social, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto São Paulo, Brazil, 3General and specialized, College of nursing at Ribeirão Preto, Ribeirão Preto São Paulo, Brazil

Introduction: The cancer diagnosis and its treatment has reduced the Health-Related Quality of Life (HRQoL) of survivors. Complementary and Alternative Therapies has been used by cancer patients to reduce symptoms and other side effects of treatment.

Objectives: To evaluate the effects of Relaxation with Guided Imagery (RGI) on HRQoL in cancer patients during chemotherapy.

Methods: A quasi-experimental study conducted in two chemotherapy centers, at Ribeirão Preto-SP, Brazil. The Quality of Life Questionnaire-Core30 was used.

Results: The sample was composed mostly of women, between 40 and 59 years. The most common cancers were breast, bowel and gastric. At one time, both groups (control and intervention) showed most common symptoms: pain, fatigue, insomnia and loss of appetite. During the study, the comparison between groups, statistically significant differences were found in Time 1 with control group showing better scores for global Quality of Life, social functioning, and nausea and vomiting. In Time 2, the differences were significant for physical functioning and Time 3 to physical, emotional, and role functioning, fatigue, and nausea and vomiting, with better scores for intervention group. Comparing the times, the control group had impairment in physical, emotional and social functioning, nausea and vomiting, and constipation, while the intervention group showed improvement in emotional functioning.

Conclusions: The results showed that RGI was effective for improving HRQoL in various functions and symptoms. This technique is simple, low-cost, safe and beneficial. This intervention provides improvement in HRQoL in adult cancer patients undergoing chemotherapy.

MASCC-0273

Depression in cancer patients who underwent chemotherapy

N. Sawada 1, F.M.C.C. FERNANDA MARA COELHO CARDOZO1, A.C.N. ADRIANA CRISTINA NICOLUSSI1, J.L.F.S. JAIR LICIO FERREIRA SANTOS2, V.A. VIVIANE ANDRADE2, J.M.P. JULIANA MARIA DE PAULA2

1General of Specialized, College of Nursing at Ribeirão Preto at University of São Paulo, Ribeirão Preto São Paulo, Brazil, 2Medicina Social, Faculdde De Medicina De Ribeirão Preto, Ribeirão Preto São Paulo, Brazil

Introduction: Depression has been widely investigated in cancer patients. It is identified as an important manifestation and often resulting from imbalance of physical and psychological aspects of patients.

Objectives: To characterize the sample and to evaluate the frequency and degree of depression in cancer patients in three different moments of the chemotherapy treatment.

Methods: Quantitative, prospective descriptive study conducted in two chemotherapy centers, at Ribeirão Preto-SP, Brazil, from June 2009 to January 2010. The Beck Depression Inventory was used to assess the degree of depression in an initial sample of 40 patients and late 34.

Results: Regarding socio-demographic and clinical, there was homogenous with respect to sex, a predominance of patients over 40 years, married, Catholic and elementary education level. Regarding the diagnosis, there was a predominance of gastrointestinal cancer in men and breast cancer in women. An increased depression frequency of 10.15 % in the patients from the first to the third moment was observed. It was observed that the frequency of depression increased at all times. At first, 7.5 % of patients had depression, the second time, this rate increased to 16.7 %, and the third time was 17.6 % of the sample with depression

Conclusions: The results showed a gradual increase of depression in cancer patients during chemotherapy. It is important that the nurse can assess and identify these symptoms, which may occur during treatment to compose strategies/interventions to minimize them and provide a better quality of life for these patients.

MASCC-0275

(-)-Epigallocatechin-3-gallate inhibits the growth of HPV positive cervical cancer hela cell line and downregulates the expression of HPV E6 and E7

S. Hussain 1, P.R.O.F. Mohammed M Safhi1, P.R.O.F. Fakhrul Islam1

1Biochemistry, Jazan University, Jazan, Saudi Arabia

Introduction: To elucidate the antiproliferative effects of Epigallocatechin-3-gallate (EGCG), a green tea polyphenol, in the HPV 18 positive human cervical cancer HeLa cell line.

