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Shrestha S, Sapkota S, Teoh SL, Kc B, Paudyal V, Lee SWH, Gan SH. Comprehensive assessment of pain characteristics, quality of life, and pain management in cancer patients: a multi-center cross-sectional study. Qual Life Res 2024:10.1007/s11136-024-03725-w. [PMID: 39105961 DOI: 10.1007/s11136-024-03725-w] [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: 06/19/2024] [Indexed: 08/07/2024]
Abstract
INTRODUCTION Pain is the most common complaint among cancer patients, significantly impairing their health-related quality of life (HRQOL). There is limited evidence on the characteristics of pain among cancer patients in Nepal with low-resource settings. OBJECTIVES The primary objective of this study was to evaluate the clinical characteristics of pain, factors influencing pain intensity, and the association of pain severity with quality of life (QoL) among cancer patients. Secondary objectives included investigating perceived barriers to pain management and medication adherence among these patients. METHODS This multi-center, cross-sectional study enrolled adult patients (over 18 years old) with reported cancer diagnoses experiencing pain. Socio-demographic characteristics (e.g., age, gender, educational status), clinical characteristics (e.g. cancer diagnosis, staging), and pain characteristics (e.g., duration, type, location, medicines used for pain management, etc.) were recorded. Outcomes were assessed using the Numeric rating scale (NRS), Pain management Index, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire, Barriers Questionnaire II, Medication Adherence Rating Scale, and Hospital Anxiety and Depression Scale. RESULTS Four hundred and eight patients participated in the study. The mean ± SD age was 54.87 ± 15.65, with 226 patients (55.4%) being female. The most common cancer diagnoses were cervical (17.6%), lung (11.8%), and colon/rectum (12.0%) cancers. The most common pain locations were the head and neck (27.0%); a majority (55.6%) reported pain duration of more than 3 months. Nociceptive pain was reported by 42.4% of patients; the mean ± SD of NRS was 4.31 ± 2.69, with 32.4% of patients experiencing moderate pain. Patients with mixed pain type (B = 1.458, p < 0.001) or pain in multiple sites (B = 1.175, p < 0.001), lower Karnofsky Performance Status (KPS) (B = -1.308, p < 0.001), and specific cancer diagnoses such as prostate (B = -2.045, p = 0.002), pancreatic (B = 1.852, p = 0.004), oesophageal (B = 1.674, p = 0.012), and ovarian cancer (B = 1.967, p = 0.047), experienced varying degrees of increased NRS score. The combined chemotherapy and radiotherapy treatment modality was associated with a lower NRS score (B = -0.583, p = 0.017). A significant inverse relationship was observed between pain severity and global health status/QoL (B = -37.36, p < 0.001. Key barriers to pain management included moderate perceptions of physiological effects, communication issues between doctors and patients, and concerns about the harmful effects of pain medicine. The prevalence of non-adherence to pain medications was 13.97%. CONCLUSION In conclusion, this study highlights the multi-faceted nature of pain management and QoL for cancer patients in Nepal with low-resource settings. These findings underscore the multifactorial nature of pain perception in cancer patients, with mixed pain types, pain in multiple sites, lower KPS, and specific cancer diagnoses, all contributing significantly to pain severity. Additionally, pain severity was associated with declining QoL. These findings contribute valuable insights into the complex aspects of cancer pain and its broader implications for the well-being of patients, offering a foundation for targeted interventions and improved pain management strategies in the context of cancer care in low-resource settings.
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Affiliation(s)
- Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia.
| | - Simit Sapkota
- Department of Clinical Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Bagmati Province, Nepal
- Department of Clinical Oncology, Civil Service Hospital, Minbhawan, Kathmandu, Bagmati Province, Nepal
| | - Siew Li Teoh
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia
| | - Bhuvan Kc
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
- College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Vibhu Paudyal
- School of Pharmacy, College of Medical and Dental 21 Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham Edgbaston, Birmingham, B15 2TT, UK
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia
- Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well Being Cluster, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
- Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Siew Hua Gan
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, 47500, Malaysia
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Mihiretie EA, Siyum TS, Tamene FB. Adequacy of cancer-related pain management using the Pain Management Index among patients with cancer in the Northwest oncology centres of Ethiopia: an institutional-based cross-sectional study. BMJ Open 2024; 14:e081744. [PMID: 38331858 PMCID: PMC10860025 DOI: 10.1136/bmjopen-2023-081744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVE The aim of this study was to assess the adequacy of cancer-related pain (CRP) management and associated factors among patients with cancer in the Northwest oncology centres of Ethiopia. DESIGN AND SETTING An institutional-based multicentre cross-sectional study was conducted among patients with cancer in the Northwest oncology centres of Ethiopia from May to July 2022. PARTICIPANTS All oncology patients at selected hospitals who fulfilled the inclusion criteria during the data collection period were the study population. MAIN OUTCOME MEASURES The main outcome of this study was the adequacy of CRP management, which was measured by the Pain Management Index (PMI). A systematic random sampling technique was used to select representatives from each study area. Data entry and analysis were done using EpiData V.4.6.1 and SPSS V.26, respectively. Binary logistic regression was conducted to determine independent predictors of the adequacy of CRP management. A p value of <0.05 was considered statistically significant. RESULTS From a total of 422 included respondents, about 67.5% of the participants had adequate CRP management (95% CI 62.8 to 72). Good performance status (adjusted OR (AOR)=0.44; 95% CI 0.24 to 0.80), presence of comorbidity (AOR=3.28; 95% CI 1.68 to 6.38) and pain history (AOR=0.33; 95% CI 0.01 to 0.11) were significantly associated with the adequacy of cancer pain management. CONCLUSION Using PMI status in the Northwest oncology centre of Ethiopia, more than two-thirds of patients with CRP obtained adequate pain management. The adequacy of CRP management was found to be influenced by factors like comorbidity, past pain history and Eastern cooperative oncology group performance status.
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Affiliation(s)
- Endalamaw Aschale Mihiretie
- Department of Pharmacy, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Amhara, Ethiopia
| | | | - Fasil Bayafers Tamene
- Department of Pharmacy, Debre Markos University College of Health Science, Debre Markos, Ethiopia
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Ghali ENHK, Pranav, Chauhan SC, Yallapu MM. Inulin-based formulations as an emerging therapeutic strategy for cancer: A comprehensive review. Int J Biol Macromol 2024; 259:129216. [PMID: 38185294 PMCID: PMC10922702 DOI: 10.1016/j.ijbiomac.2024.129216] [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: 07/07/2023] [Revised: 12/06/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
Cancer stands as the second leading cause of death in the United States (US). Most chemotherapeutic agents exhibit severe adverse effects that are attributed to exposure of drugs to off-target tissues, posing a significant challenge in cancer therapy management. In recent years, inulin, a naturally occurring prebiotic fiber has gained substantial attention for its potential in cancer treatment owing to its multitudinous health values. Its distinctive structure, stability, and nutritional properties position it as an effective adjuvant and carrier for drug delivery in cancer therapy. To address some of the above unmet clinical issues, this review summarizes the recent efforts towards the development of inulin-based nanomaterials and nanocomposites for healthcare applications with special emphasis on the multifunctional role of inulin in cancer therapy as a synergist, signaling molecule, immunomodulatory and anticarcinogenic molecule. Furthermore, the review provides a concise overview of ongoing clinical trials and observational studies associated with inulin-based therapy. In conclusion, the current review offers insights on the significant role of inulin interventions in exploring its potential as a therapeutic agent to treat cancer.
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Affiliation(s)
- Eswara Naga Hanuma Kumar Ghali
- Department of Immunology and Microbiology, School of Medicine, The University of Texas Rio Grande Valley, McAllen, TX 78504, USA; South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX 78504, USA
| | - Pranav
- Department of Immunology and Microbiology, School of Medicine, The University of Texas Rio Grande Valley, McAllen, TX 78504, USA; South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX 78504, USA
| | - Subhash C Chauhan
- Department of Immunology and Microbiology, School of Medicine, The University of Texas Rio Grande Valley, McAllen, TX 78504, USA; South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX 78504, USA.
| | - Murali M Yallapu
- Department of Immunology and Microbiology, School of Medicine, The University of Texas Rio Grande Valley, McAllen, TX 78504, USA; South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX 78504, USA.
