bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment pattern trends of erythropoiesis-stimulating agents used for chemotherapy-induced anemia by U.S. community oncologists from 2008 to 2011.
Authors: Wang Zhaohui , Katler Ann , Todoroff Karen , Bergstrom Kimberly A. 
Published: March 2020

e20649 Background: In 2007 the FDA and national treatment (tx) guidelines recommended restricting use of erythropoiesis-stimulating agents (ESAs) to treat chemo-induced anemia (CIA). This study examines ESA tx started for CIA in non myeloid cancer (NMC) patients (pts) by U.S. community oncologists from 2008 to 2011. Methods: Adult NMC pts with CIA receiving initial ESA [epoetin α (EPO) or darbepoetin α (D-EPO)] tx from 2008 to 2011 were identified using an oncology drug dispensing database. Chemo drug combinations (drug-co) prescribed prior to CIA, Hb levels that triggered the start (1st Hb) and end (last Hb) for initial ESA tx, time to tx w/ ESA and ESA dose and duration were evaluated. Results: 523 oncology practices across 48 states prescribed initial tx w/ EPO or D-EPO for 4,489, 3,845, 2,813, and 1,393 NMC pts w/ CIA in 2008, 2009, 2010, 2011, respectively. Average age was 65, 66, 66, and 67 yrs in 2008, 2009, 2010, 2011, respectively. For all pts w/ CIA, carboplatin-paclitaxel, gemcitabine, and carboplatin-etoposide were the top 3 out of 2,605 drug-co given to 7.5, 4.2 and 3.7% of pts respectively. The Table summarizes data recorded for pts evaluated with CIA and initial ESA tx. Hb starting and ending values declined while time to treat with initial ESA tx increased from 2008 to 2011. No significant change of total dose of EPO or D-EPO was observed from 2008 to 2011. Conclusions: Since restrictions on ESA use were recommended, fewer CIA pts have received ESA TX, and the Hb value for initiation has declined. Additionally, ESA tx was initiated later in the course of chemotherapy from 2008 to 2011 but total time on ESA therapy remained relatively constant. [Table: see text]
Observational study of ferric carboxymaltose in France (OncoFer; interim analysis).
Authors: Toledano Alain , Luporsi Elisabeth , Scotté Florian , Morere Jean F. , Huot-Marchand Philippe , Zakin Lorraine B. , Mahi Lamine , Bugat Roland 
Published: March 2020

e20654 Background: Iron deficiency with anemia is a frequent complication in cancer.Ferric carboxymaltose (FCM) is approved for the correction of iron deficiency in France since the beginning of 2011. This observational multicenter study has recruited 2 cohorts of patients to describe FCM use in daily practice for patients with hematological malignancies or solid tumors. Methods: Cohort 1 (retrospective): 450 patients treated in 2010 with any intravenous (IV) iron or red blood cell transfusion (BT); Cohort 2 (prospective): 450 patients treated with FCM after July 1, 2011. Patient characteristics are collected for 3 months pre and post intervention. Recruitment of the 810 patients has been completed. Results: Outcomes of the first 100 patients are described below. The majority of patients receiving FCM had metastatic solid tumors and received just under 1000 mg iron. Hematological malignancies were only included in BT cohort. Results are detailed below. Number of patients at baseline with serum ferritin (SF) level and TSAT are 10 and 7 respectively in cohort 1 and 28 and 26 respectively in cohort 2, therefore the reason for initiating FCM appeared to be based predominately on Hb level. Functional iron deficiency was present in 85% where TSAT and ferritin were measured. No related serious adverse events were reported for the IV iron preparations. Conclusions: FCM was well tolerated and seemed effective in treating iron deficiency anemia. Administration was usually delivered at home with fewer infusions required for FCM compared to iron sucrose. These interim results need to be confirmed in the final analysis. [Table: see text]
Is anemia due to chronic disease the main cause of anemia in cancer patients?
Authors: Utkan Gungor , Kenar Gokce , Akbulut Hakan , Demirkazik Ahmet , Onur Handan , Icli Fikri 
Published: March 2020

