Segui questo link per vedere altri tipi di pubblicazioni sul tema: Oncology.
Tesi sul tema "Oncology"
Cita una fonte nei formati APA, MLA, Chicago, Harvard e in molti altri stili
Vedi i top-50 saggi (tesi di laurea o di dottorato) per l'attività di ricerca sul tema "Oncology".
Accanto a ogni fonte nell'elenco di riferimenti c'è un pulsante "Aggiungi alla bibliografia". Premilo e genereremo automaticamente la citazione bibliografica dell'opera scelta nello stile citazionale di cui hai bisogno: APA, MLA, Harvard, Chicago, Vancouver ecc.
Puoi anche scaricare il testo completo della pubblicazione scientifica nel formato .pdf e leggere online l'abstract (il sommario) dell'opera se è presente nei metadati.
Vedi le tesi di molte aree scientifiche e compila una bibliografia corretta.
1
Breit, Elyse. "Education for Pediatric Oncology Nurses on Fertility Preservation of Pediatric Oncology Patients". Honors in the Major Thesis, University of Central Florida, 2014. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1578.
Testo completoAbstract (sommario):
Although the survival rate of childhood cancer is high, nearly two thirds of these survivors experience negative long-term secondary side effects from cancer treatments. Infertility is one such side effect that can have a prominent impact on quality of life as the patient ages. It is important for nurses working with pediatric oncology patients to provide the patient and family with education about risk for infertility and fertility preservation (FP) in order to allow families to make decisions about FP before cancer treatment starts. However, pediatric
oncology nurses report being uneducated about FP guidelines and are hesitant to broach this subject with families. The purpose of this HIM thesis is to review nurse perceived barriers
related to educating patients and their families about the risk for infertility following cancer treatments and FP and to make recommendations for improving communication between nurses and families about FP. A search was performed using CINAHL, PreCINAHL, PsychINFO, PsychARTICLES, and Medline databases and examined peer-reviewed quantitative and
qualitative research studies. Key terms used in the database searches were ped' OR child', onco' OR cancer', fert', and nurs'. Findings indicated that there were many barriers for
pediatric oncology nurses, which inhibited the discussion of FP with patients and families such as lack of knowledge and resources, provider attitudes toward FP, and patient factors. Based on the findings, the researcher identified several interventions to aid pediatric oncology nurses in overcoming these barriers to FP discussion.B.S.N.
Bachelors
Nursing
Nursing
2
Gananadha, Sivakumar St George UNSW. "Radiofrequency ablation in oncology". Awarded by:University of New South Wales. St George, 2006. http://handle.unsw.edu.au/1959.4/24347.
Testo completoAbstract (sommario):
Radiofrequency ablation (RFA) is an established treatment option for patients with inoperable liver tumours and is now being investigated for the treatment of lung and other solid tumours. The aim of this thesis was to investigate the use RFA to decrease blood loss during liver resection, for the treatment of the liver resection edge and to investigate the safety and efficacy of brain RFA. Blood loss is an important factor affecting both the morbidity and mortality following liver resection. The use of a novel in line RF probe to ablate the transection plane prior to liver resection resulted in decreased blood loss with easier resection. This has potential in the treatment of liver tumors in cirrhotic livers and also in other vascular organs. The other important prognostic factor affecting long-term survival in patients undergoing liver resection for liver tumors is the surgical margins. Positive margins which cannot be treated with repeat resection may be treated with cryotherapy. The use of a novel probe to ablate the resection edge with RFA was found to be equally effective as cryotherapy and superior to argon beam coagulation or diathermy in an ex-vivo model. The radiofrequency ablation of the brain was found to be safe with no hemorrhage or damage to the surrounding brain parenchyma. There was no rise in intra-cranial pressure in the animals treated with RFA. The brain RFA was found to be effective and has potential for the treatment of brain tumours. Dispersive pad site burns was a significant problem in patients treated with radiofrequency ablation for lung and liver tumours occurring in 5% of patients. Pad tissue temperature of 45oC was found to be the threshold temperature above which burns occurred. Monitoring of pad-tissue temperatures with thermocouples and application of ice packs in addition to increasing the number of pads may help decrease this complication.
3
Blackwelder, Reid B. "Integrative Approaches to Oncology". Digital Commons @ East Tennessee State University, 2006. https://dc.etsu.edu/etsu-works/6986.
Testo completo
4
Wiebe, Leonard Irving. "Radiopharmaceuticals for diagnostic oncology". Thesis, The University of Sydney, 2001. https://hdl.handle.net/2123/28451.
Testo completoAbstract (sommario):
Medicinal Chemistry and the Radiopharmaceutical Sciences
The radiopharmaceutical sciences are founded in Medicinal Chemistry and
applied in Nuclear Medicine. The radiopharmaceutical sciences include a large
component of drug design and development, and encompass the physics and chemistry of
radionuclide production using nuclear reactors and charged particle accelerators (c.g.
cyclotrons), as well as the synthesis and radiolabelling of precursor molecules, radiation
dosimetry, biological testing, pharmacokinetic and kinetic modeling, and the
administration of diagnostic and therapeutic doses of radiopharmaceuticals to patients.
Radiopharmacy, as it pertains more narrowly to the practice of pharmacy, is a subdiscipline
of medicinal and pharmaceutical chemistry in many Schools of Pharmacy. In
several countries, radiopharmacy (or nuclear pharmacy) practice is recognized as a
professional sub-specialty in Pharmacy, and is governed by state regulatory authority.
Radiopharmaceutical research and radiopharmacy practice are also found within
academic departments in chemistry and physics, and are practiced in nuclear medicine
departments of major hospitals, worldwide. My research has evolved from medicinal
chemistry, with a focus on the design, synthesis, radiolabelling, and biological and
clinical evaluation of novel compounds that are of medicinal interest.
Personal Contributions to the Submitted Publications
Radiopharmaceutical chemistry and the development of radiopharmaceuticals is
the pervading theme of the research publications arising from my research activities. The
publications presented in this submission are based on research conducted primarily at
the Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, and the
Cross Cancer Institute (Edmonton). Research collaborations have included scientists
from the Deutsches Krebsforschungszentrum (Heidelberg), the Tuebingen Universitaet
PET Center (Tuebingen), the Daniel den Hoed Cancer Hospital (Rotterdam), the Rega
Institute (Leuven), Ansto (Sydney), the University College of London Medical School
(London) and the Peter MacCallum Cancer Institute (Melbourne). Publications
submitted date from 1970 through 2000. The early publications (to the late 1970's)
reflect research that I have either conducted or assisted in personally at the research
bench. The majority of the remaining papers reflect my research leadership in terms of
concepts, experimental design and execution, and manuscript preparation. It is my
practice to actively participate in all publications that I co-author, and in general, to place
the names of junior scientists (e.g. graduate students) ahead of senior co-authors. In no
case am I a co—author because of administrative positions I have held (e.g. Division head;
Director). The senior collaborators who have influenced the scientific evolution of my
work are named in the following paragraphs. Junior scientists (e.g. graduate students,
post-doctoral fellows, research associates) have made important contributions, especially
at the research bench.
The manuscripts are grouped into three main categories, which are introduced in
the following paragraphs. Published abstracts, and international patents on hypoxia
imaging, gene therapy imaging, and drug delivery based on cyclodextrins, are not
included in this material.
5
Camacho, Castillo Luz del Carmen. "Acid ceramidase and sphingosine-1-phosphate lyase as biomarkers and therapeutic targets in cancer. (Ceramidasa ácida y Esfingosina-1-fosfato Liasa como biomarcadores y dianas terapéuticas en cáncer)". Doctoral thesis, Universitat de Barcelona, 2011. http://hdl.handle.net/10803/21624.
Testo completoAbstract (sommario):
Cer and So are involved in regulation of apoptosis and cell cycle arrest while on the other hand S1P promotes cell growth and inhibits apoptosis. The antagonistic effects of these metabolites are regulated by enzymes that interconvert Cer, So, and S1P. In this work two of these enzymes were studied: sphingosine phosphate lyase and acid ceramidase. First several methods to determine the activity of these enzymes were developed and optimized, resulting in the publication of sensitive fluorogenic and chromatographic methods for enzyme activity.
Particularly the assay optimized for acid ceramidase activity was used in the finding and identification of new inhibitors in several compound libraries. As a result compounds RBM2-1B, RBM2-1D and RBM2-1E were identified as acid ceramidase and dihydroceramide desaturase inhibitors. Furthermore compounds RBM1-12, RBM1-13 and SABRAC were also described as acid ceramidase inhibitors. Since several publications described the upregulation of acid ceramidase in advanced prostate cancer, we decided to investigate the particular effect of the acid ceramidase inhibition in a cellular model of advanced prostate cancer. Using cells PC-3/Mc we inhibited acid ceramidase through two different approaches: first silencing the gen ASAH1 and comparing the effects with chemical inhibition of the enzyme using compounds RBM1-12, RBM1-13 and SABRAC.
We evaluate the effect of acid ceramidase inhibition in cell growth, invasivity and 3D growth in vitro, finding a diminished growth and 3D growth in both cells those knockdown for ASAH1 and treated with inhibitors. Finally, the effect of ASAH1 silencing in in vivo tumor growth and lung colonization was also determined. To this end male NOD-SCID mice were used for xenotransplants with cells PC-3/Mc_ASAH1_KD or control and the tumor growth or lung colonization was followed by luminometry. We found that the silencing of ASAH1 in PC-3/Mc cells delayed the growth and also the lung colonization, highlighting the potential of acid ceramidase inhibition as adjuvant in the treatment of prostate cancer and also in the prevention of metastases formation.
6
Aguilera, Peiró Paula. "Susceptibilidad a Melanoma: nuevos aspectos clínico-patológicos, desarrollo de herramientas y modelos de estudio y evaluación de medidas preventivas". Doctoral thesis, Universitat de Barcelona, 2015. http://hdl.handle.net/10803/565908.
Testo completoAbstract (sommario):
El trabajo contenido en esta Tesis Doctoral ha ido encaminado a mejorar el conocimiento del Melanoma Familiar con el fin de mejorar su prevención y tratamiento.
En el primero de los trabajos publicados se han descrito y validado las características clínicas, histopatológicas e inmunohistoquímicas del melanoma (MM) familiar, que van a ser de utilidad para el clínico en el momento de plantear a quién ofrecer un estudio genético. Estos hallazgos van a permitir un mayor entendimiento entre la interrelación genética y ambiente en estos tumores.
Con el fin de poder llevar a cabo estos estudios histopatológicos, inmunohistoquímicos, y mucho más importante hoy en día, estudios moleculares, en el segundo trabajo se explica el desarrollo y validación de un método de muestreo tumoral para la obtención de tejido para biobanco basado en la dermatoscopia ex vivo. En la era de la biología molecular y de las terapias diana dirigidas contra el cáncer, la investigación traslacional para identificar nuevas dianas terapéuticas en el MM ofrece nuevas oportunidades para potenciales nuevos tratamientos. El tener muestras de tumor primario es de grandiosa utilidad para el paciente. El protocolo diseñado de muestreo tumoral nos va a permitir la obtención de muestras para el biobanco, preservando la arquitectura del tumor.
Para comprender mejor la patogenia del MM familiar son necesarios modelos de estudio que nos permitan abordar la compleja interrelación de estos pacientes con lam RUV. Debido a la complejidad de llevar a cabo estos trabajos con pacientes, en el cuarto trabajo se ha desarrollado un modelo murino humanizado de MM familiar que se ha constatado eficaz para el estudio de la interacción entre factores genéticos como mutaciones en CDKN2A o polimorfismos en MC1R y la RUV.
