జర్నల్ ఆఫ్ ఇంటిగ్రేటివ్ ఆంకాలజీ

Introduction: In selected patients diagnosed with Breast Cancer (BC), adjuvant chemotherapy might reduce local and systemic recurrence risk, as well as cancer death rate. The combination of Docetaxel and Cyclophosphamide (TC) is a well-recognized effective adjuvant chemotherapy regimen. Nonetheless, a considerable high rate of febrile neutropenia (FN) is associated with this regimen. We sought to investigate hematologic toxicity associated with adjuvant TC in a non-selected, “real world” cohort of BC patients.

Methods: We reviewed the electronic medical records of patients who presented to the Oncology Center from Hospital Sírio-Libanês (HSL) and Instituto do Câncer do Estado de Sao Paulo (ICESP). Patients included in the analysis received adjuvant chemotherapy with TC regimen after definitive breast surgery.

Results: 95 patients with were included in our analysis. Median age was 55.5 years. All patients had a good performance status (either ECOG 0 or 1), and the great majority had no comorbidities. Most patients received 4 cycles of chemotherapy (80%). Data on granulocyte colony stimulating factor (G-CSF) administration was available in 85 patients from our cohort. G-CSF was used as primary prophylaxis in 31 patients, and as secondary prophylaxis in 13 patients, following a prior episode of febrile neutropenia. Overall, fifteen women (15.8%) had a documented FN episode. Among women who received G-CSF as primary prophylaxis, the rate of FN was 6.45% (2 patients). In contrast, among patients who did not receive primary prophylaxis with G-CSF, FN rate was considerably higher, namely 24.07% (13 patients). Patients who received primary prophylaxis with G-CSF had a statistically significant lower risk of experiencing a FN episode (p=0.049).

Conclusion: Febrile Neutropenia rate in this group of non-selected BC patients was higher than previous reported on randomized controlled trials that evaluated adjuvant TC regimen in the same dosing and schedule as used in our cohort. Primary prophylaxis with G-CSF was associated with a statistically significant lower risk of FN and should be considered in the management of patients who receive this chemotherapy combination.

Background: Homeopathy is used by 12 to 24% of European cancer patients, representing 40.4% of patients at European integrative cancer centers. In 2011, a Swiss literature review on homeopathy led to homeopathic treatment coverage in the Swiss national health insurance program. Homeopathy for curative pediatric cancer treatment is limited to 7.4% in the Netherlands, but, 76.5% of German parents will use homeopathy as part of their children’s cancer treatment. The purpose of this paper is to determine what is needed for homeopathy to play a larger role in curative, concurrent, and supportive cancer treatment.

Methods: PubMed searches in September 2016 and January 2017 were performed with search terms “adverse effects, breast cancer, cancer, cervical cancer, endometrial cancer, homeopathy, ovarian cancer, prevention, treatment”. Curative, concurrent, and supportive homeopathic cancer treatments material was taken from these searches.

Findings: At least five homeopathic formulations are immunologic adjuvants, activating natural killer cell destruction of cancer and virally infected cells. Ultramolecular Carcinosin, Phytolacca decandra, Conium, Thuja and Klimaktoplan® are appropriate for in vivo breast cancer trials. Lycopodium clavatum 5C and 15C are ready for in vivo cervical cancer trials. Sulphur 30C, may be considered for non-small cell lung adenocarcinoma treatment trials. Conventional cancer treatment associated anxiety, asthenia, depression, dermatitis, folliculitis, hot flushes, insomnia, nausea and vomiting, and stomatitis, respond to numerous homeopathic treatments including hetero-isotherapy.

Conclusion & Significance: In vitro studies and retrospective case series indicate that homeopathy could provide curative cancer treatment for an array of cancers: Breast, cervix, gallbladder, liver, lung, oral, pancreas, periampullary, skin, and stomach. Appropriately designed randomized controlled trials (RCT) based on reproducible homeopathic treatments and clinical protocols, with intent-to-treat analysis will have increased validity. If these RCT have positive outcomes homeopathy will secure a position in curative, concurrent, and supportive cancer treatment.

Doxorubicin (DOX) has been used in the treatment of variety of cancers but its administration is limited by a dosedependent toxicity. Its cytotoxic effects on malignant cells have shown an increase in the risk of cardiotoxicity, hepatoxicity, renal insufisance. Antioxydants have been explored for both their cancer preventive properties and chemodulatory of DOX toxicity. Resveratrol (RSV) is a polyphenolic constituent of several dietary mainly of grapes and wine origin recently its anticancer potential has been extensively explored, revealing its anti-proliferative effect on different cancer cell lines, both in vitro and in vivo. RSV is also known to have modulatory effects on cell apoptosis, migration and growth via various signaling pathways. Though, RSV possesses great medicinal value, its applications as a therapeutic drug is limited. Problems like low oral bioavailability and poor aqueous solubility make RSV an unreliable candidate for therapeutic purposes. Additionally, the rapid gastrointestinal digestion of RSV is also a major barrier for its clinical translation. Hence, to overcome these disadvantages RSV-based nanodelivery systems have been considered in recent times. Nanodelivery systems of RSV have shown promising results in its uptake by the epithelial system as well as enhanced delivery to the target site. Herein we have tried to bring new new insights into the molecular mechanisms of DOX toxicity with respect to DNA damage, free radicals and whether RSV can be a playmaker as chemodulatory of DOx.