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Kelada L, Zamir O. What Promotes Positive Parenting During Breast Cancer? A Cross-Sectional Analysis of Social Support, Emotion Regulation, and Meaning in Life. Int J Behav Med 2024; 31:595-604. [PMID: 37415037 PMCID: PMC11269428 DOI: 10.1007/s12529-023-10196-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Motherhood and maintaining the child-parent relationship are top priorities for mothers with breast cancer (BC). The current study aimed to assess the positive intra- and inter-personal resources related to positive parenting among mothers with BC, as these may be promotive factors for positive parenting. Specifically, we examined whether social support (family, friend, spiritual), emotion regulation, and a sense of meaning in life are related to positive parenting among mothers undergoing BC treatments. METHODS The sample consisted of 100 Israeli mothers (mean age = 46.02 years, SD = 6.06 years) who were undergoing treatment for BC. Participating mothers had at least one child aged 6-17 years. Participants were recruited via closed social media groups to complete a questionnaire containing: the Alabama Parenting Questionnaire, Cancer Perceived Agents of Social Support tool, Emotion Regulation Questionnaire, Meaning in Life Questionnaire, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), and sociodemographic and clinical questions. We used structural equation modeling to regress the study variables on positive parenting. RESULTS Friend support (β = .35, p = .009) and meaning in life (β = .30, p = .012) were significantly related to positive parenting. Family support, spiritual support, cognitive reappraisal, and the sociodemographic and clinical variables were not related to positive parenting. CONCLUSIONS Our study suggests that promoting meaning in life and friend support may be key to helping mothers to sustain positive parenting behaviors throughout their cancer treatment. Future research may examine whether psychosocial interventions which foster meaning in life and friend support impact positive parenting among mothers with BC.
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Affiliation(s)
- L Kelada
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Mt. Scopus, 9190501, Jerusalem, Israel.
- School of Clinical Medicine, UNSW Medicine & Health, UNSW, Sydney, Australia.
- Kids Cancer Centre, Behavioural Sciences Unit, Sydney Children's Hospital, Randwick, Australia.
| | - O Zamir
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Mt. Scopus, 9190501, Jerusalem, Israel
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Sauer C, Zschäbitz S, Krauss J, Walle T, Haag GM, Jäger D, Hiller K, Bugaj TJ, Friederich HC, Maatouk I. Electronic health intervention to manage symptoms of immunotherapy in patients with cancer (SOFIA): Results from a randomized controlled pilot trial. Cancer 2024; 130:2503-2514. [PMID: 38564338 DOI: 10.1002/cncr.35300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/19/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND For patients receiving immune checkpoint inhibitors, early detection of immune-related adverse events (irAEs) is critical for one's safety. To this end, a smartphone app (SOFIA) was developed that featured the assessment of electronic patient-reported outcomes (ePROs) focusing on irAEs as well as a set of comprehensive supportive information. Its feasibility and preliminary efficacy were evaluated in a randomized controlled trial (RCT). METHODS Patients who received immune checkpoint inhibition therapy were randomly assigned to an intervention group (IG) or a control group (CG; care as usual). During the 12-week intervention period, IG patients used SOFIA to report twice weekly ePROs and receive cancer- and immunotherapy-relevant contents. Before a patient's next clinical visit, the physician in charge was given the ePRO reports. The primary objective was to test the feasibility of SOFIA. Furthermore, the preliminary efficacy of SOFIA for health-related quality of life (HRQOL), psychosocial outcomes, and medical data was examined. Clinical outcomes were assessed at baseline (T0), post-intervention (T1), and a 3-month follow-up (T2). RESULTS Seventy-one patients were randomized to the IG (n = 34) or the CG (n = 37). SOFIA showed high feasibility and acceptance. At T1, patients in the IG reported significantly better HRQOL and role functioning and less depression, distress, and appetite loss. No significant differences were revealed regarding medical data, the utilization of supportive care services, or survival. CONCLUSIONS SOFIA showed high feasibility and acceptance and improved HRQOL and psychosocial outcomes. These results suggest further evaluation of efficacy in a large-scale confirmatory multicenter RCT.
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Affiliation(s)
- Christina Sauer
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Stefanie Zschäbitz
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Jürgen Krauss
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
- Vanudis GmbH, Heidelberg, Germany
| | - Thomas Walle
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Virotherapy, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Georg Martin Haag
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Applied Tumor-Immunity, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dirk Jäger
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Applied Tumor-Immunity, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kiriaki Hiller
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Till Johannes Bugaj
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
- Section of Psychosomatic Medicine, Psychotherapy and Psycho-Oncology, Department of Internal Medicine II, Julius-Maximilian University Würzburg, Würzburg, Germany
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Slaaen M, Røyset IM, Saltvedt I, Grønberg BH, Halsteinli V, Døhl Ø, Vossius C, Kirkevold Ø, Bergh S, Rostoft S, Oldervoll L, Bye A, Melby L, Røsstad T, Eriksen GF, Sollid MIV, Rolfson D, Šaltytė Benth J. Geriatric assessment with management for older patients with cancer receiving radiotherapy: a cluster-randomised controlled pilot study. BMC Med 2024; 22:232. [PMID: 38853251 PMCID: PMC11163782 DOI: 10.1186/s12916-024-03446-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 05/24/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Geriatric assessment and management (GAM) improve outcomes in older patients with cancer treated with surgery or chemotherapy. It is unclear whether GAM may provide better function and quality of life (QoL), or be cost-effective, in a radiotherapy (RT) setting. METHODS In this Norwegian cluster-randomised controlled pilot study, we assessed the impact of a GAM intervention involving specialist and primary health services. It was initiated in-hospital at the start of RT by assessing somatic and mental health, function, and social situation, followed by individually adapted management plans and systematic follow-up in the municipalities until 8 weeks after the end of RT, managed by municipal nurses as patients' care coordinators. Thirty-two municipal/city districts were 1:1 randomised to intervention or conventional care. Patients with cancer ≥ 65 years, referred for RT, were enrolled irrespective of cancer type, treatment intent, and frailty status, and followed the allocation of their residential district. The primary outcome was physical function measured by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (QLQ-C30). Secondary outcomes were overall quality of life (QoL), physical performance, use and costs of health services. Analyses followed the intention-to-treat principle. Study registration at ClinicalTrials.gov ID NCT03881137. RESULTS We included 178 patients, 89 in each group with comparable age (mean 74.1), sex (female 38.2%), and Edmonton Frail Scale scores (mean 3.4 [scale 0-17], scores 0-3 [fit] in 57%). More intervention patients received curative RT (76.4 vs 61.8%), had higher irradiation doses (mean 54.1 vs 45.5 Gy), and longer lasting RT (mean 4.4 vs 3.6 weeks). The primary outcome was completed by 91% (intervention) vs 88% (control) of patients. No significant differences between groups on predefined outcomes were observed. GAM costs represented 3% of health service costs for the intervention group during the study period. CONCLUSIONS In this heterogeneous cohort of older patients receiving RT, the majority was fit. We found no impact of the intervention on patient-centred outcomes or the cost of health services. Targeting a more homogeneous group of only pre-frail and frail patients is strongly recommended in future studies needed to clarify the role and organisation of GAM in RT settings.
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Affiliation(s)
- Marit Slaaen
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Box 68, 2312, Ottestad, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Pb 1171 Blindern, Oslo, 0318, Norway
| | - Inga Marie Røyset
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Box 68, 2312, Ottestad, Norway.
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), N-7491, Trondheim, Norway.
- Department of Geriatric Medicine, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Box 3250 Torgarden , Trondheim, NO-7006, Norway.
| | - Ingvild Saltvedt
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), N-7491, Trondheim, Norway
- Department of Geriatric Medicine, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Box 3250 Torgarden , Trondheim, NO-7006, Norway
| | - Bjørn Henning Grønberg
- Department of Oncology, St. Olav Hospital, St. Olavs Hospital, Trondheim University Hospital, Box 3250 Torgarden , Trondheim, NO-7006, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Vidar Halsteinli
- Regional Center for Health Care Improvement, St. Olavs Hospital, Trondheim University Hospital, Box 3250 Torgarden , Trondheim, NO-7006, Norway
| | - Øystein Døhl
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), N-7491, Trondheim, Norway
- Trondheim Municipality, Trondheim Kommune, Postboks , Trondheim, Norway
| | - Corinna Vossius
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Box 68, 2312, Ottestad, Norway
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Øyvind Kirkevold
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Box 68, 2312, Ottestad, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Postboks , Tønsberg, 2136, 3103, Norway
- Department of Health Sciences in Gjøvik, NTNU, Box 191, N-2802, Gjøvik, Norway
| | - Sverre Bergh
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Box 68, 2312, Ottestad, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Postboks , Tønsberg, 2136, 3103, Norway
| | - Siri Rostoft
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Pb 1171 Blindern, Oslo, 0318, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Pb , Nydalen, Norway
| | - Line Oldervoll
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, 7807, 5020, Bergen, PB, Norway
- Department of Public Health and Nursing, NTNU, 8905, 7491, Trondheim, PB, Norway
| | - Asta Bye
- Oslo Metropolitan University (Oslomet), Postboks 4, St. Olavs Plass, 0130, Oslo, Norway
- European Palliative Care Research Centre (PRC), Institute of Clinical Medicine, Faculty of Medicine, Department of Oncology, University of Oslo, and, Oslo University Hospital, Nydalen, Norway
| | - Line Melby
- Department of Health Sciences in Gjøvik, NTNU, Box 191, N-2802, Gjøvik, Norway
| | - Tove Røsstad
- Trondheim Municipality, Trondheim Kommune, Postboks , Trondheim, Norway
- Department of Public Health and Nursing, NTNU, 8905, 7491, Trondheim, PB, Norway
| | - Guro Falk Eriksen
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Box 68, 2312, Ottestad, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Pb 1171 Blindern, Oslo, 0318, Norway
- Department of Internal Medicine, Hamar Hospital, Innlandet Hospital Trust, Skolegata 32, 2318, Hamar, Norway
| | - May Ingvild Volungholen Sollid
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Box 68, 2312, Ottestad, Norway
- Department of Health Sciences in Gjøvik, NTNU, Box 191, N-2802, Gjøvik, Norway
| | - Darryl Rolfson
- Division of Geriatric Medicine, Clinical Sciences Building, University of Alberta, 1-19811350 83 Ave, Edmonton, AB, T6G 2P4, Canada
| | - Jūratė Šaltytė Benth
- The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Box 68, 2312, Ottestad, Norway
- Institute of Clinical Medicine, University of Oslo, Campus Ahus, P.O.Box 1171, 0318, Blindern, Norway
- Health Services Research Unit, Akershus University Hospital, P.O.Box 1000, 1478, Lørenskog, Norway
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Vrancken Peeters NJMC, van Til JA, Huberts AS, Siesling S, Husson O, Koppert LB. Internal Responsiveness of EQ-5D-5L and EORTC QLQ-C30 in Dutch Breast Cancer Patients during the First Year Post-Surgery: A Longitudinal Cohort Study. Cancers (Basel) 2024; 16:1952. [PMID: 38893073 PMCID: PMC11170999 DOI: 10.3390/cancers16111952] [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: 04/26/2024] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
The EuroQoL 5-Dimension 5-Level questionnaire (EQ-5D-5L) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) are commonly used Patient-Reported Outcome Measures (PROMs) for breast cancer. This study assesses and compares the internal responsiveness of the EQ-5D-5L and EORTC QLQ-C30 in Dutch breast cancer patients during the first year post-surgery. Women diagnosed with breast cancer who completed the EQ-5D-5L and EORTC QLQ-C30 pre-operatively (T0), 6 months (T6), and 12 months post-surgery (T12) were included. Mean differences of the EQ-5D-5L and EORTC QLQ-C30 between baseline and 6 months (delta 1) and between baseline and 12 months post-surgery (delta 2) were calculated and compared against the respective minimal clinically important differences (MCIDs) of 0.08 and 5. Internal responsiveness was assessed using effect sizes (ES) and standardized response means (SRM) for both deltas. In total, 333 breast cancer patients were included. Delta 1 and delta 2 for the EQ-5D-5L index and most scales of the EORTC QLQ-C30 were below the MCID. The internal responsiveness for both PROMs was small (ES and SRM < 0.5), with greater internal responsiveness for delta 1 compared to delta 2. The EQ-5D-5L index showed greater internal responsiveness than the EORTC QLQ-C30 Global Quality of Life scale and summary score. These findings are valuable for the interpretation of both PROMs in Dutch breast cancer research and clinical care.
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Affiliation(s)
- Noëlle J. M. C. Vrancken Peeters
- Department of Surgical Oncology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands
| | - Janine A. van Til
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Anouk S. Huberts
- Department of Quality and Patient Care, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), 3511 DT Utrecht, The Netherlands
| | - Olga Husson
- Department of Surgical Oncology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands
| | - Linetta B. Koppert
- Department of Surgical Oncology, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
- Department of Quality and Patient Care, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
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5
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Klotz R, Ahmed A, Tremmel A, Büsch C, Tenckhoff S, Doerr-Harim C, Lock JF, Brede EM, Köninger J, Schiff JH, Wittel UA, Hötzel A, Keck T, Nau C, Amati AL, Koch C, Diener MK, Weigand MA, Büchler MW, Knebel P, Larmann J. Thoracic Epidural Analgesia Is Not Associated With Improved Survival After Pancreatic Surgery: Long-Term Follow-Up of the Randomized Controlled PAKMAN Trial. Anesth Analg 2024:00000539-990000000-00740. [PMID: 38335141 DOI: 10.1213/ane.0000000000006812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
BACKGROUND Perioperative thoracic epidural analgesia (EDA) and patient-controlled intravenous analgesia (PCIA) are common forms of analgesia after pancreatic surgery. Current guidelines recommend EDA over PCIA, and evidence suggests that EDA may improve long-term survival after surgery, especially in cancer patients. The aim of this study was to determine whether perioperative EDA is associated with an improved patient prognosis compared to PCIA in pancreatic surgery. METHODS The PAKMAN trial was an adaptive, pragmatic, international, multicenter, randomized controlled superiority trial conducted from June 2015 to October 2017. Three to five years after index surgery a long-term follow-up was performed from October 2020 to April 2021. RESULTS For long-term follow-up of survival, 109 patients with EDA were compared to 111 patients with PCIA after partial pancreatoduodenectomy (PD). Long-term follow-up of quality of life (QoL) and pain assessment was available for 40 patients with EDA and 45 patients with PCIA (questionnaire response rate: 94%). Survival analysis revealed that EDA, when compared to PCIA, was not associated with improved overall survival (OS, HR, 1.176, 95% HR-CI, 0.809-1.710, P = .397, n = 220). Likewise, recurrence-free survival did not differ between groups (HR, 1.116, 95% HR-CI, 0.817-1.664, P = .397, n = 220). OS subgroup analysis including only patients with malignancies showed no significant difference between EDA and PCIA (HR, 1.369, 95% HR-CI, 0.932-2.011, P = .109, n = 179). Similar long-term effects on QoL and pain severity were observed in both groups (EDA: n = 40, PCIA: n = 45). CONCLUSIONS Results from this long-term follow-up of the PAKMAN randomized controlled trial do not support favoring EDA over PCIA in pancreatic surgery. Until further evidence is available, EDA and PCIA should be considered similar regarding long-term survival.
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Affiliation(s)
- Rosa Klotz
- From the Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- The Study Center of the German Surgical Society, Heidelberg University Hospital, Heidelberg, Germany
| | - Azaz Ahmed
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
- Translational Immunotherapy, German Cancer Research Center, Heidelberg, Germany
| | - Anja Tremmel
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher Büsch
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany
| | - Solveig Tenckhoff
- The Study Center of the German Surgical Society, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Johan F Lock
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Elmar-Marc Brede
- General Medicine, Gemeinschaftspraxis für Allgemeinmedizin, Veitshöchheim, Germany
| | - Jörg Köninger
- Department of General, Visceral, Thorax and Transplantation Surgery, Stuttgart, Germany
| | - Jan-Henrik Schiff
- Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Stuttgart, Germany
- Department of Anesthesiology and Intensive Care, Philipps-University Marburg, Marburg, Germany
| | - Uwe A Wittel
- Department of General and Visceral Surgery, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Alexander Hötzel
- Department of Anesthesiology and Critical Care, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Tobias Keck
- Department of Surgery, University Medical Centre Schleswig-Holstein, Campus Lübeck, Germany
| | - Carla Nau
- Department of Anesthesiology and Intensive Care, University Medical Centre Schleswig-Holstein, Campus Lübeck, Germany
| | - Anca-Laura Amati
- Department of Visceral, Thoracic, Transplant and Pediatric Surgery, Justus Liebig University of Giessen, Giessen, Germany
| | - Christian Koch
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Justus Liebig University of Giessen, Giessen, Germany
| | - Markus K Diener
- Department of General and Visceral Surgery, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Markus A Weigand
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Markus W Büchler
- From the Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Phillip Knebel
- From the Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan Larmann
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
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Egeler MD, van de Poll-Franse LV, Tissier R, Rogiers A, Boers-Sonderen MJ, van den Eertwegh AJ, Hospers GA, de Groot JWB, Aarts MJB, Kapiteijn E, Piersma D, Vreugdenhil G, van der Veldt AA, Suijkerbuijk KPM, Neyns B, Janssen KJ, Blank CU, Retèl VP, Boekhout AH. Health-state utilities in long-term advanced melanoma survivors comparable with the general population. Qual Life Res 2023; 32:2517-2525. [PMID: 37079262 DOI: 10.1007/s11136-023-03427-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Checkpoint inhibitors have been shown to substantially improve the survival of patients with advanced melanoma. With this growing group of survivors treated with immunotherapies, assessing their health-state utilities is essential and can be used for the calculation of quality-adjusted life years and for cost-effectiveness analyses. Therefore, we evaluated the health-state utilities in long-term advanced melanoma survivors. METHODS Health-state utilities were evaluated in a cohort of advanced melanoma survivors 24-36 months (N = 37) and 36-plus months (N = 47) post-ipilimumab monotherapy. In addition, the health-state utilities of the 24-36 months survivor group were assessed longitudinally, and utilities of the combined survival groups (N = 84) were compared with a matched control population (N = 168). The EQ-5D was used to generate health-state utility values, and quality-of-life questionnaires were used to establish correlations and influencing factors of utility scores. RESULTS Health-state utility scores were similar between the 24-36 months'- and the 36-plus months' survival group (0.81 vs 0.86; p = .22). In survivors, lower utility scores were associated with symptoms of depression (β = - .82, p = .022) and fatigue burden (β = - .29, p = .007). Utility scores did not significantly change after 24-36 months of survival, and the utilities of survivors were comparable to the matched control population (0.84 vs 0.87; p = .07). DISCUSSION Our results show that long-term advanced melanoma survivors treated with ipilimumab monotherapy experience relatively stable and high health-state utility scores.
