1
|
Yamaguchi J, Sadahiro R, Hirayama T, Wada S, Nakahara R, Matsuoka H. Severe behavioral and psychological symptoms of dementia successfully treated at home with a blonanserin transdermal patch: A case report. Neuropsychopharmacol Rep 2024. [PMID: 38558544 DOI: 10.1002/npr2.12434] [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: 01/29/2024] [Revised: 02/25/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
AIM Behavioral psychological symptoms of dementia (BPSD) are sometimes difficult to treat due to severe psychiatric symptoms such as delusions of poisoning and violent behavior. Moreover, in cases of parental neglect, the management of these psychiatric symptoms becomes more difficult. Therefore, home-visiting doctors sometimes have to manage patients with BPSD and severe psychiatric symptoms, and a new approach is needed. In this case report, the effect of blonanserin transdermal patch on these patients is to be highlighted. METHODS The patient is a 91-year-old woman diagnosed with Alzheimer's disease. She had severe BPSD such as delusion of robbery and violent behavior, and refused oral medications including memantine and yokukansan. Then she was treated with blonanserin transdermal patch (20 mg/day). The severity of psychiatric symptoms of BPSD was assessed over time using the Neuropsychiatric Inventory (NPI) score. Moreover, the patient's cognitive function was also assessed over time by Mini-Mental State Examination (MMSE). RESULTS After the introduction of blonanserin patch, the patient's psychiatric symptoms were stabilized markedly, and both NPI and MMSE scores improved. The patient was able to stay at home calmly and was mentally well stabilized to the extent that she did not require hospitalization. No apparent side effects were admitted. CONCLUSIONS The blonanserin transdermal patch may be able to manage BPSD at home and is effective in patients who refuse oral medications. Home-visiting doctors may consider the use of blonanserin patches at home for patients with severe BPSD, manifesting as delusions of poisoning and refusing oral drugs.
Collapse
Affiliation(s)
- Junji Yamaguchi
- Asakusa Family Clinic, Tokyo, Japan
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ryoichi Sadahiro
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
- Kokoro Support Clinic, Tokyo, Japan
| | - Saho Wada
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Rika Nakahara
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Hasuo H, Mori K, Matsuoka H, Sakuma H, Ishikawa H. An Estimation Formula for Resonance Frequency Using Sex and Height for Healthy Individuals and Patients with Incurable Cancers. Appl Psychophysiol Biofeedback 2024; 49:125-132. [PMID: 37702816 PMCID: PMC10869367 DOI: 10.1007/s10484-023-09602-5] [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] [Accepted: 07/25/2023] [Indexed: 09/14/2023]
Abstract
Resonance frequency breathing is a technique that involves breathing that maximizes heart rate variability. It is specific to individuals and is determined through a procedure taking approximately 30 min, using a procedure that is often best carried out at specialized medical institutions. This is a physical and time-consuming burden because of hospital visits and measurements, particularly for patients with cancer. Therefore it would be beneficial if a procedure can be found to determine resonance frequency from the patient's physical characteristics, without the need for special assessment procedures. This exploratory cross-sectional study examined the correlation between individual characteristics and resonance frequency in healthy volunteers. Multiple regression analysis was performed with the measured resonance frequency as the target variable and individual characteristic parameters as explanatory variables. The study aims to build an estimation formula for resonance frequency with some of these parameters and assess its validity. In addition, the validity of the formula's applicability to patients with incurable cancers is assessed. A total of 122 healthy volunteers and 32 patients with incurable cancers were recruited as participants. The median resonance frequency of 154 participants was six breaths per min. Sex and height were selected as explanatory variables associated with the measured resonance frequency in the volunteers. The estimation formula for resonance frequency using individual characteristics was 17.90-0.07 × height for men and 15.88-0.06 × height for women. Adjusted R-squared values were 0.55 for men and 0.47 for women. When the measured resonance frequency in patients with incurable cancers was six breaths per minute or less, the resonance frequency estimated by this formula was slightly larger than the measured ones. Information on individual characteristics, such as sex and height, which can be easily obtained, was useful to construct an estimation formula for resonance frequency.
Collapse
Affiliation(s)
- Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Shinmachi 2-5-1, Hirakata, Osaka, 573-1090, Japan.
| | - Keita Mori
- Clinical Research Support Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroko Sakuma
- Department of Psychosomatic Medicine, Kansai Medical University, Shinmachi 2-5-1, Hirakata, Osaka, 573-1090, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
4
|
Hirayama T, Igarashi E, Wada S, Sadahiro R, Oshikiri H, Suzuka M, Sato Y, Utsumi Y, Sakuma A, Nakahara R, Imai T, Tomita H, Matsuoka H. Concomitant use of hydroxyzine and haloperidol did not worsen delirium in patients with cancer: A multicenter, retrospective, observational study. Palliat Support Care 2024:1-8. [PMID: 38409802 DOI: 10.1017/s1478951524000117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
OBJECTIVES There is concern that hydroxyzine exacerbates delirium, but a recent preliminary study suggested that the combination of haloperidol and hydroxyzine was effective against delirium. This study examined whether the concomitant use of hydroxyzine and haloperidol worsened delirium in patients with cancer. METHODS This retrospective, observational study was conducted at 2 general hospitals in Japan. The medical records of patients with cancer who received haloperidol for delirium from July to December 2020 were reviewed. The treatments for delirium included haloperidol alone or haloperidol combined with hydroxyzine. The primary outcome was the duration from the first day of haloperidol administration to the resolution of delirium, defined as its absence for 2 consecutive days. The time to delirium resolution was analyzed to compare the haloperidol group and hydroxyzine combination group using the log-rank test with the Kaplan-Meier method. Secondary outcomes were (1) the total dose of antipsychotic medications, including those other than haloperidol (measured in chlorpromazine-equivalent doses), and (2) the frequencies of detrimental incidents during delirium, specifically falls and self-removal of drip infusion lines. The unpaired t-test and Fisher's exact test were used to analyze secondary outcomes. RESULTS Of 497 patients who received haloperidol, 118 (23.7%) also received hydroxyzine. No significant difference in time to delirium resolution was found between the haloperidol group and the hydroxyzine combination group (log-rank test, P = 0.631). No significant difference between groups was found in either chlorpromazine-equivalent doses or the frequency of detrimental incidents. SIGNIFICANCE OF RESULTS This study showed that the concomitant use of hydroxyzine and haloperidol did not worsen delirium in patients with cancer.
Collapse
Affiliation(s)
- Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Emi Igarashi
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Saho Wada
- Division of Quality Assurance Programs, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Ryoichi Sadahiro
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hanae Oshikiri
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Masato Suzuka
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Yuji Sato
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Yusuke Utsumi
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Rika Nakahara
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Toru Imai
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroaki Tomita
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|
5
|
Matsuda Y, Hasuo H, Narita K, Matsuoka H, Morita R, Kiuchi D, Ikari T, Hori T, Okazaki K, Sakai K, Aiki S, Okabayashi H, Oyamada S, Ariyoshi K, Tokoro A, Fukunaga M. Relationship between dyspnoea and related factors in patients with cancer: a cross-sectional study. BMJ Support Palliat Care 2024; 13:e1126-e1132. [PMID: 38557730 DOI: 10.1136/bmjspcare-2021-003484] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 04/15/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Dyspnoea is a common and distressing symptom in patients with cancer. We aimed to analyse the association between dyspnoea and related factors and to estimate their causal relationship. METHODS A cross-sectional study was conducted. Patients with cancer with dyspnoea and a mean Numerical Rating Scale (NRS) of ≥3 over 24 hours were enrolled at 10 institutions in Japan from December 2019 to February 2021. The outcomes included dyspnoea, cough and pain NRS over 24 hours, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, Somatosensory Amplification Scale, opioids for dyspnoea and respiratory failure. Path analyses were conducted to estimate the direct and indirect paths with reference to dyspnoea and related factors. RESULTS A total of 209 patients were enrolled and 208 patients were included in the analysis. Cough worsened dyspnoea (β=0.136), dyspnoea increased emotional distress (β=1.104), emotional distress increased somatosensory amplification (β=0.249) and somatosensory amplification worsened cough (β=0.053) according to path analysis. CONCLUSION There may be a vicious circle among dyspnoea and related factors: cough worsened dyspnoea, dyspnoea increased emotional distress, emotional distress increased somatosensory amplification and somatosensory amplification worsened cough. When treating dyspnoea in patients with cancer, managing these factors aimed at interrupting this vicious circle may be useful. TRIAL REGISTRATION NUMBER UMIN Clinical Trials Registry (UMIN000038820).
Collapse
Affiliation(s)
- Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
| | - Keiichi Narita
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ryo Morita
- Department of Respiratory Medicine, Akita Kosei Medical Center, Akita, Japan
| | - Daisuke Kiuchi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Tomoo Ikari
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tetsuo Hori
- Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Koya Okazaki
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Kiyohiro Sakai
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine Hospital, Osakasayama, Japan
| | - Sayo Aiki
- Department of Palliative Care, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Hiroko Okabayashi
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | | | | | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Mikihiko Fukunaga
- Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
| |
Collapse
|
6
|
Narita Y, Matsushima T, Sakamoto Y, Matsuoka H, Tanioka H, Kawakami T, Shoji H, Mizukami T, Izawa N, Nishina T, Yamamoto Y, Mitani S, Nakamura M, Misumi T, Muro K. Chemotherapy after nivolumab for advanced gastric cancer (REVIVE): a prospective observational study. ESMO Open 2023; 8:102071. [PMID: 38016249 PMCID: PMC10774960 DOI: 10.1016/j.esmoop.2023.102071] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/25/2023] [Accepted: 10/21/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Nivolumab therapy is a standard-of-care treatment for heavily pretreated patients with advanced gastric cancer (AGC). Previous studies have reported improvement in the objective response rate to chemotherapy after nivolumab therapy for other types of cancer. This study evaluated the efficacy and safety of chemotherapy after nivolumab therapy in AGC. PATIENTS AND METHODS We conducted a prospective, multicenter, observational study in pretreated patients with nivolumab-refractory or -intolerant AGC. Patients received irinotecan, oxaliplatin-containing regimens, or trifluridine/tipiracil. The primary endpoint was overall survival. RESULTS A total of 199 patients were included (median age: 69 years; male: 70%; female: 30%). Median overall survival and progression-free survival were 7.5 months [95% confidence interval (CI): 6.7-9.7 months] and 2.9 months (95% CI: 2.2-3.5 months), respectively. Objective response and disease control rates were 16.8% (95% CI: 11.6% to 23.6%) and 18.9% (95% CI: 38.9% to 54.6%), respectively. A prognostic index using alkaline phosphatase and the Glasgow Prognostic Score was generated to classify patients into three risk groups (good, moderate, and poor). The hazard ratios of the moderate and poor groups to the good group were 1.88 (95% CI: 1.22-2.92) and 3.29 (95% CI: 1.92-5.63), respectively. At the initiation of chemotherapy, 42 patients had experienced immune-related adverse events due to prior nivolumab therapy. The most common grade 3-4 adverse events were neutropenia (7.5%), anemia (8.0%), and anorexia (7.5%). CONCLUSIONS The administration of cytotoxic chemotherapy after nivolumab therapy may give rise to a synergistic antitumor effect in AGC. Further investigation is warranted to confirm these findings.
