bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adoption of the International Cognition and Cancer Task Force recommendations for harmonizing studies of cancer-related cognitive impairment: A systematic review of published literature.
Authors: Ferguson Robert J. , Patel Janvi V. , Orosco Naomi Massoud , Sinagra Chloe 
Published: June 2024

e24043 Background: This abstract presents a review of published research literature to determine research investigators’ rate of adoption of the International Cognition and Cancer Task Force (ICCTF) recommended criteria for defining cancer-related cognitive impairment (CRCI). Published in 2011, the ICCTF recommendations were intended to identify psychometric standards that would facilitate harmonization of neuropsychological test data across studies for improved accuracy of estimating prevalence of CRCI in cancer populations. The ICCTF recommended standards could help decipher variability or stability of CRCI prevalence across various cancer groups, such as individuals within a diagnostic classification (e.g., lung or breast cancer) or type of cancer treatment (e.g., chemotherapy, immunotherapy, or radiation therapy). However, since publication in 2011, the use of the ICCTF recommendations in CRCI research has not been examined. Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we restricted study selection to only published studies that examined CRCI using standardized neuropsychological tests (vs. self-report measures). We then identified studies that used the ICCFT recommendations based on the ICCTF psychometric definition of cognitive impairment: In a standard battery of neuropsychological tests, one neuropsychological test score >2 standard deviations (sd) below the mean of a healthy control sample, or 2 neuropsychological test scores of >1.5 sd’s below the control mean, is considered a case of cognitive impairment. Results: We screened 146 CRCI studies published since 2011, with 93 manuscripts that utilized neuropsychological tests to evaluate CRCI. Of those, 35 (37.6%) incorporated the ICCTF recommendations in their methodology and data analysis. Between 2011 and 2022, there was a gradual adoption of ICCTF recommended standard of defining CRCI, ranging from 0% of published studies in 2011 to 56.2% in 2022, but a decline to 40% in 2023. With respect to cancer populations, ICCTF guidelines were most often used in studies of individuals with breast cancer (n = 17;18%). Conclusions: This review demonstrates increased use of the ICCTF recommended definition of CRCI in empirical investigations since their 2011 introduction but a decline in 2023. Use of the ICCTF recommendations can improve accuracy of estimating CRCI prevalence across different cancer disease populations and/or groups of individuals undergoing different cancer therapies. Greater adoption of the ICCTF definition of CRCI is encouraged especially considering a 2023 drop in its use. Broadening the study of CRCI using ICCTF recommendations among cancer populations beyond breast cancer is encouraged to better understand the breadth of impact CRCI across the spectrum of disease.
Head and neck cancer survivors’ perception of lymphedema care.
Authors: Kline-Quiroz Cristina , Murphy Barbara A. , Ridner Sheila H. , Smith Derek , Schlundt David G. , Bonnet Kemberlee 
Published: June 2024

e24046 Background: Secondary lymphedema and fibrosis occurs in more than 90% of HNC survivors. Given the progressive nature of lymphedema, prompt identification and treatment are essential. Treatment of HNC related lymphedema is fraught by numerous barriers. Advanced pneumatic compression devices (APCD) may address critical barriers. We conducted a phase 3 randomized multi-site trial in HNC survivors with treatment naïve lymphedema comparing usual care to APCD. Here in we report a qualitative analysis of participants treatment experience. Methods: Semi-structured interviews were audio recorded and transcribed after participants completed the 6th-month visit (N = 14 usual care, N = 23 APCD). Questions addressed treatment experience, perceptions of care, barriers, and facilitators. A hierarchical coding system was developed and refined using the interview guide and preliminary review of the transcripts. Transcripts were coded by experienced qualitative researchers. The coded transcripts were analyzed using an iterative inductive-deductive approach and based on our theoretical framework. Results: Participants were 65% male, 35% female and identified as 92% white, 5% black, and 5% Hispanic. The average age was 62 with a range of 32-82. We identified two distinct and one common set of barriers and facilitators. For usual care, health system (care coordination, logistics) and therapist factors (perceived skills and demeanor) were important while device characteristics (fit, comfort) were important for the APCD. Cognitive affective factors (self-efficacy, knowledge, outcome expectations, frustration) were similar for both therapies and interacted with the device/system characteristics. Conclusions: We identified distinct treatment barriers and facilitators for usual lymphedema care and treatment with APCD. Barriers identified in this study highlight practice changing opportunities to address system issues and develop interventions to enhance care and quality of life. Utilization of both treatment strategies may allow tailoring of treatments thus optimizing outcomes. Clinical trial information: NCT04797390 .
Influence of intensity-modulated radiation therapy on long-term survival and late injury in patients with nasopharyngeal carcinoma after induction chemotherapy.
Authors: Gong Xiuyun , Jin Feng 
Published: June 2024

