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Sánchez JMB, Vázquez EC, Picado AL, Crespo MEO, Muela MHDL. Menopausal in breast cancer and the effectiveness of a dietary supplement: Serotomama project. Cir Esp 2022:S2173-5077(22)00199-5. [PMID: 35724874 DOI: 10.1016/j.cireng.2022.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Juana María Brenes Sánchez
- Breast Cancer Unit, Obstetrics and Gynecology, Women's Health Institute, Clíníco San Carlos Hospital, Madrid, Spain.
| | - Elisa Cedeira Vázquez
- Breast Cancer Unit, Obstetrics and Gynecology, Women's Health Institute, Clíníco San Carlos Hospital, Madrid, Spain
| | - Amanda López Picado
- Clinical Trials and Research Unit, IdISSC, Health Department, International University of La Rioja, La Rioja, Spain
| | | | - María Herrera De La Muela
- Breast Cancer Unit, Obstetrics and Gynecology, Women's Health Institute, Clíníco San Carlos Hospital, Madrid, Spain
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202
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Pilz MJ, Gamper EM, Efficace F, Arraras JI, Nolte S, Liegl G, Rose M, Giesinger JM. EORTC QLQ-C30 general population normative data for Italy by sex, age and health condition: an analysis of 1,036 individuals. BMC Public Health 2022; 22:1040. [PMID: 35610611 PMCID: PMC9128281 DOI: 10.1186/s12889-022-13211-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 04/04/2022] [Indexed: 11/12/2022] Open
Abstract
Background General population normative values for the widely used health-related quality of life (HRQoL) measure, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire – Core 30 (EORTC QLQ-C30), are available for a range of countries. These are mostly countries in northern Europe. However, there is still a lack of such normative values for southern Europe. Therefore, this study aims to provide sex-, age- and health condition-specific normative values for the general Italian population for the EORTC QLQ-C30. Material and methods This study is based on Italian EORTC QLQ-C30 general population data previously collected in an international EORTC project comprising over 15,000 respondents across 15 countries. Recruitment and assessment were carried out via online panels. Quota sampling was used for sex and age groups (18–39, 40–49, 50–59, 60–69 and ≥ 70 years), separately for each country. We applied weights to match the age and sex distribution in our sample with UN statistics for Italy. Along with descriptive statistics, linear regression models were estimated to describe the associations of sex, age and health condition with the EORTC QLQ-C30 scores. Results A total of 1,036 respondents from Italy were included in our analyses. The weighted mean age was 49.3 years, and 536 (51.7%) participants were female. Having at least one health condition was reported by 60.7% of the participants. Men reported better scores than women on all EORTC QLQ-C30 scales but diarrhoea. While the impact of age differed across scales, older age was overall associated with better HRQoL as shown by the summary score. For all scales, differences were in favour of participants who did not report any health condition, compared to those who reported at least one. Conclusion The Italian normative values for the EORTC QLQ-C30 scales support the interpretation of HRQoL profiles in Italian cancer populations. The strong impact of health conditions on EORTC QLQ-C30 scores highlights the importance of adjusting for the impact of comorbidities in cancer patients when interpreting HRQoL data. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13211-y.
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Affiliation(s)
- Micha J Pilz
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Eva-Maria Gamper
- Innsbruck Institute of Patient-Centered Outcome Research (IIPCOR), Innsbruck, Austria
| | - Fabio Efficace
- Health Outcomes Research Unit, Italian Group for Adult Haematologic Diseases (GIMEMA) Data Centre, Rome, Italy
| | - Juan I Arraras
- Radiotherapeutic Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain.,Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Sandra Nolte
- Medical Department, Division of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Gregor Liegl
- Medical Department, Division of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Matthias Rose
- Medical Department, Division of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Johannes M Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.
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203
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Popiołek A, Brzoszczyk B, Jarzemski P, Piskunowicz M, Jarzemski M, Borkowska A, Bieliński M. Quality of Life of Prostate Cancer Patients Undergoing Prostatectomy and Affective Temperament. Cancer Manag Res 2022; 14:1743-1755. [PMID: 35620062 PMCID: PMC9129097 DOI: 10.2147/cmar.s358054] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/23/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Prostate cancer (PC) is one of the most common malignancies in men. The population of PC survivors is growing, and understanding the roles of different factors that affect quality of life (QoL) is important. We investigated the effects of affective temperament on the QoL of PC patients. Patients and Methods All subjects (n=100) underwent medical evaluation [including demographic data, medical history, physical examination, biochemical tests, and assessment of urinary incontinence (ICIQ-UI SF scale) and erectile dysfunction (ED) (IIEF-5 and subjective ED scale)] and psychological evaluation [including assessment of affective temperament using the TEMPS-A scale, depression and anxiety (using HADS), and QoL (EORTC-QLQ-C30 and EORTC-PR25)]. The relationships between individual variables were examined. Results Erection quality after treatment was associated with better QoL in most parameters. Similar strong relationships were observed between the urinary incontinence scale and QoL. Depressive, cyclothymic, irritable, and anxious temperaments were associated with decreased QoL. On the EORTC-PR25 scale, associations were observed between a depressive temperament and worse sexual function and urinary symptoms, between a cyclothymic temperament and worse urinary symptoms, and between an irritable temperament and worse sexual functioning. Multivariate analysis identified the severity of anxiety and depression symptoms measured by HADS as the most important psychological factors affecting QoL. Conclusion QoL in PC survivors depends on many factors, including age, interval since diagnosis, tumor stage, treatment, complications, and affective temperament profile. Depressive, cyclothymic, irritable, and anxious temperaments were associated with poorer QoL in selected domains, which was not observed for a hyperthymic temperament. The temperament profile of patients was associated with mood and anxiety level, which were important determinants of a poorer QoL.
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Affiliation(s)
- Alicja Popiołek
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
- Department of Internal Diseases, Jan Biziel University Hospital No.2 in Bydgoszcz, Bydgoszcz, Poland
| | - Bartosz Brzoszczyk
- Clinic of Urology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland
| | - Piotr Jarzemski
- Clinic of Urology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland
| | - Małgorzata Piskunowicz
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Marcin Jarzemski
- Clinic of Urology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland
| | - Alina Borkowska
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Maciej Bieliński
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
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Ankolekar A, van der Heijden B, Dekker A, Roumen C, De Ruysscher D, Reymen B, Berlanga A, Oberije C, Fijten R. Clinician perspectives on clinical decision support systems in lung cancer: Implications for shared decision-making. Health Expect 2022; 25:1342-1351. [PMID: 35535474 PMCID: PMC9327823 DOI: 10.1111/hex.13457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 01/28/2022] [Accepted: 02/07/2022] [Indexed: 11/27/2022] Open
Abstract
Background Lung cancer treatment decisions are typically made among clinical experts in a multidisciplinary tumour board (MTB) based on clinical data and guidelines. The rise of artificial intelligence and cultural shifts towards patient autonomy are changing the nature of clinical decision‐making towards personalized treatments. This can be supported by clinical decision support systems (CDSSs) that generate personalized treatment information as a basis for shared decision‐making (SDM). Little is known about lung cancer patients' treatment decisions and the potential for SDM supported by CDSSs. The aim of this study is to understand to what extent SDM is done in current practice and what clinicians need to improve it. Objective To explore (1) the extent to which patient preferences are taken into consideration in non‐small‐cell lung cancer (NSCLC) treatment decisions; (2) clinician perspectives on using CDSSs to support SDM. Design Mixed methods study consisting of a retrospective cohort study on patient deviation from MTB advice and reasons for deviation, qualitative interviews with lung cancer specialists and observations of MTB discussions and patient consultations. Setting and Participants NSCLC patients (N = 257) treated at a single radiotherapy clinic and nine lung cancer specialists from six Dutch clinics. Results We found a 10.9% (n = 28) deviation rate from MTB advice; 50% (n = 14) were due to patient preference, of which 85.7% (n = 12) chose a less intensive treatment than MTB advice. Current MTB recommendations are based on clinician experience, guidelines and patients' performance status. Most specialists (n = 7) were receptive towards CDSSs but cited barriers, such as lack of trust, lack of validation studies and time. CDSSs were considered valuable during MTB discussions rather than in consultations. Conclusion Lung cancer decisions are heavily influenced by clinical guidelines and experience, yet many patients prefer less intensive treatments. CDSSs can support SDM by presenting the harms and benefits of different treatment options rather than giving single treatment advice. External validation of CDSSs should be prioritized. Patient or Public Contribution This study did not involve patients or the public explicitly; however, the study design was informed by prior interviews with volunteers of a cancer patient advocacy group. The study objectives and data collection were supported by Dutch health care insurer CZ for a project titled ‘My Best Treatment’ that improves patient‐centeredness and the lung cancer patient pathway in the Netherlands.
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Affiliation(s)
- Anshu Ankolekar
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Britt van der Heijden
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Andre Dekker
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Cheryl Roumen
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Dirk De Ruysscher
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Bart Reymen
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Adriana Berlanga
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Cary Oberije
- The D-Lab, GROW School for Oncology, Maastricht University Medical Center+, Maastricht University, Maastricht, The Netherlands
| | - Rianne Fijten
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
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Yang S, Xu X. Anxiety and quality of life among papillary thyroid cancer patients awaiting final pathology results after surgery. Endocrine 2022; 76:377-384. [PMID: 35113335 DOI: 10.1007/s12020-022-02996-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/22/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE There is a lack of research on short-term mental health and health-related quality of life (HRQoL) in thyroid cancer patients. This study aimed to assess the short-term anxiety level and HRQoL of patients during the early postoperative period while awaiting pathology results, and to explore the important factors associated with state anxiety. METHODS In this single-center cross-sectional study, 349 patients with papillary thyroid cancer were included. Anxiety and HRQoL were measured using the State-Trait Anxiety Inventory (STAI) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30), respectively. RESULTS In general, papillary thyroid cancer patients reported good quality of life with a mean global quality of life score of 75.69 ± 20.66 (on a scale of 0-100, where 100 means the best). There was no significant difference in HRQoL between the two groups, except regarding social functioning (p = 0.027). The anxiety levels of the two groups were similar; however, the state anxiety score (42.17 ± 12.52) was significantly higher than the trait anxiety score (40.69 ± 11.18) among patients in the non-FNA group (p = 0.023). Dyspnea, insomnia, QL, and trait anxiety were independent factors that affected state anxiety. CONCLUSION Patients with papillary thyroid cancer had good postoperative HRQoL and a significantly higher than usual level of state anxiety while awaiting pathology results. Symptoms of dyspnea and insomnia, global quality of life, and trait anxiety are important factors associated with state anxiety. Preoperative FNA results may moderate the change in anxiety level. These findings may help clinicians provide psychological support.
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Affiliation(s)
- Shijie Yang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiequn Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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206
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Noel CW, Keshavarzi S, Forner D, Stephens RF, Watson E, Monteiro E, Hosni A, Hansen A, Goldstein DP, de Almeida JR. Construct Validity of the EuroQoL-5 Dimension and the Health Utilities Index in Head and Neck Cancer. Otolaryngol Head Neck Surg 2022; 166:877-885. [PMID: 34311628 PMCID: PMC9066667 DOI: 10.1177/01945998211030173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/16/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the construct validity of 2 health utility instruments-the EuroQoL-5 Dimension (EQ-5D) and the Health Utilities Index-Mark 3 (HUI-3)-and to compare them with disease-specific measures in patients with head and neck cancer. STUDY DESIGN Prospective cross-sectional analysis. SETTING Princess Margaret Cancer Centre. METHODS Patients were administered the EQ-5D, HUI-3, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its head and neck cancer module (EORTC QLQ-H&N35), and the University of Washington Quality of Life Questionnaire (UWQoL). Several a priori expected relations were examined. The correlative and discriminative properties of the various instruments were examined. RESULTS A total of 209 patients completed the 4 questionnaires. A significant ceiling effect was observed among EQ-5D responses (23% reported a maximum score of 1). The EQ-5D (rho = 0.79) and HUI-3 (rho = 0.60) had a strong correlation with the social-emotional domain of the UWQoL. The EQ-5D had a moderate correlation with the physical domain of the UWQoL (rho = 0.42), whereas the HUI-3 had a weak correlation (rho = 0.29). The EQ-5D and HUI-3 were able to distinguish among levels of health severity measured on the EORTC QLQ-C30 though not the QLQ-H&N35. Comparatively, the UWQoL was able to distinguish levels of disease severity on the EORTC QLQ-C30 and QLQ-H&N35. CONCLUSION The results of this study demonstrate that disease-specific domains from head and neck quality-of-life instruments are not strongly correlated with the EQ-5D and HUI-3. Consideration should be put toward development of a disease-specific preference-based measure for health economic evaluation. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Christopher W. Noel
- Department of Otolaryngology–Head and Neck Surgery, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sareh Keshavarzi
- Department of Biostatistics, University Health Network, Toronto, Canada
| | - David Forner
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Otolaryngology–Head and Neck Surgery, Dalhousie University, Halifax, Canada
| | - Robert F. Stephens
- Department of Otolaryngology–Head and Neck Surgery, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Canada
| | - Erin Watson
- Department of Dentistry, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Canada
| | - Eric Monteiro
- Department of Otolaryngology–Head and Neck Surgery, Sinai Health System, University of Toronto, Toronto, Canada
| | - Ali Hosni
- Department of Radiation Oncology, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Canada
| | - Aaron Hansen
- Department of Medical Oncology, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Canada
| | - David P. Goldstein
- Department of Otolaryngology–Head and Neck Surgery, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Canada
| | - John R. de Almeida
- Department of Otolaryngology–Head and Neck Surgery, Princess Margaret Cancer Centre–University Health Network, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Influence of Spirituality and Religiosity of Cancer Patients on Their Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094952. [PMID: 35564346 PMCID: PMC9103221 DOI: 10.3390/ijerph19094952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/14/2022] [Accepted: 04/17/2022] [Indexed: 11/16/2022]
Abstract
Taking into account the spiritual and religious dimensions is important when it comes to taking care of patients with cancer and their quality of life. The study aimed to show the degree of dependence between the level of spirituality/religiosity of people who have just been diagnosed with cancer or have been diagnosed with cancer in the past and their quality of life. The Daily Spiritual Experience Scale (DSES), the EORTC QLQ-C30 quality of life and EORTC QLQ-FA12 fatigue-related quality of life questionnaire were used. One hundred one respondents of the Catholic faith obtained 65.22 points in DSES; 49.84 points on the QLQ-C30 functioning scale, 58.75 points on the physical scale, 60.73 points on the social scale, 50.17 points on the emotional scale, 64.69 points on the cognitive scale, 55.45 points in fulfilling one’s role and 28.38 points in financial impact. In the QLQ-FA12, respondents obtained 45.94 points on the physical scale, 47.53 points on the emotional scale and 30.69 points on the cognitive scale. In the respondents’ opinion, fatigue was the disease that reduced their quality of life the most—on average, 51.27 points. The oncological patients were characterized by a high level of spirituality/religiosity and an average level of quality of life. Spirituality/religiosity had a positive relationship with physical, emotional and social functioning. On the other hand, it was negatively associated with disease symptoms, such as pain or emotional and physical fatigue. Future research is needed in the context of the quality of life, focused on the spiritual and religious sphere of functioning of cancer patients, conducted in various cultural, ethnic and religious circles, which can serve to improve the education of nurses and develop their spiritual competences.