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Affiliation(s)
- M D Egeler
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
| | - L V van de Poll-Franse
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research On Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - R Tissier
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - A Rogiers
- Department of Psychiatry, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - M J Boers-Sonderen
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A J van den Eertwegh
- Department of Medical Oncology, Amsterdam UMC, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - G A Hospers
- Department of Medical Oncology, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - M J B Aarts
- Department of Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - E Kapiteijn
- Leiden University Medical Centre, Leiden, The Netherlands
| | - D Piersma
- Medical Spectrum Twente, Enschede, The Netherlands
| | - G Vreugdenhil
- Department of Internal Medicine, Maxima Medical Centre, Eindhoven, The Netherlands
| | - A A van der Veldt
- Departments of Medical Oncology and Radiology & Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - K P M Suijkerbuijk
- Department of Medical Oncology, University Medical Cancer Center, Utrecht, The Netherlands
| | - B Neyns
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - K J Janssen
- Bristol-Myers Squibb, Utrecht, The Netherlands
| | - C U Blank
- Department of Medical Oncology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - V P Retèl
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Health Technology & Services Research, University of Twente, Enschede, The Netherlands
| | - A H Boekhout
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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Zolfaghary F, MashaghiTabari R, Dezhman M, Bijani A, Kheirkha F, Adib-Rad H. Predictors of quality of life and mental health in breast cancer survivors in Northern Iran. BMC Womens Health 2023; 23:378. [PMID: 37464348 PMCID: PMC10354929 DOI: 10.1186/s12905-023-02533-7] [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: 04/21/2023] [Accepted: 07/08/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND AND PURPOSE The global incidence of breast cancer is the highest among all cancers and is the primary reason for cancer-related fatalities. Our study aimed to assess the predictors of quality of life (QOL) and mental health in breast cancer survivors in Northern Iran. METHODS This cross-sectional study was done on 96 female breast cancer survivors between the ages of 20 and 65 and was based on convenience samples. We gathered information through demographic and fertility data, a QOL survey, and the Hospital Anxiety and Depression Scale (HADS). A significance level of P < 0.05 was set for the analysis. RESULTS In this study, results showed that 11.5% of women had the optimal quality of life, 31.3% favorable quality of life, and 57.3% undesirable quality of life. The average HADS score was 20.14 ± 3.07, with anxiety scores of 10.21 ± 2.31 and depression scores of 9.93 ± 1.64. On multiple linear regression, marital relationship and the number of children were predictors of quality of life (β=-17.624, p = 0.023 and β=-7.427, p = 0.016, respectively), as well as the husband's education and having no history of other cancers in the woman, were the most important predictors of HADS (β = 0.763, p = 0.039 and β=-0.528, p = 0.016, respectively). CONCLUSION It is crucial to provide exceptional care to breast cancer patients during treatment and post-recovery. Emotional and psychological support is a fundamental requirement for their well-being.
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Affiliation(s)
- Fatemeh Zolfaghary
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Reza MashaghiTabari
- Faculty of Medicine, Belgrade University of Medical Sciences, Belgrade, Serbia
| | - Mobina Dezhman
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkha
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hajar Adib-Rad
- Infertility and Health Reproductive Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Civilotti C, Lucchini D, Fogazzi G, Palmieri F, Benenati A, Buffoli A, Girardi V, Ruzzenenti N, Di Betta A, Donarelli E, Veglia F, Di Fini G, Gandino G. The role of integrated psychological support in breast cancer patients: a randomized monocentric prospective study evaluating the Fil-Rouge Integrated Psycho-Oncological Support (FRIPOS) program. Support Care Cancer 2023; 31:266. [PMID: 37058253 PMCID: PMC10104919 DOI: 10.1007/s00520-023-07732-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 04/04/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE This study examined the effects of Fil-Rouge Integrated Psycho-Oncological Support (FRIPOS) in a group of women with breast cancer compared with a group receiving treatment as usual (TAU). METHODS The research design was a randomized, monocentric, prospective study with three time points of data collection: after the preoperative phase (T0), in the initial phase of treatments (T1), and 3 months after the start of treatments (T2). The FRIPOS group (N = 103) and the TAU group (N = 79) completed a sociodemographic questionnaire, the Symptom Checklist-90-R (SCL-90-R) at T0; the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C30 and EORTC QLQ-BR23 at T1; and SCL-90-R, EORTC QLQ-C30, and EORTC QLQ-BR23 at T2. RESULTS A series of independent and paired t tests showed that patients in the FRIPOS group performed better on all scales related to symptomatic manifestations and on some quality of life scales (fatigue, dyspnea, and sleep disturbances) at T2. In addition, a series of ten multiple regressions were performed to predict each SCL subscale at T2 from the SCL score at T0 and the EORTC QLQ-C30 scores at T2. In nine of ten regression models (all except somatization), both FRIPOS group membership and QoL subscale contributed significantly to prediction. CONCLUSIONS This study suggests that patients in the FRIPOS group have more benefits in emotional, psychological, and collateral symptoms than patients in the TAU group and that these improvements are due to integrated psycho-oncology care.
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Affiliation(s)
- Cristina Civilotti
- Department of Psychology, University of Turin, Turin, Italy
- Salesian University Institute (IUSTO), Turin, Italy
| | - Diana Lucchini
- Breast Psycho-Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
- Associazione Priamo, Via della Lama, 61, 25133, Brescia, Italy
| | - Gianluca Fogazzi
- Breast Medical Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Fabrizio Palmieri
- Breast Surgery, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Alice Benenati
- Breast Surgery, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
- Radiation Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Alberto Buffoli
- Radiation Oncology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Veronica Girardi
- Breast Radiology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | - Nella Ruzzenenti
- Breast Pathology, EUSOMA-Certified Breast Unit, Istituto Clinico Sant'Anna, Via del Franzone 31, 25127, Brescia, Italy
| | | | | | - Fabio Veglia
- Department of Psychology, University of Turin, Turin, Italy
| | - Giulia Di Fini
- Department of Psychology, University of Turin, Turin, Italy.
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Loughan AR, Lanoye A, Willis KD, Ravyts SG, Fox A, Zukas A, Kim Y. Study protocol for Cognitive Behavioral Therapy for Insomnia in patients with primary brain tumor: A single-arm phase 2a proof-of-concept trial. Contemp Clin Trials Commun 2023; 32:101083. [PMID: 36879641 PMCID: PMC9984952 DOI: 10.1016/j.conctc.2023.101083] [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: 09/08/2022] [Revised: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Background Sleep disturbance is among the most common symptoms endorsed by patients with primary brain tumor (PwPBT), with many reporting clinically elevated insomnia and poor management of their sleep-related symptoms by their medical team. Though Cognitive Behavioral Therapy for Insomnia (CBT-I) remains the front-line treatment for sleep disturbance, CBT-I has yet to be evaluated in PwPBT. Thus, it is unknown whether CBT-I is feasible, acceptable, or safe for patients with primary brain tumors. Methods PwPBT (N = 44) will enroll and participate in a six-week group-based CBT-I intervention delivered via telehealth. Feasibility will be based on pre-determined metrics of eligibility, rates and reasons for ineligibility, enrollment, and questionnaire completion. Acceptability will be measured by participant retention, session attendance, satisfaction ratings, and recommendation to others. Safety will be assessed by adverse event reporting. Sleep will be measured both objectively via wrist-worn actigraphy and subjectively via self-report. Participants will also complete psychosocial questionnaires at baseline, post-intervention, and three-month follow-up. Conclusion CBT-I, a non-pharmacological treatment option for insomnia, has the potential to be beneficial for an at-risk, underserved population: PwPBT. This trial will be the first to assess feasibility, acceptability, and safety of CBT-I in PwPBT. If successful, this protocol will be implemented in a more rigorous phase 2b randomized feasibility pilot with the aim of widespread implementation of CBT-I in neuro-oncology clinics.
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Affiliation(s)
- Ashlee R Loughan
- Virginia Commonwealth University, Department of Neurology, USA.,Virginia Commonwealth University, Massey Cancer Center, USA
| | - Autumn Lanoye
- Virginia Commonwealth University, Department of Health Behavior and Policy, USA.,Virginia Commonwealth University, Massey Cancer Center, USA
| | - Kelcie D Willis
- Virginia Commonwealth University, Department of Psychology, USA
| | - Scott G Ravyts
- Virginia Commonwealth University, Department of Psychology, USA
| | - Amber Fox
- Virginia Commonwealth University, Department of Psychology, USA
| | - Alicia Zukas
- Medical College of South Carolina, Department of Neurosurgery, USA
| | - Youngdeok Kim
- Virginia Commonwealth University, Department of Kinesiology and Health Sciences, Richmond, VA, USA
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Hong YJ, Han S, Lim JU, Kang HS, Kim SK, Kim JW, Lee SH, Kim SJ, Yeo CD. Association between quality of life questionnaire at diagnosis and survival in patients with lung cancer. Clin Lung Cancer 2023:S1525-7304(23)00048-7. [PMID: 37061414 DOI: 10.1016/j.cllc.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/23/2023] [Accepted: 03/10/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Patients with lung cancer experience considerable symptom burden, which can decrease patients' QOL. Our aim was to investigate the association between QOL questionnaire at diagnosis and survival of lung cancer. PATIENTS AND METHODS This was a multicenter study of lung cancer patients at 7 medical centers of the Catholic University of Korea that responded to a quality of life questionnaire between December 1, 2017 and December 31, 2020. We analyzed 5 functional (physical, role, emotional, cognitive, and social functioning) and nine symptom (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties) scales and examined their associations with survival. A Cox proportional hazards model was used to evaluate the prognostic value. RESULTS In total, 1297 lung cancer patients were enrolled. The results of multivariable analysis showed that female, younger age, never smoker, stage I or II cancer, higher physical functioning, and emotional functioning were statistically significant favorable predictors for survival. On subgroup analysis according to early (stage I and II) or advanced (stage III or IV) stage, higher physical functioning and emotional functioning were each found to be favorable prognostic factors for survival. Meanwhile, fatigue, pain, insomnia, and financial difficulties were found to be associated with low scores on the emotional functioning scale; fatigue, pain, dyspnea, and financial difficulties were associated with low scores on the physical functioning scale. CONCLUSION Assessing the physical functioning and emotional functioning scales of QOL questionnaire items at diagnosis can help clinicians predict the survival of patients with lung cancer.
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Affiliation(s)
- Yu Jin Hong
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Solji Han
- Department of Statistics and Data Science, Yonsei University, Seoul, Republic of Korea
| | - Jeong Uk Lim
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hye Seon Kang
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Kyoung Kim
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Woo Kim
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Haak Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Joon Kim
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Pulmonology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea; Postech-Catholic Biomedical Engineering Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Dong Yeo
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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11
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Meng X, Shang M, Wang Q, Yan R, Jiang K, Xiang J, Liu W, Li J, Wang D, Xu J. Reliability and validity of the simplified Chinese version of the Functional Assessment of Cancer Therapy-Immune Checkpoint Modulator. Qual Life Res 2022; 32:1581-1593. [PMID: 36508144 DOI: 10.1007/s11136-022-03318-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE This study aimed to translate and culturally adapt the immune checkpoint modulator (ICM) subscale of the Functional Assessment of Cancer Therapy-Immune Checkpoint Modulator (FACT-ICM) scale and to validate the FACT-ICM scale in Chinese cancer patients receiving immune checkpoint inhibitors (ICIs) treatment. METHODS In total, 354 cancer patients treated with ICIs were included in our cross-sectional study including 2 phases. Firstly, the ICM subscale was translated and culturally adapted by standardized procedures. Then the FACT-ICM scale was validated, which included item analysis, content validity, floor and ceiling effects, internal consistency reliability, test-retest reliability, construct validity, convergent/divergent validity, and known-group validity. RESULTS The content validity indexes at the item and scale level of the ICM subscale were greater than 0.8. No floor and ceiling effects were found. The Cronbach's α and McDonald's omega coefficients of the simplified Chinese version of the FACT-ICM scale were 0.935 and 0.936, and the intraclass correlation coefficient was 0.833 (95% confidence interval: 0.574-0.940). Confirmatory factor analysis confirmed the 5-subscale structure of the simplified Chinese version of the FACT-ICM scale (χ2/df = 2.144, RMSEA = 0.057, SRMR = 0.072, and CFI = 0.848). Convergent and divergent validity further supported the construct validity of the simplified Chinese version of the FACT-ICM scale. The known-group validity of the simplified Chinese version of the FACT-ICM scale was confirmed in patients with different physical statuses. CONCLUSIONS The simplified Chinese version of the FACT-ICM scale is a valid and reliable instrument and can be used in clinical practice and research on cancer patients receiving ICIs treatment.
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12
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Khattak MA, Luke JJ, Long GV, Ascierto PA, Rutkowski P, Schadendorf D, Robert C, Grob JJ, de la Cruz Merino L, Del Vecchio M, Spagnolo F, Mackiewicz J, Chiarion-Sileni V, Carlino MS, Mohr P, De Galitiis F, Ross MI, Eroglu Z, Chen K, Jiang R, Fukunaga-Kalabis M, Krepler C, Eggermont AMM, Kirkwood JM. Adjuvant pembrolizumab versus placebo in resected high-risk stage II melanoma: Health-related quality of life from the randomized phase 3 KEYNOTE-716 study. Eur J Cancer 2022; 176:207-217. [PMID: 36202690 DOI: 10.1016/j.ejca.2022.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/08/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Adjuvant pembrolizumab significantly improved recurrence-free survival (RFS) versus placebo in resected stage IIB and IIC melanoma in the phase 3 KEYNOTE-716 study. Health-related quality of life (HRQoL) results are reported. METHODS Patients were randomly assigned 1:1 to pembrolizumab 200 mg (2 mg/kg, patients ≥12 to <18 years) Q3W or placebo for ≤17 cycles or until disease recurrence, unacceptable toxicity, or withdrawal. Change from baseline in EORTC QLQ-C30 global health status (GHS)/quality of life (QoL) was a prespecified exploratory end point. Change in EORTC QLQ-C30 functioning, symptom, and single-item scales, and EQ-5D-5L visual analog scale (VAS) were also summarized. Primary analyses were performed at week 48 to ensure adequate completion/compliance. The HRQoL population comprised patients who received ≥1 dose of treatment and completed ≥1 assessment. RESULTS The HRQoL population included 969 patients (pembrolizumab, n = 483; placebo, n = 486). Compliance at week 48 was ≥80% for both instruments. EORTC QLQ-C30 GHS/QoL, physical functioning, role functioning, and EQ-5D-5L VAS scores were stable from baseline to week 48 in both arms, with no clinically meaningful decline observed. Scores did not differ significantly between pembrolizumab and placebo. EORTC QLQ-C30 GHS/QoL, physical functioning, role functioning, and EQ-5D-5L VAS scores remained stable through week 96 in both arms. CONCLUSIONS HRQoL was stable with adjuvant pembrolizumab, with no clinically meaningful decline observed. Change from baseline in HRQoL was similar between arms. These results, in conjunction with the improved RFS and manageable safety previously reported, support the use of adjuvant pembrolizumab for high-risk stage II melanoma.
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Affiliation(s)
- Muhammad A Khattak
- Fiona Stanley Hospital and Edith Cowan University, Perth, WA, Australia.
| | - Jason J Luke
- Cancer Immunotherapeutics Center, UPMC Hillman Cancer Center, University of Pittsburgh, PA, USA
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia
| | - Paolo A Ascierto
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale," Naples, Italy
| | - Piotr Rutkowski
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Dirk Schadendorf
- Comprehensive Cancer Center, Universitaetsklinikum Essen and German Cancer Consortium, Essen, Germany
| | - Caroline Robert
- Dermatology Committee, Gustave Roussy, Université Paris-Sud, Villejuif, France
| | | | | | | | | | | | | | - Matteo S Carlino
- Melanoma Institute Australia, The University of Sydney, Westmead and Blacktown Hospitals, Sydney, NSW, Australia
| | - Peter Mohr
- Elbe Kliniken Buxtehude, Buxtehude, Germany
| | | | - Merrick I Ross
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zeynep Eroglu
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Ke Chen
- Merck & Co., Inc., Rahway, NJ, USA
| | | | | | | | - Alexander M M Eggermont
- University Medical Center Utrecht and Princess Maxima Center, Utrecht, Netherlands; Comprehensive Cancer Center Munich, Munich, Germany
| | - John M Kirkwood
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
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13
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Xu Z, Wang X, Wu Y, Wang C, Fang X. The effectiveness and safety of acupuncture for chemotherapy-induced peripheral neuropathy: A systematic review and meta-analysis. Front Neurol 2022; 13:963358. [PMID: 36262831 PMCID: PMC9574072 DOI: 10.3389/fneur.2022.963358] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of acupuncture on chemotherapy-induced peripheral neuropathy (CIPN). Methods We searched for relevant randomized controlled trials (RCTs) in PubMed, Cochrane Library, and Embase databases from their inception to 1 April 2022. The Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx), Brief Pain Inventory-Short Form (BPI-SF), the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (EORTC QLQ-C30), Numerical Rating Scale (NRS), and adverse events were the outcome measures. All studies had at least one of these outcome measures. Mean differences (MDs) with 95% confidence intervals (CIs) were assessed in the meta-analysis using the RevMan 5.3 software. Results Five studies were included in the analysis. The results showed that acupuncture and placebo acupuncture were not significantly different in reducing chemotherapy-induced neurotoxicity and functional disability (random-effects estimates; MD: 4.30; 95% CI: −0.85~9.45; P = 0.10; I2 = 74%). Acupuncture was better than placebo acupuncture in reducing pain severity and pain interference with patients' daily function (fixed-effect estimates; MD: −1.14; 95% CI: 1.87 to −0.42; P = 0.002; I2 = 13%). Acupuncture was not significantly different from placebo acupuncture in relieving CIPN symptoms (MD: −0.81; 95% CI: −2.02 to 0.40, P = 0.19). Acupuncture improved quality of life better than placebo acupuncture (MD: 10.10; 95% CI: 12.34 to 17.86, P = 0.01). No severe adverse events were recorded in all five studies. Conclusion This meta-analysis suggests that acupuncture may be more effective and safer in reducing pain severity and pain interference with patients' daily function than placebo acupuncture. Additionally, acupuncture may improve the quality of life of patients with CIPN. However, large sample size studies are needed to confirm this conclusion. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=324930, identifier: CRD42022324930.
