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Obama K, Fujimori M, Boku N, Matsuoka A, Mori K, Okizaki A, Miyaji T, Okamura M, Majima Y, Goto S, Shimazu T, Uchitomi Y. Shared decision-making support program for older patients with advanced cancer using a question prompt list and geriatric assessment: A pilot randomized controlled trial. J Geriatr Oncol 2024; 15:101778. [PMID: 38704911 DOI: 10.1016/j.jgo.2024.101778] [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] [Received: 10/01/2023] [Revised: 03/10/2024] [Accepted: 04/19/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Older patients with cancer are less likely to express their treatment preferences than younger patients. Question prompt lists (QPLs) facilitate communication between patients and physicians. Geriatric assessment (GA) is recommended when older patients with cancer make treatment decisions. This study estimated the effect size of a shared decision-making (SDM) support program combining QPLs with GA in terms of patients' subjective evaluation of the SDM process for a future definitive randomized controlled trial. We also evaluated the number and quality of aging-related communication during consultations, and feasibility and acceptability of the study for exploratory purposes. MATERIALS AND METHODS This is a pilot study with randomized allocation and blind evaluation. Patients aged 65 years or older at the National Cancer Center Hospital, Tokyo, Japan, scheduled to discuss the changes of their treatment, were randomly assigned in a 1:1 ratio to the SDM support program or usual care. This program consisted of 30-60 min of face-to-face coaching, with QPLs and GA provided before the coaching. As the primary endpoint, the decisional conflict scores given by the patients immediately after the consultation were compared between the two groups. For the secondary endpoints, the number and quality of aging-related communications during the consultations were assessed by evaluators (blinded) using audio-recordings. Adherence, burden, and usefulness were assessed for evaluating feasibility and acceptability of the SDM support program. RESULTS Forty patients were enrolled. All patients completed the GA questionnaire, for which 70% did not require any individual assistance. Answering the questionnaires took approximately 11 min. The decisional conflict scores were mean [standard deviation (SD)]: 19.3 [10.8] vs. 18.0 [11.1] (effect size: Cohen's d = 0.12) for the SDM support program and usual care groups, respectively. The number of aging-related communications during the consultation for the new treatment was higher in the SDM support program group than the usual care (mean [SD]: 3.3 [1.2] vs. 2.2 [1.5], effect size: cohen's d = 1.32). Patients felt that the SDM support program was useful but not burdensome or difficult. DISCUSSION The SDM support program was considered useful and feasible for older patients and able to facilitate communication regarding aging-related concerns. TRIAL REGISTRATION NUMBER The study protocol was registered on September 23, 2020, in the UMIN Clinical Trials Registry (UMIN000041867).
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Affiliation(s)
- Kyoko Obama
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan
| | - Maiko Fujimori
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan.
| | - Narikazu Boku
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Ayumu Matsuoka
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan
| | - Keita Mori
- Department of Biostatistics, Clinical Research Center, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan
| | - Ayumi Okizaki
- Innovation Center for Supportive, Palliative, and Psychosocial Care, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Tempei Miyaji
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan; Innovation Center for Supportive, Palliative, and Psychosocial Care, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Masako Okamura
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan
| | - Yoshiyuki Majima
- NPO Pancreatic Cancer Action Network Japan, Sodegaura, Chiba, Japan
| | - Shinichi Goto
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan
| | - Taichi Shimazu
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan
| | - Yosuke Uchitomi
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan; Innovation Center for Supportive, Palliative, and Psychosocial Care, National Cancer Center, Chuo-ku, Tokyo, Japan
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Kaneyasu T, Hoshino E, Naito M, Suzukamo Y, Miyazaki K, Kojima S, Yamaguchi T, Kawaguchi T, Miyaji T, Nakajima TE, Shimozuma K. How to select and understand guidelines for patient-reported outcomes: a scoping review of existing guidance. BMC Health Serv Res 2024; 24:334. [PMID: 38481204 PMCID: PMC10938752 DOI: 10.1186/s12913-024-10707-8] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Over the past few decades, patient-reported outcomes (PROs) have been used to understand patient health conditions better. Therefore, numerous PRO measures (questionnaires) and guidelines or guidance have been developed. However, it is challenging to select target guidance from among the many available guidance and to understand the chosen guidance. This study comprehensively collected the existing PRO guidance for clinical trials or studies and practices to support novice PRO users in academia, industry, clinical practice, and regulatory and reimbursement decision-making. METHODS For the scoping review, we searched the MEDLINE, Embase, Google Books, WorldCat, and the National Library of Medicine (NLM) Bookshelf databases from 2009 to 2023. The eligibility criteria were PRO guidance for clinical trials, clinical practice, or application such as health technology assessment. Those guidance cover aspects such as quality of life (QOL), PRO, health-related QOL, health state utilities, psychometric requirements, implementation methods, analysis and interpretation, or clinical practice applications. After the systematic search, three researchers individually reviewed the collected data, and the reviewed articles and books were scrutinized using the same criteria. RESULTS We collected the PRO guidance published in articles and books between 2009 and 2023. From the database searches, 1,455 articles and 387 books were identified, of which one book and 33 articles were finally selected. The collected PRO guidance was categorized into the adoption of PRO measures, design and reporting of trials or studies using PROs, implementation of PRO evaluation in clinical trials or studies or clinical practice, analysis and interpretation of PROs, and application of PRO evaluation. Based on this categorization, we suggest the following for novices: When selecting guidance, novices should clarify the "place" and "purpose" where the guidance will be used. Additionally, they should know that the terminology related to PRO and the scope and expectations of PROs vary by "places" and "purposes". CONCLUSIONS From this scoping review of existing PRO guidance, we provided summaries and caveats to assist novices in selecting guidance that fits their purpose and understanding it.
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Affiliation(s)
- Takako Kaneyasu
- College of Life Sciences, Department of Biomedical Sciences, Ritsumeikan University, 1-1-1, Noji-Higashi, Kusatsu, Shiga, 525-8577, Japan.
- Comprehensive Unit for Health Economic Evidence Review and Decision Support, Research Organization of Science and Technology, Ritsumeikan University, Kyoto, Japan.
| | - Eri Hoshino
- Comprehensive Unit for Health Economic Evidence Review and Decision Support, Research Organization of Science and Technology, Ritsumeikan University, Kyoto, Japan
- Division of Policy Evaluation, Department of Health Policy, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Kikuko Miyazaki
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Satomi Kojima
- Comprehensive Unit for Health Economic Evidence Review and Decision Support, Research Organization of Science and Technology, Ritsumeikan University, Kyoto, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Tempei Miyaji
- Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Takako Eguchi Nakajima
- Department of Early Clinical Development, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kojiro Shimozuma
- College of Life Sciences, Department of Biomedical Sciences, Ritsumeikan University, 1-1-1, Noji-Higashi, Kusatsu, Shiga, 525-8577, Japan
- Comprehensive Unit for Health Economic Evidence Review and Decision Support, Research Organization of Science and Technology, Ritsumeikan University, Kyoto, Japan
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Akechi T, Furukawa TA, Noma H, Iwata H, Toyama T, Higaki K, Matsuoka H, Zenda S, Iwatani T, Akahane K, Inoue A, Sagara Y, Uchida M, Imai F, Momino K, Imaizumi G, Yamaguchi T, Mashiko T, Miyaji T, Horikoshi M, Sakurai N, Onishi T, Kanemitsu Y, Murata T, Wanifuchi-Endo Y, Kuroda H, Nishikawa R, Miyashita M, Abe M, Uchitomi Y. Optimizing smartphone psychotherapy for depressive symptoms in patients with cancer: Multiphase optimization strategy using a decentralized multicenter randomized clinical trial (J-SUPPORT 2001 Study). Psychiatry Clin Neurosci 2024. [PMID: 38468404 DOI: 10.1111/pcn.13657] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/28/2024] [Accepted: 02/08/2024] [Indexed: 03/13/2024]
Abstract
AIM Patients with cancer experience various forms of psychological distress, including depressive symptoms, which can impact quality of life, elevate morbidity risk, and increase medical costs. Psychotherapy and pharmacotherapy are effective for reducing depressive symptoms among patients with cancer, but most patients prefer psychotherapy. This study aimed to develop an efficient and effective smartphone psychotherapy component to address depressive symptom. METHODS This was a decentralized, parallel-group, multicenter, open, individually randomized, fully factorial trial. Patients aged ≥20 years with cancer were randomized by the presence/absence of three cognitive-behavioral therapy (CBT) skills (behavioral activation [BA], assertiveness training [AT], and problem-solving [PS]) on a smartphone app. All participants received psychoeducation (PE). The primary outcome was change in the patient health questionnaire-9 (PHQ-9) total score between baseline and week 8. Secondary outcomes included anxiety. RESULTS In total, 359 participants were randomized. Primary outcome data at week 8 were obtained for 355 participants (99%). The week 8 PHQ-9 total score was significantly reduced from baseline for all participants by -1.41 points (95% confidence interval [CI] -1.89, -0.92), but between-group differences in change scores were not significant (BA: -0.04, 95% CI -0.75, 0.67; AT: -0.16, 95% CI -0.87, 0.55; PS: -0.19, 95% CI -0.90, 0.52). CONCLUSION As the presence of any of the three intervention components did not contribute to a significant additive reduction of depressive symptoms, we cannot make evidence-based recommendations regarding the use of specific smartphone psychotherapy.
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Hisashi Noma
- Department of Data Science, The Institute of Statistical Mathematics, Tokyo, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Tatsuya Toyama
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Sadamoto Zenda
- Division of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Tsuguo Iwatani
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | | | - Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan
| | - Yasuaki Sagara
- Department of Breast and Thyroid Surgical Oncology, Hakuaikai Medical Corporation, Sagara Hospital, Kagoshima, Japan
| | - Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Fuminobu Imai
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kanae Momino
- Department of Nursing Administration and Management, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Gen Imaizumi
- Department of Psychiatric and Mental Health Nursing, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoe Mashiko
- Division of Survivorship, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Tempei Miyaji
- Division of Survivorship, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Masaru Horikoshi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | - Tatsuya Onishi
- Department of Breast Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Takeshi Murata
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yumi Wanifuchi-Endo
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center, Nagoya, Japan
| | - Ryutaro Nishikawa
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Minoru Miyashita
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masakazu Abe
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Yosuke Uchitomi
- Division of Survivorship, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
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Minatogawa H, Izawa N, Shimomura K, Arioka H, Iihara H, Sugawara M, Morita H, Mochizuki A, Nawata S, Mishima K, Tsuboya A, Miyaji T, Honda K, Yokomizo A, Hashimoto N, Yanagihara T, Endo J, Kawaguchi T, Furuya N, Sone Y, Inada Y, Ohno Y, Katada C, Hida N, Akiyama K, Ichikura D, Konomatsu A, Ogura T, Yamaguchi T, Nakajima TE. Dexamethasone-sparing on days 2-4 with combined palonosetron, neurokinin-1 receptor antagonist, and olanzapine in cisplatin: a randomized phase III trial (SPARED Trial). Br J Cancer 2024; 130:224-232. [PMID: 37973958 PMCID: PMC10803798 DOI: 10.1038/s41416-023-02493-7] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND This study evaluated the non-inferiority of dexamethasone (DEX) on day 1, with sparing on days 2-4 in cisplatin-based chemotherapy. METHODS Patients with malignant solid tumors who were treated with cisplatin (≥50 mg/m²) were randomly assigned (1:1) to receive either DEX on days 1-4 (Arm D4) or DEX on day 1 (Arm D1) plus palonosetron, NK-1 RA, and olanzapine (5 mg). The primary endpoint was complete response (CR) during the delayed (24-120 h) phase. The non-inferiority margin was set at -15%. RESULTS A total of 281 patients were enrolled, 278 of whom were randomly assigned to Arm D4 (n = 139) or Arm D1 (n = 139). In 274 patients were included in the efficacy analysis, the rates of delayed CR in Arms D4 and D1 were 79.7% and 75.0%, respectively (risk difference -4.1%; 95% CI -14.1%-6.0%, P = 0.023). However, patients in Arm D1 had significantly lower total control rates during the delayed and overall phases, and more frequent nausea and appetite loss. There were no significant between-arm differences in the quality of life. CONCLUSION DEX-sparing is an alternative option for patients receiving cisplatin; however, this revised administration schedule should be applied on an individual basis after a comprehensive evaluation. CLINICAL TRIALS REGISTRY NUMBER UMIN000032269.
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Affiliation(s)
- Hiroko Minatogawa
- Department of Pharmacy, St. Marianna University Hospital, Kawasaki, Japan
| | - Naoki Izawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | | | - Hitoshi Arioka
- Department of Medical Oncology, Yokohama Rosai Hospital, Yokohama, Japan
| | | | - Mitsuhiro Sugawara
- Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, Sagamihara, Japan
| | - Hajime Morita
- Department of Pharmacy, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Yokohama, Japan
| | - Ayako Mochizuki
- Department of gynecology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shuichi Nawata
- Department of Pharmacy, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Keisuke Mishima
- Department of Digestive surgery, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan
| | - Ayako Tsuboya
- Department of Pharmacy, Kawasaki municipal Tama Hospital, Kawasaki, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazunori Honda
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Ayako Yokomizo
- Department of Pharmacy, St. Marianna University Hospital, Kawasaki, Japan
| | - Naoya Hashimoto
- Department of Pharmacy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takeshi Yanagihara
- Department of Medical Oncology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Junki Endo
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Hachioji, Japan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yumiko Sone
- Department of Clinical Pharmacy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yusuke Inada
- Department of Pharmacy, Yokohama Rosai Hospital, Yokohama, Japan
| | - Yasushi Ohno
- Department of Cardiology and Respiratory Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Chikatoshi Katada
- Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naoya Hida
- Department of Respiratory Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, Yokohama, Japan
| | - Kana Akiyama
- Department of pharmacy, Shizuoka Cancer Center, Nagaizumi, Japan
| | - Daisuke Ichikura
- Department of Pharmacy, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Akiko Konomatsu
- Department of Pharmacy, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan
| | - Takashi Ogura
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
- Department of Clinical Oncology, Kawasaki municipal Tama Hospital, Kawasaki, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takako Eguchi Nakajima
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan.
- Department of Early Clinical Development, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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Matsuoka A, Fujimori M, Koyama T, Sato A, Mori K, Hirata M, Tanabe N, Nakachi K, Kato S, Okamoto H, Ogawa K, Komatsu H, Iwasaku M, Miyaji T, Uchitomi Y. Prevalence of psychological distress and associated factors among patients undergoing comprehensive genomic profiling testing: protocol for a multicentre, prospective, observational study. BMJ Open 2023; 13:e072472. [PMID: 37996226 PMCID: PMC10668223 DOI: 10.1136/bmjopen-2023-072472] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION Since May 2019, comprehensive genomic profiling (CGP) has been covered by Japan's health insurance system for patients with solid tumours that have progressed on standard chemotherapy, rare tumours or tumours of unknown primary origin. Although CGP has the potential to identify actionable mutations that can guide the selection of genomically matched therapies for patients with advanced cancer and limited treatment options, less than 10% of patients benefit from CGP testing, which may have a negative impact on patients' mental status. The aim of this study is to investigate the prevalence of psychological distress and associated factors among patients with advanced cancer who are undergoing CGP testing across Japan. METHODS AND ANALYSIS This multicentre, prospective cohort study will enrol a total of 700 patients with advanced cancer undergoing CGP testing. Participants will be asked to complete questionnaires at three timepoints: at the time of consenting to CGP testing (T1), at the time of receiving the CGP results (T2; 2-3 months after T1) and 4-5 months after T2 (T3). Primary outcome is the prevalence of depression as measured by the Patient Health Questionnaire-9 at the three timepoints. Secondary outcomes are the prevalence of anxiety and Quality of Life Score. Associated factors with psychological distress will also be examined, including knowledge about CGP, attitudes, values and preferences towards CGP, satisfaction with oncologists' communication and patient characteristics as well as medical information including CGP test results and genomically matched therapies if provided. The prevalence of depression and anxiety will be estimated using the unadjusted raw rates observed in the total sample. Longitudinal changes in measures will be explored by calculating differences between the timepoints. Multivariate associations between variables will be examined using multiple or logistic regression analysis depending on the outcomes to adjust for confounders and to identify outcome predictors. ETHICS AND DISSEMINATION This study was approved by the Institutional Review Board of the National Cancer Center Japan on 5 January 2023 (ID: 2022-228). Study findings will be disseminated through peer-reviewed journals and conference presentations. TRIAL STATUS The study is currently recruiting participants and the enrolment period will end on 31 March 2025, with an expected follow-up date of 31 March 2026. TRIAL REGISTRATION NUMBER UMIN000049964.
