bluuebunny/crossref_metadata_2025_split huggingface dataset:
Samarium-153 effectiveness in the quality of life of bone metastatic cancer patients.
Authors: Tsoukalas Grecory , Tzovaras Alexandros , Tsoukalas Nikolaos , Stamatopoulou Sofia , Gatsos George , Kountourakis Pantelis , Mpaziotis Nikos , Mystakidou Kuriaki 
Published: March 2020

e20635 Background: Osseous metastases in patients suffering from cancer, is a multifactor symptom which affects quality of life. Methods: The Samarium group (SG) n=53 patients received a single bolus infusion of (153)Sm (37 MBq/kg), and we compared with a Control group(CG) n=37. Both groups of patients who had metastatic bone cancer requiring analgesia answered the following questionnaires: Greek Brief Pain Inventory (GBPI), Brief Multidimensional Life Satisfaction Scale (BMLSS), Hospital Anxiety Depression Scale (HADS), ECOG/WHO/Zubrod score and Hospital Satisfaction Scale (HSS),day 0 and 30±3 days after the intervention start.There was no statistically significant(SS) difference for the variables(V-) sex, age, pain’s localization and lodging. Results: Pain severity and pain interference change over time was the same for both groups P= 0.0005. For the V- HADS-anxiety, SG showed no SS improvementP= 0.397, something which was achieved for the CG,P= 0.031. The V- HADS improved SS for both groups P= 0.031 and P= 0.003 respectively which changed over time with the same way. This may show the strong relation between pain and depression. The V- ECOG also changed over time in the same way for both SG(P=0.005) and CG (P=0.014). The percentage of patients who changed scale towards improvement for their quality of life was 24,3% for the CG and 15,1% for the SG. The V-BMLSS change over time was similar for both groups. There was no SS difference for the V-HSS towards medical and nursing personnel for both groups (P=1.000). Myelotoxicity for the SG was moderate and reversible, as well as the side effects for the CG. Finally an equivalence test between the two groups, showing that both treatment regimens were equivalent for all variables: Pain severity=0.034, Pain interference=0.009, HAD-anxiety P=0.048, HAD-depression=0.033, BMLSS=0.016, ECOG=0.0005. During our study among the patients of the SG in some cases the stabilization of bone lesions was observed, and in one case partial and/or complete remission. Conclusions: Administration of (153)Sm is another equivalent option for those patients who are intolerant or resistant to medication treatment having a better cost-effectiveness result.
Hormone replacement therapy (HRT) prescribing patterns among gynecologic oncologists.
Authors: Huang Marilyn , Sun Charlotte C. , Westin Shannon Neville , Bodurka Diane C. 
Published: March 2020

e20637 Background: Gynecologic cancer survivors have indicated inadequate treatment of their menopausal symptoms; and while HRT can significantly improve quality of life (QOL) its safety is still debated. Our objective was to evaluate HRT practice patterns and identify potential barriers to prescribing HRT among gynecologic oncologists (GO). Methods: SGO members with active electronic mail (n=823) were queried with single answer and Likert-style questions using an internet-based program. Email reminders were sent at 3, 6, and 9 weeks. Results: Of 207 respondents (25%), 123 (59%) were male and 84 (41%) female. Providers identified personal history of blood clot (81.5%) or breast cancer (75.6%) as contraindications to prescribing HRT. More women than men cited breast cancer and personal history of a blood clot (p=0.038, p=0.08) as contraindications. HRT candidates were women with vasomotor symptoms (sx)(96.1%), those at risk for osteoporosis (55.1%), and postmenopausal women (47.8%). Sx considered amenable to HRT were hot flashes (98.5%), vaginal atrophy (89.3%) and osteoporosis (60%). Fewer women than men (p=0.02) thought HRT was acceptable treatment for vaginal atrophy. Most practitioners would recommend HRT for sexual dysfunction (61.5%). Physicians indicated that they would prescribe HRT for ovarian (55.1%) and endometrial (58.7%) cancer survivors in surveillance. Compared to females, males were more likely to prescribe HRT to ovarian cancer patients who were newly diagnosed (p=0.005), disease-free after adjuvant chemotherapy (p=0.004), on surveillance (p<0.001), or with recurrent disease (p=0.008). Similar trends occurred with endometrial cancer patients. 75% of physicians would prescribe HRT for women with cervical, vaginal, or vulvar cancer following definitive treatment. There was no consensus regarding the duration of HRT once initiated for any cancer. Interestingly, 56-71% of respondents cited evidence- based medicine as the basis for their recommendations. Conclusions: Our survey demonstrated a wide spectrum in HRT prescribing patterns of GO. As more emphasis is placed on QOL and survivorship, rigorous study of the outcomes of HRT use in our patients is of paramount importance.
Basic needs of pediatric oncology patients, families, and their psychosocial adjustment.
Authors: Uphold Heatherlun , Peterson Amy , Harper Felicity W. K. , Fox Jennifer , Foster Tanina , Phipps Sean , Taub Jeffrey Warren , Albrecht Terrance Lynn , Penner Louis 
Published: March 2020