Objectives: The purpose of this study was to examine the effect of EGCG on HPV 18 positive HeLa cervical cancer cell line and also to investigate whether it can modulate HPV viral oncogene E6 and E7 expression

Methods: The viability of the cells was assessed by MTT and Trypan blue dye exclusion method. Cell cycle analysis and apoptosis by FITC-Annexin V were measured by flow cytometry. Protein expression was detected by Western blotting. Morphological changes were observed by phase contrast microscope.

Results: EGCG strongly decreased HeLa cell line proliferation in a dose- and time-dependent manner. Microscopic examination and flow cytometry assay showed that EGCG causes reduction in cell number by its antiproliferative property. Furthermore, western blot assay of EGCG treated HeLa cell lines showed activation of caspase-3, caspase-9, cleavage of PARP, increased Bax and decreased Bcl-2 expression, decreased expression of E6 and E7 oncoproteins and increased expression of p53 and pRB proteins.

Conclusions: EGCG strongly inhibited the growth of HPV positive cervical cancer cells and induce apoptosis.

MASCC-0277

Complementary therapy promotes physical relaxation in cancer patients during chemotherapy

A.C.N. Nicolussi 1, N.O.S. Sawada2, J.L.F.S. Santos3, V.A. Andrade4, J.M.P. Paula4

1General and Specialized, College of nursing ata Ribierão Preto at University of são Paulo, Ribierão Preto, Brazil, 2General and Specialized, College of nursing ata Ribeirão Preto at University of são Paulo, Ribierão Preto, Brazil, 3Medicina social, Faculdde de Medicina de Ribeirão Preto, Ribeirão Preto, Brazil, 4General and Specialized, College of nursing at ribeirão Preto at University of São Paulo, Ribeirão Preto, Brazil

Introduction: Complementary and Alternative Therapies has been used by cancer patients to reduce disease symptoms and treatment side effects.

Objectives: To identify changes in physiological parameters: Blood Pressure (BP), Heart Rate (HR), Respiratory Rate (FR) occurred before and after the complementary therapy of relaxation with guided imagery in adult cancer patients during chemotherapy, evaluated at the beginning—first day of chemotherapy (Time 1—baseline) and after 6 months follow-up (Time 2).

Methods: A quasi-experimental study conducted in two chemotherapy centers, at Ribeirão Preto-SP, Brazil, from May 2009 to December 2011. Patients underwent complementary therapy: relaxation with guided imagery, driven by a CD recording, lasting about 15 min each session.

Results: Seventy-three patients participated in the survey. The most common cancers were breast, bowel and gynecological. We used the paired t-test to assess the difference between before and after relaxation with guided imagery at times T1 and T2. Statistically significant differences were found with p?? < 0.001 for Systolic Blood Pressure, Diastolic Blood Pressure and Heart Rate at times 1 and 2 and statistically significant with p < 0.05 for Respiratory Rate (p = 0.033) at time 1.

Conclusions: Changes in physiological parameters studied (BP, HR and RR) showed that intervention relaxation with guided imagery provided to these patients a physiological relaxation, whereas these parameters decreased after the intervention, and this reduction was statistically significant, implying that complementary therapy promoted an effective physical relaxation.

MASCC-0278

Presence of fatigue in cancer patients undergoing chemotherapy

N. Sawada 1, F.M.C.C. Cardozo1, A.C.N. Nicolussi1, J.L.F.S. Santos2, V.A. Andrade1, J.M.P. Paula1

1General of specialized, College of Nursing at ribeirão Preto at University of São Paulo, Ribeirão Preto São Paulo, Brazil, 2Medicina Social, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto São Paulo, Brazil

Introduction: Patients with cancer undergoing chemotherapy have negative feelings and symptoms related to the disease and treatment that can affect their quality of life, and among the most common symptoms is fatigue.

