bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer patients’ information needs in Nigeria.
Authors: Nwankwo Kenneth Chima , Ezeome Emmanuel 
Published: March 2020

e19572 Background: The attitudes of Nigerian cancer patients on cancer diagnosis and prognosis were studied to ascertain what diagnostic and prognostic information were disclosed to them by their physicians, and what they wanted to know about their cancer diagnosis and prognosis. Methods: Structured questionnaires were administered on all consenting cancer patients that were managed at the University of Nigeria Teaching Hospital Enugu (UNTH-E) between July and October 2011. The data collected were analyzed with Statistical Package for Social Sciences (SPSS) software version 18. Results: Two hundred and forty four (244) patients participated in the study. While 95% of the participants wanted to know the nature of their diagnosis, only76.7% admitted to being informed of the diagnosis by their doctors. Nearly 54% of participants will like to be informed of a bad prognosis when death is imminent. The word “cancer” was used to disclose the diagnosis to 69.4% of the patients. Hundred and eight (44.3%) of the patients did not have any idea what “cancer” meant or did not know how to explain it while 39.8% knew it as a deadly, incurable or a painful disease and 8.6% described it as a tumour or abnormal growth. The nature of the disease was explained to 155(66.0%) of the patients among whom 114(76%) felt they received adequate or more than adequate explanation of their cancer to enable them undergo treatment. Patient factors that significantly improved the disclosure of diagnostic information were education (p=0.044) and site of the cancer (p=0.043). There was no statistically significant association between the desire for diagnostic and prognostic information and the patients’ age, gender, educational attainment or site of the cancer. Conclusions: Most of the surveyed cancer patients in Nigeria desire to know the truth about the diagnosis of their disease and more than 50% of them desire to know when the cancer stage becomes terminal and death imminent. Physicians in Nigeria should consider the information needs of the individual patients and satisfy them.
Interactive voice response system compliance in chronic myeloid leukemiapopulation.
Authors: Garcia-Gonzalez Araceli , Ault Patricia , Williams Loretta A. , Williams Janet L. , Cleeland Charles S. , Cortes Jorge E. 
Published: March 2020

e19589 Background: Recent advances in telecommunication technology have created sophisticated systems to support and evaluate chronic disease. The telephone-based interactive voice response system (IVRS) is a simple method of delivering specific health information to patients and allowing them to interact with care providers. The IVRS has been used to monitor chronic conditions such as cancer, diabetes, asthma, hypertension, and psychiatric disorders. Our study aimed to evaluate patient adherence to routine IVRS symptom assessment in chronic myeloid leukemia (CML). Methods: We conducted a longitudinal study in patients with a diagnosis of Philadelphia chromosome-positive CML treated at a tertiary cancer center. We collected IVRS data every 2 weeks for 6 months. Upon recruitment, patients were trained to use the IVRS and selected preferred days and times to receive IVRS calls. The IVRS asked patients to rate symptoms using the M. D. Anderson Symptom Inventory CML module (MDASI-CML), which assesses 20 symptom items and 6 interference items on a 0-10 scale (0 = not present and 10 = symptom as bad as you can imagine or complete intereference). Compliance equaled the number of answered IVRS calls divided by total calls for that patient. Univariate analysis examined associations between IVRS compliance and various demographic, clinical, and treatment variables. Results: Of 160 patients enrolled in the study, 12 withdrew and were excluded from analysis. Mean age of the sample was 51 years (SD 13.7); most were female (54%) and white non-Hispanic (74%). We collected 1,197 MDASI-CML assessments overall and found a 66% compliance rate. Almost one-third (29.7%) of the patients had 100% compliance; 10% answered no IVRS calls. IVRS compliance was statistically significantly associated with marital status (p=.016) and ethnic group (p=.045). Patients who were married or white were more likely to answer IVRS calls. Conclusions: 66% of our sample answered every IVRS call. The IVRS could be extremely useful for population survey research. It should be especially useful for assessing symptoms in chronic disease over time. More studies are needed to evaluate the utility of capturing symptom clinical trials status via the IVRS in the cancer population.
How are cared surviving cancer patients? Results of an Italian national survey to medical oncologists (MO) about clinical and organizational features of follow-up (FU).
Authors: Numico Gianmauro , Pinto Carmine , Ucci Giovanni , Gori Stefania , Di Maio Massimo , Cancian Maurizio , De Lorenzo Francesco , Venturini Marco ,   Associazione Italiana di Oncologia Medica (AIOM)
Published: March 2020