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Li Y, Wang Q, Liu C, Hu X. Symptom clusters and their impact on quality of life among Chinese patients with lung cancer: A cross-sectional study. Eur J Oncol Nurs 2023; 67:102465. [PMID: 37956567 DOI: 10.1016/j.ejon.2023.102465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE To investigate the symptom clusters of Chinese patients with lung cancer, and explore their impact on quality of life (QoL) and each of its functioning. METHOD A cross-sectional study was conducted between October 2022 and April 2023 among 219 lung cancer patients at a general hospital in Sichuan Province. Data were collected using a general information questionnaire, the MD Anderson Symptom Inventory, and the EORTC QLQ-C30. R within the RStudio platform was used to conduct descriptive statistics, exploratory factor analysis and multiple regression analysis. RESULTS Psychoneurological, respiratory, gastrointestinal and fatigue-related symptom clusters were identified, each of which was significantly negatively correlated with overall QoL, global health status/QoL and each functioning. The respiratory (β = -0.60, P = 0.02) and fatigue-related symptom cluster (β = -0.86, P = 0.02) were predictors of global health status/QoL; the fatigue-related symptom cluster predicted physical (β = -1.68, P < 0.01), role (β = -1.63, P < 0.01) and cognitive functioning (β = -1.45, P < 0.01); the psychoneurological symptom cluster was a predictor of patients' emotional functioning (β = -1.26, P < 0.01); and the psychoneurological (β = -0.81, P < 0.01) and gastrointestinal symptom cluster (β = -0.60, P = 0.05) predicted social functioning. CONCLUSIONS Respiratory and fatigue-related symptom clusters were strong predictors of global health status/QoL; fatigue-related, psychoneurological and gastrointestinal symptom clusters had a negative impact on patients' functioning. Nurse practitioners should pay more attention to monitoring respiratory and fatigue-related symptom clusters to identify high-risk populations in time, and tailored interventions based on symptom clusters are needed to synergistically reduce the symptom burden, thereby improving patients' QoL.
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Affiliation(s)
- Yunhuan Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China
| | - Qi Wang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China
| | - Chunhua Liu
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China; Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Chengdu, Sichuan, PR China.
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He CC, Lin DM, Liu HZ, Wang FF, Guo XF, Zhang XB, Ai YQ, Meng LM. Nonpharmacological Interventions for Management of the Pain-Fatigue-Sleep Disturbance Symptom Cluster in Breast Cancer Patients: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. J Pain Res 2023; 16:2713-2728. [PMID: 37577159 PMCID: PMC10417742 DOI: 10.2147/jpr.s409798] [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: 02/23/2023] [Accepted: 07/09/2023] [Indexed: 08/15/2023] Open
Abstract
Background The pain-fatigue-sleep disturbance symptom cluster is commonly experienced by breast cancer patients, and a variety of nonpharmacological interventions are used to treat this symptom cluster. Objective To compare the efficacy of nonpharmacological interventions in improving the symptoms of the pain-fatigue-sleep disturbance symptom cluster in breast cancer patients. Methods A comprehensive literature search was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL, CNKI, and Wanfang databases to identify randomized controlled studies from database inception to May 2022. Two reviewers independently performed data retrieval and risk of bias assessments. The consistency model was used to conduct network meta-analyses (NMA) based on the frequentist framework to assess the interventions, which were ranked by the surface under the cumulative ranking curve (SUCRA). Finally, the CINeMA application was used to evaluate the results of the NMA and the evidence of quality. The results Twenty-three eligible studies assessing 14 interventions were included. According to SUCRA values, among the management effects of the three symptoms, the effect of progressive muscle relaxation (PMR) ranked first, followed by mindfulness-based stress reduction (MBSR). The overall evidence quality of our study ranges from very low to moderate. Conclusion PMR and MBSR were effective interventions for the pain-fatigue-sleep disturbance symptom cluster in breast cancer patients. Clinical recommendations prioritize PMR for symptom management, followed by MBSR. However, this should be interpreted cautiously, as the confidence in the evidence was not high.
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Affiliation(s)
- Cong-Cong He
- School of Nursing, Gannan Medical University, Ganzhou City, Jiangxi Province, People’s Republic of China
| | - Dong-Mei Lin
- School of Nursing, Gannan Medical University, Ganzhou City, Jiangxi Province, People’s Republic of China
| | - Hui-Zhen Liu
- School of Nursing, Gannan Medical University, Ganzhou City, Jiangxi Province, People’s Republic of China
| | - Fei-Fei Wang
- School of Nursing, Gannan Medical University, Ganzhou City, Jiangxi Province, People’s Republic of China
| | - Xiu-Fang Guo
- School of Nursing, Gannan Medical University, Ganzhou City, Jiangxi Province, People’s Republic of China
| | - Xiao-Bo Zhang
- School of Nursing, Gannan Medical University, Ganzhou City, Jiangxi Province, People’s Republic of China
| | - Yi-Qin Ai
- School of Nursing, Gannan Medical University, Ganzhou City, Jiangxi Province, People’s Republic of China
| | - Li-Min Meng
- School of Nursing, Gannan Medical University, Ganzhou City, Jiangxi Province, People’s Republic of China
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Tian F, Chen Z, Wu B. Development and validation of a nomogram to predict the risk of potentially inappropriate medication use in older lung cancer outpatients with multimorbidity. Expert Opin Drug Saf 2023; 22:725-732. [PMID: 36803141 DOI: 10.1080/14740338.2023.2183191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/14/2023] [Accepted: 01/30/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND At present, there is no predictive model that can predict the prevalence of potentially inappropriate medication (PIM) use in older lung cancer outpatients. RESEARCH DESIGN AND METHODS We measured PIM by the 2019 Beers criteria. Significant factors were identified to develop the nomogram using logistic regression. We validated the nomogram internally and externally in two cohorts. The discrimination, calibration, and clinical practicability of the nomogram were verified using receiver operating characteristic (ROC) curve analysis, Hosmer-Lemeshow test, and decision curve analysis (DCA), respectively. RESULTS A total of 3300 older lung cancer outpatients were divided into a training cohort (n = 1718) and two validation cohorts, including an internal validation cohort (n = 739) and an external validation cohort (n = 843). A nomogram for predicting PIM use patients was developed using six significant factors. ROC curve analysis showed that the area under the curve was 0.835 in the training cohort and 0.810 and 0.826 in the internal validation and external validation cohorts, respectively. The Hosmer‒Lemeshow test yielded P = 0.180, 0.779 and 0.069, respectively. The nomogram demonstrated a high net benefit in DCA. CONCLUSIONS The nomogram could be a convenient, intuitive, and personalized clinical tool for assessing the risk of PIM in older lung cancer outpatients.
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Affiliation(s)
- Fangyuan Tian
- Department of Pharmacy, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhaoyan Chen
- Department of Pharmacy, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bin Wu
- Department of Pharmacy, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Tang JH, Wing YK, Chan JWY, Lo RSK. Bright Light Therapy for Cancer-related Fatigue in a Palliative Care Unit: A Feasibility Study. J Pain Symptom Manage 2023; 65:e237-e240. [PMID: 36441072 DOI: 10.1016/j.jpainsymman.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/29/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Affiliation(s)
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Joey W Y Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR.
| | - Raymond S K Lo
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR.
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Paschos S, Lize N, Eussen S, van der Padt-Pruijsten A, van den Beuken-van Everdingen M, van Laarhoven H, den Boer M, de Graeff A, van den Borne B, Ten Have H, Kennis M, Beijer S, Raijmakers NJH, van de Poll-Franse L. Are gastrointestinal problems, nutritional care, and nutritional care needs associated with quality of life in patients with advanced cancer? Results of the observational eQuiPe study. Support Care Cancer 2023; 31:189. [PMID: 36847908 DOI: 10.1007/s00520-023-07646-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/15/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE To assess the association of gastrointestinal problems, received nutritional care, and nutritional care needs with quality of life (QoL) in patients with advanced cancer. METHODS A cross-sectional analysis within the observational prospective eQuiPe cohort study on experienced quality of care and QoL in patients with advanced cancer was performed. QoL and gastrointestinal problems were measured using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30. Received nutritional care (yes/no) and nutritional care needs (yes/a little bit/no) were measured by two questions. Gastrointestinal problems were categorized as clinically important based on the Giesinger thresholds. Univariable and multivariable linear regression analyses adjusted for age, gender, and treatment were used to analyze the association of gastrointestinal problems, received nutritional care, and nutritional care needs with QoL. RESULTS Half of the 1080 patients with advanced cancer had clinically important gastrointestinal problems, 17% experienced nutritional care needs, and 14% received nutritional care. Multivariable analyses revealed that the presence of clinically important gastrointestinal problems (β (95% CI): -13.0 (-15.6; -10.4)), received nutritional care (β (95% CI): -5.1 (-8.5; -1.7)), and nutritional care needs (β (95% CI): -8.7 (-11.9; -5.5)) were associated with a low QoL. CONCLUSION Many patients with advanced cancer experience gastrointestinal problems, while only few patients receive nutritional care. These gastrointestinal problems, nutritional care needs, and nutritional care are associated with lower QoL, probably due to reversed causality or the irreversible nature of these problems in the palliative phase. More research on the relation of nutritional care, gastrointestinal problems, and QoL is needed to optimize nutritional support in end-of-life care.
