bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of utilizing a novel mhealth platform to deliver an evidence-based exercise intervention among testicular cancer survivors (TCS).
Authors: Fung Chunkit , Peckham Jennifer , Porto Michelle , Lin Po Lin , Sahasrabudhe Deepak M. , Guancial Elizabeth A. , Ky Bonnie , Storozynsky Eugene , Janelsins Michelle Christine , Heckler Charles E. , Culakova Eva , Bruckner Lauren B. , Mohile Supriya Gupta , Mustian Karen Michelle 
Published: September 2018

e21608 Background: Cardiovascular disease results in significant morbidity among TCS. Exercise for Cancer Patients (EXCAP) is a self-directed, individually tailored intervention that improves cardiovascular fitness in cancer patients, yet this has not been tested in TCS. We conducted a randomized phase II feasibility study of a novel exercise intervention using a mHealth delivery platform for EXCAP. Methods: We developed mHealth-EXCAP, which integrates data from a wearable digital activity tracker (DAT) into a patient’s electronic medical record (EMR), allowing providers to monitor and adjust EXCAP prescriptions via a patient-centered virtual portal. We randomized TCS ( < 69 yr at diagnosis, any treatments, not in active or maintenance stage of exercise behavior) into 3 study arms: Arm 1 (mHealth-EXCAP), Arm 2 (EXCAP) and Arm 3 (usual care). TCS in both Arm 1 and 2 completed a 12 week EXCAP program with the goal of 12,000 daily steps and daily resistance exercises but Arm 1 used the mHealth platform. Arm 3 used a TCS care plan that promotes exercises. Results: 74 TCS were screened (32 ineligible; 23 declined), 19 consented and 14 (74%) completed study (3 withdrew; 2 lost to follow up) as of 1/31/17. Median age (yr) was 35 (Arm 1; n = 6), 48 (Arm 2; n = 4), and 48 (Arm 3; n = 4). In Arm 1, 83% TCS wore DAT and synced daily step data to EMR > 90% of days. EXCAP prescriptions were adjusted via EMR portal on average 5 times over 12 weeks for each TCS and their weekly daily step goals were met 73% of the time. The number of daily steps recorded by DAT and those synced from DAT to EMR differed by a mean of 1.5% steps (±1.8). Median baseline number of daily steps were 5,525 (Arm 1), 6,795 (Arm 2), and 5,904 (Arm 3) and increased by 5,236, 1,160, and 1,544 respective steps at 12 weeks, with only Arm 1 (50% TCS) achieving > 12,000 daily steps. At 3 months after intervention, 33% TCS in Arm 1 maintained > 12,000 daily steps. On average, TCS in Arm 1 performed resistance exercises 26 minutes a day/5 times a week vs. 28 minutes a day/4 times a week in Arm 2. Conclusions: mHealth-EXCAP is feasible to implement among TCS and may decrease sedentary behavior. Ongoing research will examine its effects on cardiovascular fitness and risk factors.
Nimotuzumab as a single agent palliative therapy in performance score 3 and above in EGFR expressing tumors.
Authors: Attili Suresh VS , Pawar Dilip , Sunkavalli Chinnababu 
Published: September 2018

e21635 Background: Nimotuzumab is a humanized IgG1 monoclonal antibody against the EGFR extracellular domain that has been evaluated in solid tumors as a single agent or in combination with chemotherapy and radiation. However when used without radiation, its always used in adjunct to chemotherapy. With encouraging results of other EGFR monoclonal antibodies as single agent therapies, we explored the possibility of using Nimotuzumab as single agent by which we could avoid chemo related side effects. In view of the limited options availability for subjects with PS 3 and more we thought of choosing this population for analysis of Nimotuzumab as single agent palliative therapy in PS 3 and above EGFR expressing tumors for safety and efficacy Methods: Details of the 38 subjects with pre-treated advanced refractory or progressive solid tumors having PS of more than 2 were evaluated. Nimotuzumab was administered weekly at 200 mg/m2 as single agent for 4 weeks (induction phase) and patients were stratified into those with improved PS and those without. The subjects without PS improvement were continued on the single agent and those with improvement were offered additional chemotherapy . Nimotuzumab could be continued beyond disease progression. Results: Out of 38 patients, 18 had improvement in the PS and were offered chemotherapy later. 16 patients had stable PS and disease. 3 subjects were lost to follow up and 1 patient did not continued. The median number of nimotuzumab applications was 6 (2–11) in the induction phase and the median chemotherapy cycles were 3 (1-6). No toxicity occurred during induction phases (single agent nimotuzumab) and during chemotherapy the Grade II/IV toxicities were observed in 6 (33%) cases predominantly cytopeneas, neuropathy and diarrhea. The median PFS was 142 days (95% CI, 84 to 182), and the median improvement in QOL was 6 points on a scale of 30. Conclusions: Nimotuzumab is well tolerated and may have a role in the treatment of advanced cancers as a single agent in patients with poor performance status. 47% of the patients who are otherwise not eligible for chemo became eligible and had better QOL and longer PFS [compared to historical controls]
Reductions in exercise behavior and tumor progression in newly diagnosed glioblastoma (GBM) patients.
Authors: Peters Katherine B. , Threatt Stevie , Healy Patrick , Herndon James Emmett , Lipp Eric S , Panta Sujata , Randazzo Dina , Vlahovic Gordana , Friedman Henry S. , Desjardins Annick 
Published: September 2018

