bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors in pregnant women with an oncological diagnosis and their impact in the post-partum period.
Authors: Faccio Flavia , Ionio Chiara , Mascheroni Eleonora , Peccatori Fedro , Ongaro Giulia , Cattaneo Elena , Pisoni Camilla , von Wunster Silvia , Nastasi Giuseppe , Pravettoni Gabriella , Beretta Giordano D. , Bonassi Lucia 
Published: March 2020

e23166 Background: An oncological diagnosis during pregnancy, or the choice of motherhood following cancer may be accompanied by anxiety, distress and depression. The aim of the study is to explore the possible risk factors in the perinatal period in women who experienced an oncological diagnosis before or during pregnancy. Methods: 32 pregnant women (25 breast, 3 cervix, 1 lung, 1 Hodgkin's lymphoma, 1 perivascular epithelial cell neoplasia, 1 epatic PEComa) were assessed during their 3rd trimester (T1) and three months’ post-partum (T2). At T1 mood states and post-traumatic symptoms were evaluated, at T2 parenting stress and perceived quality of life (QoL). Results: Depression, anger and anxiety correlated with lower physical and psychological QoL in the post-partum. Moreover, mothers who expressed higher levels of fatigue and confusion during pregnancy are associated to lower levels of perceived psychological QoL. Women who manifested hypervigilance and hyperarousal during pregnancy were more likely to perceive lower psychological QoL three months after birth. Finally, post-traumatic symptoms of intrusiveness during pregnancy correlated with higher levels of parenting stress and higher risk of dysfunctional parenting, together with a stronger perception of having a child with a difficult temperament in the post-partum period. Conclusions: Mood states and post-traumatic symptoms can decrease the mother’s quality of life and heighten parental distress. These preliminary results suggest implementing psychological support for women with current or previous oncological diagnosis during pregnancy in order to prevent the onset of dysfunctional parenting and/or problem behaviours in their children. [Table: see text]
Evaluation of mental and social adaptation of patients with breast cancer.
Authors: Kondrateva Kristina , Semiglazova Tatiana , Kasparov Boris , Vagaitseva Margarita , Zernova Margarita , Krutov Anton , Alekseenko Anna , Krivorotko Petr , Semiglazov Vladimir , Belyaev Aleksey , Semiglazov Vladislav ,   Petrov Research Institute of Oncology Authors' Group
Published: March 2020

e23167 Background: In 2018, in the N.N. Petrov National Medical Research Center of Oncology, there was conducted a study of the effectiveness of a mental and social adaptation of patients to the disease and treatment in the framework of The International Classification of Functioning, Disability and Health (ICF). Methods: The patients with breast cancer (n = 28, mean age 31 ±7) were examined at the stages of diagnosis and admission to the hospital. The basis of the study is the «Narcissism Evaluation Test», EORTC QLQ-C30, as well as the following ICF domains: Body function - global psychosocial functions (b122), temperament and personality functions (b126), energy and drive functions (b130), sleep functions (b134), attention functions (b140), psychomotor functions (b147), emotional functions (b152), thought functions (b160), higher-level cognitive functions (b164). Activity and participation- doing housework (d640), family relationships (d760), intimate relationships (d770), acquiring, keeping and terminating a job (d845). Results: The increase in values (7.26–13.61; p < 0.05) on the “Depersonalization” scale indicates an attempt to dissociate from threatening processes in oneself by means of dissociation and splitting, to preserve the coherence of the personality structure. This tendency can be viewed as an attempt by the patient to deny that destabilization affects his personality and lifestyle, which leads to the experience of melancholia as an attempt at destruction of Self-Concept. Such reactions are classified by us within the framework of psychogenic, i.e. conditionally normal in the situation of cancer, however, it was shown that the pathology of “psychogeny” significantly reduces the quality of life and social adaptation. For example, in 11 patients, there is a decrease in the quality of life (62.85; p < 0.05), disturbed sleep, emotions, energy and drive functions (b134, b152, b130), and there are difficulties in the resumption of labor activities (d845). Conclusions: Experiencing the threat to the integrity of Self-Concept launches psychological defenses, as a result of which a rapid regression of Self-Concept occurs before the primary narcissism. Psychogenic reactions during pathologization contribute to the patient’s social and mental maladjustment.
Mindfulness and concerns about adjuvant endocrine therapy (AET).
Authors: Henry Norah Lynn , Iacob Eli , Mooney Kathi , Garland Eric 
Published: March 2020

