1
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Wibrand C, Kyvsgaard N, Herlin T, Glerup M. Methotrexate Intolerance in Juvenile Idiopathic Arthritis: Definition, Risks, and Management. Paediatr Drugs 2024; 26:479-498. [PMID: 39044097 PMCID: PMC11335943 DOI: 10.1007/s40272-024-00643-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2024] [Indexed: 07/25/2024]
Abstract
Juvenile idiopathic arthritis is the most common rheumatic disorder in childhood and adolescence posing a significant threat of short-term and long-term disability if left untreated. Methotrexate is a folic acid analog with various immunomodulatory properties. It has demonstrated significant efficacy for the treatment of juvenile idiopathic arthritis, often considered the preferred first-line disease-modifying anti-rheumatic drug given as monotherapy or in combination with biological drugs. Despite this, there is a considerable risk for treatment disruptions owing to the high prevalence of methotrexate intolerance, with symptoms such as nausea, stomach ache, vomiting, and behavioral symptoms. Many different risk factors for the intolerance have been proposed including gender, age, disease activity, treatment duration, dosing and administration, and genetic and psychological factors. As the studies have shown contradictory results, many questions are left unanswered. Therefore, a consensus regarding outcome measures and reporting is crucial. In this review, we describe the identification and assessment of methotrexate intolerance and evaluate potential risk factors, genetic associations as well as management strategies.
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Affiliation(s)
- Camilla Wibrand
- Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Nini Kyvsgaard
- Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Troels Herlin
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Institute of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.
| | - Mia Glerup
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Institute of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark
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2
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Haverkate EC, de Vos-Kerkhof E, van de Wetering MD, de Man-van Ginkel JM, Tissing WJE, Brinksma A. Feasibility and face validity of two patient reported outcome measures for nausea: Preferences of children with cancer. J Pediatr Nurs 2024; 78:75-81. [PMID: 38889482 DOI: 10.1016/j.pedn.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/23/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE To optimize recognition and management of nausea in children with cancer using patient reported outcome measures (PROMs) and to identify preferences of children with cancer regarding two validated tools: the Baxter Retching Faces (BARF) scale and the Pediatric Nausea Assessment Tool (PeNAT). DESIGN AND METHODS This quantitative descriptive cross-sectional study (n = 34) used bespoke questionnaires to measure feasibility and face validity of the BARF and the PeNAT. Feasibility included the items: understanding, ease of use, and communication. Face validity was studied in terms of the degree in which the faces of both PROMs corresponded with children's feelings of nausea. A descriptive and comparative analysis of the data was performed. RESULTS Both the BARF and the PeNAT were rated by the children as feasible, and no significant differences were found. However, regarding the item communication, the PeNAT did not reach the cut-off value (≥80% of all children scored neutral, agree or totally agree on the Likert scale). Regarding face validity, only the BARF reached the cut-off value and corresponded significantly better with children's feelings of nausea than the PeNAT. CONCLUSION According to children with cancer, only the BARF is both feasible and meets criteria for face validity. Therefore, the BARF is recommended as a PROM for reporting nausea in children with cancer. However, possible differences between age groups should be taken into account for future research. PRACTICE IMPLICATIONS This study will help health care professionals in making a patient-centered and informed choice when using a PROM for measuring nausea in children with cancer.
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Affiliation(s)
- Els C Haverkate
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, the Netherlands.
| | | | | | | | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands, and Department of Pediatric Oncology and Hematology, University of Groningen, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, the Netherlands
| | - Aeltsje Brinksma
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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3
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Renaux Torres MC, Bouttefroy S, Letort-Bertrand M, Maurel V, Mouffak S, Scotté F, Slimano F, Treguier P, Dupuis LL, Poirée M, Thouvenin-Doulet S. [Chemotherapy-induced nausea and vomiting in pediatric oncology patients: 2023 recommendations from the Supportive Care Committee of the French Society of Cancer in Children and Adolescents]. Bull Cancer 2024; 111:608-619. [PMID: 38670821 DOI: 10.1016/j.bulcan.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 04/28/2024]
Abstract
Chemotherapy-induced nausea and vomiting (CINV) are frequent and dreaded side effects in cancer treatments. CINV has a major impact on patient's condition and quality of life. Prophylaxis is tailored to patient's profile and the emetogenic level of their chemotherapy. The aim of this study is to update the recommendations for CINV prevention and management in pediatric onco-hematology for use in France, by adapting the guidelines of the Pediatric Oncology Group of Ontario (POGO). Clinical practice guideline adaptation is a recognized method for tailoring existing clinical practice guidelines to local context. A multidisciplinary French-speaking panel was formed to discuss about POGO guideline recommendations for the acute and delayed phases, breakthrough, refractory and anticipatory CINV and the evidence supporting them. Panel members were asked whether they wanted to adopt, modify or reject each of the POGO guideline recommendations. Panel members translated each recommendation and adapted recommendations for an implementation in France. Their acceptance required agreement at least 80 % of panel members. Algorithms and tables were created, listing all the recommendations and providing a better overview for decision-making process adapted to the patient's profile. These recommendations should be reviewed for implementation at French institutions caring for pediatric cancer patients and once implemented, the rates of adherence to recommendations and CINV control should be reported.
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Affiliation(s)
| | - Séverine Bouttefroy
- Institut d'hématologie et d'oncologie pédiatrique, Centre Léon-Bérard, hospices civils de Lyon, 1, place Professeur-Joseph-Renaut, 69008 Lyon, France
| | - Maïna Letort-Bertrand
- Service oncohématologie pédiatrique, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35200 Rennes, France
| | - Véronique Maurel
- Service oncohématologie pédiatrique, CHU de Nice, 151 route Saint-Antoine-de-Ginestière, 06202 Nice, France
| | - Samia Mouffak
- Service de pharmacie, Centre hospitalier de La Rochelle, rue du Docteur-Schweitzer, 17000 La Rochelle, France
| | - Florian Scotté
- Département interdisciplinaire d'organisation du parcours patient, Institut Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - Florian Slimano
- Service de pharmacie, université de Reims Champagne-Ardenne, BioSpecT, CHU de Reims, rue du général Koenig, 51100 Reims, France
| | - Pauline Treguier
- Service oncohématologie pédiatrique, CHU de Rouen, 37, boulevard Gambetta, 76000 Rouen, France
| | - L Lee Dupuis
- Research Institute and Department of Pharmacy, The Hospital for Sick Children, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Marilyne Poirée
- Service oncohématologie pédiatrique, CHU de Nice, 151 route Saint-Antoine-de-Ginestière, 06202 Nice, France
| | - Sandrine Thouvenin-Doulet
- CHU de Saint-Étienne, service d'hématologie et d'oncologie pédiatrique, rue Albert-Raimond, 42055 Saint-Étienne cedex 02, France
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4
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Ganguly S, Sasi A, Nagaraju SKK, Bakhshi S. Anti-Emetics in Children Receiving Chemotherapy for Solid Tumors and Leukemia: Pharmacology and Optimization of Therapy for Nausea and Vomiting. Pharmaceuticals (Basel) 2024; 17:616. [PMID: 38794186 PMCID: PMC11124061 DOI: 10.3390/ph17050616] [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: 01/22/2024] [Revised: 04/17/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
The management of chemotherapy-induced nausea and vomiting (CINV) in children remains challenging due to differences in the chemotherapy regimens, their relative emetogenicity compared to that in adults and differences in drug metabolism and the available formulations. The common four classes of anti-emetics used for the treatment and prophylaxis of CINV in children include dexamethasone, neurokinin-1 receptor antagonists, 5-hydroxytryptamine-3 receptor antagonists (5HT3RAs), and olanzapine. The appropriate dose of dexamethasone for CINV prophylaxis in children is unknown, with a significant variability in dosage ranging between 6 and 32 mg/m2/day. The dose of dexamethasone is decreased by 30% when this drug is combined with (fos)aprepitant in children, in contrast to a decrease of 50% required in adults. The use of aprepitant in younger children (<12 years) is often hampered by the non-availability of oral suspension formulations in many countries; alternatively, 80 mg capsules are administered for 1-3 days in certain institutes to children weighing between 15 and 40 kg. Among the different 5HT3RAs, palonosetron is comparatively metabolized faster in children than in adults, requiring a higher dosage for similar efficacy to that achieved in adults. Olanzapine is a newer agent, used in doses between 0.1 and 0.14 mg/kg/day in children, with good anti-emetic efficacy, but has sedation and hyperglycemia as concerning adverse effects. Drug interactions between anti-emetics and between anti-emetics and chemotherapy/supportive agents (azole antifungals, cyclosporine, arsenic trioxide), especially QTc prolongation, should be considered during prescription.