e24048 Background: To retrospectively analyze the effect of nasopharyngeal primary tumor (GTVnx) target delineation after induction chemotherapy on the long-term survival and late injury of patients after intensity-modulated radiotherapy, so as to provide a reference for the optimal treatment of nasopharyngeal carcinoma. Methods: Retrospective analysis was performed on 52 patients with nasopharyngeal carcinoma who underwent target delineation and radiotherapy after induction chemotherapy in our department from December 2011 to October 2013. All patients underwent long-term survival follow-up and analysis of late injury. The survival rate was calculated by Kaplan-Meier method and log-rank test, Univariate prognostic analysis was performed. Cox model was used to conduct multivariate prognostic analysis. The late radiation toxicity was Evaluation by RTOG/EORTC. Results: From December 2011 to October 2013,52 patients were enrolled in the study group. The follow-up period was up to December 2020. Among them, 23 patients died and the mortality rate was 44.23%, the recurrence rate was 0.38%. Serious adverse reactions occurred in 7 cases (13.2%). The 1,3,5,8 year survival rates were as follows: OS was 94.2%, 82.7%, 65.4%, 49.6%, LRFS was 96.2%, 82.7%, 63.5%, 46.2%, the survival rates of DMFS were 94.2%, 78.8%, 59.6% and 44.2%. Conclusions: The 5 and 8-years OS, LRFS and DMFS of NPC after induction chemotherapy patients treated with IMRT was relatively high, Distant metastasis was the main cause of treatment failure, The main late injuries include grade Ⅰ / Ⅱ hearing impairment, dysphagia dental, caries, xerostomia, the grade Ⅲ and Ⅳ late radiation injury was lower.
The effect of epidural steroid injections for the management of spinal malignancy-related pain.
Authors: Lim Dongsik , Chang Minhye , Kim Sunmin , Kim Yu Jung , Nahm Francis Sahngun , Lee Pyung Bok , Choi Eun Joo 
Published: June 2024

e24052 Background: Spinal malignancy-related pain is common in cancer patients. There are several treatment options from systemic steroid injection to surgical treatment. Epidural steroid injection (ESI) is one of commonly performed treatment. The purpose of this study is to assess the effect of ESI in spinal malignancy-related pain. Methods: We retrospectively reviewed our cases who was diagnosed with spinal metastatic cancer, and received ESI from January 2021 to December 2022. The primary outcome was pain intensity (Visual Analogue Scale score, 0-10) at baseline, 1, 3 and 6 months after ESI. Patients with a pain reduction of more than 50% at 1 month after ESI were classified as success group (S), and others were classified as failure group (F). The secondary outcomes were change of MEDD (morphine equivalent daily dose, mg/day) at same time points. Also, each patient’s demographic data, ECOG, history of previous radiotherapy, and survival duration following ESI. Results: Totally 135 patients were enrolled, and 80 patients were analyzed. Of the 80 patients, 47 and 33 patients were classified into the S and F group, respectively (Table 1). Patients who had previous radiotherapy was 68.1% in S group, but only 48.5% in F group (p = 0.04). The 80% of group S survived over 6 months, compared to 39% of group F (p < 0.001). There were significant differences in VAS scores between S and F groups at all-time points during the follow-up period (P < 0.001) and MEDD was significantly lower in the S group at 1 (p = 0.02) and 3 months (p < 0.01). Conclusions: This study demonstrates that ESI effectively reduce pain and opioid use in patients with spinal malignancy-related pain. Given the observed survival periods, it can be inferred that earlier intervention with ESI is more likely to yield beneficial outcomes. [Table: see text]
The impact of cannabidiol (CBD) on aromatase inhibitor (AI)-associated musculoskeletal symptoms (AIMSS).
Authors: Fleege Nicole Margo Grogan , Miller Elise , Kidwell Kelley M. , Scheu Kelly L. , Kemmer Kathleen A. , Boehnke Kevin , Henry Norah Lynn 
Published: June 2024