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Affiliation(s)
- Savvas Paschos
- Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501DB, Utrecht, the Netherlands
| | - Nora Lize
- Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501DB, Utrecht, the Netherlands
| | - Simone Eussen
- Department of Epidemiology of the Faculty of Health, Medicine and Life Sciences, School for Cardiovascular Diseases (CARIM) and Care and Public Health Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | | | | | - Hanneke van Laarhoven
- Amsterdam University Medical Centers, Department of Medical Oncology, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Alexander de Graeff
- Department of Medical Oncology, UMC Utrecht Medical Center, Utrecht, the Netherlands
| | - Ben van den Borne
- Department of Pulmonology, Catharina Hospital, Eindhoven, the Netherlands
| | | | - Marjolanda Kennis
- Institution Verbeeten, Tilburg, the Netherlands
- General Practice Klein Vlijmen, Vlijmen, the Netherlands
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501DB, Utrecht, the Netherlands
| | - Natasja J H Raijmakers
- Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501DB, Utrecht, the Netherlands.
- Netherlands Association for Palliative Care (PZNL), Utrecht, the Netherlands.
| | - Lonneke van de Poll-Franse
- Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501DB, Utrecht, the Netherlands
- Netherlands Cancer Institute, Amsterdam, the Netherlands
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
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Li H, Lockwood MB, Schlaeger JM, Liu T, Danciu OC, Doorenbos AZ. Tryptophan and Kynurenine Pathway Metabolites and Psychoneurological Symptoms Among Breast Cancer Survivors. Pain Manag Nurs 2023; 24:52-59. [PMID: 36229337 PMCID: PMC9925397 DOI: 10.1016/j.pmn.2022.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Among breast cancer survivors, pain, fatigue, depression, anxiety, and sleep disturbance are common psychoneurological symptoms that cluster together. Inflammation-induced activation of the tryptophan-kynurenine metabolomic pathway may play an important role in these symptoms. AIMS This study investigated the relationship between the metabolites involved in the tryptophan-kynurenine pathway and psychoneurological symptoms among breast cancer survivors. DESIGN Cross-sectional study. SETTING Participants were recruited at the oncology clinic at the University of Illinois Hospital & Health Sciences System. PARTICIPANTS/SUBJECTS 79 breast cancer survivors after major cancer treatment. METHODS We assessed psychoneurological symptoms with the PROMIS-29 and collected metabolites from fasting blood among breast cancer survivors after major cancer treatment, then analyzed four major metabolites involved in the tryptophankynurenine pathway (tryptophan, kynurenine, kynurenic acid, and quinolinic acid). Latent profile analysis identified subgroups based on the five psychoneurological symptoms. Mann-Whitney U tests and multivariable logistic regression compared targeted metabolites between subgroups. RESULTS We identified two distinct symptom subgroups (low, 81%; high, 19%). Compared with participants in the low symptom subgroup, patients in the high symptom subgroup had higher BMI (p = .024) and were currently using antidepressants (p = .008). Using multivariable analysis, lower tryptophan levels (p = .019) and higher kynurenine/tryptophan ratio (p = .028) were associated with increased risk of being in the high symptom subgroup after adjusting for BMI and antidepressant status. CONCLUSION The tryptophan-kynurenine pathway and impaired tryptophan availability may contribute to the development of psychoneurological symptoms.
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Affiliation(s)
- Hongjin Li
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois.
| | - Mark B Lockwood
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois
| | - Judith M Schlaeger
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois
| | - Tingting Liu
- College of Nursing, Florida State University, Tallahassee, Florida
| | - Oana C Danciu
- College of Medicine, University of Illinois Chicago, Chicago, Illinois
| | - Ardith Z Doorenbos
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois
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Snijders RAH, Brom L, Theunissen M, van den Beuken-van Everdingen MHJ. Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis. Cancers (Basel) 2023; 15:591. [PMID: 36765547 PMCID: PMC9913127 DOI: 10.3390/cancers15030591] [Citation(s) in RCA: 74] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 01/20/2023] Open
Abstract
Experiencing pain and insufficient relief can be devastating and negatively affect a patient's quality of life. Developments in oncology such as new treatments and adjusted pain management guidelines may have influenced the prevalence of cancer pain and severity in patients. This review aims to provide an overview of the prevalence and severity of pain in cancer patients in the 2014-2021 literature period. A systematic literature search was performed using the databases PubMed, Embase, CINAHL, and Cochrane. Titles and abstracts were screened, and full texts were evaluated and assessed on methodological quality. A meta-analysis was performed on the pooled prevalence and severity rates. A meta-regression analysis was used to explore differences between treatment groups. We identified 10,637 studies, of which 444 studies were included. The overall prevalence of pain was 44.5%. Moderate to severe pain was experienced by 30.6% of the patients, a lower proportion compared to previous research. Pain experienced by cancer survivors was significantly lower compared to most treatment groups. Our results imply that both the prevalence of pain and pain severity declined in the past decade. Increased attention to the assessment and management of pain might have fostered the decline in the prevalence and severity of pain.
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Affiliation(s)
- Rolf A. H. Snijders
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research & Development, 3511 DT Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), 3511 DT Utrecht, The Netherlands
| | - Linda Brom
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research & Development, 3511 DT Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), 3511 DT Utrecht, The Netherlands
| | - Maurice Theunissen
- Centre of Expertise for Palliative Care, Maastricht University Medical Centre+ (MUMC+), 6229 HX Maastricht, The Netherlands
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Centre+ (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Marieke H. J. van den Beuken-van Everdingen
- Centre of Expertise for Palliative Care, Maastricht University Medical Centre+ (MUMC+), 6229 HX Maastricht, The Netherlands
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Centre+ (MUMC+), 6229 HX Maastricht, The Netherlands
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Hansen MB, Adsersen M, Rojas-Concha L, Petersen MA, Ross L, Groenvold M. Nausea at the start of specialized palliative care and change in nausea after the first weeks of palliative care were associated with cancer site, gender, and type of palliative care service-a nationwide study. Support Care Cancer 2022; 30:9471-9482. [PMID: 35960379 DOI: 10.1007/s00520-022-07310-0] [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: 04/21/2022] [Accepted: 08/01/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE Nausea is a common and distressful symptom among patients in palliative care, but little is known about possible socio-demographic and clinical patient characteristics associated with nausea at the start of palliative care and change after initiation of palliative care. The aim of this study was to investigate whether patient characteristics were associated with nausea at the start of palliative care and with change in nausea during the first weeks of palliative care, respectively. METHODS Data was obtained from the nationwide Danish Palliative Care Database. The study included adult cancer patients who were admitted to palliative care and died between June 2016 and December 2020 and reported nausea level at the start of palliative care and possibly 1-4 weeks later. The associations between patient characteristics and nausea at the start of palliative care and change in nausea during palliative care, respectively, were studied using multiple regression analyses. RESULTS Nausea level was reported at the start of palliative care by 23,751 patients of whom 8037 also reported 1-4 weeks later. Higher nausea levels were found for women, patients with stomach or ovarian cancer, and inpatients at the start of palliative care. In multivariate analyses, cancer site was the variable most strongly associated with nausea change; the smallest nausea reductions were seen for myelomatosis and no reduction was seen for stomach cancer. CONCLUSION This study identified subgroups with the highest initial nausea level and those with the least nausea reduction after 1-4 weeks of palliative care. These latter findings should be considered in the initial treatment plan.
