bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical course of patients with cisplatin (CDDP)-associated neuropathy compared to other neurotoxic chemotherapy.
Authors: Albany Costantine , Dockter Travis , Wolfe Eric G , Pachman Deirdre R. , Wagner-Johnston Nina D. , Lazzara Kayla Marie , Sego Lina M , Edwards Sara I , Snow Christin I , Hanna Nasser , Einhorn Lawrence , Loprinzi Charles L. , Costello Brian Addis 
Published: May 2019

e23078 Background: There are limited patient (pt) reported outcome data regarding CDDP neurotoxicity. Methods: CDDP-induced peripheral neuropathy was evaluated in pts with testicular cancer planning to receive CDDP (20 mg/m2/d for 5 days) for ≥ 3 cycles. Neurotoxicity was assessed with the EORTC QLQ-CIPN20 tool before each CDDP cycle and every 2-4 months after, out to 18 months. We compared these data to our studies evaluating pts receiving doxorubicin/cyclophosphamide (AC), paclitaxel and oxaliplatin. The total score of the EORTC QLQ-CIPN20, each of the three subscale scores and each individual item was computed following the standard scoring algorithm and converted to a 0-100 scale. Descriptive statistics and graphical plots were utilized. Results: 54 pts receiving CDDP (mean age 33 years) and 18 pts receiving AC were evaluated. Following completion of CDDP, neuropathy symptoms (sensory neuropathy score and numbness/tingling in toes/feet) worsened for about 6 months (consistent with the so-called “coasting phenomena”), similar to what had previously been seen with oxaliplatin (but different than what had been seen with paclitaxel). For CDDP pts, during therapy, numbness and tingling in fingers/hands were more prominent, than the same symptoms in the toes/feet. After therapy was completed, numbness, and tingling became more prominent in toes/feet, but improved in the fingers/hands. After stopping therapy, shooting/burning pain did not worsen in upper or lower extremities. During therapy, CDDP pts had less problems than had previously been seen with oxaliplatin or paclitaxel, maybe because of the younger ages of the CDDP pts. With AC, all of the CIPN-20 sensory neuropathy scores were better than was seen in the pts receiving CDDP and also in pts receiving paclitaxel and oxaliplatin in previous evaluations. Conclusions: CDDP-induced neuropathy is more similar to oxaliplatin-induced neuropathy than paclitaxel-induced neuropathy. AC chemotherapy pts do not have substantial changes in CIPN 20 scores, consistent with the CIPN 20 instrument being a measure of chemotherapy-induced neuropathy, as opposed to more general chemotherapy-induced toxicities. Clinical trial information: NCT02677727.
Systematic review and meta-analysis of definitions and reported incidences of anthracycline cardiotoxicity.
Authors: Jang Sae , Ruddy Kathryn Jean , Loprinzi Charles L. , Armenian Saro , Lenihan Daniel John , Herrmann Joerg 
Published: May 2019

e23081 Background: Anthracycline-induced cardiotoxicity (AIC) is a well-known phenomenon, but the true incidence is poorly defined, and definitions of AIC in the literature are variable. We performed a systematic review and meta-analysis to elucidate AIC definitions and the incidence of clinical heart failure (HF) and subclinical AIC reported in adult breast cancer and lymphoma patients after anthracycline (AC) therapy. Methods: 3,428 abstract and titles were identified via PubMed search. Inclusion criteria for full text review included minimum of 100 adult patients receiving ACs; median/mean follow up of at least 12 months; and specified evaluation of left ventricular ejection fraction. Outcomes were divided into clinical HF and subclinical AIC. Meta-analysis was performed with MedCalc software with random effects model. Results: 366 full text articles were reviewed. 24 studies, including a total of 11,065 patients, reported clinical HF findings; 21 studies, including a total of 8,098 patients, reported subclinical AIC findings. Meta-analysis showed an overall incidence of clinical HF of 3.1% (range 0 to 29%, CI 1.9 to 4.6%, I2= 93.9%); an incidence of 2.0% (CI 0.9 to 3.6%, I2 = 91.6%) in breast cancer patients receiving AC; and 4.8% in lymphoma patients receiving AC (CI 2.1 to 8.6%, I2 = 93.6%). Subclinical AIC was seen in 13.8% overall patients (range 2 to 45%, CI 10.4 to 17.7%, I2= 95.3%); 10.3% of breast cancer patients (CI 7.0 to 14.3%, I2= 95.0%); and 19.8% of lymphoma patients (CI 12.3 to 28.6%, I2= 94.4%). Incidence of HF correlated with increasing age (r = 0.51, p = 0.06) and cumulative dose (r = 0.51 , p = 0.19). There was notable heterogeneity of AIC definitions between studies (Table). Conclusions: Cardiotoxicity is not uncommon among patients who receive AC, particularly at doses given for the treatment of lymphoma. However, there was considerable heterogeneity in HF incidences. More uniform criteria and precise estimates are needed to inform clinical practice and trials. [Table: see text]
Impact of cisplatin-related hearing loss (HL) and tinnitus on patient functioning.
Authors: Ardeshirrouhanifard Shirin , Adra Nabil , Monahan Patrick O. , Norton Kelli , Fung Chunkit , Einhorn Lawrence H. , Frisina Robert D. , Travis Lois B. 
Published: May 2019

