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Sakurai Y, Iwasaki F, Hirose A, Matsumoto N, Miyagawa N, Keino D, Yokosuka T, Hamanoue S, Yanagimachi M, Shiomi M, Goto S, Tanaka M, Tanaka Y, Nozawa K, Goto H. Metronomic Chemotherapy for Pediatric Refractory Solid Tumors: A Retrospective Single-Center Study. J Pediatr Hematol Oncol 2024:00043426-990000000-00407. [PMID: 38691057 DOI: 10.1097/mph.0000000000002870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/28/2024] [Indexed: 05/03/2024]
Abstract
Metronomic chemotherapy (MC) is based on chronic administration of chemotherapeutic agents at minimally toxic doses without prolonged drug-free breaks, that inhibits tumor angiogenesis and induces tumor dormancy. This study aimed to determine the efficacy of MC for pediatric refractory solid tumors. We retrospectively analyzed the data of pediatric patients with relapsed/refractory solid tumors who received treatment, including low-dose continuous administration of anticancer drugs, at our institute. Of the 18 patients, the disease statuses at the initiation of MC were complete remission (n=2), partial remission/stable disease (n=5), and progressive disease (n=11). The overall survival rate was 61% at 12 months and 34% at 24 months, and the progression-free survival rate was 21% at 12 and 24 months. Although only 5 of the 18 patients showed certain tumor regression or maintained remission, tumors that stabilized, maintained remission/stable disease, and showed certain advantages in terms of overall survival rate, even if limited to progressive disease. Approximately half of the patients demonstrated temporal tumor stabilization and improved survival time. Overall, previous reports and the present study support the conclusion that MC has the potential to play an important role in pediatric cancer treatment during the advanced stage.
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Affiliation(s)
- Yukari Sakurai
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
| | - Fuminori Iwasaki
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
| | - Ayana Hirose
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
| | - Naoya Matsumoto
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
| | - Naoyuki Miyagawa
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
| | - Dai Keino
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
| | - Tomoko Yokosuka
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
| | - Satoshi Hamanoue
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
| | | | - Masae Shiomi
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
| | - Shoko Goto
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
| | | | | | - Kumiko Nozawa
- Radiology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Hiroaki Goto
- Division of Hematology/Oncology, Kanagawa Children's Medical Center
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2
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Paré-Blagoev EJ, Ruble K, Jacobson LA. Tools of the trade to address schooling related communication needs after childhood cancer: A mini-review with consideration of health disparity concerns. Semin Oncol 2020; 47:65-72. [PMID: 32253070 DOI: 10.1053/j.seminoncol.2020.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 12/28/2022]
Abstract
Over the last 60 years, success rates in treating childhood cancers have grown dramatically from 10% to greater than 85%. Negative effects of treatments, however, place survivors at risk for neurocognitive deficits that can make school challenging. Evidence shows that receiving special education services can benefit affected children. However, communication and knowledge gaps among families and service providers can present access challenges. This mini-review considers the literature on communication between medical providers, families, and school professionals and identifies recommended tools for improving success and efficiency. Additional recommendations are made regarding improving access and adoption of such tools including the need for adaptations and expansions of available resources to address health disparity concerns for an increasingly linguistically and culturally diverse population.
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Affiliation(s)
| | - Kathy Ruble
- Bloomberg Children's Center, Johns Hopkins Hospital, Baltimore, MD
| | - Lisa A Jacobson
- Kennedy Krieger Institute & Johns Hopkins School of Medicine, Baltimore, MD
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Pini S, Hugh-Jones S, Shearsmith L, Gardner P. ‘What are you crying for? I don't even know you’ – The experiences of teenagers communicating with their peers when returning to school. Eur J Oncol Nurs 2019; 39:28-34. [DOI: 10.1016/j.ejon.2018.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 11/21/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
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Collins DE, Ellis SJ, Janin MM, Wakefield CE, Bussey K, Cohn RJ, Lah S, Fardell JE. A Systematic Review Summarizing the State of Evidence on Bullying in Childhood Cancer Patients/Survivors [Formula: see text]. J Pediatr Oncol Nurs 2018; 36:55-68. [PMID: 30406714 DOI: 10.1177/1043454218810136] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND One in four school-aged children is bullied. However, the risk may be greater for childhood cancer patients/survivors (diagnosed <18 years), because of symptoms of the disease and treatment that may prejudice peers. While the serious consequences of bullying are well documented in the general population, bullying may have even greater impact in children with cancer due to the myriad of challenges associated with treatment and prolonged school absence. OBJECTIVE To summarize the state of evidence on bullying in childhood cancer patients/survivors; specifically, the rate and types of bullying experienced and the associated factors. METHOD We searched five electronic databases from inception to February 2018 for original research articles reporting on bullying in childhood cancer patients/survivors. RESULTS We identified 29 eligible articles, representing 1,078 patients/survivors ( M = 14.35 years). Self-reports from patients/survivors revealed a considerably higher rate of bullying (32.2%) compared with the general population (25%). Our review identified little information on the factors associated with bullying in patients/survivors. However, the bullying described tended to be verbal and was often related to the physical side effects of treatment, indicating that differences in appearance may prejudice peers. It was further suggested that educating the child's classmates about cancer may prevent bullying. CONCLUSIONS Our findings confirm that bullying is a significant challenge for many childhood cancer patients/survivors. Additional studies are needed to identify factors that may influence the risk of bullying, which will inform the development of evidence-based interventions and guidelines to prevent bullying in childhood cancer patients/survivors.
