bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post diagnosis weight gain and the role of exercise in breast cancer survivors.
Authors: Sanft Tara Beth , Alvarez-Reeves Marty , Irwin Melinda 
Published: March 2020

9007 Background: Obesity is linked to poor breast cancer (Br Ca) outcomes including higher risk of recurrence and death. No study has examined if post-diagnosis weight (wt) gain modifies the effect of exercise interventions on body composition. We examined wt change from diagnosis (diag) to enrollment (enroll) into a 6-mo randomized trial of exercise v. usual care to explore if post-diagnosis wt gain modified the effect of exercise on body wt, body fat, lean body mass (LBM) and bone mineral density (BMD) in breast cancer survivors. Methods: 75 inactive Br Ca survivors were recruited and randomized to exercise (n = 37) or usual care (UC) (n = 38). At baseline, women completed a questionnaire assessing self-report wt at diag and at the time of enroll into the study (~3 yr). The exercise group participated in 150 min/wk of supervised exercise. The UC group maintained their physical activity level. Body composition was assessed at enroll and 6-mo via dual-energy X-ray absorptiometry (DXA) by one radiologist blinded to intervention group. Results: Wt and DXA data were available for 68 / 75 participants. On average, women gained 3.3±8.2 kg from diag to enroll, with 53% gaining wt (mean = 8.9 ± 6.8 kg) and 47% maintaining or losing wt (mean change = -2.9 ±3.9 kg). The majority of wt gain occurred among women who were non-obese at diag (BMI < 30), with 60% of non-obese women gaining wt (mean = 8.0 ± 6.8 kg) compared with 38% of obese women gaining wt (mean = 12.2 ± 6.4 kg). Those randomized to exercise lost body fat including women who gained wt since diag (mean % fat loss for exercisers (-0.92 ± 0.31) vs. UC (0.36 ±0.30), p = .0063) and women who did not gain wt since diag (mean % fat loss for exercisers (-0.65 ± 0.39) vs. UC (0.45±0.47), p = .08) even after adjusting for obesity status at diag. Similar improvements in LBM and BMD were observed with exercise in women who did or did not gain wt since diag. Conclusions: Wt gain in Br Ca survivors is common, the majority of weight gain in this study occurred among women who were not obese at diag. Exercise led to body fat loss and other favorable body composition changes among both non-obese and obese women. Exercise and other wt management programs should be offered to all Br Ca survivors regardless of BMI at diagnosis as a strategy towards prevention of wt gain.
Falls, physical performance deficits, and functional losses in cancer survivors with chemotherapy-induced neuropathy (CIPN): A University of Rochester CCOP study.
Authors: Mohile Supriya Gupta , Fan Lin , Gewandter Jennifer S. , Mustian Karen Michelle , Peppone Luke Joseph , Heckler Charles E , Hopkins Judith O. , Dakhil Shaker R. , Miller Jessica , Morrow Gary R. 
Published: March 2020

9014 Background: CIPN impairs quality of life in cancer survivors. Little is known about the prevalence of falls, physical performance (PP) deficits, and functional losses or their association with CIPN toxicities in cancer survivors. Methods: We conducted an analysis of baseline assessments from a phase III randomized clinical trial in cancer survivors with CIPN self reported pain scores of > 4 reflecting leg and foot pain from neuropathy over the past 24 hours on a scale from 0 (“no pain”) to 10 (“pain as bad as you can imagine”). Patients also completed EORTC QLQ-CIPN-20 sensory and motor scales for neuropathy toxicities and self reported falls in the previous 3 months. A PP deficit was defined as “a lot of difficulty” or “unable to do” any of 6 physical tasks (e.g., lifting objects, walking a quarter of a mile). Functional losses were defined as “a lot of difficulty” or “unable to do” any of 5 functional tasks (e.g., managing money, bathing). We examined the association of baseline characteristics and CIPN toxicities with falls, PP deficits and functional losses using logistic regression. Results: Of 421 patients, 11.9% experienced recent falls, 58.6% reported a PP deficit, and 26.6% reported a functional loss. Patients with falls and/or PP deficits were more likely to be older (mean age 60.9 vs 58.9, p=0.02), female (75.3% vs 65.2%, p=0.03) and have less education (<high school: 7.1% vs 0.6%, p<.01). Cancer and chemotherapy history were not different between groups. Patients with falls and/or PP deficits reported higher severity of CIPN toxicities: pain (6.82 vs 6.05, p<0.01), sensory (23.3 vs 19.6, p<0.01), and motor (17.4 vs 12.7, p<0.01). In multivariable analysis, factors associated with having a fall and/or PP deficit included: older age (OR 1.03, p=0.04), low education (OR 9.34, p=0.04), and motor toxicity (OR 1.21, p<0.01). Factors associated with functional losses included: non-white race (OR 3.16, p=0.01), Hispanic ethnicity (OR 5.32, p=0.05), motor toxicity (OR 1.19, p<0.01), and PP deficit (OR 4.94, p<.01). Conclusions: CIPN toxicities, primarily motor, are significantly associated with falls, physical performance deficits, and functional losses.
A prospective study to evaluate the efficacy and safety of oral acetyl-L-carnitine (ALC) in treatment of chemotherapy-induced peripheral neuropathy (CPIN).
Authors: Sun Yuanjue , Liu Baorui , Liu Ping , Wu Changping , Zheng Rongsheng , Zhang Xiaohua , Zhuang Zhixiang , Deng Yongchuan , Zheng Leizhen , Xu Qing , Jiang Bin , Ouyang Xuenong , Gao Jianfei , Jiang Su , Zheng Wei , Li Benjamin Xiaoyi , Shu Yongqian , Yao Yang 
Published: March 2020