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Affiliation(s)
| | | | | | - Sameer Bakhshi
- Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India; (S.G.); (A.S.); (S.K.K.N.)
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5
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Meena JP, Gupta AK, Jat KR, Anandani G, Sasidharan A, Tanwar P. Efficacy and Safety of Olanzapine for the Prevention of Chemotherapy-induced Nausea and Vomiting in Children: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Pediatr Hematol Oncol 2023; 45:361-369. [PMID: 37539996 DOI: 10.1097/mph.0000000000002737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/25/2023] [Indexed: 08/05/2023]
Abstract
Chemotherapy-induced nausea and vomiting (CINV) remain the most distressing event in patients receiving highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC). This meta-analysis was conducted to evaluate the efficacy and safety of olanzapine containing regimen in preventing CINV in children on HEC and MEC. We searched PubMed, Embase, and Cochrane central register of controlled trials electronic databases to identify randomized clinical trials that compared 2 groups who either got olanzapine (olanzapine group) or placebo/no olanzapine (control group) for the prevention of CINV in children. The primary outcome was to determine the efficacy of olanzapine (complete response). The secondary outcomes were nausea control, the need for rescue medications, and adverse events of olanzapine. Three randomized clinical trials (n=394 patients) were included in this meta-analysis (olanzapine group, n=194, and placebo/control group, n=200). The pooled analysis of this meta-analysis found that olanzapine had a higher complete response in all phases of emesis in the HEC group and only in the acute phase in HEC/MEC groups compared with the control group. Olanzapine had higher nausea control in all phases of HEC but no nausea control in HEC/MEC. Olanzapine also reduced the need for rescue medications. A significant number of patients in the olanzapine group experienced somnolence (grades 1 and 2), but none of the participants discontinued the study due to side effects. In conclusion, this meta-analysis showed that olanzapine significantly prevented CINV in HEC. There was also a lesser need for rescue medications in the olanzapine group. Somnolence was higher in the olanzapine group, but it was clinically insignificant.
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Affiliation(s)
| | | | - Kana Ram Jat
- Laboratory Oncology Unit, Dr B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Anandani
- Department of Pathology, All India Institute of Medical Sciences
| | - Anju Sasidharan
- Department of Pathology, All India Institute of Medical Sciences
| | - Pranay Tanwar
- Laboratory Oncology Unit, Dr B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Esbenshade AJ, Sung L, Brackett J, Dupuis LL, Fisher BT, Grimes A, Miller TP, Ullrich NJ, Dvorak CC. Children's Oncology Group's 2023 blueprint for research: Cancer control and supportive care. Pediatr Blood Cancer 2023; 70 Suppl 6:e30568. [PMID: 37430431 PMCID: PMC10528808 DOI: 10.1002/pbc.30568] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/12/2023]
Abstract
The objective of the Cancer Control and Supportive Care (CCL) Committee in the Children's Oncology Group (COG) is to reduce the overall morbidity and mortality of therapy-related toxicities in children, adolescents, and young adults with cancer. We have targeted five major domains that cause clinically important toxicity: (i) infections and inflammation; (ii) malnutrition and metabolic dysfunction; (iii) chemotherapy-induced nausea and vomiting; (iv) neuro- and oto-toxicty; and (v) patient-reported outcomes and health-related quality of life. Subcommittees for each domain prioritize randomized controlled trials and biology aims to determine which strategies best mitigate the toxicities. The findings of these trials are impactful, informing clinical practice guidelines (CPGs) and directly leading to changes in the standard of care for oncology practice. With the development of new therapies, there will be new toxicities, and the COG CCL Committee is dedicated to developing interventions to minimize acute and delayed toxicities, lessen morbidity and mortality, and improve quality of life in pediatric and young adult patients with cancer.