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Affiliation(s)
- Daisy E Collins
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
| | - Sarah J Ellis
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
| | - Madeleine M Janin
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
| | - Claire E Wakefield
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
| | - Kay Bussey
- 3 Macquarie University, Sydney, New South Wales, Australia
| | - Richard J Cohn
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
| | - Suncica Lah
- 4 University of Sydney, Sydney, New South Wales, Australia.,5 ARC Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia
| | - Joanna E Fardell
- 1 Sydney Children's Hospital, Sydney, New South Wales, Australia.,2 University of New South Wales, Sydney, New South Wales, Australia
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The Impact of a Mother's Emotional Strains and Disclosure of Cancer on Her Child's Defensiveness and Adjustment to Cancer. Cancer Nurs 2017; 41:290-297. [PMID: 28591010 DOI: 10.1097/ncc.0000000000000516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Defensiveness is one of the strategies that children with cancer use against psychosocial difficulties, yet it remains unclear what factors may impact children's use of defensiveness. OBJECTIVE The aim of this study was to explore the psychological adjustment, including use of defensive behaviors, in children who may or may not be told about the diagnosis of cancer. METHODS A total of 58 children and 51 mothers participated in the study. Children answered questionnaires about defensiveness, anxiety, and depression, whereas mothers completed a questionnaire of anxiety, depression, and stress and a question about disclosure of cancer to child. RESULTS Significant differences were found in the defensiveness and depression scores between children with full disclosure and those with no disclosure about their cancer. Although children's adjustment has been directly related to that of their mother's adjustment, we did not find this variable to be a predictor of child's adjustment. The child's defensiveness scores were a strong predictor of child's anxiety and eventually for a high risk for depression. CONCLUSIONS Mothers' emotional strains and lack of open disclosure about cancer significantly affect the psychosocial well-being of children. IMPLICATIONS FOR PRACTICE It is essential for nurses to assess the emotional adjustment and defensiveness strategies that children with cancer use. We believe that nurses caring for children with cancer have a professional responsibility to identify and understand defensive behaviors and other characteristics of psychosocial distress and advocate for psychological interventions that will help mothers and their children cope with cancer.
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Páez Aguirre SF. Reintegración del niño con cáncer en la escuela. GACETA MEXICANA DE ONCOLOGÍA 2015. [DOI: 10.1016/j.gamo.2015.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Bonneau J, Dugas K, Louis A, Morel L, Toughza J, Frappaz D. [Educational and social outcome after childhood cancer]. Bull Cancer 2015; 102:691-7. [PMID: 25917346 DOI: 10.1016/j.bulcan.2015.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 03/22/2015] [Indexed: 11/26/2022]
Abstract
The survival rate improvement of childhood cancer survivors lead to question about their educational and social outcome. Authors suggest an international review in order to find risk factors of school or social failure after cancer experience. Principal cohort is studied in USA (the Children Cancer Survivor Study). Nevertheless, European studies are also published. The results vary, depending on subpopulation studied and on control choice (siblings or general population). Treatment improvement and supportive care make difficult to compare studies with current situations. Moreover, there are not international standard of education or social outcome. School and social behaviour are influenced by: types of tumor (cerebral tumor but also sometimes hemopathy and osteosarcoma), age at diagnosis (very young children and adolescent), treatments (neurotoxical treatments, hematopoietic stem cell transplant), and social or educational status of the parents.
