bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of rolapitant for prevention of chemotherapy-induced nausea and vomiting (CINV) in patients with gastrointestinal and colorectal cancers.
Authors: Navari Rudolph M. , Jordan Karin , Rapoport Bernardo Leon , Schnadig Ian D. , Chasen Martin , Arora Sujata , Powers Daniel , Schwartzberg Lee Steven 
Published: February 2017

222 Background: Rolapitant (VARUBI) is a selective, long-acting neurokinin-1 receptor antagonist (RA) for the prevention of CINV. Rolapitant effectively prevented CINV in phase 3 trials of patients (pts) receiving highly or moderately emetogenic chemotherapy (HEC, MEC). While MEC and HEC regimens are commonly used to treat pts with gastrointestinal and colorectal cancers (GI/CRC), very few studies have evaluated the effectiveness of a neurokinin-1 RA regimen in these pts. We assessed the incidence of CINV and efficacy of rolapitant in a subset of pts with GI/CRC. Methods: This is a post hoc analysis of 3 similarly-designed, randomized, placebo-controlled trials. Pts with cancer of the esophagus, stomach, colon/rectum, or anus received a single oral dose of 180 mg oral rolapitant or placebo prior to HEC or MEC. All pts received a 5-hydroxytryptamine type 3 (5-HT3) RA and dexamethasone (active control). The HEC studies included cisplatin, and the MEC study carboplatin, oxaliplatin, irinotecan, epirubicin, and doxorubicin. Endpoints included complete response (CR; no emesis and no use of rescue medication), no emesis, no nausea (maximum visual analogue scale [VAS] < 5 mm), no significant nausea (maximum VAS < 25mm) and complete protection (CP; no emesis, no use of rescue medication, and no significant nausea) in the overall (0-120 h), acute (≤ 24 h), and delayed (> 24-120 h) phases. Results: Out of 188 GI/CRC pts, 101 pts received rolapitant and 87 received active control. Pts treated with rolapitant had significantly higher rates of CR, no nausea, no emesis, and CP in the overall phase (P < 0.05). Rolapitant was well-tolerated and overall incidence of treatment-emergent adverse events comparable in both groups. Conclusions: Addition of rolapitant to 5-HT3RA and dexamethasone therapy significantly improved CR, no nausea, no emesis, and CP in pts with GI/CRC receiving emetogenic chemotherapy. Clinical trial information: NCT01500226, NCT01499849, NCT01500213. [Table: see text]
Rolapitant for the prevention of nausea in patients receiving moderately or highly emetogenic chemotherapy.
Authors: Navari Rudolph M. , Nagy Cindy K , Arora Sujata , Powers Daniel , Clark-Snow Rebecca Anne 
Published: February 2017

224 Background: Nausea control remains an unmet need for patients receiving moderately or highly emetogenic chemotherapy (MEC, HEC). The objective of this analysis was to determine the effect of the neurokinin-1 (NK-1) receptor antagonist rolapitant (VARUBI) on the prevention of nausea in patients receiving either MEC or HEC. Methods: Post hoc analyses of nausea from three randomized, double-blind, active-controlled, phase 3 clinical trials were performed for carboplatin-based MEC (n = 401), non-carboplatin-based MEC (n = 228), total MEC (n = 629), anthracycline/cyclophosphamide (AC)-based chemotherapy (n = 703), and cisplatin-based HEC (n = 1070). Patients were randomized 1:1 to oral rolapitant 180 mg or placebo ~1–2 h before chemotherapy. All patients received active control: granisetron 2 mg oral or 10 mcg/kg IV and oral dexamethasone 20 mg. Granisetron was continued on days 2 and 3 for patients receiving MEC or AC-based therapy and dexamethasone 8 mg twice daily on days 2–4 for patients receiving HEC. Patients self-assessed nausea on days 1–6 using a 100-mm visual analog scale (VAS). Percentage of patients with no nausea (NN; maximum VAS < 5 mm) or no significant nausea (NSN; maximum VAS < 25 mm) was determined for overall, delayed, and acute phases of CINV in cycle 1. Results: Rates of NN in the carboplatin-based MEC and total MEC subgroups were significantly higher (P < 0.05) with rolapitant than active control in the delayed and overall phases. In the cisplatin-based HEC subgroup, rates of NN and NSN were significantly higher (P < 0.05) with rolapitant than active control in the delayed, acute, and overall phases. Conclusions: Rolapitant prevents nausea during all CINV phases in patients receiving cisplatin-based HEC, and during the delayed and overall phases in patients receiving carboplatin-based MEC. Clinical trial information: NCT01500226, NCT01499849, NCT01500213.
A two-group study to evaluate the impact of an educational handbook in the care of patients with head and neck cancer (HNC).
Authors: Bauman Jessica Ruth , El-Jawahri Areej , Quinn Karen , Arcikowski Lisa , Chan Gina , Viscosi Elene , Doherty Carol , Clark John Ross , Temel Jennifer S. , Wirth Lori J. 
Published: February 2017