e20655 Background: Causes of anemia in cancer patients are often multifactorial. It may be atrributed to underlying nutritional deficiencies, such as cobalamin, folate, iron. The aim of our study is to determine prevalence of anemia and evaluate anemia parameters in newly diagnosed cancer patients. Methods: 310 newly diagnosed cancer patients (gastrointestinal tract (GIT) cancers, 35.8%; non-GIT malignancies, 64.2%) and 301 healthy individuals as control group were retrospectively evaluated in terms of anemia parameters: complete blood count (CBC) , ferritin, transferrin saturation (TSAT) , serum iron (SI), vitamin B12, folate levels. The exclusion criteria were, to be treated with cytotoxic treatments or radiotherapy before, and having a story of hemorrhage within last 3 months. Results: Anemia was observed in 49.7% of newly diagnosed cancer patients and in 13.7% of control group (P< 0.001). Mean ferritin level was 153 ng/mL in patients group and 47 ng/mL in control group (P< 0.001). By contrast, in patient group, SI and TSAT were lower (P< 0.001). Folate deficiency (≤ 3.1 ng/mL) was seen more frequent in patient group than control group (6.5% and 1%, P< 0.001). Cobalamin deficiency (≤ 200 pg/mL) was also seen more frequent in patients group than control group (39.3% and 17.7% , P< 0.001). Anemia parameters were similar in both groups of patients with GIT cancers and non-GIT cancers. Conclusions: In the current study, we found that nutritional deficiencies are more prevalent in newly diagnosed cancer patients than control group. However ferritin levels were higher in cancer patients, SI and TSAT levels were lower. This situation can be explained by acute phase response. Both cobalamin and folate deficiencies may cause ineffective erythropoiesis and also pancytopenia. If cytotoxic therapies will be administered additionally to cobalamin or folate deficient cancer patients, duration of bone marrow depression may become longer. In conclusion, we suggest to evaluate anemia parameters routinely at the time of diagnosis in cancer patients. This may provide an opportunity to replace these nutritional factors earlier and to reduce the requirement of transfusion.
What information do patients need about their disease or treatments and what they want for end of life?
Authors: Martin Reinas Gaston , Gil Deza Ernesto , Morgenfeld Eduardo L. , Gercovich Daniela , Tognelli Flavio , Gercovich Natasha , Montiel Monica , Garcia Gerardi Carlos Fernando , Rivarola Edgardo G. J. , Gercovich Felipe G. 
Published: March 2020

e20656 Background: As it is very important for Doctors, Patients (Pt) and Family to know everything related to end of life we thought it was unavoidable to develop a survey for that purpose. Methods: Between Oct 15th and Nov 15th, 2012, 1003 Pt out of 3795 Pt that were assisted at the IOHM were given the option to participate in an anonymous survey about diagnosis, prognosis, efficacy and toxicity of treatments, as well as interest in palliative care (PC), clinical investigation (CI), psychological support (PS), spiritual care (SC) for an eventual situation of coping with the end of life dilemma. Results: A total of 845 out of 1,003 (84%) Pt elected to participate. Population: Sex: fem: 332, male: 207, left blank (LB): 306. Mean age 58y (range 18 – 94). Married: 355, unmarried: 211, LB: 279. Children Yes 460 No/LB: 385. Highest educational level achieved: primary Studies:186, high School: 348, universitary:216. LB: 98. Employed:382, retired: 240, unemployed: 112, LB 111. Disclosed diagnostic and stage of disease: 470 (56%). The following results are expressed as a percentage of 845 pt: Are aware of the diagnostic (82%); Pt interested in knowing everythingabout their prognosis (85%) or their treatment’s efficacy (67%) or toxicity (52%). Pt interested in: PC (85%), CI (80%), PS (74%), SC (58%). If they were to choose a place for dying: 40% chose to die in the hospital, 30% at home, 29% did not answer and 1% was indifferent. It was possible to detect a marked increase in the amount of answers with regards to last wishes as the stage of the disease worsened (Chi square= 0.011). Pt were asked to rate the survey: 95% considered it good or very Good, 56% found it useful, 36% thought it necessary, while 23% would recommend it. Conclusions: 1) Most of the pt know their diagnosis, would like to know their prognosis and need to know everything about efficacy and toxicity of treatments. 2) 40% of the pt would prefer to die in the hospital, but analyzing this choice at earlier stages of disease may be inappropriate. 3) PC and CI are of interest to both sexes but women are more likely to request PS and SC. 4) Although the survey was considered good by 95% of pt and more than 50% found it useful, only 23% would recommend it, which speaks about the sensitive quality of these topics.
Characteristics of patients with prolonged survival after breast cancer brain metastases (BCBM).
Authors: Tomasevic Zorica , Kovac Zeljko , Tomasevic Zoran 
Published: March 2020