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Association between Health-Related Quality of Life and Completion of First-Line Treatment among Lung Cancer Patients. Cancers (Basel) 2022; 14:cancers14143343. [PMID: 35884404 PMCID: PMC9324359 DOI: 10.3390/cancers14143343] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary The aim of this study was to investigate how health-related quality of life at time of diagnosis is associated with the completion of planned first-line oncological treatment among lung cancer patients. Patients with reduced function and patients who reported fatigue, pain, appetite loss, and financial difficulties at time of diagnosis had significantly increased adjusted odds ratios for not completing the planned first-line oncological treatment. Measures of lung cancer patients’ self-reported HRQOL as part of the diagnostic evaluation at time of diagnosis may contribute to the optimization of planned oncological treatment. Abstract Experts recommend assessing lung cancer patients’ health-related quality of life (HRQOL) in the diagnostic evaluation. We investigated the association between HRQOL and completion of first-line treatment among lung cancer patients in a prospective cohort study. Clinical information on lung cancer patients was obtained from medical records, and information on quality of life and lung cancer-related symptoms was obtained through questionnaires at time of diagnosis. We used directed acyclic graphs to identify potential confounders and mediators between HRQOL and completion of first-line treatment. The association between functioning levels and symptoms and completion of first-line oncological treatment was estimated as odds ratios, with 95% confidence intervals, in logistic regression models. In all, 137 patients (52% men, mean age: 69 years) participated, out of 216 invited. Patients who reported reduced functioning had significantly increased ORs for not completing first-line treatment: poor physical function (OR 4.44), role function (OR 6.09), emotional function (OR 5.86), and social function (OR 3.13). Patients with fatigue (OR 7.55), pain (OR 6.07), appetite loss (OR 4.66), and financial difficulties (OR 17.23) had significantly increased ORs for not completing the first-line treatment. Reduced functioning and presence of symptoms were associated with not completing first-line treatment. An assessment of HRQOL could potentially aid the diagnostic evaluation and treatment planning for lung cancer patients.
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Campbell R, Costa DSJ, Stockler MR, Lee YC, Ledermann JA, Berton D, Sehouli J, Roncolato FT, Connell RO, Okamoto A, Bryce J, Oza AM, Avall-Lundqvist E, Berek JS, Lanceley A, Joly F, Hilpert F, Feeney A, Kaminsky MC, Diamante K, Friedlander ML, King MT. Measure of Ovarian Symptoms and Treatment concerns (MOST) indexes and their associations with health-related quality of life in recurrent ovarian cancer. Gynecol Oncol 2022; 166:254-262. [PMID: 35718565 DOI: 10.1016/j.ygyno.2022.05.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE The Measure of Ovarian Symptoms and Treatment (MOST) concerns is a validated patient-reported symptom assessment tool for assessing symptom benefit and adverse effects of palliative chemotherapy in women with recurrent ovarian cancer (ROC). We aimed to examine (i) how symptoms within MOST symptom indexes track together (i.e. co-occur) and (ii) the association between MOST symptom indexes and key aspects of health-related quality of life (HRQL). METHOD A prospective cohort of women with ROC completed the MOST-T35, EORTC QLQ-C30 and EORTC QLQ-OV28 at baseline and before each cycle of chemotherapy. Analyses were conducted on baseline and end-of-treatment data. Exploratory factor analysis and hierarchical cluster analysis identified groups of co-occurring symptoms. Path models examined associations between MOST symptom indexes and HRQL. RESULTS Data from 762 women at baseline and 681 at treatment-end who completed all 22 symptom-specific MOST items and at least one HRQL measure were analysed. Four symptom clusters emerged at baseline and treatment-end: abdominal symptoms, symptoms associated with peripheral neuropathy, nausea and vomiting, and psychological symptoms. Psychological symptoms (MOST-Psych) and symptoms due to disease (ovarian cancer) or treatment (MOST-DorT) were associated with poorer scores on QLQ-C30 and OV28 functioning domains and worse overall health at both time points. CONCLUSION Four MOST symptom clusters were consistent across statistical methods and time points. These findings suggest that routine standardized assessment of psychological and physical symptoms in clinical practice with MOST plus appropriate symptom management referral pathways is an intervention for improving HRQL that warrants further research.
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Affiliation(s)
- Rachel Campbell
- University of Sydney, Faculty of Science, School of Psychology, Australia.
| | - Daniel S J Costa
- University of Sydney, Faculty of Science, School of Psychology, Australia
| | - Martin R Stockler
- University of Sydney, NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia
| | - Yeh Chen Lee
- University of Sydney, NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia; Australia New Zealand Gynaecological Oncology Group (ANZGOG), Australia; Department of Medical Oncology, Prince of Wales Hospital, New South Wales, Australia
| | - Jonathan A Ledermann
- The Cancer Research UK & UCL Cancer Trials Centre, NCRI UK, London, United Kingdom
| | - Dominique Berton
- GINECO-Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France; Institut de Cancerologie de l'Ouest (ICO), Centre René Gauducheau, Saint Herblain, France
| | - Jalid Sehouli
- Arbeitsgesmeinschaft Gynäkologische Onkologie Studiengruppe (AGO) und North-Eastern German Society of Gynecologcial Oncology (NOGGO), Berlin, Germany; Department of Gynecology and Oncological Surgery, Charité, University of Berlin, Berlin, Germany
| | - Felicia T Roncolato
- University of Sydney, NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia; Australia New Zealand Gynaecological Oncology Group (ANZGOG), Australia; Department of Medical Oncology, Prince of Wales Hospital, New South Wales, Australia; Macarthur Cancer Therapy Centre, Campbelltown Hospital, NSW, Australia
| | - Rachel O Connell
- University of Sydney, NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia
| | - Aikou Okamoto
- Japanese Gynecologic Oncology Group (JGOG), Tokyo, Japan; Jikei University School of Medicine, Tokyo, Japan
| | - Jane Bryce
- Istituto Nazionale Tumori IRCCS - Fondazione G. Pascale, Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO), Napoli, Italy; Ascension St. John Clinical Research Institute, Tulsa, USA
| | - Amit M Oza
- Princess Margaret Consortium (PMHC), Toronto, Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Elisabeth Avall-Lundqvist
- Nordic Society of Gynaecological Oncology (NSGO), Copenhagen, Denmark; Department of Oncology and Department of Clinical and Experimental Medicine, Linkoping University, NSGO, Linkoping, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Jonathan S Berek
- Cooperative Gynecologic Oncology Investigators (COGI), Stanford, CA, USA; Stanford Women's Cancer Centre, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Anne Lanceley
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, United Kingdom
| | - Florence Joly
- GINECO-Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France; Centre Francois Baclesse, Caen, France
| | - Felix Hilpert
- Arbeitsgesmeinschaft Gynäkologische Onkologie Studiengruppe (AGO) und North-Eastern German Society of Gynecologcial Oncology (NOGGO), Berlin, Germany; Onkologisches Therapiezentrum, Krankenhaus Jerusalem, Hamburg, Germany
| | - Amanda Feeney
- The Cancer Research UK & UCL Cancer Trials Centre, NCRI UK, London, United Kingdom
| | - Marie C Kaminsky
- GINECO-Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France; Institut de Cancérologie de Lorraine, Alexis Vautrin, Vandoeuvre Les Nancy, France
| | - Katrina Diamante
- University of Sydney, NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia
| | - Michael L Friedlander
- Australia New Zealand Gynaecological Oncology Group (ANZGOG), Australia; Department of Medical Oncology, Prince of Wales Hospital, New South Wales, Australia
| | - Madeleine T King
- University of Sydney, Faculty of Science, School of Psychology, Australia
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16
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Amin S, Joo S, Nolte S, Yoo HK, Patel N, Byrnes HF, Costa-Cabral S, Johnson CD. Health-related quality of life scores of metastatic pancreatic cancer patients responsive to first line chemotherapy compared to newly derived EORTC QLQ-C30 reference values. BMC Cancer 2022; 22:563. [PMID: 35596182 PMCID: PMC9123808 DOI: 10.1186/s12885-022-09661-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background Metastatic pancreatic cancer (mPC) and its treatments significantly impact health-related quality of life (HRQoL). POLO, a randomized, double-blind, placebo-controlled phase 3 trial evaluated the efficacy of olaparib as maintenance therapy in germline BRCA mutated mPC patients who had not progressed during ≥16 weeks of first-line platinum-based chemotherapy. HRQoL was assessed using the EORTC QLQ-C30. To enhance score interpretation, we derived reference values for treatment-naïve mPC patients from the literature. Methods A targeted literature review identified EORTC QLQ-C30 baseline values in treatment-naïve mPC patients. Reference values were calculated by deriving means from studies meeting inclusion criteria, with scores from 0 to 100 (higher scores indicate better QoL/functioning but worse symptoms). For POLO patients, means were calculated using pooled baseline data across study arms. Results Four studies met inclusion criteria. Depending on the specific scale, sample sizes ranged from n = 466 to n = 639. Compared to newly derived reference values, POLO patients reported markedly better HRQoL scores at baseline across most scales, with eight scales showing differences of ≥10 points. POLO patients’ HRQoL scores were often close to or better than general population norm data. Conclusions This is the first study to systematically derive EORTC QLQ-C30 reference values for mPC. POLO patients had better HRQoL scores than those in the literature and similar to general population data. Comparatively high HRQoL of POLO patients are likely due to effects of prior first-line treatment and resolution of chemotherapy-related symptoms, response shift, or a combination. Newly derived reference values can enhance interpretation of mPC patients’ HRQoL. Trial registration The POLO trial was registered on 9 July 2014 with ClinicalTrials.gov as NCT 02184195. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09661-7.
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Affiliation(s)
- Suvina Amin
- AstraZeneca, One Medimmune Way, Gaithersburg, MD, 20878, USA
| | | | - Sandra Nolte
- ICON Clinical Research GmbH, Konrad-Zuse-Platz 11, 81829, Munich, Germany.,Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medical Clinic, Berlin, Germany
| | - Hyun Kyoo Yoo
- AstraZeneca, City house, 130 Hills road, Cambridge, CB2 1RE, UK
| | - Nikunj Patel
- AstraZeneca, One Medimmune Way, Gaithersburg, MD, 20878, USA
| | - Hilary F Byrnes
- ICON plc, 731 Arbor Way, Suite 100, Blue Bell, PA, 19422, USA.
| | - Sara Costa-Cabral
- Mapi Research Trust, 27, Rue de la Villette, 3rd & 4th Floors, 69003, Lyon, France
| | - Colin D Johnson
- University of Southampton, University Road, Southampton, SO17 BJ, UK
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17
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Oerlemans S, Efficace F, Kieffer JM, Kyriakou C, Xochelli A, Levedahl K, Petranovic D, Borges FC, Bredart A, Shamieh O, Gziskevicius L, Lehmann J, Scholz CW, Caocci G, Molica S, Stamatopoulos K, Panteliadou AK, Papaioannou M, Alrjoob W, Baliakas P, Rosenquist R, Malak S, Miranda A, Cocks K, van de Poll-Franse L. International validation of the EORTC QLQ-CLL17 questionnaire for assessment of health-related quality of life for patients with chronic lymphocytic leukaemia. Br J Haematol 2022; 197:431-441. [PMID: 35255152 DOI: 10.1111/bjh.18072] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 11/26/2022]
Abstract
Selecting the most appropriate chronic lymphocytic leukaemia (CLL) treatment is challenging. Patient-reported health-related quality of life (HRQoL) is therefore a critical aspect to consider. This international study by the European Organization for Research and Treatment of Cancer (EORTC) tested the psychometric properties of a newly developed measure for CLL patients: the EORTC QLQ-CLL17 to supplement the core questionnaire (EORTC QLQ-C30). Patients with CLL (n = 341) from 12 countries completed the QLQ-C30, QLQ-CLL17 and a debriefing questionnaire. Sociodemographic and clinical data were recorded from medical records. A high percentage (30%-66%) reported symptoms and/or worries (e.g. aches/pains in muscles, lack of energy and worry/fears about health). Confirmatory factor analysis showed an acceptable to good fit of the 17 items on the three scales (i.e. symptom burden, physical condition/fatigue and worries/fears about health and functioning). Completion took on average 8 min. Test-retest and convergent validity was demonstrated. The QLQ-CLL17 differentiated between patients with an Eastern Cooperative Oncology group (ECOG) performance of 0 versus 1-3 (p's < 0.01 and clinically relevant). The newly developed EORTC QLQ-CLL17 will increase sensitivity of HRQoL assessment in patients with CLL. Implementation of this questionnaire both in clinical research and practice will help to generate unique clinically relevant data to better inform CLL treatment decision-making.
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Affiliation(s)
- Simone Oerlemans
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Fabio Efficace
- Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA) Data Centre, Rome, Italy
| | - Jacobien M Kieffer
- Department of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Aliki Xochelli
- Institute of Applied Biosciences, Center for Research and Technology Hellas, Thessaloniki, Greece
| | - Kerstin Levedahl
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Duska Petranovic
- Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia
| | - Fabio Cardoso Borges
- Department of Epidemiology and National Cancer Registry (RON), Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E, Lisbon, Portugal
| | - Anne Bredart
- Institut Curie - Psycho-Oncology Unit, Paris University, Paris, France.,Psychopathology and Health Process Laboratory (LPPS) (UR 4057), PSL University, Paris, France
| | - Omar Shamieh
- Department of Palliative Medicine, King Hussein Cancer Center, Amman, Jordan
| | | | - Jens Lehmann
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Giovanni Caocci
- Hematology, Businco Hospital, University of Cagliari, Cagliari, Italy
| | | | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Center for Research and Technology Hellas, Thessaloniki, Greece
| | | | - Maria Papaioannou
- Hematology Unit, 1st Dept of Internal Medicine, AUTH, AHEPA Hospital, Thessaloniki, Greece
| | - Waleed Alrjoob
- Department of Palliative Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Panagiotis Baliakas
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Richard Rosenquist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Malak
- Hôpital René Huguenin-Institut Curie - Hématologie, Saint-Cloud, France
| | - Ana Miranda
- Department of Epidemiology and National Cancer Registry (RON), Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E, Lisbon, Portugal
| | - Kim Cocks
- York Trials Unit, University of York, York & Adelphi Values, Cheshire, UK
| | - Lonneke van de Poll-Franse
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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18
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Clarijs ME, Oemrawsingh A, Bröker MEE, Verhoef C, Lingsma H, Koppert LB. Quality of life of caregivers of breast cancer patients: a cross-sectional evaluation. Health Qual Life Outcomes 2022; 20:29. [PMID: 35183212 PMCID: PMC8858558 DOI: 10.1186/s12955-022-01930-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background The aim of this study was to evaluate the care-related quality of life in caregivers of breast cancer patients, to assess its association with breast cancer patients’ health-related quality of life (HRQoL), and to identify its potential predictors. Methods Caregivers of breast cancer patients at six and twelve months follow up were identified through the institutes electronic patient reported outcome measurement collection tool. The Care-related Quality of Life Instrument (CarerQoL) was used to obtain CarerQoL utility scores by applying a pre-existent set of Dutch tariffs and the CarerQoL VAS score, which represented the overall happiness of caregivers. The associations between breast cancer patients’ EQ-5D-5L and EORTC QLQ-C30 scores and caregivers’ CarerQoL scores was determined with Spearman’s correlation coefficients. Associations between log transformed CarerQol scores and patient and caregiver characteristics were analyzed with multivariable linear regression analyses. Results A total of 116 completed CarerQoL questionnaires were analyzed. Most caregivers were male spouses or partners (81.4%) with a mean age of 55.7 ± 16.4. The median CarerQoL utility score was 92.4/100 and median CarerQoL VAS was 8.0/10. We found weak correlations between CarerQoL VAS scores and patients’ EQ-5D-5L utility score (0.301, p = 0.002) and EQ VAS score (0.251, p = 0.009), and between EORTC QLQ-C30 scores and CarerQol VAS (0.339, p < 0.001) and utility score (0.236, p = 0.015). There was a negative association between chemotherapy and log-transformed CarerQoL utility score (B = − 0.063, p = 0.001) and VAS score (B = − 0.044, p = 0.038) at six months follow-up. Conclusions This study provides the first evaluation of the CarerQoL in caregivers of Dutch breast cancer patients. Caregivers’ happiness was associated with breast cancer patients’ HRQoL. Our results can be used as reference values for future care-related quality of life evaluations. Plain English Summary Breast cancer patients face many difficulties during their cancer journey and often need the support of their caregivers. Despite the fact that successfully providing informal care can have positive effects on caregivers’ wellbeing, it may also have a negative impact on their quality of life. Monitoring the quality of life using a standardized questionnaire, such as the CarerQoL questionnaire, may result in early detection of possible quality of life issues. In this study, we evaluated 116 caregivers and found overall high CarerQoL scores. The scores showed a positive relation to the patients’ quality of life. Lower CarerQoL scores at six months after surgery were found in caregivers of patients who received chemotherapy. Our research underlines the importance to include caregivers of breast cancer patients in clinical practice, provides reference values for future research, and the results can be used to manage the caregivers’ expectations prior to treatment.
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Nicol JL, Woodrow C, Cunningham BJ, Mollee P, Weber N, Smith MD, Nicol AJ, Gordon LG, Hill MM, Skinner TL. An Individualized Exercise Intervention for People with Multiple Myeloma—Study Protocol of a Randomized Waitlist-Controlled Trial. Curr Oncol 2022; 29:901-923. [PMID: 35200576 PMCID: PMC8870457 DOI: 10.3390/curroncol29020077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
People with multiple myeloma (MM) are second only to people with lung cancer for the poorest reported health-related quality of life (HRQoL) of all cancer types. Whether exercise can improve HRQoL in MM, where bone pain and lesions are common, requires investigation. This trial aims to evaluate the efficacy of an exercise intervention compared with control on HRQoL in people with MM. Following baseline testing, people with MM (n = 60) will be randomized to an exercise (EX) or waitlist control (WT) group. EX will complete 12-weeks of supervised (24 sessions) and unsupervised (12 sessions) individualized, modular multimodal exercise training. From weeks 12–52, EX continue unsupervised training thrice weekly, with one optional supervised group-based session weekly from weeks 12–24. The WT will be asked to maintain their current activity levels for the first 12-weeks, before completing the same protocol as EX for the following 52 weeks. Primary (patient-reported HRQoL) and secondary (bone health and pain, fatigue, cardiorespiratory fitness, muscle strength, body composition, disease response, and blood biomarkers) outcomes will be assessed at baseline, 12-, 24- and 52-weeks. Adverse events, attendance, and adherence will be recorded and cost-effectiveness analysis performed. The findings will inform whether exercise should be included as part of standard myeloma care to improve the health of this unique population.
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Affiliation(s)
- Jennifer L. Nicol
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- Correspondence:
| | - Carmel Woodrow
- Haematology, Division of Cancer, Princess Alexandra Hospital, Brisbane 4102, Australia; (C.W.); (P.M.)
| | - Brent J. Cunningham
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
| | - Peter Mollee
- Haematology, Division of Cancer, Princess Alexandra Hospital, Brisbane 4102, Australia; (C.W.); (P.M.)
- Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
| | - Nicholas Weber
- Haematology, Cancer Care Services, Royal Brisbane and Women’s Hospital, Brisbane 4006, Australia;
| | - Michelle D. Smith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia;
| | - Andrew J. Nicol
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
- Brisbane Clinic for Lymphoma, Myeloma and Leukaemia, Greenslopes Private Hospital, Brisbane 4120, Australia
| | - Louisa G. Gordon
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
- Palliative Care Outcomes Centre, School of Nursing and Cancer, Queensland University of Technology, Brisbane 4059, Australia
| | - Michelle M. Hill
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia; (L.G.G.); (M.M.H.)
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane 4006, Australia
| | - Tina L. Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia; (B.J.C.); (A.J.N.); (T.L.S.)