e20646 Background: Children are surviving cancer at increasing rates, but dealing with pediatric cancer creates substantial need for services among the families of patients. This study examined the fiscal/material/social needs of families with children in treatment, the relationship between the extent of these needs, and the psychosocial adjustment of primary caregivers. Methods: Participants included 105 pediatric cancer patients (ages 3-12), receiving outpatient cancer treatments at two large children’s hospitals, and their adult caregivers. About one year after treatment began, caregivers completed a questionnaire assessing their fiscal/material/social needs and whether the hospital offered assistance. Caregivers also completed several measures of psychosocial adjustment: satisfaction with life (Diener, 1985), perceived stress (Cohen, 1994), psychiatric symptoms (Derogatis, 1983), and post-traumatic stress symptoms (Weiss, 1996). This non-clinical study is still accruing patients, but it has reached a sample size that is large enough (90% of final sample) to justify data analysis. Results: The top 5 identified needs were: social work services, play activities during treatment, help with insurance to cover their child’s medical care, educational activities to help their child cope, and help obtaining cancer-related medical services. An analysis of the demographic correlates of these needs showed the total number of needs was significantly and negatively correlated with income, and Black families reported more needs than White families; there were no other significant demographic correlates. Total number of needs was significantly associated with caregivers’ psychosocial adjustment. Specifically, total number of needs was negatively correlated with life satisfaction, and positively associated with: caregiver perceived stress, depression, and symptoms of post-traumatic stress. Conclusions: Caregivers of pediatric cancer patients have substantial needs for basic services and the extent of these needs is associated with their psychosocial adjustment. Unmet needs may be a risk factor for patients and families. Programs that address these needs may benefit the adult caregivers and their children.
Τhe modulatory role of psychological distress in the relationship between illness perception and quality of life in patients with breast cancer.
Authors: Gercovich Daniela , Lopez Pablo , Bortolato Diego , Margiolakis Patricia , Morgenfeld Mirta , Rosell Laura , Acuna Claudia Lorena , Gil Deza Ernesto 
Published: March 2020

e20657 Background: In a previous study (Gercovich et al., 2011) we found that several dimensions of Illness Perception predicted some aspects of Quality of Life. The present study introduces Psychological Distress as a variable to assess the modulatory role it plays in the association between Illness Perception dimensions and Quality of Life in patients with breast cancer, identifying which of these two variables explain further variability in the different aspects of Quality of Life. Methods: A cohort of seventy-five patients was evaluated with the Brief Illness Perception Questionnaire, the Hospital Anxiety and Depression Scale and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-30). We calculated bivariate and partial correlations to evaluate the associations between the illness perception dimensions and different aspects of quality of life, controlling these associations by the psychological distress measure. Subsequently, we performed linear regression analysis to evaluate which of these two variables better explains the variability in the quality of life scores. Results: Although significant associations between subscales of perception of illness and quality of life were found, most of them lost their significance when controlled by distress. In the regression models, variables that predicted the variability in the quality of life best were psychopathological diagnostic and distress. Conclusions: According to the study results, psychological distress and psychopathological diagnostic were the two variables that better explained the variability in the quality of life. For this reason it is essential to learn more about the role these variables play on the quality of life and on the morbidity and mortality associated to them.
Biweekly combination therapy with gemcitabine and carboplatin compared with gemcitabine monotherapy in patients over 80 years old with advanced non-small-cell lung cancer: Subgroup analysis of the prospective randomized phase II study.
Authors: Kusagaya Hideki , Inui Naoki , Karayama Masato , Ozawa Yuichi , Nakamura Yutaro , Kuroishi Shigeki , Yokomura Koshi , Toyoshima MIkio , Shirai Toshihiro , Masuda Masafumi , Yamada Takashi , Yasuda Kazumasa , Suda Takafumi , Chida Kingo 
Published: March 2020