e20659 Background: BCBM development predicts short survival for majority of pts. However, 10%, of pts survive up to 2 yrs, and some of those pts has extended survival to more than 2 yrs after BM. Whether there are differences between pts in those arbitrary determined subgroups with prolonged survival is still unknown. The aim of this paper is to analyze and compare characteristics of BCBM pts with survival after BM (BMs) between ≥ 12 - 24 months and ≥ 25 month. Methods: A 193 consecutive BCBM pts have been registered during 5 yrs (January 2008-December 2012). All BM were confirmed by CT/MRI. All pts underwent BM treatment: WBRT 160 (83%); postoperative WBRT in 32 pts (17 %); gamma knife in 7 pts (3,6 %). BMs is known for 169 pts and was median 5,5 months (range 1-72+ months). Only pts with BMs ≥ 12 months were considered for this analysis. Results: 39/169 pts (23%) with median BMs 19 months (range 12-72+) were identified and divided in 2 groups (see Table). MBC in other organ sites, predominantly non visceral, was present in 45% pts (A) and in 40% (B), at the time of BM diagnose. There was no statistically significant difference between group A and B. Conclusions: Despite BM, a subgroup of pts still has indolent MBC course with median BMs of 19 months, and 6% has BMs of median 35 months. There were no statistically significant difference between standard clinical/pathological parameters Therefore, other characteristics, both patients and BC/BM must be considered. Better understanding of crucial characteristics of this subgroup of BCBM pts, is needed because these pts might potentially represents the best candidates for future BM preventive strategies. [Table: see text]
Development of a tailored, computerized, breast cancer risk assessment and decision support tool: What do clinicians want?
Authors: Collins Ian M. , Keogh Louise A. , Steel Emma , Mann Bruce , Emery Jon , Pirotta Marie , Moreton Jane , Butow Phyllis , Trainer Alison , Antoniou Antonis C. , Cuzick Jack M. , Hopper John L. , Phillips Kelly-Anne 
Published: March 2020

e20660 Background: End user input into the design of decision support tools is critical to enhance integration and future routine use in clinical practice. As part of the development of an evidence-based, tailored, computerized breast cancer (BC) risk assessment and management tool, we examined clinicians’ requirements. Methods: Australian breast surgeons (BSs) and primary care clinicians (PCCs) were recruited through local professional networks. Facilitated focus group discussions about current practice of assessing and managing BC risk and perceptions of the proposed tool were audiotaped transcribed and managed using QSR NVivo. A coding framework was developed based on the transcripts, data were coded and each code further analyzed to identify key themes. Results: Four focus groups, involving 12 BSs, 17 PCCs (12 doctors, 5 practice nurses) were conducted. 55 % were male, mean age 45yrs (range 25-67), mean of 14yrs in practice (range1-25+). Clinicians identified difficulties assessing and managing BC risk and lack of available tools to standardise their current inconsistent approach to risk assessment and management. Most felt confident identifying high risk women, but found differentiating women at population risk from those at moderately increased risk more difficult. They felt a tool would help them reassure anxious low to moderate risk women and avoid unnecessary onward referral or investigations and better identify and refer or manage high risk women. Desirable features in a tool included: evidence-based, accessible (web-based), visual, simple data entry process, displays absolute risk (rather than relative) and mutable risk and risk reduction estimates in multiple formats (words, pictographs, graphs) to improve comprehension, printable summary sheets. Clinicians felt that women could input risk factors before the clinic visit but that joint consumer and clinician data entry was preferable and women should only receive a risk estimate with a clinician present. Conclusions: Development of tools for BC risk assessment and management should address these clearly identified needs of end users in order to optimise translation of current and future knowledge into clinical practice.
Palliative chemotherapy during the last month of life.
Authors: Andelkovic Vladimir 
Published: March 2020