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Affiliation(s)
- Ayumu Matsuoka
- Division of Survivorship Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Maiko Fujimori
- Division of Survivorship Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Takafumi Koyama
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Ayako Sato
- Division of Survivorship Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Keita Mori
- Department of Biostatistics, Clinical Research Support Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - Makoto Hirata
- Department of Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan
| | - Noriko Tanabe
- Department of Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan
| | - Kohei Nakachi
- Department of Medical Oncology, Tochigi Cancer Center, Utsunomiya, Japan
| | - Shunsuke Kato
- Department of Clinical Oncology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Kohei Ogawa
- Department of Medical Oncology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Hirokazu Komatsu
- Department of Hematology and Oncology, Nagoya City University Institute of Medical and Pharmaceutical Sciences, Nagoya, Japan
| | - Masahiro Iwasaku
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tempei Miyaji
- Division of Survivorship Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Yosuke Uchitomi
- Division of Survivorship Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
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Hirata T, Kawaguchi T, Azuma K, Torii A, Usui H, Kim S, Hayama T, Hirate D, Kawahara Y, Kumihashi Y, Chisaka T, Wako T, Yoshimura A, Miyaji T, Yamaguchi T. Registry study of immune-related adverse events using electronic patient-reported outcome in patients with cancer receiving immune checkpoint inhibitors: protocol for a multicentre cohort study. BMJ Open 2023; 13:e073724. [PMID: 37993166 PMCID: PMC10668225 DOI: 10.1136/bmjopen-2023-073724] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/31/2023] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION The use of immune checkpoint inhibitors (ICIs) is rapidly expanding in cancer treatment. ICIs have a unique safety profile, characterised by immune-related adverse events (irAEs). The safety profile of ICIs lacks patient experience and perspectives. This study primarily aims to obtain a database for descriptive research on the status of irAEs using the Patient-Reported Outcomes version of the Common Terminology Criteria (PRO-CTCAE) in patients with gastrointestinal cancer, lung cancer and malignant pleural mesothelioma treated with regimens containing ICIs. METHODS AND ANALYSIS This is an ongoing, multicentre, observational study in Japan. Eligible patients must be at least 20 years old and have been diagnosed with lung cancer, malignant pleural mesothelioma or gastrointestinal cancer and plan to use ICIs. Participants will install the electronic PRO (ePRO) application and report adverse events via ePRO using PRO-CTCAE once weekly for up to 48 weeks. A registry will be established using background information obtained from medical records. The sample size is determined by 1 year projection without using statistical methods. Statistical analyses will include point estimates and 95% CIs for the incidence of each adverse event by cancer type and regimen at each time point. ETHICS AND DISSEMINATION This research will be conducted per the Declaration of Helsinki, the Ethical Guidelines for Life Science and Medical Research Involving Human Subjects issued by the Ministry of Education, Culture, Sports, Science and Technology and the Ministry of Health, Labor and Welfare, and the revised Personal Information Protection Law. The study protocol was approved by the Ethics Committee (approval ID T2021-0180) of Tokyo Medical University Hospital on 15 October 2021. REGISTRATION DETAILS The study began enrolling patients in December 2021. The target enrolment is 260; as of October 2022, 141 have been enrolled, and the enrolment is scheduled to end on 30 June 2023. TRIAL REGISTRATION NUMBER UMIN000046418.
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Affiliation(s)
- Taiki Hirata
- Department of Pharmacy, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Hachioji, Japan
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kanako Azuma
- Department of Pharmacy, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Ayako Torii
- Department of Pharmacy, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Hiroaki Usui
- Department of Pharmacy, Kyorin University Hospital, Mitaka, Japan
| | - Soan Kim
- Department of Pharmacy, Juntendo University Nerima Hospital, Nerima-ku, Japan
| | - Tatsuya Hayama
- Department of Pharmacy, Nihon University Itabashi Hospital, Itabashi-ku, Japan
| | - Daisuke Hirate
- Department of Pharmacy, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yosuke Kawahara
- Department of Pharmacy, JR Tokyo General Hospital, Shibuya-ku, Japan
| | - Yuki Kumihashi
- Department of Pharmacy, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Tomomi Chisaka
- Department of Pharmacy, University of Miyazaki Hospital, Miyazaki-gun, Japan
| | - Tetsuya Wako
- Department of Pharmacy, Nippon Medical School Hospital, Bunkyo-ku, Japan
| | - Akinobu Yoshimura
- Department of Clinical Oncology, Outpatient Chemotherapy Center, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Tempei Miyaji
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Kuniyoshi O, Sano M, Nakano Y, Kawaguchi T, Hatakeyama T, Tsuchiya Y, Inada Y, Harada T, Kurosaki M, Mashiko T, Miyaji T, Yamaguchi T. Protocol for the ASTRO study (SSOP-01): a multicentre prospective cohort study investigating adverse events based on electronic patient-reported outcomes in patients with breast cancer after adjuvant chemotherapy. BMJ Open 2023; 13:e071500. [PMID: 37709306 PMCID: PMC10503369 DOI: 10.1136/bmjopen-2022-071500] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/20/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION Symptom-related adverse events associated with perioperative chemotherapy in patients with breast cancer include short-term adverse events such as nausea and vomiting. However, changes in the severity and duration of prolonged symptom-related adverse events have not been fully investigated. We present a protocol of a study that aims to clarify the prevalence of symptom-related adverse events in patients with breast cancer 1 year after neoadjuvant or adjuvant chemotherapy using an electronic patient-reported outcomes (ePRO) system. METHODS AND ANALYSIS This multicentre prospective observational cohort study will include patients with breast cancer who have received preoperative or postoperative adjuvant chemotherapy. The final injection date of the cytotoxic agent will be the study initiation date. Patients will report every 2 weeks from the initiation date to 12 weeks and every 4 weeks from 12 weeks to 1 year, and they can enter this information into the ePRO system from anywhere. The primary outcome will be the prevalence of symptom-related adverse events according to the ePRO system 1 year after the date of the last injection of the cytotoxic drug used in neoadjuvant or adjuvant chemotherapy for breast cancer. To increase multi-institutional enrolment, two cohorts will be included. Cohort 1 will comprise patients with acquisition of baseline patient information regarding preoperative chemotherapy and presurgery characteristics. Cohort 2 will comprise patients without acquisition of baseline patient information. The target sample size is ≥250 per year. ETHICS AND DISSEMINATION The study protocol has been approved by the ethics committee at each participating institution. The results will be presented at major national and international conferences and submitted to peer-reviewed journals. TRIAL STATUS Registration was started in October 2021. By August 2022, a total of 132 participants were enrolled. Follow-up will be continued through December 2024. TRIAL REGISTRATION NUMBER UMIN000045422.
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Affiliation(s)
- Ouki Kuniyoshi
- Pharmaceutical Department, Ageo Central General Hospital, Ageo, Japan
| | - Motohiko Sano
- Division of Applied Pharmaceutical Education and Research, Hoshi University, Shinagawa-ku, Japan
- Department of Pharmacy Services, Saitama Medical University, Iruma-gun, Japan
| | - Yasuhiro Nakano
- Pharmaceutical Department, Cancer Institute Hospital, Koto-ku, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | | | - Yusuke Tsuchiya
- Pharmaceutical Department, Ageo Central General Hospital, Ageo, Japan
| | - Yusuke Inada
- Pharmaceutical Department, Yokohama Rosai Hospital, Yokohama, Japan
| | - Tomohiko Harada
- Pharmaceutical Department, Kanagawa Cancer Center, Yokohama, Japan
| | - Miyuki Kurosaki
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tomoe Mashiko
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tempei Miyaji
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Shinozaki T, Imai T, Kobayashi K, Yoshimoto S, Zenda S, Yamaguchi T, Eguchi K, Okano T, Mashiko T, Kurosaki M, Miyaji T, Matsuura K. Preoperative steroid for enhancing patients' recovery after head and neck cancer surgery with free tissue transfer reconstruction: protocol for a phase III, placebo-controlled, randomised, double-blind study (J-SUPPORT 2022, PreSte-HN Study). BMJ Open 2023; 13:e069303. [PMID: 37258074 DOI: 10.1136/bmjopen-2022-069303] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION There is no established methodology for the perioperative management of head and neck cancer surgery and free tissue transfer reconstruction (HNS-FTR). A single dose of corticosteroid administered immediately before surgery has been shown to reduce postoperative pain and nausea/vomiting after some types of surgery. However, the efficacy of this strategy has not been demonstrated in HNS-FTR, and the increased risk of infectious complications associated with its use cannot be ruled out. This phase III, placebo-controlled, randomised, double-blind, comparative, multicentre study seeks to determine if preoperative administration of corticosteroid hormone has an adjunctive effect in terms of reducing pain and nausea/vomiting after surgery and improving the quality of postoperative recovery. METHODS AND ANALYSIS Using the minimisation method, patients undergoing HNS-FTR are currently being recruited and randomly assigned to a study arm at a 1:1 allocation rate. The study treatment arm consists of 8.0 mg of dexamethasone phosphate dissolved in 100 mL of saline administered as a single dose by intravenous infusion. These treatments will be administered in a double-blind fashion. All patients will receive perioperative care according to the common multicentre enhanced recovery after surgery programme. The primary endpoint is the quality of postoperative recovery, as determined by the area under the curve (AUC) for total score on the Japanese version of the Quality of Recovery Score (QOR-40J) on postoperative days 2 and 4. The point estimate and CI for the difference in the AUC between the groups on postoperative days 2 and 4 will be calculated. ETHICS AND DISSEMINATION The study will be performed in accordance with the Declaration of Helsinki and Japan's Clinical Trials Act. The study protocol was approved by the Certified Review Board of National Cancer Center Hospital East (Reference K2021004). TRIAL REGISTRATION NUMBER The study was registered in the Japan Registry of Clinical Trials (jRCTs031210593; V.3.0, November 2021, available at https://jrct.niph.go.jp/en-latest-detail/jRCTs031210593).
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Affiliation(s)
- Takeshi Shinozaki
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takayuki Imai
- Department of Head and Neck Surgery, Miyagi Cancer Center, Natori, Japan
| | - Kenya Kobayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Sadamoto Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kohtaro Eguchi
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Tomoka Okano
- Department of Pharmacy, National Cancer Center-Hospital East, Kashiwa, Japan
| | - Tomoe Mashiko
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center, Tokyo, Japan
| | - Miyuki Kurosaki
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center, Tokyo, Japan
| | - Tempei Miyaji
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center, Tokyo, Japan
| | - Kazuto Matsuura
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
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Uchida M, Furukawa TA, Yamaguchi T, Imai F, Momino K, Katsuki F, Sakurai N, Miyaji T, Horikoshi M, Iwata H, Zenda S, Iwatani T, Ogawa A, Inoue A, Abe M, Toyama T, Uchitomi Y, Matsuoka H, Noma H, Akechi T. Optimization of smartphone psychotherapy for depression and anxiety among patients with cancer using the multiphase optimization strategy (MOST) framework and decentralized clinical trial system (SMartphone Intervention to LEssen depression/Anxiety and GAIN resilience: SMILE AGAIN project): a protocol for a randomized controlled trial. Trials 2023; 24:344. [PMID: 37217965 DOI: 10.1186/s13063-023-07307-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/11/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Cancer patients experience various forms of psychological distress. Their distress, mainly in the form of depression and anxiety, leads to poor quality of life, increased medical spending due to frequent visits, and decrease in treatment adherence. It is estimated that 30-50% among them would require support from mental health professionals: in reality, much less actually receive such support partly due to a shortage of qualified professionals and also due to psychological barriers in seeking such help. The purpose of the present study is to develop the easily accessible and the most efficient and effective smartphone psychotherapy package to alleviate depression and anxiety in cancer patients. METHODS Based on the multiphase optimization strategy (MOST) framework, the SMartphone Intervention to LEssen depression/Anxiety and GAIN resilience project (SMILE-AGAIN project) is a parallel-group, multicenter, open, stratified block randomized, fully factorial trial with four experimental components: psychosocial education (PE), behavioral activation (BA), assertion training (AT), and problem-solving therapy (PS). The allocation sequences are maintained centrally. All participants receive PE and then are randomized to the presence/absence of the remaining three components. The primary outcome of this study is the Patient Health Questionnaire-9 (PHQ-9) total score, which will be administered as an electronic patient-reported outcome on the patients' smartphones after 8 weeks. The protocol was approved by the Institutional Review Board of Nagoya City University on July 15, 2020 (ID: 46-20-0005). The randomized trial, which commenced in March 2021, is currently enrolling participants. The estimated end date for this study is March 2023. DISCUSSION The highly efficient experimental design will allow for the identification of the most effective components and the most efficient combinations among the four components of the smartphone psychotherapy package for cancer patients. Given that many cancer patients face significant psychological hurdles in seeing mental health professionals, easily accessible therapeutic interventions without hospital visits may offer benefits. If an effective combination of psychotherapy is determined in this study, it can be provided using smartphones to patients who cannot easily access hospitals or clinics. TRIAL REGISTRATION UMIN000041536, CTR. Registered on 1 November 2020 https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000047301 .
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Affiliation(s)
- Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
- Center for Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Fuminobu Imai
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
| | - Kanae Momino
- Department of Nursing Administration and Management, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Fujika Katsuki
- Department of Psychiatric and Mental Health Nursing, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | | | - Tempei Miyaji
- Department of Clinical Trial Data Management, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - Masaru Horikoshi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Sadamoto Zenda
- Division of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Tsuguo Iwatani
- Department of Breast Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Asao Ogawa
- Department of Psycho-Oncology Service, National Cancer Center Hospital East, Kashiwa, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Miyagi, Japan
| | - Masakazu Abe
- Division of Gynecologic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
- Department of Gynecology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Tatsuya Toyama
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Yosuke Uchitomi
- Behavioral and Survivorship Research Group, Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hisashi Noma
- Institute of Statistical Mathematics, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
- Center for Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan.
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Obama K, Fujimori M, Okamura M, Kadowaki M, Ueno T, Boku N, Mori M, Akechi T, Yamaguchi T, Oyamada S, Okizaki A, Miyaji T, Sakurai N, Uchitomi Y. Effectiveness of a facilitation programme using a mobile application for initiating advance care planning discussions between patients with advanced cancer and healthcare providers: protocol for a randomised controlled trial (J-SUPPORT 2104). BMJ Open 2023; 13:e069557. [PMID: 36977536 PMCID: PMC10069562 DOI: 10.1136/bmjopen-2022-069557] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Timely implementation of the discussion process of advance care planning (ACP) is recommended. The communication attitude of healthcare providers is critical in ACP facilitation; thus, improving their communication attitudes may reduce patient distress and unnecessary aggressive treatment while enhancing care satisfaction. Digital mobile devices are being developed for behavioural interventions owing to their low space and time restrictions and ease of information sharing. This study aims to evaluate the effectiveness of an intervention programme using an application intended to facilitate patient questioning behaviour on improving communication related to ACP between patients with advanced cancer and healthcare providers. METHODS AND ANALYSIS This study uses a parallel-group, evaluator-blind, randomised controlled trial design. We plan to recruit 264 adult patients with incurable advanced cancer at the National Cancer Centre in Tokyo, Japan. Intervention group participants use a mobile application ACP programme and undergo a 30 min interview with a trained intervention provider for discussions with the oncologist at the next patient visit, while control group participants continue their usual treatment. The primary outcome is the oncologist's communication behaviour score assessed using audiorecordings of the consultation. Secondary outcomes include communication between patients and oncologists and the patients' distress, quality of life, care goals and preferences, and medical care utilisation. We will use a full analysis set including the registered participant population who receive at least a part of the intervention. ETHICS AND DISSEMINATION The study protocol was reviewed and approved by the Scientific Advisory Board of the Japan Supportive, Palliative and Psychosocial Oncology Group (Registration No. 2104) and the Institutional Review Board of the National Cancer Centre Hospital (registration No. 2020-500). Written informed consent is obtained from the patients. The results of the trial will be published in peer-reviewed scientific journals and presented at scientific meetings. TRIAL REGISTRATION NUMBERS UMIN000045305, NCT05045040.
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Affiliation(s)
- Kyoko Obama
- Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | - Maiko Fujimori
- Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | - Masako Okamura
- Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | - Midori Kadowaki
- Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | | | - Narikazu Boku
- Department of Oncology and General Medicine, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Masanori Mori
- Division of Palliative and Supportive Care, Seirei Mikatahara Hospital, Hamamatsu, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Ayumi Okizaki
- Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | - Tempei Miyaji
- Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | - Naomi Sakurai
- Cancer Survivors Recruiting Project, General Incorporated Association, Tokyo, Japan
| | - Yosuke Uchitomi
- Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Chuo-ku, Japan
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11
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Ishiki H, Kikawa Y, Terada M, Mizusawa J, Honda M, Iwatani T, Mizutani T, Mori K, Nakamura N, Miyaji T, Yamaguchi T, Ando M, Nakamura K, Fukuda H, Kiyota N. Patient-reported outcome and quality of life research policy: Japan Clinical Oncology Group (JCOG) policy. Jpn J Clin Oncol 2023; 53:195-202. [PMID: 36702740 PMCID: PMC9991489 DOI: 10.1093/jjco/hyad007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/12/2023] [Indexed: 01/28/2023] Open
Abstract
Assessments of patient-reported outcomes and health-related quality of life in cancer clinical trials have been increasingly emphasized recently because patient and public involvement in cancer treatment development has been promoted by regulatory authorities and academic societies. To assess patient experiences during and after cancer treatment, there is interest in implementing patient-reported outcome and health-related quality of life assessments into cancer clinical trials. The Japan Clinical Oncology Group quality of life ad hoc committee previously created a version of the Quality of Life Assessment Policy in 2006. Recently, there has been increasing demand from Japan Clinical Oncology Group researchers to assess patient-reported outcome/health-related quality of life in clinical trials. Although guidelines are available regarding planning and reporting clinical trials that include patient-reported outcome/health-related quality of life as an endpoint, there are still issues regarding the lack of consensus on standardized methods for analysing and interpreting the results. Hence, it was considered necessary to reorganize the Japan Clinical Oncology Group patient-reported outcome/quality of life research committee and to revise the former patient-reported outcome/quality of life research policy to promote patient-reported outcome/health-related quality of life research in future Japan Clinical Oncology Group trials. The purpose of this Japan Clinical Oncology Group patient-reported outcome/quality of life research policy is to define patient-reported outcome/health-related quality of life research and provide guidelines for including patient-reported outcome/health-related quality of life as an endpoint in Japan Clinical Oncology Group trials.
