bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acupuncture: Real-world patient-reported outcomes of treatment-related symptoms in breast cancer survivors.
Authors: Zayas Jacqueline , Ruddy Kathryn Jean , Olson Janet E. , Couch Fergus , Bauer Brent , Mallory Molly , Yang Ping , Zahrieh David , Loprinzi Charles L. , Cathcart-Rake Elizabeth Jane 
Published: May 2019

e23111 Background: Acupuncture has been shown to reduce aromatase inhibitor-induced arthralgias, as well as possibly hot flashes and fatigue, but research has been limited. The purpose of this study was to evaluate real world perceived benefit of acupuncture for commonly experienced symptoms among breast cancer survivors. Methods: Breast cancer survivors who had used acupuncture for cancer- or treatment-related symptoms were identified using an ongoing prospective Mayo Clinic Breast Disease Registry (MCBDR) cohort. In addition, Mayo Clinic electronic health records (EHR) were queried to identify additional participants. All identified patients were mailed a survey with acupuncture-related questions. Respondents were also asked to recall their severity of arthralgia, myalgia, post-surgical pain, hot flashes, nausea/vomiting, fatigue, depression, anxiety, insomnia, lymphedema, headache, and neuropathy from 1 to 5 (1 = mild, 5 = severe) before and after acupuncture treatment. Results: Acupuncture use was reported among 413 participants in MCBDR (12% of all enrollees) and 73 patients were identified in the Mayo EHR. 241 eligible women returned surveys (median age at diagnosis 50 yrs). Mean symptom severity scores decreased from before to after acupuncture by at least 1 point for all queried symptoms (Table). Conclusions: Acupuncture is frequently used by patients for a variety of breast cancer-related symptoms. Those who do pursue acupuncture usually perceive few toxicities and substantial benefits. Cost may be a barrier to treatment for some. [Table: see text]
Association of the quality of psychosocial support and quality of life in patients with chronic oncological pain.
Authors: Gonzalez-Guerrero Juan Francisco , Alcorta-Garza Antonia Gloria , Alcorta-Nuñez Fernando , Melgoza-Alcorta Emma María , Gonzalez-Rodriguez Melany , Gonzalez-Alcorta Celia Beatriz , Alcorta-Garza Adelina 
Published: May 2019

e23113 Background: Most studies report that tumor related pain occurs between 46% and 92%. The prevalence of pain by clinical stage is 15% in initial stages, 30% in middle stages, 74% in metastatic cancer and, 87% in terminal disease. In the face of chronic diseases such as cancer, patient's relationships with their social networks are affected; among them the interpersonal relationships between the patient and his networks and these towards the patient. With this, the patient’s quality of life is affected. Most of the recent studies on health-related quality of life come from pharmaceutical groups, so it is necessary for other groups to be vigorously involved in the study of the effect of medical interventions on the quality of life, as well as on the impact on health and on the social support of patients with chronic diseases. Methods: In order to obtain the data, validated questionnaires were used as instruments to evaluate the quality of life, measuring psychosocial and health variables, as well as for the detection of the type and quality of psychosocial support perceived by the subjects. The instruments were applied to 207 patients of the Oncology Service of the University Center Against Cancer of the University Hospital “Dr. Jose Eleuterio Gonzalez” in Nuevo Leon, Mexico, during a session of 25 to 30 minutes. Results: Data were collected from 207 patients with chronic oncological pain. The satisfaction index with psychosocial support had a high linear correlation ( r = .640) with the quality of life index. On the other hand, the number of caregivers was not correlated with this last index. Fatigue was the symptom most frequently associated with a decrease in the quality of life index. In addition, pain correlated with all variables except the cognitive index. Conclusions: Satisfaction with the perceived social support is a factor associated with the quality of life in patients with chronic oncological pain; however, the number of caregivers is not. There was no relationship between the size of the network and satisfaction with it. Also, the symptoms associated with chronic oncological pain affect quality of life, identity and social functionality and roles, which in turn impact on the quality of life perceived by patients.
The effect of a structured weekly patient meeting on patient reported outcomes (PRO) and resource utilization for patients with metastatic breast cancer (MBC).
Authors: Rosenzweig Margaret Q. , Resier Victoria , Heckman Rachel , Welch Ann , Ren Dianxu 
Published: May 2019