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20
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Tsui TCO, Trudeau M, Mitsakakis N, Torres S, Bremner KE, Kim D, Davis AM, Krahn MD. Developing the Breast Utility Instrument, a preference-based instrument to measure health-related quality of life in women with breast cancer: Confirmatory factor analysis of the EORTC QLQ-C30 and BR45 to establish dimensions. PLoS One 2022; 17:e0262635. [PMID: 35120148 PMCID: PMC8815914 DOI: 10.1371/journal.pone.0262635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/31/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Breast cancer (BrC) and its treatments impair health-related quality of life (HRQoL). Utility is a measure of HRQoL that includes preferences for health outcomes, used in treatment decision-making. Generic preference-based instruments lack BrC-specific concerns, indicating the need for a BrC-specific preference-based instrument. Our objective was to determine dimensions of the European Organisation for Research and Treatment of Cancer (EORTC) general cancer (QLQ-C30) and breast module (BR45) instruments, the first step in our development of the novel Breast Utility Instrument (BUI). METHODS Patients (n = 408) attending outpatient BrC clinics at an urban cancer centre, and representing a spectrum of BrC health states, completed the QLQ-C30 and BR45. We performed confirmatory factor analysis of the combined QLQ-C30 and BR45 using mean-and variance-adjusted unweighted least squares estimation. The hypothesized factor model was based on clinical relevance, item distributions, missing data, item-importance, and internal reliability of dimensions. Models were evaluated based on global and item fit, local areas of strain, and likelihood ratio tests of nested models. RESULTS Our final model had 10 dimensions: physical and role functioning, emotional functioning, social functioning, body image, pain, fatigue, systemic therapy side effects, sexual functioning and enjoyment, arm and breast symptoms, and endocrine therapy symptoms. Good overall model fit was achieved: χ2/df: 1.45, Tucker-Lewis index: 0.946, comparative fit index: 0.951, standardized root-mean-square residual: 0.069, root-mean-square error of approximation: 0.033 (0.030-0.037). All items had salient factor loadings (λ>0.4, p<0.001). CONCLUSIONS We identified important BrC HRQoL dimensions to develop the BUI, a BrC-specific preference-based instrument.
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Affiliation(s)
- Teresa C. O. Tsui
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
- Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Maureen Trudeau
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Nicholas Mitsakakis
- Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sofia Torres
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Karen E. Bremner
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
| | - Doyoung Kim
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Aileen M. Davis
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Murray D. Krahn
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
- Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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21
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Lee YC, King MT, O'Connell RL, Lanceley A, Joly F, Hilpert F, Davis A, Roncolato FT, Okamoto A, Bryce J, Donnellan P, Oza AM, Avall-Lundqvist E, Berek JS, Ledermann JA, Berton D, Sehouli J, Feeney A, Kaminsky MC, Diamante K, Stockler MR, Friedlander ML. Symptom burden and quality of life with chemotherapy for recurrent ovarian cancer: the Gynecologic Cancer InterGroup-Symptom Benefit Study. Int J Gynecol Cancer 2022; 32:761-768. [PMID: 35086926 PMCID: PMC9185817 DOI: 10.1136/ijgc-2021-003142] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective The Gynecologic Cancer InterGroup (GCIG)-Symptom Benefit Study was designed to evaluate the effects of chemotherapy on symptoms and health-related quality of life (HRQL) in women having chemotherapy for platinum resistant/refractory recurrent ovarian cancer (PRR-ROC) and potentially platinum sensitive with ≥3 lines of chemotherapy (PPS-ROC ≥3). Methods Participants completed the Measure of Ovarian Cancer Symptoms and Treatment (MOST) and European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire QLQ-C30 questionnaires at baseline and every 3–4 weeks until progression. Participants were classified symptomatic if they rated ≥4 of 10 in at least one-third of symptoms in the MOST index. Improvement in MOST was defined as two consecutive scores of ≤3 in at least half of the symptomatic items at baseline. Improvement in HRQL was defined as two consecutive scores ≥10 points above baseline in the QLQ-C30 summary score scale (range 0–100). Results Of 948 participants enrolled, 910 (96%) completed baseline questionnaires: 546 with PRR-ROC and 364 with PPS-ROC ≥3. The proportions of participants symptomatic at baseline as per MOST indexes were: abdominal 54%, psychological 53%, and disease- or treatment-related 35%. Improvement was reported in MOST indexes: abdominal 40%, psychological 35%, and disease- or treatment-related 38%. Median time to improvement in abdominal symptoms occurred earlier for PRR-ROC than for PPS-ROC ≥3 (4 vs 6 weeks, p=0.044); median duration of improvement was also similar (9.0 vs 11.7 weeks, p=0.65). Progression-free survival was longer among those with improvement in abdominal symptoms than in those without (median 7.2 vs 2.5 months, p<0.0001). Improvements in HRQL were reported by 77/448 (17%) with PRR-ROC and 61/301 (20%) with PPS-ROC ≥3 (p=0.29), and 102/481 (21%) of those with abdominal symptoms at baseline. Conclusion Over 50% of participants reported abdominal and psychological symptoms at baseline. Of those, 40% reported an improvement within 2 months of starting chemotherapy. Approximately one in six participants reported an improvement in HRQL. Symptom monitoring and supportive care is important as chemotherapy palliated less than half of symptomatic participants.
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Affiliation(s)
- Yeh Chen Lee
- Australia New Zealand Gynaecological Oncology Group (ANZGOG), Camperdown, New South Wales, Australia.,University of Sydney, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine and Health, University of New South Wales, Randwick, New South Wales, Australia
| | - Madeleine T King
- University of Sydney, Quality of Life Office of Psycho-Oncology Research Group (PoCoG), Camperdown, New South Wales, Australia
| | - Rachel L O'Connell
- University of Sydney, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Anne Lanceley
- UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Florence Joly
- GINECO-Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France.,Oncology, Ctr Francois Baclesse, Caen, France
| | - Felix Hilpert
- Arbeitsgesmeinschaft Gynäkologische Onkologie Studiengruppe (AGO) und North-Eastern German Society of Gynecologcial Oncology (NOGGO), Kiel, Germany.,Onkologisches Therapiezentrum, Krankenhaus Jerusalem, Hamburg, Germany
| | - Alison Davis
- Australia New Zealand Gynaecological Oncology Group (ANZGOG), Camperdown, New South Wales, Australia.,Medical Oncology, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Felicia T Roncolato
- Australia New Zealand Gynaecological Oncology Group (ANZGOG), Camperdown, New South Wales, Australia.,University of Sydney, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Aikou Okamoto
- Japanese Gynecologic Oncology Group (JGOG), Tokyo, Japan.,Department of Obstetrics and Gynecology, Jikei University School of Medicine, Minato-ku, Japan
| | - Jane Bryce
- Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy.,Ascension St John Clinical Research Institute, Tulsa, Oklahoma, USA.,MITO Multicentre Italian Trials in Ovarian and gynecologic cancer, Italy
| | - Paul Donnellan
- Cancer Trials Ireland, Galway University Hospital, Galway, Ireland
| | - Amit M Oza
- Princess Margaret Consortium (PMHC), Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Elisabeth Avall-Lundqvist
- Nordic Society of Gynaecological Oncology (NSGO), Copenhagen, Denmark.,Department of Oncology and Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden.,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Jonathan S Berek
- Cooperative Gynecologic Oncology Investigators (COGI), Stanford, California, USA.,Stanford Women's Cancer Centre, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California, USA
| | | | - Dominique Berton
- GINECO-Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France.,Institut de Cancérologie de l'Ouest, Centre René Gauducheau, Saint Herblain, France
| | - Jalid Sehouli
- Arbeitsgesmeinschaft Gynäkologische Onkologie Studiengruppe (AGO) und North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany.,Department of Gynecology and Oncological Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Amanda Feeney
- The Cancer Research UK and UCL Cancer Trials Centre, NCRI UK, London, UK
| | - Marie-Christine Kaminsky
- GINECO-Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France.,Institut de Cancérologie de Lorraine, Vandoeuvre Les Nancy, France
| | - Katrina Diamante
- University of Sydney, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Martin R Stockler
- University of Sydney, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Michael L Friedlander
- Australia New Zealand Gynaecological Oncology Group (ANZGOG), Camperdown, New South Wales, Australia .,Prince of Wales Clinical School, Faculty of Medicine and Health, University of New South Wales, Randwick, New South Wales, Australia
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22
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OUP accepted manuscript. Br J Surg 2022; 109:595-602. [DOI: 10.1093/bjs/znac014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/14/2021] [Accepted: 12/30/2021] [Indexed: 11/14/2022]
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23
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Kim JH, Lee DE, Lee Y, Ha HI, Chang YJ, Chang SJ, Park SY, Lim MC. Quality of life outcomes from the randomized trial of hyperthermic intraperitoneal chemotherapy following cytoreductive surgery for primary ovarian cancer (KOV-HIPEC-01). J Gynecol Oncol 2022; 33:e54. [PMID: 35712968 PMCID: PMC9250851 DOI: 10.3802/jgo.2022.33.e54] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/06/2022] [Accepted: 04/17/2022] [Indexed: 12/28/2022] Open
Abstract
Objective To investigate the health-related quality of life (HRQOL) related to hyperthermic intraperitoneal chemotherapy (HIPEC) following primary or interval cytoreductive surgery for primary ovarian cancer. Methods Between 2010 and 2016, a total of 184 patients were randomly assigned to receive cytoreductive surgery with HIPEC (n=92) or without HIPEC (n=92). Quality of life (QOL) assessment was evaluated at baseline (before surgery); on postoperative day 7; after the 3rd and 6th cycle of adjuvant chemotherapy; and at 3, 6, 9, and 12 months after randomization. Patient-reported QOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) core questionnaire (EORTC-QLQ-C30), ovarian cancer questionnaire modules (QLQ-OV28), and the MD Anderson Symptoms Inventory (MDASI). Results Of the 184 patients enrolled, 165 (83/92 in the HIPEC group and 82/92 in the control group) participated in the baseline QOL assessment. There were no statistically significant differences in functional scales and symptom scales in QLQ-C30; symptom scales, including gastrointestinal symptoms QLQ-OV28; and severity and impact score in MDASI between the 2 treatment groups until 12 months after randomization. Conclusion HIPEC with cytoreductive surgery showed no statistically significant difference in HRQOL outcomes. Thus, implementation of HIPEC during either primary or interval cytoreductive surgery does not impair HRQOL. Trial Registration ClinicalTrials.gov Identifier: NCT01091636 Quality of life was assessed during a randomized phase III trial of hyperthermic intraperitoneal chemotherapy (HIPEC) in stage III–IV ovarian cancer. HIPEC with primary or interval cytoreductive surgery demonstrated no statistically significant difference in health-related quality of life outcomes.
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Affiliation(s)
- Ji Hyun Kim
- Center for Gynecologic Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Dong-eun Lee
- Biostatistics Collaboration Team, National Cancer Center, Goyang, Korea
| | - Yumi Lee
- Department of Nursing, Pukyong National University, Busan, Korea
| | - Hyeong In Ha
- Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Yoon Jung Chang
- Department of Cancer Control & Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
- Department of Family Medicine, Hospital, National Cancer Center, Goyang, Korea
| | - Suk-Joon Chang
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea
| | - Sang-Yoon Park
- Center for Gynecologic Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Myong Cheol Lim
- Center for Gynecologic Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
- Department of Cancer Control & Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
- Rare and Pediatric Cancer Branch and Immuno-oncology Branch, Division of Rare and Refractory Cancer, Research Institute, National Cancer Center, Goyang, Korea
- Center for Clinical Trials, Hospital, National Cancer Center, Goyang, Korea
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24
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Hasheminasab FS, Pourpasha M, Dehghan A, Galousalari MY, Hashemi SM, Setayesh M. Validity and reliability of the Persian version of the oropharyngeal Mucositis quality of life scale. BMC Oral Health 2021; 21:601. [PMID: 34814894 PMCID: PMC8609725 DOI: 10.1186/s12903-021-01938-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/31/2021] [Indexed: 11/23/2022] Open
Abstract
Background Oral mucositis is one of the serious complications of chemotherapy and/or radiotherapy that significantly affects the quality of patients’ life. The Oropharyngeal Mucositis-Specific Quality-of-Life questionnaire (OMQoL) is an acceptable instrument for measuring the quality of life in these patients. The aim of this study was to evaluate the validity and reliability of the Persian version of OMQoL questionnaire. Methods This study was a cross-sectional and multi-centric research. After translation from English to Persian, back translation, and cultural adaptation, the Persian version of the questionnaire was prepared. One hundred forty-four patients suffering from oral mucositis referred to three different university affiliated hospitals related to Zahedan, Kerman and Tehran Universities of Medical Sciences, were participated in this study. Then the questionnaire was completed by trained interviewers. The reliability was assessed by Cronbach’s alpha coefficient, and validity was measured through factor analysis, and construct validity (including discriminant validity, and convergent validity) methods. Results Cronbach's alpha in all dimensions was higher than 0.9 that indicated a perfect internal consistency. The results of factor analysis indicated that the dimensions specified in the Persian version were the same as the original version (Factor loading of all items > 0.4). The correlation coefficient for all items was more than 0.75, and the convergence validity was 100% in all dimensions. Conclusion The results of this study showed that the reliability, and validity of Persian version of OMQoL were acceptable, which can be used to measure the quality of life in patients with oral mucositis.
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Affiliation(s)
| | - Mona Pourpasha
- Department of Oral and Maxillofacial Medicine, Dentistry School, Kashan University of Medical Sciences, Kashan, Iran
| | - Azizallah Dehghan
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Seyed Mehdi Hashemi
- Clinical Immunology Research Center, Ali-Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohammad Setayesh
- Department of Traditional Medicine, School of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran.
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25
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Zarrella GV, Perez A, Dietrich J, Parsons MW. Reliability and validity of a novel cognitive self-assessment tool for patients with cancer. Neurooncol Pract 2021; 8:691-698. [PMID: 34777838 DOI: 10.1093/nop/npab045] [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: 12/14/2022] Open
Abstract
Background Subjective cognitive function is an important outcome measure in oncology. The Functional Assessment of Cancer Therapy-Brain (FACT-Br) is a quality of life (QoL) measure that includes indices of physical, emotional, social, and neurologic aspects of disease but does not measure cognitive function. This study seeks to validate a novel index of cognition derived from the FACT-Br. Methods Patients with heterogeneous cancer diagnoses (N = 214) completed neuropsychological evaluation and self-report measures. Nine FACT-Br items regarding cognition were combined to form the FACT-Br-cognitive index (CI). Reliability was evaluated by exploratory factor analysis and internal consistency. Concurrent validity was assessed by correlating FACT-Br-CI with the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive-8 scales. Discriminant validity was assessed by correlating FACT-Br-CI with other FACT-Br indices and the Beck Depression and Anxiety Inventories (BDI, BAI). Exploratory analyses evaluated the impact of cognitive performance and disease variables on FACT-Br-CI. Results The FACT-Br-CI consisted of a single factor that demonstrated high internal consistency (α = 0.867) and strong concurrent validity, correlating strongly with PROMIS Cognitive-8 scales (r = 0.675-0.782). The relationship between the FACT-Br-CI and other FACT subscales ranged from moderate to strong (r = 0.372-0.601), as did correlations with measures of depression (BDI, r = -0.621) and anxiety (BAI, r = -0.450). Modest correlations were observed with neuropsychological measures (rs = 0.249-0.300). Conclusions The FACT-Br-CI is a reliable and valid measure of self-reported cognition. Studies that included the FACT-Br could be retrospectively analyzed to assess subjective cognitive outcomes, enriching the information from prior research. Integration of the FACT-Br-CI in routine clinical care may be an efficient method of monitoring cognition.
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Affiliation(s)
- Giuliana V Zarrella
- Department of Psychiatry, Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Alice Perez
- Department of Psychiatry, Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,UConn Health, UConn School of Medicine, Farmington, Connecticut, USA
| | - Jorg Dietrich
- Stephen and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael W Parsons
- Department of Psychiatry, Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Stephen and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Pompili C, Rogers Z, Absolom K, Holch P, Clayton B, Callister M, Robson J, Brunelli A, Franks K, Velikova G. Quality of life after VATS lung resection and SABR for early-stage non-small cell lung cancer: A longitudinal study. Lung Cancer 2021; 162:71-78. [PMID: 34741885 DOI: 10.1016/j.lungcan.2021.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Video-assisted thoracoscopic (VATS) lung resection is the recommended curative treatment for early-stage non-small cell lung cancer (NSCLC). Patients considered at high surgical risk, are treated with stereotactic ablative body radiotherapy (SABR) as a lower morbidity alternative. This study aims to investigate the impact of SABR and VATS resection on patients' quality of life (QoL) over the first year after treatment. METHODS A prospective longitudinal observational study recruiting early-stage NSCLC patients from a single UK centre. QoL was assessed with EORTC QLQ-C30 and Lung Cancer Module LC13 at baseline, 6 weeks and 3, 6 and 12 months post-treatment. RESULTS From 01.03.2017 till 01.03.2018, 244/281 patients (87%) consented to participate, 225 (95 SABR and 130 VATS) were included in the analysis. SABR patients had significantly worse baseline QoL scores than VATS patients, even after adjusting for preoperative clinical factors (C-30 Global Health mean: SABR = 53.8, VATS = 71.2; Physical Functioning mean: SABR = 57, VATS = 82.2; Fatigue mean: SABR = 43.5, VATS = 23.7; C30 Dyspnea mean: SABR = 49.5, VATS = 26.2). During the 12 months post SABR treatment patients' QoL scores remained stable. In the VATS group, there was a deterioration 6-weeks after treatment in Role, Physical, Social Functions, Global Health, Fatigue, C30/LC13 Dyspnoea, Pain, Appetite loss, Constipation, LC13 Pain in Chest and Arms. The scores improved by 12 months without reaching the preoperative values. CONCLUSIONS Although QoL outcomes for SABR and VATS are not comparable due to different medical selection criteria, the QoL impact of the two treatments during the first year showed different trends which will inform patients and clinicians during decision-making discussions.