e23170 Background: Poor adherence to AET for early stage breast cancer is associated with increased recurrence and mortality. Interventions to improve adherence have been minimally effective. Mindfulness is paying attention on purpose in the present moment with an attitude of openness and acceptance. In this cross-sectional study, we examined clinicopathologic, and psychosocial factors, including dispositional mindfulness, associated with increased concerns about medication. Methods: Women with stage 1-3 breast cancer who had taken at least one dose of AET within 2 years of enrollment completed questionnaires to examine medication beliefs (Beliefs about Medication Questionnaire), symptoms (FACT-ES), treatment satisfaction (Treatment Satisfaction Questionnaire for Medication II), and mindfulness (Five Facet Mindfulness Questionnaire-15). Descriptive statistics were used for demographic and clinical variables. Linear regression was used to examine the associations between medication concerns and both treatment satisfaction and mindfulness measures. Results: Of the 101 enrolled patients, 43 were taking tamoxifen, 46 an aromatase inhibitor (AI), and 12 had discontinued AET; average time on AET was 11 months (SD 6.3). 32% had stage 2 disease and 22% had stage 3. Concerns about medications was moderately negatively correlated with mindfulness (ρ = -0.349, p < 0.001). In the baseline model, medication concerns were associated with increased side effects but not with age at diagnosis, stage, or current AET status. When controlling for age, stage, current AET status, and side effects, there was a trend towards increased mindfulness and decreased medication concerns. Conclusions: Dispositional mindfulness may be associated with fewer concerns about medication. If mindfulness is shown to influence medication adherence, interventions such as mindfulness training to improve compliance with AET could be investigated.
Coping with end-of-life stress (EOLS): Poetry as a therapeutic communication intervention.
Authors: Meyskens Frank L. , Shapiro Johanna F , Lupton Julia Reinhart 
Published: March 2020

e23172 Background: Attempts to alleviate EOLS via system changes have been variably successful. Manualized psychotherapeutic interventions have been of some usefulness. Participation in narrative communication has been widely adopted to address stress produced by life threatening events, whether by trauma or acute illness. More recently narrative form of communication has been extended to the EOL time period with some early evidence of limited benefit. Poetry involves a different realm of mental involvement and should impact on existential stressors. However, its use in improving the quality of life during the EOL period has not been explored. Methods: Two open symposia entitled “Healing and Hope: An Evening of Poetry by Patients, Family Members, and Health Professionals“ were held at the University of California-Irvine on February 22, 2018 and January 10, 2019. There were 155 attendees(80, 2018; 75,2019). 20 attendees at the 2019 event also participated in a workshop directed toward writing poetry. Results: Event reports from all 11 Medical Humanities students registered for the Symposia as a required colloqium event were very positive as were essays from 3 medical students in the Art of Doctoring class in attendance. The results and impact of the Symposia were eloquently summarized by another one of the medical students who attended: “The poetry tellers read poems that were very powerful and I was able to hear their pains, joys, and regrets. I enjoyed the discussions held after each panel was finished, which allowed me to hear some of the thoughts of the audience and connect with them. The whole experience was amazing: It really felt like we were all connected via poetry and I think that produced an environment where we could cope with emotions brought by illnesses and medicine.” Conclusions: Poetry reading, writing, and speaking should be explored as a novel educational approach and possible therapeutic tool to address existential stressors produced during and by the EOL time period in an increasingly aging patient population that and results in the well-known diminishment or destruction of their quality of life.
Psycho-Oncology: Cancer patients with past suicide attempts, or a family history of suicide.
Authors: Gercovich Daniela , Gil Deza Ernesto , Tognelli Flavio , Garcia Gerardi Carlos Fernando , Acuna Claudia Lorena , Gonzalez Cesar , Morgenfeld Eduardo L. , Morgenfeld Mirta , Rivarola Edgardo G. J. , Gercovich Felipe G. 
Published: March 2020