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Affiliation(s)
- Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Kikawa
- Department of Breast Surgery, Kansai Medical University, Osaka, Japan
| | - Mitsumi Terada
- Department of International Clinical Development, National Cancer Center Hospital, Tokyo, Japan
| | - Junki Mizusawa
- Japan Clinical Oncology Group (JCOG) Data Center, National Cancer Center Hospital, Tokyo, Japan
| | - Michitaka Honda
- Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - Tsuguo Iwatani
- Departments of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Tomonori Mizutani
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Keita Mori
- Department of Biostatistics, Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - Naoki Nakamura
- Department of Radiation Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Tempei Miyaji
- Division of Supportive Care, Survivorship and Translational Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masahiko Ando
- Department of Advanced Medicine, University Hospital, Nagoya, Japan
| | - Kenichi Nakamura
- JCOG Data Center/Operations Office, National Cancer Center, Tokyo, Japan
| | - Haruhiko Fukuda
- Japan Clinical Oncology Group (JCOG) Data Center, National Cancer Center Hospital, Tokyo, Japan
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan
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Sekine Y, Kawaguchi T, Kunimoto Y, Masuda J, Numata A, Hirano A, Yagura H, Ishihara M, Hikasa S, Tsukiji M, Miyaji T, Yamaguchi T, Kinai E, Amano K. Adherence to anti-retroviral therapy, decisional conflicts, and health-related quality of life among treatment-naïve individuals living with HIV: a DEARS-J observational study. J Pharm Health Care Sci 2023; 9:9. [PMID: 36859482 PMCID: PMC9979481 DOI: 10.1186/s40780-023-00277-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/14/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Supporting people living with HIV using anti-retroviral therapy (ART) is important due to the requirement for strict medication adherence. To date, no data from longitudinal studies evaluating adherence by treatment-naïve people living with HIV are currently available. We investigated the adherence of treatment-naïve people living with HIV over time and examined the relationships among decisional conflicts, adherence, and health-related quality of life (HRQL). METHODS The survey items included adherence (visual analogue scale [VAS]), decisional conflict (decisional conflict scale [DCS]), and HRQL (Medical Outcomes Study HIV Health Survey [MOS-HIV]). The DCS and MOS-HIV scores and the VAS and MOS scores were collected electronically at the ART initiation time point and at 4-, 24-, and 48-week post-treatment time points. RESULTS A total of 215 participants were enrolled. The mean DCS score was 27.3 (SD, 0.9); 23.3% of participants were in the high-score and 36.7% in the low-score groups. The mean adherence rates at 4, 24, and 48 weeks were 99.2% (standard error [SE], 0.2), 98.4% (SE, 0.4), and 96.0% (SE, 1.2), respectively. The least-square means of the MOS-HIV for the DCS (high vs. low scores) were 64.4 vs. 69.2 for general health perceptions and 57.7 vs. 64.0 for HRQL, respectively. CONCLUSION Adherence among treatment-naïve people living with HIV was maintained at a higher level, and HRQL tended to improve with ART. People with high levels of decisional conflict tended to have lower HRQL scores. Support for people living with HIV during ART initiation may be related to HRQL.
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Affiliation(s)
- Yusuke Sekine
- Department of Pharmacy, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Takashi Kawaguchi
- grid.410785.f0000 0001 0659 6325Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Yusuke Kunimoto
- grid.470107.5Department of Pharmacy, Sapporo Medical University Hospital, Sapporo, Japan
| | - Junichi Masuda
- grid.45203.300000 0004 0489 0290Department of Pharmacy, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Ayako Numata
- grid.45203.300000 0004 0489 0290Department of Pharmacy, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Atsushi Hirano
- grid.410840.90000 0004 0378 7902Department of Pharmacy, National Hospital organization Nagoya Medical Center, Nagoya, Japan
| | - Hiroki Yagura
- grid.416803.80000 0004 0377 7966Department of Pharmacy, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Masashi Ishihara
- grid.411704.7Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Shinichi Hikasa
- grid.272264.70000 0000 9142 153XDepartment of Pharmacy, Hyogo Medical University Hospital, Hyogo, Japan
| | - Mariko Tsukiji
- grid.411321.40000 0004 0632 2959Division of Pharmacy, Chiba University Hospital, Chiba, Japan
| | - Tempei Miyaji
- grid.69566.3a0000 0001 2248 6943Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takuhiro Yamaguchi
- grid.69566.3a0000 0001 2248 6943Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ei Kinai
- grid.410793.80000 0001 0663 3325Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan
| | - Kagehiro Amano
- grid.410793.80000 0001 0663 3325Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan
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13
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Akechi T, Yamaguchi T, Uchida M, Imai F, Momino K, Katsuki F, Sakurai N, Miyaji T, Mashiko T, Horikoshi M, Furukawa TA, Yoshimura A, Ohno S, Uehiro N, Higaki K, Hasegawa Y, Akahane K, Uchitomi Y, Iwata H. Smartphone Psychotherapy Reduces Fear of Cancer Recurrence Among Breast Cancer Survivors: A Fully Decentralized Randomized Controlled Clinical Trial (J-SUPPORT 1703 Study). J Clin Oncol 2023; 41:1069-1078. [PMID: 36322882 PMCID: PMC9928623 DOI: 10.1200/jco.22.00699] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/06/2022] [Accepted: 08/18/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Fear of cancer recurrence (FCR) is a common distressing condition. We investigated the efficacy of smartphone problem-solving therapy and behavioral activation applications in breast cancer survivors. METHODS This was a decentralized randomized trial. Participants were disease-free breast cancer survivors age 20-49 years who were randomly assigned to the smartphone-based intervention or waitlist control. Both groups received treatment as usual. The control group could access the smartphone apps during weeks 8-24. The intervention comprised smartphone problem-solving therapy and behavioral activation apps. The primary end point was the Concerns About Recurrence Scale at week 8. Secondary outcomes included the Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF), the Hospital Anxiety and Depression Scale (HADS), the Short-form Supportive Care Needs Survey (SCNS-SF34), and the Posttraumatic Growth Inventory at weeks 8 and 24 (trial registration: UMIN-CTR: UMIN000031140). RESULTS The intervention group included 223 participants, and the control group included 224 participants. Primary outcome data were obtained for 444 participants, and 213 participants in the intervention arm completed the week 24 assessment. The intervention group had statistically greater improvements than controls at week 8 on the Concerns About Recurrence Scale (difference -1.39; 95% CI, -1.93 to -0.85; P < .001), FCRI-SF (difference -1.65; 95% CI, -2.41 to -0.89; P < .001), HADS depression (difference -0.49; 95% CI, -0.98 to 0; P < .05), and SCNS-SF34 psychological domain (difference -1.49; 95% CI, -2.67 to -0.32; P < .05). These scores at week 24 were not statistically significant compared with week 8 although the HADS depression score at week 24 was significantly reduced (P = .03). CONCLUSION Novel smartphone psychotherapy offers a promising way to reduce FCR given the large number of survivors and a limited number of therapists to competently conduct psychotherapy.
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Fuminobu Imai
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Kanae Momino
- Department of Nursing Administration and Management, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Fujika Katsuki
- Department of Psychiatric and Mental Health Nursing, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | | | - Tempei Miyaji
- Department of Clinical Trial Data Management, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - Tomoe Mashiko
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
- Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Masaru Horikoshi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Toshi A. Furukawa
- Kyoto University Graduate School of Medicine/School of Public Health, Department of Health Promotion of Human Behavior, Kyoto, Japan
| | - Akiyo Yoshimura
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shinji Ohno
- Breast Oncology Center, The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - Natsue Uehiro
- Breast Oncology Center, The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | | | - Yoshie Hasegawa
- Department of Breast Surgery, Hachinohe City Hospital, Hachinohe, Aomori, Japan
| | | | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
- Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Endo M, Kawahara S, Sato T, Tokunaga M, Hara T, Mawatari T, Kawano T, Zenda S, Miyaji T, Shimokawa M, Sakamoto S, Takano T, Miyake M, Aono H, Nakashima Y. Protocol for the RETHINK study: a randomised, double-blind, parallel-group, non-inferiority clinical trial comparing acetaminophen and NSAIDs for treatment of chronic pain in elderly patients with osteoarthritis of the hip and knee. BMJ Open 2023; 13:e068220. [PMID: 36764707 PMCID: PMC9923306 DOI: 10.1136/bmjopen-2022-068220] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION In patients with chronic pain, oral analgesics are essential treatment options to manage pain appropriately, improve activities of daily living abilities and achieve a higher quality of life (QOL). It is desirable to select analgesics for elderly patients based on comparative data on analgesic effect and risk of adverse events; however, there are few comparative studies so far. The purpose of this study is to determine whether the efficacy and safety of acetaminophen are non-inferior to non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of chronic pain associated with osteoarthritis of the hip and knee in elderly patients. METHODS AND ANALYSIS This study is a multicentre, randomised controlled, double-blind, parallel-group study to compare the analgesic effect and adverse events between acetaminophen or NSAIDs (loxoprofen or celecoxib). A total of 400 elderly patients with osteoarthritis of the hip and knee will be recruited from five institutions in Japan. Patients of 65 years or older with osteoarthritis-related pain will be registered and randomly assigned to acetaminophen, loxoprofen or celecoxib with 2:1:1 allocation. The primary endpoint is change in the Brief Pain Inventory (BPI) item 3 (worst pain) score from baseline to week 8. The secondary endpoints are BPI item 3 score change from baseline to week 4, health-related QOL measured by Short Form-8 Health Survey, and occurrence of adverse events including gastrointestinal disorders and abnormal liver function. Data will be analysed in accordance with a predefined statistical analysis plan. ETHICS AND DISSEMINATION This study protocol was approved by the Kyushu University Hospital Certified Institutional Review Board for Clinical Trials on 28 January 2021 (KD2020004) and the chief executive of each participating hospital. The results of the study will be submitted to international peer-reviewed journals, and the main findings will be presented at international scientific conferences. TRIAL REGISTRATION NUMBER jRCTs071200112.
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Affiliation(s)
- Makoto Endo
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | - Shinya Kawahara
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | - Taishi Sato
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan
| | - Masami Tokunaga
- Department of Orthopaedic Surgery, Fukuoka Orthopaedic Hospital, Fukuoka, Japan
| | - Toshihiko Hara
- Department of Orthopaedic Surgery, Aso Iizuka Hospital, Iizuka, Fukuoka, Japan
| | - Taro Mawatari
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka, Japan
| | - Tsutomu Kawano
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Kitakyushu, Fukuoka, Japan
| | - Sadamoto Zenda
- Department of Radiation Oncology, National Cancer Centre Hospital East, Kashiwa, Chiba, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
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15
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Zenda S, Arai Y, Sugawara S, Inaba Y, Hashimoto K, Yamamoto K, Saigusa Y, Kawaguchi T, Shimada S, Yokoyama M, Miyaji T, Okano T, Nakamura N, Kobayashi E, Takagi T, Matsumoto Y, Uchitomi Y, Sone M. Protocol for a confirmatory trial of the effectiveness and safety of palliative arterial embolization for painful bone metastases. BMC Cancer 2023; 23:109. [PMID: 36721103 PMCID: PMC9887749 DOI: 10.1186/s12885-023-10538-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/10/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Transcatheter arterial embolization (TAE) has long been used for hemostasis of traumatic or postoperative hemorrhage and embolization of tumors. Previous retrospective studies of TAE for painful bone metastases showed 60%-80% pain reduction with a median time to response of 1-2 days. Compared with radiotherapy and bisphosphonates, time to response appeared earlier than that of radiotherapy or bone-modifying agents. However, few prospective studies have examined TAE for this indication. Here, we describe the protocol for a confirmatory study designed to clarify the efficacy and safety profile of TAE. METHODS This study will be a multicenter, single-arm confirmatory study (phase 2-3 design). Patients with painful bone metastases from any primary tumor are eligible for enrollment. TAE will be the main intervention. Following puncture of the femoral artery under local anesthesia and insertion of an angiographic sheath, angiography will confirm that the injected region includes tumor vasculature. Catheter position will be adjusted so that the embolization range does not include non-target tissues. Spherical embolic material will then be slowly injected into the artery to embolize it. The primary endpoint (efficacy) is the proportion of subjects with pain relief at 72 h after TAE and the secondary endpoint (safety) is the incidence of all NCI Common Terminology Criteria for Adverse Events version 5.0 Grade 4 adverse events and Grade ≥ 3 necrosis of the central nervous system. DISCUSSION If the primary and secondary endpoints are met, TAE can be a treatment choice for painful bone metastases. Trial registry number is UMIN-CTR ID: UMIN000040794. TRIAL REGISTRATION The study is ongoing, and patients are currently being enrolled. Enrollment started in March 2021. A total of 36 patients have participated as of Aug 2022. PROTOCOL VERSION Ver1.4, 13/07/2022.
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Affiliation(s)
- Sadamoto Zenda
- grid.497282.2Department of Radiation Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa Chiba, Japan ,grid.497282.2Department of Supportive and Palliative Care Research Support Office, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa Chiba, Japan
| | - Yasunori Arai
- grid.497282.2Department of Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa Chiba, Japan
| | - Shunsuke Sugawara
- grid.497282.2Department of Radiology, National Cancer Center Hospital East, 5-1-1 Tsukiji Chuo-Ku, Tokyo, Japan
| | - Yoshitaka Inaba
- grid.410800.d0000 0001 0722 8444Department of Diagnostic and Interventional Radiology, Aichi Cancer Center, 1-1, Kanokoden, Chikusa-Ku, Nagoya, Aichi 464-8681 Japan
| | - Kazuki Hashimoto
- grid.412764.20000 0004 0372 3116Department of Radiology, St. Marianna University School of Medicine, Sugao 2-16-1, Miyamae, Kawasaki, Kanagawa Japan
| | - Kouji Yamamoto
- grid.268441.d0000 0001 1033 6139Department of Biostatistics, Yokohama City University, 3-9 Fukuura Kanazawa-Ku, Yokohama City, Kanagawa Japan
| | - Yusuke Saigusa
- grid.268441.d0000 0001 1033 6139Department of Biostatistics, Yokohama City University, 3-9 Fukuura Kanazawa-Ku, Yokohama City, Kanagawa Japan
| | - Takashi Kawaguchi
- grid.410785.f0000 0001 0659 6325Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi Hachioji, Tokyo, Japan
| | - Sanae Shimada
- grid.497282.2Department of Supportive and Palliative Care Research Support Office, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa Chiba, Japan
| | - Marie Yokoyama
- grid.497282.2Department of Supportive and Palliative Care Research Support Office, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa Chiba, Japan
| | - Tempei Miyaji
- grid.272242.30000 0001 2168 5385Division of Supportive Care, Survivorship and Translational Research, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Tokyo, 104-0045 Japan
| | - Tomoka Okano
- grid.497282.2Department of Supportive and Palliative Care Research Support Office, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa Chiba, Japan
| | - Naoki Nakamura
- grid.412764.20000 0004 0372 3116Department of Radiation Oncology, St. Marianna University School of Medicine, Sugao 2-16-1, Miyamae, Kawasaki, Kanagawa Japan
| | - Eisuke Kobayashi
- grid.272242.30000 0001 2168 5385Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-Ku, Tokyo, Japan
| | - Tatsuya Takagi
- grid.258269.20000 0004 1762 2738Department of Orthopedic Surgery, Juntendo University School of Medicine, 3-1-3 Hongo Bunkyo-Ku, Tokyo, Japan
| | - Yoshihisa Matsumoto
- grid.486756.e0000 0004 0443 165XDepartment of Palliative Care, Cancer Institute Hospital of JFCR, 3-8-31 Ariake Koto-Ku, Tokyo, Japan
| | - Yosuke Uchitomi
- grid.272242.30000 0001 2168 5385Division of Supportive Care, Survivorship and Translational Research, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Tokyo, 104-0045 Japan
| | - Miyuki Sone
- grid.497282.2Department of Radiology, National Cancer Center Hospital East, 5-1-1 Tsukiji Chuo-Ku, Tokyo, Japan
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Obama K, Fujimori M, Boku N, Matsuoka A, Mori K, Okizaki A, Miyaji T, Kadowaki M, Okamura M, Majima Y, Shimazu T, Uchitomi Y. Shared Decision-Making Support Program for Elderly Patients with Advanced Cancer Using Question Prompts and Geriatric Assessments: Phase II Randomized Controlled Trial. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00301-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Matsuoka A, Fujimori M, Narikazu B, Takashima A, Okusaka T, Mori K, Akechi T, Shimazu T, Okizaki A, Miyaji T, Majima Y, Nagashima F, Uchitomi Y. Geriatric assessment and management with question prompt list using a web-based application for elderly patients with cancer (MAPLE) to communicate ageing-related concerns: J-SUPPORT 2101 study protocol for a multicentre, parallel group, randomised controlled trial. BMJ Open 2022; 12:e063445. [PMID: 36167377 PMCID: PMC9516071 DOI: 10.1136/bmjopen-2022-063445] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Elderly cancer patients often have ageing-related physical and psychosocial problems that should be fully shared with their oncologists. Geriatric assessment (GA) can assess these ageing-related problems and guide management. Communication support might also facilitate implementation of GA-guided management. We will conduct a multicentre, randomised controlled trial to examine the efficacy of a programme that combines a GA summary, management recommendations and communication support to facilitate ageing-related communications between elderly Japanese patients with cancer and their oncologists, and thus to implement programme-guided management. METHODS AND ANALYSIS We plan to recruit a total of 210 patients aged ≥70 years, diagnosed with incurable cancers of gastrointestinal origin, and referred for first-line or second-line chemotherapy. In the intervention arm, a summary of management recommendations based on a GA and question prompt list (QPL) will be provided to patients and shared with their oncologists at the first outpatient visit after randomisation by trained intervention providers. For 5 months after the initial intervention, implementation of GA-guided management recommendations will be reviewed monthly with the patients and their oncologists to implement management as needed. The GA and QPL will be re-evaluated at 3 months, with a summary provided to patients and their oncologists. Those participants allocated to the usual care arm will receive usual oncology care. The primary endpoint is the number of conversations about ageing-related concerns at the first outpatient visit after randomisation. ETHICS AND DISSEMINATION This study was approved by the institutional review board of the National Cancer Center Japan on 15 April 2021 (ID: 2020-592). Study findings will be disseminated through peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER UMIN000045428.