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Affiliation(s)
- Maiken Bang Hansen
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg/Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, NV, DK-2400, Copenhagen, Denmark.
| | - Mathilde Adsersen
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg/Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, NV, DK-2400, Copenhagen, Denmark
| | - Leslye Rojas-Concha
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg/Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, NV, DK-2400, Copenhagen, Denmark
| | - Morten Aagaard Petersen
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg/Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, NV, DK-2400, Copenhagen, Denmark
| | - Lone Ross
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg/Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, NV, DK-2400, Copenhagen, Denmark
| | - Mogens Groenvold
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg/Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, NV, DK-2400, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, DK-1353, Copenhagen, Denmark
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Tian F, Chen Z, Chen X, Zhao M. Increasing Trends of Polypharmacy and Potentially Inappropriate Medication Use in Older Lung Cancer Patients in China: A Repeated Cross-Sectional Study. Front Pharmacol 2022; 13:935764. [PMID: 35924052 PMCID: PMC9340379 DOI: 10.3389/fphar.2022.935764] [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: 05/04/2022] [Accepted: 06/21/2022] [Indexed: 01/10/2023] Open
Abstract
Objectives: Polypharmacy and potentially inappropriate medication (PIM) use are frequent in older lung cancer patients. This study aimed to examine the trends of polypharmacy and PIM use and explore risk factors for PIM use based on the 2019 Beers criteria in older Chinese lung cancer outpatients with multimorbidity. Methods: A repeated cross-sectional study was conducted using electronic medical data consisting of the prescriptions of older lung cancer outpatients in China from January 2016 to December 2018. Polypharmacy was defined as the use of five or more medications. The 2019 Beers criteria were used to evaluate the PIM use of older cancer outpatients (age ≥65 years), and multivariate logistic regression was used to identify the risk factors for PIM use. Results: A total of 3,286 older lung cancer outpatients and their prescriptions were included in the study. The prevalence of polypharmacy was 14.27% in 2016, 16.55% in 2017, and 18.04% in 2018. The prevalence of PIM use, according to the 2019 Beers criteria, was 31.94% in 2016, 35.78% in 2017, and 42.67% in 2018. The two most frequently used PIMs in older lung cancer outpatients were estazolam and tramadol. The logistic regression demonstrated that age 75 to 79, polypharmacy, irrational use of drugs, and lung cancer accompanied by sleep disorders, anxiety or depression, or pain were positively associated with PIM use in older lung cancer outpatients. Conclusion: The prevalence of polypharmacy and PIM use in older lung cancer outpatients with multimorbidity was high in China, and polypharmacy and PIM use increased over time. Further research on interventions rationing PIM use in the older lung cancer patient population is needed.
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Affiliation(s)
- Fangyuan Tian
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- *Correspondence: Fangyuan Tian,
| | - Zhaoyan Chen
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Xi Chen
- Department of Integrated Care Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Mengnan Zhao
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
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Al Qadire M, Al Omari O, Alaloul F, Musa A, Aloush S. Assessment of symptoms among among patients living with cancer: prevalence, distress and its correlation with quality of life. Int J Palliat Nurs 2022; 28:270-279. [PMID: 35727829 DOI: 10.12968/ijpn.2022.28.6.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: Several symptoms known to be experienced by cancer patients receiving palliative care remain under-reported, inadequately managed and unexplored in Jordan. Aim: To describe the prevalence of symptoms, the distress caused and the correlation with quality-of-life among cancer patients receiving palliative care in Jordan. Methods: A cross-sectional correlational survey design was used. The Rotterdam Symptom Checklist and the Quality-of-Life Index-Cancer version were used for data collection. Data were analysed using descriptive statistics, unpaired t-test and Pearson correlation coefficients. Results: The sample comprises of 124 patients with a mean age of 55.7 years (SD=12.9). A total of 57.3% of them were females. Patients reported having an average of 17.3 (SD=7.1) symptoms. The most reported symptoms were tiredness (90.3%), lack of energy (81.5%), sore muscles (81.5%) and worry (76.6%). The mean total score for quality of life was 17.9 (SD=5.9) out of 30. A negative (P<0.05) relationship was found between the number of concurrent symptoms and the total quality of life score. Conclusions: Palliative care patients in Jordan reported a high number of co-occurring symptoms and experienced high levels of symptom distress, which negatively impacted their quality of life. Further research to evaluate the impact of total symptom management, its efficacy and feasibility is needed.
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Affiliation(s)
- Mohammad Al Qadire
- Professor, College of Nursing, Sultan Qaboos University, Sultanate of Oman; Adult Health Department, Al Al-Bayt University, Jordan
| | - Omar Al Omari
- Associate Professor, Sultan Qaboos University, Sultanate of Oman
| | - Fawwaz Alaloul
- Associate Professor, Sultan Qaboos University, Sultanate of Oman
| | - Ahmad Musa
- Associate Professor, Al Al-Bayt University, Jordan
| | - Sami Aloush
- Associate Professor, Al Al-Bayt University, Jordan
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Prakash S, Chakrabarti D, Kumar R, Agrawal MM, Verma M, Singh S, Gupta S, Srivastava K, Gupta R, Bhatt MLB. Palliative radiotherapy: a one-week course in advanced head and neck cancer - quality of life outcomes. BMJ Support Palliat Care 2022:bmjspcare-2021-002908. [PMID: 35428653 DOI: 10.1136/bmjspcare-2021-002908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/04/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Palliative radiotherapy regimens for advanced head and neck cancers vary in doses and treatment times. Their quality of life (QoL) implications are not clearly established. METHODS We randomised patients with advanced, non-metastatic, head and neck squamous cell carcinomas (stage IVA-B) with WHO performance score of 2 or higher to receive 30 Gy in 10 fractions over two weeks (arm A) or 20 Gy in 5 fractions over one week (arm B). QoL was assessed using European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaires (QLQ)-C30 and QLQ-H&N35 questionnaires at baseline and postradiotherapy. The primary endpoint was the EORTC-defined global health status. Secondary endpoints were functional and symptom scores of QoL, response to radiotherapy and acute toxicities. The primary aim was to evaluate the one-week regimen in terms of QoL to the longer regimen. RESULTS 110 patients were randomised, the number of patients in the final analysis was 95: 49 in arm A and 46 in arm B. Baseline characteristics were similar. Clinical outcomes post-treatment were comparable. Postradiotherapy, there were improved scores for functional and symptom scales, the differences were non-significant. The duration of treatment was significantly reduced in arm B (p<0.01) with a lower score for financial difficulty (p<0.001). The difference in global health status (primary endpoint) was non-significant (p=0.82). The median overall survival was 7 months, the median progression-free survival was 5 months and these did not vary between the two groups. CONCLUSION One-week palliative radiotherapy for head and neck cancers achieves similar QoL and clinical outcomes as more protracted radiotherapy schedules with significantly reduced treatment time and financial toxicity.
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Affiliation(s)
- Sadanand Prakash
- Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Deep Chakrabarti
- Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rajendra Kumar
- Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Manas Mani Agrawal
- Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Mrinalini Verma
- Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sudhir Singh
- Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Seema Gupta
- Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Kirti Srivastava
- Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rajeev Gupta
- Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
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Fu HJ, Zhou H, Tang Y, Li J, Zhang D, Ding SY, Huang QW, Wang C. Tai Chi and other mind-body interventions for cancer-related fatigue: an updated systematic review and network meta-analyses protocol. BMJ Open 2022; 12:e052137. [PMID: 34996789 PMCID: PMC8744122 DOI: 10.1136/bmjopen-2021-052137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Fatigue is one of the most common symptoms in patients with cancer and is responsible for a reduced quality of life. There is a strong evidence base for mind-body interventions (MBIs) to manage cancer-related fatigue (CRF). However, the efficacy of Tai Chi and other MBIs in the treatment of CRF remains controversial. METHODS AND ANALYSIS We will perform a systematic review and network meta-analyses (NMAs) that aim to assess the effects of Tai Chi and other MBIs in patients with CRF. The following databases will be searched from their inception to 1 August 2021: PubMed, EMBASE, Scopus, OVID, Web of Science, Cochrane Central Register of Controlled Trials, the China National Knowledge Infrastructure, China Science and Technology Journal Database, Chinese Biomedical Database and Wan Fang Digital Journals. We will include randomised controlled trials that compare MBIs with no treatment, placebo and usual care in the treatment of CRF. The primary outcome will be changes in the fatigue state as evaluated by validated scales. We will perform a Bayesian NMA to analyse all the evidence for each outcome. The surface under the cumulative ranking curve and the mean ranks will be used to rank the various treatments. We will assess the quality of evidence contributing to network estimates of outcomes using the Grading of Recommendations Assessment, Development and Evaluation system framework. ETHICS AND DISSEMINATION This NMAs will be disseminated through publication in a peer-reviewed journal. Since no individual patient data will be involved in the review, ethics approval and concerns about privacy are not needed. PROSPERO REGISTRATION NUMBER CRD42021244999.