e21636 Background: At diagnosis, GBM patients face the immediate challenge of significant morbidity and mortality. In this population, we have shown that better exercise behavior is an independent prognostic factor for improved survival. The association between tumor progression and exercise behavior in newly diagnosed GBM patients was explored within a clinical study investigating the use of bevacizumab (BV) with concurrent chemoradiation, followed by BV and temozolomide with the continuation of BV following progression. Methods: In this prospective single-center study, exercise behavior was evaluated using the Modified Godin Leisure Questionnaire at time of study enrollment (before chemoradiation), after chemoradiation, and then every 6 mos until study discontinuation or subject demise. Physical activity was defined as MET-hr/wk with higher number equaling a better exercise behavior. Results: 68 newly diagnosed GBM patients were initially included with a mean age of 55.4 yrs (sd = 10.7 yrs). KPS range was 70-100 with the following being 70 (n = 4), 80 (n = 28), 90 (n = 34), and 100 (n = 2). Subjects who continued study participation 6 mos after the completion of chemoradiation were divided into two groups: subjects with (n = 13) and without (n = 34) tumor progression 6 mos after chemoradiation completion. Subjects that experience tumor progression < 6 mos after chemoradiation had a lower exercise behavior at baseline in comparison to their counterparts that did not experience progression < 6 mos after chemoradiation (mean = 12.8 MET-hr/wk (sd = 22.2) vs. mean = 22.4 MET-hr/wk (sd = 28.9). Moreover, this exercise behavior decreased in subjects that had tumor progression to mean = 6.6 MET-hr/wk (sd = 7.6) and remained relatively stable in subjects that did not progress with mean = 23.9 MET-hr/wk (sd = 44.9). Conclusions: Our observations of exercise behavior over time suggest that poorer baseline exercise behavior is associated with a disease progression within 6 mos of chemoradiation completion in newly diagnosed GBM patients. Moreover, this exercise behavior continues to decline after progression. Based on these observations, a greater understanding of the role of physical functioning is merited in GBM patients. Clinical trial information: NCT01740258.
Results of implementing a novel supportive oncology screening tool for comprehensive evaluation of distress and other supportive care needs.
Authors: Trosman Julia Rachel , Gerhart James , Patel Urjeet , Khosla Paramjeet , Robinson Patricia A. , Penedo Frank J. , Diaz Aidnag , Lillis Teresa , Miranda Harry , Radeke Erika K. , Roggenkamp Betty , Pasquinelli Mary , Feldman Lawrence Eric , Martin Joanna , Lo Shelly S. , Kircher Sheetal Mehta , Garcia Sofia F. , Berardi Rosa , Weldon Christine B. 
Published: September 2018

e21644 Background: The Institute of Medicine (IOM) 2013 Report recommends that supportive oncology care start at cancer diagnosis; the Commission on Cancer (CoC) Standard 3.2 requires distress screening and indicated action. Screening tools are not standardized and often address only a portion of patients’ supportive oncology needs. Methods: A collaborative of 100+ clinicians, funded by The Coleman Foundation, developed a patient-centric screening tool adapted from NCCN Distress Problem List, IOM report and CoC standards, with validated sub-tools: PHQ-4 for anxiety and depression and PROMIS short forms for pain, fatigue and physical function. Novel treatment/care and other concerns were included. The screening tool was implemented at 4 cancer centers (2 academic, 1 public & 1 safety-net). End points included correlation of PHQ-4 score with other supportive oncology needs. Descriptive statistics, Fisher’s exact test were used. Results: 2805 patients were screened. Average scores were: PHQ4 – Anxiety and Depression 1.8 (mild > 3), Pain 4.5 (mild > 4), Fatigue 8.8 (mild > 6), Physical Function 20.2 (mild < 20), see table for additional items. Higher scores on the PHQ-4 were significantly associated with each of the following: greater pain, fatigue, nutritional and specific treatment/care concerns, and lower physical function (p<.0001). Conclusions: Patients with higher anxiety and depression also have many other supportive oncology concerns. Our results support the use of a comprehensive tool capturing a spectrum of each patient’s unique concerns. This may enable earlier interventions and personalized delivery of supportive care. [Table: see text]
Changes in the sleep-wake rhythm, sleep quality, mood, and quality of life of patients receiving treatment for lung cancer: A longitudinal study.
Authors: Lin Chia-Chin , Chang Wen-Pei 
Published: September 2018