e20658 Background: Chemotherapy regimens for the elderly with non-small-cell lung cancer (NSCLC) are still controversial, especially for patients over 80 years. We previously reported that biweekly combination therapy with gemcitabine and low-dose carboplatin was well tolerated and active in elderly patients aged ≥76 years with NSCLC (Lung Cancer 77, 2012). Here we present a subanalysis of more elder patients aged ≥80 years. Methods: We conducted a phase II trial comparing biweekly combination therapy with gemcitabine (1000mg/m2) plus carboplatin (AUC 3) and monotherapy with weekly gemcitabine (1000mg/m2) in chemotherapy-naïve NSCLC patients aged ≥76 years. We performed a retrospective subgroup analysis comparing patients aged < 80 and those ≥ 80 years. We focused on patients treated with combination therapy. The primary endpoint was overall response rate and secondary endpoints were safety and progression free survival (PFS). Results: Sixteen patients were aged < 80 years (median 77.5, range, 76-79 years) and 15 patients were aged ≥80 years (median 83, range 81-88 years). Overall response rates were 25% (95% CI: 7.3-52.4%) for patients aged <80 years and 20% (95% CI: 4.3-48.1%) for patients aged ≥80 years. The median PFS in patients aged <80 years was 3.5 months (95% CI: 3.2-5.6), compared with 3.6 months (95% CI: 2.8-5.0) in patients aged ≥80 years. Additionally, the prevalence of grade 3 or 4 hematologic and non-hematologic toxicity, the completion of four cycles chemotherapy, and the need for withdrawing treatment were not significantly different between the two groups. Conclusions: In elderly patients with NSCLC, even aged ≥80 years, combination therapy with biweekly gemcitabine and low-dose carboplatin may be an efficacious treatment with a favorable toxicity profile. Clinical trial information: NCT00881296.
Assuring dietary supplement quality for cancer patients: An integrated formulary systems approach.
Authors: Markman Maurie , Levin Michael , Reilly Paul , Coyne Joseph W. , Lammersfeld Carolyn , Birdsall Timothy C. 
Published: March 2020

e20663 Background: Studies reveal up to 80% of cancer patients use some form of dietary supplements (DS). Despite the need for additional research, evidence exists that some DS may be of clinical value. In order to provide safe DS recommendations to patients, we created a Dietary Supplement Formulary Committee (DSFC). Methods: Twelve manufacturers (marketing 19 DS brands) with a reasonable reputation among providers for quality were selected. A survey tool was created to measure critical quality, GMP and FDA compliance practices; information was obtained via non-disclosure agreements; manufacturing documents were audited and compared to survey responses; FDA audit reports were obtained under Freedom of Information requests; site audits were conducted; and third party analytical testing was performed. Results: All 12 companies claimed to be operating in full compliance with FDA regulations. However, 3 had received Warning Letters from FDA for GMP violations; 2 performed a product recall within the last 5 years; 4 reported products that failed Consumerlab.com for potency or purity; 1 did not have product specifications; 1 was found by FDA to have inadequate testing; 1 was found to have a lack of sufficient controls throughout the supply chain to guard against microbiological contamination; and 2 had confirmed melamine contamination or lack of melamine testing on protein powders. Additional concerns included the use of subcontractors for certain operations, lack of stability data to support expiration dates, material discrepancies between claims and actual practice, and failure to change UPC (Universal Product Code) numbers when active ingredient formulas change. Conclusions: We observed considerable variation in the quality of DS, and in the level of compliance, which raises concerns for patient safety. One company met all quality standards. The combined use of the measures described above allowed for informed product selection. The variable quality practices identified here emphasize the need for careful formulary oversight. The USP (United States Pharmacopeial Convention), ConsumerLab.com, and the NSF International’s certification programs are current resources available to help identify quality DS.
The integration of cancer survivorship training in the curriculum of hematology/oncology fellows and radiation oncology residents.
Authors: Shayne Michelle , Culakova Eva , Milano Michael T. , Dhakal Sughosh , Constine Louis S. 
Published: March 2020

