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Fabi A, Fotia L, Giuseppini F, Gaeta A, Falcicchio C, Giuliani G, Savarese A, Taraborelli E, Rossi V, Malaguti P, Giannarelli D, Pugliese P, Cognetti F. The immersive experience of virtual reality during chemotherapy in patients with early breast and ovarian cancers: The patient’s dream study. Front Oncol 2022; 12:960387. [PMID: 36249001 PMCID: PMC9563848 DOI: 10.3389/fonc.2022.960387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022] Open
Abstract
Background A virtual reality experience (VRE) could represent a viable non-pharmacological intervention to reduce and better manage the main factors of psychophysical distress related to the diagnosis and treatment of cancer. Aim The “Patient’s Dream” study was a two-arm randomized controlled trial conducted at the Regina Elena National Cancer Institute – IRCCS (Rome, Italy) from April 2019 to January 2020 to evaluate VRE impact in patients affected by breast or ovarian cancer. Before starting the first cycle of chemotherapy (CT), patients were randomized to receive the VRE (VRE arm) as “distraction therapy” or to entertain themselves with conventional means (control arm). The primary aims were the assessment of psychological distress, anxiety and quality of life between the two study arms. Secondary endpoints were the perceived time during the first course of CT and the acute and late toxicity. Results Fourty-four patients were enrolled, 22 patients were randomly assigned to the VRE arm and 22 to the control arm. Collected data underline the absence of prevalent disturbs of anxiety and depression in both groups. Nevertheless, even if the state anxiety values before and after CT decreased in both groups, this reduction was statistically significant over time only in the VRE arm. The duration of therapy perceived by patients undergoing distraction therapy was significantly shorter when compared to the control group. The use of VRE during the first CT cycle appeared to reduce asthenia outcomes. Conclusion Obtained data suggest that the VRE positively influenced the levels of state anxiety among cancer patients and support the continuous research on VRE as a distraction intervention, with the aim to meet the clinical need for effective nonpharmacologic adjunctive therapies. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT05234996, identifier NCT05234996.
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Affiliation(s)
- Alessandra Fabi
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
- *Correspondence: Alessandra Fabi,
| | - Luana Fotia
- Service of Psyco-Oncology, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | | | | | - Chiara Falcicchio
- Service of Psyco-Oncology, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | | | - Antonella Savarese
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | | | - Valentina Rossi
- Breast Unit, San Camillo Forlanini Hospital of Rome, Rome, Italy
| | - Paola Malaguti
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Diana Giannarelli
- Biostatistic Unit, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Patrizia Pugliese
- Service of Psyco-Oncology, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
| | - Francesco Cognetti
- Medical Oncology 1, Regina Elena National Cancer Institute, IRCCS, Rome, Italy
- Department of Clinical and Molecular Medicine, University La Sapienza, Rome, Italy
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Perrone M, Garufi C, Cosimelli M, Graziano F, Falcicchio C, Bonucci A, Fotia L, Giannarelli D, Giacomelli L, Ciliberto G, Pugliese P. A Prospective Study Evaluating Health-Related Quality of Life Following a Multimodal Treatment for Colorectal Cancer. J Gastrointest Cancer 2022; 54:117-125. [PMID: 35075581 DOI: 10.1007/s12029-022-00802-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The major improvements in the diagnosis and treatment of colorectal cancer (CRC) over the past decades increased the patients' survival rates. Despite this, patients and clinicians still need to address the long-term physical and psychosocial effects over time. This paper aims to prospectively assess CRC patients' HR-QoL psychological distress and sexual functioning and identify clinical, demographic, and psychological predictors. METHODS In total, 55 patients were evaluated from diagnosis to 5-year follow-up with the following instruments: EORTC QLQ-C30 and QLQ-C38 for QoL and sexuality; HADS for psychological distress; and specific questions to detect psychological variables. RESULTS QoL worsened after diagnosis and returned to baseline values after 5 years. Sexual function significantly deteriorated over time (with no recovery, especially in women), while borderline/severe anxiety and depression decreased. A better HR-QoL at baseline was associated with better physical, social and sexual functioning, positive body image and sexual pleasure after 5 years. CONCLUSION HR-QoL allows the early detection of patients at risk, favoring prompt patient-centered interventions.