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Affiliation(s)
- Cecilia Pompili
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK; Department of Thoracic Surgery, Leeds Teaching Hospital Trust, Leeds, UK.
| | - Zoe Rogers
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Kate Absolom
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK; Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Patricia Holch
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK; School of Social Sciences, Beckett University, Leeds, UK
| | - Beverly Clayton
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Matthew Callister
- Department of Respiratory Medicine, Leeds Teaching Hospital Trust, Leeds, UK
| | - Johnathan Robson
- Department of Respiratory Medicine, Leeds Teaching Hospital Trust, Leeds, UK
| | | | - Kevin Franks
- Department of Clinical Oncology, Leeds Teaching Hospital Trust, Leeds, UK
| | - Galina Velikova
- Section of Patient Centred Outcomes Research, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, UK
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Exploring the impact of exercise and mind-body prehabilitation interventions on physical and psychological outcomes in women undergoing breast cancer surgery. Support Care Cancer 2021; 30:2027-2036. [PMID: 34648061 DOI: 10.1007/s00520-021-06617-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To compare the impact of exercise and mind-body prehabilitation interventions on changes in quality of life and cancer treatment-related symptoms in women with newly diagnosed breast cancer. METHODS The following describes a secondary analysis of a randomized window of opportunity trial (The Pre-Operative Health and Body Study). Forty-nine women were randomized to participate in either an exercise prehabilitation intervention or a mind-body prehabilitation intervention from the time of enrollment to surgery. Participants (N = 47) completed measures of quality of life, anxiety, depression, and stress at the time of enrollment (T1), post-intervention/surgery (T2), and one-month post-surgery (T3). Changes in outcome measures between groups were compared over time using longitudinal models. RESULTS Mind-body group participants experienced significant improvements in cognitive functioning in comparison to exercise group participants between T1 and T3 (difference in average change: -9.61, p = 0.04, d = 0.31), otherwise, there were no significant differences between groups. Within group comparisons demonstrated that both groups experienced improvements in anxiety (exercise: average change = -1.18, p = 0.03, d = 0.34; mind-body: average change = -1.69, p = 0.006, d = 0.43) and stress (exercise: average change = -2.33, p = 0.04, d = 0.30; mind-body: average change = -2.59, p = 0.05, d = 0.29), while mind-body group participants experienced improvements in insomnia (average change = -10.03, p = 0.04, d = 0.30) and cognitive functioning (average change = 13.16, p = 0.0003, d = 0.67). CONCLUSIONS Both prehabilitation interventions impacted cancer treatment-related symptoms. Further work in larger groups of patients is needed to evaluate the efficacy of prehabilitation interventions on quality of life in women with breast cancer. Pre-operative exercise and mind-body interventions may impact physical and/or psychological effects of cancer diagnosis and treatment in women with breast cancer. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01516190. Registered January 24, 2012.
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28
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Cochrane T, Enrico A, Gomez-Almaguer D, Hadjiev E, Lech-Maranda E, Masszi T, Nikitin E, Robak T, Weinkove R, Wu SJ, Sail KR, Pesko J, Pai M, Komlosi V, Anderson MA. Impact of venetoclax monotherapy on the quality of life of patients with relapsed or refractory chronic lymphocytic leukemia: results from the phase 3b VENICE II trial. Leuk Lymphoma 2021; 63:304-314. [PMID: 34632935 DOI: 10.1080/10428194.2021.1986217] [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: 01/21/2023]
Abstract
Venetoclax, a potent B-cell lymphoma-2 (BCL-2) inhibitor, has demonstrated clinical efficacy in chronic lymphocytic leukemia (CLL). VENICE II is an open-label, single-arm, phase 3b study (NCT02980731) evaluating the impact of venetoclax monotherapy (400 mg once daily) for ≤2 years on health-related quality of life (HRQoL) of patients with relapsed/refractory CLL. The primary endpoint was mean change in the global health status (GHS)/quality of life (QoL) subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) from baseline to Week 48. Overall, 210 patients received ≥1 dose of venetoclax; median treatment duration was 67.4 weeks. The primary endpoint was met with mean improvement of +9.3 points (n = 156, 95% confidence interval 6.1-12.5; p=.004) in GHS/QoL. At Week 48, clinically meaningful improvements were observed for role functioning, fatigue, and insomnia domains of EORTC QLQ-C30, suggesting venetoclax monotherapy has a positive impact on HRQoL. No new safety signals were reported.
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Affiliation(s)
- Tara Cochrane
- Department of Haematology, Gold Coast University Hospital, Southport, Australia.,Griffiths University, Parkwood, Australia
| | - Alicia Enrico
- Area Hematology, Hospital Italiano La Plata, Buenos Aires, Argentina
| | - David Gomez-Almaguer
- Hematology Service, Hospital Universitario, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - Evgueniy Hadjiev
- Department of Internal Medicine, Medical University Sofia, University Hospital Alexandrovska, Sofia, Bulgaria
| | - Ewa Lech-Maranda
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Tamas Masszi
- Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Eugene Nikitin
- Department of Hematology, Oncology and Chemotherapy, S. P. Botkin's City Hospital, Moscow, Russia
| | - Tadeusz Robak
- Medical University of Lodz and Copernicus Memorial Hospital, Lodz, Poland
| | - Robert Weinkove
- Wellington Blood & Cancer Centre, Capital & Coast District Health Board, Wellington, New Zealand.,Cancer Immunotherapy Programme, Malaghan Institute of Medical Research, Wellington, New Zealand
| | - Shang-Ju Wu
- Department of Internal Medicine, Division of Haematology, National Taiwan University Hospital, Taipei City, Taiwan
| | | | | | | | | | - Mary Ann Anderson
- The Clinical Haematology Department of the Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Parkville, Australia.,Division of Blood Cells and Blood Cancer, The Walter and Eliza Hall Institute, Parkville, Australia
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29
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Song YC, Sun GY, Fang H, Tang Y, Song YW, Hu C, Qi SN, Chen B, Jing H, Tang Y, Jin J, Liu YP, Lu NN, Li YX, Wang SL. Quality of Life After Partial or Whole-Breast Irradiation in Breast-Conserving Therapy for Low-Risk Breast Cancer: 1-Year Results of a Phase 2 Randomized Controlled Trial. Front Oncol 2021; 11:738318. [PMID: 34604082 PMCID: PMC8480312 DOI: 10.3389/fonc.2021.738318] [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: 07/08/2021] [Accepted: 08/27/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose To report patients’ quality of life (QoL) at 1 year in a phase 2 randomized trial comparing partial breast irradiation (PBI) with whole-breast irradiation (WBI) after breast-conserving surgery (BCS) for breast cancer. Methods Women aged ≥ 45 years with low-risk breast cancer after BCS were randomly assigned (1:1) to receive PBI (40 Gy in 10 fractions over 2 weeks) or WBI (43.5 Gy in 15 fractions over 3 weeks). The primary endpoint—the incidence of toxicities of grade 2 or higher—will be reported when participants complete 5 years of follow-up. QoL was assessed at baseline (T0), at the end of radiotherapy (RT) (T1), 6 months (T2) and 1 year (T3) after RT by using the EORTC QLQ-C30 and QLQ-BR23 questionnaires. We calculated the scores for all QOL subscales and differences in mean scores were compared. This study was registered at ClinicalTrials.gov (NCT03583619). Results Between June 2017 and January 2019, 140 women were randomly assigned to receive PBI or WBI (n = 70 per group). Fifty-nine and 56 patients treated with PBI and WBI, respectively, were eligible for the QoL analysis. There were no significant differences in any subscale scores at T0, T1, T2, or T3 between the PBI and WBI arms. The scores for most QoL subscales that were influenced by RT recovered to a similar or better level relative to T0 scores within 1 year after RT, except for the scores of the dyspnea subscale. Longitudinal analysis showed that time since RT had a significant impact on physical functioning, role functioning, social functioning, fatigue, pain, dyspnea, financial difficulties, body image, and breast and arm symptoms. Conclusion PBI using the intensity-modulated RT affords QoL comparable to that provided by WBI. Most QoL subscale scores that were influenced by RT recovered to a similar or better level relative to baseline scores within 1 year after RT.
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Affiliation(s)
- Yu-Chun Song
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guang-Yi Sun
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Fang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Tang
- Clinical Trials Center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yong-Wen Song
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chen Hu
- Division of Biostatistics and Bioinformatics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore MD, United States
| | - Shu-Nan Qi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Jing
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Tang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Jin
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue-Ping Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ning-Ning Lu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye-Xiong Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shu-Lian Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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30
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Torstveit AH, Miaskowski C, Løyland B, Grov EK, Guren MG, Ritchie CS, Paul SM, Kleven AG, Utne I. Common and distinct characteristics associated with self-reported functional status in older patients with cancer receiving chemotherapy. Eur J Oncol Nurs 2021; 54:102033. [PMID: 34537538 DOI: 10.1016/j.ejon.2021.102033] [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] [Received: 08/11/2021] [Accepted: 09/04/2021] [Indexed: 01/12/2023]
Abstract
PURPOSE To evaluate for inter-individual differences in two subjective measures of functional status in older patients (n = 112), as well as to determine which demographic, clinical, and symptom characteristics, and levels of cognitive function, were associated with initial levels and with the trajectory of the two measures. METHODS Functional status was assessed using self-report measures of physical function (PF) and role function (RF) from the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire at the initiation of chemotherapy and at 1, 3, 6, 9, and 12 months after its initiation. Hierarchical linear modeling was used to assess inter-individual differences in and characteristics associated with initial levels and changes in PF and RF. RESULTS Characteristics associated with decreases in PF at the initiation of chemotherapy were higher numbers of comorbidities and higher depression, pain, and dyspnea scores. For initial levels of poorer RF, lower Karnofsky Performance Status scores and higher pain and fatigue scores were the associated characteristics. Characteristic associated with worse trajectories of PF was not having had surgery. For RF, worse trajectories were associated with lower cognitive function and higher RF at enrollment. Characteristic associated with both lower initial levels and improved trajectories of PF was having lower performance status at enrollment. CONCLUSIONS Older patients undergoing chemotherapy experience reduced functional performance. Characteristics associated with decrements in PF and RF need to be assessed and interventions implemented to maintain and increase functional status in older oncology patients.
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Affiliation(s)
- Ann Helen Torstveit
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | | | - Borghild Løyland
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Marianne Grønlie Guren
- Department of Oncology and K G Jebsen Colorectal Cancer Research Center, Oslo University Hospital, Oslo, Norway
| | | | - Steven M Paul
- School of Nursing, University of California, San Francisco, CA, USA
| | - Anne Grethe Kleven
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway.
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Zahid N, Martins RS, Zahid W, Khalid W, Azam I, Bhamani SS, Asad N, Ahmad K, Jabbar AA, Shamim MS, Khan RJ, Javed G, Bari E, Enam SA. Translation and validation of the Urdu version of the European organization for research and treatment of cancer core quality of life questionnaire (EORTC QLQ-C30) and brain module (QLQ-BN20) in primary brain tumor patients. J Patient Rep Outcomes 2021; 5:79. [PMID: 34487251 PMCID: PMC8421474 DOI: 10.1186/s41687-021-00354-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/24/2021] [Indexed: 12/17/2022] Open
Abstract
Introduction This study translated and validated the Urdu version of the European Organization for Research and Treatment of Cancer Quality of Life (QoL) Questionnaire (EORTC QLQ-C30) and Brain Module (QLQ-BN20) amongst patients with primary brain tumors (PBT) in Pakistan, and assessed the correlation of QoL with resilience, depression, and anxiety.
Methods Translation of the EORTC QLQ-C30 and QLQ-BN20 was performed as per EORTC guidelines. A survey comprising of Urdu translations of EORTC QLQ-C30, QLQ-BN20, Wagnild and Young Resilience Scale (RS-14) and Hospital Anxiety and Depression Scale was administered to patients with PBT at a tertiary care hospital in Pakistan. Reliability (via Cronbach alpha), content validity index (CVI) scores, construct validity, and inter-scale correlations were assessed. Results Our sample consisted of 250 patients with PBT, most commonly glioma (46.8%) and meningioma (21.2%). All patients were able to understand the Urdu translations. The Cronbach alphas for the QLQ-C30 and the QLQ-BN20 were 0.860 and 0.880, respectively. The CVI scores for clarity and relevance were high for both the EORTC QLQ-C30 (0.98 and 0.96, respectively) and the QLQ-BN20 tool (0.81 and 0.95, respectively). The global QoL domain (EORTC QLQ-C30) showed significant positive correlations with resilience (r = 0.422), and significant negative correlations with depression (r = − 0.541) and anxiety (r = − 0.502). Strong inter-scale correlations were observed between physical functioning and insomnia (r = − 0.690) and role functioning and insomnia (r = − 0.641). Conclusion Our study confirms the Urdu versions of the EORTC QLQ-C30 and QLQ-BN20 as valid clinical tools for the measurement of QoL in primary brain tumors patients within the cultural and socioeconomic context of Pakistan. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-021-00354-6. Quality of life (QoL) is an important facet of well-being for patients with primary brain tumors (PBTs), as these individuals face significant distress during the course of their illness and treatment. It is important to have valid and reliable tools to accurately measure the QoL of patients with PBTs. The EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) and its brain tumor-specific module EORTC QLQ-BN20 (EORTC QLQ-Brain Neoplasms 20) are exactly that. However, the use of the EORTC QLQ-C30 and QLQ-BN20 is limited in Pakistan, where the national language is Urdu, and the majority of patients are of low socioeconomic backgrounds. Since no Urdu translations of the EORTC QLQ-C30 and QLQ-BN20 exist, we aimed to translate and validate these tools to enable their applicability in Pakistan. The Urdu versions of the EORTC QLQ-C30 and QLQ-BN20 demonstrated good validity amongst patients with PBTs. Thus, our study confirms the EORTC QLQ-C30 and QLQ-BN20 as valuable clinical tools for the measurement of QoL in primary brain tumors patients within the linguistic, cultural and socioeconomic context of Pakistan.
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Affiliation(s)
- Nida Zahid
- Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan.
| | - Russell Seth Martins
- Medical College, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Wajeeha Zahid
- Department of Community Health Sciences, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Wardah Khalid
- Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Shireen Shehzad Bhamani
- School of Nursing and Midwifery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Nargis Asad
- Department of Psychiatry, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Khabir Ahmad
- Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Adnan Abdul Jabbar
- Department of Oncology, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | | | - Rashid Jooma Khan
- Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Gohar Javed
- Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Ehsan Bari
- Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Syed Ather Enam
- Department of Surgery, Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
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Forster T, Hommertgen A, Häfner MF, Arians N, König L, Harrabi SB, Schlampp I, Köhler C, Meixner E, Heinrich V, Weidner N, Hüsing J, Sohn C, Heil J, Golatta M, Hof H, Krug D, Debus J, Hörner-Rieber J. Quality of life after simultaneously integrated boost with intensity-modulated versus conventional radiotherapy with sequential boost for adjuvant treatment of breast cancer: 2-year results of the multicenter randomized IMRT-MC2 trial. Radiother Oncol 2021; 163:165-176. [PMID: 34480960 DOI: 10.1016/j.radonc.2021.08.019] [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] [Received: 03/30/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND We recently published 2-year results of the prospective, randomized IMRT-MC2 trial, showing non-inferior local control and cosmesis in breast cancer patients after conventionally fractionated intensity-modulated radiotherapy with simultaneously integrated boost (IMRT-SIB), compared to 3D-conformal radiotherapy with sequential boost (3D-CRT-seqB). Here, we report on 2-year quality of life results. PATIENTS AND METHODS 502 patients were enrolled and randomized to IMRT-SIB (50.4 Gy in 1.8 Gy fractions with a 64.4 Gy SIB to the tumor bed) or to 3D-CRT-seqB (50.4 Gy in 1.8 Gy fractions, followed by a sequential boost of 16 Gy in 2 Gy fractions). For quality of life (QoL) assessment, patients completed the QLQ-C30 and QLQ-BR23 questionnaires at baseline, 6 weeks and 2 years after radiotherapy. RESULTS Significant differences between treatment arms were seen 6 weeks after radiotherapy for pain (22.3 points for IMRT vs. 27.0 points for 3D-CRT-seqB; p = 0.033) and arm symptoms (18.1 points for IMRT vs. 23.6 points for 3D-CRT-seqB; p = 0.013), both favoring IMRT-SIB. Compared to baseline values, both arms showed significant improvement in global score (IMRT: p = 0.009; 3D-CRT: p = 0.001) after 2 years, with slight deterioration on the role (IMRT: p = 0.008; 3-D-CRT: p = 0.001) and social functioning (IMRT: p = 0.013, 3D-CRT: p = 0.001) as well as the future perspectives scale (IMRT: p = 0.003; 3D-CRT: p = 0.0034). CONCLUSION This is the first randomized phase III trial demonstrating that IMRT-SIB was associated with slightly superior QoL compared to 3-D-CRT-seqB. These findings further support the clinical implementation of SIB in adjuvant breast cancer treatment.
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Affiliation(s)
- Tobias Forster
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Adriane Hommertgen
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Matthias Felix Häfner
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Nathalie Arians
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Laila König
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Semi Ben Harrabi
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Ingmar Schlampp
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Clara Köhler
- Department of Radiation Oncology, Heidelberg University Hospital, Germany
| | - Eva Meixner
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Vanessa Heinrich
- Department of Radiation Oncology, Eberhard-Karls-University Tuebingen, Germany
| | - Nicola Weidner
- Department of Radiation Oncology, Eberhard-Karls-University Tuebingen, Germany
| | - Johannes Hüsing
- Division of Biostatistics, Coordination Centre for Clinical Trials, University of Heidelberg, Germany
| | - Christof Sohn
- Department of Gynecology and Obstetrics, University of Heidelberg, Germany
| | - Jörg Heil
- Department of Gynecology and Obstetrics, University of Heidelberg, Germany
| | - Michael Golatta
- Department of Gynecology and Obstetrics, University of Heidelberg, Germany
| | - Holger Hof
- Strahlentherapie Rhein-Pfalz, Neustadt, Germany
| | - David Krug
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany; Department of Radiation Oncology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany; Department of Radiation Oncology, University Hospital Schleswig Holstein, Kiel, Germany; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Germany
| | - Juliane Hörner-Rieber
- Department of Radiation Oncology, Heidelberg University Hospital, Germany; Heidelberg Institute of Radiation Oncology (HIRO), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany; Department of Radiation Oncology, University Hospital Schleswig Holstein, Kiel, Germany; German Cancer Consortium (DKTK), partner site, Heidelberg, Germany.
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Arneja J, Brooks JD. The impact of chronic comorbidities at the time of breast cancer diagnosis on quality of life, and emotional health following treatment in Canada. PLoS One 2021; 16:e0256536. [PMID: 34437611 PMCID: PMC8389459 DOI: 10.1371/journal.pone.0256536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Advances in breast cancer screening and treatment have led to an increasing number of breast cancer survivors. The objective of this study was to determine the impact of comorbidities on self-reported quality of life (QOL) and emotional health following a breast cancer diagnosis and treatment. METHODS Women with a personal history of breast cancer (N = 3,372) were identified from the cross-sectional Canadian Partnership Against Cancer (CPAC) Experiences of Cancer Patients in Transitions Survey. Multinomial (nominal) logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the relationship between burden of comorbidities and overall QOL and emotional health (very poor/poor, fair, good, very good). RESULTS Of the 3,372 participants, 57% reported at least one chronic condition at the time of breast cancer diagnosis. As the number of chronic conditions at diagnosis increased, the odds of reporting worse quality of life and emotional health following treatment also increased. Specifically, compared to women reporting very good QOL, for each additional chronic condition, women reported significantly higher odds of reporting good (OR = 1.22, 95% CI: 1.12, 1.32), fair (OR = 1.76, 95% CI: 1.58, 1.96), or poor/very poor (OR = 2.31, 95% CI: 1.86, 2.88) QOL. Similarly, for each additional comorbidity, women reported significantly higher odds of reporting good (OR = 1.17, 95% CI: 1.07, 1.28), fair (OR = 1.63, 95% CI: 1.46, 1.82), or poor/very poor (OR = 2.17, 95% CI: 1.81, 2.60) emotional health, relative to very good emotional health. CONCLUSION Breast cancer survivors coping with a high comorbidity burden experience worse overall QOL and emotional health following treatment. This highlights the importance of integrating information on comorbidities into survivorship care to improve the experience and overall outcomes of patients with complex needs.