228 Background: Patients undergoing chemoradiotherapy for HNC have a significant symptom burden, psychological distress, and educational needs. We evaluated the impact of an educational handbook integrated into oncology care on patient outcomes. Methods: We conducted a two group, prospective, longitudinal study. Patients enrolled in group 1 received standard care as a control. Then, patients in group 2 received the intervention of a specialized handbook integrated into weekly visits with oncology clinicians during treatment. To assess preliminary efficacy, we evaluated satisfaction (Information Satisfaction Questionnaire-ISQ), mood (Hospital Anxiety and Depression Scale-HADS), illness perception (Brief Illness Perception Questionnaire-IPQ), and quality of life (QOL) (MD Anderson Symptom Inventory-Head and Neck-MDASI-HN) at baseline and week 3. We compared outcomes using two sample t-tests and measured effect size using Cohen’s D. Results: From 8/2014-5/2015 we enrolled and followed 30 patients in group 1. From 5/2015-12/2015, we enrolled and followed 30 patients in group 2. There were no significant differences in baseline characteristics. There were more missing data from group 2. There were high levels of satisfaction in both groups. 20/23 (87%) reported they would ‘definitely’ recommend the handbook to others. Changes in outcomes are shown in Table 1. Compared to group 1, group 2 reported a less threatening view of illness, lower better symptom burden, and less anxiety, but these were not statistically significant. Conclusions: The specialized handbook for patients with HNC was well received. The sample size was too small to detect differences in mood, QOL, illness perception, or satisfaction. Further development in a larger cohort is warranted. Clinical trial information: NCT02204631. [Table: see text]
Psychological distress in cancer patient during chemotherapy: A cross-sectional study.
Authors: Singh Harminder , Banipal Raja 
Published: February 2017

231 Background: The State of Punjab is experiencing a rising burden of cancer. The objective of this study was to analyze and compare depression, anxiety and stress levels and their impacting factors in heterogenous surviving cancer patients. Methods: this is a cross sectional study, data collection was performed by Depression, anxiety, stress scale 21-DASS 21. Results: study population include 300 cancer patients and 300 matched controls. The mean age of the cases and controls were 50.58 years ± 13. 64 and 46.1 years ± 11.78 (M ± SD). A Statistical significant difference was observed in mean scoring of depression, anxiety and stress in cancer patients when compared to control groups. Anxiety mean score significantly affected by chemotherapy cycles and duration of disease. Conclusions: Holistic approach in cancer management is a need of time as the present study revealed, the range of depression, anxiety and stress was 90%, 56% and 28% respectively. [Table: see text]
Lessons learned from a clinical-research partnership in outpatient palliative care.
Authors: Cunningham Mary , Washington Karla T , Huenke Diane L 
Published: February 2017