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Affiliation(s)
- Hong-Juan Fu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine Shierqiao Campus, Chengdu, China
- Sichuan Integrative Medicine Hospital, Chengdu, China
| | - Hao Zhou
- Sichuan Integrative Medicine Hospital, Chengdu, China
| | - Yong Tang
- Acupuncture-Moxibustion School, Chengdu University of Traditional Chinese Medicine Affiliated Hospital, Chengdu, China
| | - Jie Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine Shierqiao Campus, Chengdu, China
| | - Da Zhang
- Sichuan Integrative Medicine Hospital, Chengdu, China
| | - Song-Yi Ding
- Sichuan Integrative Medicine Hospital, Chengdu, China
| | - Qin-Wan Huang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chao Wang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine Shierqiao Campus, Chengdu, China
- Sichuan Integrative Medicine Hospital, Chengdu, China
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Kemp JA, Kwon YJ. Cancer nanotechnology: current status and perspectives. NANO CONVERGENCE 2021; 8:34. [PMID: 34727233 PMCID: PMC8560887 DOI: 10.1186/s40580-021-00282-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/05/2021] [Indexed: 05/09/2023]
Abstract
Modern medicine has been waging a war on cancer for nearly a century with no tangible end in sight. Cancer treatments have significantly progressed, but the need to increase specificity and decrease systemic toxicities remains. Early diagnosis holds a key to improving prognostic outlook and patient quality of life, and diagnostic tools are on the cusp of a technological revolution. Nanotechnology has steadily expanded into the reaches of cancer chemotherapy, radiotherapy, diagnostics, and imaging, demonstrating the capacity to augment each and advance patient care. Nanomaterials provide an abundance of versatility, functionality, and applications to engineer specifically targeted cancer medicine, accurate early-detection devices, robust imaging modalities, and enhanced radiotherapy adjuvants. This review provides insights into the current clinical and pre-clinical nanotechnological applications for cancer drug therapy, diagnostics, imaging, and radiation therapy.
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Affiliation(s)
- Jessica A Kemp
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA, 92697, USA
| | - Young Jik Kwon
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA, 92697, USA.
- Department of Chemical and Biomolecular Engineering, School of Engineering, University of California, Irvine, CA, 92697, USA.
- Department of Biomedical Engineering, School of Engineering, University of California, Irvine, CA, 92697, USA.
- Department of Molecular Biology and Biochemistry, School of Biological Sciences, University of California, Irvine, CA, 92697, USA.
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Li JJ, Li JR, Wu JM, Song YX, Hu SH, Hong JF, Wang W. Change in symptom clusters perioperatively in patients with lung cancer. Eur J Oncol Nurs 2021; 55:102046. [PMID: 34710809 DOI: 10.1016/j.ejon.2021.102046] [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: 07/07/2021] [Revised: 10/01/2021] [Accepted: 10/05/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To describe the trajectory, number, and types of symptom clusters at three time points (i.e., day of admission [T1], 2-4 days postoperatively [T2], and 1 month postoperatively [T3]) using ratings of symptom occurrence and severity and to identify the changes in these symptom clusters over time in patients with lung cancer. METHODS We analysed the data of 217 lung cancer patients who received surgical treatment at a tertiary hospital affiliated to Anhui Medical University, in Hefei City, China. The occurrence and severity of 19 symptoms at all points of measurement were measured using the general and lung cancer modules of the M.D. Anderson Symptom Inventory. Exploratory factor analysis was performed to extract the symptom clusters. RESULTS Seven symptom clusters were identified across symptom dimensions. However, only three of them (i.e., lung cancer specific, sleep disturbance, and nervous system) were relatively stable across dimensions and time. Two symptom clusters varied over time but not with dimensions (nutritional and gastrointestinal). The other two symptom clusters (psychological and respiratory) differed in terms of time and dimensions. CONCLUSIONS Findings may provide insights into the seven identified clusters and overall stability of three symptom clusters in lung cancer patients perioperatively.
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Affiliation(s)
- Jing-Jing Li
- School of Nursing, Anhui Medical University, Hefei, China; Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - Jing-Ru Li
- School of Nursing, Anhui Medical University, Hefei, China
| | - Jing-Mei Wu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Yong-Xia Song
- School of Nursing, Anhui Medical University, Hefei, China
| | - Shao-Hua Hu
- Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jing-Fang Hong
- School of Nursing, Anhui Medical University, Hefei, China.
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Tang H, Chen L, Wang Y, Zhang Y, Yang N, Yang N. The efficacy of music therapy to relieve pain, anxiety, and promote sleep quality, in patients with small cell lung cancer receiving platinum-based chemotherapy. Support Care Cancer 2021; 29:7299-7306. [PMID: 34041615 DOI: 10.1007/s00520-021-06152-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/15/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Chemotherapy induces a range of physical and psychological symptoms, including pain, sleep disorders, fatigue, and anxiety. We aimed to assess the efficacy of six-step music therapy in relieving pain and anxiety and improving sleep quality in lung cancer patients receiving platinum-based chemotherapy. METHODS Between March 2013 and October 2015, we enrolled a total of 100 patients who were diagnosed with small cell lung cancer and scheduled for platinum-based chemotherapy. Patients were randomly assigned to two groups: the music therapy group (received six-step music therapy, n=50) and the control group (not received six-step music therapy, n=50). The anxiety, pain, and sleep quality of all patients were assessed using the self-rating anxiety scale (SAS), the visual analogue scale (VAS), and the Pittsburgh Sleep Quality Index (PSQI), respectively. RESULTS There were no significant differences in the demographic characteristics and music background between the two groups. The SAS and VAS scores in the two groups were not statistically different before chemotherapy. However, patients in the music therapy group showed significantly lower SAS and VAS scores compared with the control group at both 1 day and 5 days after chemotherapy. (SAS score at 1-day post-therapy, 49.48±2.14 vs 61.46±8.8, P=0.011; SAS score at 5-day post-therapy, 39.73±1.79 vs 62.02±8.83, P=0.005; VAS score at 1-day post-therapy, 2.14±0.78 vs 4.74±1.01, P=0.005; VAS score at 5-day post-therapy, 2.06±0.79 vs 4.74±1.08, P=0.004). In addition, the total PSQI score of patients who received music therapy was also significantly higher than that of the control group after therapy (total PSQI score at 1-day post-therapy, 8.50±1.69 vs 17.81±3.01, P=0.006; total PSQI score at 5-day post-chemotherapy, 9.84±3.02 vs 18.66±2.91, P=0.012). CONCLUSION The music therapy was an effective approach in alleviating pain and anxiety and promoting sleep quality in lung cancer patients receiving platinum-based chemotherapy. TRIAL REGISTRATION Chinese Clinical Trial Registry (registration number: ChiCTR-TRC-13003993).
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Affiliation(s)
- Haoke Tang
- Music Therapist of Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, Guangdong Province, People's Republic of China
| | - Liping Chen
- Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, Guangdong Province, People's Republic of China
| | - Yichun Wang
- Department of Critical Care Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, Guangdong Province, People's Republic of China
| | - Yongchang Zhang
- Department of Lung Cancer and Gastroenterology, Hunan Cancer Hospital, Changsha, 410013, Hunan Province, People's Republic of China
| | - Nong Yang
- Department of Lung Cancer and Gastroenterology, Hunan Cancer Hospital, Changsha, 410013, Hunan Province, People's Republic of China
| | - Ning Yang
- Department of Neurology, The Third Affiliated Hospital of Guangzhou Medical University, No.63, Duobao Road, Liwan District, Guangzhou, 510150, Guangdong Province, People's Republic of China.
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Effect of Traditional Chinese Medicine Injection on Cancer-Related Fatigue: A Meta-Analysis Based on Existing Evidence. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2020:2456873. [PMID: 33424984 PMCID: PMC7774033 DOI: 10.1155/2020/2456873] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/14/2020] [Accepted: 09/18/2020] [Indexed: 11/30/2022]
Abstract
Methods We systematically searched randomized controlled studies reported through March 2020 in PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, China Biomedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases. Two investigators independently screened the studies according to the predetermined criteria, extracted data, and evaluated the bias risk of the included studies, using RevMan5.3 software. Results Twelve studies enrolling 1005 participants were included in this systematic review. We found that TCMJ could improve the clinical efficacy of CRF patients (RR = 1.24, 95% CI: 1.05–1.46, P=0.01), ameliorate fatigue status (RR = 1.44, 95% CI: 1.27–1.65, P < 0.00001), and improve quality of life (MD = 8.34, 95% CI: 3.31–13.37, P=0.001), but there was no statistical significance in the fatigue score (MD = −1.10, 95% CI: −2.23–0.04, P=0.06). Referring to the number of adverse events, the safety of TCMJ was good. Subgroup analysis showed that TCMJ could improve clinical efficacy, fatigue, and quality of life in a short time (≤4 weeks). Among them, tonic TCMJ could improve the clinical efficacy. TCMJ had advantages in improving fatigue of lung cancer and gastric cancer. In addition, life quality of lung cancer patients improved significantly. Conclusion Current research evidence showed that TCMJ could improve the clinical efficacy, fatigue status, and life quality of patients with CRF. In addition, we found that TCMJ could improve the clinical efficacy of CRF patients in a short period of time. Tonic TCMJ could improve the clinical efficacy, but heat-clearing TCMJ could not. Life quality and fatigue status of lung cancer patients improved significantly. However, due to the sample size and quality of the included studies, the results of this analysis should be treated with caution. The above conclusions still need to be verified by more large-sample and high-quality randomized controlled trials.