Objectives: To evaluate the frequency and degree of fatigue in cancer patients in three different moments of the chemotherapy treatment.

Methods: Quantitative, prospective descriptive study conducted in two chemotherapy centers, at Ribeirão Preto-SP, Brazil, from June 2009 to January 2010. The Piper Fatigue Scale-reviewed was used to assess fatigue in an initial sample of 40 patients and late 34.

Results: The sample was homogeneous regarding sex. There was a predominance of gastrointestinal cancer in men and breast cancer in women. At first, 5 % of patients had fatigue, the second time, this rate increased to 38.9 %, and the third time was 64.7 % of the sample with fatigue. These results showed an increase of fatigue in 59.7 % of patients from the first to the third moment.

Conclusions: The results showed a gradual increase of fatigue in cancer patients during chemotherapy. It is important that the nurse can assess and identify these symptoms, which may occur during treatment to compose interventions to minimize them and provide a better quality of life for these patients.

MASCC-0279

Interventions for managing cancer-related fatigue in men treated for prostate cancer: a systematic review

D. Larkin 1, V. Lopez1, E. Aromataris2

1Research Centre for Nursing and Midwifery Practice, ACT Government Health Directorate, Woden, Australia, 2Joanna Briggs Institute, University of Adelaide, Adelaide, Australia

Introduction: Cancer-related fatigue is the most frequently reported long-term side effect of treatment for prostate cancer. To provide quality supportive care for men treated for prostate cancer, it is important for nurses to understand effective non-pharmacological interventions for treating cancer related fatigue. To assess the effectiveness of non-pharmacological interventions for managing cancer-related fatigue in men treated for prostate cancer.

Methods: Multiple databases and trial registries were searched to locate eligible studies. Only experimental studies, primarily randomised controlled trials, were included. Standardised instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) were used to assess studies for methodological validity and data extraction. As statistical pooling was not possible, the findings were presented in narrative form.

Results: Of the 1,480 citations identified by searching, 15 matched the eligibility criteria of the review. Seven were excluded following critical appraisal. Of the eight included studies, five evaluated physical activity (aerobic and resistance exercise) in 447 participants and three psychosocial interventions (cognitive behavioural therapy or education interventions) in 153 participants. Exercise as an intervention to reduce fatigue has the strongest evidence for improving fatigue and the expected benefits exceed the expected harms. Psychosocial interventions such as education and cognitive behavioural therapy also were beneficial in reducing fatigue.

Conclusions: Whilst physical activity appears to show the greatest benefit, other non-pharmacological interventions such as education and cognitive behavioural therapy have demonstrated effectiveness and should also be considered as a strategy for reducing cancer-related fatigue in men treated for prostate cancer.

MASCC-0280

Review of morphine prescribing practice at the Oncology Directorate, Komfo Anokye Teaching Hospital, Ghana

K. Mensah 1

1Onocolgy Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana

Introduction: There are few opioids available in Ghana, e.g. morphine, pethidine, etc. Fentanyl patches, oxycodone, etc. are not affordable in Ghana. Morphine is the only strong opioid paid for by the National Health Insurance, hence making it easily available for patients with or without health insurance. Morphine mixture is cost-effective. Morphine as oral and parenteral preparation is the only option left to treat severe cancer pain in our clinical setting. Despite doctors prescribing oral morphine at the directorate, many cancer patients with severe cancer pain do not achieve adequate pain relief.

Objectives: This review was done to assess oral morphine prescribing pattern at the Directorate of Oncology, Komfo Anokye Teaching Hospital

Methods: A review of morphine prescription of 566 new patients folder were analysed against an established standard guideline which was modified to suit local population

Results: 7 % of patients were prescribed morphine. Several deficiencies in morphine prescribing were identified. These include prescribing morphine at 8 hourly intervals, absence of review after prescribing morphine, lack of double dosing at night, omission of breakthrough doses. Location of pain was often not indicated in the patient’s hospital folder

Conclusions: Although much is know about morphine, there is inappropriate prescribing of morphine which leads to uncontrolled cancer pain. Education and implementation of local guideline will improve the use of morphine in cancer pain management. Review of the guideline must also be carried out from time to time to determine whether such guideline has improved morphine prescription pattern.

