bluuebunny/crossref_metadata_2025_split huggingface dataset:
N-terminal pro-brain natriuretic peptide levels after receipt of anthracycline for breast cancer.
Authors: Patel Shruti R , Herrmann Joerg , Vierkant Robert A. , Olson Janet E. , Couch Fergus , Hazim Antonious Ziad , Loprinzi Charles L. , Ruddy Kathryn Jean 
Published: May 2020

e24103 Background: Many of the 200,000 patients diagnosed with breast cancer (BC) annually in the United States receive anthracycline-based therapy, increasing their risk of future congestive heart failure. N-terminal brain natriuretic peptide (NT-proBNP) has been used as a biomarker of asymptomatic cardiac dysfunction in the general population and is of interest to identify patients who might benefit from echocardiography during survivorship. This study aimed to assess how age, baseline comorbidities, and time since BC diagnosis impact NT-proBNP levels after anthracycline-based chemotherapy. Methods: This retrospective study, using samples collected in our ongoing prospective Mayo Clinic Breast Disease Registry, included 20 survivors of non-metastatic BC patients per year for each of the first 5 years after anthracycline-based chemotherapy (n=100 total). NT-pro-BNP levels were assessed using a Roche immunoassay. Cardiac risk factors were obtained by chart review. Multivariable linear regression models assessed associations between NT-proBNP values and these independent variables: baseline cardiac risk factors (including hypertension, hyperlipidemia, obesity, diabetes mellitus, and smoking), tumor ER status (surrogate for possible endocrine therapy), time between diagnosis and serum collection, T and N status, use of trastuzumab, and age. Results: The mean age at the time of BC diagnosis was 52.2 (SD 9.8). 13% of tumors were human epidermal growth factor receptor (HER2)-positive and 71% were estrogen receptor (ER) positive. NT-proBNP was elevated in 34%. Mean NT-BNP level was higher (p=0.047) for those in years 4-5 (158 pg/mL) compared to those in years 1-3 (106 pg/mL) (See Table.) Models revealed years from diagnosis to serum draw (p=0.026), older age (p=0.006), more cardiac risk factors (p=0.064), and N2-3 (p=0.001) were associated with elevated NT-pro-BNP level. Use of trastuzumab, ER status, and tumor size were not associated with NT-proBNP. Conclusions: NT-proBNP is elevated in 1/3 of survivors who received anthracycline therapy for BC. As expected, cardiac risk factors and advancing age are associated with higher NT-proBNP. NT-proBNP values >300 were only found in patients who were 4-5 years after diagnosis. Additional research will be needed to further define the diagnostic and prognostic merit of NT-proBNP in survivors after receipt of anthracycline therapy. [Table: see text]
Assessment of scalp cooling to prevent chemotherapy-induced alopecia using standard infusion room documentation and patient surveys.
Authors: Hagigeorges Dina , Bartholomay Mimi , Senna Maryanne M , Isakoff Steven J. 
Published: May 2020

