scholarly journals Emphysematous Pyelonephritis and Cystitis: Unusual Adverse Events during Concurrent Chemoradiotherapy for Lung Cancer

2017 ◽  
Vol 10 (1) ◽  
pp. 239-243 ◽  
Author(s):  
Tetsuya Yokoyama ◽  
Seiji Shinozaki ◽  
Hidenobu Arimura ◽  
Keita Nakatomi ◽  
Hiroshi Wataya
Keyword(s):  
Lung Cancer ◽  
Urinary Tract ◽  
Adverse Events ◽  
Concurrent Chemoradiotherapy ◽  
Urinary Tract Obstruction ◽  
Diabetic Woman ◽  
Emphysematous Pyelonephritis ◽  
Serious Infection ◽  
Potential Development ◽  
Risk Patients

Various adverse events can occur during antineoplastic therapy. A 67-year-old diabetic woman developed an emphysematous urinary tract infection (UTI) associated with chemoradiotherapy for lung cancer. She had received weekly carboplatin plus paclitaxel with thoracic radiotherapy and developed a fever on day 19. Computed tomography showed a large quantity of gas within the urinary tract. She was therefore diagnosed with emphysematous UTI. Poor diabetes control due to the weekly administration of dexamethasone, an existing urinary tract obstruction, and bone marrow suppression were involved in her serious infection. The potential development of emphysematous UTI during chemoradiotherapy should be considered in at-risk patients.

Upper urinary tract infection

2015 ◽  
Author(s):  
Mark Harber
Keyword(s):  
Urinary Tract ◽  
Acute Pyelonephritis ◽  
Urinary Tract Obstruction ◽  
Reflux Nephropathy ◽  
Upper Urinary Tract ◽  
Chronic Pyelonephritis ◽  
Severe Illness ◽  
Emphysematous Pyelonephritis ◽  
Suppurative Infection

Pyelonephritis is a suppurative infection of the kidney most commonly due to bacterial infection that may be either acute or chronic. Acute pyelonephritis is usefully subdivided into uncomplicated and complicated. The term complicated pyelonephritis is associated with an abnormal urinary tract, obstruction, stones, immunocompromise, diabetes, pregnancy, or in practical terms any pyelonephritis resulting in severe illness. The distinction is important principally in terms of type, duration, and place of treatment.The clinical spectrum of acute pyelonephritis ranges from relatively mild illness to pyonephrosis and emphysematous pyelonephritis with a fulminant course and high mortality.The term chronic pyelonephritis has been used to describe kidneys damaged from multiple, recurrent, or partially treated episodes of infection, but for many of these examples ‘reflux nephropathy’ is a better description as the role of infection is not always clear. However chronic or very recurrent infections may be associated with diabetes, abnormal urinary tracts, and any cause of obstructed drainage. Chronic pyelonephritis is also an accurate description for the progressive ongoing destruction of the kidney that occurs in xanthogranulomatous pyelonephritis or malakoplakia.

A multi-institutional randomized phase III study comparing weekly carboplatin plus nab-paclitaxel and daily low-dose carboplatin as regimens for concurrent chemoradiotherapy in elderly patients with unresectable locally advanced non-small cell lung cancer: Japan Clinical Oncology Group Study JCOG1914

2021 ◽  
Author(s):  
Ryo Shimoyama ◽  
Shota Omori ◽  
Shogo Nomura ◽  
Hirotsugu Kenmotsu ◽  
Toshiaki Takahashi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Adverse Events ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Low Dose ◽  
Concurrent Chemoradiotherapy ◽  
Small Cell ◽  
Thoracic Radiotherapy ◽  
Small Cell Lung

Abstract Daily low-dose carboplatin plus concurrent thoracic radiotherapy is the standard treatment for elderly patients with unresectable clinical stage (c-Stage) III non-small cell lung cancer (NSCLC) in Japan. However, a phase I study by Omori et al. suggests that weekly carboplatin and nab-paclitaxel plus concurrent thoracic radiotherapy have comparable efficacy outcomes with more manageable adverse events. In December 2020, we initiated a randomized controlled trial in Japan to confirm whether the weekly carboplatin plus nab-paclitaxel regimen is noninferior to the daily low-dose carboplatin regimen for concurrent chemoradiotherapy in elderly patients with unresectable c-Stage III NSCLC. We plan to enroll 166 patients from 50 institutions in 3.5 years. The primary endpoint is overall survival. The secondary endpoints are progression-free survival, response rate, proportion of patients starting maintenance durvalumab therapy, adverse events, site of progression, Functional Assessment of Cancer Therapy–Trial Outcome Index deterioration and Instrumental Activities of Daily Living deterioration.