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Agarwal S, Garg R, Minhas V, Bhatnagar S, Mishra S, Kumar V, Bharati SJ, Gupta N, Khan MA. To assess the Prevalence and Predictors of Cancer-related Fatigue and its Impact on Quality of Life in Advanced Cancer Patients Receiving Palliative Care in a Tertiary Care Hospital: A Cross-sectional Descriptive Study. Indian J Palliat Care 2020; 26:523-527. [PMID: 33623316 PMCID: PMC7888426 DOI: 10.4103/ijpc.ijpc_223_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/14/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Cancer-related fatigue (CRF) is one of the adverse outcomes of cancer and its treatment. Despite its high prevalence; the data are scarce from the Indian population on the prevalence of CRF and its predictors in advanced cancer patients. Hence, we aim to find the prevalence of the fatigue, its impact of fatigue on quality of life (QOL), and possible predictors. METHODS This study was conducted after approval of the ethical committee in adult patients of advanced cancer receiving palliative care. The data collected included demographic details, nutritional status, any comorbidities involving cardiorespiratory, renal, pulmonary, and neurological system, type and stage of cancer, site of metastasis, any previous or ongoing chemotherapy or radiotherapy, history of drug intake, hemoglobin, and albumin. The study parameters included assessment of fatigue, QOL, and symptom assessment as per the validated tools. The primary objective of the study was to find the prevalence of fatigue in advanced cancer patients receiving palliative care. The secondary objectives were to find predictive factors of fatigue, its impact on QOL of patients, and the relation between the fatigue and QOL receiving palliative care. The correlation between fatigue score and QOL was analyzed using Pearson's correlation coefficient. Multiple linear regression analysis was performed for identifying the predictors of CRF. RESULTS The fatigue was observed in all 110 patients in this study. Of these, severe fatigue was seen in 97 patients (Functional Assessment of Chronic Illness Therapy [FACIT]-F < 30). The median (interquartile range [IQR]) FACIT-F score was 14 (8-23). The median (IQR) of the overall QOL was 16.66 (16.6-50). The correlation between the fatigue (FACIT-F) and QOL was + 0.64 (P < 0.001). The predictors of fatigue included pain, physical functioning, Eastern Cooperative Oncology Group, tiredness, and the level of albumin. CONCLUSION We conclude that the prevalence of fatigue in Indian patients with advanced cancer receiving palliative care was high and it has a negative impact on QOL. Pain, physical functioning, performance status, and albumin were found to be independent predictors of CRF.
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Affiliation(s)
- Shilpi Agarwal
- Departments of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Garg
- Departments of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Varnika Minhas
- Departments of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Sushma Bhatnagar
- Departments of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Mishra
- Departments of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Vinod Kumar
- Departments of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Sachidanand Jee Bharati
- Departments of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Nishkarsh Gupta
- Departments of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, All India Institute of Medical Sciences, New Delhi, India
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Matsumura C, Koyama N, Sako M, Kurosawa H, Nomura T, Eguchi Y, Ohba K, Yano Y. Comparison of Patient Self-Reported Quality of Life and Health Care Professional-Assessed Symptoms in Terminally ill Patients With Cancer. Am J Hosp Palliat Care 2020; 38:283-290. [PMID: 32705893 DOI: 10.1177/1049909120944157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Few studies evaluated whether health care professionals accurately assess several symptoms for patients with cancer in palliative care units. We determined the agreement level for several symptoms related to quality of life (QOL) between patient-reported QOL assessment and health care professional-assessed symptoms based on the Support Team Assessment Schedule (STAS). METHOD An observational study was performed with terminally ill patients with cancer hospitalized in the palliative care unit between June 2018 and December 2019. Patients and health care professionals independently assessed 7 symptoms at the time of hospitalization and after 1 week. Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL). In examining the proportions of exact agreement, "exact agreement" referred to the pairs of the scores (QLQ-C15-PAL vs STAS) being (1 vs 0), (2 vs 1), (3 vs 2 or 3), or (4 vs 4). The relationships of physical functioning between QLQ-C15-PAL and Palliative Performance Scale (PPS) were examined. RESULTS Of 130 patients, approximately 60% had PPS scores from 40 to 60. The highest mean score on QLQ-C15-PAL was for fatigue (63.8). The exact agreement on symptoms between patients and health care professionals ranged from 15.4% (fatigue) to 57.7% (nausea and vomiting). The mean of the transformed QLQ-C15-PAL and proportions of exact agreement were negatively correlated (R 2 = 0.949, P < .05). The physical function scores in QLQ-C15-PAL for each PPS group showed no differences. CONCLUSION We expect patient-reported outcomes including QLQ-C15-PAL to be added to health care professionals' assessment of serious symptoms such as fatigue in terminally ill patients with cancer.
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Affiliation(s)
- Chikako Matsumura
- Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, Kyoto, Japan
| | - Nanako Koyama
- Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, Kyoto, Japan
| | - Morito Sako
- Department of Pharmacy, Tachibana Medical Corporation 38428Higashisumiyoshimorimoto Hospital, Osaka, Japan
| | - Hideo Kurosawa
- Department of Pharmacy, Tachibana Medical Corporation 38428Higashisumiyoshimorimoto Hospital, Osaka, Japan
| | - Takehisa Nomura
- Department of Pharmacy, Tachibana Medical Corporation 38428Higashisumiyoshimorimoto Hospital, Osaka, Japan
| | - Yuki Eguchi
- Palliative Care Unit, Tachibana Medical Corporation 38428Higashisumiyoshimorimoto Hospital, Osaka, Japan
| | - Kazuki Ohba
- Department of Palliative Care, Tachibana Medical Corporation Higashisumiyoshimorimoto Hospital, Osaka, Japan
| | - Yoshitaka Yano
- Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, Kyoto, Japan
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Al Maqbali M, Hughes C, Gracey J, Rankin J, Hacker E, Dunwoody L. Psychometric Properties of the Arabic Version of the Functional Assessment of Chronic Illnesses Therapy-Fatigue in Arabic Cancer Patients. J Pain Symptom Manage 2020; 59:130-138.e2. [PMID: 31647976 DOI: 10.1016/j.jpainsymman.2019.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/04/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The Functional Assessment of Chronic Illness Therapy (FACIT) is a measurement system that was developed to assess the health-related quality of life among patients with cancer and other chronic illnesses. The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) is a 40-item questionnaire, and it is one of the most frequently used instruments to assess fatigue in cancer populations. The aim of this study was to evaluate the psychometric properties of the Arabic FACIT-F among patients diagnosed with cancer. METHODS Following a translated and cross-cultural evaluation procedure of the FACIT-F Arabic version, a cross-sectional and descriptive correlational design was conducted. A total of 369 patients with cancer completed the FACIT-F, which consists of the 27-item Functional Assessment of Cancer Therapy-General (FACT-G) and the 13-item Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). The scale was assessed in terms of acceptability, internal consistency, and validity. Construct validity was explored through confirmatory factor analysis. RESULTS The FACT-G had acceptable fit in the four-factor model, whereas the FACIT-Fatigue was found to be acceptable for the one-factor model in Arabic patients diagnosed with cancer. The Cronbach's alpha coefficient for the Arabic FACIT-Fatigue was 0.92, whereas the total score for FACT-G was 0.92, which showed good reliability. There was evidence that discriminated validity analysis was generally very good for the FACIT-Fatigue and FACT-G Arabic versions. CONCLUSION The Arabic versions of the FACIT-Fatigue and FACT-G demonstrated good reliability and validity for assessing fatigue and quality of life in patients diagnosed with cancer.
