bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of complementary medicine (CAM) among women receiving chemotherapy for ovarian cancer: A comparison of attitudes between two patient populations
Authors: Helpman Bek L. , Ferguson S. E. , Mackean M. , Le L. , Rogerson A. , Dewan A. , Mackay H. 
Published: August 2020

e20545 Background: CAM use in cancer patients (pts) is common. The aim of this study was to compare patterns of CAM use and attitudes to CAM among ovarian cancer (EOC) pts in Canada and Scotland. Methods: Patients receiving chemotherapy for EOC in Princess Margaret Hospital (PMH), Toronto and the Edinburgh Cancer Centre (ECC), Scotland, completed a survey on CAM taken within the previous month as well as a questionnaire assessing patient attitudes and perceptions of CAM. A comparison between the 2 patient populations and between CAM users and non-users was made. Results: 194 pts (100 ECC: 94 PMH) were enrolled on study. The use of CAM in PMH was significantly higher than in ECC (52% vs. 36%, p=0.02). Whilst both populations thought it important for their oncologist to be aware of CAM usage (86% PMH: 93% ECC), pts from PMH were less likely to inform their compared to pts from ECC (50% vs 81%, p=0.02). Patterns of CAM use differed between the 2 populations: Multivitamins were the most common CAM in both populations (31% PMH:13% ECC). They were not considered CAM for the purpose of analysis. Most commonly used CAM in PMH were Soy products (12%), vitamin C (10%) and Green Tea (9%); in ECC pts used Omega 3 and fish oil (9%), Evening Primrose (7%) and vitamin C (6%). Although the majority of CAM users in both populations found CAM to be helpful (57% PMH: 61% ECC) only a minority thought they would cure their cancer (18% PMH: 6% ECC), prevent its spread (31% PMH: 14% ECC) or prevent a recurrence (20% PMH: 11% ECC). Users more often felt CAM relieved symptoms (45% PMH: 42% ECC), boosted the immune system (55% PMH: 56% ECC) or improved their quality of life (43% PMH: 53% ECC). ECC CAM users were more likely than PMH users to concede that CAMs have side effects (39% vs 29%) or could impact the efficacy of conventional treatment (17% vs 6%). CAM users were more likely than non-users to agree with positive statements and to disagree with negative statements about CAM. Conclusions: CAM use is common among pts receiving chemotherapy for EOC. CAM use was more prevalent among North American pts than Scottish pts. Attitudes and patterns of CAM usage differ and are culturally sensitive. Oncologists need to be aware of this when initiating discussion about CAM with their patients during cancer treatment. No significant financial relationships to disclose.
Platinum-based combination chemotherapy in the treatment of older non-small cell lung cancer (NSCLC) patients (pts): Is there a role for Complete Geriatric Assessment (CGA)? Final results from the prospective multicenter NVALT-3 study
Authors: Wymenga M. , Biesma B. , Vincent A. , Dalesio O. , Groen H. 
Published: August 2020

e20547 Background: Nearly 50% of NSCLC pts are aged over 70 years, but only few receive combination chemotherapy. CGA is often advocated to assess the benefits and risks of chemotherapy in older pts. Methods: A total of 182 NSCLC pts ≥ 70 years with stage IIIb/IV disease were randomized to 4 cycles carboplatin/gemcitabine (CG) or carboplatin/paclitaxel (CP). Primary endpoint was change in QoL at week18. At baseline, CGA was performed with nine different tests. Toxicity (tox) was scored using NCI-CTC v2. Tox related outcomes were defined as all grade III/IV tox, SAEs, ≥ grade II neurological or neuropsychiatric (NP) tox and the ability to finish all cycles. Relationship of CGA and QoL scores with tox endpoints were investigated. Results: Median age was 74 yrs (70–87). PS was 0 in 30%, 1 in 54% and 2 in 17%. Median OS was 8.6 mo (95% CI, 7.2–10.2) for CG and 6.9 mo (95% CI, 5.6–10.0) for CP. Median PFS was 4.7 mo (95% CI, 3.9–5.8) for CG and 4.5 mo (95% CI, 4.1–5.3) for CP. One year survival was 29% (95% CI, 21–41%) for CG and 23% (95% CI, 16–35%) for CP. There was no difference in the change in global QoL between arms. Quality-adjusted survival curves were not different. PS was prognostic, but not different for both arms. Pts with better Activities of Daily Living (ADL), instrumental ADL, or physical functioning were more likely to finish all chemotherapy cycles. Pts with worse emotional or role functioning or Geriatric Depression Score were more likely to experience NP tox. None of the CGA or QoL summary scores were associated with the occurrence of the other tox endpoints at p< 0.01. Conclusions: Carboplatinum based combination chemotherapy in older NSCLC pts is feasible. The choice for adding paclitaxel or gemcitabine to carboplatin cannot be made based on effects on QoL. CGA predicts toxicity to a limited extent but does not add substantial information to PS. No significant financial relationships to disclose.
Individual risk factors for venous thromboembolism (VTE) in cancer patients treated with targeted therapies (TT)
Authors: Soini B. , Caffo O. , Ferro A. , Ambrosini G. , Murgia V. , Valduga F. , Caldara A. , Eccher C. , Tumulo S. , Galligioni E. 
Published: August 2020