e20662 Background: There is no uniform definition of medical futility, but most accept treatments offering no reasonable chance of benefiting patients will fall into this category. According to literature, chemotherapy given in the last month of life has little or no benefit to patients. Various studies suggest 9-43% of patients receive palliative chemotherapy during the last month of life. Methods: Retrospective analysis was done on electronic medical records of patients who received systemic anti cancer therapy (SACT) - cytotoxic and/or targeted therapy for solid or haematological malignancies at The Gold Coast hospital within one year period. Patients that died within 30 days of SACT administration were further classified based on their diagnosis, treatment intent, type of treatment and cause of death. Results: 770 patients received SACT between 1 November 2011 and 31 October 2012. 53 deaths (6.9%) occurred within 30 days of receiving SACT. 35 (66%) of those were due to progression of disease and 6 (11.3%) were treatment related. All treatment related deaths were due to neutropenic sepsis. For 12 deaths (22.7%), there was insufficient documentation to establish the cause of death. Only one patient with acute myeloid leukaemia (1.9%) died as a result of treatment given with curative intent. 20 patients (37.7%) were on combination treatment while 33 (62.3%) were treated with single agents. 42 patients (79.2%) received treatment that included intravenous agents, while remaining 11 patients (20.8%) were on oral treatment only. 37 patients (69.8%) were on cytotoxic treatment, 12 (22.6%) patients were on targeted therapy, and remaining 4 (7.6%) were on a combination protocol. Conclusions: Results of this audit show a lower number of patients who received palliative chemotherapy in a metropolitan public hospital in Australia during the last month of life. Defining the goal of treatment and assessing functional status of patients regularly while on treatment may help identify deteriorating patients and could avoid medically futile treatment. [Table: see text]
The differences in sexual satisfaction, quality of life, and social support between patients with prostate cancer and cervical cancer after radiotherapy.
Authors: Kieszkowska-Grudny Anna , Rucinska Monika , Nawrocki Sergiusz 
Published: March 2020

e20666 Background: Cervical cancer (CxCa) and prostate cancer (PRCa) have a major impact on sexuality, quality of life (QoL) and patients (pts) require social support(SS). Study aim was to compare sexual satisfaction and activity,QoL and level of required and received SS in group of CxCa and PRCa pts min.3 months after radical radiotherapy (RTH). Methods: 97pts were included to the study:50 non-metastatic PRCa pts (54-83y, M=68,8) and47 CxCa pts (27-69y,M=54,4) after RTH. Subjects filled out:QLQ-C30,PR25,CX24, Berlin Social Support Scales (BSSS) and demographic data.The Chi2,t-Student test,and linear regression analyses were used (p<0,5). Results: However sexual activity and satisfaction in both cancer groups is significantly lower (p<0,05) than in healthy population, no differences were observed between CxCa and PRCa pts. No difference were found between general and any subscale of QoL in both groups, although men needed significantly more help with eating, dressing, washing or using the toilet. However,men felt less male than women less feminine because of cancer (p<0,001). Predictors to better femininity evaluation (R2=0,650;p<0,05)were: higher appetite, emotional functioning, perceived available instrumental support and marital status. Predictors of poor masculinity evaluation (R2=0,346;p<0,05)were: shortness of breath, age, lower perceived available emotional support. The most significant differences (p<0,05) were observed between groups in the evaluation of SS: perceived available emotional SS was higher in pts with CxCa than with PRCa, while protective-buffering SS, currently received emotional SS and general SS were higher in the group of PRCa than CxCa pts. Conclusions: QoL was similar in both groups, in some areas men needed more help that women. Sexual activity and satisfaction is lower in cancer pts in comparison with general population, but no differences were observed between CxCa and PRCa pts, however emotional SS was crucial for better sexual satisfaction. The more visible difference were found in SS, and even men with PRCa have been receiving more SS,women with CxCa perceived particular SS higher than in fact such support had experienced.
Providing cancer survivorship care plans for Spanish language speakers: Overall use and satisfaction patterns.
Authors: Hill-Kayser Christine , Vachani Carolyn , Hampshire Margaret K. , Di Lullo Gloria A. , Metz James M. 
Published: March 2020