Collapse
Affiliation(s)
- Y Narita
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya
| | - T Matsushima
- Department of Gastroenterology, Saitama Cancer Center, Saitama
| | - Y Sakamoto
- Department of Medical Oncology, Osaki Citizen Hospital, Osaki
| | - H Matsuoka
- Department of Gastrointestinal Surgery School of Medicine, Fujita Health University Hospital, Toyoake
| | - H Tanioka
- Department of Clinical Oncology, Kawasaki Medical School, Kurashiki
| | - T Kawakami
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka
| | - H Shoji
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo
| | - T Mizukami
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki; Department of Medical Oncology, NTT Medical Center Tokyo, Tokyo
| | - N Izawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki
| | - T Nishina
- Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama
| | - Y Yamamoto
- Department of Gastroenterology, University of Tsukuba Hospital, Tsukuba
| | - S Mitani
- Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka-Sayama
| | - M Nakamura
- Department of Gastroenterology, Sapporo City General Hospital, Sapporo
| | - T Misumi
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - K Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya.
| |
Collapse
|
7
|
Sadahiro R, Hatta K, Yamaguchi T, Masanori E, Matsuda Y, Ogawa A, Iwata Y, Tokoro A, Nakahara R, Hirayama T, Yanai Y, Ogawa Y, Kayano A, Ariyoshi K, Oyamada S, Uchitomi Y, Akechi T, Yamamoto N, Okita N, Yorikane E, Shimada K, Furukawa T, Hashimoto H, Maeda M, Sato T, Sekimoto A, Sasaki C, Saito E, Uezono Y, Matsuoka H. A multi-centre, double-blind, randomized, placebo-controlled trial to evaluate the effectiveness and safety of ramelteon for the prevention of postoperative delirium in elderly cancer patients: a study protocol for JORTC-PON2/J-SUPPORT2103/NCCH2103. Jpn J Clin Oncol 2023; 53:851-857. [PMID: 37340766 PMCID: PMC10473272 DOI: 10.1093/jjco/hyad061] [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: 03/30/2023] [Accepted: 05/25/2023] [Indexed: 06/22/2023] Open
Abstract
Postoperative delirium is an important issue in cancer patients, affecting surgical outcomes and the quality of life. Ramelteon is a melatonin receptor agonist with high affinity for MT1 and MT2 receptors. Clinical trials and observational studies in Japan, including in surgical cancer patients, have shown efficacy of ramelteon in delirium prevention, with no serious safety concerns. However, clinical trials from the USA have reported conflicting results. A Japanese phase II study investigated the efficacy and safety of ramelteon for delirium prevention following gastrectomy in patients aged ≥75 years, with findings suggesting the feasibility of a phase III trial. The aim of this multi-centre, double-blind, randomized placebo-controlled phase III trial is to evaluate the effectiveness and safety of oral ramelteon for postoperative delirium prevention in cancer patients aged ≥65 years as advanced medical care. The trial protocol is described here.
Collapse
Affiliation(s)
- Ryoichi Sadahiro
- Department of Psycho-Oncology, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | - Kotaro Hatta
- Department of Psychiatry, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Enokido Masanori
- Department of Psycho-Oncology, National Cancer Center East, National Cancer Center Japan, Chiba, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Asao Ogawa
- Department of Psycho-Oncology, National Cancer Center East, National Cancer Center Japan, Chiba, Japan
| | - Yusei Iwata
- Department of Psycho-Oncology, National Cancer Center East, National Cancer Center Japan, Chiba, Japan
| | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Rika Nakahara
- Department of Psycho-Oncology, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | - Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | - Yuko Yanai
- Department of Psycho-Oncology, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | - Yuko Ogawa
- Department of Psycho-Oncology, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | - Ayako Kayano
- Department of Psycho-Oncology, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | | | | | - Yosuke Uchitomi
- Division of Survivorship Research, Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Natsuko Okita
- Clinical Trial Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Eiko Yorikane
- Clinical Trial Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuaki Shimada
- National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | - Tetsuya Furukawa
- Department of Pharmacy, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | - Hironobu Hashimoto
- Department of Pharmacy, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | - Makoto Maeda
- Department of Pharmacy, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | - Tetsufumi Sato
- Department of Anesthesia and Intensive Care, National Cancer Center Japan, Tokyo, Japan
| | - Asuko Sekimoto
- Department of Nursing, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | - Chiyuki Sasaki
- Department of Nursing, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| | - Eiko Saito
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuhito Uezono
- Department of Pain Control Research, Jikei University School of Medicine, Tokyo, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, National Cancer Center Japan, Tokyo, Japan
| |
Collapse
|
8
|
Fujita Y, Matsuoka H, Chiba Y, Tsurutani J, Yoshida T, Sakai K, Nakura M, Sakamoto R, Makimura C, Ohtake Y, Tanaka K, Hayashi H, Takeda M, Okuno T, Takegawa N, Haratani K, Takahama T, Tanizaki J, Koyama A, Nishio K, Nakagawa K. Novel single nucleotide polymorphism biomarkers to predict opioid effects for cancer pain. Oncol Lett 2023; 26:355. [PMID: 37545623 PMCID: PMC10398630 DOI: 10.3892/ol.2023.13941] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/05/2023] [Indexed: 08/08/2023] Open
Abstract
There have been few studies on predictive biomarkers that may be useful to select the most suitable opioids to optimize therapeutic efficacy in individual patients with cancer pain. We recently investigated the efficacy of morphine and oxycodone using single nucleotide polymorphisms (SNPs) of the catechol-O-methyltransferase (COMT) rs4680 gene as a biomarker (RELIEF study). To explore additional biomarkers that may enable the selection of an appropriate opioid for individual patients with cancer pain, three SNPs were examined: C-C motif chemokine ligand 11 (CCL11; rs17809012), histamine N-methyltransferase (HNMT; rs1050891) and transient receptor potential V1 (TRPV1; rs222749), which were screened from 74 pain-related SNPs. These SNPs, which were identified as being significantly associated with the analgesic effect of morphine, were then used to genotype the 135 patients in the RELIEF study who had been randomized into a morphine group (n=69) or an oxycodone group (n=66). The present study then assessed whether the SNPs could also be used as selective biomarkers to predict which opioid(s) might be the most suitable to provide pain relief for patients with cancer. Oxycodone tended to provide superior analgesic effects over morphine in patients carrying the genotype AA for the CCL11 rs17809012 SNP (P=0.012 for interaction), suggesting that it could serve as a potential biomarker for personalized analgesic therapy for patients suffering with cancer pain.
Collapse
Affiliation(s)
- Yoshihiko Fujita
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
- Palliative Care Center, Kindai Hospital, Osaka 589-8511, Japan
- Palliative Care Team, National Cancer Center, Tokyo 104-0045, Japan
| | - Yasutaka Chiba
- Department of Biostatics, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Junji Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, Tokyo 142-8555, Japan
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Takeshi Yoshida
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Kiyohiro Sakai
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
- Palliative Care Center, Kindai Hospital, Osaka 589-8511, Japan
| | - Miki Nakura
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Ryo Sakamoto
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Chihiro Makimura
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Yoichi Ohtake
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Kaoru Tanaka
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Hidetoshi Hayashi
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Masayuki Takeda
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Tatsuya Okuno
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Naoki Takegawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Koji Haratani
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Takayuki Takahama
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Junko Tanizaki
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Atsuko Koyama
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
- Palliative Care Center, Kindai Hospital, Osaka 589-8511, Japan
| | - Kazuto Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| |
Collapse
|
9
|
Sri-iesaranusorn P, Sadahiro R, Murakami S, Wada S, Shimizu K, Yoshida T, Aoki K, Uezono Y, Matsuoka H, Ikeda K, Yoshimoto J. Data-driven categorization of postoperative delirium symptoms using unsupervised machine learning. Front Psychiatry 2023; 14:1205605. [PMID: 37441147 PMCID: PMC10333495 DOI: 10.3389/fpsyt.2023.1205605] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023] Open
Abstract
Background Phenotyping analysis that includes time course is useful for understanding the mechanisms and clinical management of postoperative delirium. However, postoperative delirium has not been fully phenotyped. Hypothesis-free categorization of heterogeneous symptoms may be useful for understanding the mechanisms underlying delirium, although evidence is currently lacking. Therefore, we aimed to explore the phenotypes of postoperative delirium following invasive cancer surgery using a data-driven approach with minimal prior knowledge. Methods We recruited patients who underwent elective invasive cancer resection. After surgery, participants completed 5 consecutive days of delirium assessments using the Delirium Rating Scale-Revised-98 (DRS-R-98) severity scale. We categorized 65 (13 questionnaire items/day × 5 days) dimensional DRS-R-98 scores using unsupervised machine learning (K-means clustering) to derive a small set of grouped features representing distinct symptoms across all participants. We then reapplied K-means clustering to this set of grouped features to delineate multiple clusters of delirium symptoms. Results Participants were 286 patients, of whom 91 developed delirium defined according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria. Following the first K-means clustering, we derived four grouped symptom features: (1) mixed motor, (2) cognitive and higher-order thinking domain with perceptual disturbance and thought content abnormalities, (3) acute and temporal response, and (4) sleep-wake cycle disturbance. Subsequent K-means clustering permitted classification of participants into seven subgroups: (i) cognitive and higher-order thinking domain dominant delirium, (ii) prolonged delirium, (iii) acute and brief delirium, (iv) subsyndromal delirium-enriched, (v) subsyndromal delirium-enriched with insomnia, (vi) insomnia, and (vii) fit. Conclusion We found that patients who have undergone invasive cancer resection can be delineated using unsupervised machine learning into three delirium clusters, two subsyndromal delirium clusters, and an insomnia cluster. Validation of clusters and research into the pathophysiology underlying each cluster will help to elucidate the mechanisms of postoperative delirium after invasive cancer surgery.
Collapse
Affiliation(s)
| | - Ryoichi Sadahiro
- Department of Immune Medicine, National Cancer Center Research Institute, Tokyo, Japan
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Syo Murakami
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Saho Wada
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
- Department of Neuropsychiatry, Nippon Medical School, Tama Nagayama Hospital, Tokyo, Japan
| | - Ken Shimizu
- Department of Psycho-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Teruhiko Yoshida
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Kazunori Aoki
- Department of Immune Medicine, National Cancer Center Research Institute, Tokyo, Japan
| | - Yasuhito Uezono
- Department of Pain Control Research, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kazushi Ikeda
- Division of Information Science, Nara Institute of Science and Technology, Nara, Japan
| | - Junichiro Yoshimoto
- Division of Information Science, Nara Institute of Science and Technology, Nara, Japan
- Department of Biomedical Data Science, Fujita Health University School of Medicine, Aichi, Japan
| |
Collapse
|
10
|
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 .