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Affiliation(s)
- Ayumu Matsuoka
- Division of Supportive Care, Survivorship and Translational Research, Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | - Maiko Fujimori
- Division of Supportive Care, Survivorship and Translational Research, Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | - Boku Narikazu
- Department of Oncology and General Medicine, IMSUT Hospital, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Atsuo Takashima
- Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Keita Mori
- Clinical Trial Coodination Office, Shizuoka Cancer Center, Shizuoka, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Graduate School of Medical Sciences and Medical School, Nagoya City University, Nagoya, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | - Ayumi Okizaki
- Division of Supportive Care, Survivorship and Translational Research, Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | | | - Fumio Nagashima
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Yosuke Uchitomi
- Division of Supportive Care, Survivorship and Translational Research, Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
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Horie Y, Miyaji T, Kawaguchi T, Kaneyasu T, Nagashima F, Doi A, Uneno Y, Ogura T, Yamaguchi T, Nakajima T. MO35-2 Symptom monitoring and its digitalization at daily cancer chemotherapy in Japan: a nation-wide multi-stakeholder survey. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.05.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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19
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Yamada Y, Fujiwara M, Shimazu T, Etoh T, Kodama M, So R, Matsushita T, Yoshimura Y, Horii S, Fujimori M, Takahashi H, Nakaya N, Miyaji T, Hinotsu S, Harada K, Okada H, Uchitomi Y, Yamada N, Inagaki M. Patients' acceptability and implementation outcomes of a case management approach to encourage participation in colorectal cancer screening for people with schizophrenia: a qualitative secondary analysis of a mixed-method randomised clinical trial. BMJ Open 2022; 12:e060621. [PMID: 35701062 PMCID: PMC9198687 DOI: 10.1136/bmjopen-2021-060621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES We examined the efficacy of case management (CM) interventions to encourage participation in colorectal cancer screening for patients with schizophrenia. This study aimed to clarify patients' acceptability of the intervention and the helpful components of the intervention. Simultaneously, the study aimed to determine the acceptability, appropriateness and feasibility of the intervention from the perspective of psychiatric care providers. STUDY DESIGN AND SETTING This study was a secondary qualitative analysis of a mixed-method randomised controlled trial that evaluated the efficacy of the CM approach to encourage participation in cancer screening for people with schizophrenia. The intervention comprised education and patient navigation for colorectal cancer screening. Interviews were conducted with patients who received the intervention and staff from two psychiatric hospitals in Japan who delivered the intervention. PARTICIPANTS Of the 172 patients with schizophrenia who participated in the trial, 153 were included. In addition, three out of six providers were included. DATA COLLECTION AND ANALYSIS Using a structured interview, the case manager asked participants about patient acceptability and the helpful components of the intervention. Content analysis was conducted for the responses obtained, and the number of responses was tabulated by two researchers. For the interviews with the providers, opinions obtained from verbatim transcripts were extracted and summarised. RESULTS Forty-three of the 56 patients perceived that the intervention was acceptable. For the intervention component, inperson counselling with an explanation of the screening process by psychiatric care providers was most frequently reported by the patients as helpful (48 of the 68 respondents). Psychiatric care providers evaluated the intervention as acceptable, appropriate and easy to understand and administer. However, providing the intervention to all patients simultaneously was considered difficult with the current human resources. CONCLUSIONS This study showed that the CM intervention was perceived as acceptable by patients and acceptable and appropriate by psychiatric care providers. TRIAL REGISTRATION NUMBER UMIN000036017.
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Affiliation(s)
- Yuto Yamada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
- Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan
| | - Masaki Fujiwara
- Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Tsuyoshi Etoh
- Department of Nursing, Shimane University Hospital, Izumo, Japan
| | | | - Ryuhei So
- Okayama Psychiatric Medical Center, Okayama, Japan
| | | | | | | | - Maiko Fujimori
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Hirokazu Takahashi
- Division of Screening Assessment and Management, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Shiro Hinotsu
- Department of Biostatistics and Data Management, Sapporo Medical University, Sapporo, Japan
| | - Keita Harada
- Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yosuke Uchitomi
- Group for Supportive Care and Survivorship Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Norihito Yamada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Masatoshi Inagaki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
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20
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Kawakami H, Oyamada S, Horie Y, Fumita S, Izawa N, Miyaji T, Kawaguchi T, Yamaguchi T, Nakajima T. P-35 An observational study of health-related quality of life (HRQoL) with electronic patient-reported outcome (ePRO) monitoring during nivolumab therapy for advanced gastric cancer as the 3rd or later line treatment: NIVO-G QoL study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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21
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Cruz Rivera S, Aiyegbusi OL, Ives J, Draper H, Mercieca-Bebber R, Ells C, Hunn A, Scott JA, Fernandez CV, Dickens AP, Anderson N, Bhatnagar V, Bottomley A, Campbell L, Collett C, Collis P, Craig K, Davies H, Golub R, Gosden L, Gnanasakthy A, Haf Davies E, von Hildebrand M, Lord JM, Mahendraratnam N, Miyaji T, Morel T, Monteiro J, Zwisler ADO, Peipert JD, Roydhouse J, Stover AM, Wilson R, Yap C, Calvert MJ. Ethical Considerations for the Inclusion of Patient-Reported Outcomes in Clinical Research: The PRO Ethics Guidelines. JAMA 2022; 327:1910-1919. [PMID: 35579638 DOI: 10.1001/jama.2022.6421] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Patient-reported outcomes (PROs) can inform health care decisions, regulatory decisions, and health care policy. They also can be used for audit/benchmarking and monitoring symptoms to provide timely care tailored to individual needs. However, several ethical issues have been raised in relation to PRO use. OBJECTIVE To develop international, consensus-based, PRO-specific ethical guidelines for clinical research. EVIDENCE REVIEW The PRO ethics guidelines were developed following the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network's guideline development framework. This included a systematic review of the ethical implications of PROs in clinical research. The databases MEDLINE (Ovid), Embase, AMED, and CINAHL were searched from inception until March 2020. The keywords patient reported outcome* and ethic* were used to search the databases. Two reviewers independently conducted title and abstract screening before full-text screening to determine eligibility. The review was supplemented by the SPIRIT-PRO Extension recommendations for trial protocol. Subsequently, a 2-round international Delphi process (n = 96 participants; May and August 2021) and a consensus meeting (n = 25 international participants; October 2021) were held. Prior to voting, consensus meeting participants were provided with a summary of the Delphi process results and information on whether the items aligned with existing ethical guidance. FINDINGS Twenty-three items were considered in the first round of the Delphi process: 6 relevant candidate items from the systematic review and 17 additional items drawn from the SPIRIT-PRO Extension. Ninety-six international participants voted on the relevant importance of each item for inclusion in ethical guidelines and 12 additional items were recommended for inclusion in round 2 of the Delphi (35 items in total). Fourteen items were recommended for inclusion at the consensus meeting (n = 25 participants). The final wording of the PRO ethical guidelines was agreed on by consensus meeting participants with input from 6 additional individuals. Included items focused on PRO-specific ethical issues relating to research rationale, objectives, eligibility requirements, PRO concepts and domains, PRO assessment schedules, sample size, PRO data monitoring, barriers to PRO completion, participant acceptability and burden, administration of PRO questionnaires for participants who are unable to self-report PRO data, input on PRO strategy by patient partners or members of the public, avoiding missing data, and dissemination plans. CONCLUSIONS AND RELEVANCE The PRO ethics guidelines provide recommendations for ethical issues that should be addressed in PRO clinical research. Addressing ethical issues of PRO clinical research has the potential to ensure high-quality PRO data while minimizing participant risk, burden, and harm and protecting participant and researcher welfare.
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Affiliation(s)
- Samantha Cruz Rivera
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, United Kingdom
- DEMAND Hub, University of Birmingham, Birmingham, United Kingdom
| | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, United Kingdom
- National Institute for Health and Care Research (NIHR) Applied Research Centre West Midlands, Birmingham, United Kingdom
| | - Jonathan Ives
- Centre for Ethics in Medicine, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Heather Draper
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Rebecca Mercieca-Bebber
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Carolyn Ells
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | | | - Jane A Scott
- PRO Center of Excellence, Global Commercial Strategy Organization, Janssen Global Services, Warrington, United Kingdom
| | - Conrad V Fernandez
- Division of Pediatric Haematology-Oncology, IWK Health Care Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Andrew P Dickens
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Observational and Pragmatic Research Institute, Midview City, Singapore
| | - Nicola Anderson
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | | | - Andrew Bottomley
- European Organization for Research and Treatment of Cancer, Brussels, Belgium
| | - Lisa Campbell
- Medicines and Healthcare Products Regulatory Agency, London, United Kingdom
| | | | - Philip Collis
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Patient partner, University of Birmingham, Birmingham, United Kingdom
| | - Kathrine Craig
- Fast Track Research Ethics Committee, Health Research Authority, London, United Kingdom
| | - Hugh Davies
- Fast Track Research Ethics Committee, Health Research Authority, London, United Kingdom
| | | | - Lesley Gosden
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Patient partner, University of Birmingham, Birmingham, United Kingdom
| | | | | | - Maria von Hildebrand
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Patient partner, University of Birmingham, Birmingham, United Kingdom
| | - Janet M Lord
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, United Kingdom
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, United Kingdom
| | | | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Thomas Morel
- Global Patient-Centred Outcomes Research & Policy, UCB, Belgium, Brussels
| | | | - Ann-Dorthe Olsen Zwisler
- Department of Cardiology, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - John Devin Peipert
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jessica Roydhouse
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island
| | | | - Roger Wilson
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Consumer Forum, National Cancer Research Institute, London, United Kingdom
- Patient Involvement Network, Health Research Authority, London, United Kingdom
| | - Christina Yap
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, United Kingdom
| | - Melanie J Calvert
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, United Kingdom
- DEMAND Hub, University of Birmingham, Birmingham, United Kingdom
- National Institute for Health and Care Research (NIHR) Applied Research Centre West Midlands, Birmingham, United Kingdom
- NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, United Kingdom
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, United Kingdom
- Health Data Research United Kingdom, London, United Kingdom
- UK SPINE, University of Birmingham, Birmingham, United Kingdom
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22
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Matsuoka H, Clark K, Fazekas B, Oyamada S, Brown L, Ishiki H, Matsuda Y, Hasuo H, Ariyoshi K, Lee J, Le B, Allcroft P, Kochovska S, Fujiwara N, Miyaji T, Lovell M, Agar M, Yamaguchi T, Satomi E, Iwase S, Phillips J, Koyama A, Currow DC. Phase III, international, multicentre, double-blind, dose increment, parallel-arm, randomised controlled trial of duloxetine versus pregabalin for opioid-unresponsive neuropathic cancer pain: a JORTC-PAL16 trial protocol. BMJ Open 2022; 12:e050182. [PMID: 35131817 PMCID: PMC8823224 DOI: 10.1136/bmjopen-2021-050182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Management of neuropathic cancer pain (NCP) refractory to regular opioids remains an important challenge. The efficacy of pregabalin for NCP except chemotherapy-induced peripheral neuropathy (CIPN) has already been confirmed in two randomised controlled trials (RCTs) compared with placebo. Duloxetine offers the potential of analgesia in opioid refractory NCP. However, there are no RCT of duloxetine for the management of opioid-refractory NCP as a first line treatment. Both classes of drugs have the potential to reduce NCP, but there has been no head-to-head comparison for the efficacy and safety, especially given differing side effect profiles. METHODS AND ANALYSIS An international, multicentre, double-blind, dose increment, parallel-arm, RCT is planned. Inclusion criteria include: adults with cancer experiencing NCP refractory to opioids; Brief Pain Inventory (BPI)-item 3 (worst pain) of ≥4; Neuropathic Pain on the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale of ≥12 despite of an adequate trial of regular opioid medication (≥60 mg/day oral morphine equivalent dose). Patients with CIPN are excluded.The study will recruit from palliative care teams (both inpatients and outpatients) in Japan and Australia. Participants will be randomised (1:1 allocation ratio) to duloxetine or pregabalin arm. Dose escalation is until day 14 and from day 14 to 21 is a dose de-escalation period to avoid withdrawal effects. The primary endpoint is defined as the mean difference in BPI item 3 for worst pain intensity over the previous 24 hours at day 14 between groups. A sample size of 160 patients will be enrolled between February 2020 and March 2023. ETHICS AND DISSEMINATION Ethics approval was obtained at Osaka City University Hospital Certified Review Board and South Western Sydney Local Health District Human Research Ethics Committee. The results of this study will be submitted for publication in international journals and the key findings presented at international conferences. TRIAL REGISTRATION NUMBERS: jRCTs051190097, ACTRN12620000656932.
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Affiliation(s)
- Hiromichi Matsuoka
- Department of Psycho-Oncology, Supportive and Palliative Care Development Center, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Katherine Clark
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Belinda Fazekas
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Shunsuke Oyamada
- Department of Biostatistics, Japanese Organisation for Research and Treatment of Cancer (JORTC) Data Center, Arakawa-ku, Tokyo, Japan
| | - Linda Brown
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Chuoh-ku, Tokyo, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Osaka, Japan
| | - Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University Hospital, Hirakata, Osaka, Japan
| | - Keisuke Ariyoshi
- Department of Data Management, Japanese Organisation for Research and Treatment of Cancer (JORTC) Data Center, Arakawa-ku, Tokyo, Japan
| | - Jessica Lee
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Brian Le
- Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Peter Allcroft
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Slavica Kochovska
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Noriko Fujiwara
- Department of Palliative Medicine and Advanced Clinical Oncology, IMSUT Hospital of the Institute of Medical Science,The University of Tokyo, Japan, Tokyo, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Melanie Lovell
- Palliative Care, Greenwich Hospital, Greenwich, New South Wales, Australia
| | - Meera Agar
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Chuoh-ku, Tokyo, Japan
| | - Satoru Iwase
- Department of Palliative Medicine, Saitama Medical University, Moroyama, Japan
| | - Jane Phillips
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Atsuko Koyama
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
| | - David C Currow
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Cancer Institute New South Wales, Eveleigh, New South Wales, Australia
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23
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Fujiwara M, Yamada Y, Shimazu T, Kodama M, So R, Matsushita T, Yoshimura Y, Horii S, Fujimori M, Takahashi H, Nakaya N, Kakeda K, Miyaji T, Hinotsu S, Harada K, Okada H, Uchitomi Y, Yamada N, Inagaki M. Encouraging participation in colorectal cancer screening for people with schizophrenia: A randomized controlled trial. Acta Psychiatr Scand 2021; 144:318-328. [PMID: 34242396 DOI: 10.1111/acps.13348] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/07/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE We examined the efficacy of a case management approach to improve participation in colorectal cancer screening among people with schizophrenia. METHODS This was a randomized, parallel group trial. We recruited outpatients with schizophrenia aged 40 years or over from two psychiatric hospitals in Japan. Participants were randomly assigned (1:1) to treatment as usual or case management intervention plus treatment as usual using a web-based system. Attending clinicians and participants were unmasked to the allocation. Case management included education and patient navigation for colorectal cancer screening using a fecal occult blood test. Treatment as usual included direct mail government recommendations. The primary endpoint was participation in colorectal cancer screening assessed using municipal records. We also assessed the secondary endpoint of participation in other cancer screenings (lung, gastric, breast, and cervical). RESULTS Between 3 June and 9 September 2019, 172 eligible participants were randomly assigned to the case management plus treatment as usual group (n = 86) or treatment as usual group (n = 86). One participant was ineligible and another withdrew consent; both were excluded from analysis. A significantly higher proportion of participants received colorectal cancer screening in the case management plus treatment as usual group than in the treatment as usual group (40 [47.1%] of 85 participants vs. 10 [11.8%] of 85 participants, p < 0.0001). The proportion of lung cancer screening also increased. No serious adverse events associated with the study intervention occurred. CONCLUSION The case management intervention to encourage participation in colorectal cancer screening was effective for patients with schizophrenia.
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Affiliation(s)
- Masaki Fujiwara
- Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan
| | - Yuto Yamada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Taichi Shimazu
- Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Ryuhei So
- Okayama Psychiatric Medical Center, Okayama, Japan
| | | | | | | | - Maiko Fujimori
- Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Hirokazu Takahashi
- Division of Screening Assessment and Management, Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Naoki Nakaya
- Department of Health Sciences, Saitama Prefectural University, Koshigaya, Japan
| | - Kyoko Kakeda
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Shiro Hinotsu
- Department of Biostatistics and Data Management, Sapporo Medical University, Sapporo, Japan
| | - Keita Harada
- Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yosuke Uchitomi
- Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.,Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Norihito Yamada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masatoshi Inagaki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
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24
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Shimomura K, Minatogawa H, Mashiko T, Arioka H, Iihara H, Sugawara M, Hida N, Akiyama K, Nawata S, Tsuboya A, Mishima K, Izawa N, Miyaji T, Honda K, Inada Y, Ohno Y, Katada C, Morita H, Yamaguchi T, Nakajima T. LBA63 Placebo-controlled, double-blinded phase Ⅲ study comparing dexamethasone on day 1 with dexamethasone on days 1 to 4, with combined neurokinin-1 receptor antagonist, palonosetron, and olanzapine in patients receiving cisplatin-containing highly emetogenic chemotherapy: SPARED trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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25
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Nagaoka H, Momo K, Hamano J, Miyaji T, Oyamada S, Kawaguchi T, Homma M, Yamaguchi T, Morita T, Kizawa Y. Effects of an Indomethacin Oral Spray on Pain Due to Oral Mucositis in Cancer Patients Treated With Radiotherapy and Chemotherapy: A Double-Blind, Randomized, Placebo-Controlled Trial (JORTC-PAL04). J Pain Symptom Manage 2021; 62:537-544. [PMID: 33516927 DOI: 10.1016/j.jpainsymman.2021.01.123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Oral mucositis (OM) pain due to anticancer chemo- and radiotherapy has a very negative impact on patient quality of life. However, no high-quality studies have been performed regarding the analgesic efficacy of indomethacin (IM) oral spray for OM pain. OBJECTIVES This randomized, placebo-controlled, double-blind trial aimed to evaluate the analgesic efficacy of IM oral spray for OM pain due to anticancer chemo- and radiotherapy. METHODS From July 2015 to December 2016, we enrolled adult cancer patients with OM pain that was due to anticancer chemo- or radiotherapy and was rated 4 or higher on Brief Pain Inventory (BPI) Item 5. Patients were randomly assigned in a 1:1 ratio to receive either IM oral spray or placebo. The primary endpoint was the change in the BPI Item 6 ("current pain") score from before to 30 minutes after treatment. Secondary endpoints were the areas under the curves of BPI Item 6 at 15, 60, 120, 180, and 240 minutes after treatment; five items related to meals and conversation from the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire, Head and Neck Module 35; the Clinical Global Impressions-Improvement (CGI-I) scale; and adverse events. RESULTS A total of 60 patients were assigned to receive IM oral spray (n = 33) or placebo spray (n = 27). The average change in the BPI item 6 score from before to 30 minutes after treatment was -1.85 (95% confidence interval: -2.37 to -1.32) in the IM spray group and -0.59 (-1.02 to -0.16) in the placebo group, indicating a significant difference (-1.26, -1.94 to -0.57, P < 0.01). The pain improvement persisted for 180 minutes. The intergroup differences in ability to drink liquids, ease in conversing, and CGI-I were all significant (P = 0.03, P = 0.02, and P < 0.01, respectively). No serious adverse events were reported. CONCLUSION IM oral spray alleviated short-term OM pain due to anticancer chemo- and radiotherapy, and may reduce the difficulty in eating meals.