238 Background: Palliative care providers and investigators at the University of Missouri developed a clinical-research partnership to conduct a randomized clinical trial (R21CA191165; NCT02427490; PI: Washington) of a technologically-mediated intervention for family caregivers of cancer patients aimed at decreasing caregivers’ distress and improving their quality of life. As the first year of the project drew to a close, the clinician-research team sought to systematically examine the challenges they had encountered conducting research in the outpatient palliative care clinic, which serves a 91-county catchment area that is highly rural and underserved, and to document the strategies they had employed to address them. Methods: Researchers conducted a content analysis of all weekly meeting notes and communication (i.e., emails, memos) related to Year 1 of the project, identifying major categories of identified challenges and related solutions. Results were presented to other members of the team for verification and/or clarification of key points. Results: Researchers identified five categories of challenges and related strategies: adapting processes and materials for use earlier in the cancer trajectory, accommodating a broad range of literacy levels, reaching rural caregivers, responding to technological constraints, and integrating research into the clinic workflow. Selected strategies included consultation with a Patient Advisory Board to revise recruitment materials, broadening inclusion criteria to accommodate rural caregivers without broadband internet availability in their communities, and establishing processes to allow researchers to meet with potential participants between scheduled appointments during busy clinic days. Conclusions: There are many unique considerations clinicians and researchers should take into account when developing partnerships in outpatient palliative oncology settings, particularly within predominantly rural, publicly-funded health care systems. While challenging to develop, such partnerships are instrumental in establishing an evidence base for care for individuals who are otherwise often underrepresented in large research projects. Clinical trial information: NCT02427490.
Barriers to patients’ understanding of prognosis in advanced cancer.
Authors: Pompa Tiffany , Palopoli Jason , Maddox Mark , Woodard Adonas , Ward Kristine Marie , Jain Maneesh Rajiv , Crilley Pamela A. , Topolsky Dave , King John , Khan Sigmund Benham , Amat Maelys , Styler Michael 
Published: February 2017

24 Background: An informed decision requires good communication between the patient and their oncologist in regards to diagnosis and prognosis, especially in patients with terminal cancer. This discussion entails education about their disease, treatment options, and potential outcomes. The purpose of this study was to assess advanced-stage cancer oncology patients’ comprehension of their disease, treatment options and goals of therapy. Methods: Subjects included patients with a diagnosis of metastatic cancer with an option for palliative or life extending chemotherapy in an out-patient office at Drexel University College of Medicine. Outpatient office charts were reviewed to identify eligible patients. All subjects consented to participate. Participation included completing a 34-item questionnaire about comprehension of their cancer, satisfaction, perception of their physician interaction regarding disease education and potential barriers to patient understanding. Results: 52 patients analyzed to date: 1 patient was not aware he had cancer. 3 patients (5.7%) thought there was no longer cancer in their bodies. 33 patients (62%) thought the goal of therapy was to cure their cancer. 27 patients (51%) thought the goal of therapy was to extend how long they will live. 11 patients (20.7%) thought the goal of therapy was to palliate symptoms. 5 patients (9.4%) did not know why they were on therapy for their cancer. 5 patients (9.4%) indicated they had talked about hospice with their doctor. 5 patients (9.4%) felt they shouldn’t ask any questions. 48 patients (90.5%) felt they were participating in their treatment decisions. 4 patients (7.5%) stated they didn’t understand the medical terms used by the doctors. Compared to what patients wish they knew, almost 30% felt they knew half or very little about their diagnosis and 33% felt they knew half, very little, or nothing about their prognosis. Conclusions: Due to discrepancies between patient understanding and the intended goals of care, our study highlights the need for further guidance in effectively communicating extent of disease and predicted outcome. It is also important to periodically ask patients to discuss their understanding of their diagnosis, prognosis, and treatment options.
Family Camp: A multi-disciplinary intervention for brain tumor patients and families.
Authors: Page Margaretta S , Lovely Mary , Levinson Marks Abigail , LaMarre Amanda K , Chang Susan M , Clarke Jennifer , Patt Judy , Barani Emelia 
Published: February 2017