Collapse
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.
| |
Collapse
|
11
|
Samejima J, Okami J, Tanaka Y, Kobayashi S, Kimura T, Mukai M, Nagao T, Matsuoka H, Tsuboi M. 159P Optimization and validation of a circulating microRNA biomarker panel for early detection of lung cancer in a Japanese population. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00413-6] [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: 04/03/2023]
|
12
|
Matsuoka H, Tsurutani J, Chiba Y, Fujita Y, Sakai K, Yoshida T, Nakura M, Sakamoto R, Makimura C, Ohtake Y, Tanaka K, Hayashi H, Takeda M, Okuno T, Takegawa N, Haratani K, Koyama A, Nishio K, Nakagawa K. Morphine Versus Oxycodone for Cancer Pain Using a Catechol-O-methyltransferase Genotype Biomarker: A Multicenter, Randomized, Open-Label, Phase III Clinical Trial (RELIEF Study). Oncologist 2023; 28:278-e166. [PMID: 36426809 PMCID: PMC10020805 DOI: 10.1093/oncolo/oyac233] [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: 06/22/2022] [Accepted: 10/06/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND We hypothesized that the high-dose opioid requirement in patients carrying the rs4680-GG variant in the COMT gene encoding catechol-O-methyltransferase would be greater for patients taking morphine than for those taking oxycodone, thus providing a much-needed biomarker to inform opioid selection for cancer pain. METHODS A randomized, multicenter, open-label trial was conducted at a Japanese hospital's palliative care service. Patients with cancer pain treated with regular doses of nonsteroidal anti-inflammatory drugs or acetaminophen were enrolled and randomized (1:1) into morphine (group M) and oxycodone (group O) groups. The minimum standard dose of immediate-release (IR) oral opioids was repeatedly administered by palliative care physicians to achieve pain-reduction goals (Pain reduction ≥ 33% from baseline and up to ≤ 3 on a numerical rating scale). The primary endpoint was the proportion of subjects requiring high-dose opioids on day 0 with the GG genotype. RESULTS Of 140 participants who developed cancer-related pain among 378 subjects registered and pre-screened for the genotype, 139 were evaluated in the current study. Among patients carrying a COMT rs4680-GG genotype, 48.3% required high-dose opioids in group M, compared with the 20.0% in group O (95% CI, 3.7%-50.8%; P = .029). Of those with the non-GG genotype, 41.5% treated with morphine and 23.1% with oxycodone required high-dose opioids (95% CI, 3.3%-38.3%; P = 0.098). CONCLUSION Using the COMT rs4680 genotype alone is not recommended for selecting between morphine and oxycodone for pain relief.
Collapse
Affiliation(s)
- Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan
- Palliative Care Center, Kindai Hospital, Osaka, Japan
- Palliative Care Team, National Cancer Center, Tokyo, Japan
| | - Junji Tsurutani
- Corresponding author: Junji Tsurutani, MD, Advanced Cancer Translational Research Institute, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan. Tel: +81 3 3784 8145;
| | - Yasutaka Chiba
- Department of Biostatics, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yoshihiko Fujita
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kiyohiro Sakai
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan
- Palliative Care Center, Kindai Hospital, Osaka, Japan
| | - Takeshi Yoshida
- Palliative Care Center, Kindai Hospital, Osaka, Japan
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Miki Nakura
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan
| | - Ryo Sakamoto
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan
| | - Chihiro Makimura
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yoichi Ohtake
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan
- Department of Internal Medicine, Sakai City Medical Center, Osaka, Japan
| | - Kaoru Tanaka
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hidetoshi Hayashi
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Masayuki Takeda
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Tatsuya Okuno
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Naoki Takegawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Koji Haratani
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Atsuko Koyama
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan
- Palliative Care Center, Kindai Hospital, Osaka, Japan
| | - Kazuto Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | | |
Collapse
|
13
|
Amano K, Morita T, Miura T, Mori N, Tatara R, Kessoku T, Matsuda Y, Tagami K, Otani H, Mori M, Taniyama T, Nakajima N, Nakanishi E, Kako J, Ishiki H, Matsuoka H, Satomi E, Hopkinson JB, Baracos VE, Miyashita M. Development and validation of questionnaires for eating-related distress among advanced cancer patients and families. J Cachexia Sarcopenia Muscle 2023; 14:310-325. [PMID: 36403291 PMCID: PMC9891939 DOI: 10.1002/jcsm.13133] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/05/2022] [Accepted: 10/25/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Eating-related distress (ERD) is one type of psychosocial distress among advanced cancer patients and family caregivers. Its alleviation is a key issue in palliative care; however, there is no validated tool for measuring ERD. METHODS The purpose of this study was to validate tools for evaluating ERD among patients and family caregivers. The study consisted of a development and validation/retest phase. In the development phase, we made preliminary questionnaires for patients and family caregivers. After face validity and content validity, we performed an exploratory factor analysis and discussed the final adoption of items. In the validation/retest phase, we examined factor validity with an exploratory factor analysis. We calculated Pearson's correlation coefficients between the questionnaire for patients, the Functional Assessment of Anorexia/Cachexia Therapy Anorexia Cachexia Subscale (FAACT ACS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Cachexia 24 (EORTC QLQ-CAX24) and Pearson's correlation coefficients between the questionnaire for family caregivers and the Caregiver Quality of Life Index-Cancer (CQOLC) for concurrent validity. We calculated Cronbach's alpha coefficients (Cronbach's alpha) and intraclass correlation coefficients (ICCs) for internal consistency and test-retest reliability. We performed the Mann-Whitney U test between the questionnaires and cancer cachexia based on criteria from the international consensus for known-group validity. RESULTS In the development phase, 162 pairs of patients and family caregivers were asked to participate, and 144 patients and 106 family caregivers responded. In the validation/retest phase, 333 pairs of patients and family caregivers were asked to participate, and 234 patients and 152 family caregivers responded. Overall, 183 patients and 112 family caregivers did the retest. Seven conceptual groups were extracted for the ERD among patients and family caregivers, respectively. Patient factors 1-7 correlated with FAACT ACS (r = -0.63, -0.43, -0.55, -0.40, -0.38, -0.54, -0.38, respectively) and EORTC QLQ-CAX24 (r = 0.58, 0.40, 0.60, 0.49, 0.38, 0.59, 0.42, respectively). Family factors 1-7 correlated with CQOLC (r = -0.34, -0.30, -0.37, -0.37, -0.46, -0.42, -0.40, respectively). The values of Cronbach's alpha and ICC of each factor and all factors of patients ranged from 0.84 to 0.96 and 0.67 to 0.83, respectively. Those of each factor and all factors of family caregivers ranged from 0.84 to 0.96 and 0.63 to 0.84, respectively. The cachexia group of patients had significantly higher scores than the non-cachexia group for each factor and all factors. CONCLUSIONS Newly developed tools for measuring ERD experienced by advanced cancer patients and family caregivers have been validated.
Collapse
Affiliation(s)
- Koji Amano
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.,Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Tatsuya Morita
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan
| | - Tomofumi Miura
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Ryohei Tatara
- Department of Palliative Medicine, Osaka City General Hospital, Miyakojima-ku, Osaka, Japan
| | - Takaomi Kessoku
- Department of Palliative Medicine, Yokohama City University Hospital, Yokohama, Japan.,Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Osaka, Japan
| | - Keita Tagami
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hiroyuki Otani
- Department of Palliative Care Team, and Palliative and Supportive Care, St. Mary's Hospital, Kurume, Fukuoka, Japan
| | - Masanori Mori
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan
| | - Tomohiko Taniyama
- Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Nishikyo-ku, Kyoto, Japan
| | - Nobuhisa Nakajima
- Division of Community Medicine and International Medicine, University of the Ryukyus Hospital, Nakagami-gun, Okinawa, Japan
| | - Erika Nakanishi
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Graduate School of Public Health, St. Luke's International University, OMURA Susumu & Mieko Memorial St. Luke's Center for Clinical Academia, Chuo-ku, Tokyo, Japan
| | - Jun Kako
- College of Nursing Art and Science, University of Hyogo, Akashi, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Jane B Hopkinson
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, Wales, UK
| | - Vickie E Baracos
- Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Canada
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| |
Collapse
|
14
|
Matsuoka H. [Psycho-Oncology: An Overview of Clinical Practice Guidelines for the Care of Psychologically Distressed Bereaved Families Who Have Lost a Family Member to Physical Illness, Including Cancer]. Brain Nerve 2023; 75:77-83. [PMID: 36574975 DOI: 10.11477/mf.1416202281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Psycho-oncology is an interdisciplinary field encompassing physical, psychological, social, and behavioral aspects of the cancer experience for both patients and caregivers. The Japanese Psycho-Oncology Society and the Japanese Association of Supportive Care in Cancer developed evidence-based clinical practice guidelines for the care of psychologically distressed bereaved families who have lost members to physical illness including cancer. Because of the wide variation in international attitudes toward bereavement care, we have enhanced the descriptions in the general comment section. Two clinical questions were set and a systematic literature review was conducted by the guideline development group. The level of evidence and the strength of the recommendations were graded, and the modified Delphi method was used to validate the recommendation statements. Recommendations were as follows: nonpharmacologic interventions were indicated for severe psychological distress (depression and grief), and antidepressants were indicated for depression; however, psychotropic medications, including antidepressants, were not recommended for "complicated" grief. These guidelines facilitate the provision of appropriate care for distressed bereaved families and identify areas in need of further research.