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Affiliation(s)
- Hiroka Nagaoka
- Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
| | - Kenji Momo
- Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; Department of Hospital Pharmaceutics, School of Pharmacy, Showa University
| | - Jun Hamano
- Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo
| | - Shunsuke Oyamada
- Department of Biostatistics, Japanese Organization for Research and Treatment of Cancer(JORTC) Data Center
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences
| | - Masato Homma
- Department of Pharmaceutical Sciences, Faculty of Medicine, University of Tsukuba
| | - Takuhiro Yamaguchi
- Department of Biostatistics,Tohoku University Graduate School of Medicine
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatagahara General Hospice
| | - Yosiyuki Kizawa
- Department of Palliative Medicine, Kobe University School of Medicine
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26
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Kachi K, Komori S, Shiko Y, Kawaguchi T, Miyaji T, Yamaguchi T. O8-4 Siteless study for feasibility of electronic patient-reported outcome (ePRO) collection system in oncology. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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27
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Mizukami T, Miyaji T, Narita Y, Matsushima T, Ogura T, Miyagaki H, Kawabata R, Horie Y, Kawaguchi T, Muro K, Hara H, Yamaguchi T, E Nakajima T. An observational study on nutrition status in gastric cancer patients receiving ramucirumab plus taxane: BALAST study. Future Oncol 2021; 17:2431-2438. [PMID: 33764163 DOI: 10.2217/fon-2021-0076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Limited data are available regarding the efficacy of nutrition support in advanced gastric cancer (AGC) patients receiving a standard second-line combination chemotherapy. The BALAST study is conducted as a prospective, multicenter observational study to evaluate the efficacy of nutrition support for patients with AGC treated with ramucirumab plus taxane as second-line treatment. As part of the routine care, patients who are malnourished or at risk of malnutrition will receive nutrition support from dietitians. We will enroll a total of 26 patients to estimate weight control rate at 12 weeks as primary end point. This study will generate valuable data reinforcing the role of nutrition support therapy for AGC patients receiving second-line chemotherapy.
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Affiliation(s)
- Takuro Mizukami
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, 216-8511, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Yukiya Narita
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, 464-8681, Japan
| | - Tomohiro Matsushima
- Department of Gastroenterology, Saitama Cancer Center, Saitama, 362-0806, Japan
| | - Takashi Ogura
- Department of Clinical Oncology, Kawasaki Municipal Tama Hospital, Kawasaki, 214-8525, Japan
| | | | - Ryohei Kawabata
- Department of Surgery, Osaka Rosai Hospital, Sakai, 591-8025, Japan
| | - Yoshiki Horie
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, 216-8511, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy & Life Sciences, Hachioji, 192-0392, Japan
| | - Kei Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, 464-8681, Japan
| | - Hiroki Hara
- Department of Gastroenterology, Saitama Cancer Center, Saitama, 362-0806, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan
| | - Takako E Nakajima
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, 216-8511, Japan
- Kyoto Innovation Center for Next-Generation Clinical Trials & iPS Cell Therapy, Kyoto University Hospital, Kyoto, 606-8507, Japan
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28
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Yokota T, Zenda S, Ota I, Yamazaki T, Yamaguchi T, Ogawa T, Tachibana H, Toshiyasu T, Homma A, Miyaji T, Mashiko T, Hamauchi S, Tominaga K, Ishii S, Otani Y, Orito N, Uchitomi Y. Phase 3 Randomized Trial of Topical Steroid Versus Placebo for Prevention of Radiation Dermatitis in Patients With Head and Neck Cancer Receiving Chemoradiation. Int J Radiat Oncol Biol Phys 2021; 111:794-803. [PMID: 34102298 DOI: 10.1016/j.ijrobp.2021.05.133] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/18/2021] [Accepted: 05/28/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Radiation dermatitis is one of the most common acute toxicities induced by chemoradiation therapy (CRT) for head and neck cancer (HNC). The benefit of topical steroids in the management of radiation dermatitis is still unclear. This phase 3, multi-institutional, randomized, double-blind, placebo-controlled trial evaluated the efficacy and safety of topical steroids for radiation dermatitis in patients with locally advanced HNC receiving CRT. METHODS AND MATERIALS Eligible patients were scheduled to receive bilateral neck irradiation (≥66 Gy) with concurrent cisplatin (≥200 mg/m2) as definitive or postoperative CRT. Patients were randomly assigned to receive either topical steroid or placebo when grade 1radiation dermatitis was observed or the total radiation dose reached 30 Gy. Basic skin care including gentle washing and moistening in the head and neck region was performed in both groups. The primary endpoint was the frequency of grade ≥2 radiation dermatitis, in accordance with the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. Grading of radiation dermatitis was performed by independent central review using photographs taken weekly. RESULTS A total of 211 patients were enrolled (intention to treat: steroid 101 and placebo 102). The frequency of grade ≥2 radiation dermatitis was not significantly reduced with the steroid (73.3%; 95% confidence interval, 64.6%-81.9%) compared with the placebo (80.4%; 95% confidence interval, 72.7%-88.1%; P = .23), whereas the steroid significantly reduced the frequency of grade ≥3 radiation dermatitis (13.9% vs 25.5%; P = .034). No significant differences in adverse events, including local infection or compliance with CRT, were observed between the groups. CONCLUSIONS Topical steroid may reduce the severity of radiation dermatitis in patients with HNC and thus may become an important therapeutic tool in the management of radiation dermatitis.
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Affiliation(s)
- Tomoya Yokota
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto-gun, Japan
| | - Sadamoto Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
| | - Ichiro Ota
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Tomoko Yamazaki
- Department of Head & Neck Oncology, Miyagi Cancer Center, Natori, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takenori Ogawa
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroyuki Tachibana
- Division of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takashi Toshiyasu
- Department of Radiation Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | | | - Satoshi Hamauchi
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto-gun, Japan
| | - Kuniko Tominaga
- Division of Nursing, Shizuoka Cancer Center, Sunto-gun, Japan
| | - Shinobu Ishii
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yui Otani
- Division of Nursing, Nara Medical University, Kashihara, Japan
| | - Noriko Orito
- Division of Nursing, Miyagi Cancer Center, Natori, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
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29
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Matsumoto Y, Okizaki A, Kiuchi D, Umemura S, Yamaguchi T, Oyamada S, Fujisawa D, Kobayashi N, Miyaji T, Mashiko T, Satomi E, Uehara Y, Kosugi K, Kinoshita H, Mori M, Yoshida T, Goto K, Ohe Y, Uchitomi Y, Morita T. Effectiveness of a nurse-led, screening-triggered, early specialized palliative care intervention program for patients with advanced lung cancer: A multicenter randomized controlled trial. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.12097] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12097 Background: The integration of palliative care into standard cancer treatment during the early phase of the disease can improve cancer patients’ quality of life (QOL). The current study examined the effectiveness of a nurse-led, screening-triggered, early specialized palliative care intervention program for patients (pts) with advanced lung cancer. Methods: Pts with advanced lung cancer undergoing initial chemotherapy were randomized (1:1) to the intervention group (IG) or the usual care group (UG) between January 2017 and September 2019. The intervention, which was triggered using by a brief, self-administered screening tool, comprised comprehensive need assessments, counseling, and service coordination by advanced-leveled nurses. The primary endpoint was the change from baseline of the Functional Assessment of Cancer Therapy -Lung Trial Outcome Index (TOI) at week 12, and the secondary endpoints were TOI at week 20, depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), and survival. Results: Pts were randomly allocated (102 for each group). The median age was 69 y (range, 27-91) and 77.5% were male. Seventy-two pts had extensive disease small-cell lung carcinoma and 132 Pts had stage IV non-small cell lung carcinoma. Because there was not a significant time-by-group interaction, we estimated main effects and the IG did not show a significant improvement in TOI from the baseline at week 12 and 20 compared to the UG (Mean group difference [the same applies hereafter] 2.13; 90% CI: -0.70, 4.95; P =.107, one-tailed). However, when we considered time-by-group interaction effects exploratorily, the IG did show significant improvement in TOI from baseline at week 20 compared to the UG (3.58; 90% CI: 0.15, 7.00; P = 0.043). There was no significant difference in change from baseline depression and anxiety between the two groups either at week 12 (depression −0.38; 95% CI: -1.81, 1.05; P = 0.60, anxiety -0.18; 95% CI: -1.45, 1.09; P = 0.78) or at week 20 (depression -1.27; 95% CI: -2.79, 0.25; P =.10, 1.26; 95% CI: -2.61, 0.09; P =.067). The 1-year survival rates were 49.5% (95% CI: 39.3, 58.9) in the IG and 43.4% (95% CI: 33.6, 52.8) in the UG. Conclusions: This trial failed to show statistical superiority of nurse-led, screening-triggered, early specialized palliative care intervention program over usual care, however, it’s possible delayed clinical benefits of improvement in QOL (TOI), depression and anxiety were suggested. The study design that some pts in the IG received later or no intervention, may dilute the difference of intervention between group differences. Further investigation, including the mixed method approach adopted in this study, is needed to uncover mediating factors for the effect of this low-cost, novel model of early palliative care. Clinical trial information: UMIN000025491.
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Affiliation(s)
- Yoshihisa Matsumoto
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Ayumi Okizaki
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Daisuke Kiuchi
- Department of Palliative Medicine,National Cancer Center Hospital, Tokyo, Japan
| | - Shigeki Umemura
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University School of Medicine, Sendai, Japan
| | | | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Naoko Kobayashi
- Department of Nursing, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoe Mashiko
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine,National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Uehara
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kazuhiro Kosugi
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hiroya Kinoshita
- Department of Palliative Care, Tokatsu Hospital, Nagareyama, Japan
| | - Masanori Mori
- Division of Supportive and Palliative Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Tatsuya Yoshida
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Morita
- Division of Supportive and Palliative Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
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Fujimori M, Sato A, Okusaka T, Yamaguchi T, Ikeda M, Ueno M, Ozaka M, Miyaji T, Mashiko T, Okamura M, Goto S, Majima Y, Uchitomi Y. A randomized controlled trial with a cluster of oncologists evaluating of an integrated communication support program for oncologists, caregivers, and patients with rapidly progressing advanced cancer on patient-centered conversation: J-SUPPORT 1704 study. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.12119] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12119 Background: Communication is an essential aspect of care for patients with progressive serious illnesses. Earlier discussion about patients’ values and priorities may lead to empathic communication and more goal-concordant care, and improved quality of life (QOL). This study aims to evaluate the efficacy of a newly developed integrated communication support program for oncologists, patients with rapidly progressing advanced cancer and their caregivers. Methods: Oncologists are randomly assigned to the intervention group (IG) or control group (CG). Patients with advanced pancreatic cancer after the start of first-line chemotherapy and their caregivers are allocated to the same group as their oncologists. The IG oncologists receive a 2.5-hour individual communication skills training, and patients and caregivers receive a half-hour coaching intervention to facilitate prioritizing and discussing questions and concerns about care after standard chemotherapy; the CG participants do not receive any training. Conversations during the post-intervention consultation between oncologists, patients and caregivers were audio-recorded, and were assessed on their empathic communication and information sharing performance as primary outcome. Secondary outcomes included the patient psychological distress (HADS), QOL (CoQOLo), satisfaction with communication (CSQ) and trust in oncologist (TiOS) were assessed baseline and after the consultation. Results: A total of 26 oncologists (12 intervention; 13 control; 1 excluded before randomization), 230 patients (115 intervention; 115 control), and 127 caregivers (65 intervention; 62 control) in 4 teaching hospitals are enrolled. The intervention resulted statistically significant improvements in the empathetic communication (IG: Mean = 23.4, Standard Error = 0.8; CG: M = 20.3, SE = 0.7; effect, 3.1; 95%CI, 1.0-5.3; P = 0.0063) and in the information sharing (IG: M = 17.6, SE = 0.8; CG: M = 13.2, SE = 0.5; effect, 4.4; 95%CI, 2.5-6.2; P < 0.0001). Patients in IG rated more satisfaction with communication using CSQ (effect, 2.4; 95%CI, 1.3, 3.5; P = 0.00023) than those in the CG. There were no differences in HADS total score (effect, 0.1; 95%CI, -1.0, 1.1; P = 0.90), CoQOLo score (effect, 0.4; 95%CI, -0.7, 1.4; P = 0.46) and TiOS score (effect, 0.2; 95%CI, -0.1, 0.6; P = 0.15) between patients in the IG and the CG. Conclusions: The program for oncologist and patients with rapidly progressing advanced cancer was effective in improving empathic communication and information sharing about care after standard chemotherapy, and patients’ reported satisfaction with communication without increasing psychological distress, but did not affect QOL and trust in oncologists immediately after the consultation. Clinical trial information: UMIN000033612.
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Affiliation(s)
- Maiko Fujimori
- Division of Behavioral Sciences, Research Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Masafumi Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Masato Ozaka
- Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoe Mashiko
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Masako Okamura
- Division of Behavioral Sciences, Research Center for Public Health Sciences, National Cancer Center, Chuo-Ku, Japan
| | - Shinichi Goto
- Division of Behavioral Sciences, Research Center for Public Health Sciences, National Cancer Center, Chuo-Ku, Japan
| | | | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
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Saiga M, Hosoya Y, Utsunomiya H, Kuramoto Y, Watanabe S, Tomita K, Aihara Y, Muto M, Hikosaka M, Kawaguchi T, Miyaji T, Yamaguchi T, Zenda S, Goto A, Sakuraba M, Kusano T, Miyabe K, Kuroki T, Yano T, Taminato M, Sekido M, Tsunoda Y, Satake T, Doihara H, Kimata Y. Protocol for a multicentre, prospective, cohort study to investigate patient satisfaction and quality of life after immediate breast reconstruction in Japan: the SAQLA study. BMJ Open 2021; 11:e042099. [PMID: 33589456 PMCID: PMC7887355 DOI: 10.1136/bmjopen-2020-042099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The aim of breast reconstruction (BR) is to improve patients' health-related quality of life (HRQOL). Therefore, measuring patient-reported outcomes (PROs) would clarify the value and impact of BR on a patient's life and thus would provide evidence-based information to help decision-making. The Satisfaction and Quality of Life After Immediate Breast Reconstruction study aimed to investigate satisfaction and HRQOL in Japanese patients with breast cancer who undergo immediate breast reconstruction (IBR). METHODS AND ANALYSIS This ongoing prospective, observational multicentre study will assess 406 patients who had unilateral breast cancer and underwent mastectomy and IBR, and were recruited from April 2018 to July 2019. All participants were recruited from seven hospitals: Okayama University Hospital, Iwate Medical University Hospital, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Showa University Hospital, University of Tsukuba Hospital, Osaka University Hospital and Yokohama City University Medical Center. The patients will be followed up for 36 months postoperatively. The primary endpoint of this study will be the time-dependent changes in BREAST-Q satisfaction with breast subscale scores for 12 months after reconstructive surgery, which will be collected via an electronic PRO system. ETHICS AND DISSEMINATION This study will be performed in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects published by Japan's Ministry of Education, Science and Technology and the Ministry of Health, Labour and Welfare, the modified Act on the Protection of Personal Information and the Declaration of Helsinki. This study protocol was approved by the institutional ethics committee at the Okayama University Graduate School of Medicine, Dentistry, on 2 February 2018 (1801-039) and all other participating sites. The findings of this trial will be submitted to an international peer-reviewed journal. TRIAL REGISTRATION NUMBER UMIN000032177.
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Affiliation(s)
- Miho Saiga
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan
| | - Yuko Hosoya
- Department of Plastic and Reconstructive Surgery, Iwate Medical University, Morioka, Japan
| | - Hiroki Utsunomiya
- Department of Surgery and Plastic Surgery, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Yukiko Kuramoto
- Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Satoko Watanabe
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan
| | - Koichi Tomita
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yukiko Aihara
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Mayu Muto
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Makoto Hikosaka
- Department of Plastic and Reconstructive Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sadamoto Zenda
- Division of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Aya Goto
- Department of Plastic and Reconstructive Surgery, Iwate Medical University, Morioka, Japan
| | - Minoru Sakuraba
- Department of Plastic and Reconstructive Surgery, Iwate Medical University, Morioka, Japan
| | | | - Kenta Miyabe
- Department of Plastic and Reconstructive Surgery, Showa University Hospital, Tokyo, Japan
| | - Tomoaki Kuroki
- Department of Plastic and Reconstructive Surgery, Showa University Hospital, Tokyo, Japan
| | - Tomoyuki Yano
- Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mifue Taminato
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mitsuru Sekido
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yui Tsunoda
- Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshihiko Satake
- Department of Plastic and Reconstructive Surgery, Toyama University Hospital, Toyama, Japan
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Yoshihiro Kimata
- Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan
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Minatogawa H, Izawa N, Kawaguchi T, Miyaji T, Shimomura K, Kazunori H, Iihara H, Ohno Y, Inada Y, Arioka H, Morita H, Hida N, Sugawara M, Katada C, Nawata S, Ishida H, Tsuboya A, Tsuda T, Yamaguchi T, Nakajima TE. Study protocol for SPARED trial: randomised non-inferiority phase III trial comparing dexamethasone on day 1 with dexamethasone on days 1-4, combined with neurokinin-1 receptor antagonist, palonosetron and olanzapine (5 mg) in patients receiving cisplatin-based chemotherapy. BMJ Open 2020; 10:e041737. [PMID: 33334838 PMCID: PMC7747608 DOI: 10.1136/bmjopen-2020-041737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Dexamethasone (DEX) is administered for multiple days to prevent chemotherapy-induced nausea and vomiting for patients receiving highly emetogenic chemotherapy (HEC); however, its notorious side effects have been widely reported. Although our multicentre randomised double-blind comparative study verified non-inferiority of sparing DEX after day 2 of chemotherapy when combined with neurokinin-1 receptor antagonist (NK1-RA) and palonosetron (Palo) for patients receiving HEC regimen, DEX sparing was not non-inferior in patients receiving cisplatin (CDDP)-based HEC regimens in subgroup analysis. Recently, the efficacy of the addition of olanzapine (OLZ) to standard triple antiemetic therapy on HEC has been demonstrated by several phase III trials. This study aims to confirm non-inferiority of DEX sparing when it is combined with NK-1RA, Palo and OLZ in patients receiving CDDP-based HEC regimens. METHODS AND ANALYSIS This is a randomised, double-blind, phase III trial. Patients who are scheduled to receive CDDP ≥50 mg/m2 as initial chemotherapy are eligible. Patients are randomly assigned to receive either DEX on days 1-4 or DEX on day 1 combined with NK1-RA, Palo and OLZ (5 mg). The primary endpoint is complete response (CR) rate, defined as no emesis and no rescue medications during the delayed phase (24-120 hours post-CDDP administration). The non-inferiority margin is set at -15.0%. We assume that CR rates would be 75% in both arms. Two hundred and sixty-two patients are required for at least 80% power to confirm non-inferiority at a one-sided significance level of 2.5%. After considering the possibility of attrition, we set our final required sample size of 280. ETHICS AND DISSEMINATION The institutional review board approved the study protocol at each of the participating centres. The trial result will be presented at international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER UMIN000032269.