e21657 Background: Studies on the diurnal sleep–wake rhythm of patients with lung cancer have mostly examined patients cross-sectionally, whereas the effects of lung cancer treatment over time have rarely been considered. Through long-term longitudinal tracking of patients with lung cancer, this study examined changes in their sleep–wake rhythm, sleep quality, anxiety, depressive symptoms, fatigue, and quality of life (QoL) at various treatment stages. In addition, factors affecting their QoL were explored. Methods: Hierarchical linear modelling was adopted to analyze a convenience sample of 82 patients with lung cancer. The changes in their sleep–wake rhythm, sleep, mood (anxiety, depressive symptoms, and fatigue), and QoL were observed at five time points: prior to treatment and at weeks 6, 12, 24, and 48 after the start of the treatment. The effects of sex, age, cancer stage, treatment type, comorbidities, and time were controlled to determine the predictors of patients’ QoL. Results: The results showed that patients’ sleep–wake rhythms were poor before treatments. Compared with baseline, the sleep–wake rhythms of the patients significantly improved at week 48, and anxiety significantly improved at weeks 6, 12, 24, and 48. By contrast, their fatigue became exacerbated at weeks 8 and 48. Moreover, QoL improved significantly from week 6 until the end of the treatment period. QoL was negatively affected by poor sleep quality ( β = −0.69, p = 0.00) and depressive symptoms ( β = −2.59, p < 0.001) and positively affected by regular sleep–wake rhythms ( β = 0.23, p = 0.001). Conclusions: Therefore, clinical healthcare professionals should focus more attention to the fatigue levels of patients with lung cancer before, during, and after treatment. Healthcare professionals may also need to provide such patients with health education regarding sleep hygiene and with emotional support to assist them in maintaining regular sleep–wake rhythms in order to improve their QoL.
The reasons and timing of the oral transmucosal fentanyl administration in Japan.
Authors: Kajiura Shinya , Kashii Tatsuhiko , Takaki Akiyoshi , Chikaoka Shingo , Hayashi Naomi , Matsushita Takako , Kadota Ayaka , Fukai Sakie , Nakaya Rumi , Tachida Natsumi , Yamamoto Keiko , Nakajima Kazunori , Horikawa Hideyo , Takemura Yoshinori , Shima Tomoko , Furuichi Astushi , Ando Takayuki , Miwa Toshiro , Murakami Nozomu 
Published: September 2018

e21665 Background: The oral transmucosal fentanyl disintegrating tablet, Abstral, is a formulation by which fentanyl can be rapidly absorbed across the oral mucosa producing rapid onset analgesia, and which may be effective for breakthrough cancer pain. It can be administered for the patients who cannot take the oral medicine. It has been marketed since 2014 in Japan. Methods: We selected patients who were administered Abstral for breakthrough cancer pain between 2014 and 2016 at Toyama University Hospital in Japan. We retrospectively investigated administration reasons based on medical record of those patients. Results: There were 111 patients who were administered Abstral. Primary lesions of lung/Gastrointestin/others were 43/52/16, respectively. ECOG PS 0-2/3-4 were 27/84, respectively. The median age was 66 y.o. (range 35-91 y.o.). Regularly using opioid were fentanyl patch prescribed for all patients. Median dose of fentanyl patch was 25mcg/hr (range 12.5-250mcg/hr). 90 patients (81%) had difficulties in the administration of oral medicine, which was the main reason of Abstral administration. Four patients (4%) were to reduce constipation and vomiting as side effects of oxycodone. Seven patients (6%) were to start a fentanyl patch. Three patients (3%) were assessed poor effect for short-acting opioid. Only seven patients (6%) were expected of rapid onset of analgesia effect. Abstral was administered in 27 patients (24%) during aggressive treatment such as chemotherapy administration and in 84 patients (76%) after aggressive treatment. Conclusions: The oral transmucosal fentanyl was administered for the patients who cannot take the oral medicine in Japan while it is expected to be administered to those who want to relieve breakthrough pain fast. Affirming a common understanding of the efficacy of the oral transmucosal fentanyl and breakthrough cancer pain is necessary in Japan.
Patient reported outcomes following palliative gastric RadiOtherapy for symptomatic advanced gastric cancer (PROG): Results from a phase 2 trial.
Authors: Tey Jeremy Chee Seong , Zheng Huili , Soon Yu Yang , Koh Wee Yao , Leong Cheng Nang , Lim Keith Hsiu Chin , Tham Ivan Weng Keong , Lu Jiade J. 
Published: September 2018