e20549 Background: Many anticancer drugs, alone or in combination, can significantly increase the risk of VTE in cancer patients. Vascular complications however, including VTE, have emerged as a relevant toxicity also with targeted therapies (TT) (Elice, Am. J. Hematol.2008). Recently, a simple model for predicting risk of VTE in cancer patients receiving chemotherapy (CT) has been developed, based on a number of clinical and laboratory variables (Khorana, Blood 2008). In this report, we have evaluated the incidence of VTE and assessed the predictive value of the Khorana's model, in cancer patients receiving TT, alone or combined with CT. Methods: From a consecutive series of 278 patients, treated with TT ± CT between January 2006 and August 2008, we have identified for each patient the baseline values, before TT treatment, of the following variables: age, performance status, primary site of cancer, stage, comorbidities, body mass index, hemoglobin, leukocyte and platelet count and use of erythropoiesis stimulating agents. All variables have been correlated with the occurrence of VTE, at the uni- and multivariate analysis. Results: TT treatment consisted of trastuzumab in 103 patients (37%), bevacizumab in 69 (25%), cetuximab in 29 (10%), rituximab in 41 (15%), sunitinib in 16 (6%), erlotinib in 12 (4%) and sorafenib in 8 (3%). In 163 patients (59%) TT were administered concurrently with CT. In a period of 2–360 days (median 125), 14 patients (5%) developed deep vein thrombosis, complicated by pulmonary embolism in 5. None of the variables of Khorana's model has shown any significant value, in predicting VTE risk, as well as any association with different TT (i.e. bevacizumab or sunitinib) or the concomitant administration of CT. Conclusions: In our experience, the Khorana's model does not appear able to predict the risk of VTE, in patiens receiving TT treatments. Other models may be required for identifying high risk patients, who would benefit from a prophylaxis of thrombotic events. No significant financial relationships to disclose.
Clinical findings and interventions in cancer patients referred to a cachexia clinic (CC)
Authors: Nooruddin Z. , Hui D. , Dalal S. , Bruera E. , Del Fabbro E. 
Published: August 2020

e20551 Background: The cancer-related anorexia/cachexia syndrome is primarily caused by an aberrant inflammatory response and neurohormonal dysfunction. Secondary causes that contribute to diminished nutrient intake include early satiety, constipation, nausea, vomiting, mood alterations, dysgeusia, and dysphagia. We determined the frequency and management of both secondary cachexia causes and metabolic/endocrine alterations in a new CC at a Comprehensive Cancer Center. Methods: We conducted a retrospective chart review of 159 consecutive patients who underwent structured assessments at the CC. Demographics, weight loss, secondary causes and specific treatments were analyzed. Results: The patients had the following characteristics: median age 59, females 39%, median body mass index 20.3, median weight loss over the preceding 3 months 7%, and hypoalbuminemia 76%. At consultation, 102 (64%) were on chemotherapy/radiation and 13 (8%) were on enteral or parenteral nutrition. Appetite stimulants prior to consult included megestrol (n=36, 22%), corticosteroids (n=21, 13%) and dronabinol (n=10, 6%). The median number of secondary causes was 3 (Q1-Q3 2–4), with a median of 2 (Q1-Q3 1–3) interventions per patient. 22 (14%), 105 (66%) and 32 (20%) patients had 0–1, 2–4 and 5–8 secondary cachexia causes, respectively. The table lists the significant findings and corresponding interventions. 52 (33%) were enrolled onto clinical trials for primary cachexia. Conclusions: A total of 411 treatable secondary cachexia causes and 89 endocrine/metabolic alterations were identified in our cohort. Low cost effective interventions were available for most of the common findings. [Table: see text] No significant financial relationships to disclose.
Media coverage of lung cancer
Authors: Blum D. , Boerckel W. 
Published: August 2020