Finalmente se ha evaluado una estrategia de fotoprotección sistémica mediante la realización del tercer trabajo, y se ha constatado eficaz en individuos portadores de genotipos de riesgo.The work contained in this thesis has been aimed at improving the knowledge of familial Melanoma (MM) in order to improve prevention and treatment. In the first published paper, clinical, histopathologic and immunohistochemical features of familial MM have been described and validated. All this new information will be useful to the clinician at the moment of asking who to offer a genetic study. These findings will allow a greater understanding between the interrelationship of genetics and environment in these tumors. In order to carry out these histopathologic studies, immunohistochemical, and much more important today, molecular studies, in the second paper we explain the development and validation of a method of sampling tumor for obtaining tissue for the dermatoscopy-based BioBank ex vivo. In the era of molecular biology and diana directed therapies against cancer, translational research to identify new therapeutic targets in the MM offers new opportunities for potential new treatments. Having samples of primary tumor is of great utility for the patient. The designed tumor sampling protocol will allow us to obtain samples to the BioBank, preserving the architecture of the tumor. To better understand the pathogenesis of familial MM models of study that will allow us to tackle the complex interrelation of these patients with the RUV are necessary. Due to the complexity of carrying out these works with patients, in the fourth paper a model humanized murine family MM has been developed, and has been effective for the study of the interaction between genetic factors such as mutations in CDKN2A or polymorphisms in MC1R and UVR. Finally a strategy of systemic photoprotection has been evaluated in the third work, and has been found effective in individuals carrying risk genotypes.
7
Lau, Phyllis Min-yu. "Adverse drug reactions in oncology". Monash University, Dept. of Pharmacy Practice, 2003. http://arrow.monash.edu.au/hdl/1959.1/5549.
Testo completo
8
Hugtenburg, Richard P. "Computational methods in radiation oncology". Thesis, University of Canterbury. Physics and Astronomy, 1998. http://hdl.handle.net/10092/6796.
Testo completoAbstract (sommario):
This thesis examines computer technology in radiation oncology and the intimate role that it must now play in the dosimetry practices of this discipline. Aspects of the dosimetry and implementation of five radiation therapies are examined, namely total-body irradiation (TBI), total-skin electron therapy (TSET), electron therapy, superficial therapy and ophthalmic brachytherapy. Computational techniques, in particular, Monte Carlo and several other numerical methods are used. The Monte Carlo platform, EGS4, and the treatment planning system, GRATIS, have been implemented on SUN and Silicon Graphics workstations. Monte Carlo methods are used in the investigation of electron therapy planning and superficial and brachytherapy dosimetry practices. Monte Carlo techniques are used for radiation protection calculations of linear accelerator bunker design and for the optimisation of an in vivoX-ray fluorescence (XRF) technique used to measure platinum uptake associated with cisplatin chemotherapy.
Inverse Monte Carlo methods have been examined and implemented. Inverse methods, applied to in-phantom dose measurements, are used to determine phase-space information. such as spectra, for an incident electron beam. Analogous methods are examined for megavoltage and superficial X-rays in particular, source parameterisation with attenuation and photoactivation techniques.
Two linear accelerators, a Varian 2100C and a Varian 600C, provide Megavoltage X-rays or electrons. The TBI therapy uses a 6 MV X-ray beam. The TSET technique uses 6 MeV electrons which degraded to a lower energy by a screen placed in front of the patient at an extended source distance. The 9 Me V and the 20 Me V electron modalities are also closely examined. Two Philips superficial therapy units, RT100 and RT50 provide 10 through 100 kVp X-rays. 1251 seeds are used for the investigation of ophthalmic brachytherapy dosimetry.
Methods of dosimetry incorporated in this work include in-phantom, ionisation chamber and diode measurements. Thermoluminescent dosimeters (TLDs), Silverhalide and radio chromic films are used. Measurements have been performed in water, solid water. polymethyl-methacrylate (PMMA), and polystyrene phantoms. Fricke, ferrous based gels are investigated as a method of dosimetry in a uniform medium. Three-dimensional dose distributions are examined for several radiation modalities. The concentration of radiation-induced ferric ions and hence dose is determined using magnetic resonance imaging (MRI). A high-purity germanium detector and a thalium doped sodium iodide detector are employed for the measurement of source spectra and for fluorescing and activated materials.
9
Fröhner, Michael, Oliver W. Hakenberg e Manfred P. Wirth. "Molecular Therapy in Urologic Oncology". Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133789.
Testo completoAbstract (sommario):
During recent years, significant advances have been made in the field of molecular therapy in urologic oncology, mainly for advanced renal cell carcinoma. In this hitherto largely treatment-refractory disease, several agents have been developed targeting the von Hippel-Lindau metabolic pathway which is involved in carcinogenesis and progression of the majority of renal cell carcinomas. Although cure may not be expected, new drugs, such as the multikinase inhibitors sorafenib and sunitinib and the mammalian target of rapamycine inhibitor temsirolimus, frequently stabilize the disease course and may improve survival. Fewer data are available supporting molecular therapies in prostate, bladder, and testicular cancers. Preliminary data suggest a potential role of high-dose calcitriol and thalidomide in hormone-refractory prostate cancer, whereas targeted therapies in bladder and testicular cancers are still more or less limited to single-case experiences. The great theoretical potential and the multitude of possible targets and drug combinations, however, support further research into this exciting field of medical treatment of urologic malignanciesDieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
10
Loyd, Roylin F. "Mentoring potential of oncology nurses". Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/941369.
Testo completoAbstract (sommario):
Nurses in management and clinical positions in all areas of the country are experiencing role changes due to restructuring within the health care industry. Nurses have an opportunity to embrace and enhance these changes as the trend toward Patient Focused Care continues which entails a restructuring of care delivery at all levels.Oncology nurses are specifically encouraged by the Oncology Nursing Society to mentor other nurses. The purpose of this study was to examine the concept of mentoring as related to oncology nurses who have experienced role changes due to redesigns in the health care delivery systems. The theoretical framework used in this study was Benner's "From Novice to Expert."A convenience sample of 88 oncology nurses were surveyed. The Darling Measuring Mentoring Potential Scale (MMP), a demographic questionnaire, and a cover letter were mailed. Respondent confidentiality was maintained and the procedures for protection of human subjects were followed. A descriptive correlational design was used. The research questions were analyzed using Pearson's correlation coefficient and multiple regression analysis. Means and standard deviation of mentoring characteristics were also obtained on the clustered scores. Findings of the study indicated a small, but significant difference between levels of education, role changes and mentoring potential. Levels of education and role changes accounted for 15% of the differences in mentoring potential scores. However, the mean scores for both the clustered basic and supporting mentoring characteristics were below the suggested scores as suggested for a substantial mentoring relationship.Conclusions from the study were that the concept of mentoring is still not prevalent among oncology nurses and does not play an important role in the professional lives of the respondents. The concept of mentoring needs to be formally addressed in nursing education as well as in hospital staff education and leadership programs. There needs to be continuing research regarding the concept of mentoring within the nursing profession in order to promote the benefits of this concept so that nurses may join with those in other professions to enjoy the products of mentoring.School of Nursing
11
Labeed, Fatima H. "Applications of dielectrophoresis in oncology". Thesis, University of Surrey, 2004. http://epubs.surrey.ac.uk/855/.
Testo completo
12
Maisey, Nicholas Robert. "Early response assessment in oncology". Thesis, Institute of Cancer Research (University Of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.404978.
Testo completo
13
Iyer, R. "Surgical outcomes in gynaecological oncology". Thesis, University College London (University of London), 2016. http://discovery.ucl.ac.uk/1482204/.
Testo completoAbstract (sommario):
Presently there are no reliable statistics available on complication rates associated with surgery in gynaecological cancer in the UK, apart from data from small studies involving individual centres and clinical trials. This thesis describes the United Kingdom Gynaecological Oncology Surgical Outcomes and Complications study (UKGOSOC) that was set up to prospectively capture data from ten UK gynaecological cancer centres on surgical procedures and complications in a uniform manner using agreed definitions so that data could be analysed and compared. A web-based database was set up to capture surgery and complications contemporaneously from the hospitals, and, consented women were sent a follow-up letter eight weeks postoperatively. Intraoperative and postoperative complications were recorded using a pre-determined list. Postoperative complications were graded (I-V) in increasing severity using the Clavien-Dindo system. Grade I complications were excluded from analysis. Univariable and multivariable regression analyses were performed to determine the predictors for intraoperative and postoperative complications. The Lasso method of penalised regression was used to create a risk-prediction model for comparing outcomes between the centres. Data on 2948 eligible major surgical procedures were analysed and 1462 follow-up letters were received. The overall intraoperative complication rate was 4.7% (95% CI 4.0-5.6). The hospital-reported postoperative complication rate was 14.4% (95% CI 13.2-15.7) which increased to 25.9% (95% CI 23.7-28.2) when both hospital and patient- reported postoperative complications were included. The predictors for intraoperative and postoperative complications were different apart from diabetes which was common to both. Risk-adjustment had a modest effect on the complication rates for individual centres but allowed for a fairer comparison. There was no concordance between the ranking order of the centres for intraoperative and postoperative complication rates. The overall intraoperative (≈5%) and postoperative (≈26%) complication rates and funnel graphs derived from this study could be used to benchmark performance of gynaecological oncology centres and even individual surgeons if a larger dataset becomes available nationally.
14
Upadhaya, Taman. "Multimodal radiomics in neuro-oncology". Thesis, Brest, 2017. http://www.theses.fr/2017BRES0036/document.
Testo completoAbstract (sommario):
Le glioblastome multiforme (GBM) est une tumeur de grade IV représentant 49% de toutes les tumeurs cérébrales. Malgré des modalités de traitement agressives (radiothérapie, chimiothérapie et résection chirurgicale), le pronostic est mauvais avec une survie globale médiane de 12 à 14 mois. Les aractéristiques issues de la neuro imagerie des GBM peuvent fournir de nouvelles opportunités pour la classification, le pronostic et le développement de nouvelles thérapies ciblées pour faire progresser la pratique clinique. Cette thèse se concentre sur le développement de modèles pronostiques exploitant des caractéristiques de radiomique extraites des images multimodales IRM (T1 pré- et post-contraste, T2 et FLAIR). Le contexte méthodologique proposé consiste à i) recaler tous les volumes multimodaux IRM disponibles et en segmenter un volume tumoral unique, ii) extraire des caractéristiques radiomiques et iii) construire et valider les modèles pronostiques par l’utilisation d’algorithmes d’apprentissage automatique exploitant des cohortes cliniques multicentriques de patients. Le coeur des méthodes développées est fondé sur l’extraction de radiomiques (incluant des paramètres d’intensité, de forme et de textures) pour construire des modèles pronostiques à l’aide de deux algorithmes d’apprentissage, les machines à vecteurs de support (support vector machines, SVM) et les forêts aléatoires (random forest, RF), comparées dans leur capacité à sélectionner et combiner les caractéristiques optimales. Les bénéfices et l’impact de plusieurs étapes de pré-traitement des images IRM (re-échantillonnage spatial des voxels, normalisation, segmentation et discrétisation des intensités) pour une extraction de métriques fiables ont été évalués. De plus les caractéristiques radiomiques ont été standardisées en participant à l’initiative internationale de standardisation multicentrique des radiomiques. La précision obtenue sur le jeu de test indépendant avec les deux algorithmes d’apprentissage SVM et RF, en fonction des modalités utilisées et du nombre de caractéristiques combinées atteignait 77 à 83% en exploitant toutes les radiomiques disponibles sans prendre en compte leur fiabilité intrinsèque, et 77 à 87% en n’utilisant que les métriques identifiées comme fiables.Dans cette thèse, un contexte méthodologique a été proposé, développé et validé, qui permet la construction de modèles pronostiques dans le cadre des GBM et de l’imagerie multimodale IRM exploitée par des algorithmes d’apprentissage automatique. Les travaux futurs pourront s’intéresser à l’ajout à ces modèles des informations contextuelles et génétiques. D’un point de vue algorithmique, l’exploitation de nouvelles techniques d’apprentissage profond est aussi prometteuseGlioblastoma multiforme (GBM) is a WHO grade IV tumor that represents 49% of ail brain tumours. Despite aggressive treatment modalities (radiotherapy, chemotherapy and surgical resections) the prognosis is poor, as médian overall survival (OS) is 12-14 months. GBM’s neuroimaging (non-invasive) features can provide opportunities for subclassification, prognostication, and the development of targeted therapies that could advance the clinical practice. This thesis focuses on developing a prognostic model based on multimodal MRI-derived (Tl pre- and post-contrast, T2 and FLAIR) radiomics in GBM. The proposed methodological framework consists in i) registering the available 3D multimodal MR images andsegmenting the tumor volume, ii) extracting radiomics iii) building and validating a prognostic model using machine learning algorithms applied to multicentric clinical cohorts of patients. The core component of the framework rely on extracting radiomics (including intensity, shape and textural metrics) and building prognostic models using two different machine learning algorithms (Support Vector Machine (SVM) and Random Forest (RF)) that were compared by selecting, ranking and combining optimal features. The potential benefits and respective impact of several MRI pre-processing steps (spatial resampling of the voxels, intensities quantization and normalization, segmentation) for reliable extraction of radiomics was thoroughly assessed. Moreover, the standardization of the radiomics features among methodological teams was done by contributing to “Multicentre Initiative for Standardisation of Radiomics”. The accuracy obtained on the independent test dataset using SVM and RF reached upto 83%- 77% when combining ail available features and upto 87%-77% when using only reliable features previously identified as robust, depending on number of features and modality. In this thesis, I developed a framework for developing a compréhensive prognostic model for patients with GBM from multimodal MRI-derived “radiomics and machine learning”. The future work will consists in building a unified prognostic model exploiting other contextual data such as genomics. In case of new algorithm development we look forward to develop the Ensemble models and deep learning-based techniques
15
Fröhner, Michael, Oliver W. Hakenberg e Manfred P. Wirth. "Molecular Therapy in Urologic Oncology". Karger, 2007. https://tud.qucosa.de/id/qucosa%3A27535.
