bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-level laser therapy for chemotherapy-induced peripheral neuropathy.
Authors: Lee John Muzi , Look Regan M. , Turner Crystal , Gardiner Stuart K , Wagie Terry , Douglas Jeremy , Sorenson Leslie , Evans Laura , Kirchner Sandra , Dashkoff Cyd , Garrett Karen , Johnson Nathalie 
Published: March 2020

9019 Background: Chemotherapy induced peripheral neuropathy (CIPN) is a common and serious side effect from chemotherapy agents. Low-level laser light therapy (LLLT) devices were approved in 2002 for pain management. Studies suggest a local release of serotonin, increased mitochondrial ATP production, or anti-inflammatory effects as a mechanism of action. We then questioned whether LLLT would show efficacy in mitigating symptoms caused by CIPN. Methods: In a single center prospective randomized trial, participants were randomized to receive either treatment with LLLT twice a week for 8 weeks or placebo LLLT twice a week for 4 weeks followed by actual treatment twice a week for 4 weeks. FACT/GOG-NTX, Brief Pain Inventory (BPI -Severity and Interference), SF-36 Quality of Life (Physical and Mental Score), monofilament and function testing (buttoning, coin use and walking) were conducted prior to initiation of therapy, during, at completion, and 2 months after treatment. 20 participants, 16 women and 4 men (average age 58 and 63 respectively), were enrolled between October 2009 and June 2010. 10 patients were randomized to each group. Average time from end of chemotherapy to enrollment was 32.6 months (range 2 - 120 mo). All patients had neuropathic involvement of the feet. 14 patients had additional involvement of the hands. Results: Compared to baseline, patients receiving any amount of active treatment showed significant improvement at 8 weeks in NTX, BPI, function testing, and SF36 Mental score. Those receiving 4 weeks of placebo treatment showed improvement in only BPI, NTX and SF36 Mental score. At 2-month follow up, all 20 patients showed a significant improvement in walking and SF 36 mental score, suggesting 4 weeks of active treatment improved function. No significant difference in monofilament testing was observed throughout the study in either group. Direct comparison between 4 or 8 weeks of treatment vs. placebo showed a statistically significant difference in walking function at 2-months. All patients tolerated therapy well without side effects. Conclusions: Low-level laser light therapy improved functional test over placebo and may be a viable option for non-medical management of CIPN. Further study of LLLT in CIPN is warranted.
Patient-reported cognitive impairments among women with breast cancer randomly assigned to hormonal therapy (HT) alone versus chemotherapy followed by hormonal therapy (C+HT): Results from the Trial Assigning Individualized Options for Treatment (TAILORx).
Authors: Wagner Lynne I. , Gray Robert James , Sledge George W. , Whelan Timothy Joseph , Hayes Daniel F. , Geyer Charles E. , Dees Elizabeth Claire , Cella David , Sparano Joseph 
Published: March 2020

9020 Background: Cognitive impairment is a complication of chemotherapy. Perceived cognitive impairments (PCI) were prospectively assessed among TAILORx participants randomized to HT alone versus chemotherapy followed by HT (C+HT). Methods: TAILORx participants with an OncoType DX Recurrence Score 11-25 were randomly assigned to HT or C+HT. PCI, fatigue, endocrine symptoms and health-related quality of life (HRQL) were assessed at baseline, 3, 6, 12, 24, and 36 months, using the Functional Assessment of Cancer Therapy (FACT) in 455 patients enrolled after 1/15/10. PCI change scores > 4.5 from baseline were defined a priori as clinically meaningful. Linear regression (LR) was used to model PCI scores on baseline PCI, treatment and other factors. Results: PCI scores were significantly worse at 3, 6, and 12 months compared to baseline for both groups (Table). The decline was greater for C+HT than HT at 3 months, but scores were similar at 12 months. Tests of an interaction between menopausal status and treatment were non-significant. PCI correlated with fatigue (r = 0.57-0.64) but not FACT Emotional well-being (EWB; r = 0.28-0.38); controlling for EWB did not account for differences in PCI change scores between treatment arms. Conclusions: Our study is the first to examine PCI among breast cancer patients randomized to receive C+HT vs. HT alone. C+HT was associated with greater declines in PCI at 3 months, but at 12 months PCI was similar in the C+HT and HT groups. PCI was associated with fatigue but not EWB. Pre- and post-menopausal groups demonstrated the same pattern of change. Since this study did not include a control group of patients not treated with HT, further study is required to determine if and to what extent HT contributes to PCI. [Table: see text]
Palliative cancer therapy during end of life at a regional cancer center in Norway in 2005 and 2009.
Authors: Gynnild Mari Aas , Anshushaug Malin , Kaasa Stein , Kvikstad Anne , Grønberg Bjørn Henning 
Published: March 2020