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Affiliation(s)
- Jacinthe Bonneau
- CHU, hôpital Sud, unité d'hématologie oncologie pédiatrique, 35203 Rennes, France.
| | - Karyn Dugas
- CHU de Pellegrin, maison Aquitaine ressources pour les adolescents et jeunes adultes (MARADJA), 33000 Bordeaux, France
| | - Aurélien Louis
- Centre hospitalier de Chalon-sur-Saône, unité de Pédiatrie, 71321 Chalon-sur-Saone, France
| | - Laëtitia Morel
- CHU, hôpital Sud, unité d'hématologie oncologie pédiatrique, 35203 Rennes, France
| | - Jihane Toughza
- Institut hématologie oncologie pédiatrique (IHOP), oncologie pédiatrique, 69008 Lyon, France
| | - Didier Frappaz
- Institut hématologie oncologie pédiatrique (IHOP), oncologie pédiatrique, 69008 Lyon, France
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Ishibashi A, Okamura J, Ueda R, Sunami S, Kobayashi R, Ogawa J. Psychosocial Strength Enhancing Resilience in Adolescents and Young Adults With Cancer. J Pediatr Oncol Nurs 2015; 33:45-54. [DOI: 10.1177/1043454214563935] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The purpose of this study was to explore ways of enhancing psychosocial strengths in newly diagnosed and relapsed adolescents and young adults (AYAs) to improve their resilience. A descriptive case study was used. The adolescent resilience model (ARM) and the self-sustaining process model were applied as theories. The data were analyzed using pattern-matching logic. Semistructured interviews were conducted with 18 patients aged 12 to 24 years and discharged within 10 years. We found that the newly diagnosed and the relapsing AYAs developed the 5 strength factors of the ARM during and after treatment. Whether the individuals cultivated a positive attitude and sense of purpose early or late, the AYAs developed resilience eventually. A positive attitude and sense of purpose during the early phase of care may be essential for improving resilience. The AYAs benefited from the support of their parents, friends, and previous experience. Individualized support and social resources may be important to develop these strengths. Further research is needed to develop strengths and improve resilience in newly diagnosed AYAs.
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Affiliation(s)
- Akiko Ishibashi
- The Japanese Red Cross Kyushu International College of Nursing, Munakata, Fukuoka, Japan
| | - Jun Okamura
- The Japanese Red Cross Kyushu International College of Nursing, Munakata, Fukuoka, Japan
| | - Reiko Ueda
- Okinawa Prefectural College of Nursing, Kiyoseshi, Tokyo, Japan
| | - Shosuke Sunami
- The Japanese Red Cross Narita Hospital, Naritashi, Tiba, Japan
| | | | - Junko Ogawa
- Shukutoku University, Chuo-ku, Chiba-city, Japan
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10
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Abstract
Adolescents with cancer and their parents have to deal with the challenge of returning to their pre-diagnosis social life. The purpose of this study was to describe the subjective lived experiences of Taiwanese mothers and their adolescents who had completed cancer treatment and were returning to school. Eight Taiwanese mother-adolescent dyads were recruited by purposive sampling. Core themes were extracted using phenomenological method and dyadic analysis. Findings were metaphorically captured by the theme “meshing gears.” The mothers and their adolescents were initially like 2 gears spinning alone, side by side due to experiencing different distress related to their social roles. To move toward a normal and healthy life journey, the mothers and their adolescents worked together as a well-tuned machine. This phenomenon is similar to gears meshing without friction to keep moving forward together. Our results suggest that health care professionals should provide follow-up care and interdisciplinary school reentry services to adolescent cancer survivors to improve their quality of life.
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Affiliation(s)
- Chin-Mi Chen
- Department of Nursing, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Bi-Hua Hsu
- Hsin Sheng College of Medical Care and Management, Taoyuan, Taiwan
| | - Yueh-Chih Chen
- Department of Nursing, Hungkuang University, Taichung, Taipei, Taiwan
| | - Shin-Nan Cheng
- Department of Pediatrics, Tung’s Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Jen-Jiuan Liaw
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
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Abstract
Announcement of diagnosis is a critical step in establishing a trust-based relationship of quality between patient and physician. Disclosing "bad news" is a difficult and sensitive task which has direct consequences on psychological, emotional and relational levels, as well as on therapeutic management. This is a potentially traumatic experience which requires a long process of integration and psychological adaptation. The hematologist-oncologist occupies a central position: He introduces the framework for a multidisciplinary care, while taking into account the personality and behavior of the teenager or young adult. We propose an analysis of doctor-patient interaction; an overview of psychological issues associate with diagnosis disclosure; suggestions to build and manage communication with patients; and a clarification of the role of the psychologist and of the psychological adjustment at the time of disclosure.