Testo completoAbstract (sommario):
During recent years, significant advances have been made in the field of molecular therapy in urologic oncology, mainly for advanced renal cell carcinoma. In this hitherto largely treatment-refractory disease, several agents have been developed targeting the von Hippel-Lindau metabolic pathway which is involved in carcinogenesis and progression of the majority of renal cell carcinomas. Although cure may not be expected, new drugs, such as the multikinase inhibitors sorafenib and sunitinib and the mammalian target of rapamycine inhibitor temsirolimus, frequently stabilize the disease course and may improve survival. Fewer data are available supporting molecular therapies in prostate, bladder, and testicular cancers. Preliminary data suggest a potential role of high-dose calcitriol and thalidomide in hormone-refractory prostate cancer, whereas targeted therapies in bladder and testicular cancers are still more or less limited to single-case experiences. The great theoretical potential and the multitude of possible targets and drug combinations, however, support further research into this exciting field of medical treatment of urologic malignancies.Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
16
Skinn, Barbara J. "Cultural Competence Among Oncology Nurses". University of Cincinnati / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1163797735.
Testo completo
17
RASZEJA, Veronica. "COMPLEMENTARY MEDICINE IN HAEMATO-ONCOLOGY:". Thesis, The University of Sydney, 2013. http://hdl.handle.net/2123/9984.
Testo completoAbstract (sommario):
Up to 83% of Australians diagnosed with cancer will use complementary and alternative medicines (CAMs). CAMs include physical, psychological, herbal, nutritional and spiritual therapies, and are used for a variety of reasons, including to help relieve the effects of both cancer and its conventional therapies, to enhance the efficacy of conventional treatments, to achieve a cure, to prolong life, to improve quality of life, or to meet personal or cultural needs. While some CAMs are beneficial, some, however, carry the risk of significant harm, especially when used alongside conventional therapies. Further compounding these risks are the issues of poor physician-patient communication about CAM, inadequate education about CAM, and the lack of readily-accessible, reliable and up-to-date information about CAM. This research – comprising a narrative review of the literature about CAM and a quantitative survey of NSW cancer services – was undertaken with these concerns in mind. It provides the first empirical study of the policies and practices surrounding CAM in Australian haemato-oncology units. Forty-three of 65 eligible cancer services responded to the survey - a response rate of 66%. While the majority (77%) of cancer services asked patients about CAM use at initial assessment and just over half (56%) permitted in-patients to bring their own CAMs into hospital, only eight (19%) services provided or prescribed CAM for their patients, and just six (14%) stated that their services had formal policies about CAM. Importantly, the survey also revealed that there was little regulation or monitoring of the use of CAM by in-patients, and little, if any, counselling about the risks of “unapproved” CAM. The integration of (selected) CAMs within haemato-oncology services has been posited as a solution to many of the problems associated with CAM use by patients with cancer. Integration, however, raises difficult and complex questions, and is not, by itself, a sufficient response to the concerns raised by the use of CAM by patients with cancer. To ensure the well-being and safety of patients, irrespective of whether or not cancer services choose to provide or prescribe CAMs, steps must be taken to effectively monitor and control CAM use within cancer services, to improve education and information about CAM, and to foster open, non-judgemental, physician-patient communication about CAM.
18
Bossaer, John B. "Oncology Pharmacy: Community Pharmacy Implications". Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/2337.
Testo completo
19
Houle, Nicole. "A Comparison of Oncology and Non-Oncology Nurses in Their Knowledge of Cancer Pain Management". Scholar Commons, 2011. http://scholarcommons.usf.edu/etd/3156.
Testo completoAbstract (sommario):
Abstract
Approximately 1.5 million people are diagnosed with cancer each year. Most of these people will experience pain at some point during or after their treatment. Areas of knowledge that nurses have been shown to have deficits in include assessment and pharmacological management. These types of issues can affect the treatment given to their patients. The purpose of this study is to evaluate the level of knowledge of cancer pain management in oncology and non-oncology nurses and how they compare with each other.
To study these variables, two instruments, the Pain Management Knowledge Test and a demographic survey, were distributed to all nurses during two nursing association meetings. Sixty nurses (30 from each association) chose to participate. Descriptive statistics from demographic data were used to analyze the current knowledge of oncology and non-oncology nurses while a t-test was used to determine if there was a significant difference in oncology verses non-oncology nurses knowledge of cancer pain management.
The oncology sample consisted of mostly baccalaureate degree nurses with a mean age of 49 with an average of 22 years experience and mostly worked as hospital bedside nurses. The non-oncology group consisted of an equal number of diploma/associate degree nurses and baccalaureate nurses with a mean age of 51 and an average of 25 years experience. Test scores showed that oncology nurses scored significantly higher on the Pain Management and Knowledge Test overall between the two groups (t=2.1, p=0.04).
While the oncology nurses have significantly better knowledge of cancer pain management, the overall scores were low for both groups. It is evident that nurses would benefit from additional education in cancer-related pain management in both continuing education programs as well as in schools of nursing as part of their curriculum.
20
Grimm, Elizabeth K. "The physical activity habits of oncology patients from entry to exit of an oncology rehabilitation program". Virtual Press, 2007. http://liblink.bsu.edu/uhtbin/catkey/1371841.
Testo completoAbstract (sommario):
Physical activity (PA) is related to prevention and rehabilitation (rehab) of oncology patients, however little is known about PA habits of patients with cancer. Purpose. The purpose of this study was to assess and characterize PA habits, fatigue, and mood states of cancer survivors from before participation in an exercise rehab program to the final week of a 16 session exercise rehab program. Methods. Eleven subjects (9 women, 2 men, with an average age 60.9±1 0.1 years) wore an Actigraph GT1M accelerometer and New Lifestyle series pedometer a week before beginning an exercise rehab program (baseline), the first week (week 1) and the final week of exercise rehab (week 8). Intensity counts/minute and steps were measured by the GT1M and steps were calculated by the pedometer. Results. Ten subjects were classified under the sedentary step index, walking <5,500 steps/day and further grouped under the subcategory for chronic diseased individuals proposed by Tudor-Locke and Myers of 3,500-5,500 steps/day. One subject was recorded by the accelerometer to meet the Surgeon General, American College of Sports Medicine/Center for Disease Control and Prevention, the American Cancer Society, and 10,000 step/day PA guidelines throughout the study. The accelerometer underestimated rehab activity of 4 subjects who exercised on the Nu-step during rehab. PA habits of steps and intensity varied at baseline, week 1, and week 8 and on rehab and non-rehab days. There were no patterns seen determined by diagnosis, treatment, or staging of cancer. Five subjects increased their 6 minute walk distance, 6 subjects decreased in total mood disturbance, and 4 subjects lowered their perception of fatigue. Conclusion. The intervention, exercise, with 11 cancer survivors maintained PA habits, functional ability, fatigue, and mood states over time and on rehab and non-rehab days.School of Physical Education, Sport, and Exercise Science
21
Mastice, Kathleen. "A comparison of oncology nurses' and non-oncology nurses' attitudes toward care of the dying patient /". Staten Island, N.Y. : [s.n.], 1995. http://library.wagner.edu/theses/nursing/1995/thesis_nur_1995_masti_compa.pdf.
Testo completo
22
Figueiredo, Ana Raquel Martins. "Role of PI3K in pericytes during angiogenesis". Doctoral thesis, Universitat de Barcelona, 2017. http://hdl.handle.net/10803/404276.
Testo completoAbstract (sommario):
Pericytes (PCs) are important regulators of the vascular development promoting vessel growth and stabilization. They have recently emerged as a therapeutic target to promote or inhibit angiogenesis. Therefore, advancing our basic understanding on PCs biology and its molecular regulators during physiological angiogenesis is essential to develop PC-related therapies. One of the major pathways leading to cellular proliferation, migration, and survival is relayed by PI3K. Data from our laboratory and others have demonstrated isoform selectivity stimulating PI3K signalling in the regulation of both, the ECs and vSMCs. Interestingly, in these two cell populations’ p110α seems to be the major isoform.
By using pharmacological and genetic tools together with cultured PCs and retinal systems we have found that PCs pass through different states during vessel development, and that PI3K signalling regulates these cells in an isoform-specific manner. We have seen that immature and active PCs promote vessel growth while, mature and quiescent PCs result in vascular stabilization and remodelling. Moreover and unexpectedly, our results have identified p110β as the key regulator of PCs proliferation and growth. Inactivation of p110β in PCs, but not p110α, results in PC proliferation arrest and in several morphological changes, which resemble a more mature PC. Lack of p110β in PCs also leads to a more mature vascular plexus. We observed reduced vessel density, EC proliferation arrest and increased deposition of collagen IV. Furthermore, PTEN seems to be the regulator of PI3K in PCs, opposing the p110β effects and, leading to a more mature and stable PC and subsequently also more mature vasculature.
Since p110β-PI3K controls PC growth and proliferation, it suggests that target therapy directed to p110β in cancer could affect PCs. Using a pancreatic neuroendocrine tumour mouse model (RIP1-Tag2) we have seen that pharmacological inhibition of p110β impacts on tumour progression and in PCs growth. However, it also results in a slight reduction in the overall survival of the animal, without affecting their metastatic potential. Therefore, other studies are needed to further investigate p110β as a possible PC-specific target therapy.
23
Rogers, Margaret Speicher. "Pain talk in oncology outpatient clinics". Thesis, University of Cambridge, 1999. https://www.repository.cam.ac.uk/handle/1810/265440.