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Affiliation(s)
- Hiroko Minatogawa
- Department of Pharmacy, St.Marianna University School of Medicine Hospital, Kawasaki, Japan
| | - Naoki Izawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Honda Kazunori
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | | | - Yasushi Ohno
- Department of Respirology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yusuke Inada
- Department of Pharmacy, Yokohama Rosai Hospital, Yokohama, Japan
| | - Hitoshi Arioka
- Department of Medical Oncology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Hajime Morita
- Department of Pharmacy, St. Marianna University Yokohama City Seibu Hospital, Yokohama, Japan
| | - Naoya Hida
- Department of Internal Medicine, St.Marianna University School of Medicine, Kawasaki, Japan
| | | | - Chikatoshi Katada
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Shuichi Nawata
- Department of Hospital Pharmaceutics, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Hiroo Ishida
- Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Ayako Tsuboya
- Department of Pharmacy, St. Marianna University Kawasakishi Municipal Tama Hospital, Kawasaki, Japan
| | - Takashi Tsuda
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
- Department of Hepato-Biliary-Pancreatic Center, Shonan Fujisawa Tokushukai Hospital, Fujisawa, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University School of Medicine, Sendai, Japan
| | - Takako Eguchi Nakajima
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
- Division of Kyoto Innovation Center for Next Generation Clinical Trials and iPS Cell Therapy, Kyoto University Hospital, Kyoto, Japan
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Fujisawa D, Umemura S, Okizaki A, Satomi E, Yamaguchi T, Miyaji T, Mashiko T, Kobayashi N, Kinoshita H, Mori M, Morita T, Uchitomi Y, Goto K, Ohe Y, Matsumoto Y. Nurse-led, screening-triggered, early specialised palliative care intervention programme for patients with advanced lung cancer: study protocol for a multicentre randomised controlled trial. BMJ Open 2020; 10:e037759. [PMID: 33243791 PMCID: PMC7692832 DOI: 10.1136/bmjopen-2020-037759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION It has been suggested that palliative care integrated into standard cancer treatment from the early phase of the disease can improve the quality of life of patients with cancer. In this paper, we present the protocol for a multicentre randomised controlled trial to examine the effectiveness of a nurse-led, screening-triggered, early specialised palliative care intervention programme for patients with advanced lung cancer. METHODS AND ANALYSIS A total of 206 patients will be randomised (1:1) to the intervention group or the control group (usual care). The intervention, triggered with a brief self-administered screening tool, comprises comprehensive need assessments, counselling and service coordination by advanced-level nurses. The primary outcome is the Trial Outcome Index of the Functional Assessment of Cancer Therapy (FACT) at 12 weeks. The secondary outcomes include participants' quality of life (FACT-Lung), depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), illness perception (Prognosis and Treatment Perceptions Questionnaire), medical service use and survival. A mixed-method approach is expected to provide an insight about how this intervention works. ETHICS AND DISSEMINATION This study has been approved by the Institutional Review Board of the National Cancer Center Japan (approval number: 2016-235). The findings will be disseminated through peer-reviewed publications and conference presentations and will be reflected on to the national healthcare policy. TRIAL REGISTRATION NUMBER UMIN000025491.
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Affiliation(s)
- Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Psycho-Oncology Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Shigeki Umemura
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Ayumi Okizaki
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
- Behavioral and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Tempei Miyaji
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tomoe Mashiko
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Naoko Kobayashi
- Department of Nursing, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Hiroya Kinoshita
- Department of Palliative Care, Tokatsu Hospital, Nagareyama, Chiba, Japan
| | - Masanori Mori
- Palliative and Supportive Care, Seirei Mikatahara Hospital, Hamamatsu, Shizuoka, Japan
| | - Tatsuya Morita
- Palliative and Supportive Care, Seirei Mikatahara Hospital, Hamamatsu, Shizuoka, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
- Behavioral and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yoshihisa Matsumoto
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
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Zenda S, Ryu A, Takashima A, Arai M, Takagi Y, Miyaji T, Mashiko T, Shimizu Y, Yamazaki N, Morizane C, Yamaguchi T, Kawaguchi T, Hanai A, Uchitomi Y, Oshiba F. Hydrocolloid dressing as a prophylactic use for hand-foot skin reaction induced by multitargeted kinase inhibitors: protocol of a phase 3 randomised self-controlled study. BMJ Open 2020; 10:e038276. [PMID: 33028559 PMCID: PMC7539604 DOI: 10.1136/bmjopen-2020-038276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Although topical use of moisturisers is slightly effective for the prevention and avoiding the aggravation of hand-foot syndrome induced by multikinase inhibitors, there is still room for improvement. Hydrocolloid dressing is a type of wound dressing often used for wounds such as decubitus ulcers. The purpose of this study is to verify the usefulness of application of hydrocolloid dressings as prophylaxis against development of hand-foot syndrome induced by multikinase inhibitors by comparing the effects of this dressing and standard supportive care (moisturising care alone) within the same individuals. METHODS This study is a phase 3 randomised, self-controlled study to compare prophylactic moisturising care with or without hydrocolloid dressing for hand-foot syndrome induced by multikinase inhibitors. Patients with radically unresectable advanced or recurrent colorectal carcinoma, gastrointestinal stromal tumour and hepatocellular carcinoma who scheduled to receive regorafenib or sorafenib therapy are eligible for enrolment.Supportive care for hand-foot syndrome will consist of basic moisturising care with or without hydrocolloid dressing. If hand-foot syndrome occurs, a steroid ointment will be applied two times per day at the affected sites. The primary endpoint is an incidence rate of grade 2 or more severe hand-foot syndrome (soles of the feet only) assessed by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events V.4.0. Grading of hand-foot syndrome will be performed by central review using photographs taken weekly by blinded trained physicians. The ethical approval was obtained from National Cancer Center Hospital. The results of this study will be submitted for publication in international peer-reviewed journals and the key findings will be presented at international scientific conference. DISCUSSION If the positive results are found in this study, it is shown that hydrocolloid dressing is effective not only as a symptom management but also as a prevention in hand-foot syndrome induced by multikinase. TRIAL STATUS The enrolment was started in January 2019, and planned to closed in January 2021. As of February 2020, 26 patients enrolled in this study. TRIAL REGISTRATION NUMBER UMIN Clinical Trial Registry (UMIN000034853). PROTOCOL VERSION V.1.4, 9 January 2020.
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Affiliation(s)
- Sadamoto Zenda
- Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, & Behavioral and Survivorship Research Group, Center for Public Health Sciences, Tokyo, Japan
| | - Asako Ryu
- Department of Nursing, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Atsuo Takashima
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Michiko Arai
- Department of Nursing, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yusuke Takagi
- Department of Palliative Medicine, Teikyo University School of Medicine Graduate School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Tempei Miyaji
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, & Behavioral and Survivorship Research Group, Center for Public Health Sciences, Tokyo, Japan
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Tomoe Mashiko
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, & Behavioral and Survivorship Research Group, Center for Public Health Sciences, Tokyo, Japan
| | - Yoichi Shimizu
- Department of Nursing, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Naoya Yamazaki
- Department of Dermatologic Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Chigusa Morizane
- Department of Hepatobiliary and Pancreatic Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
- Division of Biostatistics, Tohoku Graduate School of Medicine, Sendai, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Akiko Hanai
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, & Behavioral and Survivorship Research Group, Center for Public Health Sciences, Tokyo, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, & Behavioral and Survivorship Research Group, Center for Public Health Sciences, Tokyo, Japan
| | - Fukuko Oshiba
- Department of Nursing, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
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Fujimori M, Sato A, Jinno S, Okusaka T, Yamaguchi T, Ikeda M, Ueno M, Ozaka M, Takayama Y, Miyaji T, Majima Y, Uchitomi Y. Integrated communication support program for oncologists, caregivers and patients with rapidly progressing advanced cancer to promote patient-centered communication: J-SUPPORT 1904 study protocol for a randomised controlled trial. BMJ Open 2020; 10:e036745. [PMID: 32967874 PMCID: PMC7513597 DOI: 10.1136/bmjopen-2019-036745] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Communication is an essential aspect of care for patients with progressive serious illnesses. This study aims to evaluate the efficacy of a new, integrated communication support program for oncologists, patients with rapidly progressing advanced cancer and their caregivers. METHODS AND ANALYSIS The proposed integrated communication support programme is in the randomised control trial stage. It comprises a cluster of oncologists from comprehensive cancer centre hospitals in a metropolitan area in Japan. A total of 20 oncologists, 200 patients with advanced pancreatic cancer and the patients' caregivers are enrolled in this study as of the writing of this protocol report. Oncologists are randomly assigned to the intervention group (IG) or control group (CG). Patients and caregivers are allocated to the same group as their oncologists. The IG oncologists receive a 2.5-hour individual communication skills training, and patients and caregivers receive a half-hour coaching intervention to facilitate prioritising and discussing questions and concerns; the CG participants do not receive any training. Follow-up data will be collected quarterly for 6 months for a year and then annually for up to 3 years. The primary endpoint is the intergroup difference between before-intervention and after-intervention patient-centred communication behaviours during oncology visits. ETHICS AND DISSEMINATION This study is conducted in accordance with the ethical guidelines for clinical studies published by Japan's Ministry of Education, Cultural, Sports, Science and Technology, the Ministry of Health, Labour and Welfare, and the ethical principles established for research on humans stipulated in the Declaration of Helsinki and further amendments thereto. The protocol was approved by the Institutional Review Board of National Cancer Center, Japan on 4 July 2018 (ID: 2017-474). TRIAL STATUS This study is currently enrolling participants. Enrolment period ends 31 July 2020; estimated follow-up date is 31 March 2023. TRIAL REGISTRATION NUMBER UMIN Clinical Trial Registry (UMIN000033612); pre-results.
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Affiliation(s)
- Maiko Fujimori
- Division of Behavioral Science and Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Japan
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Japan
| | - Ayako Sato
- Division of Behavioral Science and Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Japan
| | - Sayaka Jinno
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Japan
| | - Takuji Okusaka
- Hepatobiliary and Pancreatic Oncology Division, National Cancer Center Hospital, Chuo-ku, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine Department of Medical Biochemistry, Sendai, Japan
| | - Masafumi Ikeda
- Department of Hepatobiliary Pancreatic Oncology, National Cancer Center-Hospital East, Kashiwa, Japan
| | - Makoto Ueno
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan
| | - Masato Ozaka
- Department of Hepatobiliary and Pancreatic Medical Oncology, Public Interest Incorporated Foundation Cancer Institute Hospital of JFCR, Koto-ku, Japan
| | - Yukiko Takayama
- Department of Medicine, Institute of Gastroenterology, Tokyo Women's Medical University Hospital, Shinjuku-ku, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Tokyo University Graduate School of Medicine, Bunkyo-ku, Japan
| | | | - Yosuke Uchitomi
- Division of Behavioral Science and Division of Health Care Research, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Chuo-ku, Japan
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Yokota T, Zenda S, Ota I, Yamazaki T, Yamaguchi T, Ogawa T, Tachibana H, Toshiyasu T, Homma A, Miyaji T, Mashiko T, Hamauchi S, Tominaga K, Ishii S, Otani Y, Orito N, Uchitomi Y. 931P Topical steroid versus placebo for the prevention of radiation dermatitis in head and neck cancer patients receiving chemoradiotherapy: A phase III, randomized, double-blinded trial: J-SUPPORT 1602(TOPICS). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Miyaji T, Kawaguchi T, Azuma K, Suzuki S, Sano Y, Akatsu M, Torii A, Kamimura T, Ozawa Y, Tsuchida A, Eriguchi D, Hashiguchi M, Nishino M, Nishi M, Inadome Y, Yamazaki T, Kiuchi T, Yamaguchi T. Patient-generated health data collection using a wearable activity tracker in cancer patients-a feasibility study. Support Care Cancer 2020; 28:5953-5961. [PMID: 32281031 DOI: 10.1007/s00520-020-05395-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 03/04/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE Incorporation of patient-generated health data (PGHD) into clinical research requires an investigation of the validity of outcomes and feasibility of implementation. This single-arm pilot trial investigated the feasibility of using a commercially available activity tracking wearable device in cancer patients to assess adherence to the device and real-time PGHD collection in a clinical research setting. METHODS From July to November 2017, enrolled adult patients were asked to wear a wristband-style device. Brief Fatigue Inventory (BFI) and MD Anderson Symptom Inventory (MDASI) were assessed at baseline and on day 29. Furthermore, 29-day Pittsburgh Sleep Quality Index, global impression of the devices, and NCI CTCAE v4 were evaluated. RESULTS Of 30 patients (mean age, 58.6 years; male, 21 [70%]), 15 (50%) and 11 (36.7%) had gastrointestinal and lung cancer, respectively, and 27 (90%, 95% CI: 0.74-0.98) were well adhered (> 70%) to the device for 28 days. The mean adherence was 84.9% (range: 41.7-95.2%). More frequent PGHD synchronization tended to show better device adherence, with moderate correlation (r = 0.62, 95% CI: 0.33-0.80, p < 000.1). CONCLUSIONS The feasibility of using a wearable activity tracker was confirmed in cancer patients receiving chemotherapy for a month. For future implementation in clinical trials, there is a need for further comprehensive assessment of the validity and reliability of wearable activity trackers. TRIAL REGISTRATION This trial was registered at the University Hospital Medical Information Network Clinical Trials Registry as UMIN: UMIN000027575.
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Affiliation(s)
- Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. .,Division of Biostatistics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji City, Tokyo, 192-0392, Japan
| | - Kanako Azuma
- Department of Pharmacy, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Shinya Suzuki
- Department of Pharmacy, Kanagawa Prefectural Keiyukai Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-shi, Kanagawa, 220-8521, Japan.,Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Yoko Sano
- Department of Pharmacy, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Moe Akatsu
- Department of Pharmacy, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Ayako Torii
- Department of Pharmacy, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Tadamasa Kamimura
- Department of Pharmacy, Kanagawa Prefectural Keiyukai Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-shi, Kanagawa, 220-8521, Japan
| | - Yuki Ozawa
- Department of Pharmacy, Kanagawa Prefectural Keiyukai Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-shi, Kanagawa, 220-8521, Japan
| | - Akihiko Tsuchida
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Daisuke Eriguchi
- Department of Thoracic Surgery, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Mizuha Hashiguchi
- Department of Internal Medicine, Kanagawa Prefectural Keiyukai Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-shi, Kanagawa, 220-8521, Japan
| | - Makoto Nishino
- Department of Internal Medicine, Kanagawa Prefectural Keiyukai Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama-shi, Kanagawa, 220-8521, Japan.,Department of Experimental Therapeutics, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Motohide Nishi
- Medidata Solutions K.K, JP Tower 29F 2-7-2, Marunouchi, Chiyoda-ku, Tokyo, 100-7029, Japan
| | - Yumi Inadome
- Medidata Solutions K.K, JP Tower 29F 2-7-2, Marunouchi, Chiyoda-ku, Tokyo, 100-7029, Japan
| | - Tsutomu Yamazaki
- Clinical Research Support Center, The University of Tokyo Hospital, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takahiro Kiuchi
- Department of Heath Communication, School of Public Health, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takuhiro Yamaguchi
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Division of Biostatistics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
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Tanaka R, Kaburaki T, Yoshida A, Takamoto M, Miyaji T, Yamaguchi T. Fluorescein Angiography Scoring System Using Ultra-Wide-Field Fluorescein Angiography Versus Standard Fluorescein Angiography in Patients with Sarcoid Uveitis. Ocul Immunol Inflamm 2020; 29:1398-1402. [PMID: 32162984 DOI: 10.1080/09273948.2020.1737141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 10/24/2022]
Abstract
Purpose: To compare standard fluorescein angiography (FA) and ultra-wide-field (UWF) FA in evaluating sarcoid uveitis activity using the scoring system adopted by the Angiography Scoring for Uveitis Working Group (ASUWG).Methods: Standard and UWF FA images of 36 eyes with sarcoid uveitis were acquired on the same day. Three graders independently graded 72 FA images using the ASUWG scoring system. We evaluated inter-observer variability using the intra-class correlation coefficient (ICC) and compared scores of each angiographic sign.Results: The ICC was 0.77 for standard FA and 0.87 for UWF FA, with respective total scores of 12.0 and 14.6. UWF FA had higher scores than standard FA for optic disc hyperfluorescence, posterior retinal vascular staining and/or leakage, and peripheral capillary leakage.Conclusions: The scores for UWF FA had a higher ICC than those for standard FA in evaluating sarcoid uveitis. Peripheral capillary leakage scores were particularly high for UWF FA.