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Affiliation(s)
- Adam J Esbenshade
- Department of Pediatrics Vanderbilt University Medical Center and the Vanderbilt Ingram Cancer, Nashville, Tennessee, USA
| | - Lillian Sung
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Julienne Brackett
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Texas Children's Cancer and Hematology Center, Baylor College of Medicine, Houston, Texas, USA
| | - L Lee Dupuis
- Department of Pharmacy and Research Institute, The Hospital for Sick Children and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Brian T Fisher
- Department of Pediatrics, Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Allison Grimes
- Department of Pediatrics, University of Texas San Antonio, San Antonio, Texas, USA
| | - Tamara P Miller
- Department of Pediatrics, Emory University School of Medicine/Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Nicole J Ullrich
- Department of Neurology, Boston Children's Hospital, Pediatric Brain Tumor Program, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Christopher C Dvorak
- Division of Pediatric Allergy, Immunology & Bone Marrow Transplantation, University of California San Francisco, San Francisco, California, USA
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7
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Beauchemin MP, Roth ME, Parsons SK. Reducing Adolescent and Young Adult Cancer Outcome Disparities Through Optimized Care Delivery: A Blueprint from the Children's Oncology Group. J Adolesc Young Adult Oncol 2023; 12:314-323. [PMID: 36716260 PMCID: PMC10282820 DOI: 10.1089/jayao.2022.0136] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Achieving equitable, high-quality cancer care delivery across socioeconomically and biologically diverse populations requires multilevel interventions, including those at the patient, provider, institution, and policy levels that influence cost, quality, and access to care. For adolescent and young adults (AYAs), who experience suboptimal health outcomes compared with younger and older people with cancer, cancer care delivery is influenced by additional contextual factors unique to the patients' developmental stage, psychosocial and economic status, and cancer subtype. In this review, we highlight the most pressing research needs in AYA cancer care delivery and opportunities to improve outcomes for this population.
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Affiliation(s)
- Melissa P. Beauchemin
- School of Nursing, Columbia University Irving Medical Center, New York, New York, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Michael E. Roth
- Division of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan K. Parsons
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
- Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
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8
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Patel P, Robinson PD, Phillips R, Baggott C, Devine K, Gibson P, Guilcher GMT, Holdsworth MT, Neumann E, Orsey AD, Spinelli D, Thackray J, van de Wetering M, Cabral S, Sung L, Dupuis LL. Treatment of breakthrough and prevention of refractory chemotherapy-induced nausea and vomiting in pediatric cancer patients: Clinical practice guideline update. Pediatr Blood Cancer 2023:e30395. [PMID: 37178438 DOI: 10.1002/pbc.30395] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 05/15/2023]
Abstract
This clinical practice guideline update provides recommendations for treating breakthrough chemotherapy-induced nausea and vomiting (CINV) and preventing refractory CINV in pediatric patients. Two systematic reviews of randomized controlled trials in adult and pediatric patients informed the recommendations. In patients with breakthrough CINV, escalation of antiemetic agents to those recommended for chemotherapy of the next higher level of emetogenic risk is strongly recommended. A similar recommendation to escalate therapy is made to prevent refractory CINV in patients who did not experience complete breakthrough CINV control and are receiving minimally or low emetogenic chemotherapy. A strong recommendation to use antiemetic agents that controlled breakthrough CINV for the prevention of refractory CINV is also made.