Testo completoAbstract (sommario):
Despite improvements in cancer management over the past 25 years, unrelieved symptoms continue to be reported. Little is known about how patients' problems and concerns are communicated to professionals during oncology treatment. This research investigates communication between cancer patients and clinicians in hospital outpatient clinics. Data were collected by non-participant observation and audio recording of consultations. Analyses were by qualitative content analysis and conversation analysis. An Objectives, Strategies and Tactics model was applied to organise the findings. 74 consultations between cancer patients and 15 doctors were observed and audio recorded. Pain talk is defined and identified as a substantial topic, occurring in 39/74 consultations. Doctor-initiated questions are the predominant discourse feature occupying over two-fifths of pain talk sequences. Their questions are prominent not only in initiating discussions but also in directing further talk. In other words, clinicians' questions control both the content and order of talk within pain talk sequences ( eg, over three-quarters of doctor-initiated questions are in a closed form which focus narrowly on limited physical aspects of patients' pain). It is argued that this limited information exchange alongside other communication tactics, is used to identify the 'right kind' of pain which may benefit from cancer therapy and to truncate talk of problems perceived to be outside of this specialist remit.
24
Peeters, Justine Kate. "Microarray bioinformatics and applications in oncology". [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2008. http://hdl.handle.net/1765/12618.
Testo completo
25
Gray, Aloma. "Oncology| Improving Nursing Competency and Skill". Thesis, Walden University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3731288.
Testo completoAbstract (sommario):
Patients diagnosed with cancer often require interventions for the accompanying mental health distress of their diagnosis; patients’ mental distress can lead to hopelessness and noncompliance. Improvements for assessment and interventions are needed. This project provides recommendations for improving oncological nursing knowledge by implementing competencies for nurses through educational modules, focusing on nursing approach, confidence, and interventions necessary for understanding methods of treatment and the measurement of distress in oncology and oncological treatment. Using established standards and competencies will improve knowledge and skill in inpatient settings. Current established nursing standards from the American Nursing Association, Institute Of Medicine/National Comprehensive Cancer Network, C-Change, and Public Mental Health Essentials were explored in order to identify gaps and create a list of recommended competencies for oncology nursing. Six associated adaptable educational modules were developed based on the adult education framework of Knowles, and participant training entailed proper use and comprehension of the Distress Thermometer for measurement of distress. The C-Change observation displayed participant (n = 102) results of approximately 119% improvement, which was observed in knowledge, communication, and confidence. Participants used the resources to reduce distress levels by initiating the selected established interventions for management, all of which was made evident in patient self-reported outcomes, using resources from published, established, standardized competencies. Having such training will allow for improved care for patients with cancer, thus having an influence on positive social change.
26
Slegtenhorst, Sonja. "Antioxidant intake in paediatric oncology patients". Thesis, Stellenbosch : Stellenbosch University, 2011. http://hdl.handle.net/10019.1/18050.
Testo completoAbstract (sommario):
Thesis (MNutr)--Stellenbosch University, 2011.ENGLISH ABSTRACT: Background: The role of antioxidants and adequate nutrition in the prevention and course of cancer treatment is globally recognised in nullifying the effects of free radicals and increasing the nutritional status of children during treatment. Objective: To investigate whether children with cancer meet their Dietary Reference Values and Safe Intakes for antioxidants, energy and protein. Design: Single centre prospective study. Setting: Children were recruited from the East of England Primary Treatment Centre using convenience sampling over 8 months. Forty-two children and adolescents diagnosed with a Solid tumour, Lymphoma or Leukaemia were eligible for data analysis (n=20 male; n=22 female). Method: Data was collected with an Estimated Food Record (EFR) in the 1st (EFR1) and 3rd month (EFR2) post-diagnosis. In the week following EFR completion, parents and/or children were contacted to complete four non-consecutive days of 24-hr food recalls. Data was categorised into diet alone, diet + food supplement (FS), tube feeding (tube) or diet + multi-vitamin-mineral supplementation (VMS). Malnutrition was determined by weight-for-age z-scores. Nutrient intake was compared to the Recommended Nutrient Intake (RNI), the Estimated Average Requirements (EAR) and the Lower Recommended Nutrient Intake (LRNI). Result: The sample consisted of 33% (n=14) diagnosed with Leukaemia, 24% (n=10) with Lymphoma and 43% (n=18) with Solid tumours. Sixty seven percent (n=28) underwent chemotherapy and 33% (n=14) a combination of therapies. Significant correlations were seen between the assessment tools in the diet alone category for both months for; vitamins A, C, E, selenium and protein and for EFR1 for zinc and energy. In both months greater numbers of children achieved ≥100% of requirements for diet + VMS (EFR 1; p<0.05; EFR2 p<0.05) than for other feeding modes. Vitamin C achieved the highest intakes compared to the RNI at 773% (EFR1) and 829% (EFR2). Intakes above 200% of the RNI were seen for vitamins A, C, E, selenium and zinc. No significant differences were seen between modes of feeding in either month for selenium or zinc. Vitamin A (EFR1≤ 100% diet alone p<0.05) and zinc (EFR1≤ 100% diet alone p=0.02) met the least of the LRNI in the 1st month compared to other antioxidants. No statistical significant difference was observed between the number of children attaining their EAR’s between the 3 modes of feeding in the 1st month and 3rd month. In the 1st month 27% (n=8) of participants consumed vitamin and/or mineral supplements, 18% in the 3rd month (n=4). In the 1st month 5% (n=2) of children were moderately malnourished and 10% (n=4) in 3rd month. Conversely in the 1st month 3% (n=1) were overweight and 3% (n=1) obese; the leukaemia group predominant. Conclusion: The research tools showed good correlation. Children using vitamin and/or mineral supplements mostly achieved their RNI’s compared to other feeding modes. Across feeding modes some children achieved antioxidant intakes above 200% RNI. LRNI’s on diet alone were not achieved for vitamin A and zinc. The study showed Leukaemics as having a higher prevalence of obesity. More research is required to determine the clinical implications of these findings.
AFRIKAANSE OPSOMMING: Agtergrond: Die rol van anti-oksidante en voldoende voeding in die voorkoming en verloop van kanker behandeling word wêreldwyd erken vir vernietiging van die effek van vry radikale en die verbetering van voedingstatus van kinders tydens behandeling. Doelwit: Om ondersoek in te stel of kinders met kanker hul Dieet Verwysingswaardes en Veilige Innames vir anti-oksidante, energie en proteïen bereik. Ontwerp: Enkel sentrum prospektiewe studie. Omgewing: Kinders was gewerf deur middel van gerieflikheidsteekproefneming oor 8 maande vanaf die “East of England Primary Treatment Centre”. Twee-en-veertig kinders en adolessente gediagnoseer met 'n Soliede tumor, Limfoom of Leukemie het in aanmerking gekom vir dataanalise (n=20 manlik, n=22 vroulik). Metode: Data was ingesamel met ‘n Geskatte Voedsel Rekord (GVR) in die eerste (GVR1) en derde maand (GVR2) na diagnose. In die week na voltooiing van die GVR is ouers en/of kinders gekontak om vier onopeenvolgende dae van 24-uur herroepe te voltooi. Data was verdeel in dieet alleen, dieet + voedsel supplement (VS), buisvoeding (buis) of dieet + multi-vitamien-mineraal supplementasie (VMS). Wanvoeding was bepaal deur middel van gewig-vir-ouderdom z-tellings. Nutriënt inname was vergelyk met die Aanbevole Nutriënt Inname (ANI), die Geskatte Gemiddelde Behoeftes (GGB) en die Laer Aanbevole Nutriënt Inname (LANI). Resultate: Die steekproef het bestaan uit 33% (n=14) gediagnoseer met Leukemie, 24% (n=10) Limfoom en 43% (n=18) Soliede tumore. Sewe-en-sestig persent (n=28) het chemoterapie ontvang en 33% (n=14) ‘n kombinasie van terapieë. Betekenisvolle korrelasies was waargeneem tussen die assesseringsinstrumente in die dieet alleen kategorie vir beide maande vir vitamiene A, C, E, selenium en proteïen en vir GVR1 ook vir sink en energie. In beide maande het ‘n groter aantal kinders ≥100% van hul behoeftes bereik vr dieet+VMS (GVR1; p<0.05; GVR2 p<0.05) as vir ander modi van voeding. Vitamien C het die hoogste innames bereik vergeleke met die ANI teen 773% (GVR1) en 829% (GVR2). Innames bo 200% van die ANI was waargeneem vir vitamiene A, C, E, selenium en sink. Geen betekenisvolle verskille was waargeneem tussen modi van voeding in enige maand vir selenium en sink nie. Vitamien A (GVR1≤100% dieet alleen p<0.05) en sink (GVR1≤100% dieet alleen p=0.02) het die minste van die LANI bereik in die eerste maand vergeleke met ander anti-oksidante. Geen statisties beduidende verskil was waargeneem tussen die aantal kinders wat hul GGB’s bereik het tussen die 3 voedingswyses in die eerste en derde maande nie. In die eerste maand het 27% (n=8) van deelnemers vitamien en/of mineraal supplemente ingeneem, en 18% (n=4) in die derde maand. In die eerste maand was 5% (n=2) van kinders matig wangevoed en 10% (n=4) in die derde maand. In die eerste maand was 3% (n=1) van kinders oorgewig en 3% (n=1) vetsugtig, die leukemie groep spesifiek. Gevolgtrekking: Die navorsingsinstrumente het goeie korrelasie getoon. Kinders wat vitamien en/of mineraal supplemente gebruik het het meestal hul ANI’s bereik vergeleke met ander modi van voeding. Oor voeding modi het sommige kinders anti-oksidant innames bo 200% ANI bereik. LANI’s op dieet alleen was nie bereik vir Vitamien A en sink nie. Hierdie studie het aangetoon dat dié met Leukemia ‘n hoër prevalensie van oorgewig/vetsug getoon het. Meer navorsing is nodig om die kliniese implikasies van die bevindinge te bepaal.
27
Leydon, Geraldine Marie-Claire. "Communication in UK outpatient oncology consultations". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.429092.
Testo completo
28
GIORDANI, Elena. "Liquid Biopsy in Real Life Oncology". Doctoral thesis, Università degli studi di Ferrara, 2022. http://hdl.handle.net/11392/2481324.
Testo completoAbstract (sommario):
Secondo il report “I numeri del cancro in Italia 2020” dell’Associazione italiana registri tumori (AIRTUM) e l’Associazione italiana di oncologia medica (AIOM), il tumore al seno resta la neoplasia più frequente in Italia e la prima causa di morte per tumore nelle donne. Il sottotipo HER2+ rappresenta il 30% dei tumori al seno ed è associato ad una prognosi infausta, sebbene l’utilizzo di terapie mirate abbia reso questo sottotipo curabile come altri biologicamente meno aggressivi. Tuttavia, i pazienti in stadio avanzato, trattati con terapie antiHER2, spesso sviluppano resistenza al trattamento. La biopsia liquida (BL) è una metodica minimamente invasiva, di facile utilizzo, sensibile e specifica, in grado di individuare l’insorgenza della resistenza anche prima che questa si manifesti clinicamente, permettendo così di ridurre tossicità e costi di un trattamento inefficace. I pazienti che presentano alterazioni di HER2 beneficiano di una terapia mirata con molti inibitori. Il monitoraggio longitudinale tramite BL dovrebbe diventare un fattore chiave nella gestione della malattia e nella scelta della strategia terapeutica più appropriata, poiché tiene conto dell'idea di evoluzione del cancro nel contesto dei principi generali dell'oncologia di precisione.
Ad oggi, lo stato di HER2 viene assegnato mediante una combinazione di Immunoistochimica e Ibridazione in Situ (IHC/ISH) su tessuto, in una scala binaria che separatamente valuta la sovra espressione e l'amplificazione genica. Ipotizzo che questo schema diagnostico (CDx), statico, una tantum, solo su tessuto, debba essere rivisto o abbandonato poiché assegna dei cut-off definiti per la terapia convenzionale antiHER2 (ad esempio, un tumore è HER2+ oppure no). Questa visione è probabilmente semplicistica, perché i nuovi agenti antiHER2 possono colpire sia i tumori HER2-alti che HER2-bassi, considerando che i livelli di HER2 diminuiscono durante la terapia. In questa tesi, propongo che i livelli di HER2 vengano valutati longitudinalmente, (su una scala continua, e in maniera bimodale), correlando la sovra espressione e la variazione del numero di copie (CNV) di HER2 e co-fattorizzandoli in un nuovo CDx. Questo permetterebbe la riallocazione dinamica dei pazienti ai diversi sottotipi e l’assegnazione di un trattamento non standard in un contesto dinamico che modifichi la pratica clinica comune.