9017 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a major side effect of many commonly used chemotherapeutic. This side effect of chemotherapy can be debilitating and effective treatment for CIPN remains elusive. Previous studies demonstrated that Acetyl-L-Carnitine (ALC) is effective in attenuating CIPN, controlled study is needed to substantiate ALC’s effect in treatment of CIPN. Methods: This study was designed to evaluate the efficacy and safety of Acetyl-L-Carnitine (ALC) Hydrochloride Enteric-coated Tablet (oral administration) in the treatment of CIPN. It was a prospective, randomized, double-blinded, placebo-controlled and paralleled clinical study (registration No. 2007L03540). Of 239 subjects enrolled in the study (NCI grade 2 or above), 118 subjects received 3g/day ALC orally for 8 weeks and 121 received placebo. Primary endpoint was set as improvement of peripheral neuropathy at least 1 grade and assessment was made in week 4, 8 and 12 after enrollment. Results: In full analyses set (FAS) and per-proposal set (PPS), the peripheral sensory neuropathy was significantly ameliorated in ALC group with 50.5% and 51.6% patients meeting the primary endpoint at week 8 and 12 respectively while only 24.1% and 23.1% of patients in the placebo group at week 8 and 12 respectively (p<0.001 in both sets). Secondary endpoint such as nerve electrophysiological test and Physical Condition Score (Karnofsky performance status, KPS) were also significantly improved in patients with ALC treatment (in FAS, P=0.0463 and P=0.022; in PPS, P=0.0076and P=0.0064, respectively). Cancer-related fatigue was significantly alleviated after ALC treatment in PPS (P=0.0135). Safety: 236 subjects were included in safety assessment and 41 patients experienced 62 adverse events during the course of study. There was no significant difference in AE/SAE incidence between the two groups (P=0.3903). Conclusions: Oral administration of ALC is effective in attenuating CIPN as well as in reducing cancer-related fatigue and improving physical conditions in cancer patients. The treatment of oral ALC is safe and well tolerated.
Methylphenidate (MP) and nursing telephone intervention (NTI) for cancer-related fatigue (CRF) in advanced cancer patients: A double-blind randomized phase II trial.
Authors: Bruera Eduardo , Yennurajalingam Sriram , Perez-Cruz Pedro Emilio , Hui David , Frisbee-Hume Susan , Allo Julio , Palmer J. Lynn 
Published: March 2020