Collapse
|
15
|
Abe A, Amano K, Morita T, Miura T, Mori N, Tatara R, Kessoku T, Matsuda Y, Tagami K, Otani H, Mori M, Taniyama T, Nakajima N, Nakanishi E, Kako J, Kiuchi D, Ishiki H, Matsuoka H, Satomi E, Miyashita M. Beliefs and Perceptions About Parenteral Nutrition and Hydration by Advanced Cancer Patients. Palliat Med Rep 2022; 3:132-139. [PMID: 36059904 PMCID: PMC9438434 DOI: 10.1089/pmr.2022.0009] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Akiko Abe
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Koji Amano
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute City, Japan
| | - Tatsuya Morita
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu City, Shizuoka, Japan
| | - Tomofumi Miura
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa City, Japan
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute City, Japan
| | - Ryohei Tatara
- Department of Palliative Medicine, Osaka City General Hospital, Osaka City, Japan
| | - Takaomi Kessoku
- Department of Palliative Medicine, Yokohama City University Hospital, Yokohama City, Japan
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama City, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City, Japan
| | - Keita Tagami
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai City, Japan
| | - Hiroyuki Otani
- Department of Palliative Care Team, and Palliative and Supportive Care, St. Mary's Hospital, Kurume City, Japan
| | - Masanori Mori
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu City, Shizuoka, Japan
| | - Tomohiko Taniyama
- Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto City, Japan
| | - Nobuhisa Nakajima
- Division of Community Medicine and International Medicine, University of the Ryukyus Hospital, Nakagami-Gun, Japan
| | - Erika Nakanishi
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai City, Japan
- Graduate School of Public Health, St. Luke's International University, OMURA Susumu and Mieko Memorial St. Luke's Center for Clinical Academia, Tokyo, Japan
| | - Jun Kako
- College of Nursing Art and Science, University of Hyogo, Akashi City, Japan
| | - Daisuke Kiuchi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai City, Japan
| |
Collapse
|
16
|
Sadahiro R, Wada S, Matsuoka YJ, Uchitomi Y, Yamaguchi T, Sato T, Esaki M, Yoshimoto S, Daiko H, Kanemitsu Y, Kawai A, Kato T, Fujimoto H, Uezono Y, Shimizu K, Matsuoka H. Prevention of delirium with agitation by yokukansan in older adults after cancer surgery. Jpn J Clin Oncol 2022; 52:1276-1281. [PMID: 35907781 DOI: 10.1093/jjco/hyac123] [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: 05/31/2022] [Accepted: 07/14/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Preventing postoperative delirium with agitation is vital in the older population. We examined the preventive effect of yokukansan on postoperative delirium with agitation in older adult patients undergoing highly invasive cancer resection. METHODS We performed a secondary per-protocol analysis of 149 patients' data from a previous clinical trial. Patients underwent scheduled yokukansan or placebo intervention 4-8 days presurgery and delirium assessment postoperatively. Delirium with agitation in patients aged ≥75 years was assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the Japanese version of the Delirium Rating Scale-Revised-98. We assessed odds ratios for yokukansan (TJ-54) compared with placebo for the manifestation of postoperative delirium with agitation across patients of all ages (n = 149) and those aged ≥65 years (n = 82) and ≥ 75 years (n = 21) using logistic regression. RESULTS Delirium with agitation manifested in 3/14 and 5/7 patients in the TJ-54 and placebo groups, respectively, among those aged ≥75 years. The odds ratio for yokukansan vs. placebo was 0.11 (95% confidence interval: 0.01-0.87). An age and TJ-54 interaction effect was detected in patients with delirium with agitation. No intergroup differences were observed in patients aged ≥65 years or across all ages for delirium with agitation. CONCLUSIONS This is the first study investigating the preventive effect of yokukansan on postoperative delirium with agitation in older adults. Yokukansan may alleviate workforce burdens in older adults caused by postoperative delirium with agitation following highly invasive cancer resection.
Collapse
Affiliation(s)
- Ryoichi Sadahiro
- Department of Psycho-Oncology, National Cancer Center Japan, Tokyo, Japan
| | - Saho Wada
- Department of Psycho-Oncology, National Cancer Center Japan, Tokyo, Japan.,Department of Neuropsychiatry, Nippon Medical School, Tama Nagayama Hospital, Tokyo, Japan
| | - Yutaka J Matsuoka
- Former Division Chief of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| | - Yosuke Uchitomi
- Department of Psycho-Oncology, National Cancer Center Japan, Tokyo, Japan.,Group for Supportive Care and Survivorship Research, Institute for Cancer Control, National Cancer Center Japan, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Tetsufumi Sato
- Department of Anesthesia and Intensive Care, National Cancer Center Japan, Tokyo, Japan
| | - Minoru Esaki
- Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Japan, Tokyo, Japan
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgery, National Cancer Center Japan, Tokyo, Japan
| | - Hiroyuki Daiko
- Department of Esophageal Surgery, National Cancer Center Japan, Tokyo, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Japan, Tokyo, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Japan, Tokyo, Japan
| | - Tomoyasu Kato
- Department of Gynecology, National Cancer Center Japan, Tokyo, Japan
| | | | - Yasuhito Uezono
- Department of Pain Control Research, Jikei University School of Medicine, Tokyo, Japan
| | - Ken Shimizu
- Department of Psycho-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Japan, Tokyo, Japan
| |
Collapse
|
17
|
Matsuoka H, Narita Y, Misumi T, Sakamoto Y, Kawakami T, Tanioka H, Matsushima T, Miwa H, Shoji H, Ishiguro A, Fushida S, Miura K, Yamada T, Shinozaki K, Mizukami T, Moriwaki T, Mitani S, Nakamura M, Muro K, Nishina T. P-61 Impacts of salvage chemotherapy after nivolumab therapy (NIVO): A REVIVE substudy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.151] [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
|
18
|
Akechi T, Kubota Y, Ohtake Y, Setou N, Fujimori M, Takeuchi E, Kurata A, Okamura M, Hasuo H, Sakamoto R, Miyamoto S, Asai M, Shinozaki K, Onishi H, Shinomiya T, Okuyama T, Sakaguchi Y, Matsuoka H. Clinical practice guidelines for the care of psychologically distressed bereaved families who have lost members to physical illness including cancer. Jpn J Clin Oncol 2022; 52:650-653. [PMID: 35253040 PMCID: PMC9157299 DOI: 10.1093/jjco/hyac025] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/13/2022] [Indexed: 11/13/2022] Open
Abstract
The Japanese Psycho-Oncology Society and the Japanese Association of Supportive Care in Cancer developed evidence-based clinical practice guidelines for the care of psychologically distressed bereaved families who have lost members to physical illness including cancer. The guideline development group formulated two clinical questions. A systematic literature review was conducted. The level of evidence and the strength of the recommendations were graded and recommendation statements validated using the modified Delphi method. The recommendations were as follows: non-pharmacological interventions were indicated for serious psychological distress (depression and grief); antidepressants were indicated for depression; however, psychotropic medications including antidepressants were not recommended for 'complicated' grief. These guidelines will facilitate the provision of appropriate care to distressed bereaved family members and highlight areas where further research is needed.
Collapse
Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Yosuke Kubota
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Yoichi Ohtake
- Department of Internal Medicine, Itami Seifu Houpital, Itami, Japan.,Department of Psychosomatic Internal Medicine and Palliative Care Medicine, Sakai City Medical Center, Sakai, Japan
| | - Noriko Setou
- Department of Disaster Psychiatry, Fukushima Medical University, Fukushima, Japan
| | - Maiko Fujimori
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Emi Takeuchi
- Division of Quality Assurance Programs, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Akiko Kurata
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima University, Higashihiroshima, Japan
| | - Masako Okamura
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Osaka, Japan
| | - Ryo Sakamoto
- Department of Psychosomatic Medicine, Kindai University Hospital, Osakasayama, Japan
| | - Seraki Miyamoto
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Asai
- Department of Medical Psychology, Nippon Medical School, Tokyo, Japan
| | - Kumiko Shinozaki
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Hideki Onishi
- Department of Psycho-Oncology, Saitama Medical University International Medical Center, Hidaka, Japan
| | | | - Toru Okuyama
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Department of Psychiatry, Nagoya City University West Medical Center, Nagoya, Japan
| | - Yukihiro Sakaguchi
- School of Human Welfare Studies, Kwansei Gakuin University, Nishinomiya, Japan
| | - Hiromichi Matsuoka
- Division of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|
19
|
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.
Collapse
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
| |
Collapse
|
20
|
Abstract
Delirium occurs very frequently in cancer patients. Insomnia is a symptom of delirium. Lemborexant is a drug that regulates sleep–wake rhythms without causing extrapyramidal symptoms. Based on its ability to improve sleep, lemborexant is expected to have efficacy for insomnia with delirium. The purpose of this study was to determine the efficacy of lemborexant for insomnia in cancer patients with delirium. A retrospective observational study was conducted between July 2020 and February 2021. Fourteen patients (six females; mean age,69 years) were included. Lemborexant was effective in 11 of 14 (78.6%) patients. Of 14 patients, 10 had hyperactive delirium. Lemborexant might have similar efficacy for insomnia with and without delirium when compared with previous studies. The efficacy rate of lemborexant was 70% for patients with insomnia and hyperactive delirium. This study might lead to dose reductions of antipsychotic medications and fewer extrapyramidal symptoms in cancer patients with delirium.
Collapse
Affiliation(s)
- Tatsuto Terada
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ryoichi Sadahiro
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Saho Wada
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Rika Nakahara
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|
21
|
Ishiki H, Hasuo H, Matsuda Y, Matsuoka H, Hiramoto S, Higuchi M, Yoshida K, Tokoro A, Hatano Y, Hori T, Kinkawa J, Nojima M. Prevalence of myofascial pain syndrome and efficacy of trigger point injection in patients with incurable cancer. A multicenter, prospective observational study. (MyCar study). Pain Med 2021; 23:1259-1265. [PMID: 34940848 DOI: 10.1093/pm/pnab350] [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] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Myofascial pain syndrome (MPS) is caused by overload or disuse of skeletal muscles. Patients with cancer are often forced to restrict their movement or posture for several reasons. The study was conducted to investigate the prevalence and risks of MPS in patients with incurable cancer. The efficacy of trigger point injection (TPI) was also explored. DESIGN AND METHODS This was a multi-center, prospective observational study. Patients with incurable cancer who started receiving specialist palliative care were enrolled. We investigated the MPS in this population and accompanying risk factors for restricting body movement. Pre- and post-TPI pain was also evaluated using a Numerical Rating Scale (NRS) in patients who received TPI. The primary outcome was the prevalence of MPS. RESULTS A total of 101 patients were enrolled from five institutions in Japan. Most of the patients (n = 94, 93.1%) had distant metastases and half of the patients (50, 49.5%) received anticancer treatment. Thirty-nine (38.6%) patients had MPS lesions at 83 sites. Multivariate analysis revealed that the significant risk factor for MPS was poor Performance Status (PS) (odds ratio 3.26, 95% confidence interval 1.18-9.02, p = 0.023).We performed TPI for 40 out of 83 MPS lesions. Mean NRS for MPS before TPI was 7.95, which improved to 4.30 after TPI (p < 0.001). CONCLUSIONS MPS was common in patients with incurable cancer and the risk factor identified in this study was poor performance status. TPI could be a treatment option.
Collapse
Affiliation(s)
- Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Osaka, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospiatl Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan.,Department of Psychosomatic Medicine, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Shuji Hiramoto
- Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Masaki Higuchi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Kohei Yoshida
- Department of Psychosomatic Medicine, Kansai Medical University, Osaka, Japan
| | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine, National Hospiatl Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Yutaka Hatano
- Department of Palliative Care, Daini Kyoritsu Hospital, Kawanishi, Japan
| | - Tetsuo Hori
- Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Junya Kinkawa
- Rehabilitation Department, Medical corporation Jinseikai, Chiba, Japan
| | - Masanori Nojima
- Rehabilitation Department, Medical corporation Jinseikai, Chiba, Japan.,Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
22
|
Hasuo H, Ishiki H, Matsuda Y, Matsuoka H, Hiramoto S, Kinkawa J, Nojima M. The Usefulness of the Armchair Sign for the Diagnosis of Psychosomatic-Prone Myofascial Pain Syndrome in Patients with Incurable Cancer: A Secondary Analysis of a Prospective Multicenter Observational Clinical Study. Palliat Med Rep 2021; 2:250-254. [PMID: 34927149 PMCID: PMC8675228 DOI: 10.1089/pmr.2021.0033] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Because psychosomatic diseases are pathological conditions, it is difficult to identify their degrees. The armchair sign is a test used to assess voluntary muscle relaxation. Objective: We aimed to evaluate the usefulness of the armchair sign for the diagnosis of psychosomatic-prone myofascial pain syndrome (MPS) in patients with incurable cancer. Design: This was a secondary analysis of a prospective multicenter observational clinical study. Setting/Patients: Patients with incurable cancer who were referred to palliative care services at five institutions in Japan between March 2018 and December 2018. Results: A total of 101 patients were enrolled, of whom 44 met MPS diagnostic criteria. Of these, 27 patients (61.3%) had psychosomatic-prone MPS. There was a significant association between the armchair sign and psychosomatic-prone MPS (p = 0.002). Sensitivity and specificity were 40.7% (95% confidence interval [CI]: 18.0–63.4) and 100.0%, respectively. The area under the curve score was 0.704 (95% CI: 0.553–0.855). Conclusions: The armchair sign may be useful as an ancillary test for the diagnosis of psychosomatic-prone MPS in patients with incurable cancer. Trial Registration: UMIN000031338. Registered February 16, 2018.