Presento dei dati che dimostrano come la BL possa aiutare nel ridisegnare il CDx nel cancro al seno avanzato. Riassumo LiqBreasTrack, un recente studio di NGS, condotto durante la mia tesi (Allegretti, Fabi; Molecular Cancer 2021) e descrivo HER2-2D, un saggio bidimensionale inedito di BL che stima le CNV e il livello di proteina di HER2 nella prima e nella seconda dimensione, rispettivamente. Il test sfrutta saggi custom di dPCR e un ELISA commerciale, è ugualmente applicabile a tessuti e sangue e dà come output finale un punteggio di HER2 cumulativo. L'applicazione principale è nel sangue, e descriverò un sottogruppo di tumori/pazienti con cancro al seno in stadio avanzato elettivamente suscettibili al blocco di HER2 da parte di Trastuzumab Emtansine (T-DM1), un potente anticorpo-coniugato a farmaco (ADC). Accennerò ad una collaborazione con il gruppo del Prof. F. Michelotti (Università Sapienza di Roma), orientata allo sviluppo di un biosensore Surface Plasmon Resonance Imaging (SPRI) per la rilevazione rapida, semplice e senza marcatura estrinseca degli anticorpi antiHER2, per future applicazioni in ambito dell’Health Technology Assessment.
In sintesi, attraverso la BL dimostro che HER2 è una caratteristica adattiva dei tumori, e i suoi cambiamenti (tra quelli genomici più generali) nel sangue possono essere studiati per assegnare in modo adattivo terapie bersaglio a coorti definite di pazienti con cancro al seno caratterizzate da diversi gradi di dipendenza oncogenica da HER2.According to the data contained in the report "I numeri del cancro in Italia 2020" edited by the Italian Association of Tumour Registers (AIRTUM) and the Italian Association of Medical Oncology (AIOM), breast cancer remains the most frequent neoplasm in Italy and the leading cause of death from cancer in women. HER2+ subtype breast cancers represent 30% of all breast cancers and used to be associated with a poor prognosis, although the application of targeted HER2 blockade has rendered this subtype at least as curable as other biologically less aggressive breast cancer subtypes. Unfortunately, patients with advanced breast cancer treated with anti-HER2 therapies almost invariably develop pharmacological resistance. Liquid biopsy (LB) is minimally invasive, easy to perform, highly sensitive and specific. It may detect molecular traits of resistance even before clinical manifestations of progression, which may reduce unnecessary anti-HER2 treatment, abating unwanted side effects, toxicity, and treatment-associated costs. Patients with tumors bearing HER2 alterations benefit from target therapy with many specific inhibitors. Longitudinal monitoring by LB is expected to become a key factor in disease management and the use of these targeted therapies, because it takes into account the idea of cancer evolution in the context of the general principles of precision oncology. The HER2 status is presently assessed by a combination of Immunohistochemistry and In Situ Hybridization (IHC/ISH) to detect gene overexpression and amplification in tissues on a binary scale that separately factors overexpression and gene amplification. I hypothesize that a static, one-time-only, tissue-only HER2 Companion Diagnostics (CDx), like the one we presently use, should be revised, or dismissed. This scale assigns defined cut-offs for conventional HER2 blockade therapy, e.g., tumors are either HER2 or non-HER2. This view is probably simplistic, because novel anti HER2 agents may effectively target both HER2-high and HER2-low tumors, and HER2 levels wane during therapy. In this thesis, I defend the hypothesis that HER2 functional expression should be assessed longitudinally (on a continuous scale, and bimodally), e.g. (over)expression and Copy Number Variation (CNV) should be fully co-factored into a novel CDx scheme, enabling dynamic reallocation of patients to different subtypes and assign non-standard treatment in a potentially practice-changing setting. I present data showing that LB may help redesigning CDx in advanced breast cancer. As an example, I briefly summarize LiqBreasTrack, a recent LB NGS study, carried out during my thesis, published at the time of writing (Allegretti M., Fabi A. et al. Molecular Cancer 2021). I also describe HER2-2D, a bidimensional LB assay that estimates HER2 CNV and HER2 protein level in the first and second dimensions, respectively. This is presently unpublished and personally developed. The assay takes advantage of customized digital PCR and a commercial ELISA, it is equally applicable to tissues and blood, and yields a cumulative HER2 score. HER2-2D main application is in blood, and I will describe a subset of breast cancer tumors/patients electively susceptible to HER2 blockade by Trastuzumab Emtansine (T-DM1), a potent Antibody-Drug Conjugate (ADC) targeting HER2. I will briefly mention a collaboration with the laboratory of Prof. Francesco Michelotti at the University of Sapienza, Rome, aimed at the construction of a novel Surface Plasmon Resonance Imaging (SPRI) biosensor for the rapid, simple and label-free detection of HER2, for future applications in the Health Technology Assessment area. In summary, thorough LB we show that HER2 is an adaptive tumor feature, and that its changes (amongst more general genomic changes) in blood may find application to adaptively assign target therapy to defined, distinct cohorts of breast cancer patients characterized by different degrees of HER2 oncogenic addiction.
29
Bertacco, Alessandra. "Transplant Oncology: from laboratory to bedside". Doctoral thesis, Università degli studi di Padova, 2020. http://hdl.handle.net/11577/3426258.
Testo completo
30
Seamon, Leigh G., James J. Java, Bradley J. Monk, Richard T. Penson, Jubilee Brown, Robert S. Mannel, Anna Oaknin et al. "Impact of tumour histology on survival in advanced cervical carcinoma: an NRG Oncology/Gynaecologic Oncology Group Study". NATURE PUBLISHING GROUP, 2017. http://hdl.handle.net/10150/626543.
Testo completoAbstract (sommario):
Background: Based primarily on studies concerning early-stage tumours (treated surgically), and locally advanced disease (treated with chemoradiation), the prognosis for women with adenocarcinoma (AC) or adenosquamous (AS) carcinoma has been reported to be poorer than those with squamous cell carcinoma (SCCA) of the cervix. It is unclear whether differences in prognosis also persist in the setting of recurrent or metastatic disease treated using chemotherapy doublets with or without bevacizumab. Methods: Cases were pooled from three Gynaecologic Oncology Group randomised phase III trials of chemotherapy doublets. Pearson's test was used to evaluate response rate (RR) of AC/AS vs SCCA, Kaplan-Meier method to estimate progression-free survival (PFS) and overall survival (OS), and Cox proportional hazards model to estimate the impact of histology on PFS and OS. Results: Of 781 evaluable patients, 77% (N = 599) had SCCA and 23% (N = 182) AC/AS. There were no significant differences in RRs between histologic subgroups. The adjusted hazard ratio (HR) for death for SCCA vs AC/AS was 1.13 (95% CI 0.93, 1.38 P = 0.23). When comparing SC/AS (N = 661, 85%) to AC alone (N = 120, 15%), the adjusted HR for death was 1.23 (95% CI 0.97, 1.57, P = 0.09). Conclusions: AC/AS and SCCA have similar survival in recurrent or metastatic cervical carcinoma when treated with chemotherapy doublets.
31
Winkfield, Karen M., Christopher R. Flowers, Jyoti D. Patel, Gladys Rodriguez, Patricia Robinson, Amit Agarwal, Lori Pierce et al. "American Society of Clinical Oncology Strategic Plan for Increasing Racial and Ethnic Diversity in the Oncology Workforce". AMER SOC CLINICAL ONCOLOGY, 2017. http://hdl.handle.net/10150/625305.
Testo completoAbstract (sommario):
In December 2016, the American Society of Clinical Oncology (ASCO) Board of Directors approved the ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce. Developed through a multistakeholder effort led by the ASCO Health Disparities Committee, the purpose of the plan is to guide the formal efforts of ASCO in this area over the next three years (2017 to 2020). There are three primary goals: (1) to establish a longitudinal pathway for increasing workforce diversity, (2) to enhance ASCO leadership diversity, and (3) to integrate a focus on diversity across ASCO programs and policies. Improving quality cancer care in the United States requires the recruitment of oncology professionals from diverse backgrounds. The ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce is designed to enhance existing programs and create new opportunities that will move us closer to the vision of achieving an oncology workforce that reflects the demographics of the US population it serves. (C) 2017 by American Society of Clinical Oncology
32
Arias, Badia Marcel. "Arming Oncolytic Adenoviruses with Transgenes to Engage Stroma Toxicity and Immune Stimulation as a Double Strategy Against Cancer". Doctoral thesis, Universitat de Barcelona, 2017. http://hdl.handle.net/10803/457630.
Testo completoAbstract (sommario):
Oncolytic virotherapy with Adenoviruses has regained importance in the past years with the appearance of fresh and promising strategies to deal with tumors. Among the major limitations of this therapy are the immune suppression induced in the tumor microenvironment, which prevents the generation of an antitumor immune response, and the presence of stromal barriers which hinder the viral spread and also contain fibroblasts, cells which are highly resistant to viral replication.
In this thesis, both limitations have been addressed in separate chapters. Firstly, aiming to induce immune activation, a panel of viruses expressing, CD200, an immune checkpoint, CD200tr, an N-terminal truncated version of the former with antagonistic effect on its receptor (CD200R), K14, a CD200 homolog from HHV-8, and K14tr, a truncated version of K14 and hence a putative antagonist to CD200R, was generated. Throughout the development of this project, we validated the viability of these viruses, we detected the transgenes in supernatants from infected cultures, we confirmed the inhibitory role of CD200 and K14 and the antagonistic one for CD200tr, but our data did not suggest a similar function for K14tr.
As for the second project, we generated oncolytic Adenoviruses expressing bacteria- derived toxins modified in such a way they become activated only stroma-specific proteases, aiming to induce indiscriminate cell death once activated at the target tissue. Alpha-toxin from Clostridium septicum and aerolysin from Aeromonas hydrophyla were the toxins of choice. During the development of this project, we successfully generated and characterized all the viruses, we detected aerolysin in supernatants from infected cultures, we confirmed toxin-mediated cytotoxicity in cultures that expressed the activating proteases, and we performed in vivo studies to evaluate the antitumor efficacy, toxicity and the effects on the stroma of the toxins. Whilst for Alpha-toxin no promising results were obtained, the aerolysin-expressing virus increased oncolytic potency in our models, indicating that it could be considered as a potential clinical candidate in stroma-abundant tumors and encouraging to follow this research pipeline.La viroteràpia amb Adenovirus oncolítics ha recuperat una embranzida que havia perdut fa anys amb l’aparició de noves estratègies per atacar els tumors. Entre les limitacions més importants que troba aquest tipus de teràpia es troben la immunosupressió induïda en el microambient tumoral, que evita la generació d’una resposta immune antitumoral, i la presència de barreres estromals, que dificulten la dispersió del virus dins el tumor i que conté fibroblasts, cèl·lules molt resistents a la replicació viral. En aquesta tesi s’han adreçat aquests dos problemes en dos capítols diferents. En primer lloc, amb l’objectiu de trobar una manera d’activar les cèl·lules del sistema immune, es va generar una bateria de virus expressant versions solubles de la proteïna humana CD200, un ligand immunoinhibidor; CD200tr, una versió truncada en un domini N- terminal de la primera que té una funció antagonista amb el seu receptor; K14, una proteïna del HHV-8 amb estructura i funció homòlogues a CD200; i K14tr, una versió truncada de K14 que es va testar com a possible antagonista alternatiu a CD200R, el receptor de CD200. En el desenvolupament d’aquest projecte, es va validar la viabilitat d’aquests virus, es va detectar transgen en sobrenedants de cultius infectats, es va confirmar el paper inhibidor de CD200 i K14 i l’antagonista de CD200tr, però no es van trobar indicis que K14tr pogués actuar de la mateixa manera. Quant a al segon projecte, es van generar virus oncolítics expressant toxines bacterianes modificades per activar-se tan sols en presència de proteases específiques de l’estroma tumoral, amb l’objectiu d’induir una mort cel·lular indiscriminada un cop activades al teixit diana. Les toxines escollides van ser l’Alpha-toxin de Clostridium septicum i l’aerolisina d’Aeromonas hydrophyla. Durant el desenvolupament del projecte es van generar i caracteritzar satisfactòriament tots els virus, es va detectar transgen en sobrenedants de cultius infectats, es va confirmar l’activitat citotòxica d’aquestes toxines en cèl·lules que expressaven les proteases a les quals havien estat dirigides, i es van fer estudis in vivo per avaluar l’eficàcia antitumoral, la toxicitat i l’efecte en l’estructura de l’estroma de les esmentades toxines. Mentre que l’Alpha-toxin no va generar resultats prometedors, els resultats obtinguts amb el virus expressant aerolisina obren la porta a considerar-lo com a un candidat clínic en tumors amb alt contingut estromal i a seguir aquesta línia de recerca.