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Affiliation(s)
- Maria Perrone
- Psychology Unit, IRCCS Regina Elena Cancer Institute, Rome, Italy.
| | - Carlo Garufi
- Medical Oncology, Azienda Ospedaliera San Camillo Forlanini Roma, Rome, Italy
| | - Maurizio Cosimelli
- Colon Rectal Surgery, Fondazione IRCCS Istituto Nazionale Dei Tumori, S.C. Oncological 2 , Milan, Italy
| | - Franco Graziano
- Department of Surgery, IRCCS Regina Elena Cancer Institute, Rome, Italy
| | | | | | - Luana Fotia
- Psychology Unit, IRCCS Regina Elena Cancer Institute, Rome, Italy
| | - Diana Giannarelli
- Biostatistics Unit, IRCCS Regina Elena Cancer Institute, Rome, Italy
| | | | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena Cancer Institute, Rome, Italy
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Maggi G, Terrenato I, Giacomelli L, Bifano V, Gravili A, Faltyn W, Ferraresi V, Favale L, Petrongari MG, Salducca N, Vari S, Falcicchio C, Rossi B, Biagini R, Pugliese P. Symptoms and their implications on quality of life and psychological distress in sarcoma patients. Future Oncol 2021; 17:817-823. [PMID: 33508959 DOI: 10.2217/fon-2020-0572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to investigate symptoms, their variation over time and their relationship with quality of life (QoL)/psychological distress in sarcoma patients, as few data regarding QoL and psychological distress in this set of patients are currently available. A total of 188 sarcoma patients from an Italian referral center were involved. Symptoms and financial difficulties were evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire from the first treatment and over the follow-up period, up to 6 years. The authors found that patients with sarcoma experience several symptoms, especially fatigue and pain, which may dramatically worsen QoL and psychological distress. In conclusion, patients with sarcoma often experience fatigue, pain and financial difficulties, which negatively impacts QoL and psychological distress. To ameliorate overall QoL, proper control of symptoms is necessary.
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Affiliation(s)
- Gabriella Maggi
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Irene Terrenato
- Biostatistic Unit - Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Luca Giacomelli
- Polistudium SRL, Milan, Italy.,Department of Surgical Sciences & Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Viviana Bifano
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Alessandra Gravili
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Wioletta Faltyn
- Sarcoma Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Virginia Ferraresi
- First Division of Medical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Leonardo Favale
- Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Maria Grazia Petrongari
- Deptartment of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Nicola Salducca
- Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Sabrina Vari
- First Division of Medical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Chiara Falcicchio
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Barbara Rossi
- Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Roberto Biagini
- Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizia Pugliese
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Maggi G, Terrenato I, Giacomelli L, Zoccali C, Condoleo MF, Falcicchio C, Baldi J, Vari S, Ferraresi V, Biagini R, Pugliese P. Sarcoma patients' quality of life from diagnosis to yearly follow-up: experience from an Italian tertiary care center. Future Oncol 2019; 15:3125-3134. [PMID: 31512484 DOI: 10.2217/fon-2019-0237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim: To investigate sarcoma patients' perception of quality of life and psychosocial distress across the different disease's stages. Patients & methods: Total 329 sarcoma patients were monitored from diagnosis up to a maximum of six consecutive follow-up visits. Results: Functional status worsened over time with the lowest value after surgery and a full recovery not earlier than the second follow-up visit. Married and single patients exhibited similar quality of life pattern. High levels of psychological distress were observed from diagnosis to active treatment periods with a progressive improvement during follow-up. Psychological distress pattern over time varied by marital status and age. Conclusion: Our study suggests the importance of integrating psychosocial care to medical therapy across the entire sarcoma journey.
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Affiliation(s)
- Gabriella Maggi
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Irene Terrenato
- Biostatistic Unit - Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Luca Giacomelli
- Department of Surgical Sciences & Integrated Diagnostics, University of Genoa, Genoa, Italy.,Polistudium SrL, Milan, Italy
| | - Carmine Zoccali
- Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Chiara Falcicchio
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Jacopo Baldi
- Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Sabrina Vari
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Virginia Ferraresi
- Medical Oncology 1 Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Roberto Biagini
- Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Patrizia Pugliese
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Fabi A, Lanzetta G, Vizza E, Corsi D, Moscetti L, Spinelli G, Mentuccia L, Lalle M, Perrone M, Baiocco L, Falcicchio C, Milani A, Giannarelli D, Cognetti F, Pugliese P. The unmet need for oncofertility preservation in women: Results of a survey by different oncological specialists in Lazio, Italy. Curr Probl Cancer 2019; 43:100479. [PMID: 31126661 DOI: 10.1016/j.currproblcancer.2019.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 03/01/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022]
Abstract
In recent years, we have witnessed a growing interest in the prevention of the loss of reproductive efficacy in young women as a result of cancer or its treatments. Indeed, recent studies have shown that loss of fertility impacts deeply on young women and sometimes may be even more stressful than the cancer diagnosis itself. In fact, the risk of treatment-associated infertility and premature menopause is a major concern for patients. Nevertheless, the approach to fertility preservation in women diagnosed with cancer is far from being standardized, and counseling strategies are poorly adopted in clinical practice. In Italy, the federal structure of public health makes it difficult to refer patients to local referral centers experienced in fertility preservation. In particular, a need exists to identify oncologists in the Lazio region specialized in fertility preservation and those facilities who are able to counsel patients regarding their sexuality. For these reasons, the Lazio section of Italian Association of Medical Oncology has led an oncofertility and oncosexuality survey to assess deficiencies in the path to start fertility preservation procedures and to help patients with cancer-related sexual problems. In total, 273 healthcare providers participated in the survey. Overall, the participants had a low interest in their patients' infertility problems, which led to a poor referral of patients to fertility preservation centers. This behavior demonstrated by healthcare providers is attributed to the necessity to rapidly start oncological treatments, the lack of knowledge of referral centers, and the little experience in tackling the subject with the patients. The interviewees also recognize communication difficulties related to lack of information on issues, absence of rehabilitations paths, and embarrassment.