9023 Background: CRF is the most common and distressing symptom in advanced cancer patients. Preliminary studies support MP and NTI for CRF (Bruera et al. JCO 2006). The primary objective of our study was to determine the effect of MP as compared to placebo (P). A secondary objective was to investigate the role of NTI as compared to control telephone intervention (CTI). Methods: Advanced cancer patients with fatigue ≥4/10 on the Edmonton Symptom Assessment Scale (ESAS), normal cognition, no evidence of major depression and hemoglobin ≥8 were eligible. Patients were randomized to 4 groups in a 2x2 factorial design (MP+NTI, P+NTI, MP+CTI and P+CTI). Primary endpoint was Functional Assessment of Chronic Illness-Fatigue (FACIT-F) subscale scores between day 15 and baseline. The dose and duration of methylphenidate was 5 mg every two hours, as needed, up to 20 mg/day. We tested the median difference in FACIT-F subscale scores between the groups using the Kruskal Wallis test and Wilcoxon signed rank test. Longitudinal regression analysis was conducted with a mixed model. Results: Total accrual was 197. Mean (SD) age was 58 (12), female 67% (N=148), white 72% (N=136), gastrointestinal cancers were the most common 22% (N=41). Baseline FACIT-F subscores were similar among the 4 groups. The median FACIT-F subscores showed significant improvement between Day 15 and baseline for all four groups except for P+CTI (Table): MP+NTI (4.5, P=0.004), P+NTI (8, P<0.001), MP+CTI (7, P<0.001), and P+CTI (5, P=0.06), with no statistically significant difference between MP and P (6 vs. 6, P=0.89). Longitudinal regression analysis showed a time effect (P<0.001) and group differences for NTI vs. CTI with FACIT-F (P=0.13) and ESAS (P=0.03). Grade 3 toxicities were similar between the MP and P arms (34/93 vs. 24/97, P=0.09). Conclusions: MP was not effective as compared to P for CRF in advanced cancer patients. NTI may be effective and should be further studied. [Table: see text]
Effect of cancer cachexia on treatment toxicity in metastatic colorectal cancer patients: Results of a prospective multicenter study.
Authors: Barret Maximilien , Dalban Cecile , Taïeb Julien , Malka David , Mansourbakht Touraj , Latko Ewa , Antoun Sami 
Published: March 2020

9026^ Background: Malnutrition reduces tolerance to treatment and survival in numerous cancers, including metastatic colorectal cancer (mCRC). Previous studies have shown that chemotherapy toxicity may be linked to sarcopenia. We evaluated the effect of sarcopenia on chemotherapy toxicity among mCRC patients. Methods: In this prospective, cross-sectional, multicenter study, oncological and nutritional data were collected in all consecutive mCRC patients between March 7th and March 20th 2005 in three hospitals. Computed tomography (CT) images were analysed using Slice-O-Matic software V4.3 (Tomovision) to evaluate cross-sectional areas (cm2) of muscle tissue (MT), visceral and subcutaneous adipose tissue (VAT and SAT). The 3rd lumbar vertebra (L3) was chosen as a reference, since L3 and whole-body measurements are linearly related. Indexed on height, MT, VAT and SAT (cm2/m2), were computed and described, after stratification on sex. In accord with the literature, sarcopenia was defined as MT <55 cm2/m2 for men and <39 cm2/m2 for women. Images were obtained within one month of clinical evaluation. Toxicities were evaluated according to the NCI-CTC, version 3.0, in the two months following clinical evaluation. Results: 53 mCRC patients (72% men (M)), participated in the study. According to body mass index (BMI) only 7% of female patients (F) and 3% M were malnourished (BMI<17 kg/m²), and 93% F and 97% M were of normal weight or overweight (BMI> 25kg/m²). These results are to be compared to the 38% (F) and 82% (M) of patients with sarcopenia. Grade 3-4 toxicities were observed in 28% of the cases, with neurotoxicity in 6%, diarrhea 2%, anemia 2%, neutropenia 9%, and nausea and vomiting 6%. In multivariate analysis including age, sex, BMI, sarcopenia, SAT and VAT, the only factor associated with grade 3-4 toxicity was sarcopenia (OR= 13.55 95% CI [1.08;169.31], p=0.043). Conclusions: In mCRC patients undergoing chemotherapy, low muscle tissue was much more frequently observed (68%) than “visible” malnutrition (4%). Despite the small number of patients included in our study, we showed that sarcopenia was associated with severe chemotherapy toxicity in mCRC.
A randomized controlled trial of expressive writing for patients with renal cell carcinoma (RCC).
Authors: Burnight Timothy , Wood Christopher G. , Tannir Nizar M. , Jonasch Eric , Pisters Louis L. , Matin Surena F. , Spelman Amy , Wei Qi , Cohen Lorenzo 
Published: March 2020