MASCC-0281

Effects of telephone follow-up consultations on discharged patients with liver cancer following non-surgical treatment

S.N. Chang 1, S.C. Shun1, Y.H. Lai1, C.H. Chen2, J.C. Sheu2

1Nursing, National Taiwan University College of Medicine, Taipei City, Taiwan, 2Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei city, Taiwan

Introduction: Due to the average of 3 to 4 days’ hospitalization, patient with liver cancer after receiving treatments still experience some levels of physical and psychological distress when they are discharged in Taiwan

Objectives: The aim of this study was to explore effects of a telephone follow-up education program on aftercare of receiving non-surgical treatments in liver cancer patients.

Methods: A randomized clinical trial study was conducted to recruit patients receiving non-surgical treatment in oncology wards at medical center in Taiwan. The control group (n = 58) received unstructured usual care by case manager and the experimental group (n = 37) received 7 times of telephone follow-up education before discharge, and at 1, 2, 3, 4, 6 and 8 weeks after discharge by a well-trained research assistant. The education included 7 issues to deal with their physical and psychological distress. The outcome of symptom distress, fatigue, anxiety, depression, self-efficacy of cancer behavior and quality of life were assessed by a set of questionnaire on the day before discharge, at 8 and 12 weeks after discharge. Data was analyzed by generalized estimating equations

Results: The level of symptom distress, fatigue, anxiety and depression in both groups decreased and the self-efficacy of cancer behavior and QOL improved monthly. However, there were no significant differences in the outcome in two groups

Conclusions: The usual care and telephone follow-up education program had the similar effect in this study. The effect of telephone education program might not be effective for liver cancer patients in Taiwan.

MASCC-0282

The psycho-spiritual empowerment process for the terminal hepatocellular carcinoma patient

Y. Chen 1

1Nursing, Changhua Christian Hospital, Changhua County, Taiwan

Introduction: Hepatocellular carcinoma is the leading cancer for male in Taiwan. Patients in terminal cancer not only experience physical discomfort, but also psychological-spiritual distress. It is noteworthy that the psychosocial and spiritual needs of patients with terminal cancer patients often are neglected by families and healthcare providers in Taiwan. However, psychosocial and spiritual well-being for patient at the end of life is urgently important,

Objectives: The objectives of the study is to explore experiences and the psycho-spiritual empowering process of the end-stage hepatocellular carcinoma patient.

Methods: The author presented a case report of a middle-aged cancer near the end of life who experienced the psychosocial and spiritual distress.

Results: Psychosocial and spiritual distress in the middle-aged hepatocellular carcinoma patient included come to loss control and powerlessness resulted from the rapidity of disease progressional; disrupted family relationships resulted from loss the main source of income and burdens on families; loneliness and worthlessness resulted from the caducity of life. The author used empowering process to encourage the patient emotional expression, strengthen families’ relational connectedness, reconstruct belongingness, fine the meaning of life, and ultimately personal strengthen and self-empowerment.

Conclusions: By sharing the experience of care, it provided important information that healthecare professionals must be strongly sensitive to psychosical and spiritual needs. In addition to ongoing psychological, social and spiritual support, meaning-making process in terminal stage is the central part of palliative care. It’s expected to the best quality of life and psycho-social-spiritual well-being will be reached.

MASCC-0283

How to decrease lens dose in patients with brain metastasis who underwent palliative whole brain radiotherapy?

G. Yavas 1, C. Yavas2, O.V. Gul1, H. Acar1, O. Ata3

1Radiation Oncology, Selcuk University, Konya, Turkey, 2Radiation Oncology, Konya Training and Research Hospital, Konya, Turkey, 3Medical Oncology, Selcuk University, Konya, Turkey

Introduction: Palliative whole brain radiotherapy (WBRT) has been the standard treatment for brain metastases.