e19592 Background: The growing demand and the resources shortage are pushing toward more efficient models of survivorship care delivery. The interface between the MO, the specialists involved in FU and Primary Care Physicians (PCP) should be optimized. While the “oncology centered” model seems hardly sustainable, a “sequential” model (PCP FU after an arbitrarily defined period of specialist FU) is gaining acceptance. A proposed alternative is a “shared-cares” model that promotes the interaction between MO and PCP throughout the whole clinical history. AIOM established a working group with the aim of promoting improvements at the national level. A survey aimed at assessing attitudes and feelings of MO was considered preliminary to any further initiative. Methods: A 25-item questionnaire was sent to the mailing list of the Society, in a 2-months period during 2011. One MO per institution was asked to answer to the questions. The sections of the survey were the following: 1) organizational features of FU; 2) clinical features involving breast (BC) and colorectal cancer (CRC) FU; 3) feelings of MO about the different meanings of FU. Results: 91 MO of 160 institutions (57%) answered. A shared organization between specialists is reported in 71% for BC and 53% for CRC. However, a shared medical record is used in only 19% and 11% respectively. The ordinary communication between MO and PCP consists in the medical report released to the pt in 87% and in other instruments in 8%. 55% and 30% of the MO follow BC and CRC pts indefinitely. In case of discharge, a conclusive letter is sent to the PCP in 74%, while a survivorship care plan is delivered in only 9%. Only 6% and 14% of the MO feel that FU has an important role in reducing mortality or in improving recurrence detection in BC. These figures grow to 31% and 47% for CRC. The educational role of FU is considered important in 36% and 32% while the psychological role in 44% and 37% for BC and CRC respectively. Conclusions: Although efforts are made to include other specialists and PCP into survivorship care, MO tend to privilege the “oncology centered” model. National efforts are being encouraged to promote the diffusion of a “shared-cares” model.
Would warning of osteonecrosis of the jaw (ONJ) have induced a change in the administration schedule of zoledronic acid (ZA)? A report from Toledo, Spain.
Authors: Rubio Salvador Ana Rosa , Chacon Jose Ignacio , Munoz Platon Enriqueta , Martinez Carrasco Begona , Cordero Franco Nazaret , Martinez Sesmero Jose Manuel , Diaz Paniagua Laura , Alonso Soler Sonia , San Juan del Moral Alberto , Fernandez Franco Lourdes , Esteban Esteban Carmen , Moya Gomez Paloma , Cruz Mora Miguel Angel 
Published: March 2020

e19596 Background: ZA therapy has been associated with the development of ONJ. In Nov 8th, 2005, osteonecrosis of the jaw was elevated to a safety warning by Spanish Drug Agency (SDA). The aim of this study was to investigate if that warning has had any effect in the pattern of ZA administration in a general hospital. Methods: We retrospectively analysed database using pharmacy, medical and nurse claims data from the Oncobass integrated claims database for all pts diagnosed with cancer who had received treatment with ZA between Jan 1, 2002, and Dec 31, 2011. Delivered doses of ZA were stratified in 2 groups: used before the SDA warning and after the SDA warning. Main variable: time between two consecutive doses (TTCD). Secondary variables: age, sex and diagnosis. Descriptive statistical analysis were applied for both groups. Comparisons of means of TTCD before and after the warning were performed with Student’s test, or the Mann-Whitney test, as necessary. Statistic significance: p value < 0.05. Results: We identified 761 patients (374 (49.2%) male; 387 (50.8%) female), median age 64 y (25 – 92) who were delivered 7301 doses [mean: 9.6 doses/patient (d/p)]: 2,353 (32.2%) before the SDA warning and 4948 (67.8%) after. Pathologies: breast cancer (BC) 257 patients (pts) (33,77%), 2,918 doses (40%), mean 11.4 d/p; multiple myeloma (MM) 167 pts (21.94%), 2001 doses (27%), 12 d/p; prostate adenocarcinoma (PA) 129 pts (16.95%), 1,510 doses (20.7%), 11.7 d/p; lung cancer (LC), 112 pts (14.72%), mean 4.2 d/p, 465 doses (6.4%); other 96 pts (12.61%), 407 doses (5,5%), 4.2 d/p. 3,126 (43%) doses were delivered to male and 4,149 (57%) to female. TTCD was significantly increased after ths SDA warning [32.12 vs 33.87 days (d); p< 0.001; CI 95% (-0.79)- (-0.90)]. By pathologies, differences were significant only for MM [35.8 vs 44.4 d; p<0.001; CI 95% (-10.19)-(-6.99)] and for PA [28.67 vs 32.03; p < 0.001; CI 95% (-5.08)-(-1.63)], but not for the other pathologies. Median d/p was unchanged before and after warnings for all pathologies except for MM (13 d/p vs 8.3 d/p). Conclusions: In our environment, ONJ warnings have not changed substantially the ZA schedule pattern, except for MM.
Measuring the functional decline of people with advanced-stage non-small cell lung cancer (NSCLC).
Authors: Denehy Linda , Murnane Andrew , Krishnasamy Meinir , Gough Karla , Granger Catherine , Mileshkin Linda R. 
Published: March 2020