e20565 Background: In 2000, a survey was conducted to assess media coverage for the four major cancers (breast, prostate, lung, colorectal). A 2004 follow-up survey revealed there were more lung cancer articles conveying positive messages and greater celebrity involvement and coverage of new treatments. A 2008 follow up survey was commissioned to determine whether the trend of increased coverage and favorability of message had persisted. Methods: Research firm Carma International analyzed a systematic random sample of 600 stories from U.S. media, including print, broadcast and web based sources (August, 2007-July, 2008). Coverage was analyzed by volume, story type, topics, awareness events and celebrity outreach. Topics and messages from this period were matched to those used in previous periods (August 1999 - July 2000, August 2003 - July 2004). Project parameters were held consistent between time periods to enable an accurate comparison of each cancer over time. Results: Lung cancer coverage experienced an increase in volume, up 23% (116 to143 stories) from the previous period, while breast cancer coverage increased 21% (333 to 402 stories). Lung cancer coverage was less positive with a drop to a slightly favorable rating of 48; research references declined from 29 to 14 and lung cancer garnered the lowest percentage of stories discussing treatment (14%); while tobacco/smoking references were found in 44% of lung cancer stories, up 31% from the earlier period and was the leading negative message. Positive message penetration declined over time for lung cancer coverage with 36% of stories carrying at least one positive message in 1999–2000 but only 28% in 2007–2008. Conclusions: While the volume of lung cancer coverage has increased significantly from over time, the tone of coverage has become significantly less favorable and more negative. Such findings identify a clear need to encourage media to consider how they report on lung cancer, specifically the prominence of smoking as a risk factor in cancer related stories, and to encourage reporting more hopeful messages including survivor stories, and new developments in lung cancer research/treatment. No significant financial relationships to disclose.
Use of the Prostate Cancer–specific Quality of Life Instrument (PROSQOLI) in clinical practice
Authors: Cescon D. W. , Canil C. , Le L. W. , Tannock I. F. 
Published: August 2020

e20569 Background: Improvement of quality of life (QOL) is a major therapeutic goal for men with advanced prostate cancer (APC). The PROSQOLI consists of a series of 9 linear analog self-assessment (LASA) scales that evaluate pain, fatigue, appetite, constipation and other symptoms, and overall well-being; it was designed and validated for use in patients with APC. Here we evaluate the use of a computer-based version of the PROSQOLI in routine clinical practice for its ability to stimulate recognition of symptoms and for its impact on clinical decision-making. Methods: Consenting patients with APC completed a touch screen version of the PROSQOLI before seeing the doctor at visits to the outpatient clinic. In phase I of the study physicians did not have access to this information; in phase II physicians were provided with results of the PROSQOLI and its changes from previous visits. Physicians’ recognition of symptoms, and changes in management were extracted from transcribed clinical notes. Results: 36 men were recruited, and data collected from 120 clinic visits (85 phase I, 35 phase II). Normalized symptom scores (0=none; 100 =very severe) were highest for fatigue (median = 42), followed by urinary problems (27) and mood (27) with no differences between phases. Median normalized pain scores were 25 in phase I and 11 in phase II (p=0.03). Changes in management occurred in 41% of phase I, and 43% of phase II visits (NS). Comparison of patient-assessed and physician-described symptoms was limited by lack of documentation in transcribed notes: mention of PROSQOLI symptoms ranged from 75% of visits for pain to 2/120 visits for mood. Presence or absence of fatigue and urinary symptoms were described at 53% and 40% of visits respectively. Rates of documentation did not differ between study phases. Conclusions: No impact on patient care could be demonstrated as a result of computer-based self-assessment of changes in symptoms and QOL. Prostate cancer-specific symptoms were poorly documented in clinical notes; improved recording of symptoms might be facilitated by the use of a tool such as the electronic touch-screen PROSQOLI. No significant financial relationships to disclose.
Do oncologists engage in bereavement practices? A survey of the Israeli Society of Clinical Oncology and Radiation Therapy (ISCORT)
Authors: Corn B. W. , Shabtai E. , Merimsky O. , Inbar M. , Rosenbaum E. , Meerovitz A. , Tamir R. , Wexler I. 
Published: August 2020