Collapse
Affiliation(s)
- Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Osaka, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Shuji Hiramoto
- Department of Clinical Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Junya Kinkawa
- Department of Rehabilitation, Medical Corporation Jinseikai, Chiba, Japan
| | - Masanori Nojima
- Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
23
|
Hasuo H, Ishikawa H, Matsuoka H. Relationship between the number of breaths that maximizes heart rate variability and height in patients with incurable cancers. Complement Ther Med 2021; 63:102780. [PMID: 34624493 DOI: 10.1016/j.ctim.2021.102780] [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: 08/31/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Resonant frequency breathing is a coping skill used for relaxation. A resonant frequency varies from person to person and is only investigated by specialized medical institutions. METHODS The relationships between patients' resonant frequencies and age, sex, height, and body weight were assessed using an analysis of variance. RESULTS The average resonant frequency among the 50 patients with incurable cancers was 6.05 breaths per minute. There was a significant difference in height between the resonant frequencies of 5, 5.5, 6, 6.5, and 7 breaths per minute (p < 0.001). CONCLUSION Resonant frequency may be correlated with height in patients with incurable cancers. TRIAL REGISTRATION UMIN000029820. Registered on November 4, 2017.
Collapse
Affiliation(s)
- Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Osaka, Japan.
| | - Hideki Ishikawa
- Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan.
| |
Collapse
|
24
|
Sakamoto R, Ohtake Y, Kataoka Y, Matsuda Y, Hata T, Otonari J, Yamane A, Matsuoka H, Yoshiuchi K. Efficacy of acceptance and commitment therapy for people with type 2 diabetes: Systematic review and meta-analysis. J Diabetes Investig 2021; 13:262-270. [PMID: 34486816 PMCID: PMC8847115 DOI: 10.1111/jdi.13658] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 12/11/2022] Open
Abstract
Aims/Introduction This systematic review and meta‐analysis aimed to investigate the efficacy and safety of acceptance and commitment therapy (ACT) for people with type 2 diabetes mellitus. Materials and Methods Several electronic databases were examined on 16 January 2021, including PubMed, CENTRAL, PsycINFO, International Clinical Trials Registry Platform and ClinicalTrials.gov. Randomized controlled trials were included to compare ACT with usual treatment for people with type 2 diabetes reported in any language. Primary outcome measures were glycated hemoglobin, self‐care ability assessed by the summary of diabetes self‐care activities and all adverse events. The secondary outcome measure was acceptance assessed by the acceptance and action diabetes questionnaire. Results Of 678 publications initially identified, three trials were included in the meta‐analysis. ACT resulted in a reduction in glycated hemoglobin (mean difference −0.62 points lower in the intervention group; 95% confidence interval −1.07 to −0.16; I2 = 0%; low‐quality evidence). In addition, ACT increased the score of the summary of diabetes self‐care activities (mean difference 8.48 points higher in the intervention group; 95% confidence interval 2.16–14.80; high‐quality evidence). Adverse events were not measured in all trials. ACT increased scores of the acceptance and action diabetes questionnaire (mean difference 5.98 points higher in the intervention group; 95% confidence interval, 1.42–10.54; I2 = 43%; low‐quality evidence). Conclusions ACT might reduce glycated hemoglobin, and increase self‐care ability and acceptance among people with type 2 diabetes.
Collapse
Affiliation(s)
- Ryo Sakamoto
- Department of Psychosomatic Medicine, Faculty of Medicine, Kindai University, Osakasayama, Japan
| | - Yoichi Ohtake
- Department of Internal Medicine, Itami Seifu Houpital, Itami, Japan.,Department of Psychosomatic Internal Medicine a Palliative Care Medicine, Sakai City Medical Center, Sakai, Japan
| | - Yuki Kataoka
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Kyoto, Japan.,Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan.,Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organisation Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Tomokazu Hata
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Otonari
- Department of Psychosomatic Medicine, International University of Health and Welfare Narita Hospital, Chiba, Japan
| | - Akira Yamane
- Department of Psychosomatic Medicine, Kansai Medical University Hospital, Hirakata, Japan
| | - Hiromichi Matsuoka
- Department of Psych-oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
25
|
Tagami K, Matsuoka H, Ariyoshi K, Oyamada S, Hiratsuka Y, Kizawa Y, Koyama A, Inoue A. The current clinical use of adjuvant analgesics for refractory cancer pain in Japan: a nationwide cross-sectional survey. Jpn J Clin Oncol 2021; 50:1434-1441. [PMID: 32869060 DOI: 10.1093/jjco/hyaa147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/02/2020] [Accepted: 07/22/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Although adjuvant analgesics are used to treat opioid-refractory cancer pain, there is insufficient evidence to support this practice and limited data to guide the choice depending on cancer pain pathophysiology, dose titration and starting dose. This survey aimed to clarify the current use of adjuvant analgesics for treating opioid-refractory cancer pain. METHODS In this cross-sectional study, we sent an online survey questionnaire to 208 certified palliative care specialists. Primary outcomes were (i) effective pathophysiological mechanism of cancer pain and (ii) initiating doses and time period to the first response to each adjuvant analgesic therapy. RESULTS In total, 87 (42%) palliative care specialists responded. Of all patients with cancer pain, 40% of patients (median) with refractory cancer pain were prescribed adjuvant analgesics. Additionally, 94.3, 93.1 and 86.2% of palliative care specialists found dexamethasone/betamethasone effective for neuropathic pain caused by tumor-related spinal cord compression, pregabalin effective for malignant painful radiculopathy and dexamethasone/betamethasone effective for brain tumor or leptomeningeal metastases-related headache, respectively. The median starting dose of pregabalin, dexamethasone/betamethasone, lidocaine and ketamine were 75, 4, 200, and 50 mg/day, respectively, and the median time to the first response of those medications were 5, 3, 2 and 3 days, respectively. CONCLUSIONS Many palliative care specialists select adjuvant analgesics depending on the pathophysiological mechanism of cancer pain in each case. They used such adjuvant analgesics in low doses for cancer pain with short first-response periods.
Collapse
Affiliation(s)
- Keita Tagami
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan.,Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | | | - Yusuke Hiratsuka
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Atsuko Koyama
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
26
|
Hasuo H, Matsuoka H, Matsuda Y, Fukunaga M. The Immediate Effect of Trigger Point Injection With Local Anesthetic Affects the Subsequent Course of Pain in Myofascial Pain Syndrome in Patients With Incurable Cancer by Setting Expectations as a Mediator. Front Psychiatry 2021; 12:592776. [PMID: 34421663 PMCID: PMC8374945 DOI: 10.3389/fpsyt.2021.592776] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/29/2021] [Indexed: 12/25/2022] Open
Abstract
A trigger point injection (TPI) with local anesthetic in myofascial pain syndrome (MPS) often has the immediate effect of a decrease in pain. It is unknown whether the immediate effect of a decrease in pain affects the subsequent course of pain. It is also unknown whether expectations of a decrease in pain mediate such effects. We aimed to clarify how the effect of a decrease in pain immediately after TPI with local anesthetic affected the subsequent course of pain, and whether it increased expectations of a decrease in pain. This was a prospective, single-center, observational clinical trial. Patients with incurable cancer who visited the palliative care department and received TPI with local anesthetic for MPS were prospectively examined. We evaluated whether the immediate effect of a TPI with local anesthetic affects the subsequent course of pain in MPS by setting expectations as a mediator, using path analysis. From 2018 to 2020, 205 patients with incurable cancer received TPI for MPS. Of these, 58.1% of patients reported an immediate effect of decreased pain. Compared with the non-immediate effect group, the immediate effect group had higher expectations of a decrease in pain, and the higher expectation was maintained at 7 days (p < 0.001). The percentage of patients with pain reduction at 7 days after TPI was 88.2% in the immediate effect group and 39.5% in the non-immediate effect group (p < 0.001). The immediate effect of decreased pain had the greatest influence on pain reduction at 7 days, both directly (β = 0.194) and indirectly through increased expectations (β = 0.293), as revealed by path analysis. The effect of a decrease in pain immediately after TPI with local anesthetic affected the subsequent course of MPS pain in patients with incurable cancer by setting expectations as a mediator. There were limitations to the discussion of these findings because this was an observational study.
Collapse
Affiliation(s)
- Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
| | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Mikihiko Fukunaga
- Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
| |
Collapse
|
27
|
Matsuoka H, Morita T, Oyamada S, Yamaguchi T, Koyama A. Between-group difference in mean values or changes in pain intensity? Evaluating the distribution of change from baseline in a neuropathic cancer pain clinical trial. Ann Palliat Med 2020; 9:4398-4402. [PMID: 33081474 DOI: 10.21037/apm-20-930] [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] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/10/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Faculty of Medicine, Kindai University, Osaka, Japan; Palliative Care Center, Faculty of Medicine, Kindai University, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Tatsuya Morita
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Shunsuke Oyamada
- Japanese Organisation for Research and Treatment of Cancer (JORTC), NPO, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Atsuko Koyama
- Department of Psychosomatic Medicine, Faculty of Medicine, Kindai University, Osaka, Japan; Palliative Care Center, Faculty of Medicine, Kindai University, Osaka, Japan
| |
Collapse
|
28
|
Hasuo H, Ishiki H, Matsuoka H, Fukunaga M. Clinical Characteristics of Myofascial Pain Syndrome with Psychological Stress in Patients with Cancer. J Palliat Med 2020; 24:697-704. [PMID: 32996846 DOI: 10.1089/jpm.2020.0371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 01/14/2023] Open
Abstract
Background: Despite the suggestion of a relationship between development or progression of myofascial pain syndrome (MPS) and psychological stress, few studies have reported its proportion or association with treatment efficacy. Objective: We aimed to investigate the proportion of MPS with psychological stress among cancer patients and to compare the efficacy of trigger point injection (TPI) in the same patients with/without psychological stress. Design: This was a prospective observational study. Setting/Patients: Participants were 205 patients with cancer who received TPIs for MPS at a hospital in Japan. Results: The proportion of patients with MPS and psychological stress was 0.57 (95% confidence interval [CI] 0.50-0.64). The TPI efficacy rate at seven days after treatment was 0.55 (95% CI 0.46-0.64) for patients with MPS and psychological stress and 0.82 (95% CI 0.74-0.90) for their counterparts without psychological stress (p < 0.004). The odds ratio for TPI efficacy seven days after treatment with psychological stress versus without psychological stress was 0.25 (95% CI 0.13-0.49). Conclusions: MPS was a clinical symptom of psychosomatic disorder in approximately half of our patients. The TPI efficacy for patients with MPS who had psychological stress was lower than for their counterparts without psychological stress. Trial registration: UMIN000041210. Registered 27 July 2020 (retrospectively registered).