240 Background: The diagnosis of a brain tumor is a catastrophic life changing event that impacts the entire family. Patients and caregivers experience dramatic role changes, concern for their children, financial stress, and isolation. For many, the situation is overwhelming. A novel intervention to address these needs is “Family Camp”. Our vision for camp was to provide respite to the entire family, decrease caregiver stress, improve family connections and promote a sense of understanding and connection with the community at large. Methods: In a unique partnership with the widow of a former patient, the members of the UCSF Neuro-Oncology Division created and offered a weekend camp for brain tumor patients with children. Team members included MDs, RNs, social workers, psychologists, artists, body workers, “camp counselors” and community volunteers. In addition to respite, camp was structured through art, songs, projects and games to deliver opportunities for understanding and community building, including understanding the disease and its impact on the family. Therapeutic interventions included couples activities, counseling, parenting strategies, and providing a sense of connection to others dealing with brain tumors, the health care team, and camp volunteers. Anxiety, stress, depression, coping and values based living were measured pre and post camp using DASS21, CES-D, Brief Cope, Values Based Living instruments, and survey questions. Results: 11 families attended camp for 3 days in 2014. Improvement was noted in post camp testing of depression, anxiety and stress versus pre-camp. Survey questions showed the most common and important outcome to be connection, specifically that patients, caregivers, and children made connections with similar others. Families reported being able to relax and felt taken care of. They liked the opportunity for undistracted family time, getting to know their health providers outside of the office, and couples benefited from family counseling. Conclusions: Capitalizing on the unique skills of a multi-disciplinary team, one that includes the patient’s health care team, can lead to the delivery of a novel intervention that improves the illness experience of brain tumor patients and families.
How do parents with advanced cancer communicate with their children? A qualitative study.
Authors: Hailey Claire Emery , Yopp Justin M , Mayer Deborah , Park Eliza M 
Published: February 2017

241 Background: Parents with advanced or incurable cancer may struggle when communicating with their children about their illness. Most literature on family communication about cancer reflects the opinions of parents with early-stage cancer or the experiences of children. The life-limiting nature of incurable illness distinguishes the experiences of parents with advanced cancer. Therefore, the aim of this study was to describe how parents with advanced cancer communicated about their illness with their dependent children. Methods: We conducted semi-structured interviews with 46 patients with stage IV solid tumor malignancies who had at least one child under 18 years of age. Interviews addressed illness-related communication with children as well as other topics related to the experience of parenting with advanced cancer. Data were analyzed using thematic content analysis. Results: Parents usually sought to protect their children by limiting details about their illness or framing discussions in an optimistic manner. Age and developmental stage of children greatly influenced how parents communicated and what information was divulged. Disclosure about the life-limiting nature of their illness varied significantly. Parents identified several barriers to communication including children’s avoidance of discussion, personal difficulty accepting the terminal nature of their illness, uncertainty about prognosis, and concerns about how to communicate with their children. Despite these barriers, many parents had not received professional guidance to facilitate their communication. Conclusions: Parents with advanced cancer reported a wide diversity in motivations and techniques in discussing their illness with their children. Despite the availability of child-focused communication resources, parents identified several barriers to illness-related communication with their children. Results from this study can provide guidance for clinicians to help patients overcome these challenges and to assist parents with the difficult task of communicating with children about their illness. Future research interventions to address communication barriers may lead to improved outcomes for patients and their families.
Caregiver time burden in newly diagnosed glioblastoma: A prospective analysis.
Authors: Hemminger Lauryn , Pittman Christine , Mohile Nimish 
Published: February 2017