scholarly journals Emphysematous Cystitis: Report of an Atypical Case

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Karen De Baets ◽  
Joost Baert ◽  
Luc Coene ◽  
Marc Claessens ◽  
Robert Hente ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Rapid Progression ◽  
Emphysematous Pyelonephritis ◽  
Bladder Drainage ◽  
Atypical Case ◽  
Emphysematous Cystitis ◽  
Bladder Necrosis ◽  
Overall Mortality

We report the atypical case of a nondiabetic 66-year old male with severe abdominal pain and vomiting who was found to have emphysematous cystitis. Of all gas-forming infections of the urinary tract emphysematous cystitis is the most common and the least severe. The major risk factors are diabetes mellitus and urinary tract obstruction. Most frequent causative pathogens areEscherichia coliandKlebsiella pneumoniae. The clinical presentation is nonspecific and ranges from asymptomatic urinary tract infection to urosepsis and septic shock. The diagnosis is made by abdominal imaging. Treatment consists of broad-spectrum antibiotics, bladder drainage, and management of the risk factors. Surgery is reserved for severe cases. Overall mortality rate of emphysematous cystitis is 7%. Immediate diagnosis and treatment is necessary because of the rapid progression to bladder necrosis, emphysematous pyelonephritis, urosepsis, and possibly fatal evolution.

Is there a role for hypofractionated thoracic radiotherapy in limited-stage small cell lung cancer? a propensity score matched analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21107-e21107
Author(s):  
Sondos Zayed ◽  
Hanbo Chen ◽  
Emma M Ali ◽  
George Rodrigues ◽  
Andrew Warner ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Logistic Regression ◽  
Propensity Score ◽  
Adverse Events ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Cox Regression ◽  
Small Cell ◽  
Small Cell Lung

e21107 Background: Concurrent chemoradiotherapy is the standard of care for limited-stage small cell lung cancer (LS-SCLC). While conventional fractionation (CF) and hyperfractionation are the most commonly used radiotherapy schedules worldwide, hypofractionation (HF) continues to be a standard radiation regimen used in several countries. In the absence of randomized evidence comparing CF and HF, the aim of this study was to compare overall survival (OS), progression-free survival (PFS), and toxicity outcomes for CF and HF in LS-SCLC. Methods: In this single institution retrospective review, consecutive LS-SCLC patients treated between 2000-2013 with HF (40Gy/15, 45Gy/15, 45Gy/20 fractions) or CF (60Gy/30 or 66Gy/33 fractions) were included. Propensity scores were generated using a multivariable logistic regression model. Patients were matched on a 1:1 ratio with a caliper distance of 0.20. OS and PFS were estimated using the Kaplan-Meier method with differences evaluated using log-rank tests. As a sensitivity analysis, univariable and multivariable Cox regression was performed in all unmatched patients. Logistic regression was performed to identify predictors of all pulmonary and esophageal adverse events. Results: In the 117 patients, there were significant baseline differences between the CF and HF cohorts. Patients who received CF were older, smoked more often concurrently with treatment, had higher ECOG performance status, different T and N stage patterns, and more commonly received concurrent chemoradiotherapy and prophylactic cranial irradiation. After propensity score matching, 72 patients were included, 36 in the HF and CF cohorts respectively. No statistically significant difference was noted between matched HF and CF cohorts for OS (P = 0.724) or PFS (P = 0.862). Similarly, multivariable Cox regression revealed no differences in OS (P = 0.886) or PFS (P = 0.717) between HF and CF in all unmatched patients. There was no difference in any pulmonary (P = 0.350) or esophageal (P = 0.097) adverse events between matched HF and CF cohorts. Skin adverse events were significantly higher for CF (41.7%) compared with HF (16.7%, P = 0.020) in matched patients. No grade 5 adverse events were observed. Conclusions: In this propensity score matched comparison of HF and CF in LS-SCLC patients who underwent curative-intent radiation treatment, HF and CF were associated with comparable OS, PFS, and toxicity outcomes. HF may therefore be a reasonable alternative to CF, should its efficacy be confirmed in prospective studies.

