bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with utilization of palliative care among hospitalized patients with cholangiocarcinoma.
Authors: Ibodeng Gogo-Ogute , Jackson Inimfon , Guarin Geneva , Thanikachalam Kannan 
Published: June 2023

e24159 Background: Cholangiocarcinoma has a rising incidence and a low 5-year survival rate. Patients with this malignancy have a very high symptom burden, however, there are only a few studies reported on the prevalence of palliative care utilization in this population. This study examines the prevalence, sociodemographic, hospital-level, and patient-related factors associated with the utilization of palliative care among hospitalized patients with cholangiocarcinoma in the United States. Methods: Data from the National Inpatient Sample, 2016–2020, were used to conduct retrospective cohort analyses. Descriptive analyses were performed to evaluate the prevalence of palliative care consultations among hospitalized patients with a diagnosis of cholangiocarcinoma. Multivariable logistic regression models were used to examine the factors associated with the receipt of palliative care in this population. Results: Approximately 17.9% of our cohort received palliative care during their hospital stay. Cholangiocarcinoma patients aged 65 years and older were more likely to receive palliative care (AOR: 1.19; 95% CI: 1.06–1.32) compared to those less than 65 years. Female patients had 10% higher odds (95% CI: 1.02–1.18) of palliative care utilization relative to their male counterparts. Compared to patients on Medicare, those with Medicaid (AOR: 1.50; 95% CI: 1.29–1.75), private (AOR: 1.27; 95% CI: 1.13–1.42) or other insurance types (AOR: 2.31; 95% CI: 1.95–2.75) were more likely to receive palliative care during their hospital stay. While patients who had elective admissions were less likely (AOR: 0.45; 95% CI: 0.40–0.51) to utilize palliative care relative to those admitted non-electively, those admitted to urban teaching hospitals had 25% higher odds (AOR: 1.29; 95% CI: 1.06–1.57) of palliative care utilization when compared to patients admitted to rural hospitals. Additionally, hospitalized patients with a diagnosis of intrahepatic cholangiocarcinoma had 1.39 times higher odds (95% CI: 1.25–1.55) of receiving palliative care when compared to patients diagnosed with extrahepatic cholangiocarcinoma. Other factors associated with palliative care utilization were hospital region, Charlson comorbidity index and patient disposition. Conclusions: Palliative care consultations among hospitalized patients diagnosed with cholangiocarcinoma remain suboptimal. Our study highlights some of the sociodemographic and hospital-level barriers to the utilization of palliative care services which should guide healthcare providers on areas to improve upon with the goal of improving access to palliative care among hospitalized patients with cholangiocarcinoma.
Platelet decline rate as the indication of using recombinant human thrombopoietin to prevent chemotherapy induced thrombocytopenia: A prospective, randomized, controlled study.
Authors: Wang Zhongliang , Ye Ting , Fan Li , Zhang Jieying , Cao Rubo , Liu Yanshen , Peng Ling , Chen Jing 
Published: June 2023

e24171 Background: Doxorubicin combined with ifosfamide is the common regimen for patients with sarcoma, which will induce severe thrombocytopenia. Sarcoma patients especially those with rapid platelet count decline after receiving this regimen could not avoid severe thrombocytopenia, even Recombinant Human Thrombopoietin(rhTPO) was used when the platelet count decreased to 75,000/μL according to current guidelines. The present study aimed to test the efficiency and safety of using rhTPO to prevent severe thrombocytopenia when rapid platelet count decline occurred. Methods: Our previous data showed those patients with rapid platelet count decline more than 40% within 3 days after administration of doxorubicin combined with ifosfamide were more likely to develop severe thrombocytopenia. In this prospective study, 53 patients with this characteristic were randomly assigned to prevention group (starting rhTPO immediately after enrollment) or treatment group (starting rhTPO when platelet count was less than 75,000/μL after chemotherapy). rhTPO was administrated with 300IU/kg·d until the platelet count increased to 100,000/μL or by 50,000/μL. Incidence and duration of grade 3 to 4 thrombocytopenia, proportion of platelet transfusion and adverse reactions were collected and analyzed. Results: The incidence of grade 3 to 4 thrombocytopenia in the prevention group and the treatment group was 63% and 81% respectively (p = 0.224), however the incidence of grade 4 thrombocytopenia in the former was significantly lower than that in the latter(22% versus 50% , p = 0.047).The duration of grade 3 to 4 thrombocytopenia in the prevention group had a declining trend compared with the treatment group( 2.6±2.8d versus 3.7±3.3d, p = 0.198). There was no difference in the proportion of platelet transfusion between the two groups. No rhTPO related toxicities of grade 3 to 4 were observed in both groups. Conclusions: For sarcoma patients treated with doxorubicin combined with ifosfamide, rapid platelet count decline more than 40% within 3 days after chemotherapy can be used as an indicator for the prophylactic administration of rhTPO, which can significantly reduce the probability of grade 4 thrombocytopenia without increasing toxicity. Clinical trial information: ChiCTR1900022667 .
Effects of the coronavirus disease 2019 pandemic on anxiety and spirituality in patients with cancer undergoing chemotherapy: A cross-sectional study.
Authors: Barbosa Oliveira Francisca Fernanda , Sant'Ana Rosane Oliveira , Matos Carlos Anna Clara Aragão , Crispim André Alves , Coelho Lívia Moreira Caetano , Nóbrega Malta Cássia Emanuella , Borges Maria Marcela Fontes , Souza Thuany Pinto Rocha de , Silva-Fernandes Isabelle Joyce de Lima , Picanço-Albuquerque Clarissa Gondim , Silva Lúcio Flávio Gonzaga , Silva Paulo Goberlanio de Barros 
Published: June 2023