9029 Background: Most previous research examining the efficacy of brief expressive writing interventions have used small sample sizes and followed people for no more than 3 months. We conducted a large randomized trial to examine an expressive writing intervention for patients with renal cell carcinoma and followed them for 10 months after the end of the writing sessions. Methods: Two hundred patients with RCC were randomly assigned to either write their deepest thoughts and feelings about their cancer (EW) or to write about neutral topics (NW) on four separate occasions over 10 days for a maximum of 20 minutes at each writing session. Patients completed the MD Anderson Symptom Inventory (MDASI), Brief Fatigue Inventory, SF-36, IES, CES-D, and PSQI at baseline and then again 1, 4, and 10 months after the writing sessions. Results: The mean age of the participants was 58 (range 34-82 years), 41% were women, and staging data were 39% stage I, 15% stage II, 19% stage III, and 27% stage IV. The groups were well balanced on all demographic and medical characteristics. Examination of group differences 1 month after the writing sessions, controlling for the respective baseline measure, revealed decreased IES scores for the EW group (intrusive thoughts: EW, 5.0 v NW, 7.2; p<.02; avoidance behaviors: EW, 6.3 v NW, 8.7; p<.07). By 4 months after the intervention, the EW group reported higher levels of SF-36 Social Functioning scores (EW: 52.6 v NW: 49.7; p<.04). At the 10 month time point, the EW group reported fewer cancer-related symptoms (EW: 20.8 v NW: 30.8; p<.04), higher levels of SF-36 Role Physical scores (EW: 69.6 v NW: 54.0; p<.02), and fewer sleep disturbances (subscale of the PSQI; EW: 1.4 v NW: 1.6; p<.05). Means for the other SF-36 subscales at 10 months were in the expected, but did not reach statistical significance. There were no group differences for CES-D or fatigue scores at any time point. Mediation analyses revealed that IES scores at 1 month mediated the effects of EW on cancer-related symptoms (F= 1.85, p<.06) at the 10 month follow up. Conclusions: These findings indicate expressive writing leads to short-term reduction in intrusive thoughts about the cancer experience and results in long-term improvement in aspects of quality of life.
Strength and endurance training in the treatment of lung cancer patients staged IIIA/IIIB/IV.
Authors: Henke Corinna C. , Cabri Jan , Fricke Lothar , Pankow Wulf , Kandilakis Giannis , Feyer Petra C. , De Wit Maike 
Published: March 2020

9033 Background: This RCT tested the effect of a specially designed strength and endurance training on the independence in activities of daily living and quality of life in lung cancer patients staged IIIA/IIIB/IV while receiving palliative chemotherapy. The aim was to break the vicious circle created through the connection of physical inactivity and the worsening of symptoms and side effects. Methods: Between August 2010 and December 2011 lung cancer patients staged IIIA/IIIB/IV with a good performance status receiving an inpatient palliative chemotherapy treatment at the Vivantes Hospital Neukölln/Berlin, were randomized into an intervention and control group. The Barthel Index and the EORTC QLQ-C30/ LC13 questionnaire were used for evaluation. The Six-Minute-Walk-Test and stair walking in combination with the Modified Borg Scale have been used to test the patient’s endurance capacity. Furthermore muscle strength was examined. Non-parametrical data were statistically analyzed with the Wilcoxon and Mann-Whitney-U test. For parametric data student t- tests were used. A significance level of p< .05 was accepted. Results: Out of 46 patients, who signed the informed consent, 29 patients completed the trial (18= Intervention group, 11= Control group). Significant differences between the groups were detectable in the Barthel Index (IGmean(SD)=92.08 (15.15); CGmean=81.67 (14.98); p=.041), and in single scores of the EORTC QLQ C-30/LC-13 questionnaire (Physical Functioning p=.025; Haemoptysis p=.019, Pain in Arms or Shoulder p=.048, Peripheral Neuropathy p=.050, Cognitive functioning p=.050). Significant differences were found between the groups concerning the 6MWT, stair walking and strength capacity (IG>CG). Additionally the level of dyspnoea decreased significantly in the IG while performing submaximal walking activities. Conclusions: The training program has a positive impact on the patient’s independence in carrying out activities of daily living. Although it does not have a significant impact on the patient’s quality of life, single factors can be significantly improved. Moreover it has a positive effect on the patient’s endurance and strength capacity. The dyspnoea perception is improved.
Factors associated with life expectancy (LE) < 3 months (mo) among older adults receiving palliative chemotherapy (chemo).
Authors: Hurria Arti , Hardt Molly , Tew William P. , Mohile Supriya Gupta , Owusu Cynthia , Gross Cary P. , Gajra Ajeet , Lichtman Stuart M. , Katheria Vani , Ramani Rupal , Zavala Laura , Klepin Heidi D. ,   on behalf of the Cancer and Aging Research Group (CARG)
Published: March 2020