e24106 Background: Chemotherapy induced alopecia (CIA) is one of the most distressing reported side-effects of cancer treatment, with patients (pts) reporting negative impacts on self-image and quality of life. Scalp cooling (SC) devices can prevent CIA. SC efficacy varies by chemotherapy regimen and dose, and taxane-based therapies report better outcomes. Here we report the efficacy of SC with the Paxman SC system using a standard infusion room nursing assessment and patient surveys. Methods: Pts using SC at the MGH Cancer Center between 4/2018 and 12/2019 were included in the analysis. Routine infusion room nursing assessments included CTCAE 4.0 grading for alopecia. A retrospective review of SC pts with documented CTCAE grades was conducted with success defined as grade (Gr) 0 or 1 alopecia at the final infusion. CTCAE results were compared to patient surveys of self-assessed success. Additional data include disease type, regimen and SC discontinuation details. Results: 64 pts who initiated SC and had CTCAE grade recorded were included. The most common chemotherapy regimens were docetaxel/cyclophosphamide (33%), docetaxel/carboplatin/trastuzumab/pertuzumab (19%), paclitaxel/trastuzumab (16%) and paclitaxel weekly/pertuzumab/trastuzumab (6%). Breast cancer was the most common disease type (92%). 77% of pts had successful hair retention (Gr 0 = 23 (36%), Gr 1 = 26 (41%)). 3 pts received anthracycline-based therapy and 1 successfully retained hair. Among 11 pts who completed post-treatment surveys, patient reported outcome and CTCAE were concordant in 9 (82%) pts. 13 (20%) pts terminated SC early; 9 (69%) after 2 treatments (tx), 2 (15%) after 3 tx, 1 (8%) after one tx and 1 (8%) after 5 tx. The most common reason for early dc was extent of alopecia (10, 77%). Other factors in the decision were time and discomfort. Of the 51 pts who completed SC for the entire chemotherapy tx, 48 (94%) received a taxane-based regimen and 46 (90%) had successful hair retention. Conclusions: In this single institution experience, we observed a high success rate of scalp cooling to prevent chemotherapy induced alopecia in a population of mostly breast cancer patients receiving taxane-based regimens. Concordance between patient reported outcome of success and routine standard of care nursing CTCAE documentation in the electronic medical record provides a simple and accurate method to monitor outcomes with scalp cooling. Despite high success, 20% discontinued SC, suggesting further studies to improve outcomes and tolerability are needed.
Finding a risk assessment model for thromboembolic events in hospitalized cancer patients: The Indicate Study.
Authors: Platania Marco , Nichetti Federico , Provenzano Leonardo , Montelatici Giulia , Franza Andrea , Porcu Luca , De Braud Filippo G. 
Published: May 2020

e24108 Background: Hospitalized cancer patients are at increased risk for Thromboembolic Events (TEs). Given the hemorrhagic risk associated with untailored thromboprophylaxis, the identification of patients at low TE risk who might not receive it during in-hospital stay would be clinically useful. Methods: The INDICATE study was a monocentric, observational study enrolling patients with active solid malignancy hospitalized for at least two nights for treatment administration, diagnostic procedures or acute medical illness (excluding TEs). The primary objective was to assess the Negative Predictive Value (NPV) of low-grade Khorana Score (e.g. KS = 0), evaluated at the time of patients’ in-hospital admission, for TEs prediction during and after (next 45 days) hospitalization. The primary analysis was conducted on patients with KS = 0. However, all-grade KS patients were enrolled for secondary outcomes analysis. Assuming a 7% of TEs as the unsatisfactory percentage and a 3% as the satisfactory percentage, expecting about 5% of collected data as incomplete, all consecutive patients who fulfil the inclusion criteria irrespective of the KS were enrolled, until a total of 149 patients with KS = 0 were included to detect the favorable NPV with one-sided alpha equal to 0.10 and power equal to 0.80. Results: Between November 2016 and May 2019, a total of 535 patients were enrolled. Among these, 153 (28.6%) had a KS = 0. The primary study endpoint was met: 29 (5.4%) patients received a diagnosis of TEs during or after hospitalization, with 7 (4.6%) cases in the KS = 0 group. However, patients with higher KS values did not show increasing TE incidence. Among the other evaluated risk assessment models, the ONKOTEV scoreshowed the best predictive potential, with significantly higher values in patients with TEs (p < 0.001).Of note, TEs were associated with poorer overall survival (median, 6.7 vs 24.8 months, log rank p < 0.001). Conclusions: The INDICATE study showed that hospitalized cancer patients with KS = 0 at admission have a low risk of TEs, and could thus be spared from routine thromboprophylaxis. Further studies are needed to better define a RAM in this population.
A pilot randomized, placebo-controlled, double-blind study of omega-3 fatty acids to prevent paclitaxel-associated acute pain syndrome.
Authors: Dayao Zoneddy R. , Brown-Glaberman Ursa Abigail , Pankratz V. Shane , Chen Lu , Lafky Jacqueline M. , Loprinzi Charles L. , Barton Debra L. 
Published: May 2020