e20667 Background: The population of cancer survivors is steadily increasing. Cancer specialists require an understanding of survivors’ needs to insure optimal delivery of post-treatment care. Residency and fellowship training traditionally focus on cancer therapy, while survivorship care is often not emphasized. As a paradigm shift in our training programs, we instituted a Cancer Survivorship Workshop. Methods: In academic year 2011-2012 a Cancer Survivorship Workshop course was held at the James P. Wilmot Cancer Center/University of Rochester, a comprehensive cancer center with accredited training programs in Hematology Oncology (HO) and Radiation Oncology (RO). Course objectives included 1) learning about survivorship from patient, primary care physician, and oncologist perspectives using an evidenced-based curriculum; 2) designing treatment summaries (TS) and survivorship care plans (SCP) for 5 malignancies (lung, breast, prostate, colon, lymphoma) for integration into the electronic medical record and dissemination to patients; 3) establishing collaboration between HO and RO trainees by working together in assigned teams. Course impact was assessed pre- and post- training with a 13 question survey. Questions were answered using a 10 point scale, with a pre-defined rating system for each question. Results: Significant differences in responses to several survey questions were observed comparing pre- and post-course experience. Improvement in comfort level when discussing survivorship issues with patients (median pre-course score=6, post-course=8; p=.001), reported knowledge of survivorship care for 5 types of cancer (5 to 7; p=.002), confidence in ability to explain a SCP to a patient (5 to 8; p=.001), and comfort discussing late effects of treatment with patients (5 to 8; p=.001). The number of articles read regarding cancer survivorship increased. Five unique sets of TS and SCP’s were completed. Conclusions: This study demonstrates the feasibility of implementing cancer survivorship education into the curriculum of HO and RO training. This represents, to our knowledge, the first documented educational undertaking of its kind nationally in HO and RO Programs.
Current approaches in the treatment of malignant ascites in Germany and Austria.
Authors: Lueftner Diana , Küpferling Susanne , Oskay-Özcelik Gülten , Jehn Christian 
Published: March 2020

e20670 Background: Malignant Ascites (MA) is a common manifestation of advanced cancer associated with a poor prognosis and decreased quality of life. Currently there are no evidence based guidelines for the management of MA and only one agent is approved for its treatment. We conducted a survey with physicians throughout Germany and Austria, to get an overview of current approaches and opinions in the treatment of MA. Methods: 128 medical oncologists (MO), gastroenterologists (GE) and gynecologists (GYN) completed an electronic questionnaire consisting of 33 questions. Answers were evaluated with descriptive statistics. Results: 90% of the physicians were from Germany, 10% from Austria. 48% of those were MO, 30% were GYN and 14% were GE. Most physicians treated an average of 34 pts/year with MA. 26% of these pts suffered from ovarian, 20% from pancreatic, 17% from gastric and 14% from colorectal cancer. The majority of the physicians associated MA with poor prognosis (92%) and significant reduction in quality of life (87%). One third felt MA was a contraindication for full dosing of systemic chemotherapy. Paracentesis (P) was performed in 70% of pts with with symptom relieve and quality of life being the main reasons. Almost half of the pts required 3-5 P, 50% even more than 5 P during the course of their disease. Only 15% of pts needed multiple P per week, the majority (79%) needed the procedure either once a week or every 14 days. In 61% of pts 3-5 l ascites fluid was drained. Only in 8%, 5 l and more were removed. Volume substitution with IV albumin was performed in 40% of pts. Most pts (55%) had to stay 1-3h in a healthcare facility for the procedure. However 21% had to stay > 1 day. While almost all physicians (89%) performed a P at some point in the treatment of MA, 75% felt that a systemic chemotherapy and 55% thought a concomitant diuretic therapy were a necessary adjunct. 7% of the pts received a targeted treatment with catumaxomab. Conclusions: Even though repeated P is the main pillar of treatment of MA, its effect is only temporary, must be performed multiple times, requiring hospital resources. Further treatment strategies have to be evaluated in prospective studies. Targeted therapies like catumaxomab should be integrated into these.
Role of pre-operative serum magnesium (Mg) concentration on post-operative pain intensity and opioid usage in gynecologic surgery.
Authors: Azari Laleh , Stelts Sundae , Santoso Joseph T , Kocak Mehmet 
Published: March 2020