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Affiliation(s)
- Priya Patel
- Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Robert Phillips
- Department of Haematology and Oncology, NHS Trust, Leeds Teaching Hospital, Leeds, UK
| | - Christina Baggott
- Cancer Clinical Trials Office, Stanford Cancer Institute, Palo Alto, California, USA
| | - Katie Devine
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Paul Gibson
- Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada
- Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Gregory M T Guilcher
- Section of Paediatric Oncology and Blood and Marrow Transplant, Alberta Children's Hospital, Calgary, Alberta, Canada
- Departments of Oncology and Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Mark T Holdsworth
- College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
| | - Eloise Neumann
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Andrea D Orsey
- Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, Connecticut, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | | | - Jennifer Thackray
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Sandra Cabral
- Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada
| | - Lillian Sung
- Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - L Lee Dupuis
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
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9
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Zhong FP, Zhong J, Zhong MY. Effect of music therapy on chemotherapy-induced nausea and vomiting in gastrointestinal cancer: A systematic review and meta-analysis. World J Gastrointest Surg 2023; 15:471-479. [PMID: 37032801 PMCID: PMC10080606 DOI: 10.4240/wjgs.v15.i3.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/06/2023] [Accepted: 02/27/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND Chemotherapy is the primary treatment for patients with advanced gastrointestinal cancer, but it has many adverse reactions, particularly nausea and vomiting. Music therapy can reduce anxiety symptoms, avoid the response to the human body under various stress conditions through psychological adjustment, and improve the adverse reactions of chemotherapy.
AIM To investigate the impact of music therapy on relieving gastrointestinal adverse reactions in chemotherapy for patients with digestive tract cancer by meta-analysis.
METHODS EMBASE, PubMed, OVID, WoS, CNKI, CBM, and VIP database were all used for searching relevant literature, and the efficacy after treatment was combined for analysis and evaluation.
RESULTS This study included seven articles. The results of meta-analysis indicated that music therapy could reduce the nausea symptom score of patients after chemotherapy [mean difference (MD) = -3.15, 95% confidence interval (CI): -4.62 to -1.68, Z = -4.20, P < 0.0001]. Music therapy could reduce the vomiting symptom score of patients after chemotherapy (MD = -2.28, 95%CI: -2.46 to -2.11, Z = -25.15, P < 0.0001). Furthermore, music therapy could minimize the incidence of grade I and above nausea or vomiting in patients after chemotherapy (odds ratio = 0.38, 95%CI: 0.26-0.56, Z = -4.88, P < 0.0001). Meta-regression analysis found that publication year was not a specific factor affecting the combined results. There was no significant publication bias (P > 0.05).
CONCLUSION Music therapy can significantly improve the scores of nausea and vomiting symptoms in patients with digestive system cancer during chemotherapy and reduce the incidence of grade I and above nausea and vomiting after chemotherapy, making it an effective psychological intervention method worthy of clinical promotion.
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Affiliation(s)
- Fang-Ping Zhong
- Department of Oncology, Pingxiang Second People’s Hospital, Pingxiang 337000, Jiangxi Province, China
| | - Jun Zhong
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou 511436, Guangdong Province, China
| | - Ming-Yan Zhong
- Department of Oncology, Pingxiang Second People’s Hospital, Pingxiang 337000, Jiangxi Province, China
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Carmack CL, Agosta MT, Ann-Yi S, Bruera E. Treating Radiation Anxiety with Systematic Desensitization: Head and Neck Cancer Case Reports. J Palliat Med 2023. [PMID: 36730789 DOI: 10.1089/jpm.2022.0232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Introduction: Head and neck cancer patients have high rates of psychological distress, which may be exacerbated by the treatments they receive. Many patients who undergo radiation therapy report significant anxiety associated with the thermoplastic mask required for immobilization during treatment. Case Description: This report presents two examples of head and neck cancer patients reporting high mask anxiety, along with a history of claustrophobia, who expressed concern about their abilities to initiate and adhere to treatment. Both were referred to supportive care psychology before radiation treatment initiation. With counseling and the use of systematic desensitization, they were successfully able to complete their treatments. Discussion: Results of these case reports highlight the value of integrating early supportive care in the treatment of head and neck cancer and support the need for further study in future randomized controlled trials.