e23116 Background: Women with MBC experience unmet unique symptom management and psychosocial needs due to chronic treatment for an eventually life ending illness. Methods: The MBC Program of Care is a 1 hour weekly, nurse led review of scheduled clinic patients by an interdisciplinary team incorporating structured needs appraisal and referral for supportive, palliative care resources. Outcomes included referral rates to supportive services, patient reported outcomes (PRO) of symptom distress, generalized anxiety and overall well-being. Health care utilization outcomes included clinic calls as well as inpatient and emergency room visits. A prospective, paired pre and post experimental design. One hundred and eighteen women with MBC who visited an urban outpatient breast cancer clinic from September 2016-November 2016 (pre) and from January 2017-March 2017 (post). Validated instruments of symptoms ( Adapted Memorial Symptom Assessment), anxiety (Generalized Anxiety Scale), and overall well-being scores (0-10 Likert) assessed PROs. Electronic chart review evaluated social work and palliative care referrals, hospital admissions, emergency room visits and phone calls to the outpatient clinic pre and post program implementation. T test and chi squared test for paired comparison of mean was performed. Results: Following program implementation, referrals to palliative care (p = .000) and social work (p = .001) increased significantly. PROs of symptoms (p = .001); anxiety (p = 0.002); and overall well-being (p = .002) improved significantly. Health care utilization including emergency department visits (p = .001) and patient calls (p = .005) decreased significantly post program implementation, although hospital admissions increased (p = .003). Cost of program was $750 weekly. Conclusions: Systematic review of patient needs and referral to existing supportive services improved MBC PROs and decreased emergency room visits and clinic calls. Post hospital admission increase may be attributed to MBC disease progression. This is a cost effective MBC model of palliative care implementation.
Implementation of the VA Symptom Assessment Scale (VSAS): Five-year experience.
Authors: Friedman Daphne Ruth , Patil Vikas , Rasmussen Kelli Marie , Sauer Brian C , Kelley Michael J. , Halwani Ahmad Sami 
Published: May 2019

e23120 Background: Cancer patients experience symptoms which may precede diagnosis, occur during therapy, and persist into survivorship. Symptom assessments and patient reported outcomes have been shown to improve quality of life and extend survival in cancer patients. The Veterans Administration Symptom Assessment Scale (VSAS) is a clinical tool to document cancer-related symptoms. Here, we report VSAS adoption in five Veterans Health Administration (VHA) hematology-oncology sites during a five-year period. Methods: Data was collected from the Corporate Data Warehouse (CDW): VSAS data, date of birth, gender, race, ethnicity, vital status, year of cancer diagnosis, ICD-O-3, VHA facility, and clinic stop codes. Descriptive analyses of patient demographics, disease characteristics, and VSAS utilization was performed. VSAS is comprised of 13 symptoms, rated on a 0 to 10 scale. A VSAS visit was defined as the date the VSAS was administered to a patient. Results: From January 2013 through June 2018, there were 41,917 instances of VSAS administered to 9,409 unique patients at five VHA facilities: 8,512 (90.5%) were male; 5,241 (56%) were non-Hispanic White, 3,743 (40%) were Black, and 297 (3%) were other racial categories or not available. The median age at the first VSAS visit was 67 years. In patients whose oncologic diagnosis was recorded by a cancer registrar (4,536), the most common diagnoses were prostate cancer, lung cancer (all histologies), colon cancer, and multiple myeloma. The number of VSAS administrations increased annually, from 866 in 2013 to 12,775 in 2017, which may be attributed to increased adoption of VSAS across and within VHA facilities. Individual patients completed the VSAS 1-57 times (median 2). At the five VHA facilities utilizing VSAS in 2017, VSAS was administered at 56% of hematology-oncology clinic visits. Conclusions: VSAS is a tool to measure and document patient symptom burden, and has been successfully adopted in the last five years at select VHA facilities. Expanded use of VSAS throughout the VHA is an important step in improving the quality of life and extending survival of veterans with cancer and blood disorders.
Complementary medicine and cancer: A French multicenter survey.
Authors: Correard Florian , Blanc-léger Françoise , Roux Clarisse , Lobrot Florence , Pinguet Frédéric , Pourrat Xavier , Pourroy Bertrand , Donamaria Catherine , Kopferschmitt Jacques 
Published: May 2019