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Affiliation(s)
- Jasleen Arneja
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer D. Brooks
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Suehs CM, Solovei L, Hireche K, Vachier I, Mariano Goulart D, Gamon L, Charriot J, Serre I, Molinari N, Bourdin A, Bommart S. Complication and lung function impairment prediction using perfusion and computed tomography air trapping (CLIPPCAIR): protocol for the development and validation of a novel multivariable model for the prediction of post-resection lung function. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1092. [PMID: 34423004 PMCID: PMC8339869 DOI: 10.21037/atm-21-214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/21/2021] [Indexed: 12/24/2022]
Abstract
Background Recent advancements in computed tomography (CT) scanning and post processing have provided new means of assessing factors affecting respiratory function. For lung cancer patients requiring resection, and especially those with respiratory comorbidities such as chronic obstructive pulmonary disease (COPD), the ability to predict post-operative lung function is a crucial step in the lung cancer operability assessment. The primary objective of the CLIPPCAIR study is to use novel CT data to develop and validate an algorithm for the prediction of lung function remaining after pneumectomy/lobectomy. Methods Two sequential cohorts of non-small cell lung cancer patients requiring a pre-resection CT scan will be recruited at the Montpellier University Hospital, France: a test population (N=60) on which predictive models will be developed, and a further model validation population (N=100). Enrolment will occur during routine pre-surgical consults and follow-up visits will occur 1 and 6 months after pneumectomy/lobectomy. The primary outcome to be predicted is forced expiratory volume in 1 second (FEV1) six months after lung resection. The baseline CT variables that will be used to develop the primary multivariable regression model are: expiratory to inspiratory ratios of mean lung density (MLDe/i for the total lung and resected volume), the percentage of voxels attenuating at less than ‒950 HU (PVOX‒950 for the total lung and resected volume) and the ratio of iodine concentrations for the resected volume over that of the total lung. The correlation between predicted and real values will be compared to (and is expected to improve upon) that of previously published methods. Secondary analyses will include the prediction of transfer factor for carbon monoxide (TLCO) and complications in a similar fashion. The option to explore further variables as predictors of post-resection lung function or complications is kept open. Discussion Current methods for estimating post-resection lung function are imperfect and can add assessments (such as scintigraphy) to the pre-surgical workup. By using CT imaging data in a novel fashion, the results of the CLIPPCAIR study may not only improve such estimates, it may also simplify patient pathways. Trial registration Clinicaltrials.gov (NCT03885765).
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Affiliation(s)
- Carey Meredith Suehs
- Department of Respiratory Diseases, The University of Montpellier, CHU Montpellier, Montpellier, France
| | - Laurence Solovei
- Department of Thoracic Surgery, The University of Montpellier, CHU Montpellier, Montpellier, France
| | - Kheira Hireche
- Department of Thoracic Surgery, The University of Montpellier, CHU Montpellier, Montpellier, France
| | - Isabelle Vachier
- Department of Respiratory Diseases, The University of Montpellier, CHU Montpellier, Montpellier, France
| | - Denis Mariano Goulart
- Department of Nuclear Medicine, The University of Montpellier, CHU Montpellier, Montpellier, France.,PhyMedExp, CNRS, INSERM, The University of Montpellier, CHU Montpellier, Montpellier, France
| | - Lucie Gamon
- Department of Medical Information, The University of Montpellier, CHU Montpellier, Montpellier, France
| | - Jérémy Charriot
- Department of Respiratory Diseases, The University of Montpellier, CHU Montpellier, Montpellier, France
| | - Isabelle Serre
- Department of Pathology, The University of Montpellier, CHU Montpellier, Montpellier, France
| | - Nicolas Molinari
- IMAG, CNRS, The University of Montpellier, CHU Montpellier, Montpellier, France
| | - Arnaud Bourdin
- Department of Respiratory Diseases, The University of Montpellier, CHU Montpellier, Montpellier, France.,PhyMedExp, CNRS, INSERM, The University of Montpellier, CHU Montpellier, Montpellier, France
| | - Sébastien Bommart
- PhyMedExp, CNRS, INSERM, The University of Montpellier, CHU Montpellier, Montpellier, France.,Department of Radiology, The University of Montpellier, CHU Montpellier, Montpellier, France
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Coleridge SL, Bryant A, Kehoe S, Morrison J. Neoadjuvant chemotherapy before surgery versus surgery followed by chemotherapy for initial treatment in advanced ovarian epithelial cancer. Cochrane Database Syst Rev 2021; 7:CD005343. [PMID: 34328210 PMCID: PMC8406953 DOI: 10.1002/14651858.cd005343.pub6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Epithelial ovarian cancer presents at an advanced stage in the majority of women. These women require a combination of surgery and chemotherapy for optimal treatment. Conventional treatment has been to perform surgery first and then give chemotherapy. However, there may be advantages to using chemotherapy before surgery. OBJECTIVES To assess whether there is an advantage to treating women with advanced epithelial ovarian cancer with chemotherapy before debulking surgery (neoadjuvant chemotherapy (NACT)) compared with conventional treatment where chemotherapy follows debulking surgery (primary debulking surgery (PDS)). SEARCH METHODS We searched the following databases up to 9 October 2020: the Cochrane Central Register of Controlled Trials (CENTRAL), Embase via Ovid, MEDLINE (Silver Platter/Ovid), PDQ and MetaRegister. We also checked the reference lists of relevant papers that were identified to search for further studies. The main investigators of relevant trials were contacted for further information. SELECTION CRITERIA Randomised controlled trials (RCTs) of women with advanced epithelial ovarian cancer (Federation of International Gynaecologists and Obstetricians (FIGO) stage III/IV) who were randomly allocated to treatment groups that compared platinum-based chemotherapy before cytoreductive surgery with platinum-based chemotherapy following cytoreductive surgery. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias in each included trial. We extracted data of overall (OS) and progression-free survival (PFS), adverse events, surgically-related mortality and morbidity and quality of life outcomes. We used GRADE methods to determine the certainty of evidence. MAIN RESULTS We identified 2227 titles and abstracts through our searches, of which five RCTs of varying quality and size met the inclusion criteria. These studies assessed a total of 1774 women with stage IIIc/IV ovarian cancer randomised to NACT followed by interval debulking surgery (IDS) or PDS followed by chemotherapy. We pooled results of the four studies where data were available and found little or no difference with regard to overall survival (OS) (Hazard Ratio (HR) 0.96, 95% CI 0.86 to 1.08; participants = 1692; studies = 4; high-certainty evidence) or progression-free survival in four trials where we were able to pool data (Hazard Ratio 0.98, 95% CI 0.88 to 1.08; participants = 1692; studies = 4; moderate-certainty evidence). Adverse events, surgical morbidity and quality of life (QoL) outcomes were variably and incompletely reported across studies. There are probably clinically meaningful differences in favour of NACT compared to PDS with regard to overall postoperative serious adverse effects (SAE grade 3+): 6% in NACT group, versus 29% in PDS group, (risk ratio (RR) 0.22, 95% CI 0.13 to 0.38; participants = 435; studies = 2; heterogeneity index (I2) = 0%; moderate-certainty evidence). NACT probably results in a large reduction in the need for stoma formation: 5.9% in NACT group, versus 20.4% in PDS group, (RR 0.29, 95% CI 0.12 to 0.74; participants = 632; studies = 2; I2 = 70%; moderate-certainty evidence), and probably reduces the risk of needing bowel resection at the time of surgery: 13.0% in NACT group versus 26.6% in PDS group (RR 0.49, 95% CI 0.30 to 0.79; participants = 1565; studies = 4; I2 = 79%; moderate-certainty evidence). NACT reduces postoperative mortality: 0.6% in NACT group, versus 3.6% in PDS group, (RR 0.16, 95% CI 0.06 to 0.46; participants = 1623; studies = 5; I2 = 0%; high-certainty evidence). QoL on the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) scale produced inconsistent and imprecise results in three studies (MD -0.29, 95% CI -2.77 to 2.20; participants = 524; studies = 3; I2 = 81%; very low-certainty evidence) but the evidence is very uncertain and should be interpreted with caution. AUTHORS' CONCLUSIONS The available high to moderate-certainty evidence suggests there is little or no difference in primary survival outcomes between PDS and NACT. NACT probably reduces the risk of serious adverse events, especially those around the time of surgery, and reduces the risk of postoperative mortality and the need for stoma formation. These data will inform women and clinicians (involving specialist gynaecological multidisciplinary teams) and allow treatment to be tailored to the person, taking into account surgical resectability, age, histology, stage and performance status. Data from an unpublished study and ongoing studies are awaited.
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Affiliation(s)
- Sarah L Coleridge
- Department of Obstetrics and Gynaecology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Andrew Bryant
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Sean Kehoe
- Institute of Cancer and Genomics, University of Birmingham, Birmingham, UK
| | - Jo Morrison
- Department of Gynaecological Oncology, Musgrove Park Hospital, Taunton, UK
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Sauer C, Krauß J, Jäger D, Zschäbitz S, Haag GM, Walle T, Sauer S, Kiermeier S, Friederich HC, Maatouk I. eHealth intervention to manage symptoms for patients with cancer on immunotherapy (SOFIA): a study protocol for a randomised controlled external pilot trial. BMJ Open 2021; 11:e047277. [PMID: 34281921 PMCID: PMC8291315 DOI: 10.1136/bmjopen-2020-047277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Immune checkpoint therapy (ICT) is associated with a distinct pattern of immune-related adverse events (irAEs) caused by inadvertently redirecting immune responses to healthy tissues. IrAEs can occur at any time; however, in most cases, they arise during the first 14 weeks of the beginning of immune checkpoint blockade. In many cases, immunotherapy must be discontinued due to irAEs. Early detection of irAEs triggers the temporary withholding of ICT or initiation of short-term immunosuppressive treatment, is crucial in preventing further aggravation of irAEs and enables safe re-exposure to ICT. This prospective study aims to evaluate the feasibility of an eHealth intervention for patients under immunotherapy (managing symptoms of immunotherapy, SOFIA). The SOFIA-App consists of two components: SOFIA-Monitoring, a tool to rate patient-reported outcomes (PROs) including irAEs, and SOFIA-Coaching, which provides important information about cancer-specific and immunotherapy-specific topics and the counselling services of the National Centre for Tumour Diseases (NCT) Heidelberg. METHODS AND ANALYSIS We outlined a patient-level two-arm randomised controlled pilot trial of the intervention (SOFIA) versus no-SOFIA for patients with cancer beginning an immunotherapy, aged ≥18 years, recruited from the NCT, Heidelberg. Feasibility outcomes include: recruitment rate; drop-out rate; reasons for refusal and drop-out; willingness to be randomised, utilisation rate of SOFIA-Monitoring and utilisation time of SOFIA-Coaching, physicians utilisation rate of the PROs; feasibility of the proposed outcome measures and optimal sample size estimation. The clinical outcomes are measures of quality of life, psychosocial symptoms, self-efficacy, physician-patient communication and medical process data, which are assessed at the beginning of the intervention, postintervention and at 6-month follow-up. ETHICS AND DISSEMINATION This trial protocol was approved by the Ethical Committee of Heidelberg University, Germany (Reference, S-581/2018). TRIAL REGISTRATION NUMBER We registered the study in the German Clinical Trial Register (Reference: DRKS00021064). Findings will be disseminated broadly via peer-reviewed empirical journals, articles and conference presentations.
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Affiliation(s)
- Christina Sauer
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
- National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
| | - Jürgen Krauß
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - Dirk Jäger
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - Stefanie Zschäbitz
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - Georg Martin Haag
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Walle
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Virotherapy, German Cancer Research Center, Heidelberg, Germany
| | - Simeon Sauer
- Department of Biotechnology, Hochschule Mannheim, Mannheim, Germany
| | - Senta Kiermeier
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
- National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
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Armbrust R, Richter R, Woopen H, Hilpert F, Harter P, Sehouli J. Impact of health-related quality of life (HRQoL) on short-term mortality in patients with recurrent ovarian, fallopian or peritoneal carcinoma (the NOGGO-AGO QoL Prognosis-Score-Study): results of a meta-analysis in 2209 patients. ESMO Open 2021; 6:100081. [PMID: 33743329 PMCID: PMC8010392 DOI: 10.1016/j.esmoop.2021.100081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/11/2021] [Accepted: 01/30/2021] [Indexed: 11/18/2022] Open
Abstract
Objective Recurrent ovarian cancer is an incurable disease with variable but poor prognosis. Health-related quality of life (HRQoL) is a patient-reported outcome measure generally applied to measure effects of therapies. Our aim was the development and validation of a risk score for the prediction of short-term mortality using the combination of sociodemographic and clinical factors and HRQoL. Methods For exploratory and validation analysis, the North-Eastern German Society of Gynecological Oncology (NOGGO) and Working Group Gynecological Oncology (AGO) study databases were screened for trials. Only trials which obtained defined HRQoL measurements were included in the final analysis. Multivariable logistic regression analyses were used to identify risk factors and their weighting for the risk score. Modulation with cubic regression analyses revealed median survival and short-term mortality defined as 1-year mortality for each value. Results For exploration, 974 patients from three clinical studies of the NOGGO and for validation, 1235 patients from several clinical studies of the AGO were eligible. The risk score included platinum-free interval, performance status, age, global QoL and nausea/vomiting. Receiver operating characteristic analysis showed a good predictive value with an area under the curve of 0.81 for model 1 in the exploration and 0.74 in the validation. Short-term mortality in model 1 was 8.2%, 23.5% and 58.4% in the exploration sample, and 19.7%, 38.1% and 63.4% in the validation sample for patients under low, medium and high risk, respectively. Conclusions This risk score discriminates well between recurrent ovarian cancer patients under low, medium and high risk of short-term mortality. It may help to identify a risk group under high risk for short-term mortality that can be used for randomization in clinical trials and may support decision making for palliative chemotherapy. This newly developed NOGGO-AGO QoL prognosis score clearly discriminates recurrent ovarian cancer (rOC) patients under low, medium and high risk for short-term survival (<1 year). The risk score included platinum-free interval, performance status, age, global QoL and nausea/vomiting. NOGGO-AGO QoL score can be used for stratification or randomization in clinical trials and for identification of a group under high risk for short-term mortality. It may also help the decision making for chemotherapy and provide more precise information of further life expectation for rOC patients.
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Affiliation(s)
- R Armbrust
- Department of Gynecology with Center for Oncological Surgery, Virchow Campus Clinic, Charité Medical University, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - R Richter
- Department of Gynecology with Center for Oncological Surgery, Virchow Campus Clinic, Charité Medical University, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - H Woopen
- Department of Gynecology with Center for Oncological Surgery, Virchow Campus Clinic, Charité Medical University, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - F Hilpert
- Department of Gynecology, Krankenhaus Jerusalem Hamburg, Hamburg, Germany
| | - P Harter
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - J Sehouli
- Department of Gynecology with Center for Oncological Surgery, Virchow Campus Clinic, Charité Medical University, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
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38
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Delrieu L, Bouaoun L, Fatouhi DE, Dumas E, Bouhnik AD, Noelle H, Jacquet E, Hamy AS, Coussy F, Reyal F, Heudel PE, Bendiane MK, Fournier B, Michallet M, Fervers B, Fagherazzi G, Pérol O. Patterns of Sequelae in Women with a History of Localized Breast Cancer: Results from the French VICAN Survey. Cancers (Basel) 2021; 13:1161. [PMID: 33800346 PMCID: PMC7962808 DOI: 10.3390/cancers13051161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022] Open
Abstract
Breast cancer (BC) remains complex for women both physically and psychologically. The objectives of this study were to (1) assess the evolution of the main sequelae and treatment two and five years after diagnosis in women with early-stage breast cancer, (2) explore patterns of sequelae associated with given sociodemographic, clinical, and lifestyle factors. The current analysis was based on 654 localized BC patients enrolled in the French nationwide longitudinal survey "vie après cancer" VICAN (January-June 2010). Information about study participants was collected at enrollment, two and five years after diagnosis. Changes over time of the main sequelae were analyzed and latent class analysis was performed to identify patterns of sequelae related to BC five years after diagnosis. The mean age (±SD) of study participants at inclusion was 49.7 (±10.5) years old. Six main classes of sequelae were identified two years and five years post-diagnosis (functional, pain, esthetic, fatigue, psychological, and gynecological). A significant decrease was observed for fatigue (p = 0.03) and an increase in cognitive sequelae was reported (p = 0.03). Two latent classes were identified-functional and esthetic patterns. Substantial sequelae remain up to five years after BC diagnosis. Changes in patient care pathways are needed to identify BC patients at a high risk.
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Affiliation(s)
- Lidia Delrieu
- Department Prevention, Cancer, Environment, Léon Bérard Cancer Center, 69008 Lyon, France; (L.D.); (H.N.); (B.F); (B.F.)
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France; (E.D.); (A.-S.H.); (F.C.); (F.R.)
| | - Liacine Bouaoun
- International Agency for Research on Cancer, 69372 Lyon, France;
| | - Douae El Fatouhi
- Center of Research in Epidemiology and Population Health, UMR 1018 Inserm, Institut Gustave Roussy, Paris-Sud Paris-Saclay University, 94807 Villejuif, France; (D.E.F.); (G.F.)
| | - Elise Dumas
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France; (E.D.); (A.-S.H.); (F.C.); (F.R.)
- MINES ParisTech, PSL Research University, CBIO-Centre for Computational Biology, 75006 Paris, France
| | - Anne-Deborah Bouhnik
- INSERM, IRD, SESSTIM, Economics & Social Sciences Applied to Health & Analysis of Medical Information, Aix Marseille University, 13007 Marseille, France; (A.-D.B.); (M.-K.B.)
| | - Hugo Noelle
- Department Prevention, Cancer, Environment, Léon Bérard Cancer Center, 69008 Lyon, France; (L.D.); (H.N.); (B.F); (B.F.)
| | - Emmanuelle Jacquet
- Oncology and Blood Diseases Department, University Hospital Center, Joseph Fourier University, CEDEX 9, 38043 Grenoble, France;
| | - Anne-Sophie Hamy
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France; (E.D.); (A.-S.H.); (F.C.); (F.R.)
- Department of Medical Oncology, Institut Curie, 75005 Paris, France
| | - Florence Coussy
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France; (E.D.); (A.-S.H.); (F.C.); (F.R.)
- Department of Medical Oncology, Institut Curie, 75005 Paris, France
| | - Fabien Reyal
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France; (E.D.); (A.-S.H.); (F.C.); (F.R.)