9040 Background: With increasing number of available therapies, there is a risk that patients (pts) are overtreated. Palliative cancer therapy is mostly recommended for pts with good Performance Status (PS). In one study, 42 % of pts received chemotherapy (CTx) during the last 30 days of life – suggesting that this may not always be the case. Methods: All pts who, according to the national registry, died from cancer in our region in 2005 and 2009 were analyzed. Data were collected from individual medical records. Endpoints: Time from the end of palliative cancer therapy until death. Whether there were differences depending on age; type of cancer; year of death or if they were seen at a palliative care unit (PCU). PS when the last cancer therapy was initiated. Results: 616 pts died in 2005; 599 in 2009. We excluded 495 pts: No cancer therapy (n=260); no information of cancer (n=101); last therapy with curative intention (n=83); hematological malignancy (n=51). Median age 71 (6 - 99); 49 % men; median overall survival from diagnosis: 16.9 mos. Last therapy was radiotherapy (RT): 31 %; CTx: 40 %; hormonal: 15 %; surgery: 11 %. 4 % died from treatment complications. Median time from start of last CTx or RT until death: 100 days; from end of last CTx or RT: 63 days. Younger pts received more CTx and RT in the last 30 days: Age < 60: 28 %; 60-70: 23 % and 70+: 12 % (p<.001). The table shows the use of CTx and RT the last 30 and 14 days for the most common cancers. Among those who got CTx in the last 30 days (n=74); 54 % had PS 2; 14 % PS 3-4. Among those who got RT in the last 30 days (n=61), 31 % had PS 2; 54 % PS 3-4. Of the 49 % referred to the PCU, fewer received CTx or RT in the last 30 days (PCU: 14 %, no PCU: 22 %; p=.002) and 14 days (PCU: 5 %, no PCU: 12 %; p<.001). Conclusions: Many pts received cancer therapy the last month of life. The percentage varies with age, cancer type and was lower in 2009 than in 2005. Pts seen at the PCU received less CTx and RT. Many pts had a poorer PS at the start of last cancer therapy than recommended. [Table: see text]
Predictors of resilience in women treated for breast cancer: A prospective study.
Authors: Bennett Barbara Kaye , Lloyd Andrew R. , Webber Kate , Friedlander Michael , Goldstein David ,   FolCan Study Group
Published: March 2020

9044 Background: Because a cancer diagnosis may be regarded as a potentially traumatic event with untoward consequences, much research has focussed on negative aspects of cancer diagnosis and treatment, emphasising psychological outcomes. A recent paradigm shift recognises that such a psycho-pathological approach discounts the human capacity for resilience "the ability to maintain relatively stable functioning following an aversive life event" (Bonanno GA Curr Direct in Psychol Science 2005 14(3) 135). Predictors of resilience in women who recovered uneventfully from surgical and adjuvant treatment for early stage breast cancer were investigated in a prospective study. Methods: Validated self-report measures of mood, somatic symptoms, temperament, illness attitudes, and social support were completed post-surgery. Clinical, tumor and treatment details were recorded. At end treatment and subsequently at 1, 3, 6, 9 and 12 months, self-report measures of mood and somatic symptoms were completed. Resilience was defined as: no evidence of protracted psychological or somatic distress in the 12 months following treatment completion. Identified resilient and non-resilient groups were compared and predictors sought by logistic regression. Results: Of 218 women evaluated, 106 (49%) were classified as "resilient." They either reported no clinically significant psychological or other distress post-surgery (34%) and 12months following adjuvant treatment or recovered promptly (15%) and remained well. There were no significant differences in age (52 years); marital status; tumor size; treatment; treatment toxicity (nadir hemoglobin and neutrophil count) or mortality at 5 years post treatment (8 confirmed deaths in each group). Logistic regression identified low neuroticism (temperament or personality trait) as the most significant predictor of resilience. Conclusions: These findings suggest that without any intervention almost half the women treated for breast cancer adapt well to diagnosis and treatment. These outcomes warrant further research, to provide further insight into how individuals cope with major illness and to facilitate development of programs to aid those in whom outcomes are protracted.
Patient-physician communication about code status preferences: A randomized controlled trial.
Authors: Rhondali Wadih , Perez-Cruz Pedro Emilio , Hui David , Chisholm Gary B. , Dalal Shalini , Baile Walter F. , Chittenden Eva , Filbet Marilène , Bruera Eduardo 
Published: March 2020