e23085 Background: Patients given cisplatin-based chemotherapy (CBC) experience HL and tinnitus. However, the impact of these toxicities on psychosocial and physical functioning in cancer survivors has not been systematically evaluated. Methods: Eligible testicular cancer survivors (TCS) aged ≤ 55 y at diagnosis and given first-line CBC at Indiana U., completed comprehensive questionnaires. The validated 25-item Hearing Handicap Inventory for Adults (HHIA) quantified emotional (13 items) and social difficulties (12 items) related to HL. The validated 20-item Tinnitus Primary Function Questionnaire (TPFQ) assessed domains affected by tinnitus, i.e., concentration, emotion, hearing, sleep (5 items each). For each HHIA scale, TCS were grouped into 3 standard handicap levels: 016% (none/minimal), 18-42% (mild/moderate), and 44-100% (significant). Proportions of social vs. emotional handicap were compared with a McNemars test. For TPFQ, each scale score is continuous (0: [no interference] to 100% [total interference by tinnitus]) and computed as the mean of 5 items. TPFQ measures were compared by signed-rank tests (P < 0.05 was significant). Results: Of 43 TCS (median age: 35 y, range 2074 y; median time since chemotherapy completion: 7 y, range 2-27 y), 95% were white, and 70% had at least a college degree. Median cumulative cisplatin dose was 300 (range 200-600 mg/m2). The most commonly administered regimen was bleomycin, etoposide and cisplatin; 23 (53.5%) reported HL, and 25 (58%) had tinnitus. Of TCS with HL, 25% had some degree of related handicap (total HHIA scale: 20% and 5% for mild/moderate and significant handicap, respectively). More TCS had social vs. emotional handicap (33.3% vs. 14.3%, P = 0.13). Tinnitus had significantly greater interference with emotion (median: 14, range 0-84) compared to concentration [(median 6, range 0-41), p = 0.04)], and sleep [(median: 0, range (0-78), p = 0.001)]. Other comparisons were not significant. Conclusions: Cisplatin-related HL has a considerably greater negative impact on social vs. emotional measures, and affected TCS may benefit from hearing aids. TCS experiencing significant issues related to emotion due to tinnitus may benefit from interventions to lessen their impact.
Detection of bone metastases through diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) compared with PET/CT 18F-NaF.
Authors: Barragan-Campos Hector Manuel , Le Faou Anne Laurence , Burgos-Jaramillo Martín , Lopez-Soto Fernando , Altamirano Ley Javier , De la Peña-Lopez Roberto 
Published: May 2019