e23173 Background: “The suicide rate in cancer patients is twice that observed in the general population in the United States” (JNCI vol 100, 24, page 1750, 2008). This paper focuses ona population with great psychological risk: cancer patients (Pt) with previous suicide attempts (SA) or a family history of suicide (FS); both grouped under SAFS for the purpose of this study. Methods: Between 9/26/2012 and 11/28/2018 all new patients (Pt) admitted to IOHM filled out a Past Medical History Form (PMHF) (ASCO 2013 ABST. e17539) with their preexisting clinical conditions. The database was locked and anonymized. Those with a history of SAFS before cancer diagnosis were selected. Results: Out of 15,617 Pt, 184 Pt (1.2%) were SAFS(141 Pt were SA, 39 Pt were FS and 4 Pt were both). The relative risk ofSA was ten times larger for those with FS. Psychiatric Medication: Antipsychotics: 15Pt (8%), Antidepressants: 23 Pt (12%) and Benzodiazepines 45 Pt(24%), No treatment 101 Pt (55%). Population Characteristics: Sex: F:144 Pt . M: 40 Pt. Age: 56y (r = 26-88). Tumor Dx: Breast (65 Pt ) - Gastrointestinal (24 Pt) - Urological (21 Pt ) - Lung (21 Pt ) -Gynecological (19 Pt) - Hematological (11 Pt) -Head &Neck (8 Pt) - Endocrine (7 Pt) - Other (8 Pt). Stages: Early (0-I-II-III): 130 Pt, Advanced: 54 Pt. Ob-Gyn history:25 Pt (17%) nulliparous, 18 Pt (12%) with one child, 77 Pt (53%) with 2 or 3 children and 24 Pt (17%) with more than 3 children; 62 Pt (43%) had previous abortions. Average severe comorbidities (respiratory and psychiatric) was 3 per Pt (r = 0-18). Toxic habits: Smoking: 120 Pt (65%), Alcohol: 37 Pt (20%) and Illicit Drugs: 4 Pt (2%). Follow-up: 19 months (r = 0-70). No Pt had any SA, or commited suicide, during the follow-up.Living patients:177 (96%). Conclusions: 1) In our vast cohort, 184 Pt (1.2%) were identified as highly vulnerable psychiatric Pt due to SAFS. 2) Given the high psychological risk and stressful cancer diagnosis, 83 Pt (45%) were prescribed psychiatric drugs. 3) Follow-up of SAFS Pt by a multidisciplinary team is requiredfor adequate Pt and family support.
Understanding patient advance directives status in a community oncology practice using an electronic patient-reported outcomes (ePRO) system.
Authors: Buzaglo Joanne S. , Skinner Karen E , Stepanski Edward , Tankersley Cynthia , Schwartzberg Lee S. 
Published: March 2020

e23181 Background: The National Comprehensive Cancer Network and the American Society of Clinical Oncology recommend that providers encourage early advance care planning with their patients1; yet, many cancer patients do not have advance directives (ADs). A potential reason for low AD rates is inadequate communication between the provider and patient. To address this gap, we developed an outpatient clinic AD initiative for any stage cancer patients via an ePRO system. The AD module was designed to ensure that patients are aware of ADs and to assess whether or not the patient had ADs, specifically a Living Will and/or a durable power of attorney. The study purpose was to assess patient AD status at the patient’s initial visit to an oncology clinic. Methods: This study used a retrospective, observational design that involved use of PRO and clinical data collected via the Patient Care Monitor™ (PCM), a web-based ePRO system linked to electronic medical record data. All data used in this study were collected as part of routine clinical care. All patients at an initial visit to an oncology clinic completed the PCM survey, including the AD module, via a handheld e-tablet. Results: Overall, 9,682 patients completed the AD module (mean age 63; 31% male/69% female; 58% married; 62% White, 35% Black). Cancer type was known for 75% of all patients (29% breast, 11% hematologic, 7% lung, 7% colorectal, 3% prostate, 17% other types). One third of all patients (33%) reported having an AD at the time of the initial visit to the oncology clinic, specifically 24% indicated having a Living Will and 9% a durable power of attorney. The remaining two-thirds (67%) indicated either NOT having an AD (56%) or not knowing if they had an AD (11%). Patients with ADs were more likely to be older ( M=68 v. 60 yrs), male (38% v 31%), White (41% v 20% Black) and married/partnered (35% v 29%); ps <.0001. Conclusions: This study demonstrates that the majority of patients do not have ADs at the time of an initial visit to a community-based oncology practice. Using an ePRO system can be an innovative and efficient way to identify unmet needs of patients and link them to resources for developing advance directives. 1Brown AJ, Shen MJ, Urbauer D, et al. Room for improvement: An examination of advance care planning documentation among gynecologic oncology patients. Gynecol Oncol. Sep 2016;142(3):525-530.
National society-supplied patient materials on prostate cancer screening for the general public: A readability analysis.
Authors: Rooney Michael Kevin , Morgans Alicia K. , Meeks Joshua J , Kundu Shilajit , Schaeffer Edward M. , Hussain Maha H. A. , Kalapurakal John A. , Sachdev Sean 
Published: March 2020