9034 Background: Optimal treatment decision-making for older adults with advanced cancer requires a better understanding of risk factors associated with limited LE. Our objective was to evaluate the factors associated with LE< 3mo among patients (pts) age > 65 who were beginning a new chemo regimen. Methods: We conducted a secondary analysis of a multi-site cohort study of pts ≥65 years receiving chemo (Hurria et al, JCO 2011). This analysis included only pts receiving palliative chemo. Bivariate analysis and multivariate logistic regression were utilized to identify factors associated with LE < 3 mo including: sociodemographics, labs [hemoglobin (Hb), albumin, liver function, creatinine clearance], and geriatric assessment (GA) variables (functional status, social support, comorbidity, psychological, cognitive, and nutritional status). Results: Among 290 pts (median age 72 [range 65-91], 52% female) with advanced cancer (gastrointestinal 28%, lung 31%, breast/gyn 22%, other 19%), 13.4% died within 3 mo of chemo initiation. In bivariate analysis, pts with LE < 3mo were more likely (p<0.05 for each variable) to have lower albumin and Hb, unintentional weight loss, and poorer physical function [defined as need for assistance with instrumental activities of daily living (IADL), lower score on Medical Outcomes Survey (MOS) Physical Health, MD-rated and patient-rated Karnofsky performance status (KPS), and MOS Social Activity score]. Measures of functional status were highly correlated with one another and therefore one functional status measure (in addition to measures significant in bivariate analysis) was included in each multivariate logistic regression. In multivariate analyses, (controlling for age, comorbidity, and line of chemo) poorer physical function (as evaluated by need for assistance with IADLs, MOS Physical <70, or MD-rated KPS <70) and unintentional weight loss were independently associated with LE<3mo (p<0.05). Conclusions: Among older pts with advanced cancer who were prescribed a new chemo regimen for palliative intent, physical function measures (as evaluated by geriatric assessment and MD report) and unintentional weight loss were associated with LE < 3months.
The influence of age plus standard clinical approach with or without comprehensive geriatric assessment (CGA) on treatment decisions in older cancer patients: Final results.
Authors: Decoster Lore , Kenis Cindy , Van Puyvelde Katrien , De Greve Jacques , Conings Godelieve , Knapen Marie Claire , Lobelle Jean Pierre , Milisen Koen , Vanorle Katrien , Flamaing Johan , Wildiers Hans 
Published: March 2020

9035 Background: The aim of this prospective study was to examine how age and standard clinical approach with and without CGA results determine treatment decisions in older cancer patients (pts). Methods: This study,conducted in 2 Belgian university hospitals, included pts ≥ 70 years with a malignant tumor (breast, colorectal, ovarian, lung, prostate and hematological) if a new cancer therapy was considered. All pts underwent a uniform CGA. Results were communicated to the treating physician. After the treatment decision, an interview with the treating physician was performed, using a predefined questionnaire: 1/ What would be your oncological treatment proposal in case the pt was 55y without other comorbidity? 2/ Is this different from your treatment proposal for this pt according to age and standard clinical approach without CGA results? 3/ Is this different from your treatment proposal for this pt with CGA results? Results: From October 2009 till July 2011, 937 pts were included in the study. Median age was 76y (range 70-95) and 63.5% was female. A total of 902 (96.3%) questionnaires were completed and 56.2% of the physicians were aware of the CGA results at treatment decision. In 381 pts (42.2%; 95%CI 39.0-45.5) age and standard clinical approach led to a different treatment decision compared to younger pts without comorbidity. This influence was most prominent for chemotherapy decisions: 309 patients did not receive standard chemotherapy (reduced dose (13), less toxic regimen (163), less toxic regimen at reduced dose (5) or no chemotherapy (128)). When the physician was aware of the CGA, these results influenced their treatment in 6.7% (95%CI: 4.5-8.9), mostly concerning chemotherapy. In 8 pts CGA results encouraged the treating physician to choose a more aggressive chemotherapy regimen and in 11 pts CGA results led to a decision of palliative care. Conclusions: Based on this prospective trial, we conclude that physicians use adapted treatment regimens in older versus younger pts, only based on age and standard clinical approach. CGA results change the treatment decision in 6.7% and sometimes trigger the use of a more aggressive treatment.