e23127 Background: There have been few reports about Complementary Therapy (TC) use in outpatients who are on active cancer chemotherapy in France. TC may interact with cancer treatments, reduce efficacy, or enhance adverse effects. Methods: This is a cross-sectional survey on TC use in 7 French hospitals (outpatient chemotherapy, conventional hospitalization and medical consultation departments). Eligible patients had to be followed for a cancer and be over 18. Results: 415 patients answered the questionnaire. 54% were female, More than 80% of patients were over 50. 230 patients (55.4%) reported using TCs. TCs were prescribed or recommended for 180 patients. The main TC users were patients with melanoma or other cutaneous cancer (90% of them) and bone and soft tissues sarcomas (86% of them). Most patients used only one TC (52.6%). The most used TCs were Phytotherapy (48%), Homeopathy (40%), supplemental dietary (35%) and aromatherapy (21%). 110 patients (47, 8% of patients with TC) used phytotherapy. The most used plants (≥5% of use) were: Curcuma and its derivative curcumine (13.9%), desmodium (7.4%), thymus (5%). 93 patients used homeopathy (40.4% of patients with TC). Only 48 patients used aromatherapy (20.9% of patients with TCM or 11.6% of the whole population). 81 patients used Supplemental dietary (35.2% of patients with TCM or 19.5% of the whole population). Only 27 patients used oligo-elements (11.7% of patients with TCM or 6.5% of the whole population),). Interestingly, 20% of patients declared to use others TCs (Physical activity, Acupuncture, Somatotherapy, Sophrology, Chinese traditional Medecine, Specific diet, Psychotherapy…). Patient who used TC were mainly under chemotherapy regimen.For each TC, most patients considered that they were useful or very useful. The main reasons for using TCs were “Wellbeing and psychological support” (35.8%), “Clinical symptoms and chemotherapy tolerance improvement” (34.6%) and “Treatment of cancer” (17.7%). Conclusions: To protect cancer patients from the potential hazard of combining their cancer treatment with TCs, patients should systematically be encouraged to report their TC use, while oncologists and pharmacists should be trained on evidence of TC, and patient guidance for a safer TC use.
Depression and health care utilization and costs in patients diagnosed with cancer.
Authors: Steel Jennifer Lynne , Richards Geena , Billiar Timothy , Procopio Judith , Miceli Jessica , Hecht Carol Lynn , Kucinski Barbara , Tsung Allan , Murphy Emily , Marsh J. Wallis , Antoni Michael , Vodovotz Yoram , Layshock Mikhaila , Spring Michael , Pathak Ritambhara , Cheng Hannah , Geller David A. 
Published: May 2019

e23128 Background: The aims of this study were to examine the associations between depression and complications, health care utilization and costs in patients with cancer. Methods: Patients diagnosed with cancer were administered a battery of questionnaires, including the Center for Epidemiological Studies-Depression (CES-D) Scale. Health care utilization and costs for patients was collected for one year after the administration of the CES-D. Descriptive statistics, Chi-square and ANOVA, and ordered restricted inference analyses were performed. Results: Of the 100 patients, the mean age was 64.0 years (SD = 10.3), the majority of patients were male (51%), Caucasian (89%), diagnosed with hepatocellular or cholangiocarcinoma (47%) and stage III and IV cancer (60%), and 34% of patients had clinical levels of depressive symptoms (CES-D > 16). No demographic or disease specific variables were associated with depressive symptoms or outcomes. Surgical patients with clinical levels of depression had a greater number of complications [Chi-square = 4.4, p = 0.036] and a greater severity of complications using Clavien-Dindo classification [Chi-square = 4.5, p = 0.033]. Patients undergoing chemotherapy, who reported depressive symptoms in the clinical range, were more likely to require medical intervention for chemotherapy side effects [Chi-square = 4.2, p = 0.04]. Patients with clinical levels of depressive symptoms also had a greater number of emergency room visits [F(1,99) = 8.4, p = 0.005]. Patients who reported clinical levels of depressive symptoms had significantly higher median costs associated with the loss of work force productivity (Median = $7154 versus $2104; p = 0.015), hospital costs (Median = $29,917 versus $8292, p = 0.019), and cost per registration (Median = $3324 versus $1247, p = 0.017) but lower physician costs (Median = $6171 versus $10,821; p = 0.026) than patients with non-clinical levels of depressive symptoms. Conclusions: Depressive symptoms are associated with increased complications and health care utilization and costs. There is an urgent need for effective and scalable interventions to reduce depressive symptoms in patients diagnosed with cancer to improve quality of life and reduce health care utilization and costs.
Efficacy of different TCM treatment techniques combined with standardized step therapy for cancer pain: A network.
Authors: Lv Peng , Li Ya , Zhang Zhenzhu , Shi Fengqin , Hou Li 
Published: May 2019