e19605 Background: People affected by lung cancer maybe highly symptomatic. This study aimed to quantify changes in physical function and health-related quality of life (HRQoL) in patients with advanced NSCLC. Methods: A prospective cohort study was performed. Patients with stage III and IV NSCLC were recruited within one month of starting treatment and assessed at baseline, 2, 4 and 6 months or until they became too unwell. HRQoL and functional status were measured using the EORTC QLQ-C30, the 6-minute walk test (6MWT) and timed up and go test (TUG). Comparisons between baseline and follow-up assessments were carried out by fitting linear mixed models to each outcome separately. Results: 39 patients (21 male) were included in the analysis; median age of 63 (range 40-80). 59% were receiving treatment with curative intent. 28% had stage 4 disease with 26% deceased by 4 months. Response rates at 2 and 4 months were 71.8% and 53.8% for 6MWT and TUG and 87.2% and 64.1% for EORTC. The mean 6MWT at baseline was significantly lower than predicted for the age, sex and height of the cohort (417.9 versus 550.4 metres, p<0.0005). Significant decline in mean 6MWT distance was seen at 2 (decrease of 42.4m, 95%CI -59.0, -25.7, p<0.0005) and 4 month follow-ups (decrease of 63.6m, 95%CI -85.6, -41.5, p<0.0005) compared to baseline. Significant increases in time taken to complete the TUG were also seen at 2 (increase of 0.76 sec, 95%CI 0.54 – 0.98, p<0.0005) and 4 month follow-ups (increase of 1.01 sec, 95%CI 0.76 – 1.27, p<0.0005) compared with baseline. In contrast, global health status and physical functioning as assessed by the QLQ-C30 showed small but significant decreases at the 2 month follow-up compared to baseline (decrease of 8.04, p=0.01 and decrease of 7.67, p=0.024 respectively), but no significant differences between baseline and the 4 month follow-up. Conclusions: Patients with advanced NSCLC show clinically and statistically significant decrements in physical function at commencement of treatment. This continues to decline rapidly and significantly over time, despite small changes in self-reported HRQoL. The 6MWT demonstrated clinically relevant changes in physical function. Interventions to address this problem are urgently needed.
Concurrent stereotactic robotic radiosurgery and hyperthermia for palliation of pain in recurrent advanced malignancies.
Authors: Papaiah Susheela Sridhar , Govindarajan Mallarajapatna , Rajan Sudhan , Bilimaga Ramesh s , Anchineyan Pichandi , Amalraj Jerrin , Gupta Monica , D Madhusudan , Pundalika Mohan , Ajaikumar Basavalinga S. 
Published: March 2020

e19619 Background: The management of advanced recurrent malignancy after definitive treatment is challenging. Palliation of pain in these cases by medication alone may not be sufficient. The role of Radiotherapy and hyperthermia were tried in the past with little benefit but side effects of radiation were considerably high due to large volume of disease. This study aims at Concurrent Robotic radiosurgery with hyperthermia for large volume disease for palliation of pain in recurrent advanced malignancy. Methods: Ten cases of recurrent advanced malignancy with Visual analog pain scale (VAS) score of > 8 were treated by concurrent stereotactic robotic radiosurgery and hyperthermia between July 2010 to Jan 2012. All patients underwent PET CT based radiosurgery planning,Sterotactic Robotic Radiosurgery was delivered to Gross Tumor Volume (GTV) to dose of 30Gy in 3-5 fractions using fiducial tracking method.Hyperthermia was delivered using Celsius 42 locoregional hyperthermia device for an hour after stereotactic robotic radiosurgery on alternate day for 3-5 sessions. All patients received premedication and pain medications during treatment. All patients were analyzed for tolerance of treatment, acute toxicity and pain control. Pain control was assessed at the end of treatment and 6 weeks. Results: Among 10 patients 7 were female and 3 were male, age ranged from 40 to 72 years. 4 patients were carcinoma cervix, 2 were carcinoma rectum, 1 cholangiosarcoma, 1 carcinoma pancreas, 1 carcinoma esophagus with supraclavicular lymphnode, 1 mucoepidermoid ca of maxilla. All patients completed the planned treatment of concurrent Sterotactic Robotic Radiosurgery and Hyperthermia without any acute toxicity. At the end of treatment all patients had reduction in the pain. 7 patients had more than 60% reduction. At the end of 6 weeks 8 patients had >80% reduction and off the analgesics. Conclusions: Concurrent Sterotactic Robotic Radiosurgery and hyperthermia is well tolerated and may gives good palliation of pain with improved quality of life in recurrent advanced malignancy. However randomized trial in this regard will be required.
Efficacy, safety, and cost-effectiveness (CE) analysis of pegfilgrastim (P) and lenograstim (L) in patients (pts) with nonmetastatic breast cancer (nmBC) receiving myelosuppressive chemotherapy (mCT).
Authors: Papa Anselmo , Rossi Luigi , Tomao Federica , Ricci Fabio , Giordani Erika , Spinelli Gian Paolo , Lo Russo Giuseppe , Basso Enrico , Verrico Monica , Zaccarelli Eleonora , Rinaldi Giulia , Stati Valeria , Pasciuti Giulia , Strudel Martina , Zoratto Federica , Tomao Silverio 
Published: March 2020