9049 Background: Code status discussions are important in cancer care. The best modality for such discussions has not been established. Our objective was to determine the impact of a physician ending a code status discussion with a question (autonomy approach) versus a recommendation (beneficence approach) on patients’ do-not-resuscitate (DNR) preference. Methods: Patients in a supportive care clinic watched two videos showing a physician-patient discussion regarding code status. Both videos were identical except for the ending: one ended with the physician asking for the patient’s code status preference and the other with the physician recommending DNR. Patients were randomly assigned to watch the videos in different sequences. The main outcome was the proportion of patients choosing DNR for the video patient. Results: 78 patients completed the study. 74% chose DNR after the question video, 73% after the recommendation video (p=NS). Median physician compassion score was very high and not different for both videos (p=0.73). 30/30 patients who had chosen DNR for themselves and 30/48 patients who had not chosen DNR for themselves chose DNR for the video patient (100% v/s 62%, p<0.001). Age (OR=1.1/year, p=0.01) and white ethnicity (OR=9.43, p=0.004) predicted DNR choice for the video patient. Conclusions: Ending DNR discussions with a question or a recommendation did not impact DNR choice or perception of physician compassion. Therefore, both approaches are clinically appropriate. All patients who chose DNR for themselves and most patients who did not choose DNR for themselves chose DNR for the video patient. Age and race predicted DNR choice.
The effect of melatonin on appetite and other symptoms in patients with advanced cancer and cachexia: A double-blind placebo-controlled trial.
Authors: Del Fabbro Egidio , Dev Rony , Hui David , Palmer J. Lynn , Bruera Eduardo 
Published: March 2020

9062 Background: Patients with advanced cancer experience anorexia and weight loss which impairs their quality of life. Prior studies suggest melatonin, a frequently used integrative medicine may attenuate weight loss, anorexia, fatigue, and depression. These studies were limited by a lack of blinding and absence of placebo controls. The primary objective of this study was to compare melatonin to placebo for appetite in patients with cachexia. Methods: A randomized, double-blind, 28 day trial of melatonin 20mg vs. placebo in patients with advanced lung or gastrointestinal cancer, appetite scores >3 on a 0 to 10 scale (10 = worst appetite) and a history of weight loss ≥ 5% within 6 months. Patients unable to maintain oral intake, thyroid or adrenal dysfunction, or with a karnofsky <40 were excluded from the study. The assessments included weight, symptom severity by Edmonton Symptom Assessment Scale (ESAS) and quality of life by the Functional Assessment of Anorexia/Cachexia Therapy (FAACT).Differences between groups from baseline to day 28 were analyzed using one-sided two sample t tests (appetite, pain and well-being) or Wilcoxon two-sample tests for the other variables. Interim analysis at half point had a Lan-DeMets monitoring boundary with an O’Brien-Fleming stopping rule. The decision boundaries for the interim test was to accept the null hypothesis of no treatment difference (futility) if the test statistic Z < 0.39 (p ≥ 0.348). Results: After interim analysis of 48 patients, the study was closed by the Data Safety Monitoring Board for futility. There were no significant differences between groups in appetite (p=0.78), weight (p= 0.17), FAACT score (p=0.95), insomnia (p=0.62) or other symptoms measured by the ESAS from baseline to day 28.No significant toxicities were observed. Conclusions: In cachectic patients with advanced cancer, 20mg oral Melatonin at night does not improve appetite, weight or quality of life compared to placebo.
Decision-making preferences of advanced cancer Hispanic patients from the United States and Latin America.
Authors: Parsons Henrique Afonseca , Yennurajalingam Sriram , Rosina Duarte Eva , Palma Alejandra , Bunge Sofia , Palmer J. Lynn , Delgado-Guay Marvin Omar , Bruera Eduardo 
Published: March 2020