33
Rodríguez, Lobato Luis Gerardo. "Factores pronósticos en pacientes con amiloidosis sistémica por cadenas ligeras". Doctoral thesis, Universitat de Barcelona, 2018. http://hdl.handle.net/10803/663901.
Testo completoAbstract (sommario):
La amiloidosis de cadenas ligeras (AL) es una neoplasia rara, que se caracteriza por la presencia de células plasmáticas (CP) clonales en la médula ósea (MO), las cuales producen una inmunoglobulina (Ig) de cadena ligera monoclonal frecuentemente de isotipo lambda. Las Ig de cadena ligera amiloidogénicas se agregan y se depositan en el tejido como fibrillas de amiloide. La presentación clínica es muy heterogénea y el diagnóstico requiere una alto índice de sospecha. El pronóstico depende principalmente del órgano afecto, así como del tamaño y biología de la CP clonal. El objetivo del tratamiento es suprimir la producción de la proteína precursora de la fibrilla generada por la clona de CP, y minimizar la toxicidad relacionada al tratamiento. Alcanzar una adecuada respuesta hematológica se asocia a una prolongación de la supervivencia; sin embargo, para muchos pacientes aún es una enfermedad con un pronóstico ominoso. Existen otros factores de riesgo potenciales aún no estudiados, como la aparición de bandas oligoclonales (BOC), la presencia de inmunoparesia (IP) al diagnóstico y el porcentaje de infiltración de la MO por CP, aún no completamente bien caracterizados en esta patología.
Los objetivos de la presente tesis doctoral fueron: Determinar la incidencia, historia natural e impacto pronóstico de las BOC tras el tratamiento de pacientes con amiloidosis AL. Investigar el impacto pronóstico en términos de supervivencia y respuesta a tratamiento de la IP al dianóstico. Analizar la correlación entre el porcentaje de infiltración de la MO por CP y características clínicas de los pacientes, así como los resultados clínicos en términos de supervivencia.
En el primer trabajo publicado, analizamos el papel de las BOC, definidas como la presencia de una banda monoclonal detectada por inmunofijación de proteínas séricas y/o urinarias, distinta a la proteína M original al diagnóstico, ya sea en la cadena pesada y/o ligera. Descubrimos por primera vez que la incidencia de BOC, después de la terapia de primera línea, es incluso mayor que en pacientes con mieloma múltiple. Este fenómeno humoral oligoclonal fue más frecuente en los pacientes que lograron una respuesta completa. Aquellos pacientes que mantuvieron las BOC durante más de un año tuvieron un mejor pronóstico, incuso en aquellos con características de mal pronóstico (estratificación de riesgo de la Clínica Mayo del 2004), reflejando la importancia de una respuesta inmune humoral más robusta en amiloidosis AL.
En el segundo trabajo publicado, analizamos el papel de la IP definida como la supresión de todas las Ig no involucradas por debajo del límite inferior de la normalidad para nuestro laboratorio. Demostramos que la presencia de IP en el momento del diagnóstico, tiene un impacto negativo en la supervivencia, especialmente en etapas tempranas de la enfermedad, y podría ser un indicador pronóstico discriminatorio adicional. Además, demostramos que la recuperación de la IP un año después del inicio del tratamiento podría ser un marcador independiente de supervivencia a largo plazo.
En el tercer y último trabajo publicado, analizamos la correlación entre la infiltración de CPMO, las características clínicas y los resultados de la amiloidosis AL. En este trabajo, demostramos que una mayor infiltración de CPMO (>10%) se asoció con un mayor daño sistémico orgánico, en particular, afectación cardíaca, una mayor mortalidad temprana y un peor pronóstico, y rara vez, se relacionó con el desarrollo de las características del mieloma múltiple. Curiosamente, los pacientes con menor infiltración de CPMO se asoció con una mayor prevalencia de daño renal.Systemic immunoglobulin light chain amyloidosis (AL) is a rare plasma cell neoplasm, characterized by a clonal population of bone marrow (BM) plasma cells (PC) that produces a monoclonal immunoglobulin (Ig) light-chain, more frequently of the lambda isotype. The amyloidogenic Ig light-chains aggregate and deposit in tissue as amyloid fibrils with a predominant β-pleated sheet structure. The clinical presentation is heterogeneous, and its diagnosis requires a high index of suspicion. Prognosis depends on the organ involvement as well as the size and biology of the plasma cell clone. The treatment goal is to suppress the production of the fibril precursor protein by the underlying plasma cell clone, while minimizing the treatment-related toxicity. In the first publication, we studied the oligoclonal bands (OB), defined as the presence of a serum and/or urine immunofixation electrophoresis (IFE) monoclonal spike that was different from the original M-protein either in heavy and/or light chains or with a different IFE migration pattern. We uncovered for first-time that the incidence of OB after fist-line therapy is even higher than in patients with multiple myeloma. This oligoclonal humoral phenomenon was more frequent in patients who achieved a complete response, and those patients with OB for more than one year had a significantly better outcome, even in those with poor prognostic features, thereby reflecting the relevance of a more robust humoral immune response. The second biomarker was immunoparesis (IP) defined as the suppression of all uninvolved the immunoglobulins below the lower limit of normality. We showed that the presence of IP at diagnosis could have a negative impact on survival, especially in early stages of the disease, and could be an additional powerful discriminatory prognostic indicator. Also, we showed that the recovery of IP one-year after treatment onset could be an independent long-term marker of survival. In the third and last publication, we analyze the correlation between the BMPC infiltration, clinical features and outcomes in AL amyloidosis. We showed that a higher BMPC infiltration (>10%) was associated with increased systemic organ damage (cardiac involvemen), a higher early mortality, and worst prognosis, being rarely related to the development of myeloma features.
34
Grundy, Margaret. "Advancing knowledge for haemato-oncology nursing practice". Thesis, Middlesex University, 2008. http://eprints.mdx.ac.uk/13587/.
Testo completoAbstract (sommario):
Nurses working in haemato-oncology require specialised knowledge and yet, formal education programmes and textbooks devoted to the speciality are limited. In advancing knowledge for haemato-oncology nursing practice this project endeavours to develop, synthesise, organise and disseminate available evidence making it more accessible to practising nurses. The project consists of two inter-related parts: reflection on, and critique of, the development and editing of the second edition of a nursing textbook and a Delphi study of research priorities in haemato-oncology nursing included as a chapter of the textbook. In aiming to expand and advance the knowledge base for nurses working in haematooncology the concept of knowledge, ways of acquiring knowledge and types of nursing knowledge are explored and critically analysed. A textbook is mainly a source of empirical knowledge but ways of encouraging the development of other forms of relevant knowledge are discussed in relation to the format of the textbook. Critical reflection on the development of the textbook is also undertaken to detennine usefulness and value. Development of the first edition of the textbook and analysis of existing literature in haemato-oncology nursing highlighted the paucity of research informing the speciality. This provided the incentive to undertake the Delphi study. Round 1 generated a wide range of research topics, subsequently used to develop the questionnaire for round 2. Round 2 results demonstrated close clustering and little discrimination between research topics. Round 3 was therefore undertaken to increase the reliability and credibility of results and further discriminate between research priorities. Results from rounds 2 and 3 were remarkably consistent with several strong research themes emerging. These themes provide the foundations for the development of a research strategy with the potential to further advance knowledge for haemato-oncology nursing practice.
35
Magtoto, Joanne. "Team-based approaches to psychosocial oncology care". Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/51472.
Testo completoAbstract (sommario):
Background:
While the health system in Canada recognizes the need for comprehensive cancer care, barriers
must be overcome to achieve this goal. One is improving how professionals work together. This
study explores social workers’ and counsellors’ experiences offering psychosocial cancer care as
part of a cancer system that prioritizes medically related cancer care. My study objective is to
increase understanding on how the health care system can better support team-based
approaches in providing psychosocial cancer care for families faced with cancer.
Methods:
I explored, through a generic qualitative research methodology, the experiences of eight social
workers or counsellors who utilize team-based approaches in psychosocial cancer care. Using a
semi-structured interview approach, I asked each participant to describe their experiences with
team-based approaches in cancer care.
Findings:
Findings are presented using the ecological systems perspective, with the themes representing
micro, mezzo, and macro level facilitators and barriers to psychosocial cancer care within a
team-based approach. The overarching theme identified by participants was the need for
building authentic and close working relationships with their colleagues. At a micro level,
relationships between cancer care providers was identified as an asset when working in an
oncology setting facing larger system influences that detract from offering psychosocial cancer care. Within this overarching theme participants described the following mezzo and macro
factors in facilitating or detracting from team-based approaches in offering psychosocial care:
flexible infrastructure and resources, space, staff availability, medical dominance, and limited
time and resources.
Implications:
Exploring team-based approaches in psychosocial cancer care is understudied in oncology
and health system research. This study may fill some of this knowledge gap, specifically by
highlighting the need for authentic and close relationships with colleagues especially in times of high and demanding workloads within an emotionally fatiguing work environment such as
oncology. The participants’ experiences mirror the challenges identified in psychosocial
oncology in Canada and future research may expand this study by developing theoretical
frameworks for team-based approaches within a psychosocial oncology context, and by
translating theory into cancer care practice that addresses the needs of mind, body, and soul.Arts, Faculty of
Social Work, School of
Graduate
36
Kiely, Daniel James. "Advancing surgical simulation in robotic gynecologic oncology". Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=122989.