e23131 Background: Comparative study results between the efficacies of traditional Chinese medicine (TCM) therapy with Western medicine therapy in the treatment of cancer pain remain controversial. We use the standardized step treatment as a common control to compare the effectiveness of different Chinese medical methods combined with standardized step therapy for cancer pain using a network meta-analysis. Methods: Randomized controlled trials of the effectiveness of various Chinese medical methods and standardized ladder treatments in PubMed, The Cochrane Library, EmBase, Web of Science, CNKI, VIP, and Wan-Fang databases were searched. Stata14.0 and WinBUGS1.4.3 software were used for statistical analysis. Risk ratio(RR) with their 95% confidence interval were estimated as effect size between treatments. Results: Seventy RCTs were included, a total of 6,936 patients with cancer pain, involving five treatments.The results of network meta-analysis showed that there were significant statistical differences between the four Chinese medical methods combined with standardized step treatment and simple standardized step treatment: Chinese medicine orally combined with standardized step treatment vs simple standardized step treatment: RR = 2.60, 95% CI (2.09, 3.30); Chinese medicine external application combined with standardized ladder treatment vs simple standardized ladder treatment: RR = 2.83, 95% CI (2.31, 3.50); acupuncture physiotherapy combined with standardized ladder treatment vs simple standardized ladder treatment: RR = 3.56, 95% CI (1.92, 7.26); Chinese medicine injection combined with standardized ladder treatment vs simple standardized ladder treatment: RR = 2.22, 95% CI (1.63, 3.05). Conclusions: There are significant statistical differences between different Chinese medical methods combined with standardized step treatment and simple standardized step treatment. For patients with cancer pain, standardized step therapy combined with acupuncture physiotherapy or external application of traditional Chinese medicine can be preferred. Due to the lack of existing research, the conclusions of the study need to be confirmed by high quality RCT.
Delphi consensus on the follow-up of cancer patients with breakthrough pain under opioid treatment.
Authors: Gonzalez Larriba Jose Luis , Cayuela Diego , Fernandez Calvo Ovidio , Garcera Salvador , Molina Raquel , Reina-Zoilo Juan José , Guillem Vicente , Camps Carlos , Feyjoo Margarita 
Published: May 2019

e23135 Background: Breakthrough cancer pain (BTcP) is one of the most common symptoms related with the disease and its treatment. Its management differs from that of chronic pain but there is not a wide consensus about fundamental aspects of BTcP definition, diagnosis, follow-up, and management. The objective of this study promoted by ECO Foundation, is to reach a consensus on the follow-up of patients with BTcP under opioid treatment. Methods: This work was conducted using a modified Delphi method organized in two rounds and involving a panel of 84 medical oncologists. A questionnaire of 66 items was developed. The items proposed to reach a consensus included the following topics: 1) When to perform the first and subsequent BTcP treatment evaluations; 2) What to assess at the first follow-up visit and how; and 3) What to assess in the following visits and how. Results: After two rounds, a consensus was reached on 80.3% of the items proposed. The main agreements reached include: The first follow-up visit should preferably be face-to-face; increase the number of visits after detecting poor control of BTcP; assess pain control episodes of BTcP in the first and following visits; adjust treatment dose of opioids due to poor control of BTcP; and adopt measures to prevent aberrant opioid-induced behaviors when treating BTcP in patients with cancer. Conclusions: This Delphi consensus highlights the different points of view of medical oncologists regarding the follow-up of patients with BTcP under opioids treatment. Nonetheless, the conclusions reached can facilitate optimizing monitoring of these patients and promote long-term effectiveness of BTcP control.
Clinical outcomes of manual aspiration thrombectomy for Ilio-femoral venous thrombosis in cancer patients.
Authors: Lee Myung Ah , Kim Eu Hyun , Lee Hae Giu , Oh Jung Suk , Chun Ho Jong , Choi Byung Gil 
Published: May 2019