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208
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Maeng CH, Kim BH, Chon J, Kang WS, Kang K, Woo M, Hong IK, Lee J, Lee KY. Effect of multimodal intervention care on cachexia in patients with advanced cancer compared to conventional management (MIRACLE): an open-label, parallel, randomized, phase 2 trial. Trials 2022; 23:281. [PMID: 35410294 PMCID: PMC8996396 DOI: 10.1186/s13063-022-06221-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/26/2022] [Indexed: 12/15/2022] Open
Abstract
Background Cancer cachexia (CC) is a multifactorial process characterized by progressive weight loss, muscle mass, and fat tissue wasting, which adversely affects the quality of life and survival of patients with advanced stages of cancer. CC has a complex and multifactorial pathophysiology, and there is no established standard treatment. Therefore, it is often irreversible and a single treatment modality is unlikely to suppress its progression. We are conducting a randomized trial to investigate the efficacy and safety of a multimodal intervention compared to the best supportive care for patients who received palliative chemotherapy. Methods Patients with lung or gastrointestinal cancers undergoing palliative chemotherapy are eligible. Patients are randomized into a multimodal intervention care (MIC) arm versus a conventional palliative care (CPC) arm. MIC includes ibuprofen, omega-3-fatty acid, oral nutritional supplement, weekly physical, psychiatric assessment, nutritional counseling, and complementary and alternative medicine. CPC includes basic nutritional counseling and megestrol acetate as needed (i.e., anorexia ≥ grade 2). All interventions are performed for 12 weeks per subject. The co-primary outcomes are change (kg) in total lean body mass and handgrip strength (kg) from the baseline. A total of 112 patients will be assigned to the two arms (56 in each group). Discussion The purpose of this study is to evaluate the effect of MIC in preventing or alleviating CC in patients who underwent palliative chemotherapy. As there is no established single treatment for CC, it is expected that the results of this clinical trial will provide new insights to significantly improve the quality of life of patients with cancer. Considering the complex mechanisms of cachexia, the effect of MIC rather than a single specific drug is more promising. In this study, we did not overly restrict the type of cancer or chemotherapy. Therefore, we attempted to measure the effects of complex interventions while preserving clinical situations. Thus, it is expected that the results of this study can be applied effectively to real-world practice. Trial registration This clinical trial was registered in the Clinical Research Information Service (KCT0004967), Korean Clinical Trial Registry on April 27, 2020, and ClinicalTrial.gov (NCT 04907864) on June 1, 2021.
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209
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Mlakar I, Lin S, Nateqi J, Gruarin S, Diéguez L, Piairo P, Pires LR, Tement S, Aleksandraviča I, Leja M, Arcimoviča K, Bleret V, Kaux JF, Kolh P, Maquet D, Gómez JG, Mata JG, Salgado M, Horvat M, Ravnik M, Flis V, Smrke U. Establishing an Expert Consensus on Key Indicators of the Quality of Life among Breast Cancer Survivors: A Modified Delphi Study. J Clin Med 2022; 11:2041. [PMID: 35407649 PMCID: PMC8999421 DOI: 10.3390/jcm11072041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: The needs of cancer survivors are often not reflected in practice. One of the main barriers of the use of patient-reported outcomes is associated with data collection and the interpretation of patient-reported outcomes (PROs) due to a multitude of instruments and measuring approaches. The aim of the study was to establish an expert consensus on the relevance and key indicators of quality of life in the clinical practice of breast cancer survivors. (2) Methods: Potential indicators of the quality of life of breast cancer survivors were extracted from the established quality of life models, depicting survivors' perspectives. The specific domains and subdomains of quality of life were evaluated in a two-stage online Delphi process, including an international and multidisciplinary panel of experts. (3) Results: The first round of the Delphi process was completed by 57 and the second by 37 participants. A consensus was reached for the Physical and Psychological domains, and on eleven subdomains of quality of life. The results were further supported by the additional ranking of importance of the subdomains in the second round. (4) Conclusions: The current findings can serve to optimize the use of instruments and address the challenges related to data collection and interpretation as the facilitators of the adaption in routine practice.
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Affiliation(s)
- Izidor Mlakar
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia;
| | - Simon Lin
- Data Science Department, Symptoma, 1030 Vienna, Austria;
| | - Jama Nateqi
- Medical Department, Symptoma, 4864 Attersee, Austria; (J.N.); (S.G.)
| | - Stefanie Gruarin
- Medical Department, Symptoma, 4864 Attersee, Austria; (J.N.); (S.G.)
| | - Lorena Diéguez
- RUBYnanomed, 4700-314 Braga, Portugal; (L.D.); (P.P.); (L.R.P.)
| | - Paulina Piairo
- RUBYnanomed, 4700-314 Braga, Portugal; (L.D.); (P.P.); (L.R.P.)
| | | | - Sara Tement
- Faculty of Arts, Department of Psychology, University of Maribor, 2000 Maribor, Slovenia;
| | - Ilona Aleksandraviča
- Institute of Clinical and Preventive Medicine of the University of Latvia, LV-1586 Riga, Latvia; (I.A.); (M.L.)
| | - Mārcis Leja
- Institute of Clinical and Preventive Medicine of the University of Latvia, LV-1586 Riga, Latvia; (I.A.); (M.L.)
| | - Krista Arcimoviča
- Oncology Centre of Latvia, Riga East Clinical University Hospital, LV-1038 Riga, Latvia;
| | - Valérie Bleret
- Department of Senology, University Hospital of Liège, 4000 Liège, Belgium; (V.B.); (D.M.)
| | - Jean-François Kaux
- Physical and Rehabilitation Medicine, University Hospital of Liège, 4000 Liège, Belgium;
| | - Philippe Kolh
- Department of Information Systems Management, University Hospital of Liège, 4000 Liège, Belgium;
| | - Didier Maquet
- Department of Senology, University Hospital of Liège, 4000 Liège, Belgium; (V.B.); (D.M.)
| | - Jesús Garcia Gómez
- Oncology Department, University Hospital Complex of Ourense (SERGAS), 32005 Ourense, Spain; (J.G.G.); (J.G.M.)
| | - Jesus García Mata
- Oncology Department, University Hospital Complex of Ourense (SERGAS), 32005 Ourense, Spain; (J.G.G.); (J.G.M.)
| | - Mercedes Salgado
- Department of Medical Oncology, Galician Health Services (SERGAS), 15703 Santiago de Compostela, A Coruña, Spain;
| | - Matej Horvat
- Department of Oncology, University Medical Centre Maribor, 2000 Maribor, Slovenia; (M.H.); (M.R.); (V.F.)
| | - Maja Ravnik
- Department of Oncology, University Medical Centre Maribor, 2000 Maribor, Slovenia; (M.H.); (M.R.); (V.F.)
| | - Vojko Flis
- Department of Oncology, University Medical Centre Maribor, 2000 Maribor, Slovenia; (M.H.); (M.R.); (V.F.)
| | - Urška Smrke
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia;
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Caliskan K, Can G. Determining the symptoms and coping methods of patients at home after hematopoietic stem cell transplantation. Support Care Cancer 2022; 30:5881-5890. [PMID: 35376995 DOI: 10.1007/s00520-022-07017-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/25/2022] [Indexed: 11/12/2022]
Abstract
AIM This descriptive study was conducted to determine symptoms experienced at home in the early period by patients who received hematopoietic stem cell transplantation (HSCT), identify coping behaviors used by the patients in the management of symptoms and assess the quality of life of these patients. METHOD The study included 200 patients who had received HSCT at a private hospital in Kocaeli in Turkey between October 2017 and November 2018 and been discharged. The data of the study were collected by using a patient information and interview form developed by the researcher, the Memorial Symptom Assessment Scale and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. RESULTS The mean age of the patients was approximately 51, 39% (n = 78) of the patients were female, 61% (n = 122) were male, and the vast majority (82%) were married. The three most frequently experienced symptoms among the patients after being discharged were identified as pain (63%), weakness (48%), and loss of appetite (43%). It was found that the vast majority of the patients complied with coping behaviors reported in the literature, but these behaviors were partially effective. Clinical diagnosis, type of transplant, status of re-hospitalization of the being discharged, and number of problems experienced were identified as variables that were significantly effective on the treatment-related symptom experiences and many dimensions of the quality of life of the patients (p < 0.05). CONCLUSION It was determined that the patients who were included in this study experienced various symptoms on different levels and at different frequencies. Regarding the effectiveness of the approaches used by the patients in coping with the symptoms they experienced, it was determined that the approaches they used to cope with nausea-vomiting, fever and insomnia were effective, and those they used for weight loss and anxiety were ineffective.
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Affiliation(s)
- Kader Caliskan
- Anadolu Medical Center, Cumhuriyet Mahallesi, 2255 Sokak, No: 3 Gebze, 41400, Kocaeli, Turkey.
| | - Gulbeyaz Can
- Istanbul University - Cerrahpasa Florence Nightingale Nursing Faculty, Abide-i Hürriyet Cad, Caglayan 34403, Istanbul, Turkey
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Patel DI, Gonzalez A, Moon C, Serra M, Bridges PB, Hughes D, Clarke G, Kilpela L, Jiwani R, Musi N. Exercise and Creatine Supplementation to Augment the Adaptation of Exercise Training Among Breast Cancer Survivors Completing Chemotherapy: Protocol for an Open-label Randomized Controlled Trial (the THRIVE Study). JMIR Res Protoc 2022; 11:e26827. [PMID: 35363152 PMCID: PMC9015753 DOI: 10.2196/26827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 08/24/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In breast cancer survivors, chemotherapy-induced muscle loss has been shown to be attenuated with structured resistance exercise. Creatine supplementation can increase bioenergetics in skeletal muscle, which helps to improve overall strength and endurance and reduce muscular fatigue. Therefore, we hypothesize that adding creatinine supplementation to exercise training will accelerate improvements in strength, endurance, and bioenergetics in breast cancer survivors. OBJECTIVE The primary objective is to determine the effects of combining creatine supplementation with exercise on modulating strength and physical function in breast cancer survivors by comparing these effects to those of exercise alone. The secondary objectives are to determine if creatine supplementation and exercise can increase the intramuscular storage of creatine and improve body composition by comparing this intervention to exercise alone. METHODS We aim to test our hypothesis by conducting an open-label randomized controlled trial of 30 breast cancer survivors who have completed chemotherapy within 6 months of enrollment. Eligible participants will be equally randomized (1:1) to either a creatine and exercise group or an exercise-only group for this 12-week intervention. Individuals who are randomized to receive creatine will be initially dosed at 20 g per day for 7 days to boost the availability of creatine systemically. Thereafter, the dose will be reduced to 5 g per day for maintenance throughout the duration of the 12-week protocol. All participants will engage in 3 center-based exercise sessions, which will involve completing 3 sets of 8 to 12 repetitions on chest press, leg press, seated row, shoulder press, leg extension, and leg curl machines. The primary outcomes will include changes in strength, body composition, and physical function in breast cancer survivors. The secondary outcomes will be intramuscular concentrations of creatine and adenosine triphosphate in the vastus lateralis, midthigh cross-sectional area, and quality of life. RESULTS As of October 2021, a total of 9 patients have been enrolled into the study. No unexpected adverse events have been reported. CONCLUSIONS Creatine is being studied as a potential agent for improving strength, endurance, and bioenergetics in breast cancer survivors following chemotherapy. The findings from our trial may have future implications for supporting breast cancer survivors in reversing the muscle loss experienced during chemotherapy and improving their physical function and quality of life. TRIAL REGISTRATION ClinicalTrials.gov NCT04207359; https://clinicaltrials.gov/ct2/show/NCT04207359. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/26827.