Testo completoAbstract (sommario):
Objective: To advance robotic surgery simulation in gynecologic oncology by: (1) conducting a randomized controlled trial of a virtual reality, proficiency-based robotic simulation curriculum to teach robotic suturing and (2) developing an inanimate model for training in the procedure of robotic pelvic lymphadenectomy. Methods: (1) Residents and attending surgeons in surgical specialties were randomized to a proficiency-based virtual reality robotic simulation curriculum or usual clinical work over 5 weeks. Ability to perform robotic suturing of an inanimate model of the vaginal cuff with the actual da Vinci® robot was assessed at baseline and after the intervention period. (2) Using anatomic texts and virtual model of the anatomy of the human pelvis, an inanimate model for training in robotic pelvic lymphadenectomy was developed using low-cost materials. The model was robotically dissected by three gynecologic oncologists and two gynecologic oncology fellows all of whom rated the model post-dissection using a structured rating scale.Results: (1) As compared to controls, the training group showed a trend to greater improvement in ability to perform robotic suturing of an inanimate model of the vaginal cuff as assessed by a global rating scale and a statistically significantly greater improvement in total knots performed. (2) The pelvic lymphadenectomy model was rated favorably for both anatomic realism and potential as a training tool. Discussion: Participation in a virtual reality robotic surgery training curriculum shows a trend to improving ability to perform inanimate tasks with the actual da Vinci® robot, suggesting a translational benefit. A high fidelity training model of robotic pelvic lymphadenectomy has been developed using low-cost materials. Both projects help to advance surgical simulation in gynecologic oncology, the first at the level of basic task training and the second in advanced techniques.Objectifs: Améliorer la simulation chirurgicale en gynécologie oncologique par: (1) un essai randomisé contrôlé pour évaluer un curriculum de simulation en réalité virtuelle pour enseigner l'enseignement des sutures (2) développement d'un modèle anatomique pour simuler la technique de curage ganglionnaire pelvienne. Méthodes: (1) Résidents et chirurgiens étaient randomisés au curriculum d'entrainement en simulation robotique (réalité virtuelle) ou groupe témoin pendant 5 semaines. L'habileté à la suture robotique avec le da Vinci® pour faire la fermeture de la voûte vaginale était évaluée avant et après l'intervention. (2) En utilisant les livres anatomiques et un modèle virtuelle de l'anatomie du pelvis, un modèle inanimé pour l'entrainement en curage ganglionnaire par voie robotique a été créé. Le modèle était disséqué et par la suite évalué par trois gynécologues oncologues et deux fellows en gynécologie oncologie. Résultats: (1) Le groupe d'entrainement a mieux amélioré que le groupe témoin en le nombre total de noeuds fait et a montré une tendance à une plus grande amélioration en évaluation avec une échelle standardisé. (2) Le modèle de curage ganglionnaire pelvienne a eu des résultats favorables aux évaluations par les médecins qui ont fait la dissection. Discussion: L'essai randomisé démontre qu'il y a au moins une tendance pour l'entrainement en réalité virtuelle d'améliorer l'habileté de faire les exercices avec le robot da Vinci®. Un modèle de curage ganglionnaire pelvienne avec une fidélité élevée a été créé avec des bonnes évaluations. Les deux projets aident à avancer la simulation en gynécologie oncologie, le premier en technique de base et la deuxième en techniques avancées.
37
Webb, Steven D. "Mathematical oncology and periodic wave train forcing". Thesis, Heriot-Watt University, 2000. http://hdl.handle.net/10399/521.
Testo completo
38
Lloyd, Katherine L. "Machine learning stratification for oncology patient survival". Thesis, University of Warwick, 2017. http://wrap.warwick.ac.uk/107703/.
Testo completoAbstract (sommario):
Personalised medicine for cancer treatment promises benefits for patient survival and effective use of medical resources. This goal requires the development of predictive models for the identification and implementation of biomarkers for the prediction of patient survival given treatment options. This thesis addresses research questions in this area. The systematic review detailed in Chapter 2 investigates the literature concerning the prediction of resistance to chemotherapy for ovarian cancer patients using statistical methods and gene expression measurements. The range of models used by studies in the systematic review highlights the popularity of traditional models, such as Cox proportional hazards, with few more complex models being utilised. In Chapters 3 and 4, new methods are presented for modelling right-censored survival data. Due to the nature of biomedical data, the methods used need to be flexible and adequately account for high dimensional, noisy data. Gaussian processes fulfil these requirements and were hence used for the development of three Gaussian process models for right-censored survival data. Chapter 3 details these models, and they are applied to synthetic and cancer data in Chapter 4. In all cases the Gaussian processes for survival were found to equal or outperform all comparison models, as measured by concordance index. Given the application to molecular cancer data, it was expected that the data would be high dimensional. Two feature selection methods are investigated in Chapter 5 for use with Gaussian processes to address this. In Chapter 6 a program is developed for the analysis of the data produced by a test for cancer mutations using qPCR. The automated program was designed to isolate the analysis from the user and produce results and reports for clinical use. It is observed that this approach of automated analysis would be suitable for application to any form of clinical test or complex predictive model without the requirement of user guidance.
39
Humphries, Kathleen R. "Perceptions of music therapy among oncology nurses". Scholarly Commons, 2013. https://scholarlycommons.pacific.edu/uop_etds/259.
Testo completoAbstract (sommario):
The purpose of this study was to investigate the perceptions of music therapy among oncology nurses to pinpoint areas in which music therapists can further advocate for the profession and educate the nursing staff. The study's research objectives included: (a) Examining the perceptions of music therapy regarding role, purpose of the treatment and perceived benefits, and nurses' application of music as a nursing intervention; and (b) Comparing differences in perceptions of music therapy among different settings (i.e. pediatric versus an adult), and facilities with or without music therapy services. Two-hundred and sixty-four members of the Oncology Nursing Society completed the survey. The majority of the participants (81.4%) were aware of music therapy, despite the fact that only 37.5% of the respondents worked in facilities currently offering music therapy. According to participants, volunteer musicians are primary deliverers of music therapy (43.8%), followed by nurses identifying themselves as music therapy facilitators (29.5%). Significant differences were found between the oncology nurses in adult versus pediatric settings with regard to the following referral circumstances: pre/post-operative (x² = 4.33, p < .05), playroom/music group activities/socialization (x² = 12.88, p < .001), and motor skills (x² = 6, p < .05). Results indicated a skewed vision of music therapy as well as a lack of education on all of the applications and benefits of music therapy.
40
Van, Zyl Elizma. "Glutamine supplementation in oncology : a systematic review". Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5198.
Testo completoAbstract (sommario):
Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: See full text for abstract
AFRIKAANSE OPSOMMING: Sien volteks vir opsomming
41
Wallace, Rick L. "Engaging the Clergy in the Oncology Workforce". Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/8736.
Testo completo
42
Simas, Ana Luísa Oliveira de. "Training report : clinical studies coordination in oncology". Master's thesis, Universidade de Aveiro, 2014. http://hdl.handle.net/10773/12966.
Testo completoAbstract (sommario):
Mestrado em Biomedicina FarmacêuticaThis report describes a curricular training experience in Study Coordination, developed at Unidade de Investigação Clínica (Clinical Research Unit) of Instituto Português de Oncologia do Porto Francisco Gentil, E.P.E. (Portuguese Oncology Institute-Porto), in the ambit of the Master in Pharmaceutical Medicine at University of Aveiro. This report describes the State of the Art in Pharmaceutical R&D Process in Europe, especially in Oncology, emphasising its current trends and stressing specificities of special and vulnerable populations, in the scope of the traineeship. The study coordination activities were essentially performed in the Pathology Clinics of Lung, Urology, Gynaecology, Paediatrics, and the Intensive Care Service. The activities developed had the main goal of acquiring experience in oncology clinical trials, while reinforcing the knowledge from my academic background. These activities included screening and randomisation of patients, preparation and processing of study visits, data entry and query resolution, and documents management, among other activities transversal to the 15 clinical trials, accompanied in the traineeship. Globally, the traineeship allowed a good overview of the activities involved in the conduction of clinical trials in a hospital, and a worthy introduction to the marketplace. I strengthened the knowledge acquired from my academic background. I developed competences and skills at the professional and personal level, such as dealing with unforeseen situations, and developed strategies to overcome challenges. I sharpened my vision of careers in clinical research, and hope to continue addressing new challenges in this area.
43
Vedam, Subrahmanya. "Management of Respiratory Motion in Radiation Oncology". VCU Scholars Compass, 2002. http://scholarscompass.vcu.edu/etd_retro/162.
Testo completoAbstract (sommario):
Respiratory motion poses significant problems in the radiotherapy of tumors located at sites (lung, liver, pancreas, breast) that are affected by such motion. Effects of respiratory motion on the different stages of the radiotherapy process (imaging, treatment planning and treatment delivery), has formed the focus of significant research over the last decade. Results from such research have revealed that respiratory motion affects the instantaneous position of almost all structures in the thorax and abdomen to different degrees based on their corresponding anatomic location and muscular attachments. As an example, diaphragm motion was found to be of the order of 1.5 cm, predominantly in the superior-inferior (SI) direction during normal breathing. This indicates a similar magnitude of motion for tumors located in the lower lobes of the lung and in the abdomen.The conventional method of accounting for such motion is to add a margin (based on an estimate of the expected range of organ motion) around the clinical target volume (CTV) that is delineated from the image data. This margin also includes errors due beam-bony anatomy alignment during radiation delivery and errors in patient position between simulation and subsequent treatment delivery sessions. Such a margin estimate may or may not encompass the "current" extent of motion exhibited by the tumor, resulting in either a higher dose to the surrounding normal tissue or a potential cold spot in the tumor volume. Several clinical studies have reported the existence of a direct relationship between the reduction in mean dose to the lung and the incidence of radiation induced pneumonitis. Therefore, subjecting additional normal lung tissue to high dose radiation by adding large margins based on organ motion estimates may result in an increased risk of radiation induced lung injury.Monitoring and accounting for respiratory motion can however potentate a reduction in the amount of normal tissue that receives high dose radiation, thereby decreasing the probability of normal tissue complication and also increasing the possibility for dose escalation to the actual tumor volume. The management (monitoring and accounting) of respiratory motion during radiation oncology forms the primary theme of this dissertation.Specific aims of this thesis dissertation include (a) identifying the deleterious effects of respiratory motion on conventional radiation therapy techniques (b) examining the different solutions that have been proposed to counter the deleterious effects of respiratory motion during radiotherapy (c) summarizing the relevant work conducted at our institution as part of this thesis in addressing the issue of respiratory motion and (d) visualizing the future direction of research in the management of respiratory motion in radiation oncology.Among the various techniques available to manage respiratory motion in radiation oncology such as respiratory gated and breath hold based radiotherapy, our research initially focused on respiratory gated radiotherapy, employing a commercially available external marker based real time position monitoring system. Multiple session recordings of simultaneous diaphragm motion and external marker motion revealed a consistent linear relationship between the two signals indicating that the external marker motion (along the anterior-posterior (AP) direction) could be used as a "surrogate" for motion of internal anatomy (along the SI direction). The predictability of diaphragm motion based on such external marker motion both within and between treatment sessions was also determined to be of the order of 0.1 cm.Analysis of the parameters that affected the accuracy and efficacy of respiratory gated radiotherapy revealed a direct relationship between the amount of residual motion and the width of the "gate" window. It also followed therefore that a trade-off existed between the width of the "gate" and the accuracy of gated treatments and also the overall "Beam ON" time. Further, gating during exhale was found to be more reproducible than gating during inhale. Although, it was evident that a reduction in the width of the "gate" implied a reduction in the margins added around the clinical target volume (CTV), such a reduction was limited by setup error.A study of the potential gains that could be derived from respiratory gating (based on motion phantom experimental set up) indicated a potential CTV-PTV margin reduction of 0.2-1.1 cm while employing gating alone in combination with an electronic portal imaging device, thus decreasing the amount of healthy tissue receiving radiation. In addition, gating also improved the quality of images obtained during simulation by reducing the amount of motion artifacts that are typically seen during conventional spiral CT imaging.Imparting some form of training was hypothesized to better enable patients to breathe in a reproducible fashion, which was further thought to increase the accuracy and efficacy of gated radiotherapy, especially when the "gate" was set close to the inhale portion of the breathing cycle. An analysis of breathing patterns recorded from five patients over several sessions under conditions of normal quiet breathing, breathing with audio instructions and breathing with visual feedback indicated that training improved the reproducibility of amplitude or frequency of patient breathing cycles.An initial exploration into respiration synchronized radiotherapy was thought to facilitate realization of reduced margins without having to hold the radiation beam delivery during a breathing cycle (as is the case with gating). A feasibility study based on superimposition of respiratory motion of a tumor (simulated by a sinusoidal motion oscillator) onto the initial beam aperture as formed by the multileaf collimator (MLC) revealed that tumor dose measurements obtained with such a set up were equivalent to those delivered to a static tumor by a static beam.Finally, a feasibility study for a method to acquire respiration synchronized images of a motion phantom and a patient (in order to perform respiration synchronized treatment planning and delivery) yielded success in the form of a 4D CT data set with reduced motion artifacts.In summary, respiratory gated radiotherapy and respiration synchronized are both viable approaches to account for respiratory motion during radiotherapy. While respiratory gated radiotherapy has been successfully implemented in some centers, several technical advances are required to enable similar success in the implementation of respiration synchronized radiotherapy. However, the potential clinical gains that can be obtained from either of the above approaches and their relative contributions to margin reduction will determine their future applicability as routine treatment procedures.