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Affiliation(s)
- Cindy L Carmack
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Monica T Agosta
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sujin Ann-Yi
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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11
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Patel P, Robinson PD, Cohen M, Devine K, Gibson P, Holdsworth MT, Neumann E, Orsey A, Phillips R, Spinelli D, Thackray J, van de Wetering M, Woods D, Cabral S, Sung L, Dupuis LL. Prevention of acute and delayed chemotherapy-induced nausea and vomiting in pediatric cancer patients: A clinical practice guideline. Pediatr Blood Cancer 2022; 69:e30001. [PMID: 36221901 DOI: 10.1002/pbc.30001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/11/2022]
Abstract
This clinical practice guideline provides recommendations for preventing acute and delayed phase chemotherapy-induced nausea and vomiting (CINV) in pediatric patients. The recommendations are based on two systematic reviews of randomized controlled trials evaluating interventions to prevent (1) acute phase CINV and (2) delayed phase CINV. Recommendations for acute phase and delayed phase CINV prophylaxis are made for patients receiving chemotherapy of varying emetogenicity, as well as for patients not able to receive dexamethasone or a neurokinin-1 receptor antagonist. Evidence gaps, including antiemetic safety and optimal dosing, were identified.
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Affiliation(s)
- Priya Patel
- Pediatric Oncology Group of Ontario, Toronto, Canada
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada
| | | | | | - Katie Devine
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Paul Gibson
- Pediatric Oncology Group of Ontario, Toronto, Canada
- Division of Haematology/Oncology, McMaster Children's Hospital, Hamilton, Canada
| | - Mark T Holdsworth
- College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA
| | - Eloise Neumann
- Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Andrea Orsey
- Division of Pediatric Hematology/Oncology, Connecticut Children's Medical Center, Hartford, Connecticut, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Robert Phillips
- Department of Haematology and Oncology, Leeds Teaching Hospital, NHS Trust, Leeds, UK
| | | | - Jennifer Thackray
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Deborah Woods
- University of California, Davis Health, Pediatric Hematology/Oncology, Davis, California, USA
| | - Sandra Cabral
- Pediatric Oncology Group of Ontario, Toronto, Canada
| | - Lillian Sung
- Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - L Lee Dupuis
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
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Lee Wong C, Li CK, Choi KC, Wei So WK, Yan Kwok JY, Cheung YT, Chan CWH. Effects of immersive virtual reality for managing anxiety, nausea and vomiting among paediatric cancer patients receiving their first chemotherapy: An exploratory randomised controlled trial. Eur J Oncol Nurs 2022; 61:102233. [DOI: 10.1016/j.ejon.2022.102233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
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Beauchemin MP, Raghunathan RR, Accordino MK, Cogan JC, Kahn JM, Wright JD, Hershman DL. New persistent opioid use among adolescents and young adults with sarcoma. Cancer 2022; 128:2777-2785. [PMID: 35599575 PMCID: PMC10664461 DOI: 10.1002/cncr.34238] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/16/2022] [Accepted: 03/24/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adolescents and young adults (AYA) with sarcoma experience both acute and chronic pain related to their disease and treatment. Studies in older adults have reported a high risk of persistent opioid use after cancer therapy among previously opioid-naive patients; however, few studies have evaluated posttreatment opioid use among AYAs. This article describes patterns of new persistent opioid use among AYAs in the year after treatment for sarcoma. METHODS Opioid-naive patients who were 10 to 26 years old and diagnosed with sarcoma (2008-2016) were identified with the IBM Marketscan Database. Included subjects had an International Classification of Diseases code for sarcoma (ninth or tenth revision), received anticancer therapy (chemotherapy, surgery, and/or radiation) within 30 days of the first diagnosis code, and had continuous insurance coverage (commercial or Medicaid) for more than 12 months both before the diagnosis and after the last therapy. The primary outcome was new persistent opioid use, which was defined as at least 2 opioid prescriptions in the 12 months following treatment completion. Covariates included age, sex, insurance, tumor type, surgical procedure, mental health (MH) or substance use diagnoses before or during therapy, and concomitant lorazepam use. RESULTS In total, 938 patients met the inclusion criteria; 521 (56%) were male, and 578 (62%) were younger than 18 years. In total, 727 (78%) had commercial insurance, and 273 (29%) had an MH diagnosis either before or during the treatment period. Of the total group, 464 (49%) used opioids during treatment only. Of those who used opioids during treatment, 135 (23%) received at least 2 prescriptions in the year after therapy. In a multivariable analysis, Medicaid versus commercial insurance (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.15-2.64) and non-soft tissue sarcoma (OR for Ewing sarcoma, 3.23; 95% CI, 1.81-5.78; OR for osteosarcoma, 2.05; 95% CI, 1.36-3.09) conferred a higher likelihood of new persistent use. CONCLUSIONS In this cohort of AYAs treated for sarcoma, 64% of the patients received opioid prescriptions during treatment, and 23% of these patients became new persistent users. Because of the risks associated with persistent opioid use, studies of novel pain management strategies along with age-appropriate education and anticipatory guidance are urgently needed. LAY SUMMARY Using an insurance claims database, we conducted a study to determine the rate of new persistent opioid use among adolescents and young adults treated for sarcoma. We found that 64% of adolescents and young adults treated for sarcoma received opioid prescriptions during treatment, and 23% of these patients met the criteria for new persistent opioid use. These findings support the need for age-appropriate education and novel pain management strategies in this vulnerable population.