e23145 Background: To determine the outcomes and feasibility of manual aspiration thrombectomy (MAT) for treatment of symptomatic ilio-femoral deep vein thrombosis (IFDVT) in cancer patients. Methods: In this retrospective study, one hundred and thirty-five consecutive patients (56 men; mean age, 63 years; 149 limbs) with acute (n = 113; 83.7%), subacute (n = 14; 10.4%), and chronic (n = 8; 5.9%) symptomatic IFDVT underwent MAT-based endovascular treatment, with adjunctive balloon angioplasty and stent placement performed in 94 patients. Degree of thrombus removal on venography and symptom improvement was assessed for evaluation of technical and clinical success, respectively. Results: Technical success (thrombus removal > 50%) was achieved in 90.4%, and clinical success was observed in 71.5%. The primary patency rates were 88.1%, 81.6%, 76.0%, 74.1% and 69.1% at 1, 3, 6, 12, and 30 months, respectively. Recurrent IFDVT occurred in 19.3% of patients, 0.79 cases per patients-years of follow up. According to the analysis by causes of IFDVT, recurrent rate was 19.3%, 21.2%, and 14.3% in unknown, compression/invasion of the vein by cancerous mass, and May-Thurner syndrome groups, respectively (p = 0.798). No procedure-related complication developed. Conclusions: MAT is a feasible treatment option with favorable outcomes and minimal risk of complication in cancer patients with symptomatic IFDVT.
Is cancer associated thrombosis (CAT) an underestimated issue in oncology clinical practice? Real-world data regarding long term management of CAT.
Authors: Tsoukalas Nikolaos , Bokas Alexandros , Bournakis Evangelos , Christopoulou Athina , Papandreou Christos , Isaakidou Athina , Koumakis Georgios , Samelis Georgios Fotios , Ntokou Anna , Andreadis Charalampos , Kalofonos Haralabos , Aravantinos Gerasimos , Sougleri Maria , Samantas Epaminondas , Makrantonakis Paris , Mauri Davide , Athanasiadis Athanasios , Ziras Nikolaos , Varthalitis Ioannis I. , Boukovinas Ioannis 
Published: May 2019

e23150 Background: Cancer is associated with thrombosis due to different pathophysiological processes. CAT is the 2nd cause of death in oncology patients and can occur anytime during the natural history of cancer. CAT is not rare complication, can delay anti-cancer therapy and increase health systems costs. Methods: A prospective observational study (Greek Management of Thrombosis-GMaT) conducted by HeSMO in Greek Oncology units for two years aiming to record clinical practice of CAT management. Patients with active cancer who received CAT treatment or thromboprophylaxis were enrolled after signing informed consent. Results: 546 patients were enrolled from 18 oncology units. Primary cancers were: lung 23.9%, pancreas 13.3%, breast 7.6%, colorectal 8.9%, stomach 8.3%, ovarian 7.6% and other 30.5%. 120 patients received LMWH for Venus Thombo-Embolism (VTE) treatment (Group A) and 426 for thromboprophylaxis (Group B). Group A: 89/120 (74.17%) patients continued in 2nd year and 58.6% received CAT treatment (6.9±4.4 months). Only 2 had VTE recurrence in 2nd year (versus 3 in 1st year). 4/120 (3.33%) had bleeding events (grade 1) in 1st year while no bleeding events occurred in 2nd year. Group B: 345/426 (80.98%) patients continued in 2nd year. 126 (30%) had Khorana score ≥3 and 300 (70%) had Khorana score ≤2. In 2nd year, 123 (35.65%) received thromboprophylaxis (7.3±3.7 months) while 79.4% of them were initially treated with High Thrombotic Treatment Agents (HTTA: e.g. platinum, 5-FU) and 83.1% had metastatic disease. In 2nd year, 52.5% received LMWHs at prophylactic dose and 47.5% at therapeutic dose. Overall, 12 (2.82%) had thrombotic events whereas 4 were recorded in 2nd year. Notably, patients treated with therapeutic doses had lower probability to have a thrombotic event (OR: 5.8, 95% CI: 1.7 to 20.5, p < .05). Six (1.41%) bleeding events (grade 1) occurred in 1st year and one (0.81%) in 2nd year. Conclusions: LMWHs can be used for long term CAT management. Therapeutic LMWHs doses as thromboprophylaxis are safe and effective. Khorana score is a useful model for CAT risk assessment but some other factors such as disease stage and HTTA might be taken into account. CAT can occur anytime during the natural history of cancer. Oncologists should be aware about CAT and its negative influences in patients’ prognosis and quality of life.