e24115 Background: Paclitaxel, a widely used chemotherapeutic agent, is associated with an acute pain syndrome (P-APS) and chronic chemotherapy-induced peripheral neuropathy (CIPN). Currently, there is no standard of care for P-APS. Commonly used analgesics, including NSAIDs and narcotics, have considerable toxicity profiles. Omega-3 fatty acids, a common dietary supplement, have well established anti-inflammatory and neuroprotective properties. The primary aim of the study was to assess if omega 3 fatty acids could prevent P-APS. Methods: Patients scheduled to receive weekly paclitaxel (70-90mg/m2) were randomized to receive 4 g of omega-3 acid ethyl esters (Lovaza) or placebo, beginning 1 week prior to starting paclitaxel and continued until paclitaxel was discontinued. Patients completed acute pain questionnaires at baseline, Days 2-7, prior to each subsequent treatment and one month after completion of therapy. The EORTC- QLQ CIPN 20 questionnaire was completed prior to each dose of paclitaxel and 1 month after completion. The primary objective was to compare the effect of omega 3 fatty acids, versus placebo, on the maximum pain score for the week following the 1st treatment and each subsequent paclitaxel treatment, and to compare pain medication use between the 2 arms. The secondary objective was to compare the effect of the intervention on the severity of CIPN. Results: 49 patients were randomized to treatment versus placebo. Linear mixed effects models were applied with the addition of a bootstrap approach to overcome limitations in the distributional assumptions to compare outcomes between treatment groups. Placebo results were similar to the reported natural history of P-APS. There was no significant difference in trends over time between the 2 groups in the maximum pain score at week 1 (p = .14) and over 12 weeks (p = .21). There was also no difference noted in the rates of use of over the counter analgesics (p = .39) and narcotics (p = .46). CIPN results did not differ between the 2 groups (p = .08). Conclusions: The results of this pilot study do not support the use of omega-3 fatty acids for the prevention of paclitaxel-associated pain syndrome. Clinical trial information: NCT01821833 .
A phase III randomized clinical trial of diclofenac versus tramadol for mucositis-related pain in head and neck cancer patients undergoing concurrent chemoradiation.
Authors: Dhumal Sachin Babanrao , Noronha Vanita , Patil Vijay Maruti , Joshi Amit , Menon Nandini Sharrel , Jain Parmanand , Prabhash Kumar 
Published: May 2020

e24124 Background: Oral mucositis related pain during CTRT in head and neck cancers is a common problem. Unfortunately, in spite of it being common, there is limited evidence for selection of systemic analgesic in this situation. Hence, this study was designed to compare the analgesic effect of an NSAID (diclofenac) versus a weak opioid (tramadol). Methods: This was an open-label, parallel design, superiority randomized controlled study. In this study head and neck cancer patients undergoing radical or adjuvant chemoradiation, who had grade 1 or above mucositis (in accordance with CTCAE version 4.03) and had pain related to it were randomly assigned to either diclofenac or tramadol for mucositis related pain control. The primary endpoint was analgesia after the 1st dose. The secondary endpoints were the rate of change in analgesic within 1 week, adverse events, and quality of life. Results: 128 patients were randomized, 66 in diclofenac and 62 in tramadol arm. The median AUC for the diclofenac arm and the tramadol arm were 348.936 units (Range 113.64-1969.23) & 420.87 (101.97-1465.96) respectively (p = 0.05619). Five patients (8.1%) in the tramadol arm and 11 patients (16.7%) in the diclofenac arm required a change in analgesic within 1 week of starting the analgesic (p = 0.184). There was no statistically significant difference in any adverse events between the 2 arms. However, the rate of any grade of renal dysfunction was numerically higher in diclofenac arm (10.6% versus 4.8%, p = 0.326). Conclusions: In this phase 3 study, evaluating diclofenac and tramadol for Chemoradiation induced mucositis pain, the analgesic efficacy of both analgesics was found to be similar but diclofenac was associated with a higher rate of renal dysfunction. Clinical trial information: CTRI/2016/09/007302 .
Prevalence of chemotherapy-induced nausea and vomiting with moderately emetogenic chemotherapy in platinum-based regimens.
Authors: Shah Nilomi , Nishimura Kris , Tan Evelyn , Hsu Hana 
Published: May 2020