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Affiliation(s)
- Alessandra Fabi
- Medical Oncology, Regina Elena National Cancer Institute, Rome, Italy.
| | - Gaetano Lanzetta
- Medical Oncology, Istituto Neurotramutologico Italiano, Grottaferrata, Rome, Italy
| | - Enrico Vizza
- Gynecologic Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Domenico Corsi
- Medical Oncology, Fatebene Fratelli Hospital, Rome, Italy
| | - Luca Moscetti
- Medical Oncology, Azienda Ospedaliero Universitaria Policlinico di Modena, Modena, Italy
| | | | | | | | - Maria Perrone
- Psyco-Oncology Service, Regina Elena National Cancer Institute, Rome, Italy
| | - Linda Baiocco
- Gynecologic Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Chiara Falcicchio
- Psyco-Oncology Service, Regina Elena National Cancer Institute, Rome, Italy
| | | | | | | | - Patrizia Pugliese
- Psyco-Oncology Service, Regina Elena National Cancer Institute, Rome, Italy
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Fabi A, Falcicchio C, Giannarelli D, Maggi G, Cognetti F, Pugliese P. The course of cancer related fatigue up to ten years in early breast cancer patients: What impact in clinical practice? Breast 2017; 34:44-52. [PMID: 28500901 DOI: 10.1016/j.breast.2017.04.012] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/24/2017] [Accepted: 04/25/2017] [Indexed: 11/29/2022] Open
Abstract
Little is known about the cancer related fatigue (CRF) along cancer course and risk factors that could predict CRF development and persistence in breast cancer (BC) survivors. This prospective study detected incidence, timing of onset, duration of CRF, impact on QoL and psychological distress. Seventy-eight early BC patients, undergoing chemotherapy (CT) followed or not by hormonal therapy were assessed for QoL and psychological distress by EORTC QLQC30 and HADs questionnaires. Fatigue was investigated with mix methods, structured interview and psychometric measures. A qualitative analysis was added to assess the behavioral pattern of CRF. Low fatigue levels were identified after surgery (9%), increasing during (49%) and at the end of CT (47%), maintaining after 1 year (31%) and declining up to ten years of follow-up. Prevalence of CRF was higher at the end of CT and lower at follow-up. At the end and after 1 and 2 years from CT, persistence of CRF was associated to anxiety in 20%, 11% and 5% and to depression in 15%, 10% and 5% respectively. A relationship between CRF and psychological distress was observed; patients presenting depression and anxiety before CT were at higher risk for fatigue onset at a later period. A relationship between fatigue and QoL was noted at the end of CT. Our study shows the fatigue timely trend in early BC patients from surgery, CT and follow-up. Identification of biological, psychological, social predictor factors related to fatigue could be helpful for early interventions in patients at higher risk of developing fatigue.
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Affiliation(s)
- Alessandra Fabi
- Regina Elena National Cancer Institute, Division of Medical Oncology 1, via Elio Chianesi 53, 00124, Rome, Italy.
| | - Chiara Falcicchio
- Regina Elena National Cancer Institute, Service of Psiconcology, via Elio Chianesi 53, 00124, Rome, Italy
| | - Diana Giannarelli
- Regina Elena National Cancer Institute, Biostatistic Unit, via Elio Chianesi 53, 00124, Rome, Italy
| | - Gabriella Maggi
- Regina Elena National Cancer Institute, Service of Psiconcology, via Elio Chianesi 53, 00124, Rome, Italy
| | - Francesco Cognetti
- Regina Elena National Cancer Institute, Division of Medical Oncology 1, via Elio Chianesi 53, 00124, Rome, Italy
| | - Patrizia Pugliese
- Regina Elena National Cancer Institute, Service of Psiconcology, via Elio Chianesi 53, 00124, Rome, Italy
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Pace A, Villani V, Parisi C, Di Felice S, Lamaro M, Falcicchio C, Bonucci A, Pugliese P, di Napoli A, Di Lallo D. Rehabilitation pathways in adult brain tumor patients in the first 12 months of disease. A retrospective analysis of services utilization in 719 patients. Support Care Cancer 2016; 24:4801-6. [DOI: 10.1007/s00520-016-3333-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 07/07/2016] [Indexed: 02/01/2023]
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