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Affiliation(s)
- Mohammed Al Maqbali
- Institute of Nursing and Health Research , Ulster University, Newtownabbey, UK.
| | - Ciara Hughes
- Institute of Nursing and Health Research , Ulster University, Newtownabbey, UK
| | - Jackie Gracey
- Institute of Nursing and Health Research , Ulster University, Newtownabbey, UK
| | - Jane Rankin
- Physiotherapy Department, Cancer Centre , Belfast Health and Social Care Trust, Belfast, UK
| | - Eileen Hacker
- School of Nursing , Indiana University, Indianapolis, USA
| | - Lynn Dunwoody
- Psychology Research Institute , Ulster University, Coleraine, UK
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23
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Wang Z, Li S, Wu L, Qi Q, Liu H, Jin X, Tian J, Zhang M, Ma X, Sun D, Xu S, Wu H. Effect of acupuncture on lung cancer-related fatigue: study protocol for a multi-center randomized controlled trial. Trials 2019; 20:625. [PMID: 31706345 PMCID: PMC6842537 DOI: 10.1186/s13063-019-3701-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/04/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Fatigue is one of the primary symptoms in lung cancer, with a prevalence of 88.0% in survivors of cancer, and an even higher prevalence post resection surgery. Effective fatigue control after lung cancer surgery is important for patient recovery and quality of life. Some studies have shown that acupuncture might be effective in treating cancer-related fatigue; however, randomized controlled trials (RCTs) of suitable sample size are limited. METHOD/DESIGN This is a multi-center, patient-blinded RCT. A total of 320 eligible patients will be recruited in four centers and randomly assigned to either the acupuncture group or the sham acupuncture group in a 1:1 ratio. Treatment will be given twice per week for 12 sessions. Treatment will be given at acupoints GV20, GV29, CV12, CV6, CV4, and bilateral LI4, LR3, SP6, ST36. The primary outcome will be assessed using the Chinese version of The Brief Fatigue Inventory. The secondary outcomes will be measured using The European Organization for Research and The Treatment of Cancer Quality of Life Questionnaire, and the Hamilton Rating Scale for Depression. The primary outcome will be assessed at all main points (baseline, the 3rd week, the 6th week, and at follow up time points) and the secondary outcomes will be assessed at baseline and the 6th week. Intention-to-treat analysis will be used in this RCT. DISCUSSION This trial protocol provides an example of the clinical application acupuncture treatment in the management of lung cancer-related fatigue. If the acupuncture treatment protocol confirms that acupuncture is an effective and safe option for lung cancer-related fatigue, it can be adopted as a standardized treatment. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1900022831. Registered on 27 April 2019. URL: http://www.chictr.org.cn/showproj.aspx?proj=37823.
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Affiliation(s)
- Zhaoqin Wang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
| | - Shanshan Li
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071 China
| | - Luyi Wu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
| | - Qin Qi
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
| | - Huirong Liu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
| | - Xiaoming Jin
- Stark Neurosciences Research Institute & Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - Jianhui Tian
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Ming Zhang
- Shanghai Chest Hospital, Shanghai, 200030 China
| | - Xiaopeng Ma
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
| | - Deli Sun
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Shifen Xu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071 China
| | - Huangan Wu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
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Matsuda A, Yamada Y, Ishizuka N, Matsushima E, Kobayashi K, Ohkubo T, Yamaoka K. Effectiveness of a Self-Monitoring Quality of Life Intervention For Patients with Cancer Receiving Palliative Care: A Randomized Controlled Clinical Trial. Asian Pac J Cancer Prev 2019; 20:2795-2802. [PMID: 31554379 PMCID: PMC6976827 DOI: 10.31557/apjcp.2019.20.9.2795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Use of patient-reported outcome measures in routine clinical practice has important benefits for
patients with cancer. To examine the effect of a self-monitoring quality of life (QOL) intervention on global QOL and
physical and emotional function in patients with cancer receiving palliative care. Methods: Prospective randomized
study had been undertaken at Toshima Hospital, Japan. This study compared an intervention group that completed the
shortened Care Notebook booklet versus a control group that received usual care. The primary outcome was global QOL
and secondary outcomes were physical and emotional function. Participants completed the European Organization for
Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative at baseline, and at 1 and 3 weeks.
The effects of the intervention were evaluated with a linear mixed-effects model. Results: Forty-three patients were
randomized. One patient in each group could not receive the allocated intervention, leaving 41 patients for inclusion
in the modified intention-to-treat (ITT) analysis for the primary outcome. Twenty-seven patients were analyzed for the
secondary outcomes using per protocol set (PPS). The ITT analysis showed no significant overall effect on global QOL
(P=0.285), but the PPS analysis showed a significant overall effect on global QOL (P=0.034) and physical function
(P=0.047) for group difference over time in the linear mixed-effects model. Conclusions: Use of the Care Notebook
might have beneficial effects. The results could be interpreted as the effectiveness of the intervention of the Care
Notebook for with cancer receiving palliative care.
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Affiliation(s)
- Ayako Matsuda
- Teikyo University School of Medicine, Department of Hygiene and Public Health, Tokyo, Japan.
| | - Yosuke Yamada
- Toshima Hospital, Division Chief of Palliative Care Unit, Tokyo, Japan
| | - Noriko Ishizuka
- Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Section of Liaison Psychiatry and Palliative Medicine, Tokyo, Japan
| | - Eisuke Matsushima
- Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Section of Liaison Psychiatry and Palliative Medicine, Tokyo, Japan
| | - Kunihiko Kobayashi
- Saitama Medical University International Medical Center, Department of General Thoracic Surgery, Saitama, Japan
| | - Takayoshi Ohkubo
- Teikyo University School of Medicine, Department of Hygiene and Public Health, Tokyo, Japan.
| | - Kazue Yamaoka
- Teikyo University Graduate School of Public Health, Tokyo, Japan
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25
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Protective Effect of Ganoderma (Lingzhi) on Radiation and Chemotherapy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1182:119-142. [DOI: 10.1007/978-981-32-9421-9_4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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26
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Lashbrook M, Bernardes CM, Kirshbaum MN, Valery PC. Physical functioning and psychological morbidity among regional and rural cancer survivors: A report from a regional cancer centre. Aust J Rural Health 2018; 26:211-219. [PMID: 29799149 DOI: 10.1111/ajr.12419] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To identify factors associated with psychosocial, physical and practical difficulties of daily living and distress among cancer survivors from a regional area in Australia. DESIGN Cross-sectional study. SETTING Riverina region of southern New South Wales. PARTICIPANTS The sample included 134 patients who completed treatment for breast, colorectal, lung or cancer at the Riverina Cancer Care Centre. MAIN OUTCOME MEASURES Distress was assessed by the Distress Thermometer. Psychosocial, physical and practical difficulties of daily living were assessed by the Patient-Reported Outcomes Measurement Information System questionnaires. RESULTS A high proportion of cancer survivors had abnormal scores for physical function, sleep disturbance, satisfaction with role, fatigue and pain interference, with many also displaying abnormal scores for anxiety, depression and distress. Survivors living in rural areas and those who had undergone surgery had higher odds of having abnormal scores for sleep disturbance than their counterparts. Living without a partner increased the odds of anxiety and depression. Having advanced disease increased the odds of anxiety and pain. Colorectal cancer and higher education were associated with depression. CONCLUSION Monitoring for abnormal physical and psychosocial issues after cancer treatment is essential to maintain or improve psychosocial well-being during survivorship. When developing survivorship care plans for patients residing in regional centres, health professionals should consider availability of high-quality and accessible support services in regional areas of Australia.
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Affiliation(s)
- Mari Lashbrook
- The Riverina Cancer Care Centre, Wagga Wagga, New South Wales, Australia.,QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Christina M Bernardes
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Marilynne N Kirshbaum
- School of Health (Nursing), Charles Darwin University, Darwin, Northern Territory, Australia
| | - Patricia C Valery
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
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27
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Cheng CS, Chen LY, Ning ZY, Zhang CY, Chen H, Chen Z, Zhu XY, Xie J. Acupuncture for cancer-related fatigue in lung cancer patients: a randomized, double blind, placebo-controlled pilot trial. Support Care Cancer 2017; 25:3807-3814. [PMID: 28707168 DOI: 10.1007/s00520-017-3812-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/27/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a distressing symptom that is the most common unpleasant side effect experienced by lung cancer patients and is challenging for clinical care workers to manage. METHODS We performed a randomized, double-blind, placebo-controlled pilot trial to evaluate the clinical effect of acupuncture on CRF in lung cancer patients. Twenty-eight patients presenting with CRF were randomly assigned to active acupuncture or placebo acupuncture groups to receive acupoint stimulation (LI-4, Ren-6, St-36, KI-3, and Sp-6) twice per week for 4 weeks, followed by 2 weeks of follow-up. The primary outcome was the change in intensity of CFR based on the Chinese version of the Brief Fatigue Inventory (BFI-C). As the secondary endpoint, the Functional Assessment of Cancer Therapy-Lung Cancer Subscale (FACT-LCS) was adopted to assess the influence of acupuncture on patients' quality of life (QOL). Adverse events and safety of treatments were monitored throughout the trial. RESULTS Our pilot study demonstrated feasibility among patients with appropriate inclusion criteria and good compliance with acupuncture treatment. A significant reduction in the BFI-C score was observed at 2 weeks in the 14 participants who received active acupuncture compared with those receiving the placebo (P < 0.01). At week 6, symptoms further improved according to the BFI-C (P < 0.001) and the FACT-LCS (P = 0.002). There were no significant differences in the incidence of adverse events in either group (P > 0.05). CONCLUSION Fatigue is a common symptom experienced by lung cancer patients. Acupuncture may be a safe and feasible optional method for adjunctive treatment in cancer palliative care, and appropriately powered trials are warranted to evaluate the effects of acupuncture.