e24060 Background: Although treatment with an AI for 5-10 years decreases 10-year breast cancer (BC) mortality by about 40%, up to 25% of patients will stop treatment early because of treatment-related, intolerable joint and muscle pain and stiffness, called AIMSS. Only acupuncture, duloxetine, and exercise have been shown to reduce AIMSS. While the exact underlying mechanism is unknown, it is thought to be due in part to ongoing systemic inflammation. CBD has anti-nociceptive and anti-inflammatory properties, making it a potential treatment option for AIMSS. Methods: Women with stage 0-3 hormone receptor-positive BC experiencing AIMSS (defined as worst joint pain ≥4/10 during prior 7 days that developed or worsened since starting AI therapy) were eligible for enrollment in this single arm, single center phase 2 open label clinical trial (NCT04754399). Patients received an FDA-approved formulation of CBD (Epidiolex), titrated over 4 weeks from 25 mg BID to 100 mg BID and then continued at maximum tolerated dose for a total of 15 weeks. Patient-reported outcomes (PRO) data were collected serially, including the Brief Pain Inventory (BPI) and the PROMIS Profile 29+2 v2.1. The primary endpoint was the number of CBD-treated patients with at least a 2-point reduction (minimal clinically important difference) in worst pain from baseline to 15 weeks. Statistical analysis was completed using paired t-tests and linear mixed models. Results: Of 39 eligible patients (Table 1), 11 discontinued participation early due to patient discretion (n = 6) or adverse event (n = 5). There were no grade 3-4 toxicities. Analyzing data from all 39 patients, there was an improvement in BPI worst pain (0-10 scale) of 0.13 per week of treatment after baseline (p < 0.001), resulting in an average improvement in worst pain of 1.95 at the end of 15 weeks. Of the 28 patients who completed the study, 17 (60.7%) reported a ≥2-point improvement in BPI worst pain between baseline and week 15. There was a significant improvement in PROMIS T score at week 15 in both physical function (2.34, p = 0.01) and ability to participate in social roles and activities (2.71, p = 0.02). Conclusions: Treatment with CBD was associated with an improvement in joint pain for a subset of patients. Additional analyses are ongoing to further investigate the impact of CBD on AIMSS and to explore which patients are most likely to benefit from treatment with CBD. Clinical trial information: NCT04754399 . [Table: see text]
The role of shared decision-making in cancer pain management: Insights from a systematic review.
Authors: Monteiro Andrea L , Yousef Andro , Sweiss Karen , DiDomenico Robert , Sharp Lisa K. 
Published: June 2024

e24078 Background: Effective pain management in cancer care is crucial for patient quality of life. Shared decision-making (SDM) interventions are increasingly recognized for their potential to improve patient outcomes by facilitating patient engagement in care decisions. This systematic review synthesizes evidence on the impact of SDM interventions in cancer pain management. Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted a comprehensive search across multiple databases, including PubMed, EMBASE, Scopus, CINAHL, PsycINFO, Web of Science, and the Cochrane Library. The search also extended to grey literature sources such as conference proceedings, dissertations, and unpublished reports to ensure a thorough coverage of the subject matter. Our search strategy employed a combination of MeSH terms and keywords related to 'decision making,' 'patient participation,' 'pain management,' and 'cancer.' This strategy was tailored to each database's unique syntax and search operators. Results: Ten studies, including six pilot and feasibility studies and four randomized controlled trials (RCTs) and Preintervention-Postintervention studies, were systematically reviewed. The interventions implemented diverse SDM strategies ranging from digital tools and personalized education to clinical decision support systems, targeting key aspects of pain management and patient-provider communication. Frequent intervention components included patient-reported outcome dashboards, symptom management support, and educational resources for pain management. The Tailored Education and Coaching (TEC) intervention notably increased pain-specific patient communication by 31%, while the PAINRelieveIt intervention did not significantly impact analgesic adherence but effectively reduced pain misconceptions among caregivers. Some interventions, like the Carevive CPS, showed high patient involvement in SDM (94.1%) and compliance with quality oncology practice initiative metrics (98%). However, the effectiveness of these interventions varied, with some showing no significant impact on primary pain outcomes. The variability in measured outcomes such as pain intensity, analgesic adherence, and patient satisfaction indicates a context-dependent effectiveness of SDM interventions, highlighting the importance of personalized approaches and the role of implementation strategies in influencing patient engagement and intervention success. Conclusions: SDM interventions in cancer pain management are diverse in structure and impact. Some interventions show promise in improving communication and reducing misconceptions, but their direct effect on pain outcomes varies.
Utilization of palliative care for geriatric veterans with newly diagnosed stage 3 and 4 pancreatic cancer.
Authors: Panjrolia Ekta , Tannous Toufic , Resendes Natasha M. , Islam Raiyan , Hammel Iriana M. 
Published: June 2024

