bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of an instrument to assess the needs of cancer patients in an ambulatory chemotherapy unit
Authors: Bernal L. , Casas A. , Cayuela A. , Corral J. , Flor M. , Moreno J. , Iglesias L. , Puerto R. , Ramirez P. , Toscano F. 
Published: March 2020

19593 Background: The physical deterioration, suffering and proximity of death associated with cancer dramatically affect the patient. Knowing about their perception of the circumstances that influence quality of life and adaptation to the disease, allows us to take appropriate medical action to satisfy their needs and improve the quality of patient care. Patients and Methods: The aim of this study was to evaluate treatment-related symptoms, information access, patient-doctor relationships, health service management, confidence, waiting time and financial needs of patients receiving ambulatory chemotherapy, through an “ad hoc” questionnaire. Different samples of patients were used to design the questionnaire: 141 patients for item identification, and completeness and acceptability evaluation; 47 patients for construct validity and prevalence of needs. The construct validity of the questionnaire was tested via analysis of the principal components, while reliability was evaluated in terms of the internal consistency of dimensions and test-retest scores. Results: The principal components found through factor analysis with Varimax rotation identified seven dimensions with Cronbrach′s a coefficients >0.70, which accounted for 64.3% of the variance. Internal consistency was high: Cronbrach′s a coefficients were 0.82. Test-retest reliability was acceptable with intraclass correlation coefficients ranging from 0.60 to 0.83. The most common needs were more information about diagnosis and prognosis (63%); over 50% of patients perceived shortcomings in communication with their doctors; 85% perceived sufficient intimacy in doctors‘ offices; 76% perceived that they had waited too long before being seen by doctors and given treatment. Conclusions: The validation analysis showed rather good reliability, structure validity and internal consistency. The needs expressed by patients are related to objective aspects of the disease, to time spent in contact with the service, to disease duration and to treatment lines. More vulnerable patients (elderly, low education level, more advanced treatment lines) express less needs, which is why they need an individualized analysis of their circumstances and greater attention from the professionals who take care of them. No significant financial relationships to disclose.
Quality of life in colorectal cancer patients with hepatic arterial infusion (HAI) pumps
Authors: Sun V. C. , Nelson R. , Wagman B. , Carroll M. , Lee B. , Marx H. , Yen Y. , Wagman L. D. 
Published: March 2020

19602 Background: More than half of patients diagnosed with colorectal cancer will develop hepatic metastases. Most patients with hepatic metastases will recur within two years after resection. Hepatic arterial infusion (HAI) pumps deliver regional treatment. However, very few studies quantitatively explore the patient's experience of living with an HAI pump and how this experience impacts HAI-related quality of life (QOL). This study explored the impact of HAI pump treatment on patient's overall QOL within the specific domains of physical, psychological, social, and functional well-being. Methods: Twenty-five colorectal cancer patients treated with HAI pumps completed an HAI pump- specific QOL assessment tool at one data collection time point. The QOL assessment tool items were derived from the investigator's previous QOL research with this patient population [Blair et al., 2002, Annals of Surgical Oncology]. Demographic, disease and QOL data were summarized using descriptive statistics. Results: Of the 25 patients accrued, 32% were receiving treatments through their HAI pump and 68% were not. There were no significant difference in QOL between treatment status, gender, and age (<65 or = 65). Currently treated pump patients experienced more appetite changes (p=0.03), sleep changes (p=0.08), and more restrictions in traveling (p=0.08). Male patients had more concerns with lifting heavy items (p=0.05), while female patients had more concerns with isolation (p=0.17) and changes in the type of clothing worn (p=0.16). Younger patients had more concerns with vigorous activity (p=0.01), bending (p=0.08), and were more self-conscious of their appearance with the pump (p=0.01). Conclusions: Overall, in this study, colorectal cancer patients with HAI pumps reported good QOL and were satisfied with their overall treatment experience. Although there was no comparative statistical analysis performed in this study, several QOL concerns remain worrisome for patients. Defining these specific QOL concerns in HAI patients will enhance clinical understanding of their unique experience with this treatment modality and impact patient management. This will enable further development of educational tools and research to test interventions to support HAI patients and sustain their QOL. No significant financial relationships to disclose.
A feasibility study of an intensive combined modality smoking cessation program in the radiation oncology clinic
Authors: Hoopes D. J. , Hudson D. M. , Langer M. P. , Sinha B. , Pai H. , McDaniel A. M. 
Published: March 2020