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Gray WN, Szulczewski LJ, Regan SMP, Williams JA, Pai ALH. Cultural Influences in Pediatric Cancer. J Pediatr Oncol Nurs 2014; 31:252-71. [DOI: 10.1177/1043454214529022] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To review the literature on cultural factors influencing clinical care and family management of pediatric cancer. Methods: A literature review including 72 articles related to cultural issues in pediatric cancer was conducted. Information was organized around several clinically driven themes. Results: Cultural factors influenced many aspects of the cancer experience including illness representations, reaction to diagnosis, illness disclosure patterns, complementary and alternative medicine use, management of medical procedures, coping strategies, and end of life issues. Conclusion: Increased awareness of cultural factors is needed to improve clinical care and reduce health disparities. Specific strategies to approach cultural differences are provided to enhance patient and family care from diagnosis to cure/end of life.
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Affiliation(s)
| | | | | | | | - Ahna L. H. Pai
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Razban F, Iranmanesh S, Rafei H. Nurses' attitudes toward palliative care in south-east Iran. Int J Palliat Nurs 2013; 19:403-10. [DOI: 10.12968/ijpn.2013.19.8.403] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Farideh Razban
- School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran, and Department of Nursing, Sirjan School of Medical Sciences, Sirjan, Iran
| | | | - Hossein Rafei
- School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Xue D, Wheeler JL, Abernethy AP. Cultural differences in truth-telling to cancer patients: Chinese and American approaches to the disclosure of ‘bad news’. PROGRESS IN PALLIATIVE CARE 2013. [DOI: 10.1179/1743291x11y.0000000004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Arabiat D, Alqaissi N, Hamdan-Mansour A. Children's knowledge of cancer diagnosis and treatment: Jordanian mothers' perceptions and satisfaction with the process. Int Nurs Rev 2011; 58:443-9. [DOI: 10.1111/j.1466-7657.2011.00899.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Affiliation(s)
- Susan Shaw
- Faculty of Health and Environmental Sciences, AUT University, New Zealand
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Parsons SK, Saiki-Craighill S, Mayer DK, Sullivan AM, Jeruss S, Terrin N, Tighiouart H, Nakagawa K, Iwata Y, Hara J, Grier HE, Block S. Telling children and adolescents about their cancer diagnosis: cross-cultural comparisons between pediatric oncologists in the US and Japan. Psychooncology 2006; 16:60-8. [PMID: 16874746 DOI: 10.1002/pon.1048] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE Over the last 50 years, direct communication about cancer with adults has shifted from an approach of not telling to one of telling. Less is known about communication practices with children. The purpose of this study is to (1) describe patterns of communication at diagnosis between pediatric oncologists and children with cancer and (2) compare cultural differences in these practices in the US and Japan. METHODS This 2003 survey, developed in English and translated into Japanese was mailed to members of the American Society of Pediatric Hematology/Oncology and the two Japanese Societies of Pediatric Hematology and Oncology; there were 350 US and 362 Japanese respondents. Descriptive statistics and logistic regressions were performed. RESULTS US physicians had a consistent pattern of telling children (65% always told the child; less than 1% rarely or never told). Japanese physicians had greater variability in their patterns of telling (with only 9.5% always telling, 34.5% rarely or never telling). Direct communication with the child was influenced by personal attitudes, patient factors, and work culture in both countries. Many more variables emerged as influencing Japanese physicians' communication practices than for US physicians. US physicians were influenced by their own sense of responsibility for telling, while Japanese physicians were more influenced by personal attitudes, patient factors, and work culture. CONCLUSIONS US and Japanese physicians differed when communicating directly with the child about his or her cancer. The impact of these practices on children and their parents should be explored and the parent and child's perspectives elicited. This information will help facilitate culturally sensitive patient and family centered communication.
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Affiliation(s)
- Susan K Parsons
- Center on Child and Family Outcomes, Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, Boston, MA 02111, USA.
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