e20673 Background: Hypomagnesemia is a common problem, occurring in nearly 12% of hospitalized patients. Due to the link of hypomagnesemia with surgery and the potential antinociceptive effects of Mg multiple trials have been conducted. Unfortunately, the role of IV and epidural Mg supplementation in pain management perioperatively remains controversial. An unanswered question from the literature to date is whether low serum Mg concentrations correlate with pain intensity. This review of patients undergoing gynecological surgeries examines whether pre-operative serum Mg level can affect pain scores and opioid use postoperatively. Methods: This was a retrospective study of the electronic medical record at Methodist University Hospital from October 1st, 2011 to July 31st, 2012. Included for analysis are all cases that underwent a gynecologic surgery and were performed under one attending surgeon. Each patient included in the study had perioperative serum Mg levels, resting and moving pain intensity scores, and amount of opioids used. Patients were excluded for any of the following criteria: missing data, discharge in less than 24 hours, robotic surgery, and use of ketamine in anesthesia. Statistical analysis included descriptive statistics, Spearman’s rank correlation coefficient, and logistic regression. Results: The analysis included 121 patients; 54% were Caucasian, the mean age was 51.7 years and 89% of surgeries were for oncologic indications. Pre-operative serum Mg level was not significantly associated with resting or moving pain intensity scores on post operative day (POD) 1 (p=0.66; p=0.68) or POD 2 (p=0.58, p=0.83). Pre-operative Mg level was not significantly associated with opioid use on POD 1 or 2. Two variables had a possible correlation with opioid usage, on average older patients used a lower level of opioid on average and patients with higher BMI used a higher level of opioids. Conclusions: Preoperative magnesium level has no correlation with pain scores or opioid use. While repletion maybe warranted and magnesium supplementation has minimal toxicity and cost, effect on post-operative pain is uncertain. Larger randomized trials may be warranted.
Care cycle on advanced cancer: Reforming a value-based system.
Authors: Tsukuda Hiroshi , Suzumura Tomohiro , Yonesaka Kimio , Fukuoka Masahiro 
Published: March 2020

e20682 Background: In Japan, reconstruction of medical service system for cancer patients is urgent necessity. On medical service system, economist Michael E. Porter and Elizabeth Olmsted Teisberg advocated that value in health care is determined in addressing the patient's particular medical condition over the full cycle of care. In our facility, we adopted their concept to our cancer care system. Methods: In our facility, the cancer care team conducted by medical oncologists provides the best value across the full span of care services. In order to manage our care delivery value chain (CDVC) for advanced cancer, we innovated 'Annshin Card' system. 'Annshin means comfort in Japan. This card functions as a key among the patients, home nursing teams and us. We analyzed 772 patients from the tumor registry of our hospital from 7/12/2010 to 12/31/2012. The following factors were evaluated: (1) the overall incidence rate of emergency visit among patients with an 'Annshin cards', (2) the length of hospitalization and the rate of mortality at our palliative care unit (PCU) as hospitalizing indicators and (3) the medical profession income and expenditure rate as an indicator of cost-benefit. Results: (1) Of 772 patients, 419 patients were adopted 'Annshin card' system. Among patients with an 'Annshin card', the overall incidence rate of an emergency visit was 2.0 visits per 100 patients per month (/100/month). (2) Of 772 patients, 411 patients have been hospitalized in PCU and 748 events of hospitalization to PCU occurred. On 748 events, the average length of hospitalization was 19.8 [ 0-263 ] days; leaving hospital mortality was 274 events (36.6%). (3) On the medical profession income and expenditure rate, before vs. after launching our system, 85.3% vs. 95.8%, respectively. Conclusions: Our CDVC for advanced cancer not only reduced the emergency visit rate, but improved the indicators of hospitalization. Furthermore this system brought cost-benefit. We suppose that the concept of care cycles is effective for cancer patient management.