19604 Background: Radiotherapy (RT) patients present for daily treatment over many weeks, often accompanied by friends and family. This represents a unique opportunity for intensive smoking intervention concurrently with RT in both cancer patients and their companions. Methods: Eligible participants included smoking cancer patients scheduled to receive = 3 weeks of RT and their smoking family/friends. All participants received bupropion and 9 individualized behavioral interventions (BI) in the RT clinic with an addiction professional, followed by 9–12 scheduled intensive relapse prevention encounters (in person or by telephone). The primary endpoint was feasibility determined by accrual and program completion. Other endpoints included carbon-monoxide (CO) confirmed and participant-reported tobacco abstinence. During 4 months of enrollment, smoking and basic eligibility data were prospectively collected on consultations seen in clinic. Results: Over 8 months 20 cancer patients and 3 family members were enrolled. Based on our sampling, this represented greater than 40% of eligible smokers seen in clinic. Six cancer patients withdrew, all on or before the third BI. 13 participants completed all 9 BIs while 4 patients completed 7–8 BIs. 11 participants reported compliance with bupropion therapy. One participant discontinued bupropion citing increased depression. No other possible adverse events to bupropion or BI were discovered. At the completion of BI, 16 participants had exhaled CO concentrations < 10ppm and 14 participants self-reported tobacco abstinence. Of the 17 participants completing 7–9 behavioral interventions, the median number of relapse prevention sessions was 4 (range 0–8). With a median follow-up of 5.85 months, the 3-month crude self-reported abstinence rate was 41% (7/17). Conclusions: Tobacco cessation with bupropion and intensive BI for cancer patients and their companions during RT was feasible. A significant number of eligible smokers enrolled and completed BI during RT. However, few participants completed scheduled prevention encounters following RT. No significant financial relationships to disclose.
Once-weekly epoetin beta treatment in anemic patients with breast cancer receiving chemotherapy: Interim analysis of a multicenter, single arm study
Authors: Del Mastro L. , Clavarezza M. , Amadori D. , Garrone O. , Mattioli R. , Ponchio L. , Latini L. , Saracchini S. , Fabi A. , Gamucci T. 
Published: March 2020

19605 Background: Epoetin beta administered three times weekly is effective in the treatment of anemia in patients with malignancy. This study investigated the efficacy and safety of a more convenient and reduced frequency administration of epoetin beta 30,000 IU sc once weekly in anemic patients with early or metastatic breast cancer receiving chemotherapy (CT). Methods: Patients >18 years with early or metastatic breast cancer receiving CT with hemoglobin (Hb) <11 g/dL were enrolled in this open-label, single-arm, multicenter study. Patients received epoetin beta until Hb was = 12 g/dL. The primary endpoint was the proportion of patients with an Hb increase =2 g/dL from baseline or achievement of Hb =12 g/dL after 12 weeks of treatment in the absence of transfusion. Other endpoints included: median time to response, median change in Hb level after 12 weeks of treatment from baseline and proportion of patients with a Hb increase =1 g/dL at week 4. Adverse events (AEs), vital signs, and laboratory safety were recorded. Results: Interim data are presented for 101 patients (out of 200 patients enrolled) who had completed treatment to date. Patients’ characteristics were: median age 58 years (33–81), PS 0–1 88%, metastatic disease 49%, median baseline Hb 10.1 g/dL (7.8–11.7). Overall, 46% (95% CI: 35.5–57.6) of patients responded according to the primary end point, the median time to response was 42 days (95%CI: 15–103). Secondary objectives: median Hb increase after 12 weeks was 1.7 g/dL (CI95%: -1.6 to +5.4), at week 4 an Hb rise =1 g/dL was observed in 44% of patients (CI95%: 33.0–57.4). Overall, 13/101 (13%) patients required red blood transfusions, the median number of transfusion was 2. The incidence of treatment-related AEs (6.9%) was consistent with the current label for epoetin beta. Conclusions: These preliminary results indicate that Epoetin beta 30,000 IU once weekly is effective and well tolerated in patients with early or advanced breast cancer receiving CT. [Table: see text]
Neutropenic complications in ovarian cancer patients receiving chemotherapy: Results of a prospective observational study
Authors: Myer B. S. , Cosler L. E. , Crawford J. , Dale D. C. , Selby C. , Wolff D. A. , Poniewierski M. S. , Culakova E. , Lyman G. H. 
Published: March 2020