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Affiliation(s)
- Darpan I Patel
- Biobehavioral Research Laboratory, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Mays Cancer Center, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Angela Gonzalez
- Biobehavioral Research Laboratory, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Crisann Moon
- Biobehavioral Research Laboratory, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Monica Serra
- Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Preston Blake Bridges
- Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Daniel Hughes
- Mays Cancer Center, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
- Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Geoffrey Clarke
- Research Imaging Institute, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Lisa Kilpela
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Rozmin Jiwani
- Biobehavioral Research Laboratory, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Nicolas Musi
- Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
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212
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High dose rate brachytherapy in the management of anal cancer: a review. Radiother Oncol 2022; 171:43-52. [DOI: 10.1016/j.radonc.2022.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 12/29/2022]
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213
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Yılmaz NG, Timmermans DRM, Portielje J, Van Weert JCM, Damman OC. Testing the effects on information use by older versus younger women of modality and narration style in a hospital report card. Health Expect 2022; 25:567-578. [PMID: 34953006 PMCID: PMC8957735 DOI: 10.1111/hex.13389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/28/2021] [Accepted: 10/05/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Hospital report cards (HRCs) are usually presented in a textual and factual format, likely hampering information processing. OBJECTIVE This study aimed to investigate the effects of audiovisual and narrative information in HRCs on user responses, and to test differences between older and younger women. DESIGN A 2 (modality [textual vs. audiovisual]) × 3 (narration style [factual vs. process narrative vs. experience narrative]) online experiment was conducted. Information about breast cancer care was used as a case example. Age (younger [<65] vs. older [≥65]) was included as a potential effect modifier. SETTING AND PARTICIPANTS A total of 631 disease-naïve women (Mage = 56.06) completed an online survey. The outcomes were perceived cognitive load, satisfaction, comprehension, information recall and decisional conflict. Data were analysed using AN(C)OVAs. RESULTS Audiovisual (vs. textual) information resulted in higher information satisfaction across age groups, but was associated with lower comprehension in older women. An experience narrative (vs. factual information) increased satisfaction with attractiveness and emotional support of the information only in older women. A three-way interaction effect was found, suggesting that older women were most satisfied with the comprehensibility of audiovisual factual or textual process narrative information. Younger women were most satisfied with the comprehensibility of audiovisual process narrative or textual factual information. DISCUSSION AND CONCLUSION Audiovisual and narrative information in an HRC showed beneficial effects on satisfaction measures. In particular, audiovisual information could be incorporated into HRCs to increase satisfaction with information. PUBLIC CONTRIBUTION Lay persons helped in optimizing the visuals used in the stimulus materials by checking for clarity.
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Affiliation(s)
- Nida Gizem Yılmaz
- Department of Public and Occupational HealthAmsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of Communication ScienceAmsterdam School of Communication Research/ASCoR, University of AmsterdamAmsterdamThe Netherlands
| | - Danielle R. M. Timmermans
- Department of Public and Occupational HealthAmsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Johanneke Portielje
- Department of Medical OncologyLeiden University Medical CenterLeidenThe Netherlands
| | - Julia C. M. Van Weert
- Department of Communication ScienceAmsterdam School of Communication Research/ASCoR, University of AmsterdamAmsterdamThe Netherlands
| | - Olga C. Damman
- Department of Public and Occupational HealthAmsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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A Comparison between Patient- and Physician-Reported Late Radiation Toxicity in Long-Term Prostate Cancer Survivors. Cancers (Basel) 2022; 14:cancers14071670. [PMID: 35406443 PMCID: PMC8996858 DOI: 10.3390/cancers14071670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/19/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Radiotherapy is widely used as treatment for localized prostate cancer. Due to a high incidence and a good survival after treatment, a large number of prostate cancer survivors are at risk of developing late radiation toxicity. Symptoms may significantly affect quality of life; therefore, the monitoring of toxicities and evaluating their impact are increasingly important matters. Toxicities have always been assessed by physicians, but there is a growing interest in the use of questionnaires to be completed by patients themselves, so-called patient-reported outcome measures. The aim of this study was to compare both outcomes in long-term prostate cancer survivors, and to determine which outcome correlates best with a biological predictor of late radiation toxicity. In symptomatic patients, we found a low agreement; patients assigned greater severity to symptoms than the trial physician assistant did. Neither outcome correlated with the biological predictor. Consideration of both perspectives seems warranted to provide the best care. Abstract Patient-reported outcome measures (PROMs) are advocated for the monitoring of toxicity after radiotherapy. However, studies comparing physician- and patient-reported toxicity show low concordance. In this study, we compared physician- and patient-reported toxicity in long-term prostate cancer survivors after radiotherapy, and we determined the correlation with a presumable risk factor for late toxicity: γ-H2AX foci decay ratio (FDR). Patients formerly included in a prospective study were invited to participate in this new study, comprising one questionnaire and one call with a trial physician assistant. Concordance was calculated for seven symptoms. Gamma-H2AX FDRs were determined in ex vivo irradiated lymphocytes in a previous analysis. Associations between FDR and long-term prevalence of toxicity were assessed using univariable logistic regression analyses. The 101 participants had a median follow-up period of 9 years. Outcomes were discordant in 71% of symptomatic patients; in 21%, the physician-assessed toxicity (using CTCAE) was higher, and, in 50%, the patients reported higher toxicity. We did not find a correlation between presence of toxicity at long-term follow-up and FDR. In conclusion, patients assigned greater severity to symptoms than the trial physician assistant did. Consideration of both perspectives may be warranted to provide the best care.
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215
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Cáceres MC, Nadal-Delgado M, López-Jurado C, Pérez-Civantos D, Guerrero-Martín J, Durán-Gómez N. Factors Related to Anxiety, Depressive Symptoms and Quality of Life in Breast Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3547. [PMID: 35329232 PMCID: PMC8955820 DOI: 10.3390/ijerph19063547] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/07/2022] [Accepted: 03/15/2022] [Indexed: 12/15/2022]
Abstract
Breast cancer (BC) is a major public health problem internationally. Although illness survival rates have improved, patients usually suffer multiple symptoms, both physical and psychological, which can affect their quality of life (QoL). The main aim of this study was to evaluate depressive symptoms, anxiety and the QoL of people with BC. An observational, cross-sectional study was carried out at Badajoz University Hospital (Spain). A total of 200 women with BC were included. EORTC QLQ-C30 and QLQ-BR23 questionnaires were used to assess QoL. Patients were screened for depressive symptoms using the Beck Depression Inventory (BDI) and for state anxiety and trait anxiety using the State Anxiety Inventory (STAI). Thirty-eight percent of the patients in the sample had moderate to severe anxiety, which was related to the time of diagnosis, advanced stage of illness and surgical treatment. We found that 28% of patients had depressive symptoms, related mainly with time of diagnosis, adjuvant therapy and number of cycles of chemotherapy (CT). Patients with the longest time since diagnosis, in stage III, and in treatment with CT, especially those with the greatest number of cycles, had the worst scores in QoL. We found a positive association between depressive symptoms and anxiety with QoL in patients with BC.
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Affiliation(s)
- Macarena C. Cáceres
- Departamento de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, 06006 Badajoz, Spain; (C.L.-J.); (J.G.-M.); (N.D.-G.)
| | | | - Casimiro López-Jurado
- Departamento de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, 06006 Badajoz, Spain; (C.L.-J.); (J.G.-M.); (N.D.-G.)
| | - Demetrio Pérez-Civantos
- Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura Hospital Universitario de Badajoz, 06006 Badajoz, Spain;
| | - Jorge Guerrero-Martín
- Departamento de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, 06006 Badajoz, Spain; (C.L.-J.); (J.G.-M.); (N.D.-G.)
| | - Noelia Durán-Gómez
- Departamento de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad de Extremadura, 06006 Badajoz, Spain; (C.L.-J.); (J.G.-M.); (N.D.-G.)
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216
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Gosain R, Gupta M, Roy AM, Strosberg J, Glaser KM, Iyer R. Health-Related Quality of Life (HRQoL) in Neuroendocrine Tumors: A Systematic Review. Cancers (Basel) 2022; 14:1428. [PMID: 35326587 PMCID: PMC8946839 DOI: 10.3390/cancers14061428] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 12/28/2022] Open
Abstract
Therapeutic advancements in neuroendocrine tumors (NETs) have improved survival outcomes. This study aims to review the impact of the current therapeutics on health-related quality of life (HRQoL) in NET patients. A literature review was performed utilizing PubMed, The Cochrane Library, and EMBASE, using the keywords "Carcinoid", "Neuroendocrine tumor", "NET", "Quality of life", "Chemotherapy", "Chemoembolization", "Radiofrequency ablation", "Peptide receptor radionucleotide therapy", "PRRT", "Surgery", "Everolimus", "Octreotide", "Lanreotide", "Sunitinib", and "Somatostatin analog". Letters, editorials, narrative reviews, case reports, and studies not in English were excluded. Out of 2375 publications, 61 studies met our inclusion criteria. The commonly used instruments were EORTC QLQ-C30, FACT G, and EORTC- QLQ GI.NET-21. HRQoL was assessed in all pivotal trials that led to approvals of systemic therapies. All systemic therapies showed no worsening in HRQoL. The NETTER-1 study was the only study to show a statistically significant improvement in HRQoL in several domains. The trial examining sunitinib versus placebo in pancreatic NETs showed no change in QoL, except for worsening of diarrhea. In addition to clinical outcomes, patient-reported outcomes are a key element in making appropriate treatment decisions. HRQoL data should be readily provided to patients to assist in shared decision-making.
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Affiliation(s)
- Rohit Gosain
- University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, UPMC Chautauqua Hospital, Jamestown, NY 14701, USA;
| | - Medhavi Gupta
- Program in Women’s Oncology, Women and Infants Hospital and Warren Alpert Medical School of Brown University, Providence, RI 02912, USA;
| | - Arya Mariam Roy
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA;
| | - Jonathan Strosberg
- Department of Gastro Intestinal Oncology, Moffitt Cancer Center, 12902 Magnolia Dr., Tampa, FL 33612, USA;
| | - Kathryn M. Glaser
- Department of Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA;
| | - Renuka Iyer
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA;
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Lew TE, Anderson MA. Health-related quality of life for patients with chronic lymphocytic leukaemia - A critical outcome measure in the era of highly effective therapies. Br J Haematol 2022; 197:394-396. [PMID: 35262916 DOI: 10.1111/bjh.18118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Thomas E Lew
- Department of Haematology, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Australia.,Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Mary Ann Anderson
- Department of Haematology, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Australia.,Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
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Saulnier T, Philipps V, Meissner WG, Rascol O, Traon APL, Foubert-Samier A, Proust-Lima C. Joint models for the longitudinal analysis of measurement scales in the presence of informative dropout. Methods 2022; 203:142-151. [DOI: 10.1016/j.ymeth.2022.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 11/29/2022] Open
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Chen W, Li J, Peng S, Hong S, Xu H, Lin B, Liang X, Liu Y, Liang J, Zhang Z, Ye Y, Liu F, Lin C, Xiao H, Lv W. Association of Total Thyroidectomy or Thyroid Lobectomy With the Quality of Life in Patients With Differentiated Thyroid Cancer With Low to Intermediate Risk of Recurrence. JAMA Surg 2022; 157:200-209. [PMID: 34935859 PMCID: PMC8696698 DOI: 10.1001/jamasurg.2021.6442] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE Owing to the good prognosis of differentiated thyroid cancer (DTC), guidelines recommend total thyroidectomy (TT) or thyroid lobectomy (TL) as surgical treatment for DTC with low to intermediate risk of recurrence. However, the association of these surgeries with the health-related quality of life (HRQOL) of patients with DTC with low to intermediate risk of recurrence is unclear. OBJECTIVE To longitudinally compare the HRQOL of patients with DTC undergoing different surgeries. DESIGN, SETTING, AND PARTICIPANTS This prospective observational longitudinal cohort study enrolled patients diagnosed with DTC with low to intermediate risk of recurrence at the First Affiliated Hospital, Sun Yat-sen University, China, from October 1, 2018, to September 31, 2019. Eligible patients were categorized into TL and TT groups according to the surgery they underwent. They were evaluated preoperatively and followed up at 1, 3, 6, and 12 months postoperatively using 3 HRQOL-related questionnaires (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, version 3.0; Hospital Anxiety and Depression Scale; and Thyroid Cancer-Specific Quality of Life Questionnaire); serum thyrotropin levels, complications, and patient satisfaction were also monitored. Data were analyzed to compare the HRQOL of patients undergoing different surgeries at different time points. EXPOSURES Total thyroidectomy or TL. MAIN OUTCOMES AND MEASURES The primary end point was HRQOL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, version 3.0; Hospital Anxiety and Depression Scale; and Thyroid Cancer-Specific Quality of Life Questionnaire) at different time points, and the secondary end points were postoperative complications, thyrotropin level, and patient satisfaction. RESULTS Of the 1060 eligible patients, 563 underwent TL (438 women [77.8%]; median [IQR] age, 38 [31-45] years), and 497 underwent TT (390 women [78.5%]; median [IQR] age, 38 [32-48] years). Compared with the TL group, including the 1- to 4-cm tumor subgroup, the TT group experienced more postoperative HRQOL problems at 1 and 3 months postoperatively. However, nearly all the differences disappeared at 6 and 12 months postoperatively. CONCLUSIONS AND RELEVANCE Results of this study suggest that HRQOL of patients with DTC with low to intermediate risk of recurrence is not associated with the extent of surgery, and HRQOL may not be an important consideration when making surgical decisions. If better HRQOL is requested in the short term, TL may be preferred.
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Affiliation(s)
- Wanna Chen
- Department of Breast and Thyroid Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jie Li
- Department of Breast and Thyroid Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Sui Peng
- Clinical Trial Unit, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shubin Hong
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Heyang Xu
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bo Lin
- Department of Breast and Thyroid Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoli Liang
- Department of Breast and Thyroid Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yihao Liu
- Clinical Trial Unit, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiadong Liang
- Department of Breast and Thyroid Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhaoxi Zhang
- Department of Breast and Thyroid Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yingnan Ye
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Fang Liu
- Department of Breast and Thyroid Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Cuiyu Lin
- Department of Breast and Thyroid Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haipeng Xiao
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Weiming Lv
- Department of Breast and Thyroid Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Ninkron P, Yau S, Noosorn N. Predictors of smoking initiation among Thai adolescents from
low-income backgrounds: A case study of Nakhon Pathom
low-cost housing estates. Tob Induc Dis 2022; 20:21. [PMID: 35280045 PMCID: PMC8861864 DOI: 10.18332/tid/145143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 12/08/2021] [Accepted: 12/19/2021] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Globally, an estimated 1.3 billion people in the world smoke tobacco products, of which more than 8 million die annually. A disproportionate number of these deaths occur in low- and middle-income countries like Thailand. Over 19% (10.7 million) of the Thai population aged ≥15 years were estimated to be smokers; of these, 7.8% were aged 15–18 years. Nearly 1 in 10 Thai students is a current tobacco user; about 20% of these smokers had initiated smoking before their 10th birthday. This shows that early smoking initiation among Thai youths is indeed a public health problem. This study was conducted to examine the factors associated with smoking initiation among adolescents from low-income backgrounds. METHODS A cross-sectional study was conducted among youth aged 15–18 years living in low-cost housing estates in Nakhon Pathom province between 1 December 2019 and 30 July 2020. A total of 290 participants were recruited by stratified random sampling. A proprietary questionnaire was used to collect the data, which were analyzed by binary logistic regression. RESULTS Risk factors for smoking initiation were having one or both parents deceased (OR=2.28; 95% CI: 1.218–3.471, p=0.001), having divorced parents (OR=1.67; 95% CI: 1.158–2.509, p=0.013), and poor academic performance (OR=2.50; 95% CI: 0.133–3.551, p=0.032). Protective factors were having knowledge of cigarettes (OR=0.65; 95% CI: 0.179–0.895, p=0.004) and correct perception of legal public smoking places (OR=0.45; 95% CI: 0.140–0.850, p=0.025). CONCLUSIONS To curb the risks of early smoking initiation among youths of low-income backgrounds, both education and health authorities need to collaboratively design interventions tailored to raise awareness of the negative health impacts of tobacco, improve the performance of underperforming students, and meet the social needs of students whose parents are either deceased or separated to improve their social ties.