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Affiliation(s)
- Melissa P. Beauchemin
- School of Nursing, Columbia University Irving Medical Center, New York, New York
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
- Division of Pediatric Hematology/Oncology/Stem Cell Transplantation, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Rohit R. Raghunathan
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
| | - Melissa K. Accordino
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
- Division of Hematology/Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Jacob C. Cogan
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
- Division of Hematology/Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Justine M. Kahn
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
- Division of Pediatric Hematology/Oncology/Stem Cell Transplantation, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Jason D. Wright
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
| | - Dawn L. Hershman
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
- Division of Hematology/Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
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Akdeniz Kudubes A, Bektas M, İnce D, Olgun N. The effect of text message reminders on nausea, vomiting and quality of life in children with cancer receiving cisplatin. J Pediatr Nurs 2022; 64:e109-e118. [PMID: 34955361 DOI: 10.1016/j.pedn.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 12/11/2021] [Accepted: 12/11/2021] [Indexed: 10/30/2022]
Abstract
PURPOSE This study was conducted to examine the effect of text message reminders on nausea, vomiting, and quality of life in children with cancer receiving cisplatin. METHODS The study was conducted with a pretest-posttest unpaired group model design. The study included 80 children with cancer and their parents (40 controls and 40 experiments) aged between 8 and 18 years, who were on cisplatin treatment, who did not have cognitive disability as a clinical diagnosis, who received chemotherapy during their stay in the clinic, who were literate in Turkish and who volunteered to participate in the study. The educational contents prepared by the researchers to reduce nausea and vomiting were sent to the parents in the experimental group in the form of a text message every day for three weeks. Descriptive statistics, correlation analysis, and regression analysis were used to evaluate the data. RESULTS While NVTS, ARINVc, ARINVp, Quality of Life Scale pretest and posttest mean scores of both 8-12 and 13-18 age control group children were similar, it was determined that the experimental group's posttest mean scores were higher than the pretest mean scores, and there was a statistically significant difference between the experimental group's pretest and posttest mean scores in terms of the group, time and group*time. In this study, the education program explains 42%, 15%, 16%, 43%, and 43% of the increase in the mean scores of NVTS, ARINVc, ARINVp, Quality of Life Scale Child and Parent Form, respectively, in children aged 8-12. Also, the education program explains 10%, 27%, 28%, 38%, and 39% of the increase in the mean scores of NVTS, ARINVc, ARINVp, Quality of Life Scale Adolescent and Parent Form, respectively, in children aged 13-18. CONCLUSIONS It has been observed that text message reminders effectively reduce the level of nausea and vomiting and increase the quality of life. PRACTICE IMPLICATIONS The results of this study, text message reminders can be applied as an alternative intervention method, and including technology-based practices in the care of children with cancer is important in increasing the quality of care.
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Affiliation(s)
- Aslı Akdeniz Kudubes
- Department of Pediatric Nursing, Bilecik Şeyh Edebali University Faculty of Health, Bilecik, Turkey.
| | - Murat Bektas
- Department of Pediatric Nursing, Faculty of Nursing, Dokuz Eylul University, İnciraltı, İzmir, Turkey.
| | - Dilek İnce
- Pediatric Oncology Department, Oncology Institute, Dokuz Eylul University, İnciraltı, İzmir, Turkey.
| | - Nur Olgun
- Pediatric Oncology Department, Oncology Institute, Dokuz Eylul University, İnciraltı, İzmir, Turkey.