19610 Background: A nationwide, prospective cohort study of patients receiving cancer chemotherapy was undertaken to better define treatment-associated toxicities and delivered dose intensity. Methods: Following informed consent, 3,670 patients initiating a new chemotherapy regimen with lymphoma (n=547) or carcinomas of the colon (n=521), breast (n=1,473), lung (n=907) or ovary (n=312) were prospectively registered at 117 randomly selected US oncology practices between March 2002 and December 2005. Pretreatment characteristics including clinical and sociodemographic factors and practice setting associated with reductions in chemotherapy dose intensity over 4 cycles were evaluated. Results: Chemotherapy regimen standards and intended dose and schedule were defined in 97% and 93% of patients, respectively. Average initial (planned) relative dose intensity (RDI) was 90% while the mean RDI actually delivered over 4 cycles was 83%. Reductions in RDI =15% of standard were planned in 23% of patients and actually occurred over 4 cycles in 38%. Body surface area (BSA) calculated by the method of Mosteller exceeded the BSA utilized by the oncology practices in two-thirds of patients most often due to capping at 2 m2. Obese patients with a body mass index (BMI) =30 were more likely to receive planned RDI reductions =15% (30%) than patients with BMI <30 (21%) (P<.0001). Other factors associated with planned reductions in RDI in multivariate analysis included: older age, male gender, lower education, absence of myeloid growth factor prophylaxis and cancers of the lung or ovary as well as the practice setting, size and geographic location. Factors associated with unplanned (subsequent) reductions in RDI included: older age, male gender, poorer Charlson comorbidity index, prior chemotherapy, lung cancer, low baseline hematocrit, white blood or platelet count, poor renal or hepatic function and low serum albumin as well as smaller practice and rural setting. Conclusions: A substantial proportion of patients receiving cancer chemotherapy experience both planned and unplanned reductions in RDI. Further understanding of factors associated with such reductions may provide opportunities for improving the quality of cancer care and clinical outcomes. [Table: see text]
Incidence of hepatitis virus infection and severe liver dysfunction in patients receiving chemotherapy for solid tumors
Authors: Alici S. , Alici O. , Izmirli M. , Tunahan H. , Gercik F. , Begenik H. 
Published: March 2020

19611 Background: Hepatitis virus infection through virus reactivation has a high risk of mortality in patients with solid malignancies receiving chemotherapy. Methods: We examined the incidence of both hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and severe liver dysfunction (alanine aminotransferase >ten times the normal upper limit and total bilirubin >5 mg/dl) during chemotherapy in 171 patients with solid tumor. Results: Six patients (3.5%) were infected with HCV and 17 patients (9.9%) were infected with HBV. One patients (0.5%) were infected with both HCV and HCV. There were severe liver dysfunction in 29 (16.9%) all patients. HCV- or HBV-infected patients showed severe liver dysfunction at a significantly higher incidence than non-infected patients (7/22 (31%) vs. 18/149 (12%), p<0.047). Furthermore, the incidence of severe liver dysfunction in HCV-infected patients was significantly higher than in HBV- infected patients (6/8 (75.0%) vs. 18/149 (18.2%), p<0.01). Three of eight HBV infected patients were initially negative for hepatitis B surface antigen (HBsAg) by latex agglutination and became positive for HBsAg during chemotherapy. Furthermore, all three patients developed severe liver dysfunction and two developed fatal fulminant hepatitis. From an examination of the original stock of serum samples before chemotherapy, two patients were found to be positive for HBV-DNA by polymerase chain reaction (PCR). Although post-transfusion HBV infection was suspected in the one remaining patient, the cause of HBV infection could not be clarified due to the impossibility of examination in blood donors. Conclusions: Since HBV-infected patients develop severe liver dysfunction at a higher incidence than either patients not infected with virus or HCV-infected patients before chemotherapy for hematological malignancies, it is recommended that HBV- DNA should be tested by PCR to detect HBV marker-negative carriers and liver function tests should be carefully monitored. No significant financial relationships to disclose.
Protracted infusion of 5 fluorouracil and toxicity during CMF administration in adjuvant setting of breast cancer
Authors: Capoblanco A. , Capobianco A. , Ardito R. , Bochicchio A. , Coccaro M. , Di Leo P. , Romano C. , Tartarone A. 
Published: March 2020