Collapse
Affiliation(s)
- Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
| | - Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Japan
| | - Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Sakai City, Japan
| | - Mikihiko Fukunaga
- Department of Psychosomatic Medicine, Kansai Medical University, Hirakata, Japan
| |
Collapse
|
29
|
Ishiki H, Hamano J, Nagaoka H, Matsuda Y, Tokoro A, Matsuoka H, Izumi H, Sakashita A, Kizawa Y, Oyamada S, Yamaguchi T, Iwase S. Prevalence of Extrapyramidal Symptoms in Cancer Patients Referred to Palliative Care: A Multicenter Observational Study (JORTC PAL12). Am J Hosp Palliat Care 2020; 38:823-829. [PMID: 32940536 DOI: 10.1177/1049909120960441] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Neuroleptics are commonly used in palliative care settings. However, adverse events of neuroleptics, known as extrapyramidal symptoms (EPSs), might be overlooked in clinical practice. We conducted this study to explore the prevalence of EPSs in palliative care setting. METHODS This multicenter, prospective, observational study included patients who 1) were referred to either a specialist palliative care team or a palliative care unit, 2) had a diagnosis of cancer, and 3) were ≥20 years of age. We investigated the prevalence of EPSs and medications used. The primary outcome was the overall Drug-Induced Extrapyramidal Symptom Scale (DIEPSS) score. RESULTS Between November 2015 and October 2016, 149 patients from 5 centers in Japan were enrolled. The median age was 67 years (range: 21-88 years) and the study population included 81 men (54.4%). The cancer types included lung (55 patients, 36.9%), upper gastrointestinal tract (5, 3.3%), hepatobiliary (19, 12.8%); breast (12, 8.1%); head and neck (10, 6.7%), gynecologic (10, 6.7%), genitourinary (10, 6.7%), and others (28, 18.8%). The median Karnofsky performance status was 60 (20-100). Most patients (86.6%) did not experience delirium. Thirty-nine (26.2%) patients received one or more EPS-inducing medications. EPSs occurred in 4 (2.7%) patients with a cutoff score of 5 points for 5 parkinsonism items in DIEPSS. CONCLUSION A lower frequency (<3%) of patients than expected in this population had EPSs. Therefore, we concluded that an interventional study is not feasible. However, medications that cause EPSs are often used in palliative care; therefore, a longitudinal study is warranted. TRIAL REGISTRATION This study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) (UMIN000019810) on 16, November, 2015.
Collapse
Affiliation(s)
- Hiroto Ishiki
- Department of Palliative Medicine, 68380Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Jun Hamano
- Center for Palliative and Supportive Care, 38515University of Tsukuba Hospital, Tsukuba, Japan
| | - Hiroka Nagaoka
- Center for Palliative and Supportive Care, 38515University of Tsukuba Hospital, Tsukuba, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization 73782Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine, National Hospital Organization 73782Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hiromichi Matsuoka
- Palliative Care Center, Cancer Center, 12872Kindai University Hospital, Osaka, Japan.,Faculty of Health, University of Technology Sydney, Australia
| | - Hiroaki Izumi
- Palliative Care Center, Cancer Center, 12872Kindai University Hospital, Osaka, Japan.,Division of Medical Oncology, Sasaki Foundation Kyoundo Hospital, Tokyo, Japan
| | - Akihiro Sakashita
- Department of Palliative Medicine, 12885Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, 12885Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Takuhiro Yamaguchi
- Division of Biostatistics, 13101Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoru Iwase
- Department of Palliative Medicine, 68380Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Department of Palliative Medicine, Saitama Medical University, Saitama, Japan
| |
Collapse
|
30
|
Honda M, Kimura Y, Isoyama T, Sakaridani N, Sejima T, Ono K, Takahashi C, Komi T, Matsuoka H, Takenaka A. Efficacy and safety of combination treatment with tadalafil and mirabegron for persistent storage symptoms despite tadalafil treatment in patients with benign prostatic hyperplasia. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32991-8] [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
|
31
|
|
32
|
Matsuoka H, Kabata D, Taura A, Matsui T, Takahi K, Hirano F, Katayama M, Okamoto A, Suenaga Y, Suematsu E, Yoshizawa S, Ohmura K, Ito S, Takaoka H, Oguro E, Kuzuya K, Okita Y, Udagawa C, Yoshimura M, Teshigawara S, Harada Y, Isoda K, Yoshida Y, Ohshima S, Tohma S, Saeki Y. Lack of association between a disease-susceptible single-nucleotide polymorphism, rs2230926 of TNFAIP3, and tumour necrosis factor inhibitor therapeutic failure in Japanese patients with rheumatoid arthritis. Scand J Rheumatol 2020; 49:253-255. [PMID: 32406335 DOI: 10.1080/03009742.2020.1716992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- H Matsuoka
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan.,Department of Clinical Research, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - D Kabata
- Department of Medical Statics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - A Taura
- Department of Clinical Research, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - T Matsui
- Department of Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Japan
| | - K Takahi
- Department of Orthopedics and Rheumatology, NHO Osaka Toneyama Medical Center, Toyonaka, Japan
| | - F Hirano
- Department of Internal Medicine, NHO Asahikawa Medical Center, Asahikawa, Japan
| | - M Katayama
- Department of Rheumatology, NHO Nagoya Medical Center, Nagoya, Japan
| | - A Okamoto
- Department of Rheumatology, NHO Himeji Medical Center, Himeji, Japan
| | - Y Suenaga
- Department of Rheumatology, NHO Beppu Medical Center, Beppu, Japan
| | - E Suematsu
- Department of Rheumatology, NHO Kyushu Medical Center, Fukuoka, Japan
| | - S Yoshizawa
- Department of Rheumatology, NHO Fukuoka National Hospital, Fukuoka, Japan
| | - K Ohmura
- Department of Rheumatology and Clinical Immunology, Kyoto University, Kyoto, Japan
| | - S Ito
- Department of Rheumatology, Niigata Rheumatic Center, Niigata, Japan
| | - H Takaoka
- Section of Internal Medicine and Rheumatology, Kumamoto Shinto General Hospital, Kumamoto, Japan
| | - E Oguro
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - K Kuzuya
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - Y Okita
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - C Udagawa
- Department of Clinical Research, NHO Osaka Minami Medical Center, Kawachinagano, Japan.,Department of Molecular Chemistry, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Osaka, Japan
| | - M Yoshimura
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - S Teshigawara
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - Y Harada
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - K Isoda
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - Y Yoshida
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - S Ohshima
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - S Tohma
- Department of Rheumatology, NHO Tokyo National Hospital, Tokyo, Japan
| | - Y Saeki
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan.,Department of Clinical Research, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| |
Collapse
|
33
|
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.
Collapse
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
| |
Collapse
|
34
|
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.
Collapse
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
| |
Collapse
|
35
|
Yoshida Y, Yamada T, Matsuoka H, Hirata K, Kuramochi H, Kosugi C, Takahashi M, Fukazawa A, Sonoda H, Matsuda A, Watanabe T, Koizumi M, Aisu N, Hasegawa S, Yoshida H, Sakamoto K, Ishida H, Koda K. Biweekly TAS-102 and bevacizumab as a third-line chemotherapy for metastatic colorectal cancer: A phase II multicenter clinical trial (TAS-CC4 study). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.098] [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: 11/14/2022] Open
|
36
|
Kakuta T, Komatsu S, Kojima K, Fujii H, Kimura S, Dai K, Kawakami H, Matsuoka H, Higuchi Y, Abe H, Inoue T, Okumura Y, Asakura M, Hirayama A, Kodama K. P1831Prediction of cardiovascular events by atheromatous plaques detected by non-obstructive general angioscopy: two-year results of EAST-NOGA Registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0583] [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: 11/12/2022] Open
Abstract
Abstract
Background
Non-obstructive general angioscopy (NOGA) has revealed the intimal damages or atheromatous plaques as well as its spontaneous rupture of the aorta. Recent study revealed that plaque debris or different size of cholesterol crystals were detected in the blood above the spontaneous ruptured aortic plaque observed by NOGA and these plaque materials might cause the peripheral organ damages as the embolic source. These various morphological changes may cause the acute aortic events or atheroembolic events on the peripheral organs, such as brain, kidney, peripheral artery and so on.
Purpose
EAST-NOGA (Evaluation of AtheroSclerotic and rupture events by Non-Obstructive General Angioscopy) is a multi-center prospective observational study to assess the relationship between the findings of NOGA and future cardiovascular events.
Methods
Five hundred and seventy-seven patients with atherosclerotic cardiovascular disease who underwent NOGA study. The major cerebrocardiovascular events including cardiovascular death, non-fatal myocardial infarction, non-fatal cerebral infarction, and acute aortic syndrome were accumulated during the 2-year follow-up after NOGA study.
Results
The median number of aortic atheromatous plaques was 6 [IQR: 3–12]. A total of 514 patients were followed up (89.1%). The mean follow-up duration was 757±120 days. Major adverse cardiovascular events developed in 23 (4.5%) during 2 years follow-up. Patients with MACE and cerebral infarction, had significantly greater number of aortic atheromatous plaques (11 [5–19] vs. 6 [3–11], p<0.001, 12 [4–20] vs. 6 [3–12], p=0.014, respectively). In a univariate analysis, the number of aortic atheromatous plaques and ruptured plaque were significant predictors of MACE (HR: 1.09 95% confidence interval 1.05–1.14, p<0.001) and (HR: 1.12, 95% confidence interval 1.02–1.23, p=0.02). In a multivariate logistic analysis, the number of aortic atheromatous plaques is one of the independent predictors of MACE (HR 1.05, 95% confidence interval 1.00–1.10, p=0.032).
Conclusion
The number of atheromatous plaques identified by NOGA has a significant relation to the onset of cerebral infarction, which suggest the atheromatous plaque were vulnerable and ruptured spontaneously, then cause the aortogenic cerebral infarction. The NOGA study would be useful for predicting the futured atheroembolic events.