- Department of Surgical Oncology, Institut Curie, University Paris, 75005 Paris, France
| | - Pierre-Etienne Heudel
- Department of Medical Oncology, Léon Bérard Cancer Center, 69008 Lyon, France; (P.-E.H.); (M.M.)
| | - Marc-Karim Bendiane
- INSERM, IRD, SESSTIM, Economics & Social Sciences Applied to Health & Analysis of Medical Information, Aix Marseille University, 13007 Marseille, France; (A.-D.B.); (M.-K.B.)
| | - Baptiste Fournier
- Department Prevention, Cancer, Environment, Léon Bérard Cancer Center, 69008 Lyon, France; (L.D.); (H.N.); (B.F); (B.F.)
| | - Mauricette Michallet
- Department of Medical Oncology, Léon Bérard Cancer Center, 69008 Lyon, France; (P.-E.H.); (M.M.)
| | - Béatrice Fervers
- Department Prevention, Cancer, Environment, Léon Bérard Cancer Center, 69008 Lyon, France; (L.D.); (H.N.); (B.F); (B.F.)
- Cancer Research Center of Lyon, INSERM UA8, Léon Bérard Cancer Center, 69008 Lyon, France
| | - Guy Fagherazzi
- Center of Research in Epidemiology and Population Health, UMR 1018 Inserm, Institut Gustave Roussy, Paris-Sud Paris-Saclay University, 94807 Villejuif, France; (D.E.F.); (G.F.)
- Department of Population Health, Luxembourg Institute of Health (LIH), 1445 Strassen, Luxembourg
| | - Olivia Pérol
- Department Prevention, Cancer, Environment, Léon Bérard Cancer Center, 69008 Lyon, France; (L.D.); (H.N.); (B.F); (B.F.)
- Cancer Research Center of Lyon, INSERM UA8, Léon Bérard Cancer Center, 69008 Lyon, France
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39
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Sisodia RC, Dewdney SB, Fader AN, Wethington SL, Melamed A, Von Gruenigen VE, Zivanovic O, Carter J, Cohn DE, Huh W, Wenzel L, Doll K, Cella D, Dowdy SC. Patient reported outcomes measures in gynecologic oncology: A primer for clinical use, part I. Gynecol Oncol 2021; 158:194-200. [PMID: 32580886 DOI: 10.1016/j.ygyno.2020.04.696] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/18/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Rachel C Sisodia
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, United States of America.
| | - Summer B Dewdney
- Division of Gynecologic Oncology, Rush University Medical Center, Chicago, IL, United States of America
| | - Amanda N Fader
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Stephanie L Wethington
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Alexander Melamed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States of America
| | - Vivian E Von Gruenigen
- Department of Obstetrics and Gynecology, University Hospitals of Cleveland, United States of America
| | - Oliver Zivanovic
- Memorial Sloan Kettering Cancer Center, 300 East 66th Street, 8th Floor, New York, NY, 10065, United States of America
| | - Jeanne Carter
- Memorial Sloan Kettering Cancer Center, 300 East 66th Street, 8th Floor, New York, NY, 10065, United States of America
| | - David E Cohn
- Department of Obstetrics and Gynecology, Ohio State University College of Medicine, Columbus, OH 43210, United States of America
| | - Warner Huh
- Department of Obstetrics and Gynecology, University and Alabama, Birmingham, AL, United States of America
| | - Lari Wenzel
- Universtiy of California, Irvine, United States of America
| | - Kemi Doll
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States of America
| | - David Cella
- Department of Medical Social Sciences and Robert H Lurie Comprehensive Cancer Center, Northwestern University, United States of America
| | - Sean C Dowdy
- Division of Gynecologic Oncology, Mayo Clinic, Rochester, MN 55905, United States of America
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40
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Coleridge SL, Bryant A, Kehoe S, Morrison J. Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer. Cochrane Database Syst Rev 2021; 2:CD005343. [PMID: 33543776 PMCID: PMC8094177 DOI: 10.1002/14651858.cd005343.pub5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Epithelial ovarian cancer presents at an advanced stage in the majority of women. These women require surgery and chemotherapy for optimal treatment. Conventional treatment has been to perform surgery first and then give chemotherapy. However, there may be advantages to using chemotherapy before surgery. OBJECTIVES To assess whether there is an advantage to treating women with advanced epithelial ovarian cancer with chemotherapy before debulking surgery (neoadjuvant chemotherapy (NACT)) compared with conventional treatment where chemotherapy follows debulking surgery (primary debulking surgery (PDS)). SEARCH METHODS We searched the following databases on 11 February 2019: CENTRAL, Embase via Ovid, MEDLINE (Silver Platter/Ovid), PDQ and MetaRegister. We also checked the reference lists of relevant papers that were identified to search for further studies. The main investigators of relevant trials were contacted for further information. SELECTION CRITERIA Randomised controlled trials (RCTs) of women with advanced epithelial ovarian cancer (Federation of International Gynaecologists and Obstetricians (FIGO) stage III/IV) who were randomly allocated to treatment groups that compared platinum-based chemotherapy before cytoreductive surgery with platinum-based chemotherapy following cytoreductive surgery. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias in each included trial. MAIN RESULTS We found 1952 potential titles, with a most recent search date of February 2019, of which five RCTs of varying quality and size met the inclusion criteria. These studies assessed a total of 1713 women with stage IIIc/IV ovarian cancer randomised to NACT followed by interval debulking surgery (IDS) or PDS followed by chemotherapy. We pooled results of the three studies where data were available and found little or no difference with regard to overall survival (OS) (1521 women; Hazard Ratio (HR) 0.95, 95% CI 0.84 to 1.07; I2 = 0%; moderate-certainty evidence) or progression-free survival in four trials where we were able to pool data (1631 women; HR 0.97, 95% CI 0.87 to 1.07; I2 = 0%; moderate-certainty evidence). Adverse events, surgical morbidity and quality of life (QoL) outcomes were poorly and incompletely reported across studies. There may be clinically meaningful differences in favour of NACT compared to PDS with regard to serious adverse effects (SAE grade 3+). These data suggest that NACT may reduce the risk of need for blood transfusion (risk ratio (RR) 0.80; 95% CI 0.64 to 0.99; four studies,1085 women; low-certainty evidence), venous thromboembolism (RR 0.28; 95% CI 0.09 to 0.90; four studies, 1490 women; low-certainty evidence), infection (RR 0.30; 95% CI 0.16 to 0.56; four studies, 1490 women; moderate-certainty evidence), compared to PDS. NACT probably reduces the need for stoma formation (RR 0.43, 95% CI 0.26 to 0.72; two studies, 581 women; moderate-certainty evidence) and bowel resection (RR 0.49, 95% CI 0.26 to 0.92; three studies, 1213 women; moderate-certainty evidence), as well as reducing postoperative mortality (RR 0.18; 95% CI 0.06 to 0.54:five studies, 1571 women; moderate-certainty evidence). QoL on the EORTC QLQ-C30 scale produced inconsistent and imprecise results in two studies (MD -1.34, 95% CI -2.36 to -0.32; participants = 307; very low-certainty evidence) and use of the QLQC-30 and QLQC-Ov28 in another study (MD 7.60, 95% CI 1.89 to 13.31; participants = 217; very low-certainty evidence) meant that little could be inferred. AUTHORS' CONCLUSIONS The available moderate-certainty evidence suggests there is little or no difference in primary survival outcomes between PDS and NACT. NACT may reduce the risk of serious adverse events, especially those around the time of surgery, and the need for bowel resection and stoma formation. These data will inform women and clinicians and allow treatment to be tailored to the person, taking into account surgical resectability, age, histology, stage and performance status. Data from an unpublished study and ongoing studies are awaited.
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Affiliation(s)
- Sarah L Coleridge
- Obstetrics and Gynaecology, Taunton and Somerset NHS Foundation Trust, Taunton, UK
| | - Andrew Bryant
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Sean Kehoe
- Institute of Cancer and Genomics, University of Birmingham, Birmingham, UK
| | - Jo Morrison
- Department of Gynaecological Oncology, Musgrove Park Hospital, Taunton, UK
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Kosmala R, Fokas E, Flentje M, Sauer R, Liersch T, Graeven U, Fietkau R, Hohenberger W, Arnold D, Hofheinz RD, Ghadimi M, Ströbel P, Staib L, Grabenbauer GG, Folprecht G, Kirste S, Uter W, Gall C, Rödel C, Polat B. Quality of life in rectal cancer patients with or without oxaliplatin in the randomised CAO/ARO/AIO-04 phase 3 trial. Eur J Cancer 2020; 144:281-290. [PMID: 33383348 DOI: 10.1016/j.ejca.2020.11.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/03/2020] [Accepted: 11/15/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The CAO/ARO/AIO trial has shown that oxaliplatin added to preoperative chemoradiotherapy and postoperative chemotherapy significantly improved disease-free survival in locally advanced rectal cancer (LARC). Here, we present a post-hoc analysis of quality of life (QoL) in disease-free patients. PATIENTS AND METHODS Between 2006 and 2010, 1236 patients with LARC were randomly assigned either to preoperative chemoradiotherapy followed by total mesorectal excision and postoperative chemotherapy (N = 623) or combined with oxaliplatin (N = 613). QoL questionnaires (EORTC QLQ-C30, colorectal module CR38) were completed at baseline, after postoperative chemotherapy and during follow-up. Analysis was performed according intent-to-treat. RESULTS Available questionnaires (baseline) were 82% (N = 512) in the control and 84% (N = 513) in the investigational group. Response rates were 49% (533 of 1086) at 1 year and 43% (403 of 928) at 3 years. Global health status (GHS) for disease-free patients was stable in both groups (range 0-100). At baseline: standard arm 62.0 (mean, SD 21.6; N = 491) versus oxaliplatin arm 63.2 (mean, SD 22; N = 503); at 3 years: 69.4 (SD 19.3; N = 187) versus 65.4 (SD 22.2; N = 202). After treatment and at 3 years, no significant differences (≥10 points) between groups were found in QoL subscales. Disease-free patients experiencing neurotoxic side-effects (grade 1-4) showed reduced GHS at 3 years versus patients without neurotoxicity (mean 59.2 versus 69.3; P < 0.001), while grade 3-4 rate was low. CONCLUSION The addition of oxaliplatin was not associated with worse overall QoL. This information is of interest to patients in many ongoing rectal cancer trials. TRIAL REGISTRATION INFORMATION NCT00349076.
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Affiliation(s)
- Rebekka Kosmala
- Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany.
| | - Emmanouil Fokas
- Department of Radiotherapy, University of Frankfurt, Germany; Frankfurt Cancer Institute, Germany; German Cancer Research Centre (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK) Partner Site, Frankfurt, Germany
| | - Michael Flentje
- Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
| | - Rolf Sauer
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Torsten Liersch
- Department of General, Visceral and Paediatric Surgery, University Medical Centre Göttingen, Göttingen, Germany
| | - Ullrich Graeven
- Department of Haematology/Oncology and Gastroenterology, Kliniken Maria Hilf GmbH, Mönchengladbach, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany
| | | | - Dirk Arnold
- Department of Oncology, Haematology and Palliative Care, Asklepios Klinik Altona, Asklepios Tumorzentrum Hamburg, Hamburg
| | - Ralf-Dieter Hofheinz
- Interdisciplinary Tumour Center, University Hospital Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Michael Ghadimi
- Department of General, Visceral and Paediatric Surgery, University Medical Centre Göttingen, Göttingen, Germany
| | - Philipp Ströbel
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | - Ludger Staib
- Department of Surgery, Klinikum Esslingen, Esslingen, Germany
| | - Gerhard G Grabenbauer
- Department of Radiation Oncology and Radiotherapy, DiaCura & Klinikum Coburg, Coburg, Germany
| | - Gunnar Folprecht
- Medical Department I, University Cancer Centre, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Simon Kirste
- Department of Radiation Oncology, University Hospital Freiburg, Freiburg, Germany
| | - Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology, University Erlangen-Nürnberg, Erlangen, Germany
| | - Christine Gall
- Department of Medical Informatics, Biometry and Epidemiology, University Erlangen-Nürnberg, Erlangen, Germany
| | - Claus Rödel
- Department of Radiotherapy, University of Frankfurt, Germany; Frankfurt Cancer Institute, Germany; German Cancer Research Centre (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK) Partner Site, Frankfurt, Germany
| | - Bülent Polat
- Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany.
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Cox MC, Nusca SM, Di Landro F, Marsilli G, Stella G, Sigona M, Ponzelli F, Passerini Desideri J, Di Gregorio F, Santoboni F, Vetrano M, Trischitta D, Manno R, Vulpiani MC. Exercise training (ET) in adult and elderly patients receiving anti-lymphoma treatments is feasible and may improve the provision of care. Leuk Lymphoma 2020; 62:560-570. [PMID: 33231126 DOI: 10.1080/10428194.2020.1842396] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Lymphoma treatments can produce adverse effects leading to a reduced quality-of-life (QoL). Besides, in patients ≥65years, it can promote an accelerated geriatric decay. We conducted a prospective study on supervised Exercise-Training (ET), in consecutive, patients aged 18-80years, during anti-lymphoma treatments.16/30 (53%), median-age = 65.5y, participated to the ET sessions, this was the Interventional Group (IG); 14/30 (47%), median-age = 63y, were the Reference Group (RG). Both groups participated to the fitness and the QoL assessments, at baseline (T0), 3-months (T1) and 6-months (T2) after the start of chemotherapy. The adherence to the ET program was 50% (95% CI:36-64%). The IG showed substantial improvements compared to the CG in cardiorespiratory fitness (Cooper test) at both T1 and T2 and in all the functional domain of the QoL questionnaire (QLQ-C30) at T2. This study showed ET, during chemotherapy, is feasible and safe, even in patients ≥65 years. Furthermore, it may improve the provision of care.
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Affiliation(s)
- Maria Christina Cox
- Haematology Unit, Sant'Andrea Hospital, 'Sapienza' University of Rome, Rome, Italy.,Haematology Department, King's College Hospital NHS Trust, London, UK.,Università Telematica San Raffaele, Italy
| | - Sveva Maria Nusca
- Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, PhD Course in "Translational Medicine and Oncology", 'Sapienza' University of Rome, Rome, Italy.,Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, 'Sapienza' University of Rome, Italy
| | - Francesca Di Landro
- Haematology Unit, Sant'Andrea Hospital, 'Sapienza' University of Rome, Rome, Italy
| | - Gabriella Marsilli
- Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, 'Sapienza' University of Rome, Italy
| | - Giulia Stella
- Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, 'Sapienza' University of Rome, Italy
| | - Matilde Sigona
- Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, 'Sapienza' University of Rome, Italy
| | - Federica Ponzelli
- Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, 'Sapienza' University of Rome, Italy
| | - Jasmine Passerini Desideri
- Division of Cardiology, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, 'Sapienza' University of Rome, Italy
| | | | - Flavia Santoboni
- Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, 'Sapienza' University of Rome, Italy
| | - Mario Vetrano
- Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, PhD Course in "Translational Medicine and Oncology", 'Sapienza' University of Rome, Rome, Italy
| | - Donatella Trischitta
- Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, 'Sapienza' University of Rome, Italy
| | | | - Maria Chiara Vulpiani
- Department of Medical and Surgical Sciences and Translational Medicine, Sant'Andrea University Hospital, PhD Course in "Translational Medicine and Oncology", 'Sapienza' University of Rome, Rome, Italy.,Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, 'Sapienza' University of Rome, Italy
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43
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Viada C, Bouza C, Fors M, Frías A, Alvarez M, García L, Wilkinson B, Rodríguez C, Crombet T, Ballesteros J. Underlying dimensions of the EORTC QLQ-C30 in a Cuban population of patients with advanced non-small cell lung cancer. Qual Life Res 2020; 29:3441-3448. [PMID: 33136243 DOI: 10.1007/s11136-020-02584-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Quality of Life Core Questionnaire of the European Organization for the Research and Treatment of Cancer (EORTC QLQ-C30) is one of the most used quality of life questionnaires in cancer studies. It provides scores for five functional scales, nine symptom scales, and two single items which assess overall health status and quality of life. However, high correlations among QLQ-C30 items suggest a reduced dimensionality for the scale. OBJECTIVE To assess the dimensionality of the EORTC QLQ-C30 using item response theory (IRT) in a training sample and confirmatory factor analysis (CFA) in a test sample. METHODS We analyzed responses to QLQ-C30 from 1,107 patients with advanced lung cancer who were included in five clinical trials of immunotherapy. We used non-parametric and parametric IRT models (Mokken, and Samejima's graded response) in a random training set (n = 332) for initial assessment of dimensions and item characteristics of the QLQ-C30. Finally, we used CFA in the test set (n = 775) to confirm the measurement domains. RESULTS Mokken model showed that QLQ-C30 fits a unidimensional scale, whereas Samejima model showed that most QLQ-C30 items present adequate difficulty and discrimination. All items showed adequate scalability indexes with an overall scalability of 0.47 (medium scale). The QLQ-C30-reduced dimensionality was confirmed by CFA (comparative fit index = 0.98, root mean square error of approximation = 0.055) with all items presenting factorial loadings > 0.40. CONCLUSIONS The EORTC QLQ-C30 fits a unidimensional latent construct identified with perceived quality of life in advanced lung cancer patients. TRIAL REGISTRATION RPCEC00000161, RPCEC00000181 and RPCEC00000205.
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Affiliation(s)
- Carmen Viada
- Center of Molecular Immunology (CIM), Havana, Cuba.
| | | | | | | | | | | | | | | | | | - Javier Ballesteros
- University of the Basque Country, UPV/EHU, Leioa, Spain.,CIBERSAM, Madrid, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
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44
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Abstract
Radical and palliative treatments for non-small cell lung cancer (NSCLC) have faced a significant evolution during last decades, which in turn has modified their effects on the patient quality of life (QoL). QoL data collection is becoming methodologically rigorous, with published recommendations and societal statements. In lung cancer surgery, there is no standardization in collecting and analyzing this outcome yet. However, to face the evolution in lung cancer therapies, few initiatives like the European Organization for the Research and Treatment of Cancer (EORTC) lung cancer module update project or the Patient-Reported Outcomes Measurement Information System (PROMIS), have now the potential to help thoracic surgeons to collect QoL data with validated dynamic instruments to make this outcome comparable to the clinical ones. This review aims to give an overview of the available and most commonly used QoL questionnaires in lung cancer surgery in order to facilitate future research and practical implementation.
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Affiliation(s)
- Cecilia Pompili
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St. James's, University of Leeds, Leeds, UK.,Division of Thoracic Surgery, St. James's University Hospital, Leeds, UK
| | - Michael Koller
- Center for Clinical Studies Regensburg, University of Regensburg, Regensburg, Germany
| | - Galina Velikova
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St. James's, University of Leeds, Leeds, UK
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45
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Deterioration of Health-Related Quality of Life Scores under Treatment Predicts Longer Survival. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3565238. [PMID: 32879881 PMCID: PMC7448240 DOI: 10.1155/2020/3565238] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 07/23/2020] [Indexed: 12/14/2022]
Abstract
Objectives Baseline health-related quality of life (HRQoL) scores predict survival, which has already been demonstrated in various studies. However, we were interested in whether changes in baseline scores during treatment are also significant predictors of survival. Methods and Materials We analysed the data of 400 consecutive cancer patients receiving radiochemotherapy. Leading diagnoses were head and neck cancer (34.5%), rectal cancer (24.5%), and lung cancer (13%). HRQoL was studied at baseline, six weeks after therapy and after each completed year after the start of therapy until drop out of the study using the EORTC QLQ-C30 questionnaire. The change score was calculated as the baseline score subtracted from the score after therapy. Statistics included Kaplan-Meier estimates and Cox regression. Results High global health status (p = 0.005) and low pain scores (p = 0.040) at baseline were related to favourable overall survival. Change scores of role functioning (p = 0.027), global health status (p < 0.018), and pain (p < 0.001) were predictive of overall survival. Pain was the superior predictor of survival (p = 0.001) among all variables and QoL scores studied by multivariate analysis. A deterioration in pain was associated with a 2.8 times higher chance of survival (HR 0.36). Conclusions Deterioration of HRQoL baseline pain score by cancer treatment is a favourable and superior prognostic factor for survival.