9063 Background: To determine whether preferences in frequency of passive decision making differ between Hispanic patients from Latin America (HLA) and Hispanic-American (HA) patients. Methods: We conducted a survey of advanced cancer Hispanic patients referred to outpatient palliative care clinics in the U.S, Chile, Argentina, and Guatemala. Information on demographic variables, PS,andMarin Acculturation Assessment Tool (only U.S. patients) was collected. Decision-making preference was evaluated by the decision-making assessment tool. Results: A total of 387 patients with advanced cancer were surveyed: 91 (24%) in the US, 100 (26%) in Chile, 94 (25%) in Guatemala, and 99 (26%) in Argentina. Median age was 59 years, and 61% were female. HLA preferred passive decision-making strategies significantly more frequently with regard to involvement of the family (24% versus 10%, p=0.009) or the physician (35% versus 26%, p<0.001), even after controlling for age and education (OR 3.8, p<0.001 for physician and 2.4, p=0.03 for family) (Table 1). 76/91 HA (83.5%), and 242/293 HLA (82%) preferred family involvement in decision-making (p=NS). No differences were found in decision-making preferences between low- and highly acculturated U.S. Hispanics. Conclusions: HA prefer more active decision-making as compared to HLA. Among HA, acculturation did not seem to play a role in decision-making preference determination. Our findings in this study confirm the importance of family participation in decision making in both HA and HLA. However, HA patients were much less likely to want family members or physicians to make decisions on their behalf. [Table: see text] [Table: see text]
Clostridium difficile-associated diarrhea in cancer patients treated with fidaxomicin or vancomycin.
Authors: Cornely Oliver A. , Miller Mark , Fantin Bruno , Mullane Kathleen M. , Kean Yin , Gorbach Sherwood 
Published: March 2020

9067 Background: Oncology patients are at risk for infections, including C difficile infection (CDI). Fidaxomicin (FDX) is a novel antibiotic highly specific for C difficile with improved sustained response compared with vancomycin (VAN). Another important clinical outcome of CDI is time to resolution of diarrhea (TTROD), corresponding to the duration of passing unformed bowel movements. Methods: 183 patients with a current diagnosis of cancer were compared to non-cancer patients from a combined population of 1105 subjects with CDI in two phase 3 trials comparing 10 days of treatment with FDX (400 mg/day) or VAN (500 mg/day). Number of unformed bowel movements (UBM) per 24 h was monitored. Response was considered as ≤3 UBM/24 h. Time to resolution of diarrhea was defined as time in hours from the first dose of study drug to the last UBM on the day preceding two days of ≤3 UBM/24 h. Kaplan-Meier survival analysis (K-M) used the log rank test for significance (p<0.05). Results: The response rate at end of treatment was 79.2% for 183 patients with cancer, compared to 88.6% for 922 patients without cancer (p<0.001). Median TTROD was longer by 45 h in patients with cancer than those without. In the VAN treatment group, median TTROD was 65 h longer in patients with cancer vs those without and significant by K-M. In the FDX group, although median TTROD was longer by 20 h in patients with cancer vs those without, the difference was not significant by K-M. For patients with cancer, TTROD was significantly shorter during treatment with FDX than with VAN. Conclusions: Patients with cancer responded more slowly to treatment for CDI than did non-cancer patients; however, resolution of diarrhea was more rapid by 49 h during treatment with FDX than with VAN. [Table: see text]
Development of a geriatric vulnerability score (GVS) in elderly advanced ovarian cancer (AOC) patients (pts) treated in first line: A prospective GINECO trial.
Authors: Freyer Gilles , Weber Beatrice E. , Lebrun-Jezekova Daniela , Tinquaut Fabien , Tredan Olivier , Sevin Emmanuel , Stefani Laetitia , Pujade-Lauraine Eric , Falandry Claire 
Published: March 2020