e20671 Background: Cancer survivorship care plans may be communication aides to assist healthcare providers and empower survivors. A paucity of information exists regarding the provision of survivorship care plans to the Spanish speaking population. Methods: The LIVESTRONG Care Plan is an Internet-based tool for creation of survivorship care plans, originally launched in 5/07. It is available at www.livestrongcareplan.org, and via OncoLink, a cancer information website based at the University of Pennsylvania, serving over 3.9 million pages/ month to 185,000 unique IP addresses. A direct link on the homepage directs users to the Spanish version. All information is provided and translated by oncology nurses and physicians. Results: Since launch of the tool, 293 Spanish care plans have been created (1% of total care plans). Care plans in Spanish have been created by survivors in 78% of cases, and healthcare providers in 22%. This differs from the entire user population, in which use by HCP approaches 50% (p=< 0.001). Spanish-speaking users are 52% female, and 82% Latino/a, and less likely from the US (60% vs 87% , p=0.02), also being from Mexico (15%), Spain (10%), Chile (9%), Puerto Rico (5%) and Venezuela (3%). Spanish users were most often survivors of breast (20%) GU (33%) and GI (20%) cancers (vs general population 50%, p = 0.03; 10%, p = 0.04; 11%, p = 0.03, respectively). Only 8% of Spanish-speaking users report having received previous survivorship information vs 13% in the overall group (p=0.07). All users (100%) of the Spanish version rate experience and satisfaction with the care plan as “very good” or “excellent.” Average time for completion of Spanish plans was 9:28 min. Conclusions: Most users of the Spanish plan are survivors who have not received this information before, from the US and several Central/South American countries. They are highly satisfied with the information provided. Healthcare providers are proportionally less likely to use the Spanish version of the plan than survivors are.
Oncologists’ perceptions of rounding alongside palliative care physicians: Results of a post-intervention survey study.
Authors: LeBlanc Thomas William , Tulsky James A , Abernethy Amy Pickar , Jones Christopher A , Galanos Anthony N , Riedel Richard F. 
Published: March 2020

e20674 Background: In August 2011, a new rounding model was instituted on the inpatient solid tumor oncology service at Duke. This model incorporated a palliative care physician as a second attending on service, alongside the rounding solid tumor oncologist. We sought to assess the oncologists’ perceptions of this model, and of palliative care, 1 year later. Methods: We developed a 15-item survey assessing 3 domains: (1) perceptions about palliative care in general, (2) lessons learned from palliative care colleagues, if any, and (3) changes in the experience of rounding on the solid tumor oncology service. Faculty were invited to participate by e-mail, via an anonymous web link. All oncology faculty who rounded at least 2 weeks since August 2011 were included. Results: Response rate was 73% (8 of 11). 75% (N=6) of respondents had rounded both before and after the new model was instituted. 75% reported a more positive perception of palliative care (N=6), 88% (N=7) reported learning new ways to manage cancer patients’ symptoms, and 100% agreed that the palliative care physician brings a valuable skill set to the team. Only 1 respondent felt that palliative care physicians detract from oncologic issues, and none thought the palliative care physicians discuss hospice too early. 88% (N=7) reported greater willingness to round on the service under the new model, and 100% agreed that rounding was more enjoyable since the addition of the palliative care attending to the team. 100% agreed that palliative care is a necessary component of comprehensive cancer care, and that palliative care should have a presence in the outpatient cancer clinics; 88% (N=7) reported feeling comfortable doing palliative care in their own clinical practice. All agreed that “palliative care” is different from “hospice care.” Conclusions: Rounding alongside palliative care physicians on an inpatient oncology service may improve oncologists’ perceptions of palliative care, teach them new symptom management skills, and improve their willingness to do inpatient rounding. Fears about palliative care physicians inappropriately introducing hospice too early for patients with solid tumors may be unfounded.