e20588 Background: What happens to the patient-physician relationship after the patient succumbs to the illness? To begin answering this question, we determined the extent to which oncologists are involved in bereavement rituals for their patients. Methods: An e-mail survey was sent to ISCORT oncologists querying them as to their involvement in bereavement rituals including funerals, visitations (e.g., shiva), condolence phone calls, and condolence letters. Results were described using summary statistics, Wilcoxon, and Fisher's exact test. Results: The survey response rate was 69% (126/182). Median age of respondents was 49 y and the male:female ratio was 2:1. Generally, only 2% of oncologists attend funeral services and 1% visit the family. A higher number telephoned the surviving family members (27%) or sent written condolences (18%). When a ‘special bond‘ developed between doctor and patient, there was a significant increase in those who attended the funeral (8%), participated in a visitation (18%), or made phone calls (54%), p < .0001 for all three rituals. There was no higher likelihood to participate in bereavement practices as a function of subspecialty (Medical v. Radiation v. Surgical Oncologist), gender, religiosity, or personal death anxiety. The rank ordered reasons for not participating in bereavement activities are lack of time, fear of burnout, need to maintain boundaries, and death anxiety. Males, more often than females, indicated that time constraints were the most important factor in determining their participation (P = .025). There was a weakly significant association between the physician's spirituality and participation in specific bereavement rituals. Interestingly, 11% of oncologists indicated that they would participate in bereavement visits if compensated for their time. Conclusions: Most oncologists do not engage in bereavement rituals for their deceased patients. When they do, they are less likely to attend a funeral or visit the family, and more likely to send a condolence card or call. No significant financial relationships to disclose.
Dyadic coping among breast cancer patients treated with radiotherapy
Authors: Pat-Horenczyk R. , Machyevsky D. , Brom D. , Schwartz I. , Inbar M. , Rice A. , Wexler I. , Corn B. 
Published: August 2020

e20589 Background: Cancer poses a major stressor for patients and their partners. Understanding dyad coping is useful for determining if one partner's involvement is beneficial or harmful to the other. We sought to evaluate whether dyadic coping enhances resilience in the context of other risk and protective factors for coping with serious illness. Methods: An IRB-approved questionnaire was offered to breast cancer patients and their spouses. Consent was obtained from 21 dyads who were queried prior to initiation of breast irradiation and within 2 weeks of completing treatment. The nature of dyadic coping (positive or negative), level of posttraumatic stress, functional impairment, depression, and markers of resiliency were assessed for each partner at the beginning and conclusion of therapy. Results: Depression was significantly higher in patients than in their spouses (df = 1, 13; F = 6.13; p = 0.028). Over the course of the radiotherapy, partner's depression improved while the patient's depression worsened (df=1,13; F=5.46; p=0.030). The patient's negative dyadic coping assessment before radiation therapy was positively associated with depression (β = 0.78; df = 31.3; t = 2.15; p = 0.04), as well as the partner's depression (β = 0.92; df = 31.3; t = 2.52; p = 0.017) and posttraumatic stress (β = 0.74; df = 31.7; t = 2.10; p = 0.04). Patient's pre-radiation negative dyadic coping was negatively associated with the partner's flexibility (β = -.21; df = 19; t = -2.28; p = 0.03) and self efficacy (β = 0.46; df = 21.8; t = 2.96; p = 0.007) at completion of therapy. Positive dyadic coping assessment was not associated with negative coping behaviors on the part of either the patient or partner. Conclusions: The results of this pilot study support interventions incorporating dyadic support to enhance the resilience of patients and partners. Intervention should promote flexibility and self-efficacy while providing tools for altering negative dyadic coping patterns. No significant financial relationships to disclose.
The era of oral drugs in oncology: What do patients think about their efectiveness?
Authors: Homet B. , Hitt R. , Ghanem I. , Malón D. , Cortés-Funes H. 
Published: August 2020