e24082 Background: Locally advanced and metastatic pancreatic cancer continues to be difficult to treat with high mortality. For stage 3 and stage 4 pancreatic cancer, there remains no meaningful advances in treatment and standard of care heavily relies on a palliative approach. Yet, there remains reports that early use of palliative care (PC) may be underutilized despite palliative care being mainstay of treatment. We sought to further characterize which factors may play a role in PC referral within the geriatric veteran population. Methods: This retrospective cohort study included veterans who were diagnosed and treated for pancreatic cancer within the Veterans Integrated Services Network (VISN) 8 which includes Veterans Affairs medical facilities in Florida, southern Georgia, Puerto Rico and the U.S. Virgin Islands. Demographic data such as age, sex, race, ethnicity and branch of service and treatment data such as chemotherapy and PC use were pulled from the electronic medical record. We conducted a chart review to determine stage and ECOG status at the time of diagnosis. Of this cohort, 99 veterans were identified who met the criteria of 65 years of age or older at the time of newly diagnosed stage 3 or stage 4 pancreatic cancer. Statistical analyses were conducted using GraphPad Prism 10.1.2 software and analyses consisted of t-test, Mann-Whitney, chi-squared, multiple regression model and odds ratio. Results: The mean age for veterans who did not receive PC was 74.66 years and veterans who did receive PC mean age was 74.79, revealing no statistically significant difference (p = 0.9205). The median ECOG for veterans who did and did not receive PC was 1 (p = 0.6609). Chemotherapy use in the PC and no PC groups did not differ with about 49% of veterans in the no PC group receiving chemotherapy and 42% of veterans received PC and chemotherapy (p = 0.5329). Furthermore, sex, race, ethnicity, stage 3 vs 4, and branch of military service were not found to be statistically significant between the PC and no PC groups. We found no statistically significant relationship between frequency of PC utilization (p = 0.4450) with age (OR = 1.001; 95% CI 0.9331-1.072), ECOG score (OR = 1.059; 95% CI 0.7425 – 1.504) or chemotherapy use (OR = 0.7353; 95% CI 0.2936 – 1.821). The OR for age, ECOG and chemotherapy use all cross 1.0 demonstrating that these independent variables do not have a correlation with PC utilization. Conclusions: Between geriatric veterans with newly diagnosed stage 3 and stage 4 pancreatic cancer who did and did not receive PC, there appears to be no statistically significant difference in ECOG status, age, ethnicity, use of chemotherapy or branch of military service. Our data demonstrates that otherwise prognostic features such as age and ECOG did not differ in veterans who did and not receive PC regardless of chemotherapy use, however overall more PC referrals are still needed within this patient population.
Assessing our adherence to bone protection standards in metastatic prostate cancer in the largest Irish center: Are we falling behind?
Authors: Aslam Razia , Hadi Danial , Shah Syed Muhammad Bilal , Barron Emma 
Published: June 2024