242 Background: Caregiver (CG) burden is particularly high in glioblastoma (GBM) because neurologic deficits lead to cognitive dysfunction and physical dependence. The amount of time that CGs devote to GBM pts is not well described. The extent to which time burden impacts CG quality of life and perceived burden is unknown. Methods: We performed an IRB-approved prospective analysis of 38 CGs of pts with newly diagnosed GBM enrolled over 8 mo. at a single academic institution. CGs were defined as individuals responsible for any aspect of pt support, and multiple CGs were allowed for each pt. CGs completed the Caregiver Quality of Life in Cancer (CQOLC) survey plus questions about CG role and time dedicated to pt care within 2 mo. of initial neuro-oncology visit. We described time burden and correlated this with 3 CQOLC questions addressing CG stress, emotional well-being, and perceived burden. Results: 30/38 CGs completed the surveys. The 30 CGs (21 female) included 16 spouses, 8 children, 3 parents, 2 siblings and 1 friend. 21 were primary CGs (13 female). 21 CG spent > 40 hrs/wk with pt, 10 spent > 40 hrs/wk on direct pt care, and 7 spent > 40 work hrs/wk caring for the pt. Table 1 illustrates CG time burden stratified by primary vs non-primary CG. CG time spent on direct pt care positively correlated with CGs feeling overwhelmed by their responsibilities as assessed by the CQOLC (p < 0.0001, spearman coefficient 0.66). Amount of work hrs spent on pt care also correlated with the CG feeling overwhelmed. (p = 0.0003, spearman coefficient 0.61). Conclusions: CG time burden in GBM is substantial even at the time of diagnosis, and is most notable in primary CGs. CG time burden correlates with signs of emotional distress as measured by the CQOLC. Assessing time burden for individual CGs may help identify early risk for distress and develop interventions to improve CG quality of life. [Table: see text]
The influence of spirituality and religiosity on the personal use and practice patterns with complementary and alternative medicine (CAM): A national survey of US oncologists.
Authors: Lee Richard T. , Powers-James Catherine , Alvarez Adriana L. , Milbury Kathrin , Adan Francoise , Lopez Gabriel , Cohen Lorenzo , Delgado-Guay Marvin , Olopade Olufunmilayo I. , Curlin Farr A 
Published: February 2017

248 Background: Although cancer patients frequently use CAM, it is uncertain how oncologists’ spirituality and religiosity impact their decisions to use or recommend CAM with their patients. Methods: A US probability sample of 1,000 ASCO members was contacted by mail and email to complete a survey regarding clinical approaches to herb and supplement (HS) use by cancer patients. Results: Of 927 deliverable surveys, 423 surveys were returned for a response rate of 46%. Respondents were mostly men (72%), Caucasian (76%), with a median age of 48. Approximately 16% reported no religion, 19% Jewish, 24% Catholic, 28% Christian, and 13% other religions. Eighteen percent reported attending religious services at least once a week including 15% who attend several times per week. Twenty-eight percent reported high theological pluralism (skepticism regarding whether one religion is the only true religion). Fifty-eight percent self-described themselves as very or moderately spiritual. Univariate analyses indicated significant correlations with self-reported spirituality and religious service attendance and the likelihood of personal CAM use, recommending any CAM, and recommending HS. In multivariate analyses, predictors of personal CAM use were: female gender (OR = 5.6, CI 0.09-0.37), non-Caucasian (OR = 3.0, CI 0.16-0.70), educated in HS (OR = 2.6, CI 1.37-5.08), attending religious services less than monthly (OR = 3.0, CI 0.17-0.65), and self –reported high or moderate spirituality (OR = 3.2, CI 1.5-6.6). Physician predictors for sometimes or often recommending HS were male gender (OR = 1.85, CI 0.92-3.75) and self–reported low spirituality (OR = 2.9, CI, 0.15-0.77). Recommending CAM was associated with female gender (OR = 2.6, CI 0.15-0.97), educated in HS (OR = 3.4, CI 1.46-7.78), and self–reported high or moderate spirituality (OR = 2.8, CI 1.26-6.31). No correlations were found with religious affiliation. Conclusions: This is the first study to identify self-reported spirituality as a significant factor among US oncologists’ decision to use CAM and recommend CAM to patients, and further studies are needed to explore this potential influence.