Objectives: We aimed to evaluate the lens, optic nerve and eye doses with two different radiotherapy techniques in patients with brain metastasis who undergone WBRT

Methods: Ten patients with brain metastasis were included. For each patient, two different treatment plans were created for whole brain. Helmet-field (HF) (anterior border was 2 cm posterior to lens, inferior border was the bottom of C2 vertebra) and classical technique with collimation (CT) (anterior border was defined as skin fall of, inferior border was the bottom of cranial base) were generated for all patients. Two techniques were compared with respect to the lens doses, the dose homogeneity index (DHI), and the monitor unit counts (MU) required for the treatment. Student-t test was used for statistical analysis

Results: There was no difference between two techniques in terms of both DHI (p: 0.182) and MU counts (p: 0,167). The maximum and mean doses received by the right lens, left lens and right eye were significantly reduced with CT (p values for maximum doses 0,007, 0,012 and 0,010; for median doses 0,027, 0,046 and 0,002 respectively). CT with collimation was found to be more advantageous, with respect to the lens doses in addition the dose received by the right eye during WBRT.

References: Kocer I, Taysi S, Ertekin MV. et al. The effect of L-carnitine in the prevention of ionizing radiation-induced cataracts: a rat model. Graefe’s Arch Clin Exp Ophthalmol 2007; 245:588–594.

MASCC-0284

Comparison of two different radiotherapy techniques in stomach cancer patients who underwent concomitant chemoradiotherapy

G. Yavas 1, C. Yavas2, G. Cobanoglu1, O.V. Gul1, H. Acar1, O. Ata3

1Radiation Oncology, Selcuk University, Konya, Turkey, 2Radiation Oncology, Konya Training and Research Hospital, Konya, Turkey, 3Medical Oncology, Selcuk University, Konya, Turkey

Introduction: Postoperative chemoradiotherapy has been the standard treatment for patients with stomach cancer.

Objectives: To compare two different radiotherapy techniques

Methods: Ten stomach cancer patients who underwent total gastrectomy and lymph node dissection were included. Two different treatment plans were created for the tumor bed and regional lymph nodes. Three-field and 4 F plans were compared for the doses in the planning target volume (PTV), the organ at risk (OAR) volumes (including kidneys, liver, spleen and spinal cord), the dose homogeneity index (DHI), and the monitor unit counts (MU) required for the treatment. Student-t test was used for statistical analysis

Results: There was no difference between two techniques in terms of DHI (p: 0.576). The mean dose received by the liver was significantly reduced with 3F technique (p < 0.001); whereas the mean doses of the kidneys, spleen and spinal cord were decreased with 4F technique (p values were 0.007, 0.021 and <0.001 respectively) (Table 1). The dose to %10, %30, %40 and %50 of the total liver volume were significantly reduced with 3F technique (p values were 0.026, 0.009, 0.001 and <0.001 respectively). The MU counts required for the treatment was significantly lower with 4F technique (p < 0.001)

Conclusions: Four-field technique was found to be more advantageous than the 3 F technique, with respect to the OAR, other than the liver, and monitor units required for treatment in patients with stomach cancer without any known liver disease.

References: Buergy D, Lohr F, Baack T et al. Radiotherapy for tumors of the stomach and gastroesophageal junction. Radiat Oncol. 2012 Nov 16;7:192.

MASCC-0285

The impact of dose calculation algorithms for peripheral dose distributions of enhanced dynamic and physical wedges

H. Acar1, G. Yavas 1, C. Yavas2

1Radiation Oncology, Selcuk University, Konya, Turkey, 2Radiation Oncology, Konya Training and Research Hospital, Konya, Turkey

Introduction: The peripheral dose is important when anatomical structures with very low dose tolerances are involved.