e23188 Background: Recent data suggest that prostate cancer mortality may be increasing for the first time in 20 years, possibly related to a decrease in PSA screening. Most professional societies recommend men aged 55 to 69 make screening decisions using a shared-decision making (SDM) model. However the quality and time of SDM can vary significantly, often leaving patients uncertain about the implications of pursuing or foregoing screening. In this setting of individualized decisions, patients may seek supplemental information. However, little is known about the accuracy, breadth and readability of available education materials, which if designed optimally could improve SDM. Methods: For 11 predetermined professional societies (ACP, ACPM, ACS, AFP, AMA, ASCO, AUA, CDC, NCI, NIH, USPSTF), patient education materials designed for prostate cancer screening were queried. Materials were analyzed using seven well-validated readability metrics and evaluated for educational content. For content comparison, 10 materials from academic cancer centers and independent organizations were identified using top public search engine results. Results: We identified 12 professional society materials and 20 from popular non-society sources. Mean readability level for society materials ranged from 9.7 to 11.3 grade, well above AMA and NIH recommended 6th and 8th grade reading levels (P < 0.0001). In comparison to general materials, professional society materials more often discussed the role of risk factors in making screening decisions (70% vs 100%, P = 0.03). However, society materials did often omit important guideline-based content, including statements that decisions should involve patient values and preferences (42%) and can vary by patient age (35%). Conclusions: Widely available prostate cancer screening education materials are written at inappropriately high reading levels and often omit important content. Improvement of such materials would encourage SDM for patients considering screening.[Table: see text]
Physical methods of rehabilitation (PMR) in patients with lung cancer.
Authors: Kasparov Boris , Semiglazova Tatiana , Denis Kovlen , Gennady Ponomarenko , Kluge Valeriya , Krutov Anton , Zernova Margarita , Kondrateva Kristina , Karina Khidishyan , Belyaev Alexey , Donskih Roman , Bahtyar Adhamov , Semiglazov Vladislav , Kharchenko Evgeniya Vladimirovna , Levchenko Nikita , Levchenko Evgeny 
Published: March 2020

e23189 Key words: physical therapy, rehabilitation, lung cancer. Background: The strategy of searching evidences for using rehabilitation technologies in patients with lung cancer (LC) is based on scientometric analysis. Methods: Since 1991 to 2018 analysis of 249682 studies was performed. It was completed by using PICO(T) technologies in databases such as PEDro, PubMed, E-library and Cochrane Library. Medical subject headings (lung cancer, rehabilitation, physical therapy, etc) were used to search the information in international databases. The trials were rated by PEDro scale including 10 points of evidence level : randomization, endpoint evaluation, blinding and etc. Results: Almost 55.9% of studies showed the level from 4 to 8 points on the PEDro scale and were verified by distribution profile. One trial had 9 points (0,8 %). Recommended evidence-based use of PRM technology in the rehabilitation of patients with LC (table): Conclusions: This results will form the base of clinical guidelines of new evidence-based Development of Patient Rehabilitation of patients with LC in Russian Federation.[Table: see text]
A randomized phase II study of durvalumab and tremelimumab compared to doxorubicin in patients with advanced or metastatic soft tissue sarcoma (MEDISARC, AIO-STS 0415).
Authors: Grünwald Viktor , Bauer Sebastian , Hermes Barbara , Ivanyi Philipp , Lindner Lars H , Pink Daniel , Reichardt Peter , Richter Stephan , Tuchscherer Armin ,   Sarcoma Working Group of the Working Group Medical Oncology within German Cancer Society
Published: March 2020