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Affiliation(s)
- Paranee Ninkron
- Department of Public Health, Faculty of Science and Technology, Nakhon Pathom Rajabhat University, Nakhon Pathom, Thailand
| | - Shamsudeen Yau
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
- Society for Family Health, Kaduna State Office, Kaduna, Nigeria
| | - Narongsak Noosorn
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
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Driessen KAJ, de Rooij BH, Vos MC, Boll D, Pijnenborg JMA, Hoedjes M, Beijer S, Ezendam NPM. Cancer-related psychosocial factors and self-reported changes in lifestyle among gynecological cancer survivors: cross-sectional analysis of PROFILES registry data. Support Care Cancer 2022; 30:1199-1207. [PMID: 34453569 PMCID: PMC8727401 DOI: 10.1007/s00520-021-06433-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 07/11/2021] [Indexed: 12/03/2022]
Abstract
PURPOSE Obesity is prevalent in gynecological cancer survivors and is associated with impaired health outcomes. Concerns due to cancer and its treatment may impact changes in lifestyle after cancer. This study aimed to assess the association between cancer-related psychosocial factors and changes in physical activity and diet, 18 months after initial treatment among gynecological cancer survivors. METHODS Cross-sectional data from the ROGY Care study were used, including endometrial and ovarian cancer patients treated with curative intent. The Impact of Cancer Scale (IOCv2) was used to assess cancer-related psychosocial factors. Self-reported changes in nutrients/food groups and in physical activity post-diagnosis were classified into change groups (less/equal/more). Multivariable logistic regression models were used to assess associations. RESULTS Data from 229 cancer survivors (59% endometrial, 41% ovarian, mean age 66 ± 9.5, 70% tumor stage I) were analyzed. In total, 20% reported to eat healthier from diagnosis up to 18 months after initial treatment, 17% reported less physical activity and 20% more physical activity. Health awareness (OR 2.79, 95% CI: 1.38; 5.65), body change concerns (OR 3.04 95% CI: 1.71; 5.39), life interferences (OR 4.88 95% 2.29; 10.38) and worry (OR 2.62, 95% CI: 1.42; 4.85) were significantly associated with less physical activity up to 18 months after initial treatment whereby gastrointestinal symptoms were an important confounder. CONCLUSION(S) This study underlines the need to raise awareness of the benefits of a healthy lifestyle and to provide tailored lifestyle advice, taking into account survivors' health awareness, body change concerns, life interferences, worry and gastrointestinal symptoms, in order to improve health behavior among gynecological cancer survivors. TRIAL REGISTRATION http://clinicaltrials.gov Identifier: NCT01185626, August 20, 2010.
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Affiliation(s)
- Karin A J Driessen
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Belle H de Rooij
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - M Caroline Vos
- Department of Obstetrics and Gynecology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Dorry Boll
- Department of Gynecology, Catharina Hospital, Eindhoven, The Netherlands
| | - Johanna M A Pijnenborg
- Department of Obstetrics & Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Meeke Hoedjes
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Sandra Beijer
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Nicole P M Ezendam
- The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
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Minnaar CA, Maposa I, Kotzen JA, Baeyens A. Effects of Modulated Electro-Hyperthermia (mEHT) on Two and Three Year Survival of Locally Advanced Cervical Cancer Patients. Cancers (Basel) 2022; 14:cancers14030656. [PMID: 35158924 PMCID: PMC8833695 DOI: 10.3390/cancers14030656] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 12/18/2022] Open
Abstract
(1) Background: Modulated electro-hyperthermia (mEHT) is a mild to moderate, capacitive-coupled heating technology that uses amplitude modulation to enhance the cell-killing effects of the treatment. We present three year survival results and a cost effectiveness analysis from an ongoing randomised controlled Phase III trial involving 210 participants evaluating chemoradiotherapy (CRT) with/without mEHT, for the management of locally advanced cervical cancer (LACC) in a resource constrained setting (Ethics Approval: M120477/M704133; ClinicalTrials.gov ID: NCT033320690). (2) Methods: We report hazard ratios (HR); odds ratio (OR), and 95% confidence intervals (CI) for overall survival and disease free survival (DFS) at two and three years in the ongoing study. Late toxicity, quality of life (QoL), and a cost effectiveness analysis (CEA) using a Markov model are also reported. (3) Results: Disease recurrence at two and three years was significantly reduced by mEHT (HR: 0.67, 95%CI: 0.48-0.93, p = 0.017; and HR: 0.70, 95%CI: 0.51-0.98, p = 0.035; respectively). There were no significant differences in late toxicity between the groups, and QoL was significantly improved in the mEHT group. In the CEA, mEHT + CRT dominated the model over CRT alone. (4) Conclusions: CRT combined with mEHT improves QoL and DFS rates, and lowers treatment costs, without increasing toxicity in LACC patients, even in resource-constrained settings.
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Affiliation(s)
- Carrie Anne Minnaar
- Department of Radiation Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa; (C.A.M.); (J.A.K.)
- Department of Radiation Oncology, Wits Donald Gordon Academic Hospital, Johannesburg 2193, South Africa
| | - Innocent Maposa
- Department of Epidemiology & Biostatistics, University of the Witwatersrand, Johannesburg 2193, South Africa;
| | - Jeffrey Allan Kotzen
- Department of Radiation Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa; (C.A.M.); (J.A.K.)
- Department of Radiation Oncology, Wits Donald Gordon Academic Hospital, Johannesburg 2193, South Africa
| | - Ans Baeyens
- Department of Radiation Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa; (C.A.M.); (J.A.K.)
- Radiobiology, Department of Human Structure and Repair, Ghent University, 9000 Ghent, Belgium
- Correspondence:
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Sharma R, Choudhary A, Bhaskar S, Bhardwaj M, Bano S, Gupta N. A prospective study of outcome predictors of intramedullary spinal cord tumors. JOURNAL OF RADIATION AND CANCER RESEARCH 2022. [DOI: 10.4103/jrcr.jrcr_49_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Banerjee J, Soni N, Saravanan M, Rao A, Upadhyay A, Dey A. Authors' reply to Padmanabhan. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_343_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Short-Term Efficacy and Quality of Life of Gastric Cancer Patients Undergoing Radical Gastrectomy Assisted by External Vision. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:4256347. [PMID: 34899964 PMCID: PMC8660229 DOI: 10.1155/2021/4256347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/28/2021] [Accepted: 11/03/2021] [Indexed: 01/04/2023]
Abstract
Objective To evaluate the clinical effects and survival prognosis of radical gastrectomy assisted by external vision in gastric cancer. Methods A total of 60 hospitalized gastric cancer patients from June 2016 to December 2018 were selected and divided into the observation group and control group according to different surgical procedures. The control group was treated with traditional open radical gastrectomy, while the observation group was treated with radical gastrectomy assisted by an external vision microscope. Relevant surgical indicators, visual analogue scale (VAS), postoperative complications, and life quality assessment were analyzed and compared between the two groups. Results The incision length and intraoperative blood loss in the observation group were smaller than those in the control group, and the difference was statistically significant (P < 0.05); compared with the control group, the observation group had significantly shorter hospital stay, earlier postoperative first exhaust time, and lower gastric fluid volume at the 3rd day after surgery (P < 0.05). The pain scores of the observation group at 1, 4, and 12 weeks after surgery were lower than those of the control group (P < 0.05), and the difference was significant. The quality of life scores at the 1st week and 12th week after surgery showed that the dysphagia symptom scores of the observation group and the control group were significantly reduced but the two groups had significant differences in fatigue, physical function, pain score, postoperative pain, and overall quality of life. The observation group was significantly better than the control group (P < 0.05). Follow-up studies showed no significant difference between mortality and cancer recurrence (P > 0.05); the patients recovered well at postoperation, and the diet of the observation group was better than that of the control group (P < 0.05); gastric reflux and knife pain were less than those of the control group (P < 0.05). Conclusion Radical gastrectomy assisted by external vision for gastric cancer yields clinical benefits for gastric cancer patients, which not only dramatically shortened the length of hospital stay but also effectively ameliorated the quality of life of patients, all indicating that external vision-assisted surgery was significantly better than traditional gastrectomy in improving the postoperative quality of life of gastric cancer patients in the absence of increasing the risk of adverse events.
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226
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Zhu Y, Hu Y, Kong X, Xiao Q, Pan Z, Zheng Z, Wei Y, Ziqiang W, Wang D, Chen J, Chen K, Zheng S, Wang M, Wu X, Ding K. Cohort profile: The National Colorectal Cancer Cohort (NCRCC) study in China. BMJ Open 2021; 11:e051397. [PMID: 34903541 PMCID: PMC8672005 DOI: 10.1136/bmjopen-2021-051397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The National Colorectal Cancer Cohort (NCRCC) study aims to specifically assess risk factors and biomarkers related to endpoints across the colorectal cancer continuum from the aetiology through survivorship. PARTICIPANTS The NCRCC study includes the Colorectal Cancer Screening Cohort (CRCSC), which recruited individuals who were at high risk of CRC between 2016 and 2020 and Colorectal Cancer Patients Cohort (CRCPC), which recruited newly diagnosed patients with CRC between 2015 and 2020. Data collection was based on questionnaires and abstraction from electronic medical record. Items included demographic and lifestyle factors, clinical information, survivorship endpoints and other information. Multiple biospecimens including blood, tissue and urine samples were collected. Participants in CRCSC were followed by a combination of periodic survey every 5 years and annual linkage with regional or national cancer and death registries for at least 10 years. In CRCPC, follow-up was conducted with both active and passive approaches at 6, 12, 18, 24, 36, 48 and 60 months after surgery. FINDINGS TO DATE A total of 19 377 participants and 15 551 patients with CRC were recruited in CRCSC and in CRCPC, respectively. In CRCSC, 48.0% were men, and the average age of participants at enrolment was 58.7±8.3 years. In CRCPC, 61.4% were men, and the average age was 60.3±12.3 years with 18.9% of participants under 50 years of age. FUTURE PLANS Longitudinal data and biospecimens will continue to be collected. Based on the cohorts, several studies to assess risk factors and biomarkers for CRC or its survivorship will be conducted, ultimately providing research evidence from Chinese population and optimising evidence-based guidelines across the CRC continuum.
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Affiliation(s)
- Yingshuang Zhu
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yeting Hu
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiangxing Kong
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Xiao
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhizhong Pan
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhaoxu Zheng
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye Wei
- Department of General Surgery, Zhongshan Hospital Fudan University, Shanghai, China
| | - Wang Ziqiang
- Departments of 1Gastrointestinal Surgery and 2Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Da Wang
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaqi Chen
- Department of Medical Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kun Chen
- Department of Epidemiology and Biostatistics, Cancer Institute of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shu Zheng
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Meilin Wang
- Department of Environmental Genomics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China
| | - Xifeng Wu
- Center for Biostatistics, Bioinformatics, and Big Data, Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Kefeng Ding
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University Cancer Center, Hangzhou, China
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Health-related quality of life of glioblastoma patients receiving post-operative concomitant chemoradiotherapy plus adjuvant chemotherapy: A longitudinal study. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2021.101339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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228
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Karlsen J, Tandstad T, Sowa P, Salvesen Ø, Stenehjem JS, Lundgren S, Reidunsdatter RJ. Pneumonitis and fibrosis after breast cancer radiotherapy: occurrence and treatment-related predictors. Acta Oncol 2021; 60:1651-1658. [PMID: 34618657 DOI: 10.1080/0284186x.2021.1976828] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Radiation pneumonitis (RP) and radiation fibrosis (RF) are common side effects after breast cancer (BC) radiotherapy (RT). However, there is a great variation in the frequency of RP and RF. This study presents the occurrence of- and the treatment-related predictors for RP and RF. Further, physician- and patient-reported pulmonary symptoms during the first year after postoperative RT for BC are demonstrated. MATERIALS AND METHODS From 2007 to 2008, 250 BC patients referred for postoperative RT were included in a prospective cohort study and followed during the first year after RT. High-resolution computed tomography of the lungs and symptom registration were performed before RT and 3, 6, and 12 months after RT. Patient-reported symptoms were registered by standard quality of life questionnaires. Logistic regression analyses were applied to estimate treatment-related predictors for radiological RP (rRP), clinical RP (cRP), radiological RF (rRF), and clinical RF (cRF). RESULTS The occurrence of rRP and cRP at three months was 78% and 19%, while 12 months after RT rRF and cRF was 89% and 16%, respectively; all reported as grade 1. In multivariable analyses, mastectomy predicted cRP at three months (OR = 2.48, p = .03) and cRF at six months, ipsilateral lung volume receiving 20 Gray or more (V20), V30, and mean lung dose (MLD) predicted rRP at six months (OR = 1.06, p = .0003; OR = 1.10, p = .001; and OR = 1.03, p = .01, respectively). Endocrine treatment predicted cRF at 12 months (OR = 2.48, p = .02). Physicians reported significant more dyspnea at 3 months (p = .003) and patients reported 'a little dyspnea' more at 3 and 12 months compared to baseline (p = .007). CONCLUSION RP and RF are prevalent in the first year after BC radiation. Mastectomy predicted cRP at three months. V20, V30, D25, and MLD predicted rRP at 6 months, and endocrine treatment predicted cRF at 12 months. Patients and physicians reported dyspnea differently.