Objectives: In this study, the two available calculation algorithms of the Varian Eclipse 8.6 treatment planning system(TPS), the anisotropic analytic algorithm(AAA) and pencil-beam convolution(PBC) was used to compare measured and calculated peripheral dose distribution of physical wedged(PW) and enhanced dynamic wedged fields(EDW)

Methods: Peripheral dose measurements were carried out for 6 and 18 MV photons using a 0.6 cc Farmer-type ionization chamber in the slab phantom. Measurements were performed using 15°, 30°, 45° and 60° PW and EDW for three different field sizes at dmax and up to a maximum distance of 50 cm beyond the field edges. Peripheral dose was further computed using two different algorithms of a TPS. The measured and calculated datas were then compared to find which algorithm calculates peripheral dose distribution more accurately

Results: Both algorithms from the TPS adequately model the peripheral dose distribution up to 45°. For large field sizes with 60° EDW, the largest deviation between calculated and measured dose distribution is less than 3.5 % using the AAA, but can increase up to 9.7 % of the distribution using PBC.

Conclusions: The AAA models wedged peripheral dose distributions more accurately than the PBC does for all studied conditions; the differences between the algorithms are more significant for large wedge angles and large field sizes. It must be emphasized that the use of PBC for planning large-field treatments with 60° EDW could lead to inaccuracies of clinical significance.

MASCC-0286

Evaluation of doses in the Wernicke and Broca’s areas using two different radiotherapy techniques in patients with right frontal glioblastoma multiforme

G. Yavas 1, C. Yavas2, H. Acar1

1Radiation Oncology, Selcuk University, Konya, Turkey, 2Radiation Oncology, Konya Training and Research Hospital, Konya, Turkey

Introduction: Broca’s and Wernicke’s areas, which are important language areas of the brain, are commonly irradiated in patients with right frontal lobe glioblastoma multiforme (GBM).

Objectives: We aimed to evaluate the doses in the Broca’s and Wernicke’s areas using parallel opposed two field and three field technique in patients with right frontal GBM.

Methods: Two different treatment planning techniques of right-frontal GBM were generated for Rando phantom: two field technique using parallel opposed field and three field technique (two field parallel opposed and a vertex field). Both plans were compared for doses in planning target volume (PTV), Broca’s and Wernicke’s areas. Additionally to test the accuracy of treatment planning system (TPS) dose calculation; thermoluminescent dosimeters (TLD) were used to measure PTV and organs at risk (OAR) doses

Results: The three field technique allowed the lower doses in the Broca’s and Wernickes’s areas when compared to two field technique. The doses calculated in the Broca’s area and Wernicke’s area were 0.98 % ± 0.03 and 0.09 % ± 0.06 of the isocenter dose with three field and 1.06 % ± 0.04 and 0.133 % ± 0.03 of the isocenter dose with two field techniques respectively. When the doses measured by TLD and calculated with TPS were compared; for Broca’s area, TLD measured dose was compatible with TPS calculated dose were 3.23 % and 2.92 % for two field and three field techniques respectively. In the same manner for Wernicke’s area, they were 4.12 % and 3.95 %

Conclusions: Three field technique seems to be more advantageous than two field technique in terms of doses of Broca’s and Wernicke’s areas three field technique is superior to two field technique.

MASCC-0287

Management of anemia and iron deficiency in a cancer center in France

F. Lai Tiong 1, C. Brami1, N. Jovenin1, P. Soibinet1, C. Crespel1, O. Dubroeucq1, H. Curé1

1DOM, Institut Jean Godinot, Reims, France

Introduction: About 75 % of cancer patient treated by chemotherapy suffer at least once from severe or moderate anemia. Even if cancer-related anemia is multifactorial, anemia of chronic disease due to the inflammatory status of cancer disease reduced iron level and its absorption required for utilization of erythropoietin.

Objectives: Description of management of anemia in an oncology day unit in 2012 to improve our practices

Methods: Prospective analytic study between May to November 2012 in an oncology day unit at “Institut Jean Godinot Cancer Center” in Reims, France. All patients included suffered from moderate or severe anemia (OMS) and they were at least treated by che