Acknowledgement/Funding
None
Collapse
Affiliation(s)
- T Kakuta
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - S Komatsu
- Osaka Gyoumeikan Hospital, Osaka, Japan
| | - K Kojima
- Nihon University School of Medicine, Tokyo, Japan
| | - H Fujii
- Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - S Kimura
- Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - K Dai
- Hiroshima City Hospital, Hiroshima, Japan
| | - H Kawakami
- Ehime Prefectural Imabari Hospital, Imabari, Japan
| | - H Matsuoka
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | | | - H Abe
- Dokkyo Medical University, Mibu, Japan
| | - T Inoue
- Dokkyo Medical University, Mibu, Japan
| | - Y Okumura
- Nihon University School of Medicine, Tokyo, Japan
| | - M Asakura
- Hyogo College of Medicine, Nishinomiya, Japan
| | | | - K Kodama
- Osaka Gyoumeikan Hospital, Osaka, Japan
| |
Collapse
|
37
|
Matsuoka H, Agar M, Vandersman Z, Good P, Fazekas B, Brown L, Hardy J, Weil J, Currow DC. Harms From Haloperidol for Symptom Management in Palliative Care-a Post Hoc Pooled Analysis of Three Randomized Controlled Studies and Two Consecutive Cohort Studies. J Pain Symptom Manage 2019; 58:e6-e8. [PMID: 31121249 DOI: 10.1016/j.jpainsymman.2019.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 05/13/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osaka, Japan; Palliative Care Center, Cancer Center, Kindai University Hospital, Osaka, Japan; Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) and Palliative Care Clinical Studies Collaborative (PaCCSC), University of Technology Sydney, NSW, Australia
| | - Meera Agar
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) and Palliative Care Clinical Studies Collaborative (PaCCSC), University of Technology Sydney, NSW, Australia
| | - Zac Vandersman
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) and Palliative Care Clinical Studies Collaborative (PaCCSC), University of Technology Sydney, NSW, Australia
| | - Philip Good
- St Vincent's Private Hospital, Brisbane, QLD, Australia
| | - Belinda Fazekas
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) and Palliative Care Clinical Studies Collaborative (PaCCSC), University of Technology Sydney, NSW, Australia
| | - Linda Brown
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) and Palliative Care Clinical Studies Collaborative (PaCCSC), University of Technology Sydney, NSW, Australia
| | - Janet Hardy
- Department of Palliative and Supportive Care, Mater Health Services and Mater Research Institute, University of Queensland, Brisbane, QLD, Australia
| | - Jennifer Weil
- Department of Palliative Medicine, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - David Christopher Currow
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) and Palliative Care Clinical Studies Collaborative (PaCCSC), University of Technology Sydney, NSW, Australia.
| |
Collapse
|
38
|
Yamaguchi M, Suzuki R, Oguchi M, Miyazaki K, Taguchi S, Amaki J, Maeda T, Kubota N, Maruyama D, Terui Y, Sekiguchi N, Takizawa J, Tsukamoto H, Murayama T, Ando T, Matsuoka H, Hasegawa M, Wada H, Sakai R, Kameoka Y, Tsukamoto N, Choi I, Masaki Y, Shimada K, Fukuhara N, Utsumi T, Uoshima N, Kagami Y, Asano N, Katayama N. CLINICAL OUTCOMES AND DIAGNOSIS-TO-TREATMENT INTERVAL IN PATIENTS WITH NK/T-CELL LYMPHOMA: 7-YEAR FOLLOW-UP OF THE NKEA STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.86_2630] [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: 11/09/2022]
Affiliation(s)
- M. Yamaguchi
- Department of Hematology and Oncology; Mie University Graduate School of Medicine; Tsu Japan
| | - R. Suzuki
- Oncology and Hematology; Shimane University Hospital; Izumo Japan
| | - M. Oguchi
- Radiation Oncology; Cancer Institute Hospital of Japanese Foundation for Cancer Research; Tokyo Japan
| | - K. Miyazaki
- Department of Hematology and Oncology; Mie University Graduate School of Medicine; Tsu Japan
| | - S. Taguchi
- Radiation Oncology; Cancer Institute Hospital of Japanese Foundation for Cancer Research; Tokyo Japan
| | - J. Amaki
- Hematology and Oncology; Tokai University School of Medicine; Kanagawa Japan
| | - T. Maeda
- Hematology; Kurashiki Central Hospital; Kurashiki Japan
| | - N. Kubota
- Hematology; Saitama Cancer Center; Ina Japan
| | - D. Maruyama
- Hematology; National Cancer Center Hospital; Tokyo Japan
| | - Y. Terui
- Hematology Oncology; Cancer Institute Hospital of Japanese Foundation for Cancer Research; Tokyo Japan
| | - N. Sekiguchi
- Comprehensive Cancer Therapy; Shinshu University School of Medicine; Matsumoto Japan
| | - J. Takizawa
- Hematology; Endocrinology and Metabolism, Niigata University Faculty of Medicine; Niigata Japan
| | - H. Tsukamoto
- Hematology; Showa University School of Medicine; Tokyo Japan
| | - T. Murayama
- Hematology; Hyogo Cancer Center; Akashi Japan
| | - T. Ando
- Hematology; Respiratory Medicine and Oncology, Saga University; Saga Japan
| | - H. Matsuoka
- Medical Oncology/Hematology; Kobe University; Kobe Japan
| | - M. Hasegawa
- Radiation Oncology; Nara Medical University; Kashihara Japan
| | - H. Wada
- Hematology; Kawasaki Medical School; Kurashiki Japan
| | - R. Sakai
- Medical Oncology; Kanagawa Cancer Center; Yokohama Japan
| | - Y. Kameoka
- Hematology; Nephrology and Rheumatology, Akita University; Akita Japan
| | - N. Tsukamoto
- Oncology Center; Gunma University Hospital; Maebashi Japan
| | - I. Choi
- Hematology; National Hospital Organization Kyushu Cancer Center; Fukuoka Japan
| | - Y. Masaki
- Hematology and Immunology; Kanazawa Medical University; Kanazawa Japan
| | - K. Shimada
- Hematology and Oncology; Nagoya University School of Medicine; Nagoya Japan
| | - N. Fukuhara
- Hematology & Rheumatology; Tohoku University School of Medicine; Sendai Japan
| | - T. Utsumi
- Hematology; Shiga Medical Center for Adults; Moriyama Japan
| | - N. Uoshima
- Hematology; Japanese Red Cross Kyoto Daini Hospital; Kyoto Japan
| | - Y. Kagami
- Hematology; Toyota Kosei Hospital; Toyota Japan
| | - N. Asano
- Molecular Diagnostics; Shinshu Medical Center; Suzaka Japan
| | - N. Katayama
- Department of Hematology and Oncology; Mie University Graduate School of Medicine; Tsu Japan
| |
Collapse
|
39
|
Matsuoka H, Tagami K, Ariyoshi K, Oyamada S, Kizawa Y, Inoue A, Koyama A. Attitude of Japanese palliative care specialists towards adjuvant analgesics cancer-related neuropathic pain refractory to opioid therapy: a nationwide cross-sectional survey. Jpn J Clin Oncol 2019; 49:486-490. [PMID: 30793161 DOI: 10.1093/jjco/hyz002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/27/2018] [Accepted: 01/04/2019] [Indexed: 11/13/2022] Open
Abstract
Cancer-related neuropathic pain (CNP) requires therapy involving multiple pharmaceuticals, including anticonvulsants and antidepressants; however, strong evidence to support this practice is limited. This study is a cross-sectional questionnaire-based survey. As the standard dose of adjuvant analgesics for CNP refractory to opioid therapy is not clear, the purpose of this study is to clarify the opinions of specialists about the usage of duloxetine and pregabalin for patients with CNP refractory to opioid therapy. Two hundred and eight certified palliative care specialists were surveyed and a total of 87 (42%) responses were analyzed. Twenty-five percent of specialists had considered increasing duloxetine doses up to 60 mg/day and 58% had considered increasing pregabalin doses up to 300 mg/day for CNP refractory to opioid therapy. However, 23% of the specialists succeeded in increasing duloxetine doses up to 60 mg/day and 17% in increasing pregabalin doses up to 300 mg/day, respectively.
Collapse
Affiliation(s)
- Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osakasayama City, Osaka, Japan.,Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Keita Tagami
- Department of Palliative Medicine, Tohoku University School of Medicine, Japan
| | | | | | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Japan
| | - Atsuko Koyama
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osakasayama City, Osaka, Japan
| |
Collapse
|
40
|
Kim S, Noda Y, Samezima Y, Kanai T, Tamura K, Nishida T, Shimizu K, Umakoshi T, Morishita H, Matsuoka H, Kashiwa Y. A CASE OF PULMONARY ALVEOLAR PROTEINOSIS TREATED WITH SEGMENTAL BRONCHOALVEOLAR LAVAGE IN THE ICU. Chest 2019. [DOI: 10.1016/j.chest.2019.02.095] [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: 11/15/2022] Open
|
41
|
Matsuoka H, Allingham S, Fazekas B, Brown L, Vandersman Z, Clark K, Agar MR, Currow DC. Comparability of the Australian National Cancer Symptom Trials (CST) Group's Study Populations to National Referrals to Non-CST Specialist Palliative Care Services Participating in the Palliative Care Outcomes Collaboration. J Pain Symptom Manage 2019; 57:e9-e14. [PMID: 30273716 DOI: 10.1016/j.jpainsymman.2018.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 11/22/2022]
Affiliation(s)
- Hiromichi Matsuoka
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Samuel Allingham
- Palliative Care Outcomes Collaboration, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Belinda Fazekas
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Linda Brown
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Zac Vandersman
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Katherine Clark
- Northern Sydney Local Health District Cancer and Palliative Care Network, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Meera R Agar
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - David C Currow
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
| |
Collapse
|
42
|
Currow DC, Matsuoka H, Allingham S, Fazekas B, Brown L, Vandersman Z, Clark K, Agar M. Comparability of the Cancer Supportive Care Clinical Studies Collaborative (CSCCSC) study population to national referrals to other specialist palliative care services. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.34_suppl.63] [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
63 Background: There are no agreed national nor international criteria for referral to palliative care. Key population characteristics have been defined to aid the generalizability of research findings in palliative care clinical studies. To codify differences in key demographic factors between patients with cancer participating in the Australian national Cancer Supportive Care Clinical Studies Collaborative (CSCCSC) phase III symptom control studies and the population referred to other Australian palliative care services. Methods: This study compares two contemporaneous consecutive cohorts generated through clinical trial participation and the national palliative care clinical quality improvement registry in Australia. Age, sex, cancer diagnosis, language, and socio-economic status were compared. Results: Cohorts were people with cancer: enrolled in CSCCSC phase III clinical studies (n=902; 17 sites); and registered by the Australian national Palliative Care Outcomes Collaboration (PCOC; n=75,240; 117 sites). Participants in CSCCSC studies were younger than those of PCOC (median 71 (IQR 62, 79) versus median 73 (IQR 63, 81); p=0.003 respectively). There was no significant difference in sex (p=0.483). Patients who spoke English accounted 95.0% of enrollees in the CSCCSC group and 92.2% in the PCOC group (p = 0.004). Clinical study participants had higher socioeconomic status that the PCOC group (p=0.022). Conclusions: Overall, the slightly different demographic patterns are reflective of the differences often seen between phase III trials and the populations to whom the results will be applied. Age differences particularly need to be taken into account when considering the best way to apply each study’s findings.