44
Chavez, Marin. "Underreporting of Fatigue in Gynecologic Oncology Patients". Thesis, The University of Arizona, 2017. http://hdl.handle.net/10150/623271.
Testo completoAbstract (sommario):
A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.Cancer‐related fatigue (CRF) is a well‐documented symptom among gynecologic oncology patients. However, there is little known about the etiology, and treatment options are currently suboptimal. While the lack of knowledge surrounding the intricacies of CRF impedes effective care, there is arguably a more serious barrier to delivering adequate treatment. Fatigue symptoms are highly underreported to physicians making it impossible to offer treatment to a large subsection of patients. This study will focus specifically on gynecologic oncology patients, a population with a staggering prevalence of CRF. The purpose of this study is to identify clinical, psychosocial, and lifestyle characteristics that may be associated with the underreporting of fatigue specifically in gynecologic oncology patients. The design of this study is a cross‐sectional survey. 89 subjects were recruited from three outpatient sites. Inclusion criteria included: (a) women age ≥18 years old with a known ovarian, uterine, cervical, vaginal, vulvar, or primary peritoneal cancer; (b) Currently attending physician’s office hours and/or undergoing chemotherapy at one of the above listed centers. This study will focus specifically on the reporting of CRF in gynecologic oncology patients. Results showed that barriers to reporting fatigue were significantly correlated with the chemotherapy cycle a patient was undergoing. Additionally, the date of last treatment, a patient’s weight, and the cancer stage was associated with higher levels of underreporting in this population. The prevalence of cancer related fatigue is staggering; however, there is limited research as to why patients are underreporting such a significant symptom to their health care team. With the knowledge from this study, screening for fatigue can become more efficient by targeting women in specific chemotherapy cycles. Practitioners can also use this data to identify patients with high‐risk characteristics that might contribute to their unwillingness to discuss fatigue symptoms.
45
Gemarino, Junelle F. "Cultural Competence Among Oncology Health Care Providers". CSUSB ScholarWorks, 2014. https://scholarworks.lib.csusb.edu/etd/76.
Testo completoAbstract (sommario):
The purpose of the study was to examine cultural competence among oncology health care providers. Specifically, the study assessed how career type, presence of previous diversity training, and education affected overall cultural competence of oncology health care providers.
The study used a quantitative survey design with self-administered questionnaires. A total of 36 voluntary oncology health care providers completed the cultural competence assessment survey. Participants were asked of their cultural awareness/sensitivity, cultural behaviors, previous experiences of diversity trainings, and some demographics questions. Descriptive (e.g. mean, frequency distributions) and inferential (e.g. t-test, one-way analysis of variance) statistics were used to analyze the data.
Findings of the study showed that the levels of cultural competence among oncology health care providers were low to moderate. Oncology health care providers who were social workers and registered nurses tended to report more frequent culturally competent behaviors, compared to other career types of health care providers. The study also found that those who had specific previous diversity training tended to report higher levels of cultural competence compared to those who did not have those diversity trainings. Findings of the study suggest that there be a need for improvement in the cultural competency practice among oncology health care providers. The results of this study could serve as a reference in the initial evaluation of exploring cultural competency health care practice in the specialization of oncology.
46
Ashford, Dimitri Shabree. "BELIEFS ABOUT SELF-CARE AMONG ONCOLOGY PROVIDERS". CSUSB ScholarWorks, 2014. https://scholarworks.lib.csusb.edu/etd/54.
Testo completoAbstract (sommario):
The research question in this project explores self-care practices that oncology providers utilize to manage stress, burnout, and compassion fatigue in their work environment. As an exploratory study, this research project examines self-care practices among the oncology providers and how self-care relates to the quality of patient care. The survey provided to the participants focused on the individual well-being such as spiritual, social support, physical, and emotional support. Findings from this study indicated that oncologist utilize spiritual self-care more than any other medical professional. The older adults utilize their social support systems more than the younger adults. Individuals with three or more children are better at utilizing their social support, physical self-care, and emotional support systems than individuals with two or less children.
47
Sansourekidou, Patricia. "Accessibility of Innovative Services in Radiation Oncology". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7738.
Testo completoAbstract (sommario):
The field of radiation oncology (RO) involves the use of highly advanced techniques to treat cancer and safely spare healthy organs. The discipline has experienced rapid growth in the past 25 years, with technological advancement as the driving force. Available data and an instrument to effectively measure the accessibility of innovation in the field were lacking. The purpose of this study was to investigate the accessibility of innovative services in RO in the United States and assess possible diffusion patterns. Two hundred and forty medical physicists practicing in RO in the United States completed a custom Internet-based survey. The diffusion of innovation theory was used as the theoretical framework for the study. A quantitative cross-sectional analysis was performed to assess how innovation scores may vary depending on individual and organizational factors. ANOVA, Spearman correlation, and multiple linear regression were used to analyze the data. University affiliation, urbanicity, appreciation, and motivation were found to be statistically significant factors affecting accessibility to innovative services. Statistically significant barriers preventing innovation were lack of evidence, increased complexity, staffing constraints, lack of interest from others, lack of interoperability, and lack of reimbursement. Medical physicists are in a leadership position to influence the adoption of innovative services in RO. Encouraging the utilization of innovative and Food and Drug Administration-approved techniques may improve cancer outcomes and consequently have a positive social change effect on public health.
48
Cashavelly, Barbara J. "Sexual attitudes of oncology and rehabilitation nurses". Thesis, Boston University, 1988. https://hdl.handle.net/2144/38013.
Testo completoAbstract (sommario):
Thesis (MS)--Boston UniversityPLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
Sexuality is one quality of being human. Sexual health must be addressed as a significant and integral element of total health care. Nurses caring for patients with oncology and neuromuscular related disabilities are presented with situations concerning sexual dysfunctions that require judgement, knowledge and sensitivity. Yet, studies have shown that nurses demonstrate low sexual knowledge levels and conservative sexual attitudes. They often neglect this aspect of patient care. The sexual attitudes of nurses may be a significant obstacle to their effective functioning in the field of sexual counseling. This proposed study will investigate sexual attitudes of oncology nurses and rehabilitation nurses.
2031-01-01
49
Cribaro, George Paul. "Three-dimensional atlas of vascular networks in human glioblastoma". Doctoral thesis, Universitat Autònoma de Barcelona, 2018. http://hdl.handle.net/10803/666671.
Testo completoAbstract (sommario):
El glioblastoma multiforme (GBM) presenta activación de marcadores neuroinflamatorios, que promueven la activación de las células gliales locales y la infiltración de monocitos y linfocitos. Esta activación inflamatoria y la angiogénesis local se considera que pueden promover el crecimiento del tumor conjuntamente, y la angiogénesis parece ser crítica para la supervivencia y propagación del tumor. Se cree que las redes de vasos sanguíneos actúan como vías para que los macrófagos M2 activados alternativamente y las células tumorigénicas entren en áreas cerebrales sanas. Los vasos sanguíneos en el GBM muestran notables alteraciones morfológicas, aunque la importancia de estos cambios aún no se comprende bien.
Como tal, es oportuno revisar la microarquitectura básica de la vasculatura del glioma. Aquí, analizamos la microvasculatura tridimensional (3D) en bloques de tejido de biopsias humanas de 60 µm de espesor y flotantes. Mediante inmunofluorescencia, visualizamos los componentes de la membrana basal y de las células endoteliales, examinando varias poblaciones del microambiente tumoral (MET). Después de la detección inmunohistoquímica, las muestras se visualizaron con un microscopio confocal de barrido láser y las imágenes 3D resultantes se analizaron con software especializado (Imaris y Fiji) para cuantificar los parámetros morfo- y topológicos relevantes. Posteriormente, estos parámetros se compararon con el tejido normal y se correlacionaron con la severidad del tumor.
Nuestro análisis muestra evidencia de una profunda alteración de la membrana basal, probablemente por una deposición alterada de colágeno IV y consecuentemente vemos discontinuidad de la pared del vaso y disociación de CD31/colágeno IV, resultando en vasos sanguíneos aparentemente sin revestimiento de células endoteliales. Los vasos tienen apariencia aberrante, con diámetros más grandes y variables, distribución desigual e irregular del colágeno IV y fenestración de la pared del vaso. Se identificaron patrones de vascularización tumoral primaria (cooptación, looping, intususcepción y vasos corolarios silenciosos) y estrategias de ramificación predominantes.
Nuestros datos confirman que el glioma humano utiliza múltiples estrategias de vasculogénesis, y muchas alteraciones de la vasculatura tumoral se correlacionan positivamente con la gravedad del tumor. Se estableció que las células T aumentan en el GBM y pueden entrar más profundamente en los tumores de mayor severidad. Además, una mayor penetración se correlaciona positivamente con una mayor discontinuidad de las paredes de los vasos sanguíneos. Los macrófagos y microglia también aumentan con la tumorigenicidad; y las células MHCII+ y GFAP+ ocupan nichos tumorales distintos.
Hemos desarrollado una técnica de inmunotinción de muestras fiable y replicable que preserva las relaciones estructurales, lo que nos permite estudiar la vasculatura del glioma y las poblaciones de células del MET y recopilar datos relevantes sobre las relaciones intercelulares en el espacio. Un análisis tan profundo del tejido humano es esencial para comprender las enfermedades cerebrales en su entorno natural y mirar más allá de los modelos experimentales.Glioblastoma multiforme (GBM) presents activation of neuroinflammatory markers, which promotes local glial cell activation and monocyte and lymphocyte infiltration. This inflammatory activation and local angiogenesis are thought together to promote tumor growth, and this angiogenesis appears critical to tumor survival and propagation. Blood vessel networks are believed to act as paths for alternatively activated M2 macrophages and tumorigenic cells to enter naïve brain areas. GBM blood vessels show important morphological alterations yet the significance of these changes is poorly understood. As such, revisiting the basic microarchitecture of glioma vasculature is opportune. Here, we analyze the microvasculature three-dimensionally (3D) in 60-µm thick, free-floating human biopsy tissue blocks, visualizing basement membrane and endothelial cell components and examining several tumor microenvironment (TME) populations. After immunohistochemical detection, samples were imaged in 3D with a laser scanning confocal microscope and the resulting 3D image stacks were analyzed with specialized software (Imaris and Fiji) to quantify relevant morpho- and topological parameters which were compared with normal tissue and correlated with tumor severity. Our analysis shows evidence of profound basement membrane disruption, i.e. altered collagen IV deposition and consequent vessel wall discontinuity and CD31/collagen IV disassociation, resulting in blood vessels apparently without intact endothelial cell lining. Vessels seem clearly aberrant with larger, more variable diameters, uneven, irregular collagen IV distribution and vessel wall fenestration. We identified primary tumor vascularization patterns (cooption, looping, intussusception and silent corollary vessels) and predominant branching strategies. Our data confirms that the human glioma environment utilizes multiple vasculogenesis strategies and many tumor vasculature alterations correlate positively with increased tumor severity. We established that T cells increase in GBM conditions and may enter more deeply into the tumor with increasing severity, increased penetration correlating positively with vessel wall discontinuity. TAMMs increase with tumorigenicity; MHCII+ and GFAP+ cells occupy distinct TME niches. We have developed a reliable and replicable sample immunostaining technique that preserves structural relationships, allowing us to study the glioma vasculature and MET cell populations and collect relevant data on spatial relationships. Such a deep analysis of human tissue is essential to understand brain diseases in their natural environment and to look beyond experimental models.
50
Visioli, Andrew. "High intensity focused ultrasound : applications in clinical oncology". Thesis, Institute of Cancer Research (University Of London), 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.422332.
Testo completo