e23086 Background: To evaluate a diagnostic test which can allow the comparison between Diffusion-weighted imaging with background suppression (DWIBS) the novel diagnostic modality versus PET/CT 18F-NaF, the gold standard for the diagnosis of bone metastases (BM). Methods: University bioethics committee authorized the protocol. Patients with solid cancer and suspicion of BM (by clinical findings, imaging, and tumor biomarkers), who met inclusion criteria were included and provided their signed informed consent. The DWIBS in a MR 3.0 T was performed first and then the PET/CT 18F-NaF. Each study was interpreted blinded. Statistics to evaluate a diagnostic test were performed. Results: From April 2014 to April 2016, 91 patients (100%) were interviewed, 88 (93.4%) met the inclusion criteria. Nine patients (8%) were excluded: death 3, respiratory failure 2, refused participating 2, pacemaker 1, claustrophobia 1. Seventy-nine patients (86.8%) were included, of which 81.0% (64/79) were women. Primary cancer was: a) breast 73.4 b) prostate 15.2%; c) Non-Hodgkin lymphoma 2.5%; d) cervical 2.5%; e) thyroid 2.5%; f) lung 1.3%; g) colon 1.3%; and h) testicular 1.3%. Diagnostic performance of DWIBS compared to PET/CT 18F-NaF, sensitivity 88.1% (Confidence Interval [CI95%, 73.3-96.0), specificity of 48.7% (CI 95%, 31.9-65.6), PPV of 66.0% (CI 95%, 58.2-73.1), NPV of 78.3% (CI 95%, 59.7-89.7), PLR 1.7 (CI 95%, 1.2-2-4), NLR 0.2 (CI 95%, 0.1-0.6) and prevalence of 53.1% (CI 95%, 41.6-54.5). Results were stratified in quartiles (excellent, good, fair, and poor). Conclusions: DWIBS has excelent sensibility, fair specificity, good PPV, and excellent NPV. These data suggest DWIBS could be used as a proxy of PET/CT 18F-NaF.
Effect of pre-treatment anxiety and depression on long term survival of prostate cancer patients treated radically with radiation and hormone therapy.
Authors: Jones Lauren , O'Cathail Micheal , Hosni Shaymaa Usama , Little Jessica , Cox Ashley , Fergusson Eamonn , Sundar Santhanam 
Published: May 2019

e23087 Background: The evidence for effect of anxiety and depression on cancer survival rates is contradictory (Ref : Prostate-JCO 2014.32:2471, Breast-JCO 1987. 5:768, Lung-JPSM 2017.53:1057). We assessed the effect of prospectively collected HADS score (Hospital Anxiety and Depression Scale) on subsequent long term survival. Methods: After ethics approval & informed consent, 145 prostate cancer patients (pts) were enrolled, onto a QOL study. HADS questionnaire was prospectively completed at baseline & at 3 mths after start of androgen deprivation therapy (ADT). Survival data collected in Jan 2019. PATIENT CHARACTERISTICS: Median age 69 (range 50 to 78); T stage T2:63.5%, T3:28.4%. Gleason 7 in 53.4% and 8-10 in 39.2%; Median PSA 10.2 (0.3 to 102); Median testosterone 11.6 (0.6 to 26.7); ADT duration median 6 mths (2 to 60 mths); Median overall survival 10.11 yrs Results: At baseline, HADS anxiety scores normal (0-7) in 78%; abnormality mild (8-10) in 12%; moderate (11-14) in 6% and severe (15-21) in 2%.. At > 3 mths, respective anxiety scores (%) were 71.3, 17.5, 7.7 and 3.5. At baseline, HADS depression scores (%) were 91.2, 5.2, 1.4 and 0.7. At > 3 mths, respective depression scores were (%) 83.9, 11.2, 3.5 and 1.4 Although median survival was numerically lower in pts scoring high on HADS at baseline, the survival rates were not statistically significant on Log rank test. Moreover, on Cox regression analysis with Age, Gleason Score, T Stage, baseline PSA as co-variates, there was no increased hazard from higher HADS scores (Table). Conclusions: Biological factors probably outweigh the influence of psychological factors on overall survival. [Table: see text]
Is in vivo reflectance confocal microscopy a useful assessment tool in chemotherapy-induced peripheral neuropathy (CIPN)?
Authors: Ramnarine Sabrina , Rolke Roman , Dougherty Patrick M. , Williams Linda J , Alessi Fox Christi , Coleman Andrew , Fallon Marie T 
Published: May 2019