e24131 Background: Kaiser Permanente East Bay considers cisplatin ≤40 mg/m2, carboplatin at any AUC, and oxaliplatin at any dose as moderate emetogenic risk where patients are administered 5-hydroxytriptamine type 3-receptor antagonist (5-HT3 RA) and dexamethasone. However, national guidelines differ in their management with cisplatin and carboplatin of AUC ≥4. Moreover, it has been noted within our institution that patients receiving oxaliplatin often require escalation of antiemetic regimen despite 5-HT3 RA and dexamethasone prophylaxis. The objective of the study was to determine the prevalence of CINV in patients receiving platinum-based chemotherapy despite moderate prophylaxis for cycle 1. Methods: The study was a retrospective single-center cohort-control analysis assessing patients from Kaiser Permanente East Bay initiated on cycle 1 with carboplatin AUC ≥4, low dose cisplatin ≤40 mg/m2, or any dose of oxaliplatin. Evaluation of CINV was defined as rates of no complete response (emesis or use of rescue) during the acute (0 – 24 hours), delayed (24 – 120 hours) and overall periods (0-120 hours) after cycle 1 of treatment. A descriptive analysis was performed for the primary endpoint where the rate of no complete response (emesis or use of rescue) was expressed using the percentage of patients with the outcome. For the secondary endpoint, the patient-related risk factors associated with no complete response were determined by chi-squared for univariate covariates. Results: Between January 2016 to August 2019, 90 patients on cisplatin ≤40 mg/m2, 243 patients on carboplatin AUC ≥4, and 204 patients on any dose of oxaliplatin were enrolled in the study. The percentages of patients who had no complete response were 16%, 13%, 11% in the acute phase; 39%, 34%, and 38% in the delayed phase; 47%, 36%, and 39% in the overall phase, respectively. Univariate analysis using chi-squared revealed that age less than 60 years and females were associated with an increased risk for no complete response in the overall phase. In contrast, prior chemotherapy was significantly associated with a decreased risk in the overall phase. Conclusions: The prevalence of CINV despite moderate antiemetic management at Kaiser Permanente East Bay is more prominent in the delayed phase compared to the acute phase and consistent with trends determined in literature. Patients who are younger than 60 years of age, who are female, or had no prior history of chemotherapy are relevant risk factors associated with CINV in our patient demographics.
Advanced cancer patients' (CP) attitudes and perceptions regarding reasons for outpatient supportive care (SC) referral at a comprehensive cancer center: A randomized controlled study.
Authors: Wong Angelique , Fossella Frank V. , Simon George R. , Maddi Rama , Lu Zhanni , Williams Janet L. , Thomas Lisa , Liu Diane D. , Wu Jimin , Hui David , Bruera Eduardo , Yennu Sriram 
Published: May 2020

e24135 Background: Current ASCO guidelines propose early access to SC in all CP to improve quality of care, quality of life, and symptoms. Very few studies have evaluated patients’ perceived criteria for referral to outpatient SC and perceptions of patients who are referred early in their disease trajectory. Methods: In this study we evaluated CP attitudes and perceptions regarding the role of and access to outpatient Supportive Care clinic (SCC) at a comprehensive cancer center. CP with life expectancy of greater than 6 months (as determined by the oncologist) and who are newly registered at MD Anderson Cancer Center were randomized to either obtain an educational brochure that explained the role of the SCC or no brochure. Both groups then completed a survey regarding the role and access to of outpatient SCC. After completion of the survey, patients were asked if they would like to be seen by the SC team. If so, they were scheduled by their oncologist for a SC consult. Results: 288 patients were evaluable: median age was 63, 43% were female, 84% were Caucasian, and the most common cancer type was lung cancer (39%). Median survival was 15 months. Patients who received a brochure reported more understanding of the role of SC vs those who did not receive a brochure (63% vs 37%, p = 0.04). Both groups felt that SC could help to address physical (47% vs 54%) and psychosocial (50% vs 50%) symptoms. Both groups felt SC could help to address questions regarding prognosis (50% vs 50%) and future care (53% vs 47%). Both groups did not feel that time (50% vs 50%) nor financial concerns (49% vs 51%) would be barriers to access SC. Both groups did not feel that receiving SC would impede their cancer care (60% vs 40%) nor change their oncologists’ perspective of them (25% vs 75%). Both groups felt they could receive SC and cancer care simultaneously (50% vs 50%). Approximately half of the patients in both groups perceived it was not too early for a referral to SC. There were no statistical differences in these groups for these findings. Conclusions: Patients who received a brochure had a better understanding of the role of SC. A very significant proportion in both groups had limited awareness of the value of SC. Oncologist driven referral and education of SC may facilitate better understanding of the value of SC. Further studies are needed.
Correlational study of different analgesic programs on patients' quality of life, mood, and dignity.
Authors: Wang Long , Zhang Xue , Liu Zhimin , Shan Mei , Hu Xinyan , Zuo Jing , Wang Yudong , Fan Zhisong , Cui Yanzhi , Jiang Da 
Published: May 2020