TPS11075 Background: Soft tissue sarcomas (STS) are rare tumors and exhibit substantial histological diversity. Efficacious targeted 1st line treatment for advanced or metastatic STS is not available, and the standard therapy has been anthracycline-based for decades. This strategy shows poor efficacy, as demonstrated by a median Overall Survival (OS) of 12-20 months. Several STS subtypes, however, have been shown to express PD-L1, and immune checkpoint inhibitors (ICI) have demonstrated principle anti-tumor activity in pretreated STS. Our ongoing clinical trial tests the activity and safety of ICI combination therapy in the first-line setting. We hypothesize that the dual checkpoint blockade with Durvalumab (PD-L1) and Tremelimumab (CTLA-4) improves overall survival in STS when compared to the standard of care doxorubicin. Methods: MEDISARC is a multi-center phase II trial that is enrolling adult treatment-naïve patients with histologically confirmed STS of intermediate or high grade (FNCLCC grade 2 or 3) not amenable to surgery with curative intent and ECOG performance status 0-2. Chemosensitive histologic STS are eligible. 100 patients will be randomized 1:1, stratified by ECOG status (0 vs. 1/2). Patients in the experimental arm are treated with fixed doses of durvalumab (1.5 g Q4W) and tremelimumab (75 mg Q4W for 3 cycles, then Q12W) until Progressive Disease (PD) or for a maximum of 12 months. Doxorubicin treatment in the standard arm is at 75 mg/m2 Q3W and limited to 6 cycles. OS is the primary endpoint. Secondary endpoints include 2-year OS rate, PFS, ORR according to conventional and modified RECIST 1.1, safety and tolerability and health-related quality of life (EORTC QLQ-C30). OS analysis may be performed when the required number of events (E=70) has been observed. All randomized and treated subjects will be included in the efficacy and safety analysis. The accompanying translational research aims to identify prognostic and predictive biomarkers in blood and tumor tissue. Enrollment of patients started in April 2018 and is ongoing. As of February 2019, 32 patients have been enrolled. The study is sponsored by AIO-Studien-gGmbH, Berlin, Germany. Clinical trial information: 2016-004750-15.
Phase 3 PhALLCON study: Ponatinib (PON) versus imatinib (IM) with reduced-intensity chemotherapy (CT) in patients (pts) with newly diagnosed Philadelphia chromosome–positive (Ph+) ALL.
Authors: Jabbour Elias , Martinelli Giovanni , Vignetti Marco , Ribera Josep-Maria , Gomez-Almaguer David , Minami Yosuke , Xu Jing , Srivastava Shouryadeep , Neumann Frank , Kantarjian Hagop M. 
Published: March 2020

TPS7061 Background: Therapies for adults with newly diagnosed Ph+ ALL are limited and associated with poor outcomes. PON, a potent TKI, is active against native BCR-ABL1 and all identified single resistance mutations, including T315I, which confers resistance to other TKIs (Zhou. Chem Biol Drug Des 2011;77). In the phase 2 PACE study, PON had a 41% major hematologic response rate in heavily pretreated Ph+ ALL, but responses were not durable mainly due to compound mutations (Cortes. Blood 2018;132; Pritchard. Blood 2016;128). As PON suppresses single BCR-ABL1 resistance mutations, resistance in Ph+ ALL is acquired through compound mutations. Decreased likelihood of compound mutations with first-line PON in Ph+ ALL may lead to more durable responses compared with PON in later lines of therapy. In a phase 2 study of PON with CT in newly diagnosed Ph+ ALL, long-term outcomes were improved vs first/second-generation TKIs (Jabbour. Lancet Haematol 2018;5). The PhALLCON trial compares first-line PON vs IM with reduced-intensity CT. Methods: This open-label trial (NCT03589326) is enrolling 230–320 pts (≥18 y) with newly diagnosed Ph+ or BCR-ABL1–positive ALL (p190/p210) and ECOG status ≤2. Pts are randomized 2:1 to PON 30 mg/d or IM 600 mg/d PO with reduced-intensity CT in induction (cycles [C] 1-3), consolidation (C4-9), and maintenance (C10-20). PON dose is reduced to 15 mg once pt achieves minimal residual disease–negative (MRD−) complete remission (CR). After 20C, pts stay on single-agent PON/IM. CNS prophylaxis: 2x/mo in C1-6. Primary endpoint: MRD− (BCR-ABL/ABL1 ≤0.01%) CR (end of induction). Key secondary endpoint: EFS; others in the Table. Subgroup analysis: pts with/without HSCT. Exploratory endpoints include mutation status. Initiated Aug 2018; to include ~110 sites in ≤35 countries. Currently, 5 active sites (4 US, 1 Spain); accrual ongoing. Clinical trial information: NCT03589326. [Table: see text]