9079 Background: Two previous prospective GINECO studies in elderly patients have underlined the prognostic value of geriatric covariates (Co) on overall survival (OS) (Freyer G., et al. Ann Oncol. 2005 and Tredan O, et al Ann Oncol 2007). Methods: This open prospective trial was designed to confirm the impact of geriatric Co including psycho-geriatric Co on OS of elderly pts (≥70) with stage III-IV AOC treated in first line with 6 courses of carboplatin AUC5/3weeks. Geriatric Co were tested for their impact on OS in uni- and multivariate analyses. The best fitting proportional hazard model (GVS) was developed with the inclusion of major (MaC) and minor Co (miC). Results: From 08/2007 to 01/2010, 111 pts were included in 21 centres. A majority of pts displayed characteristics of vulnerability: age (median:78, range: 70-93, ≥80:41%), PS≥2: 43%, ≥3 major comorbidities: 27%, ≥4 comedications: 69%, ADL score<6: 55%, IADL score<25: 75%, HADS≥15:37%. A total of 74% of pts, however, completed planned chemotherapy. Gr3-4 haematological toxicity was observed in 50% of pts (thrombocytopenia [27%], anaemia [19%], and neutropenia [30%]) and gr3-4 non-haematological toxicity was fatigue (16%), anorexia (13%) and infection (10%). Median OS was 16.2 months (95%CI[14-21]). MaC were: albuminemia<35g/L; ADL score <6; IADL score <25 and miC: lymphopenia<1G/L; HADS£14. The survival score=exp(0.320*Number [MaC] +0.354*Number[miC]) was validated upon a bootstrap analysis. Using a cutoff of 3, the simplified GVS score = Number[MaC] + Number[miC] discriminated two groups with significantly different OS :11.5 vs 21.7 months; HR=2.94; p<10-4, but also treatment completion rates: 65.4% vs 82.1%; OR=0.41; p=0.04; severe adverse events (SAE): 52.7% vs 28.6%; OR=2.8; p=0.009 and unplanned hospital admissions: 52.8% vs 30.3% OR=2.6; p=0.02. Conclusions: The GVS identified a group of pts at high risk of severe toxicity, early treatment stopping, unplanned hospitalization and poor outcome. GVS provides a useful tool to identify vulnerable pts in future elderly AOC trials.
Correlations between depression according DSM-IV-TR (DSM) criteria, three validated scales, oncologist assessment, and clinical psychiatric interview in elderly advanced ovarian cancer (AOC) patients (pts): A GINECO study.
Authors: Filbet Marilène , Rhondali Wadih , Freyer Gilles , ADAM Virginie , Dezerlle Martine , Abgrall-Barbry Gaelle , Gobet-Bourcelot Sophie , Machavoine Jean-Luc , Chomat-Neyraud Muriel , Gane Nicolas , Saltel Pierre , Falandry Claire 
Published: March 2020

9080 Background: Depression is a major outcome in cancer pts. Clinicians typically rely on their clinical impression of depression rather than pts self-reports. Our aim was to explore the association between patient-reported depression, oncologist assessment (OA) and a clinical psychiatric interview (CPI) in elderly AOC pts. Methods: This analysis was a secondary endpoint of theElderly Women AOC trial, designed to assess the impact of geriatric covariates, notably depression, on survival in pts over 70 receiving 6 courses of carboplatin. Depression was assessed using the Geriatric Depression Scale-30 (GDS; cut off score of 10/30), the Hospital Anxiety Depression Scale (HADS; cut off score of 15/42), the distress thermometer (DT; cut off score of 4/10) and OA (yes/no). CPI was conducted by psychologists within 10 days after inclusion. The interview guide for CPI (yes/no) was constructed and adapted from three validated scale: GDS, Hamilton Depression Rating Scale Hamilton (HDRS), Montgomery Asberg Depression Rating Scale (MADRS) and the DSM criteria. DSM was considered as the gold standard. Results: Out of 111 pts, 100 (90.1 %) completed all the assessment (OA, GDS, HADS, DT, CPI). Patients characteristics were: mean age 78, performance status ≥2: 48 (55%). Thirty six pts (36%) were identified as depressed by the CPI versus 17 (17%) by OA, 32 (32%) by the GDS, 36 (36%) by the HADS, 58 (58%) by the DT and 16 (16%) according to DSM. We found a significant correlation between DSM and GDS (r=0.58; p<0.001), DSM and CPI (r=0.53; p<0.001). We did not find any significant correlation between DSM and OA (r=-0.05;p=0.733), DSM and DT (r=-0.07;p=0.583), and between DSM and HADS (r=0.127;p=0.258). Identification according to OA (yes/no) resulted in 87% false negatives and 18% false positives rates. The best sensitivity and specificity as a screening tool was found for GDS, 94% and 80% respectively. Conclusions: The use of validated tools such as GDS and a collaboration between psychologists and oncologists are warranted to better identify emotional disorders in elderly women with AOC.