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Affiliation(s)
- Jarle Karlsen
- Department of Oncology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Torgrim Tandstad
- Department of Oncology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Piotr Sowa
- Department of Neuroradiology, Oslo University Hospital, Oslo, Norway
| | - Øyvind Salvesen
- Department of Cancer Research and Clinical Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jo S. Stenehjem
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Steinar Lundgren
- Department of Oncology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Randi J. Reidunsdatter
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
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Dance and Music for Improving Health among Patients with Breast Cancer and Parkinson’s Disease: A Narrative Review. ENDOCRINES 2021. [DOI: 10.3390/endocrines2040042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Although a longer life may bring new opportunities for older people and society, advancing age is a leading risk factor for developing several chronic diseases, consequently limiting the health span. During the ageing process, changes in the activity of several endocrine glands may occur, leading to different clinical conditions. Being physically active becomes fundamental for healthy ageing. Despite regular physical activity being shown to have many health benefits, patients with cancer and neurodegenerative diseases remain physically inactive. Over the past two decades, there has been a major increase in arts engagement (e.g., dance and music) on health and well-being in both clinical and non-clinical contexts. Dance and music have been shown to induce positive effects on hormonal glands, patients’ sociality, and self-confidence. Therefore, this review aims to highlight evidence regarding the effects of music and dance on hormonal responses and as preventive and compliance tools for heathy ageing in breast cancer and Parkinson’s disease patients.
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Gray LA, Hernandez Alava M, Wailoo AJ. Mapping the EORTC QLQ-C30 to EQ-5D-3L in patients with breast cancer. BMC Cancer 2021; 21:1237. [PMID: 34794404 PMCID: PMC8600775 DOI: 10.1186/s12885-021-08964-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 11/04/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The types of outcomes measured collected in clinical studies and those required for cost-effectiveness analysis often differ. Decision makers routinely use quality adjusted life years (QALYs) to compare the benefits and costs of treatments across different diseases and treatments using a common metric. QALYs can be calculated using preference-based measures (PBMs) such as EQ-5D-3L, but clinical studies often focus on objective clinician or laboratory measured outcomes and non-preference-based patient outcomes, such as QLQ-C30. We model the relationship between the generic, preference-based EQ-5D-3L and the cancer specific quality of life questionnaire, QLQ-C30 in patients with breast cancer. This will result in a mapping that allows users to convert QLQ-C30 scores into EQ-5D-3L scores for the purposes of cost-effectiveness analysis or economic evaluation. METHODS We use data from a randomized trial of 602 patients with HER2-positive advanced breast cancer provided 3766 EQ-5D-3L observations. Direct mapping using adjusted, limited dependent variable mixture models (ALDVMM) is compared to a random effects linear regression and indirect mapping using seemingly unrelated ordered probit models. EQ-5D-3L was estimated as a function of the summary scales of the QLQ-C30 and other patient characteristics. RESULTS A four component mixture model outperformed other models in terms of summary fit statistics. A close fit to the observed data was observed across the range of disease severity. Simulated data from the model closely aligned to the original data and showed that mapping did not significantly underestimate uncertainty. In the simulated data, 22.15% were equal to 1 compared to 21.93% in the original data. Variance was 0.0628 in the simulated data versus 0.0693 in the original data. The preferred mapping is provided in Excel and Stata files for the ease of users. CONCLUSION A four component adjusted mixture model provides reliable, non-biased estimates of EQ-5D-3L from the QLQ-C30, to link clinical studies to economic evaluation of health technologies for breast cancer. This work adds to a growing body of literature demonstrating the appropriateness of mixture model based approaches in mapping.
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Affiliation(s)
- Laura A Gray
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK.
| | - Monica Hernandez Alava
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Allan J Wailoo
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
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Drami I, Lord AC, Sarmah P, Baker RP, Daniels IR, Boyle K, Griffiths B, Mohan HM, Jenkins JT. Preoperative assessment and optimisation for pelvic exenteration in locally advanced and recurrent rectal cancer: A review. Eur J Surg Oncol 2021; 48:2250-2257. [PMID: 34922810 DOI: 10.1016/j.ejso.2021.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 01/06/2023] Open
Abstract
The pre-operative phase in planning a pelvic exenteration or extended resections is critical to optimising patient outcomes. This review summarises the key components of preoperative assessment and planning in patients with locally advanced rectal cancer (LARC) and locally recurrent rectal cancer (LLRC) being considered for potential curative resection. The preoperative period can be considered in 5 key phases: 1) Multidisciplinary meeting (MDT) review and recommendation for neoadjuvant therapy and surgery, 2) Anaesthetic preoperative assessment of fitness for surgery and quantification of risk, 3) Shared decision making with the patient and the process of informed consent, 4) Prehabilitation and physiological optimisation 5) Technical aspects of surgical planning. This review will focus on patients who have been recommended for surgery by the MDT and have completed neoadjuvant therapy. Other important considerations beyond the scope of this review are the various neoadjuvant strategies employed which in this patient group include Total Neo-adjuvant Therapy and reirradiation. Critical to improving perioperative outcomes is the dual aim of achieving a negative resection margin in a patient fit enough for extended surgery. Advanced, realistic communication is required pre-operatively and should be maintained throughout recovery. Optimising patient's physiological and psychological reserve with a preoperative prehabilitation programme is important, with physiotherapy, psychological and nutritional input. From a surgical perspective, image based technical preoperative planning is important to identify risk points and ensure correct surgical strategy. Careful attention to the entire patient journey through these 5 preoperative phases can optimise outcomes with the accumulation of marginal gains at multiple timepoints.
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Affiliation(s)
- I Drami
- Dukes' Club, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK.
| | - A C Lord
- Dukes' Club, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - P Sarmah
- Dukes' Club, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - R P Baker
- Advanced Malignancy Subcommittee, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - I R Daniels
- Advanced Malignancy Subcommittee, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - K Boyle
- Advanced Malignancy Subcommittee, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - B Griffiths
- Advanced Malignancy Subcommittee, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - H M Mohan
- Dukes' Club, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
| | - J T Jenkins
- Advanced Malignancy Subcommittee, Association of Coloproctology of Great Britain and Ireland, Royal College of Surgeons of England, London, UK
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Scarfò L, Karamanidou C, Doubek M, Garani-Papadatos T, Didi J, Pontikoglou C, Ling J, Payne C, Papadaki HΑ, Rosenquist R, Stavroyianni N, Payne S, Ghia P, Natsiavas P, Maramis C, Stamatopoulos K. MyPal ADULT study protocol: a randomised clinical trial of the MyPal ePRO-based early palliative care system in adult patients with haematological malignancies. BMJ Open 2021; 11:e050256. [PMID: 34728446 PMCID: PMC8565565 DOI: 10.1136/bmjopen-2021-050256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The systematic collection of electronic patient-reported outcome (ePRO) in the routine care of patients with chronic haematological malignancies such as chronic lymphocytic leukaemia (CLL) and myelodysplasia syndromes (MDS) can constitute a very ambitious but worthwhile challenge. MyPal is a Horizon 2020 Research & Innovation Action aiming to meet this challenge and foster palliative care for patients with CLL or MDS by leveraging ePRO systems to adapt to the personal needs of patients and caregiver(s). METHODS AND ANALYSIS In this interventional randomised trial, 300 patients with CLL or MDS will be recruited across Europe. Patients will be randomly allocated to early palliative care using the MyPal system (n=150) versus standard care including general palliative care if needed (n=150). Patients in the experimental arm will be given access to the MyPal digital health platform which consists of purposely designed software available on smartphones and/or tablets. The platform entails different functionalities including physical and psychoemotional symptom reporting via regular questionnaire completion, spontaneous self-reporting, motivational messages, medication management and a personalised search engine for health information. Data on patients' activity (daily steps and sleep quality) will be automatically collected via wearable devices. ETHICS AND DISSEMINATION The integration of ePROs via mobile applications has raised ethical concerns regarding inclusion criteria, information provided to participants, free and voluntary consent, and respect for their autonomy. These have been carefully addressed by a multidisciplinary team. Data processing, dissemination and exploitation of the study findings will take place in full compliance with European Union data protection law. A participatory design was adopted in the development of the digital platform involving focus groups and discussions with patients to identify needs and preferences. The protocol was approved by the ethics committees of San Raffaele (8/2020), Thessaloniki 'George Papanikolaou' Hospital (849), Karolinska Institutet (20.10.2020), University General Hospital of Heraklion (07/15.4.2020) and University of Brno (01-120220/EK). TRIAL REGISTRATION NUMBER NCT04370457.
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Affiliation(s)
- Lydia Scarfò
- Internal Medicine, Vita Salute San Raffaele University, Milan, Italy
- Strategic Research Program on CLL, IRCCS San Raffaele Hospital, Milan, Italy
| | - Christina Karamanidou
- Institute of Applied Biosciences, Centre for Research and Technology-Hellas, Thessaloniki, Greece
| | - Michael Doubek
- Department of Haematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | | | - Jana Didi
- Department of Haematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | - Charalampos Pontikoglou
- Department of Hematology, University of Crete School of Medicine, Heraklion, Crete, Greece
- Department of Hematology, University Hospital of Heraklion, Heraklion, Greece
| | - Julie Ling
- Head Office, European Association for Palliative Care, Vilvoorde, Belgium
| | - Cathy Payne
- Head Office, European Association for Palliative Care, Vilvoorde, Belgium
| | - Helen Α Papadaki
- Department of Hematology, University of Crete School of Medicine, Heraklion, Crete, Greece
- Department of Hematology, University Hospital of Heraklion, Heraklion, Greece
| | - Richard Rosenquist
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | | | - Sheila Payne
- International Observatory on End of Life Care, University of Lancaster, Lancaster, UK
| | - Paolo Ghia
- Strategic Research Program on CLL, IRCCS San Raffaele Hospital, Milan, Italy
- Medical Oncology, Vita Salute San Raffaele University, Milan, Italy
| | - Pantelis Natsiavas
- Institute of Applied Biosciences, Centre for Research and Technology-Hellas, Thessaloniki, Greece
| | - Christos Maramis
- Institute of Applied Biosciences, Centre for Research and Technology-Hellas, Thessaloniki, Greece
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research and Technology-Hellas, Thessaloniki, Greece
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van Kleef JJ, Dijksterhuis WPM, van den Boorn HG, Prins M, Verhoeven RHA, Gisbertz SS, Slingerland M, Mohammad NH, Creemers GJ, Neelis KJ, Heisterkamp J, Rosman C, Ruurda JP, Kouwenhoven EA, van de Poll-Franse LV, van Oijen MGH, Sprangers MAG, van Laarhoven HWM. Prognostic value of patient-reported quality of life for survival in oesophagogastric cancer: analysis from the population-based POCOP study. Gastric Cancer 2021; 24:1203-1212. [PMID: 34251543 PMCID: PMC8502147 DOI: 10.1007/s10120-021-01209-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Accumulating evidence of trials demonstrates that patient-reported health-related quality of life (HRQoL) at diagnosis is prognostic for overall survival (OS) in oesophagogastric cancer. However, real-world data are lacking. Moreover, differences in disease stages and tumour-specific symptoms are usually not taken into consideration. The aim of this population-based study was to assess the prognostic value of HRQoL, including tumour-specific scales, on OS in patients with potentially curable and advanced oesophagogastric cancer. METHODS Data were derived from the Netherlands Cancer Registry and the patient reported outcome registry (POCOP). Patients included in POCOP between 2016 and 2018 were stratified for potentially curable (cT1-4aNallM0) or advanced (cT4b or cM1) disease. HRQoL was measured with the EORTC QLQ-C30 and the tumour-specific OG25 module. Cox proportional hazards models assessed the impact of HRQoL, sociodemographic and clinical factors (including treatment) on OS. RESULTS In total, 924 patients were included. Median OS was 38.9 months in potentially curable patients (n = 795) and 10.6 months in patients with advanced disease (n = 129). Global Health Status was independently associated with OS in potentially curable patients (HR 0.89, 99%CI 0.82-0.97), together with several other HRQoL items: appetite loss, dysphagia, eating restrictions, odynophagia, and body image. In advanced disease, the Summary Score was the strongest independent prognostic factor (HR 0.75, 99%CI 0.59-0.94), followed by fatigue, pain, insomnia and role functioning. CONCLUSION In a real-world setting, HRQoL was prognostic for OS in patients with potentially curable and advanced oesophagogastric cancer. Several HRQoL domains, including the Summary Score and several OG25 items, could be used to develop or update prognostic models.
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Affiliation(s)
- J J van Kleef
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Office D3-312, PO Box 22660, 1100DD, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Public Health Research Institute, Amsterdam, The Netherlands
| | - W P M Dijksterhuis
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Office D3-312, PO Box 22660, 1100DD, Amsterdam, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - H G van den Boorn
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Office D3-312, PO Box 22660, 1100DD, Amsterdam, The Netherlands
| | - M Prins
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Office D3-312, PO Box 22660, 1100DD, Amsterdam, The Netherlands
| | - R H A Verhoeven
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Office D3-312, PO Box 22660, 1100DD, Amsterdam, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - S S Gisbertz
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - M Slingerland
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - N Haj Mohammad
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - G-J Creemers
- Department of Medical Oncology, Catharina Hospital, Eindhoven, The Netherlands
| | - K J Neelis
- Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands
| | - J Heisterkamp
- Department of Surgery, Elizabeth-TweeSteden Hospital, Tilburg, the Netherlands
- Comprehensive Cancer Network EMBRAZE, Breda, The Netherlands
| | - C Rosman
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J P Ruurda
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E A Kouwenhoven
- Department of Surgery, Hospital Group Twente, Almelo, The Netherlands
| | - L V van de Poll-Franse
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - M G H van Oijen
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Office D3-312, PO Box 22660, 1100DD, Amsterdam, The Netherlands
| | - M A G Sprangers
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Public Health Research Institute, Amsterdam, The Netherlands
| | - H W M van Laarhoven
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Office D3-312, PO Box 22660, 1100DD, Amsterdam, The Netherlands.