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Affiliation(s)
- Chien-Shan Cheng
- Deparment of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China
| | - Lian-Yu Chen
- Deparment of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China
| | - Zhou-Yu Ning
- Deparment of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China
| | - Chen-Yue Zhang
- Deparment of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China
| | - Hao Chen
- Deparment of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China
| | - Zhen Chen
- Deparment of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China
| | - Xiao-Yan Zhu
- Deparment of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China.
| | - Jing Xie
- Deparment of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, China.
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28
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Kolak A, Kamińska M, Wysokińska E, Surdyka D, Kieszko D, Pakieła M, Burdan F. The problem of fatigue in patients suffering from neoplastic disease. Contemp Oncol (Pozn) 2017; 21:131-135. [PMID: 28947882 PMCID: PMC5611502 DOI: 10.5114/wo.2017.68621] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 12/20/2016] [Indexed: 12/12/2022] Open
Abstract
Modern therapeutic management of patients with cancer is associated with many adverse side effects, including fatigue defined as weariness, burnout, lassitude, malaise, apathy, impatience, and/or inability to perform daily activities. It occurs frequently before the diagnosis of cancer and may persist for a long time after the end of cancer therapy. It is a common problem that occurs regardless of the type of cancer and applied therapeutic procedure. The appearance of this symptom significantly affects the quality of life of patients and often reduces the effectiveness of implemented treatment. The symptom of fatigue occurs among approximately 80% of patients treated with chemotherapy and/or radiotherapy, as well as among more than 75% of patients with metastatic disease. Causes of fatigue include metabolic and immune system disorders as well as increased level of tumour necrosis factor α (TNF-α). Recent studies also indicate a significant contribution of other cytokines, especially pro-inflammatory ones, i.e. interleukin-1 (IL-1), interleukin-6 (IL-6), soluble tumour necrosis factor receptor type II (sTNF type II) and C-reactive protein (CRP). A patient reporting fatigue should be properly diagnosed and thoroughly interviewed by doctors. Patients are mostly treated non-pharmacologically (by means of physical exercise and psychotherapy) and pharmacologically (by applying methylphenidate and methylprednisolone). What is also extremely important is proper education of the patient and their closest family/friends on the symptoms, which significantly reduces anxiety and stress. On the other hand therapeutic management hinders the subjectivity of feeling and lack of standardised scales to rate symptoms.
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Affiliation(s)
- Agnieszka Kolak
- St. John of Dukla Lublin Region Cancer Centre, Lublin, Poland
| | | | | | - Dariusz Surdyka
- St. John of Dukla Lublin Region Cancer Centre, Lublin, Poland
| | - Dariusz Kieszko
- St. John of Dukla Lublin Region Cancer Centre, Lublin, Poland
| | - Magdalena Pakieła
- Department of Social Nursing, Warsaw Medical University, Warsaw, Poland
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29
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Shinozaki T, Ebihara M, Iwase S, Yamaguchi T, Hirakawa H, Shimbashi W, Kamijo T, Okamoto M, Beppu T, Ohori J, Matsuura K, Suzuki M, Nishino H, Sato Y, Ishiki H. Quality of life and functional status of terminally ill head and neck cancer patients: a nation-wide, prospective observational study at tertiary cancer centers in Japan. Jpn J Clin Oncol 2016; 47:47-53. [PMID: 27677662 DOI: 10.1093/jjco/hyw138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/27/2016] [Accepted: 08/30/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Little is known about quality of life and functional status of patients with terminally ill head and neck cancers. METHODS We conducted a multicenter, prospective, observational study to examine quality of life and functional status in terminally ill head and neck cancer patients. RESULTS Of the 100 patients meeting inclusion criteria, 72 were observed until death. There was no significant difference in the quality of life score between baseline and Week 3. Forty patients (54.9%) could speak and 22 patients (30.5%) could have oral intake upon study entry. Fifty-three patients (74.6%) received enteral nutrition. Twenty-six patients (36.6%) required dressing changes for fungating tumors. The route of nutritional intake (nasogastric tube vs. percutaneous gastric tube) might be predictive for the duration of hospital stay (64 vs. 21 days, P = 0.0372). CONCLUSION There was no significant relationship between quality of life and functional status seen in this study. Feeding tube type could have the most impact on quality of life.
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Affiliation(s)
- Takeshi Shinozaki
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa
| | | | - Satoru Iwase
- Department of Palliative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai
| | - Hitoshi Hirakawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya
| | - Wataru Shimbashi
- Department of Head and Neck Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
| | - Tomoyuki Kamijo
- Department of Head and Neck Surgery, Shizuoka Cancer Center, Nagaizumicho
| | - Makito Okamoto
- Department of Otolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, Sagamihara
| | - Takeshi Beppu
- Department of Head and Neck Surgery, Saitama Cancer Center, Saitama
| | - Junichiro Ohori
- Department of Otolaryngology, Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima
| | - Kazuto Matsuura
- Department of Head and Neck Surgery, Miyagi Cancer Center, Natori
| | - Motoyuki Suzuki
- Department of Otolaryngology, Head and Neck Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka
| | - Hiroshi Nishino
- Department of Otolaryngology, Head and Neck Surgery, Jichi Medical University, Shimotsuke
| | - Yuichiro Sato
- Department of Head and Neck Surgery, Niigata Cancer Center, Niigata, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo
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30
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Effects of the polysaccharides extracted from Ganoderma lucidum on chemotherapy-related fatigue in mice. Int J Biol Macromol 2016; 91:905-10. [PMID: 27208798 DOI: 10.1016/j.ijbiomac.2016.04.084] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/19/2016] [Accepted: 04/29/2016] [Indexed: 11/23/2022]
Abstract
The weight-loaded swimming capability, tumor growth, survival time and biochemical markers of Ganoderma lucidum polysaccharides (GLPs) in a chemotherapy-related fatigue mouse model were tested in the present study. The results showed that the middle-dose GLPs (GLP-M) and the high-dose GLPs (GLP-H) could increase the exhausting swimming time, which was observed to decrease in the cisplatin control group(PCG) and the tumor control group (TCG).The GLP-M and the GLP-H had reduced serum levels of tumor necrosis factor-αand interleukin-6, which were up-regulated by cisplatin. Cisplatin and the presence of tumor significantly enhanced the malondialdehyde (MDA) content and inhibited the activity of superoxide dismutase (SOD) in the muscle. Administration of GLPs at a high dose decreased the levels of MDA and up-regulated the SOD activity. The high-dose GLPs+cisplatin group presented a decreased tendency of tumor volume and a lower tumor weight compared with PCG. Moreover, the mice in the GLP-M and GLP-H groups had longer survival times compared with the mice in the TCG and PCG.The levels of creatinine and serum blood urea nitrogen, which are up-regulated by cisplatin, were significantly reduced by GLP-M and GLP-H. Therefore, these results suggest that GLPs might improve chemotherapy-related fatigue via regulation of inflammatory responses, oxidative stress and reduction of nephrotoxicity.
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31
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Carnio S, Di Stefano RF, Novello S. Fatigue in lung cancer patients: symptom burden and management of challenges. LUNG CANCER (AUCKLAND, N.Z.) 2016; 7:73-82. [PMID: 28210163 PMCID: PMC5310693 DOI: 10.2147/lctt.s85334] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Lung cancer (LC) remains the most common cause of cancer death in several countries across the world. Fatigue is the most frequently reported symptom in LC patients throughout the entire course of disease, and all international guidelines recommend early screening for cancer-related fatigue (CRF) and symptoms that can affect patients' quality of life. In patients with LC, fatigue belongs to the symptom cluster of pain, depression, and insomnia, which are commonly observed simultaneously, but are typically treated as separate although they may have common biological mechanisms. The treatment of CRF remains one of the difficult areas in the oncology field: scarce evidence supports pharmacological therapies, while some interesting data arising indicates alternative remedies and physical exercise seem to be one of the most effective approaches for CRF at any stage of LC.
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Affiliation(s)
- Simona Carnio
- Oncology Department, University of Turin, AOU San Luigi, Orbassano, Italy
| | | | - Silvia Novello
- Oncology Department, University of Turin, AOU San Luigi, Orbassano, Italy
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