19618 Background: Protracted infusion of 5FU(PI) increases response rates and reduces toxicity when compared to bolus administration (BA): the mechanism of action of this drug appears to depend on the dose and the schedule of administration. In some trials 5FU was given as a BA: 30% incidence of severe mucositis or diarrhea was observed. These side effect decreased to less than 15% in trials in which 5FU was infused over 30 minutes and even less when the same dose of 5FU was given over 1 hour or over 2 hours. The CMF i.v. schedule with BA of all three drugs in the adjuvant setting of breast cancer has been shown to be associated with frequent gastrointestinal and mielo-toxicity. PI of 5FU in the CMF schedule can reduce toxicity and improve the quality of life. Methods and Results: From July 2003 to October 2006, 95 patients with breast cancer, mean age 56 years (range 40–75) were treated with adjuvant CMF (1, 8 every 28 days) with 5FU PI (1 hour). Toxicity and compliance were compared to those of 75 patients treated in our institution with CMF-5FU BA (10 min). Toxicity was coded by NCI-CTC. We observed that the patients treated with CMF-5FU PI compared to 5FU BA showed G2–3 nausea: 31.5% vs 46%, G2–3 emesis: 26.3% vs 34.6%, G2 diarrhea: 0% vs 2.6%,asthenia: 18.9% vs 33.3%, G2 neutropenia: 21.0% vs 30.6%, G3 neutropenia: 18.9% vs 20.0% ,G4 neutropenia: 9.4% vs 12%,G3–4 mucositis: 12.6% vs 18.6% and hand -foot syndrome 1.0% vs 0%. Compliance in CMF with 5FU PI compared to CMF with 5FU BA was: 6 cycles administered in 92.6% vs 88.0%, day 8 omitted in 11.5% vs 13.3%, dose reduction in 15.7% vs 17.3%. Conclusions: In our experience, 5 FU PI reduces the gastrointestinal toxicity, particularly nausea and emesis compared to BA.We suggest that less toxicity treatment schedule improves the quality of life and is mandatory mainly in frail and elderly patients. No significant financial relationships to disclose.
Cancer survival: Which low molecular weight heparin (LMWH) is best?
Authors: Spahr J. E. , Akerley W. , Rodgers G. M. 
Published: March 2020

19624 Background: The role of LMWH in cancer survival is controversial. There have been 6 randomized trials specifically evaluating cancer survival with LMWH. The objective of this study was to determine which LMWH is best for cancer survival, based on literature data. Methods: We performed a review of the literature for studies published from 1990 - 2007. Results: We identified 14 studies that included data on cancer survival and the use of LMWH, even if the primary endpoint was not cancer survival. We found studies for 5 LMWH products (See Table ). Conclusions: Based on our analysis, dalteparin is the most well studied LMWH in cancer. The 4 best designed trials looking at cancer survival were performed using dalteparin with over 1190 patients. The magnitude of benefit appears to be greatest in patients with better up-front estimated survival, and absence of metastatic disease. The estimated survival benefit was 25%. The second best studied LMWH appears to be nadroparin, with 5 trials with over 480 patients, including the MALT trial, and the most recently published Icli trial. Unfortunately, nadroparin is currently not available in the US. The studies of the other LMWH lack evidence to draw significant conclusions. The results of this study must be interpreted with caution. As there have been no randomized clinical trials comparing one LMWH against another in cancer survival, the studies we compared were not always similar in design or LMWH dosing, and cannot be compared head-to-head. No significant financial relationships to disclose. [Table: see text]
Epoetin-alfa initiation at Hb 10–11 or Hb <10 g/dL: Analysis of safety and efficacy
Authors: Szczudlo T. K. , Croot C. , McKenzie R. , Henry D. 
Published: March 2020