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Zeng C, Chen H, Xu Y, Ji H, Du N, Song X, Hou L. Risk factors for chemotherapy-induced vomiting after general anesthesia in children with retinoblastoma: a retrospective study. Transl Pediatr 2021; 10:3005-3013. [PMID: 34976766 PMCID: PMC8649612 DOI: 10.21037/tp-21-245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The chemotherapy-induced vomiting (CIV) severely affects the daily function, nutritional status, treatment compliance, therapeutic efficacy, curability, and the quality of life of patients. The aim of this study was to find the risk factors for CIV after general anesthesia in patients with retinoblastoma (RB). METHODS A retrospective review of the hospital records of children with RB, who underwent chemotherapy between January 2017 and December 2019, was conducted at our hospital. RESULTS Data of a total of 803 children with RB were reviewed. The incidence of CIV in children with RB was 19.30%. Univariate analysis showed statistically significant differences in age, height, weight, chemotherapy regimen, anesthesia dose, duration of surgery and general anesthesia, platelet count, platelet distribution width, lymphocytes, and indirect bilirubin between patients with and without vomiting (P<0.05). Multivariate logistic regression analysis showed that the main predictors of CIV in children with RB included older age [odds ratio (OR), 1.32; 95% confidence interval (CI): 1.11-1.56; P<0.01], low platelet count (OR, 0.997; 95% CI: 0.995-0.999; P<0.05), and chemotherapy regimen (intravenous chemotherapy versus intra-arterial chemotherapy; OR, 0.47; 95% CI: 0.29-0.76; P<0.01). CONCLUSIONS This study revealed age, chemotherapy regimen, and platelet count as risk factors of CIV after general anesthesia in children with RB. Younger age and higher platelet count were protective factors for CIV. Compared with intravenous chemotherapy, the incidence of CIV was lower than that of intra-arterial chemotherapy. Although these factors cannot be modified, they can predict whether a patient may experience vomiting, assisting medical staff to formulate measures and intervenes in advance. KEYWORDS Retinoblastoma (RB); chemotherapy-induced vomiting (CIV); general anesthesia; multivariate analysis; risk factors.
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Affiliation(s)
- Changjuan Zeng
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Jiao Tong University, School of Nursing, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Huifang Chen
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yanjuan Xu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Hong Ji
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Na Du
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Xuefei Song
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Lili Hou
- Department of Nursing, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Linder LA, Ameringer S, Stegenga K, Macpherson CF, Erickson J. A Person-Centered Approach to Symptom Assessment and Management for Children and Adolescents Receiving Cancer Treatment. Semin Oncol Nurs 2021; 37:151164. [PMID: 34134924 DOI: 10.1016/j.soncn.2021.151164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Discuss the clinical assessment and management of symptoms for children and adolescents receiving treatment for cancer with attention to a person-centered approach to care. DATA SOURCES Review of currently published literature and guidelines pertaining to symptom assessment and management for children and adolescents receiving treatment for cancer. CONCLUSION Symptoms such as pain, nausea, and fatigue are commonly reported by children and adolescents receiving cancer treatment and are associated with greater symptom burden. Symptom assessment should be tailored to the child or adolescent and include the child's or adolescent's preference for reporting symptoms and attention to the symptoms that are of greatest priority. Evidence-based guidelines for the management of symptoms, including pain and nausea, are available to guide symptom management interventions and should be tailored to provide person-centered care. IMPLICATIONS FOR NURSING PRACTICE Nurses can lead efforts through clinical practice and research initiatives to advance person-centered symptom care for children and adolescents with cancer on a global level. Priorities for future work to advance person-centered symptom assessment and management include (1) identification of best practices for symptom assessment, (2) attention to social determinants of health and their subsequent influence on symptom outcomes, (3) compilation of evidence for management of less commonly reported symptoms, and (4) implementation of published clinical guidelines for symptom management in practice settings.
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Affiliation(s)
- Lauri A Linder
- College of Nursing, University of Utah, Salt Lake City; Primary Children's Hospital, Salt Lake City, UT.
| | | | | | | | - Jeanne Erickson
- Milwaukee College of Nursing, University of Wisconsin, Milwaukee
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