e24139 Background: To evaluate the effects between oral sustained release opioids and other analgesic drugs on the quality of life, mood and dignity of patients with cancer pain. Methods: Participants were cancer patients with cancer pain recruited from a tertiary cancer hospital in North China. Patients were divided into group A (oral sustained-release strong opioids,) and group B (non-sustained release strong opioid analgesia, as tramadol, oxycodone aminophenol, non-steroidal analgesia, etc.) to assess their quality of life, mood and dignity. Data were collected using the Patient Dignity Inventory, the MD Anderson Symptom Inventory–Chinese, the distress thermometer, the Hospital Anxiety and Depression Scale, and the 30-question core Quality of Life Questionnaire from the European Organisation for Research and Treatment of Cancer, and were analyzed using quantitative methods. Results: The study included 297 cancer pain patients, including 172 males and 125 females, with a median age of 58 years, most of whom were lung cancer (n = 88), esophageal/gastric cancer (n = 63) and colorectal cancer (n = 52). Patients in group A(n = 224) had better pain control (P < 0.001), symptom burden (P < 0.001), psychological distress (P < 0.001), anxiety (P = 0.001) and Sense of dignity (P = 0.014) than those in group B(n = 73). In terms of quality of life assessment, patients in group A were more likely to suffer from nausea and vomiting (P = 0.003), and patients in group A were better than those in group B (Ps < 0.05), except for the similarity of social cognitive function, decreased appetite, diarrhea and constipation. Conclusions: The analgesic program with oral sustained - release strong opioids for cancer pain patients not only has better analgesic effect than other programs, but also has obvious advantages in physical symptoms, psychological emotion, sense of dignity and overall quality of life.
Effect of music therapy on symptoms, adverse events, and quality of life of breast cancer patients undergoing chemotherapy: A randomized clinical trial.
Authors: Cossetti Leal Rachel Jorge Dino , Lima Talita Uchoa , Pereira Emanuel Cabral , Nascimento Raniere Victor Braga , Oliveira Eduardo José Silva Gomes , Oliveira Caio Marcio Barros , Moura Ed Carlos Rey , Nogueira Neto Joao , Leal Plinio da Cunha 
Published: May 2020

e24140 Background: Music can influence human behavior and may be used as complementary therapy in health care. Objective: To assess the effect of music therapy on symptoms, adverse events and quality of life (QoL) of breast cancer patients undergoing chemotherapy (CT). Methods: Non-blinded, randomized clinical trial. Patients were randomized into two groups: musical group (MG) or control group (CG), and followed during the first 3 cycles of CT. Sociodemographic data, WHOQOL-BREF, BDI-II, BAI and Chemotherapy Toxicity Scale were assessed. Patients were evaluated after each of the first three CT cycles. MG underwent a 30-minute musical intervention prior to CT. There was no intervention in the CG. Results: Higher QoL scores on functional scales were observed for the MG in comparison to the CG after the first and third sessions of chemotherapy. Depression (p < 0.001) and anxiety scores (p < 0.001) and vomiting (p 0.01) incidence were lower for the MG in the third CT session. All participants in the MG reported positive changes in life in the Subjective Impression of the Subject questionnaire, as well as improvement in fatigue and reduced stress levels. Conclusions: Improvements in QoL, anxiety, depression, and incidence of vomiting were associated with music therapy intervention, suggesting a positive effect of music therapy on adverse events of cancer CT. Clinical trial information: RBR-88r347 .