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Park JH, Lee DH, Kim SI, Kim NK, Jeon JY. Moderate to vigorous physical activity participation associated with better quality of life among breast and colorectal cancer survivors in Korea. BMC Cancer 2020; 20:365. [PMID: 32357850 PMCID: PMC7193341 DOI: 10.1186/s12885-020-06819-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 04/02/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND To investigate the association between physical activity (PA) and quality of life (QoL) among breast and colorectal cancer survivors in Korea. METHODS A total of 224 cancer survivors (151 breast and 73 colorectal cancers) who completed treatments were recruited. We measured PA level with Godin Leisure-Time Exercise Questionnaire and QoL with European Organization for Research and Treatment of Cancer (EORTC) QLQ C-30. RESULTS Moderate to vigorous PA was significantly correlated with global QoL (r = .311, p < 0.01), physical functioning (r = .231, p < 0.01), fatigue (r = -.176, p < 0.05), pain (r = -.154, p < 0.05), and dyspnea (r = -.221, p < 0.01) while no correlation was found between light PA and QoL after controlling for potential confounders. When we further divided our participants into four groups by total PA level, we found a strong linear dose-response relationship between higher total PA and better QoL outcomes (p < .001). Compared with participants in the lowest quartile, those in the highest quartile had significantly better score in global QoL (65.8 ± 2.7 vs. 77.6 ± 2.8, p = 0.003), physical functioning (67.2 ± 2.3 vs. 85.3 ± 2.4, p = 0.007), fatigue (35.9 ± 3.2 vs. 23.6 ± 3.2, p = 0.008), pain (22.7 ± 3.3 vs. 13.0 ± 3.4, p = 0.046), and dyspnea (13.7 ± 2.5 vs. 5.9 ± 2.6, p = 0.034). CONCLUSIONS Higher PA level was associated with better QoL among breast and colorectal cancer survivors in Korea. Increasing PA levels should be included as one of important strategies to improve QoL in cancer survivors.
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Affiliation(s)
- Ji-Hye Park
- Department of Sport Industry Studies, Yonsei University, 50 Yonsei-ro, Seodaemun-Gu, Seoul, South Korea
- Frontier research institute of Convergence Sports Science, Yonsei University, Seoul, South Korea
| | - Dong Hoon Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Seung Il Kim
- Department of Surgery, Yonsei University College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-Gu, Seoul, South Korea.
| | - Nam Kyu Kim
- Department of Surgery, Yonsei University College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-Gu, Seoul, South Korea
| | - Justin Y Jeon
- Department of Sport Industry Studies, Yonsei University, 50 Yonsei-ro, Seodaemun-Gu, Seoul, South Korea.
- Frontier research institute of Convergence Sports Science, Yonsei University, Seoul, South Korea.
- Cancer Prevention Center, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
- The Institute of Convergence Science, Yonsei University, Seoul, South Korea.
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EMR 20006-012: A phase II randomized double-blind placebo controlled trial comparing the combination of pimasertib (MEK inhibitor) with SAR245409 (PI3K inhibitor) to pimasertib alone in patients with previously treated unresectable borderline or low grade ovarian cancer. Gynecol Oncol 2019; 156:301-307. [PMID: 31870556 DOI: 10.1016/j.ygyno.2019.12.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/01/2019] [Accepted: 12/02/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To compare the combination of a MEK inhibitor (pimasertib) and a PI3K inhibitor (SAR245409) to pimasertib alone in recurrent unresectable borderline/low malignant potential (LMP) or low-grade serous ovarian carcinoma (LGSOC), determining whether combination is superior. METHODS Patients with previously treated, recurrent LMP or LGSOC with measurable disease received either combination of pimasertib (60 mg daily) + SAR245409 (SAR) (70 mg daily) or pimasertib alone (60 mg BID) until progression or unacceptable toxicity. Primary endpoint was objective response rate (ORR) by RECIST 1.1, determining whether combination was superior to pimasertib alone. Secondary endpoints included progression free survival (PFS), disease control, and adverse events. RESULTS Sixty-five patients were randomized between September 2012 and December 2014. ORR was 9.4% (80% CI, 3.5 to 19.7) in the combination arm and 12.1% (80% CI, 5.4 to 22.8) in the pimasertib alone arm. Median PFS was 7.23 months (80% CI, 5.06 to -) and 9.99 (80% CI, 7.39 to 10.35) for pimasertib alone and pimasertib + SAR, respectively. Six-month PFS was 63.5% (80% CI, 47.2% to 75.9%) and 70.8% (80% CI, 56.9% to 80.9%). Eighteen (56.3%) patients in the combination arm and 19 (57.6%) patients in the pimasertib alone arm discontinued the trial. The study was terminated early because of low ORR and high rate of discontinuation. CONCLUSIONS Response to pimasertib alone (ORR 12%) suggests that MEK inhibition could be used as an alternative treatment method to cytotoxic chemotherapy in this population. The MEK inhibitor alone was as effective as the combination, although the trial was limited by small numbers. Additional studies investigating the role of single agent or combination MEK and PI3K inhibition are warranted to further evaluate the utility of these treatments and describe a standard of care for LGSOC.
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Coleridge SL, Bryant A, Lyons TJ, Goodall RJ, Kehoe S, Morrison J. Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer. Cochrane Database Syst Rev 2019; 2019:CD005343. [PMID: 31684686 PMCID: PMC6822157 DOI: 10.1002/14651858.cd005343.pub4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Epithelial ovarian cancer presents at an advanced stage in the majority of women. These women require surgery and chemotherapy for optimal treatment. Conventional treatment has been to perform surgery first and then give chemotherapy. However, there may be advantages to using chemotherapy before surgery. OBJECTIVES To assess whether there is an advantage to treating women with advanced epithelial ovarian cancer with chemotherapy before debulking surgery (neoadjuvant chemotherapy (NACT)) compared with conventional treatment where chemotherapy follows debulking surgery (primary debulking surgery (PDS)). SEARCH METHODS We searched the following databases on 11 February 2019: CENTRAL, Embase via Ovid, MEDLINE (Silver Platter/Ovid), PDQ and MetaRegister. We also checked the reference lists of relevant papers that were identified to search for further studies. The main investigators of relevant trials were contacted for further information. SELECTION CRITERIA Randomised controlled trials (RCTs) of women with advanced epithelial ovarian cancer (Federation of International Gynaecologists and Obstetricians (FIGO) stage III/IV) who were randomly allocated to treatment groups that compared platinum-based chemotherapy before cytoreductive surgery with platinum-based chemotherapy following cytoreductive surgery. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias in each included trial. MAIN RESULTS We found 1952 potential titles, with a most recent search date of February 2019, of which five RCTs of varying quality and size met the inclusion criteria. These studies assessed a total of 1713 women with stage IIIc/IV ovarian cancer randomised to NACT followed by interval debulking surgery (IDS) or PDS followed by chemotherapy. We pooled results of the three studies where data were available and found little or no difference with regard to overall survival (OS) (1521 women; hazard ratio (HR) 1.06; 95% confidence interval (CI) 0.94 to 1.19, I2 = 0%; moderate-certainty evidence) or progression-free survival in four trials where we were able to pool data (1631 women; HR 1.02; 95% CI 0.92 to 1.13, I2 = 0%; moderate-certainty evidence). Adverse events, surgical morbidity and quality of life (QoL) outcomes were poorly and incompletely reported across studies. There may be clinically meaningful differences in favour of NACT compared to PDS with regard to serious adverse effects (SAE grade 3+). These data suggest that NACT may reduce the risk of need for blood transfusion (risk ratio (RR) 0.80; 95% CI 0.64 to 0.99; four studies,1085 women; low-certainty evidence), venous thromboembolism (RR 0.28; 95% CI 0.09 to 0.90; four studies, 1490 women; low-certainty evidence), infection (RR 0.30; 95% CI 0.16 to 0.56; four studies, 1490 women; moderate-certainty evidence), compared to PDS. NACT probably reduces the need for stoma formation (RR 0.43, 95% CI 0.26 to 0.72; two studies, 581 women; moderate-certainty evidence) and bowel resection (RR 0.49, 95% CI 0.26 to 0.92; three studies, 1213 women; moderate-certainty evidence), as well as reducing postoperative mortality (RR 0.18; 95% CI 0.06 to 0.54:five studies, 1571 women; moderate-certainty evidence). QoL on the EORTC QLQ-C30 scale produced inconsistent and imprecise results in two studies (MD -1.34, 95% CI -2.36 to -0.32; participants = 307; very low-certainty evidence) and use of the QLQC-30 and QLQC-Ov28 in another study (MD 7.60, 95% CI 1.89 to 13.31; participants = 217; very low-certainty evidence) meant that little could be inferred. AUTHORS' CONCLUSIONS The available moderate-certainty evidence suggests there is little or no difference in primary survival outcomes between PDS and NACT. NACT may reduce the risk of serious adverse events, especially those around the time of surgery, and the need for bowel resection and stoma formation. These data will inform women and clinicians and allow treatment to be tailored to the person, taking into account surgical resectability, age, histology, stage and performance status. Data from an unpublished study and ongoing studies are awaited.
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Affiliation(s)
- Sarah L Coleridge
- Taunton and Somerset NHS Foundation TrustObstetrics and GynaecologyMusgrove Park HospitalTauntonUKTA1 5DA
| | - Andrew Bryant
- Newcastle UniversityInstitute of Health & SocietyMedical School New BuildRichardson RoadNewcastle upon TyneUKNE2 4AX
| | - Thomas J Lyons
- University of BristolSchool of Medical Sciences38 Kings Parade AvenueBristolUKBS8 2RB
| | - Richard J Goodall
- Imperial College LondonDepartment of Surgery and CancerKensingtonLondonUKSW7 2AZ
| | - Sean Kehoe
- University of BirminghamInstitute of Cancer and GenomicsBirminghamUKB15 2TT
| | - Jo Morrison
- Musgrove Park HospitalDepartment of Gynaecological OncologyTaunton and Somerset NHS Foundation TrustTauntonSomersetUKTA1 5DA
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Piccirillo MC, Scambia G, Bologna A, Signoriello S, Vergote I, Baumann K, Lorusso D, Murgia V, Sorio R, Ferrandina G, Sacco C, Cormio G, Breda E, Cinieri S, Natale D, Mangili G, Pisano C, Cecere SC, Di Napoli M, Salutari V, Raspagliesi F, Arenare L, Bergamini A, Bryce J, Daniele G, Gallo C, Pignata S, Perrone F. Quality-of-life analysis of the MITO-8, MaNGO, BGOG-Ov1, AGO-Ovar2.16, ENGOT-Ov1, GCIG study comparing platinum-based versus non-platinum-based chemotherapy in patients with partially platinum-sensitive recurrent ovarian cancer. Ann Oncol 2019; 29:1189-1194. [PMID: 29462248 DOI: 10.1093/annonc/mdy062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background MITO-8 showed that prolonging platinum-free interval by introducing non-platinum-based chemotherapy (NPBC) does not improve prognosis of patients with partially platinum-sensitive recurrent ovarian cancer. Quality of life (QoL) was a secondary outcome. Patients and methods Ovarian cancer patients recurring or progressing 6-12 months after previous platinum-based chemotherapy (PBC) were randomized to receive PBC or NPBC as first treatment. QoL was assessed at baseline, third and sixth cycles, with the EORTC C-30 and OV-28 questionnaires. Mean changes and best response were analysed. Progression-free survival, response rate, and toxicity are also reported for proper interpretation of data. All analyses were based on intention-to-treat. Results Out of the 215 patients, 151 (70.2%) completed baseline questionnaire, balanced between the arms; thereafter, missing rate was higher in the NPBC arm. At mean change analysis, C30 scores were prevalently worse in the NPBC than PBC arm, statistical significance being attained for emotional functioning, global health status/QoL, fatigue, and dyspnoea (effect sizes ranging from 0.30 to 0.51). Conversely, as for OV28 scale, the other chemotherapy side-effects item was significantly worse with PBC at three and six cycles, with a larger effect size (0.70 and 0.54, respectively). At best response analysis, improvement of emotional functioning and pain and worsening of peripheral neuropathy and other chemotherapy side-effects were significantly more frequent in the PBC arm. Progression-free survival (median 9 versus 5 months, P = 0.001) and objective response rate (51.6% versus 19.4%, P = 0.0001) were significantly better with PBC. Allergy, blood cell count, alopecia, nausea, musculoskeletal, and neurological side-effects were more frequent and severe with PBC; hand-foot skin reaction, rash/desquamation, mucositis, and vascular events were more frequent with NPBC. Conclusion MITO-8 QoL analysis shows that deterioration of some functioning and symptom scales is lower with PBC, with improvement of emotional functioning and pain, despite worsening of toxicity-related items. ClinicalTrials.gov NCT00657878.
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Affiliation(s)
- M C Piccirillo
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli
| | - G Scambia
- Department of Protection of Women's Health, Rising Life, Child and Adolescent, Università Cattolica del Sacro Cuore, Roma
| | - A Bologna
- Medical Oncology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia
| | - S Signoriello
- Medical Statistics, Università degli Studi della Campania "Luigi Vanvitelli", Napoli
| | - I Vergote
- University Hospital Leuven, Leuven; Leuven Cancer Institute, Leuven, Belgium
| | - K Baumann
- UKGM Gynecology, Frauenklinik, Marburg, Germany
| | - D Lorusso
- Department of Protection of Women's Health, Rising Life, Child and Adolescent, Università Cattolica del Sacro Cuore, Roma; Gynaecologic Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milano
| | - V Murgia
- Medical Oncology, Ospedale S. Chiara, Trento
| | - R Sorio
- Medical Oncology C, Centro di Riferimento Oncologico, Aviano, PN
| | - G Ferrandina
- Department of Protection of Women's Health, Rising Life, Child and Adolescent, Università Cattolica del Sacro Cuore, Roma; Gynaecologic Oncology, Centro di Ricerca e Formazione ad Alta Tecnologia nelle Scienze Biomediche, Università Cattolica del Sacro Cuore, Campobasso
| | - C Sacco
- Oncology Department, AO S. Maria della Misericordia, Udine
| | - G Cormio
- Università di Bari, Bari; Ginecoloy Oncology, Istituto Oncologico "Giovanni Paolo II", Bari
| | - E Breda
- Medical Oncology, Ospedale S.Giovanni Calibita Fatebenefratelli, Roma
| | - S Cinieri
- Medical Oncology, Ospedale Antonio Perrino, Brindisi
| | - D Natale
- Medical Oncology, Ospedale San Massimo, Penne, PE
| | - G Mangili
- Obstertic and Gynaecologic Department, Ospedale San Raffaele, Milano
| | - C Pisano
- Uro-Gynaecologic Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli, Italy
| | - S C Cecere
- Uro-Gynaecologic Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli, Italy
| | - M Di Napoli
- Uro-Gynaecologic Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli, Italy
| | - V Salutari
- Department of Protection of Women's Health, Rising Life, Child and Adolescent, Università Cattolica del Sacro Cuore, Roma
| | | | - L Arenare
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli
| | - A Bergamini
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli; Obstertic and Gynaecologic Department, Ospedale San Raffaele, Milano
| | - J Bryce
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli
| | - G Daniele
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli
| | - C Gallo
- Medical Statistics, Università degli Studi della Campania "Luigi Vanvitelli", Napoli
| | - S Pignata
- Uro-Gynaecologic Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli, Italy.
| | - F Perrone
- Clinical Trials Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS - Fondazione G.Pascale, Napoli
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Lu W, Giobbie-Hurder A, Freedman RA, Shin IH, Lin NU, Partridge AH, Rosenthal DS, Ligibel JA. Acupuncture for Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer Survivors: A Randomized Controlled Pilot Trial. Oncologist 2019; 25:310-318. [PMID: 32297442 DOI: 10.1634/theoncologist.2019-0489] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/23/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most debilitating long-term side effects in breast cancer survivors. We conducted a randomized controlled pilot trial to assess the feasibility, safety, and effects of an acupuncture intervention on CIPN in this population. PATIENTS AND METHODS Women with stage I-III breast cancer with grade 1 or higher CIPN after taxane-containing adjuvant chemotherapy were randomized 1:1 to an immediate acupuncture (IA) arm or to a waitlist control group (CG). Participants in the IA arm received 18 sessions of acupuncture over 8 weeks, then received no additional acupuncture. Patients in the CG arm received usual care over 8 weeks, followed by nine sessions of acupuncture over 8 weeks. Measures including Patient Neurotoxicity Questionnaire (PNQ), Functional Assessment of Cancer Therapy-Neurotoxicity subscale (FACT-NTX), and Brief Pain Inventory-short form (BPI-SF) were collected at baseline and at 4, 8, and 16 weeks after enrollment. RESULTS Forty women (median age, 54) were enrolled (20 to IA and 20 to CG), with median time between completion of chemotherapy and enrollment of 14 months (range 1-92). At 8 weeks, participants in the IA arm experienced significant improvements in PNQ sensory score (-1.0 ± 0.9 vs. -0.3 ± 0.6; p = .01), FACT-NTX summary score (8.7 ± 8.9 vs. 1.2 ± 5.4; p = .002), and BPI-SF pain severity score (-1.1 ± 1.7 vs. 0.3 ± 1.5; p = .03), compared with those in the CG arm. No serious side effects were observed. CONCLUSION Women with CIPN after adjuvant taxane therapy for breast cancer experienced significant improvements in neuropathic symptoms from an 8-week acupuncture treatment regimen. Additional larger studies are needed to confirm these findings. IMPLICATIONS FOR PRACTICE Chemotherapy-induced peripheral neuropathy (CIPN) is a toxicity that often persists for months to years after the completion of adjuvant chemotherapy for early breast cancer. In a randomized pilot trial of 40 breast cancer survivors with CIPN, an 8-week acupuncture intervention (vs. usual care) led to a statistically and clinically significant improvement in subjective sensory symptoms including neuropathic pain and paresthesia. Given the lack of effective therapies and established safety profile of acupuncture, clinicians may consider acupuncture as a treatment option for mild to moderate CIPN in practice.
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Affiliation(s)
- Weidong Lu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Anita Giobbie-Hurder
- Division of Biostatistics, Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Rachel A Freedman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Im Hee Shin
- Department of Medical Statistics and Informatics, School of Medicine at the Catholic University of Daegu, Daegu, Republic of Korea
| | - Nancy U Lin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - David S Rosenthal
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jennifer A Ligibel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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