e24145 Background: Prostate cancer ranks as the second most prevalent cancer in men globally, often necessitating androgen deprivation therapy (ADT) as part of its treatment. While ADT effectively diminishes testosterone levels, a vital factor in prostate cancer cell growth, it concurrently poses a notable side effect – an accelerated rate of bone loss. This heightened bone loss elevates the vulnerability of patients to osteoporosis and fractures. The optimization of bone health entails early identification of patients susceptible to osteoporosis and fractures, the implementation of preventative measures, and prompt interventions to mitigate bone loss and fracture risks. Methods: The audit aims to evaluate adherence to established guidelines, such as those outlined by the National Comprehensive Cancer Network (NCCN) and the European Society for Medical Oncology (ESMO), concerning the assessment and optimization of bone health. A retrospective analysis was performed on the medical records of prostate cancer patients who underwent Androgen Deprivation Therapy (ADT) at St James Hospital in Dublin. Pertinent data, encompassing patient demographics, duration of ADT, documentation of bone health assessment, frequency of Bone Mineral Density (BMD) testing, utilization of preventive measures (e.g., calcium and vitamin D supplementation), and any interventions for bone health optimization (such as bisphosphonate therapy and denosumab), was systematically collected. Results: A comprehensive review encompassed 57 patients, revealing that 38 patients (67%) exhibited metastatic disease. Among them, 42 patients (74%) presented with castrate-sensitive disease. Out of the total, 24 patients (42%) underwent a baseline Dual-Energy X-ray Absorptiometry (DEXA) scan. Results indicated that 12 patients were diagnosed with Osteoporosis, 9 with Osteopenia, and 3 with normal Bone Mineral Density (BMD). At baseline, 26 patients (46%) initiated Calcium and Vitamin D supplements, while 12 patients (21%) commenced Bisphosphonates/Denosumab based on DEXA scan outcomes. Notably, 8 (14%) patients experienced a skeletal/bone-related event which is much higher than reported in literature. Conclusions: The findings are intended to guide healthcare professionals in optimizing bone health strategies, with the ultimate goal of improving patients' quality of life and minimizing the risk of fractures and related complications. Identified areas for improvement in clinical practices will be addressed by implementing recommended recommendations, aiming to enhance patient care, decrease the risk of osteoporosis and fractures, and overall improve patient outcomes. A re-audit is planned to monitor ongoing adherence to guidelines and assess the impact of interventions implemented as a result of this study.
Risk Factors for Postoperative Chylothorax Occurrence Following Pediatric Congenital Heart Surgery
Authors: Nguyen Tran-Chau , Hoang Thao-Vy , Nguyen Ha-Giang , Culbertson Casey 
Published: June 2024

Objectives: Chylothorax, a rare but potentially life-threatening complication post congenital heart surgery, warrants early identification of risk factors to implement preventive strategies and timely interventions. This study aims to determine risk factors associated with chylothorax occurrence at our cardiac intensive care unit.
Methods: We conducted a nested case-control study involving 2042 children who underwent congenital heart surgery at Nhi Dong 1 hospital (Ho Chi Minh City, Vietnam) from Feb 25th, 2015, to October 12th, 2019. Among these, 38 chylothorax cases were matched by sex and year of surgery to 76 randomly selected control patients. Univariate analysis and logistic regression were performed to identify independent factors associated with chylothorax occurrence after congenital heart surgery.
Results: Neonatal cardiac surgery, RACHS-1 risk category ≥ 3, aortic arch repair, the arterial switch operation, prolonged bypass time (median 160 mins vs 87 mins) and aortic clamp time (median 89.5mins vs 51 mins), delayed sternal closure and unexpected reoperation were all associated with postoperative chylothorax occurrence on univariate analysis. Additionally, body weight < 4.5 kg (p=0.027), postoperative dysrhythmias (p=0.004), and high volume of chest tube output (> 10% of total expected blood volume) within the first 6 postoperative hours after cardiac intensive care unit admission (p=0.014) emerged as independent risk factors for postoperative chylothorax occurrence with odds ratios and 95% confident interval of 2.78 (1.12-6.87), 3.38 (1.29-8.86) & 3.82 (1.55-9.39), respectively. These factors served as predictors of postoperative chylothorax occurrence with a sensitivity of 42.1%, specificity of 90.8%, positive predictive value of 69.6% and a negative predictive value of 75.8%.
Conclusions: High chest tube output within the first 6 postoperative hours, postoperative dysrhythmias, and body weight of < 4.5kg at surgery significantly increase the risk of postoperative chylothorax in our institution.
Keywords: Postoperative chylothorax, chylothorax post pediatric cardiac surgery, pediatric chylothorax