Collapse
Affiliation(s)
| | | | - Samuel Allingham
- Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | | | - Linda Brown
- University of Technology Sydney, Sydney, Australia
| | | | - Katherine Clark
- Northern Sydney Local Health District Cancer and Palliative Care Network, Sydney, Australia
| | - Meera Agar
- University of Technology Sydney, Sydney, Australia
| |
Collapse
|
43
|
Hatano Y, Matsuoka H, Lam L, Currow DC. Side effects of corticosteroids in patients with advanced cancer: a systematic review. Support Care Cancer 2018; 26:3979-3983. [PMID: 29980905 DOI: 10.1007/s00520-018-4339-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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] [Received: 01/09/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Corticosteroids are commonly used in palliative care settings, but are associated with several side effects. Although adverse events (AEs) are highly distressing for patients, few data are available from prospective studies to look at incidence or predictors of such harms. The aim of this study is to identify AE reporting among studies of patients with advanced cancer receiving corticosteroids for any reason. METHODS A systematic review was conducted using the following data sources: PubMed, Medline, SCOPUS, Cochrane reviews, and CINAHL. Randomized controlled trials (RCTs) with patients with advanced cancer assessing the effect of corticosteroids were included. Consecutive cohort observational studies of corticosteroid toxicities in cancer patients were also included. RESULTS Twenty-seven RCTs and 12 consecutive cohort observational studies were identified. The most frequently reported primary outcome of RCTs was nausea and vomiting (8/27). Dexamethasone was prescribed in almost half of RCTs (13/27). In consecutive cohort studies, the primary outcomes were a wide variety of symptoms. Dexamethasone was also the most common glucocorticoid used (7/12). In terms of quality of AE reporting, two RCTs and one consecutive cohort study used a validated AE assessment tool in their studies. CONCLUSIONS Side effects of corticosteroids in advanced cancer patients were poorly reported with few data using validated tools. Researchers should be aware of the guideline of AE reporting to provide the best evidence of risk-benefit balance. Developing specific consensus guidelines about AE reporting in studies of glucocorticoids in studies of people with advanced cancer would be useful.
Collapse
Affiliation(s)
- Yutaka Hatano
- Faculty of Medicine, Department of Psychosomatic Medicine, Kindai University, Osaka, Japan
| | - Hiromichi Matsuoka
- Faculty of Medicine, Department of Psychosomatic Medicine, Kindai University, Osaka, Japan
- IMPACCT, Faculty of Health, University of Technology Sydney, P O Box 123, Ultimo, New South Wales, 2007, Australia
| | - Lawrence Lam
- Tung Wah College, Homantin, Kowloon, Hong Kong
- Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - David C Currow
- IMPACCT, Faculty of Health, University of Technology Sydney, P O Box 123, Ultimo, New South Wales, 2007, Australia.
| |
Collapse
|
44
|
Xu R, Muro K, Kim T, Park Y, Wang W, Han SW, Kotaka M, Deng YH, Ahn J, Nakamura M, Ba Y, Cho SH, Kato T, Zhang T, Lee KW, Matsuoka H, Fang WJ, Morita S, Iwasa S, Junichi S. Impact of UGT1A1 genotype on the efficacy and safety of irinotecan-based chemotherapy in metastatic colorectal cancer (mCRC): A preplanned analysis of the phase III AXEPT trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy431.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
45
|
Okamura S, Osaki T, Nishimura K, Ohsaki H, Shintani M, Matsuoka H, Maeda K, Shiogama K, Itoh T, Kamoshida S. Thymidine kinase-1/CD31 double immunostaining for identifying activated tumor vessels. Biotech Histochem 2018; 94:60-64. [DOI: 10.1080/10520295.2018.1499962] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- S. Okamura
- Laboratory of Pathology, Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - T. Osaki
- Laboratory of Pathology, Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - K. Nishimura
- Laboratory of Pathology, Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - H. Ohsaki
- Laboratory of Pathology, Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - M. Shintani
- Department of Medical Technology, Kobe Tokiwa University, Japan
| | - H. Matsuoka
- Department of Surgery, Fujita Health University School of Medicine
| | - K. Maeda
- Department of Surgery, Fujita Health University School of Medicine
| | - K. Shiogama
- Department of Morphology and Cell Function, Fujita Health University School of Health Sciences, Toyoake, Japan
| | - T. Itoh
- Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - S. Kamoshida
- Laboratory of Pathology, Department of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| |
Collapse
|
46
|
Yamaguchi T, Matsuda Y, Matsuoka H, Hisanaga T, Osaka I, Watanabe H, Maeda I, Imai K, Tsuneto S, Wagatsuma Y, Kizawa Y. Efficacy of immediate-release oxycodone for dyspnoea in cancer patient: cancer dyspnoea relief (CDR) trial. Jpn J Clin Oncol 2018; 48:1070-1075. [DOI: 10.1093/jjco/hyy139] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 09/04/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Takashi Yamaguchi
- Division of Palliative Care, Department of Medicine, Konan Hospital, Kobe, Japan
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Takayuki Hisanaga
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Iwao Osaka
- Department of Palliative Medicine, Shizuoka Cancer Center, Nagaizumi, Japan
| | - Hiroaki Watanabe
- Department of Palliative Care, Komaki City Hospital, Komaki, Japan
| | - Isseki Maeda
- Gratia Hospice, Gratia Research and Clinical Education (GRACE) Center, Gratia Hospital, Minoh, Japan
| | - Kengo Imai
- Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Satoru Tsuneto
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yukiko Wagatsuma
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
47
|
Shigematsu T, Okayama H, Kawaguchi N, Fukuyama N, Iseki Y, Matsuda K, Tanaka Y, Hosokawa S, Kosaki T, Kawamura G, Kawada Y, Hiasa G, Yamada T, Kazatani Y, Matsuoka H. P2698A non-invasive assessment of fractional flow reserve using hybrid 13N-ammonia positron emission tomography/computed tomography coronary angiography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2698] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Shigematsu
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Okayama
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - N Kawaguchi
- Ehime University Graduate School of Medicine, Radiology, Toon, Japan
| | - N Fukuyama
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Iseki
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - K Matsuda
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Tanaka
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - S Hosokawa
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Kosaki
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - G Kawamura
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Kawada
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - G Hiasa
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Yamada
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Kazatani
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Matsuoka
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| |
Collapse
|
48
|
Kojima K, Komatsu S, Kakuta T, Fukamachi D, Kimura S, Fujii H, Matsuura M, Dai K, Matsuoka H, Hirayama A, Kodama K. P4543Association of aortic vulnerable ruptured plaque and renal function: novel evaluation by non-obstructive angioscopy registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4543] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Kojima
- Nihon University School of Medicine, Division of Cardiology, Department of Medicine, Tokyo, Japan
| | - S Komatsu
- Osaka Gyoumeikan Hospital, Cardiovascular center, Osaka, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, cardiology, Tsuchiura, Japan
| | - D Fukamachi
- Nihon University School of Medicine, Division of Cardiology, Department of Medicine, Tokyo, Japan
| | - S Kimura
- Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - H Fujii
- Yokohama Minami Kyosai Hospital, cardiology, Yokohama, Japan
| | - M Matsuura
- Kindai University Sakai Hospital, Caldiology, Sakai, Japan
| | - K Dai
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - H Matsuoka
- Ehime Prefectural Central Hospital, Cardiology, Matsuyama, Japan
| | - A Hirayama
- Nihon University School of Medicine, Division of Cardiology, Department of Medicine, Tokyo, Japan
| | - K Kodama
- Osaka Gyoumeikan Hospital, Cardiovascular center, Osaka, Japan
| |
Collapse
|
49
|
Kawamura G, Okayama H, Kawaguchi N, Kido S, Matsuda K, Aono T, Kosaki T, Hosokawa S, Tanaka Y, Shigematsu T, Kawada Y, Hiasa G, Yamada T, Matsuoka H, Kazatani Y. P1712Diagnostic performance of coronary flow reserve ratio for the detection of coronary artery disease on 13N-ammonia positron emission tomography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1712] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- G Kawamura
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Okayama
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - N Kawaguchi
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - S Kido
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - K Matsuda
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Aono
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Kosaki
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - S Hosokawa
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Tanaka
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Shigematsu
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Kawada
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - G Hiasa
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Yamada
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Matsuoka
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Kazatani
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| |
Collapse
|
50
|
Ebina K, Hirao M, Hashimoto J, Matsuoka H, Iwahashi T, Chijimatsu R, Etani Y, Okamura G, Miyama A, Yoshikawa H. Impact of switching oral bisphosphonates to denosumab or daily teriparatide on the progression of radiographic joint destruction in patients with biologic-naïve rheumatoid arthritis. Osteoporos Int 2018; 29:1627-1636. [PMID: 29574517 DOI: 10.1007/s00198-018-4492-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 11/23/2017] [Accepted: 03/16/2018] [Indexed: 11/25/2022]
Abstract
UNLABELLED In biologic-naïve female RA patients, switching oral BPs to DMAb significantly reduced radiographic joint destruction compared to continuing oral BPs or switching to TPTD at 12 months, which were significantly associated with a decrease of a bone resorption marker at 6 months. INTRODUCTION The aim of this study was to clarify the effects of switching oral bisphosphonates (BPs) to denosumab (DMAb) or daily teriparatide (TPTD) on the progression of radiographic joint destruction in patients with biologic-naïve rheumatoid arthritis (RA). METHODS A retrospective, case-controlled study involving 90 female RA patients (mean age 68.2 years, 96.7% postmenopausal, disease activity score assessing 28 joints with CRP (DAS28-CRP) 2.4, methotrexate treatment 81.1%, prednisolone treatment 68.9%, and prior BP treatment 44.8 months), who were allocated depending on each patient's and physician's wishes, to (1) the BP-continue group (n = 30), (2) the switch-to-DMAb group (n = 30), or (3) the switch-to-TPTD group (n = 30), was conducted. Patients were retrospectively selected to minimize the difference of possible clinical backgrounds that may affect the joint destruction of RA. The primary endpoint was to clarify the change of the modified total Sharp score (mTSS) from baseline to 12 months. RESULTS After 12 months, the mean changes of the modified Sharp erosion score were significantly lower in the switch-to-DMAb group (0.2 ± 0.1; mean ± standard error) than in the switch-to-TPTD group (1.3 ± 0.5; P < 0.05), and mTSS was significantly lower in the switch-to-DMAb group (0.3 ± 0.2) than in the BP-continue group (1.0 ± 0.3; P < 0.05) and the switch-to-TPTD group (1.7 ± 0.6; P < 0.05). The logistic regression analysis showed that mTSS changes were significantly associated with the percent changes of TRACP-5b at 6 months (β = 0.30, 95% CI = 0.002-0.016; P < 0.01). CONCLUSIONS Changes of systemic bone turnover induced by switching BPs to DMAb or TPTD may affect not only systemic bone mass, but also local joint destruction, and its clinical relevance should be considered comprehensively.
Collapse
Affiliation(s)
- K Ebina
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - M Hirao
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - J Hashimoto
- Department of Rheumatology, National Hospital Organization, Osaka Minami Medical Center, 2-1 Kidohigashi, Kawachinagano, Osaka, 586-8521, Japan
| | - H Matsuoka
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - T Iwahashi
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - R Chijimatsu
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Y Etani
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - G Okamura
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - A Miyama
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - H Yoshikawa
- Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| |
Collapse
|