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Taggar AS, Mann P, Folkert MR, Aliakbari S, Myrehaug SD, Dawson LA. A systematic review of intraluminal high dose rate brachytherapy in the management of malignant biliary tract obstruction and cholangiocarcinoma. Radiother Oncol 2021; 165:60-74. [PMID: 34695521 DOI: 10.1016/j.radonc.2021.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To conduct a systematic review evaluating the impact of high dose rate (HDR) intraluminal brachytherapy (ILBT) in the management of malignant biliary obstruction and cholangiocarcinoma with specific focus on stent patency, clinical outcomes and toxicities. METHODS AND MATERIALS A review of published articles was conducted using Medline, Embase and Cochrane databases using the search terms "bile duct carcinoma" or "cholangiocarcinoma" or "bile duct neoplasms" in combination with "brachytherapy" or "high dose rate brachytherapy" or "HDR brachytherapy". Studies published in English and reporting outcomes of ≥10 patients were included in the review. Only the most recent experience was included if same patients were included in sequential publications. RESULTS Seventeen studies were identified that met the inclusion criteria. Significant heterogeneity was observed in treatment regimens, which included use of surgery, external beam radiation (EBRT), and/or intra-arterial and intravenous chemotherapy in conjunction with ILBT. Nevertheless, among the included studies, use of ILBT appeared to result in longer duration of stent patency: 10 months with ILBT compared to 4-6 months without ILBT. A trend was observed towards prolonged local control and improved complete and partial response rates in patients treated with ILBT with or without EBRT. Weighted mean overall survival of patients treated with ILBT alone was 11.8 months compared to 10.5 months for those that received EBRT +/- chemotherapy in addition to ILBT. The included studies reported low complication rates and toxicity related to ILBT. CONCLUSION Brachytherapy can be an effective and safe tool in the management of malignant biliary tract obstruction in combination with stenting. Both retrospective and prospective studies have suggested improved outcomes when HDR ILBT is combined with percutaneous stenting.
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Affiliation(s)
- Amandeep S Taggar
- Sunnybrook Odette Cancer Centre, Toronto, Canada; University of Toronto, Canada.
| | - Paveen Mann
- Sunnybrook Odette Cancer Centre, Toronto, Canada
| | | | | | - Sten D Myrehaug
- Sunnybrook Odette Cancer Centre, Toronto, Canada; University of Toronto, Canada
| | - Laura A Dawson
- Princess Margaret Cancer Centre, Toronto, Canada; University of Toronto, Canada
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235
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Jana K, Ray S, DAS R, Kumar D, Mandal TS, DAS S. ALCOHOLIC VS. NON-ALCOHOLIC CHRONIC PANCREATITIS: SURGEONS' PERSPECTIVE FROM A TERTIARY CENTRE IN INDIA. ACTA ACUST UNITED AC 2021; 34:e1595. [PMID: 34669885 PMCID: PMC8521776 DOI: 10.1590/0102-672020210002e1595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/04/2021] [Indexed: 11/21/2022]
Abstract
Background: Although alcohol is the most common cause for chronic pancreatitis worldwide, idiopathic type is prevalent in India. Natural history and disease progression are different between these two groups. There is paucity of data comparing surgical outcome and quality of life in these patients. Aim: To evaluate clinical features, surgical outcome and quality of life between these two groups of patients. Method: All patients with chronic pancreatitis who underwent surgery were prospectively reviewed. Results: From 98 patients, 42 were alcoholic. Number of male and the mean age at the time of operation was significantly more in alcoholic patients. Smoking, preoperative hospital admission rate and the prevalence of local complications like inflammatory pancreatic head mass, biliary stricture and left sided portal hypertension were distinctly more common in alcoholic group. Frey procedure was required more commonly in alcoholic group. Mean postoperative hospital stay and overall postoperative complication rate were comparable between the two groups. Over a median follow up of 18 months there was significant improvement in quality of life and pain score in both the groups. Improvement of physical functioning score at follow-up was significantly more in alcoholic group but the requirement for analgesic medications were significantly more in alcoholic group. However, appetite loss was more perceived by non-alcoholic group. Conclusion: Alcoholic chronic pancreatitis presents with more local complications associated with chronic pancreatitis. Frey procedure is a safe and well accepted surgery in this group. Though they required more analgesic requirement in short term follow up, other aspects of quality of life are similar to non-alcoholic group.
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Affiliation(s)
- Koustav Jana
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
| | - Sukanta Ray
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
| | - Roby DAS
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
| | - Dilip Kumar
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
| | - Tuhin S Mandal
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
| | - Somak DAS
- Department of Surgical Gastroenterology, SSKM Hospital and IPGMER, Kolkata, West Bengal-700020, India
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Yoo C, Kim KP, Jeong JH, Kim I, Kang MJ, Cheon J, Kang BW, Ryu H, Lee JS, Kim KW, Abou-Alfa GK, Ryoo BY. Liposomal irinotecan plus fluorouracil and leucovorin versus fluorouracil and leucovorin for metastatic biliary tract cancer after progression on gemcitabine plus cisplatin (NIFTY): a multicentre, open-label, randomised, phase 2b study. Lancet Oncol 2021; 22:1560-1572. [PMID: 34656226 DOI: 10.1016/s1470-2045(21)00486-1] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/15/2021] [Accepted: 08/16/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND The prognosis of patients with advanced biliary tract cancer who have progressed on gemcitabine plus cisplatin is dismal. We aimed to investigate the efficacy and safety of second-line liposomal irinotecan plus fluorouracil and leucovorin in patients with metastatic biliary tract cancer that has progressed on gemcitabine plus cisplatin. METHODS This multicentre, open-label, randomised, phase 2b (NIFTY) study was done at five academic institutions in South Korea and included patients aged 19 years or older with histologically or cytologically confirmed metastatic biliary tract cancer that had progressed on first-line gemcitabine plus cisplatin and an Eastern Cooperative Oncology Group performance status of 0 or 1. By use of an interactive web-based response system integrated with an electronic data capture system, patients were randomly assigned (1:1) using permuted blocks (block size 4) to receive either intravenous liposomal irinotecan (70 mg/m2 for 90 min) plus intravenous leucovorin (400 mg/m2 for 30 min) and intravenous fluorouracil (2400 mg/m2 for 46 h) every 2 weeks or leucovorin and fluorouracil only every 2 weeks, and were stratified by primary tumour site, previous surgery with curative intent, and participating centre. Study treatment was continued until the patient had disease progression or unacceptable toxicities, or withdrew consent. The primary endpoint was blinded independent central review (BICR)-assessed progression-free survival. The primary endpoint and safety were assessed in the full analysis set and the safety analysis set, respectively, both of which comprised all randomly assigned patients who received at least one dose of the study treatment. This trial is registered with ClinicalTrials.gov, NCT03524508, and enrolment is complete. FINDINGS Between Sept 5, 2018, and Feb 18, 2020, 193 patients were screened for eligibility, of whom 174 (88 in the liposomal irinotecan plus fluorouracil and leucovorin group and 86 in the fluorouracil plus leucovorin group) were enrolled and included in the full analysis and safety analysis sets. At a median follow-up of 11·8 months (IQR 7·7-18·7), the median BICR-assessed progression-free survival was significantly longer in the liposomal irinotecan plus fluorouracil and leucovorin group (7·1 months, 95% CI 3·6-8·8) than in the fluorouracil and leucovorin group (1·4 months, 1·2-1·5; hazard ratio 0·56, 95% CI 0·39-0·81; p=0·0019). The most common grade 3-4 adverse events were neutropenia (21 [24%] of 88 in the liposomal irinotecan plus fluorouracil and leucovorin group vs one [1%] of 86 in the fluorouracil and leucovorin group) and fatigue or asthenia (11 [13%] vs three [3%]). Serious adverse events occurred in 37 (42%) patients receiving liposomal irinotecan plus fluorouracil and leucovorin and 21 (24%) patients receiving fluorouracil and leucovorin. There were no treatment-related deaths. INTERPRETATION Adding liposomal irinotecan to fluorouracil and leucovorin significantly improved BICR-assessed progression-free survival in patients with advanced biliary tract cancer. Liposomal irinotecan plus fluorouracil and leucovorin could be considered a standard-of-care second-line therapy for advanced biliary tract cancer. FUNDING Servier and HK inno. N TRANSLATION For the Korean translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Changhoon Yoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| | - Kyu-Pyo Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae Ho Jeong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ilhwan Kim
- Division of Oncology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Myoung Joo Kang
- Division of Oncology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Jaekyung Cheon
- Division of Hematology and Oncology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Seoul, South Korea
| | - Byung Woog Kang
- Department of Oncology/Hematology, Kyungpook National University Hospital, Kyungpook National University, Daegu, South Korea
| | - Hyewon Ryu
- Division of Hematology and Oncology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, South Korea; Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyung Won Kim
- Asan Image Metrics, Clinical Research Center, Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ghassan K Abou-Alfa
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Medical College at Cornell University, New York, NY, USA
| | - Baek-Yeol Ryoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Trivedi R, Man H, Madut A, Mather M, Elder E, Dhillon HM, Brand A, Howle J, Mann G, DeFazio A, Amis T, Cain SW, Phillips AJK, Kairaitis K. Irregular Sleep/Wake Patterns Are Associated With Reduced Quality of Life in Post-treatment Cancer Patients: A Study Across Three Cancer Cohorts. Front Neurosci 2021; 15:700923. [PMID: 34630009 PMCID: PMC8494030 DOI: 10.3389/fnins.2021.700923] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/31/2021] [Indexed: 01/20/2023] Open
Abstract
Background: Cancer patients often describe poor sleep quality and sleep disruption as contributors to poor quality of life (QoL). In a cross-sectional study of post-treatment breast, endometrial, and melanoma cancer patients, we used actigraphy to quantify sleep regularity using the sleep regularity index (SRI), and examined relationships with reported sleep symptoms and QoL. Methods: Participants were recruited post-primary treatment (35 diagnosed with breast cancer, 24 endometrial cancer, and 29 melanoma) and wore an actigraphy device for up to 2 weeks and SRI was calculated. Self-report questionnaires for cancer-related QoL [European Organization for Research and Treatment of Cancer EORTC (QLQ-C30)] were completed. Data were compared using analysis of variance (ANOVA) or Chi-Square tests. Multivariate linear regression analysis was used to determine independent variable predictors for questionnaire-derived data. Results: Age distribution was similar between cohorts. Endometrial and breast cancer cohorts were predominantly female, as expected, and body mass index (BMI) was higher in the endometrial cancer cohort, followed by breast and melanoma. There were no differences between tumor groups in: total sleep time, sleep onset latency, bedtime, and SRI (breast 80.9 ± 8.0, endometrial 80.3 ± 12.2, and melanoma 81.4 ± 7.0) (all p > 0.05). A higher SRI was associated with both better functional and symptom scores, including increased global QoL, better physical functioning, less sleepiness and fatigue, better sleep quality, and associated with less nausea/vomiting, dyspnea, and diarrhea (all p < 0.05). Conclusion: In cancer patients post-treatment, greater sleep regularity is associated with increased global QoL, as well as better physical functioning and fewer cancer related symptoms. Improving sleep regularity may improve QoL for cancer patients.
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Affiliation(s)
- Ritu Trivedi
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Hong Man
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Ayey Madut
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Marius Mather
- Sydney Informatics Hub, The University of Sydney, Camperdown, NSW, Australia
| | - Elisabeth Elder
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia
| | - Haryana M Dhillon
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW, Australia.,Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW, Australia
| | - Alison Brand
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Department of Gynecological Oncology, Westmead Hospital, Westmead, NSW, Australia
| | - Julie Howle
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Crown Princess Mary Cancer Centre, Westmead and Blacktown Hospitals, Sydney, NSW, Australia.,Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Graham Mann
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia.,Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Anna DeFazio
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Department of Gynecological Oncology, Westmead Hospital, Westmead, NSW, Australia.,Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, NSW, Australia.,Sydney West Translational Cancer Research Centre, Westmead, NSW, Australia
| | - Terence Amis
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Westmead, NSW, Australia.,Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Sydney West Translational Cancer Research Centre, Westmead, NSW, Australia.,Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, NSW, Australia
| | - Sean W Cain
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Andrew J K Phillips
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Kristina Kairaitis
- Ludwig Engel Centre for Respiratory Research, The Westmead Institute for Medical Research, Westmead, NSW, Australia.,Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Sydney West Translational Cancer Research Centre, Westmead, NSW, Australia.,Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, NSW, Australia
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238
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Wang M, Reeve BB. Evaluations of the sum-score-based and item response theory-based tests of group mean differences under various simulation conditions. Stat Methods Med Res 2021; 30:2604-2618. [PMID: 34617840 PMCID: PMC8649417 DOI: 10.1177/09622802211043263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The use of patient-reported outcomes measures is gaining popularity in clinical
trials for comparing patient groups. Such comparisons typically focus on the
differences in group means and are carried out using either a traditional
sum-score-based approach or item response theory (IRT)-based approaches. Several
simulation studies have evaluated different group mean comparison approaches in
the past, but the performance of these approaches remained unknown under certain
uninvestigated conditions (e.g. under the impact of differential item
functioning (DIF)). By incorporating some of the uninvestigated simulation
features, the current study examines Type I error, statistical power, and effect
size estimation accuracy associated with group mean comparisons using simple sum
scores, IRT model likelihood ratio tests, and IRT expected-a-posteriori scores.
Manipulated features include sample size per group, number of items, number of
response categories, strength of discrimination parameters, location of
thresholds, impact of DIF, and presence of missing data. Results are summarized
and visualized using decision trees.