e23088 Background: The lack of standardized diagnostic or assessment tools in CIPN pose an unmet need for objective and reliable measures. Advances in non-invasive, in vivo reflectance confocal microscopy (RCM) offer a painless method to identify markers of peripheral neuropathy such as loss of Meissner’s corpuscles (MC). This study aims to investigate the feasibility of RCM in CIPN by assessing MC density in healthy controls compared to cancer patients. Methods: RCM imaging (Vivascope 1500) was performed on the fingertip (digit V) to evaluate MC density in 45 healthy controls and 9 cancer patients prior to starting chemotherapy. Quantification was completed by two reviewers, one being blinded to achieve unbiased identification as the maximum MC count/6x6 mm image. Quantitative Sensory Testing (thermal and mechanical detection thresholds) along with the grooved pegboard test (sensorimotor function) were conducted for comparison with MC density. Spearman’s correlation coefficients were used to determine associations. Results: In healthy controls (25 females, 20 males; mean age 58.9, range 24-81 years), females exhibited a greater mean MC density compared with males (49.9 ± 7.1 MC vs 30.9 ± 4.2 MC; p = 0.03). Variances were observed across age range by decade (p < 0.0001). MC density was inversely correlated with mechanical detection (ρ = -0.51) and warm detection thresholds (ρ = -0.47) in contrast to cold pain threshold (ρ = 0.49). All correlations were significant (p < 0.01). Time to complete the grooved pegboard test correlated with MC density in the dominant hand (p = 0.02) and non-dominant hand (p < 0.01). Compared with age and gender matched controls, cancer patients had reduced MC density (22.0 ± 9.3 vs 35.4 ± 14.1; p = 0.03), mirroring deficits in cold detection threshold and the grooved pegboard test. Inter-rater reliability of MC density count showed an intraclass correlation of 0.96 (p < 0.0001). Conclusions: The findings from this study support the clinical utility of RCM in CIPN. Assessment of MC density using RCM may provide meaningful markers of sensory loss, sensorimotor function and an ability to detect possible subclinical deficits in patients at risk of CIPN prior to initiating chemotherapy.
Factors affecting sleep quality and its association to quality of life in adult Filipinos with cancer.
Authors: Gerona Amabelle Trina Borgonia , Baquilod Ryelene , Bernardo Deborah A. , De Guzman Roselle B. 
Published: May 2019

e23100 Background: Sleep disturbances are highly prevalent in cancer patients and may be attributable to factors including pain, treatment side effects and psychological factors. However, the relationship between sleep and cancer is bidirectional. There is substantial evidence that sleep disturbance is associated with many aspects of cancer treatment, morbidity, mortality and quality of life. This study evaluated sleep quality in adult Filipinos with cancer and determined the association of demographic characteristics and clinical features to sleep quality. Methods: This was a cross-sectional surveillance study conducted among adult Filipinos with cancer seen at the Ambulatory Care Unit of a tertiary hospital. Questionnaires were answered to assess subjective sleep quality, pain score and quality of life. Frequency and percentages were determined. Determination of factors affecting sleep quality was analyzed using univariate and multivariate statistics. Results: Of the 406 cancer patients studied, 80% were women and the mean age was 53 years old. Majority (62%) had breast cancer. Seventy-nine percent (79%) of the patients had a PSQI score of 5 or greater, indicating poor sleep quality. Sleep among participants was characterized by prolonged time to fall asleep and shortened sleep duration. Majority reported some degree of daytime dysfunction due to poor sleep. Age, gender and marital status did not appear to affect the quality of sleep. Among disease-related factors, presence of more advanced disease, increasing pain severity and treatment with chemotherapy and/or radiotherapy were demonstrated to lead to poorer sleep quality. Surprisingly, even patients who were not receiving any active therapies (on-going surveillance) complained of sleep disturbance. Upon further investigation, poor sleep quality was shown to predict a worse quality of life among the study participants. Conclusions: Overall, the quality of sleep among adult Filipinos with cancer is significantly impaired. In particular, presence of more advanced disease, treatment with chemotherapy and radiotherapy and moderate to severe pain significantly increase the risk of having poor sleep. In turn, disturbed sleep predicted a poorer quality of life. These findings support the need to include assessment of sleep quality for a more holistic approach to cancer care.
Are patients with advanced colon cancer availing of palliative care services?: Findings from a high-volume urban center.
Authors: Jamorabo Daniel S , Renelus Benjamin D , Kancharla Pragnan , Briggs William M 
Published: May 2019

e23101 Background: Palliative care is integral to cancer treatment. Our goal was to investigate the factors associated with palliative care service involvement for hospitalized colon cancer patients. Methods: We carried out a retrospective study of all colon cancer patients diagnosed and hospitalized at our institution from 1/1/2010 through 12/31/2017. We identified 667 patients, including 370 women (55%). We used Fisher’s exact test to find statistically significant differences in proportions of patients seen by the palliative care service based on sex, race, cancer stage, surgical intervention, and chemotherapy administration. Results: We found that 561/667 (84%) colon cancer patients were not evaluated by the palliative care service (including 301 women; 54%) and that overall they were unlikely to have been evaluated regardless of sex, race, cancer stage, or chemotherapy (Table). Patients who underwent surgery were equally likely to be seen by the team as those who did not have surgery. We found that 53% (150/285) of patients with Stage III and IV disease received neither chemotherapy nor palliative care evaluation. Conclusions: The palliative care service is underutilized at our facility even when patients with advanced stage disease are hospitalized. Even when patients are not on chemotherapy, the palliative care service remains uninvolved. This may be due to inadequate staffing, misconceptions that providers and patients have about palliative care, or lack of coordination between inpatient and outpatient providers. We did not find that palliative care service utilization led to a statistically significant difference in survival, but their involvement is critical to helping address patients’ goals of care and symptoms. It is also instrumental to improving cancer patients’ quality of life both in the outpatient and inpatient setting, regardless of cancer stage or survival, as in our patient population. More effort is needed to include the palliative care service in the care of patients with advanced colon cancer. [Table: see text]
The efficacy and safety of exercise in metastatic solid cancer: A meta-analysis of randomized control trials.
Authors: Nadler Michelle , Saleh Ramy , Desnoyers Alexandra , Amir Eitan 
Published: May 2019