e20600 Background: With the growing number of drugs available for the treatment of cancer, most of them of oral administration, some aspects of the everyday clinical practice are changing. Interesting is the opinion of the patients (pts) about oral therapy. Methods: We researched differences in preference, tolerance, effectiveness, and safety by means of the delivery of a survey to (pts) who had received oral and intravenous (IV) treatment. One hundred and ninety (pts) were enrolled from September to November 2008. Results: Seventy percent of the (pts) studied were women, the median age at diagnosis was 60 years (range, 28 - 91 years). Fifty percent had gynaecologic tumors; thirty percent digestive; eighteen percent lung cancer and two percent other tumors, with a median of 3 different lines of therapy (range, 1 to 9). Patients preferred the oral route over the IV (76% vs. 20% respectively; P<0.001) and four percent had no preference. Tolerance was better with oral therapy (64%) than with (IV) chemotherapy (CT) (36%; P<0.001). When the (pts) were asked for effectiveness, sixty percent of them considered the (IV) chemotherapy more effective, while eleven percent chose oral therapy and twenty-nine percent found both equally effective (p<0.001). Sixty one percent of the (pts) evaluated as more secure (IV) chemotherapy, while eight percent did so with oral therapy and thirty one percent did not think that differences existed with one or another route of administration (p< 0.001). Conclusions: The constant evolution in cancer therapy and the increasing participation of (pts) in therapeutic decisions makes it imperative to know the opinion of (pts) on these new treatments. When patients are asked for tolerance or preference, the majority of them choose the oral route. However, when asked about important issues such as effectiveness or safety that offers a treatment, most of them prefer the intravenous route. No significant financial relationships to disclose.
Distal or proximal venous port device insertion: Results of a prospective randomized trial
Authors: Marcy P. , Chamorey E. , Macchiavello J. , Largillier R. , Peyrade F. , Ferrero J. , Hanoun-Levi J. , Poudenx M. , François E. , Frenay M. 
Published: August 2020

e20605 Background: Open, nonblinded, prospective, randomized, controlled trial comparing two techniques of venous port device insertion: percutaneous distal (phlebography-guided arm port- study technique- 2) vs proximal surgical (cephalic vein cutdown- control technique- 1) placement -To determine whether technique 1 is superior to technique 2. Methods: 230 eligible patients beginning a course of i.v. chemotherapy via a port device catheter with an expected duration of treatment of 3 months or longer were randomized (written informed consent). Eligibility criteria included adult patients with solid tissue malignancy (neuro oncology, gynecology, lung, abdominal, head§neck) beginning a course of I.V.chemotherapy, normal hemostatic parameters, no organ failure, a life expectancy >3months, WHO status<3. Exclusion criteria included current anticoagulant therapy, previous ipsilateral venous catheter/pacewires/surgical axillary node dissection/radiodermatitis, local tumor growth/sepsis, symptomatic brain metastasis, psychosis. The silicone rubber 7F catheter was connected to a 11mm port reservoir, and implanted under local anesthesia using either technique 1 or 2 after randomization. Outcome measurements included technical feasibility/procedure duration, port complications, quality of life (EORTC) questionnaires. Results: Median study duration was 12.2 vs 11.9 months (p: 0.9), median chemotherapy cycles were 6.0 in both groups. Patients groups differed significantly in venous access side (left access in group 2) and sex ratio (p=0.028). In group 2, technical success rate was higher (99 vs 91%, p<0.02), procedure was shorter: 18.0min (10.0–90.0) vs 21min (15.0- 45.0)(p<0.008), but global complication rate was higher (p<0.05). Device complication related explantation rate was 11.9 vs 2.8% (p=0.022). Conclusions: Both techniques are safe and effective. Despite a higher technical success rate and a shorter procedure duration, arm port insertion has a lower complication-free duration. Distal (arm port) technique should be recommended in young female cancer patients (neckline cosmesis/discretion), head and neck cancer patients, obese patients (upright position) and in patients presenting with respiratory insufficiency or at high risk for pneumothorax. No significant financial relationships to disclose.