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Affiliation(s)
- Mian Wang
- Lineberger Comprehensive Cancer Center, 2331University of North Carolina at Chapel Hill, Carrboro, NC, USA
| | - Bryce B Reeve
- Department of Population Health Sciences, 3065Duke University School of Medicine, Durham, NC, USA
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Schwartz CE, Stark RB, Borowiec K, Myren KJ. No impact of Asian ethnicity on EORTC QLQ-C30 scores: Group differences and differential item functioning in paroxysmal nocturnal hemoglobinuria. Health Qual Life Outcomes 2021; 19:228. [PMID: 34583705 PMCID: PMC8477512 DOI: 10.1186/s12955-021-01860-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/13/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, life-threatening terminal-complement-mediated disease resulting in intravascular hemolysis and thrombosis with significant morbidity and premature mortality. There exists no disease-specific quality-of-life (QOL) measure for PNH. Its QOL effects resemble those of hematologic cancers, which supports the use of cancer-specific QOL measures in PNH clinical trials. The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 has published norms for many European and North American countries, but not for Asian countries. We investigated differences by Asian ethnicity in scores and item function on the EORTC QLQ-C30. METHODS This secondary analysis focused on two non-inferiority PNH trials (301 and 302) comparing eculizumab and ravulizumab (n = 441). Analysis of covariance examined the main effect of Asian ethnicity on baseline EORTC QLQ-C30 scores, after adjusting for propensity scores encompassing trial, demographic and clinical factors. Mixed modeling of longitudinal data compared subscale scores in Asian vs. non-Asian patients, after propensity adjustment. Differential item function (DIF) was examined using ordinal regression models at baseline and longitudinally, to predict item score from total score, ethnicity, and their interaction to test for uniform DIF (significant main effect for Asian) and non-uniform DIF (significant Asian-by-total-score interaction). RESULTS Of the 15 baseline domains, Asian patients scored slightly better on role and emotional functioning and slightly worse on constipation and diarrhea (0.22 < Cohen's d < 0.36). In longitudinal models, Asians reported slightly higher appetite loss, diarrhea, and financial difficulties than non-Asians (R2 increment < 0.0005). There was negligible uniform and non-uniform DIF, i.e., R2 0 to 0.018, far below Zumbo's (1999) criterion of 0.13. On average there were larger differences from norms for Asians (mean = 0.05, sd = 0.44) than non-Asians (mean = -0.07, sd = 0.36), but the size and direction of the differences varied considerably by domain, age, and gender. CONCLUSION When compared to norms, Asian patients showed no systematic biases. DIF results supported this finding. We conclude that Asian ethnicity does not impact interpretation of EORTC QLQ-C30 scores.
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Affiliation(s)
- Carolyn E Schwartz
- DeltaQuest Foundation, Inc, 31 Mitchell Road, Concord, MA, 01742, USA.
- Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA.
| | - Roland B Stark
- DeltaQuest Foundation, Inc, 31 Mitchell Road, Concord, MA, 01742, USA
| | - Katrina Borowiec
- DeltaQuest Foundation, Inc, 31 Mitchell Road, Concord, MA, 01742, USA
- Department of Measurement, Evaluation, Statistics, & Assessment, Boston College Lynch School of Education and Human Development, Chestnut Hill, MA, USA
| | - Karl-Johan Myren
- Health Economics and Outcome Research, Alexion Pharmaceuticals, Inc, Stockholm, Sweden
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Schwartz CE, Stark RB, Borowiec K, Nolte S, Myren KJ. Norm-based comparison of the quality-of-life impact of ravulizumab and eculizumab in paroxysmal nocturnal hemoglobinuria. Orphanet J Rare Dis 2021; 16:389. [PMID: 34526067 PMCID: PMC8442345 DOI: 10.1186/s13023-021-02016-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/24/2021] [Indexed: 11/25/2022] Open
Abstract
Aims Paroxysmal nocturnal hemoglobinuria (PNH) is a rare and life-threatening intravascular hematologic disorder with significant morbidity and premature mortality. Clinical trials (NCT02946463 and NCT03056040) comparing ravulizumab with eculizumab for PNH have supported the non-inferiority of the former and similar safety and tolerability. This secondary analysis compared PNH trial participants after 26 weeks on either treatment (n = 438) to a general-population sample (GenPop) (n = 15,386) and investigated response-shift effects. Methods Multivariate analysis of covariance (MANCOVA) investigated function and symptom scores on the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 of people with PNH as compared to GenPop, after covariate adjustment. Risk-factor groups were created based on clinical indicators known to be associated with worse PNH outcomes, and separate MANCOVAs were computed for lower- and higher-risk-factor groups. Differential item functioning (DIF) analyses examined whether item response varied systematically (1) by treatment, (2) compared to GenPop, and (3) over time, the latter two suggesting and reflecting response-shift effects, respectively. DIF analyses examined 24 items from scales with at least two items. Recalibration response shift was operationalized as uniform DIF over time, reflecting the idea that, for a given group, the difficulty of endorsing an item changes over time, after adjusting for the total subscale score. Reprioritization response shift was operationalized as non-uniform DIF over time, i.e., the relative difficulty of endorsing an item over time changes across the total domain score. Results Across PNH risk-factor levels, people who had been on either treatment for 26 weeks reported better-than-expected functioning and lower symptom burden compared to GenPop. Ravulizumab generally showed larger effect sizes. Results were similar for lower and higher PNH risk factors, with slightly stronger effects in the former. DIF analyses revealed no treatment DIF, but did uncover group DIF (9 items with uniform DIF, and 11 with non-uniform) and DIF over time (7 items with uniform DIF, and 3 with non-uniform). Conclusions This study revealed that people with PNH on ravulizumab or eculizumab for 26 weeks reported QOL levels better than those of the general population. Significant effects of DIF by group and DIF over time support recalibration and reprioritization response-shift effects. These findings suggest that the treatments enabled adaptive changes. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-02016-8.
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Affiliation(s)
- Carolyn E Schwartz
- DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, 01742, USA. .,Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA.
| | - Roland B Stark
- DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, 01742, USA
| | - Katrina Borowiec
- DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, 01742, USA.,Department of Measurement, Evaluation, Statistics, and Assessment, Boston College Lynch School of Education and Human Development, Chestnut Hill, MA, USA
| | - Sandra Nolte
- Division of Psychosomatic Medicine, Medical Department, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Karl-Johan Myren
- Health Economics and Outcome Research, Alexion Pharmaceuticals, Inc., Stockholm, Sweden
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Latorzeff I, Bruguière E, Bogart E, Le Deley MC, Lartigau E, Marre D, Pasquier D. Use of a Biodegradable, Contrast-Filled Rectal Spacer Balloon in Intensity-Modulated Radiotherapy for Intermediate-Risk Prostate Cancer Patients: Dosimetric Gains in the BioPro-RCMI-1505 Study. Front Oncol 2021; 11:701998. [PMID: 34513681 PMCID: PMC8427159 DOI: 10.3389/fonc.2021.701998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/21/2021] [Indexed: 01/12/2023] Open
Abstract
Background/purpose Dose-escalated external beam radiotherapy (RT) is effective in the control of prostate cancer but is associated with a greater incidence of rectal adverse events. We assessed the dosimetric gain and safety profile associated with implantation of a new biodegradable rectal spacer balloon. Materials/methods Patients scheduled for image-guided, intensity-modulated RT for intermediate-risk prostate cancer were prospectively included in the French multicenter BioPro-RCMI-1505 study (NCT02478112). We evaluated the dosimetric gain, implantation feasibility, adverse events (AEs), and prostate-cancer-specific quality of life associated with use of the balloon spacer. Results After a scheduled review of the initial recruitment target of 50 patients by the study's independent data monitoring committee (IDMC), a total of 24 patients (including 22 with dosimetry data) were included by a single center between November 2016 and May 2018. The interventional radiologist who implanted the balloons considered that 86% of the procedures were easy. 20 of the 24 patients (83.3%) received IMRT and 4 (16.7%) received volumetric modulated arc therapy (78-80 Gy delivered in 39 fractions). The dosimetric gains associated with spacer implantation were highly significant (p<0.001) for most variables. For the rectum, the median (range) relative gain ranged from 15.4% (-9.2-47.5) for D20cc to 91.4% (36.8-100.0) for V70 Gy (%). 15 patients (62%) experienced an acute grade 1 AE, 8 (33%) experienced a late grade 1 AE, 1 (4.2%) experienced an acute grade 2 AE, and 3 experienced a late grade 2 AE. No grade 3 AEs were reported. Quality of life was good at baseline (except for sexual activity) and did not markedly worsen during RT and up to 24 months afterwards. Conclusion The use of a biodegradable rectal spacer balloon is safe, effective and associated with dosimetric gains in modern RT for intermediate-risk prostate cancer.
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Affiliation(s)
- Igor Latorzeff
- Department of Radiotherapy, Clinique Pasteur, Toulouse, France
| | - Eric Bruguière
- Department of Imaging, Clinique Pasteur, Toulouse, France
| | - Emilie Bogart
- Methodology and Biostatistics Unit, Centre Oscar Lambret, Lille, France
| | | | - Eric Lartigau
- Academic Department of Radiation Oncology, Centre Oscar Lambret, Lille, France.,CRIStAL UMR CNRS 9189, Lille University, Lille, France
| | - Delphine Marre
- Department of Physics, Clinique Pasteur, Toulouse, France
| | - David Pasquier
- Academic Department of Radiation Oncology, Centre Oscar Lambret, Lille, France.,CRIStAL UMR CNRS 9189, Lille University, Lille, France
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Cáceres M, Pérez-Civantos D, Guerrero-Martín J, Delgado M, Jurado C, Durán-Gómez N. Depressive Symptoms and Quality of Life Associated With the Use of Monoclonal Antibodies in Breast Cancer Treatment. Oncol Nurs Forum 2021; 48:535-545. [PMID: 34411080 DOI: 10.1188/21.onf.535-545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To assess the relationship between (a) chemotherapy and monoclonal antibody (mAb) treatments and (b) depressive symptoms and quality of life (QOL) in patients with breast cancer. SAMPLE & SETTING 182 women with breast cancer in Spain who were undergoing chemotherapy with or without mAbs. METHODS & VARIABLES An observational, cross-sectional study was carried out. The European Organisation for Research and Treatment of Cancer (EORTC) QOL Questionnaire-Core 30 and the EORTC QOL Questionnaire-Breast Cancer were used to assess QOL. Patients were screened for depressive symptoms using the Beck Depression Inventory-II. RESULTS No relationship was found between the use of mAbs with chemotherapy and QOL, except for incidence of diarrhea. However, depressive symptoms had a negative and highly significant influence on the majority of the QOL parameters. IMPLICATIONS FOR NURSING The presence of depressive symptoms negatively affects QOL. Used concurrently, mAbs and chemotherapy do not negatively influence QOL, but some adverse effects, such as diarrhea, are common.
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Keum J, Chung MJ, Kim Y, Ko H, Sung MJ, Jo JH, Park JY, Bang S, Park SW, Song SY, Lee HS. Usefulness of Smartphone Apps for Improving Nutritional Status of Pancreatic Cancer Patients: Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e21088. [PMID: 34463630 PMCID: PMC8441607 DOI: 10.2196/21088] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/20/2020] [Accepted: 06/17/2021] [Indexed: 12/22/2022] Open
Abstract
Background Approximately 80% of pancreatic ductal adenocarcinoma (PDAC) patients suffer from anorexia, weight loss, and asthenia. Most PDAC patients receive chemotherapy, which often worsens their nutritional status owing to the adverse effects of chemotherapy. Malnutrition of PDAC patients is known to be associated with poor prognosis; therefore, nutritional management during chemotherapy is a key factor influencing the outcome of the treatment. Mobile apps have the potential to provide readily accessible nutritional support for patients with PDAC. Objective We aimed to evaluate the efficacy of a mobile app–based program, Noom, in patients receiving chemotherapy for PDAC. Methods We prospectively enrolled 40 patients who were newly diagnosed with unresectable PDAC from a single university-affiliated hospital in South Korea, and randomly assigned them into a Noom user group (n=20) and a non-Noom user group (n=20). The 12-week in-app interventions included meal and physical activity logging as well as nutritional education feedback from dietitians. The non-Noom user group did not receive any nutrition intervention. The primary outcomes were the changes in the nutritional status and quality of life (QoL) from the baseline to 12 weeks. The secondary outcomes included the changes in the skeletal muscle index (SMI) from the baseline to 12 weeks. The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) and the Patient-Generated Subjective Global Assessment (PG-SGA) were used as paper questionnaires to assess the QoL and nutritional status of the patients. Intention-to-treat and per-protocol analyses were conducted. Regarding the study data collection time points, we assessed the nutritional status and QoL at the baseline (T0), and at 4 (T1), 8 (T2), and 12 (T3) weeks. Abdominal computed tomography (CT) imaging was conducted at the baseline and after 8 weeks for tumor response and SMI evaluation. The skeletal muscle area (cm2) was calculated using routine CT images. The cross-sectional areas (cm2) of the L3 skeletal muscles were analyzed. Results Between February 2017 and January 2018, 48 patients were assessed for eligibility. Totally 40 patients with pancreatic cancer were included by random allocation. Only 17 participants in the Noom user group and 16 in the non-Noom user group completed all follow-ups. All the study participants showed a significant improvement in the nutritional status according to the PG-SGA score regardless of Noom app usage. Noom users showed statistically significant improvements on the global health status (GHS) and QoL scales compared to non-Noom users, based on the EORTC QLQ (P=.004). The SMI decreased in both groups during chemotherapy (Noom users, 49.08±12.27 cm2/m2 to 46.08±10.55 cm2/m2; non-Noom users, 50.60±9.05 cm2/m2 to 42.97±8.12 cm2/m2). The decrement was higher in the non-Noom user group than in the Noom user group, but it was not statistically significant (-13.96% vs. -3.27%; P=.11). Conclusions This pilot study demonstrates that a mobile app–based approach is beneficial for nutritional and psychological support for PDAC patients receiving chemotherapy. Trial Registration ClinicalTrials.gov NCT04109495; https://clinicaltrials.gov/ct2/show/NCT04109495.