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Affiliation(s)
- Rie Tanaka
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Toshikatsu Kaburaki
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan.,Department of Ophthalmology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Atsushi Yoshida
- Department of Ophthalmology, The Cancer Institute Hospital Of JFCR, Tokyo, Japan
| | - Mitsuko Takamoto
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Department of Clinical Trial Data Management, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Furukawa A, Abe Y, Miyaji T, Hatakenaka M, Naito M, Ageta K, Takeuchi S, Morizane A, Nishida T, Ito H. 1044 Simple echocardiographic scoring in screening for aortic stenosis by emergency physicians in the emergency department. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.636] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background; Aortic stenosis (AS) is one of the important critical diseases and may influence hemodynamics in cardiovascular or non-cardiovascular emergency, however, there is no established methodology to diagnose AS in a focused cardiac ultrasound (FOCUS). We have previously reported that our developed visual AS score was a simple index for AS screening using rapid echocardiography and it could successfully diagnose clinically significant AS. The purpose of the present study was to evaluate the diagnostic accuracy of visual AS score assessed by emergency physicians in the emergency department. Methods; Visual AS score was calculated as the sum of the scores of each three aortic cusp’s opening in a short-axis view scored as follows: 0 = not restricted, 1 = restricted, or 2 = severely restricted; and classified in 0 – 6 as we previously reported. Emergency physicians who did not specialize in cardiology or ultrasonography underwent basic 30 minutes training to visualize aortic valve in a short-axis view and to assess visual AS score beforehand. They performed echocardiography and evaluated visual AS score in emergency outpatients with suspected cardiovascular diseases such as chest symptom, consciousness disorder, abnormal vital signs, heart murmur or abnormal electrocardiogram in the emergency department. Then, another assessment of visual AS score and complete echocardiography including quantitative assessment of AS was performed by expert sonographers. Aortic valve area index (AVAI) was calculated using continuity equation and body surface area, and an AVAI > 0.85 cm/m2, 0.6 - 0.85 cm/m2, and < 0.6 cm/m2 were defined as none or mild, moderate and severe AS, respectively. Results: Sixty patients underwent evaluations of visual AS score by emergency physicians. Visual AS score could not be assessed in 5 patients and continuity equation could not be evaluated in 2 patients, both due to poor echocardiographic imaging quality. Visual AS scores assessed by emergency physicians and expert sonographers showed strong positive correlation (R = 0.94, P < 0.0001). Fourteen patients (26 %) including 6 with shock or hypotension, 3 with congestive heart failure, 2 with syncope, 1 with acute myocardial infarction, 1 with suspected cardiac tamponade and 1 with abnormal electrocardiogram had moderate or more degree of AS in complete echocardiography performed by expert sonographers. Visual AS score 3 or more assessed by emergency physicians had 86 %, 100 %, 100 % and 95 % of a diagnostic sensitivity, specificity, positive predictive value and negative predictive value, respectively. Conclusion: Visual AS score in FOCUS is useful to screen for AS for emergency physicians who do not specialize in cardiology.
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Affiliation(s)
- A Furukawa
- Kochi Health Sciences Center, Department of Cardiology, Kochi, Japan
| | - Y Abe
- Osaka City General Hospital, Department of Cardiology, Osaka, Japan
| | - T Miyaji
- Kochi Health Sciences Center, Department of Cardiology, Kochi, Japan
| | - M Hatakenaka
- Kochi Health Sciences Center, Department of Emergency Medicine, Kochi, Japan
| | - M Naito
- Kochi Health Sciences Center, Department of Emergency Medicine, Kochi, Japan
| | - K Ageta
- Kochi Health Sciences Center, Department of Emergency Medicine, Kochi, Japan
| | - S Takeuchi
- Kochi Health Sciences Center, Department of Emergency Medicine, Kochi, Japan
| | - A Morizane
- Kochi Health Sciences Center, Department of Emergency Medicine, Kochi, Japan
| | - T Nishida
- Kochi Health Sciences Center, Department of Emergency Medicine, Kochi, Japan
| | - H Ito
- Okayama University, Department of Cariology, Okayama, Japan
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Matsuoka H, Iwase S, Miyaji T, Kawaguchi T, Ariyoshi K, Oyamada S, Satomi E, Ishiki H, Hasuo H, Sakuma H, Tokoro A, Matsuda Y, Tahara K, Otani H, Ohtake Y, Tsukuura H, Matsumoto Y, Hasegawa Y, Kataoka Y, Otsuka M, Sakai K, Nakura M, Morita T, Yamaguchi T, Koyama A. Predictors of duloxetine response in patients with neuropathic cancer pain: a secondary analysis of a randomized controlled trial-JORTC-PAL08 (DIRECT) study. Support Care Cancer 2019; 28:2931-2939. [PMID: 31761974 DOI: 10.1007/s00520-019-05138-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 07/09/2019] [Accepted: 10/16/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Duloxetine has some effect against cancer neuropathic pain (CNP); however, predictors of duloxetine response are unclear. This study sought to identify predictors of duloxetine response in patients with CNP. METHODS Patients (N = 70) with CNP unresponsive to or intolerant of opioid-pregabalin combination therapy, with a brief pain inventory-short form (BPI-SF) Item 5 score (average pain) ≥ 4, and with a total hospital anxiety and depression scale score < 20, were randomized to a duloxetine or a placebo group. Multiple linear regression analysis was conducted to identify predictors of duloxetine response as a secondary analysis with the change in the average pain score on day 10 from day 0 as the dependent variable, and the following five covariates; baseline (day 0) average pain score, baseline opioid dose, continuation/discontinuation of pregabalin, and items 20 and 21 score of the short-form McGill pain questionnaire 2 (SF-MPQ-2) as independent variables. RESULTS Of the four domains (continuous pain, intermittent pain, neuropathic pain, and affective descriptors) score of SF-MPQ-2 on day 0, significant differences were observed in the neuropathic pain domain (p = 0.040) in change on the average pain between day 10 and day 0 in the duloxetine group. Multiple linear regression analysis revealed that patients with a high score for SF-MPQ-2 Item 21 (tingling pain) on day 0 had a significantly greater change in average pain between day 10 and day 0 (p = 0.046). CONCLUSION Patients with a high score for SF-MPQ-2 Item 21 might benefit more from duloxetine.
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Affiliation(s)
- Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan. .,Palliative Care Center, Kindai University Faculty of Medicine, Osaka, Japan. .,Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Satoru Iwase
- Department of Palliative Medicine, University of Saitama Medical University, Saitama, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Keisuke Ariyoshi
- Japanese Organization for Research and Treatment of Cancer (JORTC), JORTC Data Center, Tokyo, Japan
| | - Shunsuke Oyamada
- Japanese Organization for Research and Treatment of Cancer (JORTC), JORTC Data Center, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Hideaki Hasuo
- Department of Psychosomatic Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Hiroko Sakuma
- Department of Psychosomatic Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Kazuki Tahara
- Yamanobe General Hospital Internal medicine, Nara, Japan
| | - Hiroyuki Otani
- Department of Palliative Medicine, National Kyushu Cancer Center, Fukuoka, Japan
| | - Yoichi Ohtake
- Itami Seifu Hospital Internal medicine, Hyogo, Japan
| | | | - Yoshihisa Matsumoto
- Department of Palliative Medicine, National Cancer Center East, Kashiwa, Japan
| | - Yoshikazu Hasegawa
- Department of Medical Oncology, Izumi City General Hospital, Izumi, Japan
| | - Yuki Kataoka
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Masatomo Otsuka
- Department of Palliative Medicine, Kindai University Nara Hospital, Nara, Japan
| | - Kiyohiro Sakai
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan.,Palliative Care Center, Kindai University Faculty of Medicine, Osaka, Japan
| | - Miki Nakura
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan
| | - Tatsuya Morita
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Atsuko Koyama
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan.,Palliative Care Center, Kindai University Faculty of Medicine, Osaka, Japan
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Fujiwara M, Inagaki M, Shimazu T, Kodama M, So R, Matsushita T, Yoshimura Y, Horii S, Fujimori M, Takahashi H, Nakaya N, Kakeda K, Miyaji T, Hinotsu S, Harada K, Okada H, Uchitomi Y, Yamada N. A randomised controlled trial of a case management approach to encourage participation in colorectal cancer screening for people with schizophrenia in psychiatric outpatient clinics: study protocol for the J-SUPPORT 1901 (ACCESS) study. BMJ Open 2019; 9:e032955. [PMID: 31678957 PMCID: PMC6830660 DOI: 10.1136/bmjopen-2019-032955] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION One of the reasons for the high mortality rate from cancer in people with schizophrenia is delay in diagnosis. Many studies have shown lower cancer screening rates in people with schizophrenia; however, there are no interventions for people with schizophrenia to increase cancer screening. Therefore, we developed a case management (CM) intervention to encourage participation in cancer screening. The purpose of this study was to examine the efficacy of CM to encourage participation in cancer screening for people with schizophrenia, with particular focus on colorectal cancer screening by faecal occult blood testing, compared with usual intervention (UI), namely, municipal public education. METHODS AND ANALYSIS This is an individually randomised, parallel group trial with blinded outcome assessments. The participants will be randomly allocated to either the CM plus UI group or UI alone group in a 1:1 ratio using a web-based program at a data management centre. The primary end point of the study is participation in colorectal cancer screening in the year of intervention, which will be assessed based on municipal records. ETHICS AND DISSEMINATION This study is performed in accordance with Ethical Guidelines for Medical and Health Research Involving Human Subjects published by Japan's Ministry of Education, Science, and Technology and the Ministry of Health, Labour, and Welfare and the modified Act on the Protection of Personal Information as well as the Declaration of Helsinki. This study was approved by the institutional ethics committee at the Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Okayama University Hospital on 23 April 2019 (approval number: RIN1904-003). The findings of this trial will be submitted to an international peer-reviewed journal. TRIAL REGISTRATION NUMBER UMIN000036017.
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Affiliation(s)
- Masaki Fujiwara
- Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan
| | - Masatoshi Inagaki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Taichi Shimazu
- Division of Prevention, Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Ryuhei So
- Okayama Psychiatric Medical Center, Okayama, Japan
| | | | | | | | - Maiko Fujimori
- Division of Health Care Research, Behavioral Sciences and Survivorship Research Group and Division of Cohort Consortium Research, Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Hirokazu Takahashi
- Division of Screening Assessment and Management, Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Naoki Nakaya
- Department of Health Sciences, Saitama Prefectural University, Koshigaya, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kyoko Kakeda
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - Shiro Hinotsu
- Department of Biostatistics, Sapporo Medical University, Sapporo, Japan
| | - Keita Harada
- Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital and Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Norihito Yamada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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42
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Matsuoka H, Iwase S, Miyaji T, Kawaguchi T, Ariyoshi K, Oyamada S, Satomi E, Ishiki H, Hasuo H, Sakuma H, Tokoro A, Shinomiya T, Otani H, Ohtake Y, Tsukuura H, Matsumoto Y, Hasegawa Y, Kataoka Y, Otsuka M, Sakai K, Matsuda Y, Morita T, Koyama A, Yamaguchi T. Additive Duloxetine for Cancer-Related Neuropathic Pain Nonresponsive or Intolerant to Opioid-Pregabalin Therapy: A Randomized Controlled Trial (JORTC-PAL08). J Pain Symptom Manage 2019; 58:645-653. [PMID: 31254640 DOI: 10.1016/j.jpainsymman.2019.06.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 12/31/2022]
Abstract
CONTEXT Although opioids and pregabalin are widely used for cancer-related neuropathic pain (CNP), no clinical trials exist to determine which medications are effective when an opioid-pregabalin combination therapy fails. OBJECTIVES We investigated the efficacy of duloxetine for CNP nonresponsive or intolerant to opioid-pregabalin combination therapy. METHODS A multicenter, randomized, double-blind, placebo-controlled trial was performed at 12 specialized palliative care services in Japan. Patients with CNP average pain scores (Brief Pain Inventory [BPI]-Item 5) ≥ 4 in the previous 24 hours and nonresponsive or intolerant to opioid-pregabalin combination therapy were eligible. Patients with chemotherapy-induced peripheral neuropathies were excluded. Patients were administered duloxetine 20 mg/day titrated to 40 mg/day or placebo for 10 days. The primary endpoint was BPI-Item 5 on Day 10. Responder analysis measured proportions of patients with 30% and 50% pain decreases. RESULTS Seventy patients were enrolled. Complete case analysis revealed mean BPI-Item 5 on Day 10 of 4.03 for Group D vs. 4.88 for Group P (P = 0.053). Baseline observation carried forward analysis revealed mean BPI-Item 5 on Day 10 of 4.06 and 4.91 for Groups D and P, respectively (P = 0.048). Clinically meaningful pain improvement (≥30%) was reported by 44.1% (n = 15) of patients in Group D vs. 18.2% (n = 6) in Group P (P = 0.02); 32.4% (n = 11) vs. 3.0% (n = 1) of patients in Groups D and P, respectively, reported pain reduction ≥ 50% (P = 0.002). CONCLUSION Adding duloxetine to opioid-pregabalin therapy might have clinical benefit in alleviating refractory CNP. Further studies are needed to conclude the efficacy of adding duloxetine.
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Affiliation(s)
- Hiromichi Matsuoka
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) and Palliative Care Clinical Studies Collaborative (PaCCSC), University of Technology Sydney, Sydney, Australia; Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan.
| | - Satoru Iwase
- Department of Palliative Medicine, University of Saitama Medical University, Saitama, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Keisuke Ariyoshi
- Japanese Organization for Research and Treatment of Cancer (JORTC), JORTC Data Center, Tokyo, Japan
| | - Shunsuke Oyamada
- Japanese Organization for Research and Treatment of Cancer (JORTC), JORTC Data Center, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Hideaki Hasuo
- Department of Psychosomatic Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Hiroko Sakuma
- Department of Psychosomatic Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Toshiaki Shinomiya
- Department of Palliative Medicine, Nara Medical University, Kashihara, Japan
| | - Hiroyuki Otani
- Department of Palliative Medicine, National Kyushu Cancer Center, Fukuoka, Japan
| | - Yoichi Ohtake
- Department of Psychosomatic Internal Medicine and Palliative Care, Sakai City Medical Center, Sakai, Japan
| | - Hiroaki Tsukuura
- Department of Medical Oncology, Nagoya University Hospital, Aichi, Japan
| | - Yoshihisa Matsumoto
- Department of Palliative Medicine, National Cancer Center East, Kashiwa, Japan
| | - Yoshikazu Hasegawa
- Department of Medical Oncology, Izumi City General Hospital, Izumi, Japan
| | - Yuki Kataoka
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Masatomo Otsuka
- Department of Palliative Medicine, Kindai University Nara Hospital, Nara, Japan
| | - Kiyohiro Sakai
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Tatsuya Morita
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Atsuko Koyama
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
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Yamaguchi T, Kawaguchi T, Miyaji T. [Patient Reported Outcome(PRO)in Oncology]. Gan To Kagaku Ryoho 2019; 46:1345-1356. [PMID: 31530769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In recent years, the importance of patient-reported outcomes(PRO)in addition to clinician-outcome assessment has been particularly recognized in clinical trials and routine clinical care of practice. PRO is defined as "any report of the status of a patient's health condition that comes directly from the patient, without interpretation of the patient's response by a clinician or anyone else". For example, in oncology field, NCI-CTCAE has conventionally been used for adverse event assessment. However, it has been pointed out that the adverse event reported by medical staffs tends to underestimate as compared by patients themselves. Hence, PRO version of the Common Terminology Criteria for Adverse Events(PRO-CTCAE), is expected to play an important role. In this article, the background of importance of PRO in oncology, the role of PRO in clinical outcome assessments, the difference between PRO and QOL, significance that PRO evaluation brings to patients and clinical practice, PRO-CTCAE and recent methodology of PRO research will be overviewed.
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Affiliation(s)
- Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine
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44
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Yoshida Y, Manaka T, Nitadori JI, Shinozaki-Ushiku A, Doke T, Saito T, Sato J, Miyaji T, Yamaguchi T, Oyama H, Fukayama M, Nakajima Y, Nakajima J. A comparison between 2- and 3-dimensional approaches to solid component measurement as radiological criteria for sublobar resection in lung adenocarcinoma ≤ 2 cm in size. Surg Today 2019; 49:828-835. [PMID: 30968225 DOI: 10.1007/s00595-019-01806-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/31/2019] [Accepted: 03/20/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE We compared three-dimensional (3D) and two-dimensional (2D) measurements of the solid component to determine radiological criteria for sublobar resection of lung adenocarcinoma ≤ 2 cm in size. METHODS We included 233 surgical cases. The maximum size of the solid component for 3D measurement was calculated by delineating the solid component on successive axial images and reconstructing the 3D surface model. RESULTS The predictive performance for adenocarcinoma in situ (n = 43) and minimally invasive adenocarcinoma (n = 77) were equivalent to areas under the curve of 0.871 and 0.857 for 2D and 3D measurements (p = 0.229), respectively. A solid component of 5 mm had a prognostic impact on both measurements ( ≤ 5 mm versus > 5 mm; p = 0.003 for 2D and p = 0.002 for 3D, log-rank test). Survival rates at 5 years were 94.7-96.9% following lobectomy and sublobar resection among patients with a solid component ≤ 5 mm in size. Sublobar resection resulted in worse survival rates, with declines at 5 years of 15.8% on 2D and 11.5% on 3D measurements, than lobectomy in patients with a solid component > 5 mm in size. CONCLUSIONS A solid component ≤ 5 mm in size is an appropriate criterion for sublobar resection for both measurements. In addition, 2D measurement is justified because of its simple implementation.