e19620 Background: Neutropenia (N) is common in pts who receive mCT. This retrospective study was conducted to determine efficacy, safety and cost of single injection of P (6 mg) compared with daily L (263 μg), in primary prophilaxis of N in pts affected by nmBC, who received mCT. Methods: 50 women (median age 54 years) underwent to median 6 (range 4–8) CT doses with antracyclines +/- taxanes. At every cycle, 28 pts received daily L (median 5 injections from day 5 to 9), while 22 pts received one dose of P on day 2. Absolute neutrophil count, incidence of G3/G4-N, bone pain (BP: Numerical Rate Scale >7) and CE analysis were evaluated. Results: In overall population (OP) incidence of G3-N and G4-N was 25% and 68%, respectively in L vs 22.7% and 41%, respectively in P; two cases (7%) of febrile N (FN) occurred in pts treated with L and three cases (13.6%) of FN in P. In 19 pts treated with FEC100 (10 pts L vs 9 pts P) we observed 0% of G3-N and 30% of G4-N in L while 33% of G3-N and 44% of G4-N in P. 31 pts received TAC/AC+T (18 pts L vs 13 pts P) with G3-N and G4-N 38.8% and 66.6%, respectively in L vs 15.3% and 30.7%, respectively in P. 18.2% of pts, who received P, had BP vs 35.7% in L. Reduction of CT doses was observed in 35.7% in L vs 41% in P. In Italy the cost of 1 injection of P was about 1489,00 euro compared with about 655,00 euro for 5 injections of L. Conclusions: In our experience, 1 injection of P was more effective and expensive than 5 daily administration of L to control N in OP and in particular in TAC/AC+T, while in FEC100, L was satisfactory with good CE profile. No difference about incidence of NF. Safety of P and L were similar with a lower incidence of BP in P.
Using practice algorithms to deliver cancer survivorship care.
Authors: Palos Guadalupe R. , Zandstra Fran , Russell Ludivine , Flores Jacklyn J , DeJesus Yvette , Foxhall Lewis E , Rodriguez Maria Alma 
Published: March 2020

e19625 Background: Clinical practice algorithms provide a framework to guide providers’ practice in delivering care to long-term cancer survivors. Here we describe how algorithms were developed in a comprehensive cancer center and types of metrics used to evaluate their feasibility. Methods: Survivorship practice algorithms were based on a multidisciplinary care approach successfully used to build screening and treatment algorithms. This model consisted of four phases: development, adoption, implementation, and evaluation of algorithms. Phase 1, expert clinicians and researchers identified and agreed upon a specific cancer site. Group-consensus and literature reviews/syntheses were used to determine eligibility criteria to transition patients to survivorship care. Phase 2, reviews and approval processes were conducted by credentialing and regulatory committees to ensure adoption of the algorithms into clinical practice. Phase 3, pilot programs were conducted to implement the algorithm(s) in disease-specific survivorship clinics. Phase 4, metrics to evaluate progress included the number of algorithms and providers’ use of and adherence to the algorithms. Results: Between 09/2008 – 12/2011, nine multidisciplinary disease-specific survivorship clinics were operationalized. Thirty-seven practice algorithms were developed to provide survivorship care based on each survivor’s specific needs. The algorithms’ framework included: 1) surveillance for recurrent or new primary malignancies; 2) primary and secondary cancer prevention recommendations; 3) management of toxicities and latent treatment effects; and 4) assessment of psychosocial functioning. Conclusions: Practice algorithms provide an organized plan to deliver comprehensive and holistic care to long-term survivors. Given the projected increase in cancer survivors, further research is needed to determine how practice algorithms impact providers’ practice and survivors’ outcomes.
Validation of the patient-generated part of the PG-SGA against the malnutrition screening tool (MST).
Authors: Swinton Nelda , Kasymjanova Goulnar , Grossman Mary , Cohen Victor , Pepe Carmela , Agulnik Jason Scott , Small David 
Published: March 2020