e21667 Background: To determine the effect of gastric radiotherapy (RT) on patient reported outcomes (PROs; secondary endpoint) in the PROG trial. Methods: Patients with symptomatic locally advanced or metastatic gastric carcinoma with at least one index symptom of bleeding, pain or obstruction were treated with palliative gastric radiotherapy to a dose of 36Gy in 12 fractions (at 3Gy daily fractions). PROs were assessed using the European Organisation for Research and Treatment of Cancer Qualify of Life Questionanaire-C30 and stomach module STO22. The primary PRO hypothesis was that at least 30% of patients will achieve a > 10 point absolute improvement (considered significant) in the fatigue, nausea/vomiting and pain subscales in the C30, and dysphagia and pain subscales in the STO22 at 12 fractions and one month after radiotherapy. Assessments were performed at baseline, 12 fractions and one month post radiotherapy. Paired T test was used to compare the mean scores from baseline, and at 12 fractions and one month post completion of RT Results: Questionnaires were available from 49 of 50 patients (98%) at baseline, 36 of 45 patients (80%) at 12 fractions and 16 of 38 patients (42%) at one-month post RT. At 12 fractions, 50%, 28% and 44% of patients achieved a significant improvement in fatigue, nausea/vomiting and pain subscales in the C30 respectively. 42% and 28% of patients achieved a significant improvement in dysphagia and pain subscale in the STO22. The observed mean difference was 11 points and 4 points for pain subscale in the C30 and STO22 (P < 0.02). At one-month post RT, 63%, 31% and 50% of patients achieved a significant improvement in fatigue, nausea/vomiting and pain subscales in the C30 respectively. 44% and 19% of patients achieved a significant improvement in dysphagia and pain subscale in the STO22. There were no significant differences in the mean scores in the subscales of interest. Conclusions: Palliative gastric radiotherapy resulted in improvements in fatigue, dysphagia and pain at 12 fractions and at 1-month post radiotherapy in a significant proportion of patients. A phase III trial comparing the effects of different fractionation regimens on PROs is warranted. Clinical trial information: NCT01341756.
Assessment of dysgeusia and taste identification in patients undergoing chemotherapy for breast cancer.
Authors: Kuba Sayaka , Fujiyama Rie , Yamanouchi Kosho , Sakimura Chika , Hatachi Toshiko , Matsumoto Megumi , Yano Hiroshi , Kobayashi Kazuma , Takatsuki Mitsuhisa , Hayashida Naomi , Nagayasu Takeshi , Eguchi Susumu 
Published: September 2018