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Affiliation(s)
- Yukihiro Yoshida
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Toshiki Manaka
- Department of Bioengineering, The University of Tokyo Graduate School of Engineering, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Jun-Ichi Nitadori
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Aya Shinozaki-Ushiku
- Department of Pathology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takehito Doke
- Department of Bioengineering, The University of Tokyo Graduate School of Engineering, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toki Saito
- Department of Clinical Information Engineering, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Jiro Sato
- Department of Radiology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takuhiro Yamaguchi
- Department of Clinical Trial Data Management, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroshi Oyama
- Department of Clinical Information Engineering, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masashi Fukayama
- Department of Pathology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yoshikazu Nakajima
- Department of Bioengineering, The University of Tokyo Graduate School of Engineering, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Jun Nakajima
- Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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45
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Akechi T, Yamaguchi T, Uchida M, Imai F, Momino K, Katsuki F, Sakurai N, Miyaji T, Horikoshi M, Furukawa TA, Iwata H, Uchitomi Y. Smartphone problem-solving and behavioural activation therapy to reduce fear of recurrence among patients with breast cancer (SMartphone Intervention to LEssen fear of cancer recurrence: SMILE project): protocol for a randomised controlled trial. BMJ Open 2018; 8:e024794. [PMID: 30413519 PMCID: PMC6231603 DOI: 10.1136/bmjopen-2018-024794] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION One of the most common distressing conditions experienced by breast cancer survivors is fear of cancer recurrence (FCR). There is, however, no standard intervention for ameliorating FCR. Our clinical experience and previous studies have suggested the potential benefits of problem-solving therapy (PST) and behavioural activation (BA). Given the huge number of cancer survivors and limited number of therapists to competently conduct PST and BA, we have developed PST and BA smartphone applications. This study aimed to evaluate the efficacy of the smartphone-based PST (Kaiketsu-App) and BA (Genki-App) apps in reducing FCR in patients with breast cancer. METHODS AND ANALYSIS The SMartphone Intervention to LEssen fear of cancer recurrence project is an open-label, individually randomised, parallel-group trial. Allocation will be managed by a central server using a computer-generated random allocation sequence provided by an independent data centre. Participants will be randomised to smartphone-based intervention plus treatment as usual (TAU) or waitlist control with TAU alone. The primary endpoint of the study is the Japanese version of the Concerns About Recurrence Scale, which will be administered as an electronic patient-reported outcome on the patients' smartphone after 8 weeks. ETHICS AND DISSEMINATION The present study is subject to the ethical guidelines for clinical studies published by Japan's Ministry of Education, Science and Technology and Ministry of Health, Labour and Welfare and the modified Act on the Protection of Personal Information as well as the ethical principles established for research on humans stipulated in the Declaration of Helsinki and further amendments thereto. The protocol was approved by the Institutional Review Board of Nagoya City University on 15 January 2018 (ID: 60-00-1171). TRIAL STATUS The randomised trial, which commenced on 2 April 2018, currently enrols participants. The estimated end date for this study is in March 2020. TRIAL REGISTRATION NUMBER UMIN000031140; Pre-results.
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Fuminobu Imai
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Kanae Momino
- Department of Nursing Administration and Management, Nagoya City University School of Nursing, Nagoya, Japan
| | - Fujika Katsuki
- Department of Psychiatric and Mental Health Nursing, Nagoya City University School of Nursing, Nagoya, Japan
| | | | - Tempei Miyaji
- Department of Clinical Trial Data Management, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - Masaru Horikoshi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Toshi A Furukawa
- Department of Health Promotion of Human Behavior, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yosuke Uchitomi
- Behavioral and Survivorship Research Group, Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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46
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Zenda S, Yamaguchi T, Yokota T, Miyaji T, Mashiko T, Tanaka M, Yonemura M, Takeno M, Okano T, Kawasaki T, Nakamori Y, Ishii S, Shimada S, Kanamaru M, Uchitomi Y. Topical steroid versus placebo for the prevention of radiation dermatitis in head and neck cancer patients receiving chemoradiotherapy: the study protocol of J-SUPPORT 1602 (TOPICS study), a randomized double-blinded phase 3 trial. BMC Cancer 2018; 18:873. [PMID: 30189840 PMCID: PMC6127935 DOI: 10.1186/s12885-018-4763-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 08/20/2018] [Indexed: 01/15/2023] Open
Abstract
Background To date, the clinical benefit of topical steroid use has only been demonstrated for radiation dermatitis induced by 50–60 Gy irradiation in breast cancer. However, these agents are also often used clinically for the control of radiation dermatitis induced by high-dose (>60Gy) irradiation with chemotherapy in head and neck cancer. Despite this, the prophylactic efficacy of topical steroids for radiation dermatitis induced by high-dose irradiation is still unclear. The aim of this study is to clarify the benefit of topical steroids in basic nursing care for radiation dermatitis induced by chemoradiotherapy in patients with head and neck cancer. Methods The study is being conducted as a multicenter 2-arm randomized double-blinded placebo-controlled Phase 3 trial in Japan. The study was started in May 2017, with participant enrollment between May 2017 and April 2019. Patients scheduled to receive definitive or postoperative chemoradiotherapy for head and neck cancer are eligible for enrollment. All patients will receive chemoradiotherapy, consisting of single agent CDDP and 70-Gy irradiation. Bilateral neck irradiation is mandatory. Supportive care for radiation dermatitis will consist of basic nursing care with topical steroid or placebo. When radiation dermatitis grade 1 is seen or total radiation dose reaches 30 Gy, minimally required intervention will be started as a first step. If radiation dermatitis worsens to grade 2, the irradiated area will be covered with a moderately absorbent surgical pad and steroid or placebo topical cream. The primary endpoint is a comparison of the proportion of patients with ≥ grade 2 radiation dermatitis by NCI Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0. Ethical approval has been obtained from all participating sites. The results of this study will be submitted for publication in international peer-reviewed journals and the key findings will be presented at international scientific conferences. Discussion Evidence supporting the benefit of adding topical steroids in general nursing care for radiation dermatitis induced by high-dose irradiation with chemotherapy is insufficient. This trial aims to clarify the clinical benefit of topical steroid for radiation dermatitis induced by high-dose irradiation with chemotherapy. The trial is ongoing and is currently recruiting. Trial registration number UMIN000027161. Protocol version 3.0, 18 April 2017.
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Affiliation(s)
- Sadamoto Zenda
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, 5-1-1 Tukiji Chuoku Tokyo, Japan. .,Department of Radiation Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa Chiba, 277-8577, Japan.
| | - Takuhiro Yamaguchi
- Department of Clinical Trial Data Management, Graduate School of Medicine, Tohoku University, 2-1-1 Katahira Aobaku Sendai, Japan.,Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyoku Tokyo, Japan.,Department of Pharmacy, National Cancer Center Hospital East, 5-1-1 Tsukiji Chuoku Tokyo, Japan.,QOL Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsuikiji Chuoku Tokyo, Japan
| | - Tomoya Yokota
- Department of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi Suntogun, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyoku Tokyo, Japan.,Department of Pharmacy, National Cancer Center Hospital East, 5-1-1 Tsukiji Chuoku Tokyo, Japan.,QOL Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsuikiji Chuoku Tokyo, Japan
| | - Tomoe Mashiko
- Suxac Inc, 2-2-15 Minamiaoyama Minatoku Tokyo, Japan
| | - Mari Tanaka
- Department of Radiation Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa Chiba, 277-8577, Japan
| | - Masahito Yonemura
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyoku Tokyo, Japan.,Department of Pharmacy, National Cancer Center Hospital East, 5-1-1 Tsukiji Chuoku Tokyo, Japan
| | - Misaki Takeno
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyoku Tokyo, Japan.,Department of Pharmacy, National Cancer Center Hospital East, 5-1-1 Tsukiji Chuoku Tokyo, Japan
| | - Tomoka Okano
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyoku Tokyo, Japan.,Department of Pharmacy, National Cancer Center Hospital East, 5-1-1 Tsukiji Chuoku Tokyo, Japan
| | - Toshikatsu Kawasaki
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyoku Tokyo, Japan.,Department of Pharmacy, National Cancer Center Hospital East, 5-1-1 Tsukiji Chuoku Tokyo, Japan
| | - Yuko Nakamori
- Department of Radiation Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa Chiba, 277-8577, Japan
| | - Shinobu Ishii
- Department of Radiation Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa Chiba, 277-8577, Japan
| | - Sanae Shimada
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, 5-1-1 Tukiji Chuoku Tokyo, Japan.,Department of Radiation Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa Chiba, 277-8577, Japan
| | - Miyuki Kanamaru
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, 5-1-1 Tukiji Chuoku Tokyo, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, 5-1-1 Tukiji Chuoku Tokyo, Japan.,QOL Research Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsuikiji Chuoku Tokyo, Japan
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Matsuda Y, Morita T, Miyaji T, Ogawa T, Kato K, Kawaguchi T, Tokoro A, Iwase S, Yamaguchi T, Inoue Y. Morphine for Refractory Dyspnea in Interstitial Lung Disease: A Phase I Study (JORTC-PAL 05). J Palliat Med 2018; 21:1718-1723. [PMID: 30129820 DOI: 10.1089/jpm.2018.0272] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Dyspnea is common in interstitial lung disease (ILD) patients and often refractory to conventional treatment. Little is known regarding the safety of systemic morphine in ILD patients. Objective: The objective of this study is to evaluate the safety of a single subcutaneous morphine injection and to determine the recommended dose of morphine for alleviating dyspnea in ILD patients. Design: We conducted a dose-escalation Phase I study for investigating the recommended dose of a single subcutaneous morphine injection to alleviate dyspnea in ILD patients. Setting/Subjects: Eligible subjects were ILD inpatients with dyspnea at rest who were refractory to conventional dyspnea treatment. The morphine doses used were 1 mg and 2 mg in cohort 1 and cohort 2, respectively. The primary endpoint was dose-limiting toxicity, which was defined as (1) respiratory depression, that is, 30% reduction of respiratory rate and 10 Torr increase of PaCO2 compared with baseline; (2) hypotension, that is, 20% reduction of systemic blood pressure compared with baseline and presentation of hypotension-related symptoms; or (3) grade 3, 4, or 5 treatment-emergent adverse events graded by Common Terminology Criteria for Adverse Events (version 4). Results: A total of six patients were enrolled, with three patients each in cohorts 1 and 2. No dose-limiting toxicities were observed; three patients experienced worsened somnolence, but no patients experienced sedation. Conclusion: We conclude that 2 mg of morphine has a tolerable safety profile in ILD patients with dyspnea, and can be tested in further clinical trials.
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Affiliation(s)
- Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
- Clincal Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Tatsuya Morita
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoko Ogawa
- Department of Pharmacy, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Kuniko Kato
- Department of Nursing, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
- Clincal Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Satoru Iwase
- Department of Palliative Medicine, Saitama Medical University, Saitama, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshikazu Inoue
- Clincal Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
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48
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Satomi E, Matsuoka H, Iwase S, Miyaji T, Kawaguchi T, Ariyoshi K, Oyamada S, Hasuo H, Tokoro A, Shinomiya T, Tsukuura H, Otake Y, Otsuka M, Hasegawa Y, Matsumoto Y, Kataoka Y, Otani H, Kidera Y, Aoyama M, Yamaguchi T. A multi-center, randomized, double-blinded, placebo-controlled trial of additive effect of duloxetine for neuropathic cancer pain refractory to opioids and gabapentinoids: JORTC- PAL08 (DIRECT study). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.10102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Eriko Satomi
- Department of Palliative Medicine,National Cancer Center Hospital, Tokyo, Japan
| | - Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osakasayama, JP
| | - Satoru Iwase
- Department of Palliative Medicine, Saitama Medical University Hospital, Saitama, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | | | | | - Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Osaka, JP
| | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine and Supportive and Palliative Care Team, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | | | - Hiroaki Tsukuura
- Department of Clinical Oncology and Chemotherapy,Nagoya University Hospital, Nagoya, JP
| | - Yoichi Otake
- Department of General medicine and Psychosomatic medicine, Sakai City Medical Center, Osaka, Japan
| | - Masatomo Otsuka
- Department of Palliative Care, Kindai University Nara Hospital, Nara, JP
| | | | - Yoshihisa Matsumoto
- Department of Palliative Medicine, National Cancer Center Hospital East, Chiba, Japan
| | - Yuki Kataoka
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Hiroyuki Otani
- Department of Palliative and Supportive Care, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yasuhiro Kidera
- Department of Pharmacy and Clinical research center, Kindai University Hospital, Osakasayama, Japan
| | - Mayuri Aoyama
- Department of pharmacy, National Cancer Center Hospital, Tokyo, Japan
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49
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Miyaji T, Kawaguchi T, Azuma K, Suzuki S, Sano Y, Akatsu M, Torii A, Kamimura T, Ozawa Y, Tsuchida A, Eriguchi D, Haraguchi M, Nishino M, Tokuda Y, Nishi Y, Nishi M, Takeya R, Inadome Y, Yamazaki T, Yamaguchi T. Feasibility trial of collecting patient-generated health data using a wearable device and electronic patient-reported outcomes in cancer patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e18725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Kanako Azuma
- Department of Pharmacy, Tokyo Medical University Hospital, Tokyo, Japan
| | - Shinya Suzuki
- Department of Pharmacy, Kanagawa Prefectural Keiyukai Keiyu Hospital, Kanagawa, Japan
| | - Yoko Sano
- Department of Pharmacy, Tokyo Medical University Hospital, Tokyo, Japan
| | - Moe Akatsu
- Department of Pharmacy, Tokyo Medical University Hospital, Tokyo, Japan
| | - Ayako Torii
- Department of Pharmacy, Tokyo Medical University Hospital, Tokyo, Japan
| | - Tadamasa Kamimura
- Department of Pharmacy, Kanagawa Prefectural Keiyukai Keiyu Hospital, Kanagawa, Japan
| | - Yuki Ozawa
- Department of Pharmacy, Kanagawa Prefectural Keiyukai Keiyu Hospital, Kanagawa, Japan
| | - Akihiko Tsuchida
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Daisuke Eriguchi
- Department of General Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Mizuha Haraguchi
- Department of Internal Medicine, Kanagawa Prefectural Keiyukai Keiyu Hospital, Kanagawa, Japan
| | - Makoto Nishino
- Department of Internal Medicine, Kanagawa Prefectural Keiyukai Keiyu Hospital, Kanagawa, Japan
| | - Yoshiki Tokuda
- Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Yoshiko Nishi
- Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | | | | | | | - Tsutomu Yamazaki
- Clinical Research Support Center, The University of Tokyo Hospital, The University of Tokyo, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Miyagi, Japan
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50
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Ishigami H, Fujiwara Y, Fukushima R, Nashimoto A, Yabusaki H, Imano M, Imamoto H, Kodera Y, Uenosono Y, Amagai K, Kadowaki S, Miwa H, Yamaguchi H, Yamaguchi T, Miyaji T, Kitayama J. Phase III Trial Comparing Intraperitoneal and Intravenous Paclitaxel Plus S-1 Versus Cisplatin Plus S-1 in Patients With Gastric Cancer With Peritoneal Metastasis: PHOENIX-GC Trial. J Clin Oncol 2018; 36:1922-1929. [PMID: 29746229 DOI: 10.1200/jco.2018.77.8613] [Citation(s) in RCA: 194] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose Intraperitoneal paclitaxel plus systemic chemotherapy demonstrated promising clinical effects in patients with gastric cancer with peritoneal metastasis. We aimed to verify its superiority over standard systemic chemotherapy in overall survival. Patients and Methods This randomized phase III trial enrolled patients with gastric cancer with peritoneal metastasis who had received no or short-term (< 2 months) chemotherapy. Patients were randomly assigned at a two-to-one ratio to receive intraperitoneal and intravenous paclitaxel plus S-1 (IP; intraperitoneal paclitaxel 20 mg/m2 and intravenous paclitaxel 50 mg/m2 on days 1 and 8 plus S-1 80 mg/m2 per day on days 1 to 14 for a 3-week cycle) or S-1 plus cisplatin (SP; S-1 80 mg/m2 per day on days 1 to 21 plus cisplatin 60 mg/m2 on day 8 for a 5-week cycle), stratified by center, previous chemotherapy, and extent of peritoneal metastasis. The primary end point was overall survival. Secondary end points were response rate, 3-year overall survival rate, and safety. Results We enrolled 183 patients and performed efficacy analyses in 164 eligible patients. Baseline characteristics were balanced between the arms, except that patients in the IP arm had significantly more ascites. The median survival times for the IP and SP arms were 17.7 and 15.2 months, respectively (hazard ratio, 0.72; 95% CI, 0.49 to 1.04; stratified log-rank P = .080). In the sensitivity analysis adjusted for baseline ascites, the hazard ratio was 0.59 (95% CI, 0.39 to 0.87; P = .008). The 3-year overall survival rate was 21.9% (95% CI, 14.9% to 29.9%) in the IP arm and 6.0% (95% CI, 1.6% to 14.9%) in the SP arm. Both regimens were well tolerated. Conclusion This trial failed to show statistical superiority of intraperitoneal paclitaxel plus systemic chemotherapy. However, the exploratory analyses suggested possible clinical benefits of intraperitoneal paclitaxel for gastric cancer.
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Affiliation(s)
- Hironori Ishigami
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Yoshiyuki Fujiwara
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Ryoji Fukushima
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Atsushi Nashimoto
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Hiroshi Yabusaki
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Motohiro Imano
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Haruhiko Imamoto
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Yasuhiro Kodera
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Yoshikazu Uenosono
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Kenji Amagai
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Shigenori Kadowaki
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Hiroto Miwa
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Hironori Yamaguchi
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Takuhiro Yamaguchi
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Tempei Miyaji
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
| | - Joji Kitayama
- Hironori Ishigami and Tempei Miyaji, The University of Tokyo; Ryoji Fukushima, Teikyo University, Tokyo; Yoshiyuki Fujiwara, Osaka International Cancer Institute; Motohiro Imano and Haruhiko Imamoto, Kindai University, Osaka; Atsushi Nashimoto, Nanbugo General Hospital; Hiroshi Yabusaki, Niigata Cancer Center Hospital, Niigata; Yasuhiro Kodera, Nagoya University; Shigenori Kadowaki, Aichi Cancer Center Hospital, Aichi; Yoshikazu Uenosono, Kagoshima University, Kagoshima; Kenji Amagai, Ibaraki Prefectural Central Hospital, Ibaraki; Hiroto Miwa, Hyogo College of Medicine, Hyogo; Hironori Yamaguchi and Joji Kitayama, Jichi Medical University, Tochigi; and Takuhiro Yamaguchi, Tohoku University, Miyagi, Japan
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