e19626 Background: It is important to identify cancer patients (pts) who are at risk for malnutrition as many pts experience an array of nutritional problems which can impact upon their treatment plan and quality of life. This requires using an easy and reliable screening tool such as the MST or the scored PG-SGA. The scored PG-SGA is a more extensive tool consisting of a patient (pt) - generated section identifying symptoms that can impact on nutritional status. It also includes a second part consisting a pt’s physical examination. Both sections are summed to give an overall PG-SGA score. We hypothesized that the PG-SGA‘s pt-generated part alone, could be a comparable screening tool to the MST. Methods: We performed a prospective analysis from our out-patient pulmonary oncology clinic between July 1, 2010 to January 1, 2012 on non-small cell lung cancer (NSCLC) pts at various times in their cancer trajectory and used the MST as the gold standard. Pts were asked the MST’s questions by an oncology dietitian and completed the pt - generated part of the PG-SGA. Cut off points of ≥ 2 for the MST and ≥ 4 for the PG-SGA ( pt-generated part) were used to identify pts at risk for malnutrition. Results: 144 pts with NSCLC (72 male, 72 female, aged 67 ± 11 years) completed the questionnaires. Sixty-nine percent (99/144) had advanced disease. Fifty-six percent (81/144) of pts had a score ≥ 2 on the MST and 70 % (101/144) pts had a score ≥ 4 on the PG-SGA ( pt generated part). In 114 cases, the MST and PG-SGA scores were congruent: 76 were true positive and 38 were true negative. And in 30 cases the scores were discordant: 25 were false positive and 5 were false negative. The PG-SGA had a sensitivity of 94 % and a specificity of 60% in comparison to the MST. Conclusions: The pt-generated part of the PG-SGA alone had a sensitivity of 94% when compared to the MST. This tool could be used to screen for malnutrition risk in NSCLC pts attending an out-patient oncology clinic.
Multidisciplinary care clinics: A model to deliver personalized survivorship care.
Authors: Zandstra Fran , Palos Guadalupe R. , Russell Ludivine , Flores Jacklyn J , DeJesus Yvette , Foxhall Lewis E , Rodriguez Maria Alma 
Published: March 2020

e19629 Background: Multidisciplinary care models provide a comprehensive approach to improve the care of long-term cancer survivors as recommended by the Institute of Medicine report.. Here we describe a Multidisciplinary Survivorship Care Model and the metrics used to evaluate the delivery of personalized care to long-term survivors. Methods: Critical components used to develop survivorship services included: 1) engaging clinical and administrative leadership; 2) conducting extensive reviews/syntheses of published literature including health promotion, prevention and risk reduction, late treatment effects, and rehabilitative services for each disease-site; 3) determining eligibility criteria to transition patients from active-disease care to survivorship care; 4) developing, implementing, and evaluating algorithms by involving a multidisciplinary team expert-consensus; 5) obtaining approval for integration of algorithms into practice by institutional credentialing and regulatory committees; 6) identifying appropriate survivorship clinics to pilot the feasibility of algorithms in routine clinical operations; 7) performing improvement checks of the clinic operations; and 8) revising operations and scheduling as needed. Metrics used to evaluate the progress of the clinical activity of each multidisciplinary survivorship care clinic (MSCC) included number of unique patients transitioned, number seen, number of arrived appointments, number of summary care plans issued, and survivors’ satisfaction. Results: The MSCCs included gynecology, thyroid, genitourinary, stem cell transplant, breast, head and neck, colorectal, lymphoma, and melanoma, with varied launch dates for each clinic. Between 09/01/2008 and 12/31/2011, there were a total of 7396 unique survivors, 12,741 arrived appointments, and 10,016 summary care plans completed within 30 days from appointment. Conclusions: Dedicated multidisciplinary survivorship care models are a comprehensive approach to deliver long-term survivorship care. Comparative effectiveness and other health outcomes research examining the feasibility, usability, acceptance, and effectiveness of the MSCC by providers and survivors is warranted.