19628 Background: Current guidelines recommend consideration of epoetin alfa (EPO) therapy for chemotherapy-induced anemia (CIA) either when Hb <11 g/dL (National Comprehensive Cancer Network) or when Hb < 10g/dL (ASCO/ASH 2002). The objective was to evaluate the safety and efficacy of EPO in patients (pts) with CIA when EPO was initiated at Hb 10–11 or at <10 g/dL. Methods: A post hoc analysis was performed on data from randomized, well-controlled trials conducted from 2002–2006. Trials in which EPO therapy was initiated at the approved dose of 40,000 Units weekly in male and female pts with Hb <11g/dL and =1 post-baseline Hb value were included. Two trials were identified, T1 and T2. Safety was assessed by the proportion of pts experiencing clinically relevant thrombovascular events (CR- TVEs) who received =1 dose of EPO. Efficacy was assessed by RBC transfusion requirements (Day 1 - end of treatment [EOT] and Day 29 - EOT) and achievement of durable Hb response (Hb =11 g/dL for =2 consecutive weeks). Results: Baseline (BL) characteristics (age, gender, platinum-based therapy, ECOG PS, and tumor type) were similar between the Hb 10–11 and <10 g/dL groups. BL Hb was 10.53 and 9.29 g/dL in T1 and 10.28 and 9.53 g/dL in T2 for the Hb 10–11 and Hb<10 g/dL subsets, respectively. Results are summarized below ( table ). Conclusions: These results show that patients treated with EPO at an Hb of 10–11 g/dL appear to have a lower incidence of CR-TVEs compared to patients treated at Hb <10 g/dL. In addition, patients who started EPO treatment at an Hb of 10–11 g/dL had fewer RBC transfusions and higher durable Hb response. Trial 1 - Waltzman et al. The Oncologist. 2005;10:642–650. Trial 2 - Henry et al. Curr Med Res Opin. 2006;22:1403–1413. No significant financial relationships to disclose. [Table: see text]
Exploration of pain management following implementation of WHO pain guidelines
Authors: Subongkot S. , Khounnikhom S. , Pratheepawanit Johns N. , Sookprasert A. 
Published: March 2020

19646 Background: Pain is among the most common symptoms encountered in cancer patients and remains the first priority of care. Methods: This cross sectional study aimed to explore a pattern of pain management at KKU Hospital by utilizing a numeric rating scale (0–10). Cancer pain patients were categorized based on prior analgesic exposure into two groups; Naïve group, and Routine group. Treatments were defined according to WHO as 1) drug treatment relevant to pain severity, 2) analgesics being prescribed as around-the- clock and 3) analgesics used for break-through pain for patients receiving strong opioid. Results: From Dec 2005 to Jul 2006, 261 patients were enrolled. 93.1% (n=243) were in advanced stages and 88.5% (n=231) were in moderate to severe pain. This pain interfered with patient’s daily life activities mildly to moderately as each pain score increased (p-value<0.01). In Naive group (n=159), 32.7% (n=52) were given analgesics following the WHO on both days 1 and day 3 of admission whereas 40.2% (n=64) patients were not. A decreased pain score was greater (2.61, SD±1.5) in a group following the WHO on day 1. Additionally, a decreased pain score was greater (3.91, SD±1.8) in a group following the WHO on day 3 (p-value <0.0001). This pain score decreased was also clinically significant as pain score reduced more than 3 points. In Routine group (n=102), 32 (31.4%) were given analgesics following the WHO guideline on both day 1 and day 3 of admission. In contrast, 36 (35.3%) were not. A decreased pain score was greater (2.59, SD±1.8) in a routine group following the WHO on day 1. Moreover, a decreased pain score was greater (3.95, SD±1.8) in a group following the WHO on day 3. The clinical significance of pain score reduced was also found on day 3. Of the 261 evaluable patients, the pattern of analgesics usage following the WHO guideline was increased in both groups comparing to at the beginning of the study. Conclusions: The results demonstrated that patients who received pain management following the WHO guideline reported significantly lower pain intensity than those not following the WHO. No significant financial relationships to disclose.