e23107 Background: The prevalence of people living with metastatic solid cancers is increasing. Such patients can experience cancer-related fatigue, decreased physical function (PF), and poor quality of life (QoL). Exercise has been shown to improve these symptoms in the curative setting, but there is uncertainty about the efficacy and safety of exercise in patients with metastatic cancer. Methods: Studies were identified from 3 prior systematic reviews and updated using a search of PubMed. Included studies were prospective randomized controlled trials of any moderate/high intensity aerobic exercise or resistance training intervention versus control in patients with metastatic solid cancers. The mean score and standard deviation (SD) for validated outcome measures (QoL, PF, and fatigue) were extracted for intervention and control groups at baseline and post-intervention. The effect of exercise was evaluated as the pooled change between baseline and post-intervention comparing exercise and control groups. Analysis was performed using the Mann Whitney test. Results: Of 21 trials which met inclusion criteria, 7 were excluded due to incomplete data. Among patients with mean baseline scores, exercise was not associated with significant change in fatigue, PF or QoL, although improvement was noted in 6-minute walk test (6-MWT) (14.7 vs 27.4 meters). QoL scores showed non-significant improvement (0.4 vs 4.9). In those with baseline scores 2SD below mean, exercise provided clinically meaningful improvement in PF using two different subscales (0.44 vs 8.5 and -1.0 vs 5.1) and avoidance of decline in 6-MWT (-29.75 vs -0.38m), although these did not meet statistical significance. There was a statistical improvement in sit-to-stand at the mean and 2 SD below the mean (2.5 vs 6.5, p = 0.029) for both groups. Only 5 papers reported adverse events in a standardized fashion in both groups. No differences in falls, fractures, or pain were reported. Conclusions: In patients with metastatic solid cancers, exercise interventions are associated with clinically meaningful improvements in PF, and statistically improved sit-to-stand scores. The effects are seen in patients with baseline score at the mean or lower.
Breast cancer patients’ quality of life: Real-world data.
Authors: Kosmidis Paris A. , Athanasakou Barbara , Kosmidis Thanos 
Published: May 2019

e23115 Background: CareAcross is a digital platform dedicated to support, inform and engage with cancer patients. It also collects medical and other data, and generates real world evidence. Methods: In an effort to collect and analyze information from breast cancer patients regarding side effects in relation to their treatments and supplements intake, we contacted 4837 patients in the UK, Germany, France, Spain and Italy. 474 had triple negative breast cancer (TNBC) and the remaining 4363 other breast cancer subtypes (non-TNBC). All data was collected anonymously, with strong privacy and security controls. Results: Different regimens were given either as adjuvant or as systemic treatments. AC treatment was given to 9% of TNBC vs 4% of non-TNBC patients; FEC-T to 20% vs 13%, FEC to 10% vs 8%, taxanes to 37% vs 20% and platinum-based chemotherapy to 12% vs 2%, respectively. Among non-TNBC patients, 12% received Trastuzumab and 53% received hormonal treatment. Eighty four TNBC and 696 non-TNBC patients were asked regarding side effects as well as vitamins and supplements intake. Among them, 76 TNBC patients reported an average of 2.8 side effects (95% CI 1.0-8.0) vs 577 non-TNBC patients reporting an average of 2.8 side effects (95% CI 1.0-13.0); p < 0.92. Similarly, an average of 5.0 vitamins and supplements was reported by 64 TNBC patients (95% CI 10.0-17.0) and an average of 3.8 was reported by 555 non-TNBC patients (95% CI 1.0-29.0); p < 0.023. Toxicity and supplements are tabulated below. Conclusions: The real world evidence obtained through an international analysis shows that TNBC patients receive more toxic treatments due to the aggressive disease, as expected. However, TNBC patients experience similar toxicities with non-TNBC patients, but their consumption of vitamins and supplements is much higher. [Table: see text]