Myokardiale Funktion bei Feten mit Lower Urinary Tract Obstruction

2018 ◽  
Author(s):  
O Graupner ◽  
C Enzensberger ◽  
M Götte ◽  
A Wolter ◽  
V Müller ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Lower Urinary Tract Obstruction ◽  
Lower Urinary

Efficacy and Safety of Antigen-specific Immunotherapy in the Treatment of Patients with Non-small-cell Lung Cancer: A Systematic Review and Meta-analysis

2019 ◽  
Vol 19 (3) ◽  
pp. 199-209 ◽  
Author(s):  
Bing-Di Yan ◽  
Xiao-Feng Cong ◽  
Sha-Sha Zhao ◽  
Meng Ren ◽  
Zi-Ling Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Adverse Events ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Specific Immunotherapy ◽  
Meta Analysis ◽  
Small Cell ◽  
Efficacy And Safety ◽  
Small Cell Lung

Background and Objective: We performed this systematic review and meta-analysis to assess the efficacy and safety of antigen-specific immunotherapy (Belagenpumatucel-L, MAGE-A3, L-BLP25, and TG4010) in the treatment of patients with non-small-cell lung cancer (NSCLC). </P><P> Methods: A comprehensive literature search on PubMed, Embase, and Web of Science was conducted. Eligible studies were clinical trials of patients with NSCLC who received the antigenspecific immunotherapy. Pooled hazard ratios (HRs) with 95% confidence intervals (95%CIs) were calculated for overall survival (OS), progression-free survival (PFS). Pooled risk ratios (RRs) were calculated for overall response rate (ORR) and the incidence of adverse events. </P><P> Results: In total, six randomized controlled trials (RCTs) with 4,806 patients were included. Pooled results showed that, antigen-specific immunotherapy did not significantly prolong OS (HR=0.92, 95%CI: 0.83, 1.01; P=0.087) and PFS (HR=0.93, 95%CI: 0.85, 1.01; P=0.088), but improved ORR (RR=1.72, 95%CI: 1.11, 2.68; P=0.016). Subgroup analysis based on treatment agents showed that, tecemotide was associated with a significant improvement in OS (HR=0.85, 95%CI: 0.74, 0.99; P=0.03) and PFS (HR=0.70, 95%CI: 0.49, 0.99, P=0.044); TG4010 was associated with an improvement in PFS (HR=0.87, 95%CI: 0.75, 1.00, P=0.058). In addition, NSCLC patients who were treated with antigen-specific immunotherapy exhibited a significantly higher incidence of adverse events than those treated with other treatments (RR=1.11, 95%CI: 1.00, 1.24; P=0.046). </P><P> Conclusion: Our study demonstrated the clinical survival benefits of tecemotide and TG4010 in the treatment of NSCLC. However, these evidence might be limited by potential biases. Therefore, further well-conducted, large-scale RCTs are needed to verify our findings.

scholarly journals Bilateral Psoas Muscle Abscess Associated with Emphysematous Cystitis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Jae-Ki Choi ◽  
Jae-Cheol Kwon
Keyword(s):  
Urinary Tract ◽  
Early Recognition ◽  
Interventional Procedure ◽  
Psoas Muscle ◽  
Good Prognosis ◽  
Emphysematous Pyelonephritis ◽  
Perinephric Abscess ◽  
Emphysematous Cystitis ◽  
Tract Infections ◽  
Prolonged Antibiotic Therapy

Psoas muscle abscess associated with emphysematous urinary tract infection is very rare. There were very few reports about urinary tract infections such as renal abscess, perinephric abscess, and emphysematous pyelonephritis complicated with psoas muscle abscess; however, psoas muscle abscess associated with emphysematous cystitis has not yet been reported. Here, we report a case of bilateral posas muscle abscess following emphysematous cystitis in an 81-year-old nondiabetic man, who was treated successfully with prolonged antibiotic therapy and supportive care. Early recognition of psoas muscle abscess can prevent aggressive interventional procedure and warrant good prognosis.

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