e21668 Background: Dysgeusia is a common side effect of chemotherapy (CT) and often impacts negatively on QOL. This study analyzed the prevalence of gustatory test abnormalities in breast cancer (BC) patients undergoing CT. Methods: We enrolled 33 BC patients who were undergoing CT (26 adjuvant CT and 7 CT for advanced BC) and conducted 2 gustatory tests on CT day. In the test of sensitivity using the instillation method (IM), 4 basic taste stimuli (sweet, salty, sour, and bitter) at 5 concentrations were applied to the entire oral cavity. For the electrogustometry method (EM), we measured the amount of current for perception of metallic tastes, examining the front two thirds of the tongue (cranial nerve VII) and the back third of the tongue (cranial nerve IX). We compared awareness of dysgeusia with results of the 2 gustatory tests. Results: Median CT duration was 83 days (12–1,353). Fifteen (45%) patients had awareness of dysgeusia (Grade 1: 11, Grade 2: 4). IM revealed 8 (24%) patients with abnormalities, 7 in a single taste species and 1 in 3 taste species. EM revealed 20 (61%) patients withabnormalities, 7 in the cranial nerve VII and 20 in the cranial nerve IX innervation area. All patients with abnormalities in the cranial nerve VII innervation area also had abnormalities in the cranial nerve IX innervation area. Among 15 patients with awareness of dysgeusia, there were 5 (33%) IM abnormalities and 12 (80%) EM abnormalities (4 in the cranial nerve VII and 12 in the cranial nerve IX innervation area). Among 18 patients without awareness of dysgeusia, there were 3 (16%) IM abnormalities and 8 (44%) EM abnormalities (3 in the cranial nerve VII and 8 in the cranial nerve IX nerve innervation area). Patients with IM abnormalities had a higher frequency of abnormalities in the cranial nerve VII innervation area than the normal range (50% and 12%, respectively; p = 0.04); there was no significant difference in the cranial nerve IX innervation area. Conclusions: Nearly half of the patients reporteddysgeusia, but most of these could correctly identify the four basic tastes. Further studies to clarify the discrepancy between subjective and objective observations could lead to effective prevention and treatment of dysgeusia.
Online education needs and preferences of patients with cancer and their caregivers.
Authors: Herrmann Tara , Peters Pamela M. , Van Laar Emily Sherene 
Published: September 2018

e21669 Background: Patients and caregivers have many questions upon receiving a diagnosis of cancer. One way to help alleviate this burden, and enable participation in care is through education. Patient education correlates with higher levels of satisfaction and improved clinical outcomes. However, little is known about how patients and caregivers define their education needs. Methods: We surveyed patients with cancer and caregivers to assess their perceived education needs and resources. Results:2327 individuals representing 9 malignancies participated in the survey. Participants were predominantly patients (72%), with a majority (51%) having received their initial diagnosis of cancer within the past 2 years. Less than a quarter (22%) of respondents felt their educational needs were being completely met by available resources. Respondents were most likely to seek out information at the time of diagnosis (24%) and to increase understanding of treatment options (24%). Conversely, individuals were least likely to seek education upon disease progression (7%). In all malignancies examined, the 2 topics considered most important were treatment options (70%-89%) and understanding test results (74%-87%) while information about how to take medication as prescribed was deemed least important (46%-67%). Conclusions: Our study identified a lack of educational materials available and designed to meet cancer patients’ needs on the internet. Given that few patients and caregivers reported that their educational needs are being met, efforts may be needed to ensure that those patients who want to receive education to become informed patients can find what they need, when they need it.
Improving distress screening completion rates: Does virtual robot animation make a difference?
Authors: Dvorak Tomas , Robinson Diane , Ross Emily , Milliard Sharlin , Metcalf David , Hajdenberg Julio 
Published: September 2018

e21672 Background: Distress screening is an important part of cancer patients’ care. Programs accredited by Commission on Cancer must implement distress screening programs, based on improved doctor-patient relationships and clinical outcomes. We are interested in evaluating the use of an anthropomorphic robotic interface to improve survey completion rates and the patient experience. Methods: A validated distress screening survey was scheduled for 74 patients in 2016 in an IRB-exempt survey study. Patients were randomly assigned to fill out the survey on iPAD (N = 33), or on iPAD with a virtual robot animation (“Betty”) introducing the survey (N = 41). Patients were then asked to fill out a validated 10 question Technology Acceptance Model questionnaire (TAM) asking about ease of iPAD use. A five point Likert scale was used. Finally, two yes/no questions were asked: 1) “Were you more interested in filling out the distress screening survey because of the “Betty” animation?”, and 2) “Did the animation make filling out the distress screening survey more enjoyable?” Results: The survey completion rate was 24/33 = 73% for control and 26/41 = 63% for intervention groups (p = 0.86). Forty five patients completed the TAM questionnaire, with completion rate 92% and 88%, respectively. Average iPAD TAM score was 4.3 in the control group and 4.0 in the intervention group (p = 0.12), and none of the 10 questions showed statistically significant difference in ease of use. The last two questions evaluating “Betty” directly were answered by 17/23 and 15/23 patients, respectively. 8/17 felt they were more interested in filling out the distress screening because of “Betty”, and 7/15 felt “Betty” made the distress screening more enjoyable. Conclusions: The presence of “Betty” as part of the survey process did not negatively impact the completion rates. There was no significant difference between the groups in perceived ease of use of the iPAD on which the survey was administered. Approximately half of the patients taking the distress survey with the “Betty” animation felt they were more interested in filling out the survey and the process was more enjoyable. We are currently evaluating whether a true robot may improve completion rates and patient experience.