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Affiliation(s)
- Jiyoung Keum
- Division of Gastroenterology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea.,Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Moon Jae Chung
- Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youngin Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea.,Noom Korea, Inc, Seoul, Republic of Korea
| | | | - Min Je Sung
- Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Gastroenterology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Jung Hyun Jo
- Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong Youp Park
- Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seungmin Bang
- Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Woo Park
- Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Si Young Song
- Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hee Seung Lee
- Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
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Brazilian Validation of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group (QLG) Computerised Adaptive Tests (CAT) Core. Curr Oncol 2021; 28:3373-3383. [PMID: 34590597 PMCID: PMC8482129 DOI: 10.3390/curroncol28050291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/06/2021] [Accepted: 08/26/2021] [Indexed: 11/17/2022] Open
Abstract
Background: This study aimed to validate the Brazilian version of EORTC CAT Core and compare the Brazilian results with those from the original European EORTC CAT Core validation study. Methods: After validated translation, 168 cancer patients from Brazil receiving radiation therapy with or without chemotherapy was assessed. Translated EORTC CAT Core and all QLQ-C30 items were administered to patients using CHES (Computer-Based Health Evaluation System) before (T0) and after (T1) treatment initiation. The association between QLQ-C30 and CAT scores and ceiling/floor effects were estimated. Based on estimates of relative validity (cross-sectional, known-group differences and changes over time), relative sample-size requirements for CAT compared to QLQ-C30 were estimated. Results: Correlation coefficients between CAT and QLQ-C30 domains ranged from 0.63 to 0.93; except for dyspnoea, all coefficients were >0.82 (corresponding figures were 0.81–0.93 in the European study). On average across domains, floor/ceiling was reduced by 10% using CAT (9% in the European study) corresponding to a relative reduction of 32% (37% in the European study). Analyses of known-group validity and responsiveness indicated that, on average across domains, the sample-size requirements may be reduced by 17% using CAT rather than QLQ-C30, without loss of power (28% in the European study). The Brazilian sample had less symptom/quality of life impairment than the European sample, which likely explains the lower sample-size reduction using CAT when comparing with the European sample. Conclusions: The results in the Brazilian cohort were generally similar to those from the European sample and confirm the validity and usefulness of the EORTC CAT Core.
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Arraras JI, Nolte S, Liegl G, Rose M, Manterola A, Illarramendi JJ, Zarandona U, Rico M, Teiejria L, Asin G, Hernandez I, Barrado M, Vera R, Efficace F, Giesinger JM. General Spanish population normative data analysis for the EORTC QLQ-C30 by sex, age, and health condition. Health Qual Life Outcomes 2021; 19:208. [PMID: 34461909 PMCID: PMC8404330 DOI: 10.1186/s12955-021-01820-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/11/2021] [Indexed: 11/19/2022] Open
Abstract
Purpose General population normative data for the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire facilitates interpretation of data assessed from cancer patients. This study aims to present normative data of the general Spanish population. Methods/patients Data were obtained from a prior larger study collecting EORTC QLQ-C30 norm data across 15 countries. Data were stratified by sex and age groups (18–39, 40–49, 50–59, 60–69 and > 70 years). Sex and age distribution were weighted according to population distribution statistics. Sex- and age-specific normative values were analysed separately, as were participants with versus those without health conditions. Multiple linear regression was used to estimate the association of each of the EORTC QLQ-C30 scales with the determinants age, sex, sex-by-age interaction term, and health condition. Results In total, 1,165 Spanish individuals participated in the study. Differences were found by sex and age. The largest sex-related differences were seen in fatigue, emotional functioning, and global QOL (Quality of Life), favouring men. The largest age differences were seen in emotional functioning, insomnia, and pain, with middle-aged groups having the worst scores. Those > 60 years old scored better than those < 60 years old on all scales except for physical functioning. Participants with no health conditions scored better in all QLQ-C30 domains. Conclusions The present study highlights differences in HRQOL between specific sex/age strata and especially between people with and without a health condition in the general Spanish population. These factors must be considered when comparing general population HRQOL data with that of cancer patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01820-x.
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Affiliation(s)
- Juan Ignacio Arraras
- Oncology Departments, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain.
| | - Sandra Nolte
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medical Clinic, Department of Psychosomatic Medicine, Berlin, Germany
| | - Gregor Liegl
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medical Clinic, Department of Psychosomatic Medicine, Berlin, Germany
| | - Matthias Rose
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medical Clinic, Department of Psychosomatic Medicine, Berlin, Germany
| | - Ana Manterola
- Radiotherapeutic Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Jose Juan Illarramendi
- Medical Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Uxue Zarandona
- Oncology Departments, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Mikel Rico
- Radiotherapeutic Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Lucia Teiejria
- Medical Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Gemma Asin
- Radiotherapeutic Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Irene Hernandez
- Medical Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Marta Barrado
- Radiotherapeutic Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Ruth Vera
- Medical Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Fabio Efficace
- Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center, Rome, Italy
| | - Johannes M Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
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Ankolekar A, De Ruysscher D, Reymen B, Houben R, Dekker A, Roumen C, Fijten R. Shared decision-making for prophylactic cranial irradiation in extensive-stage small-cell lung cancer: an exploratory study. Transl Lung Cancer Res 2021; 10:3120-3131. [PMID: 34430352 PMCID: PMC8350106 DOI: 10.21037/tlcr-21-175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/25/2021] [Indexed: 12/30/2022]
Abstract
Background Prophylactic cranial irradiation (PCI) offers extensive-stage small-cell lung cancer (ES-SCLC) patients a lower chance of brain metastasis and slightly longer survival but is associated with a short-term decline in quality of life due to side-effects. This tradeoff between survival and quality of life makes PCI suitable for shared decision-making (SDM), where patients and clinicians make treatment decisions together based on clinical evidence and patient preferences. Despite recent clinical practice guidelines recommending SDM for PCI in ES-SCLC, as well as the heavy disease burden, research into SDM for lung cancer has been scarce. This exploratory study presents patients’ experiences of the SDM process and decisional conflict for PCI. Methods Radiation oncologists (n=7) trained in SDM applied it in making the PCI decision with ES-SCLC patients (n=25). We measured patients’ preferred level of participation (Control Preferences Scale), the level of SDM according to both groups (SDM-Q-9 and SDM-Q-Doc), and patients’ decisional conflict [decisional conflict scale (DCS)]. Results Seventy-nine percent of patients preferred a collaborative role in decision-making, and median SDM scores given by patients and clinicians were 80 (IQR: 75.6–91.1) and 85.2 (IQR: 78.7–88.9) respectively, indicating satisfaction with the process. However, patients experienced considerable decisional conflict. Over 50% lacked clarity about which choice was suitable for them and were unsure what to choose. Sixty-four percent felt they did not know enough about the harms and benefits of PCI, and 60% felt unable to judge the importance of the harms/benefits in their life. Conclusions ES-SCLC patients prefer to be involved in their treatment choice for PCI but a substantial portion experiences decisional conflict. Better information provision and values clarification may support patients in making a choice that reflects their preferences.
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Affiliation(s)
- Anshu Ankolekar
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Dirk De Ruysscher
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Bart Reymen
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Ruud Houben
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Andre Dekker
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Cheryl Roumen
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Rianne Fijten
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
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Effects of High-Intensity Interval Training on Cardiorespiratory Fitness, Body Composition, and Quality of Life in Overweight and Obese Survivors of Breast Cancer. REHABILITATION ONCOLOGY 2021. [DOI: 10.1097/01.reo.0000000000000270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Thielen FW, Kersten MJ, Kuizenga P, Hoogendoorn M, Posthuma EF, Stevens WB, A Uyl-de Groot C, Blommestein HM. Cost-effectiveness of lenalidomide plus rituximab versus rituximab monotherapy in patients with previously treated follicular lymphoma: a societal view. Expert Rev Anticancer Ther 2021; 21:1411-1422. [PMID: 34428992 DOI: 10.1080/14737140.2021.1971520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Efficacy of lenalidomide plus rituximab (R-LEN) compared to rituximab monotherapy (R-mono) for patients with previously treated follicular lymphoma (FL) was investigated in AUGMENT (NCT01938001). Our aim was to evaluate the cost-effectiveness of R-LEN versus R-mono in this setting from a Dutch perspective. AREAS COVERED Cost-effectiveness was assessed through a partitioned survival model from three perspectives (i.e. societal, healthcare, and societal, including future non-medical costs). Patient-level data from AUGMENT informed effectiveness parameters (i.e. long-term survival) and health state utilities. Resource use and prices were based on AUGMENT and the literature. Clinical experts validated efficacy input parameters and results. Uncertainty was explored through sensitivity and scenario analyses. EXPERT OPINION R-LEN resulted in 1.7 incremental discounted quality-adjusted life years (QALYs). Total incremental discounted costs were 67,161 EUR from a societal perspective. In conclusion, R-LEN was cost-effective at a willingness-to-pay (WTP) threshold of 50,000 EUR/QALY in the base-case analyses(incremental cost-effectiveness ratio = 40,493 EUR/QALY). Scenario and sensitivity analyses indicated some level of uncertainty regarding this conclusion, depending on the chosen WTP-threshold and perspective.
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Affiliation(s)
- Frederick W Thielen
- Section Health Technology Assessment, Erasmus School of Health Policy and Management/Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
| | - Marie-José Kersten
- Division of Haematology, Amsterdam University Medical Centers, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Pim Kuizenga
- Celgene BV A Bristol Myers Squibb Company, Utrecht, The Netherlands
| | - Mels Hoogendoorn
- Division of Haematology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Eduardus Fm Posthuma
- Department of Internal Medicine, Leiden University Medical Center & Reinier de Graaf Hospital, Delft, The Netherlands
| | - Wendy Bc Stevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carin A Uyl-de Groot
- Section Health Technology Assessment, Erasmus School of Health Policy and Management/Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
| | - Hedwig M Blommestein
- Section Health Technology Assessment, Erasmus School of Health Policy and Management/Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands
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Comparing Outcomes of a Digital Commercial Weight Loss Program in Adult Cancer Survivors and Matched Controls with Overweight or Obesity: Retrospective Analysis. Nutrients 2021; 13:nu13092908. [PMID: 34578787 PMCID: PMC8470305 DOI: 10.3390/nu13092908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022] Open
Abstract
Maintaining a healthy weight is beneficial for cancer survivors. However, weight loss program effectiveness studies have primarily been in highly controlled settings. This is a retrospective study exploring real-world outcomes (weight loss and program engagement) after use of a digital commercial weight loss program (Noom) in cancer survivors and matched controls. All participants had voluntarily self-enrolled in Noom. Weight and engagement data were extracted from the program. Cancer-related quality of life was secondarily assessed in a one-time cross-sectional survey for survivors. Controls were a sample of Noom users with overweight/obesity who had no history of cancer but 0–1 chronic conditions. Primary outcomes were weight change at 16 weeks and program engagement over 16 weeks. Engagement included frequency of weight, food, and physical activity logging, as well as number of coach messages. Multiple regression controlling for baseline age, gender, engagement, and BMI showed that survivors lost less weight than controls (B = −2.40, s.e. = 0.97, p = 0.01). Survivors also weighed in less (survivors: 5.4 [2.3]; controls: 5.7 [2.1], p = 0.01) and exercised less (survivors: 1.8 [3.2]; controls: 3.2 [4.1], p < 0.001) than controls. However, survivors sent more coach messages (survivors: 2.1 [2.4]; controls: 1.7 [2.0], p < 0.001). Despite controls losing more weight than cancer survivors (−7.0 kg vs. −5.3 kg), survivors lost significant weight in 4 months (M = −6.2%). Cancer survivors can have success on digital commercial programs available outside of a clinical trial. However, they may require additional support to engage in weight management behaviors.
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Koeppel M, Körbi C, Winkels RM, Schmitz KH, Wiskemann J. Relationship Between Cancer Related Fatigue, Physical Activity Related Health Competence, and Leisure Time Physical Activity in Cancer Patients and Survivors. Front Sports Act Living 2021; 3:687365. [PMID: 34423290 PMCID: PMC8374069 DOI: 10.3389/fspor.2021.687365] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/12/2021] [Indexed: 12/18/2022] Open
Abstract
Background: A large body of evidence supports the positive effects of leisure time physical activity (LTPA) and exercise on cancer survivors. However, only a fraction of survivors manages to attain international PA recommendations. This can be attributed to several external and internal barriers toward PA those patients seem to encounter, with cancer related fatigue (CRF) being the most reported internal barrier. Nevertheless, self-efficacy and knowledge about the utilization of LTPA can serve as facilitators of PA, which also correspond to certain constituents of physical activity related health competence (PAHCO). Since PAHCO is not investigated in cancer survivors we investigated if PAHCO can mediate the negative relationship between CRF and LTPA. Methods: We surveyed 398 cancer survivors with different cancer types and therapy status. The patients completed the EORTC QLQ-FA12 (EORTC FA12) to assess CRF, the PAHCO questionnaire to assess PAHCO and the SQUASH to assess LTPA. We followed a two-step structural equation modeling approach. The first step established the measurement model, in the second step we fitted the mediation model. Since 163 patients chose not to answer the SQUASH, the mediation model was only fitted to the data of the remaining 235 participants. Results: The proposed measurement model of the PAHCO offered an excellent fit. We found small to moderate positive associations between the PAHCO dimensions and the LTPA, and negative moderate relationships between the PAHCO and the EORTC FA12 dimensions. We did not observe a relationship between the EORTC FA12 dimensions and the LTPA (p > 0.05). The hypothesized mediation models did not display an appropriate fit. Conclusion: The PAHCO confirmed its factorial validity; furthermore, it appears to have a positive relationship to LTPA. Therefore, integrating psycho-educational aspects can be beneficial in order to increase the PAHCO in exercise interventions. Because of the cross-sectional character of this study, causal conclusions are not suitable, therefore the longitudinal relationships of LTPA, CRF, and PAHCO require further investigation.
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Affiliation(s)
- Maximilian Koeppel
- Institute of Sport Science, Heidelberg University, Heidelberg, Germany.,Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States.,Working Group Exercise Oncology, Division Medical Oncology, National Center for Tumordiseases Heidelberg and Heidelberg University Hospital, Heidelberg, Germany
| | - Carlotta Körbi
- Institute of Sport Science, Heidelberg University, Heidelberg, Germany
| | - Renate M Winkels
- Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States.,Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Kathryn H Schmitz
- Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Joachim Wiskemann
- Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States.,Working Group Exercise Oncology, Division Medical Oncology, National Center for Tumordiseases Heidelberg and Heidelberg University Hospital, Heidelberg, Germany
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