e24200 Background: The objective of this study was to evaluate anxiety and spirituality levels in oncology patients during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This short-term cross-sectional study applied a previously validated General Anxiety Disorder-7 (GAD7) scale and spirituality inventory to 230 patients undergoing antineoplastic chemotherapy during the second wave of COVID-19 in Brazil. The means ± SD of the scales were calculated and correlated (Spearman's rho). After categorization, chi-square and multinomial regression models were used to identify risk factors (p < 0.05). Results: The levels of anxiety (6.16±5.11) and spirituality (17.22±2.66) were moderately and inversely correlated (p = 0.001, r = -0.212). Women (p = 0.025), fatigue (p = 0.048), and insomnia (p = 0.001) were associated with an increased incidence of anxiety; however, spirituality was associated with a reduced incidence of fatigue (p = 0.032). Death of family or friends due to COVID-19 increased the risk of high levels of anxiety (p < 0.05), while in multivariate analysis, insomnia (p = 0.030) and sleep difficulty (p = 0.031) were also directly associated with anxiety and spirituality reduced the interruption of chemotherapy during the COVID-19 pandemic (p = 0.036). Conclusions: Fear of the COVID-19 pandemic altered the psychoemotional environment of patients undergoing chemotherapy, resulting in increased levels of anxiety. However, spirituality was an important coping strategy in patients undergoing cancer treatment.
Oncology literacy: Educational book for children, families and health professionals.
Authors: Mozzilli Simone Lehwess , Andrade Verônica , Oliveira Milena , Salvetti Marina 
Published: June 2023

e24208 Background: With the progress of technology, not only the range of treatments and procedures increases, but also the amount of information and the complexity of the language. Appropriate materials are needed especially when stakeholders have different specificities, but need to speak the same language to understand each other and facilitate engagement in treatment. The aim of this study was to evaluate Beabook, an educational book designed for children with cancer, their family members and health professionals. Methods: The educational book, which has more than 150 terms from the oncology environment and is in more than 200 hospitals and institutions in Brazil, was scored using SAM - Suitability Assessment of Materials, a grading scale to evaluate suitability of health information materials based on categories: content, literacy demand, graphics, layout and typography, learning stimulation and motivation, and cultural appropriateness. Results: The book was analyzed by 61 participants, including children (n = 12) undergoing cancer treatment, remission, palliative care and cured, validating with a score of 26 (maximum scale score - 100%), family members (n = 20): mothers, fathers, siblings, uncles, with a score of 25.6 (98.4%) and health professionals (n = 29): doctors, nurses, psychologists, nutritionists, physiotherapists among others, with score of 25.4 (97.6%), resulting in a final score of 25.6 (98.6%), which represents material above expectations, fully adequate. Conclusions: An educational book suitable for different groups with different perspectives is of great importance in an environment where information is often omitted with the intention of protecting children, ludic communication is confused with fanciful stories and professionals do not have support materials to learn to communicate with patients and families. Studies prove that a unified, standardized and adequate language between stakeholders increases engagement and empowerment, being important mainly in the health area, where helping in the diagnosis and treatment does not imply only in the provision of clinical resources but in the guidance and sharing of information that demystify and build new representations.
Impact of breast cancer on employment in Mexico.
Authors: Villarreal-Garza Cynthia , Gonzalez-Sanchez David G. , Ramirez Arantxa , Vazquez Juarez Daniela , Platas Alejandra , Platas Ana Laura 
Published: June 2023

e24219 Background: Women constitute 40% of the workforce in Mexico and are essential contributors to the household and national income. Understanding how BC impacts an individual’s work-life and how the workplace supports patients’ journeys is important to understand the economic burden of this disease. This study focuses on the changes in the employment status of Mexican BC patients after their initial treatment. Methods: An online survey was created and distributed throughout Médicos Investigadores en la Lucha Contra el Cáncer, a BC NGO, social media networks from July to November 2022. Patients with BC who had completed initial treatment and lived in Mexico were invited to participate. The survey consists of multiple-choice questions and the opportunity to explain certain responses. Results were analyzed and visualized using Excel and RAWGraphs. Results: A total of 73 participants completed the survey. The average age (range) of participants was 46 years old (26-66) and 50.7% reported living as a couple. 84% of patients had completed high school or higher education. Most participants had stage 2 (34%) or stage 3 disease (33%). Table 1 describes the employment status of the other 73 participants before, during, and after initiating treatment. 53% considered having the support of their colleagues and employer during their initial treatment. The rest considered that their work environment was indifferent (21%), offered no support (14%), or decided not to disclose their diagnosis (12%). Additionally, some patients commented about workplace discrimination because of their disease: “Customers wouldn’t purchase clothes because my lack of a breast disgusted them” (after a radical mastectomy) and “I was forced to quit because “it was better for me” and they were afraid I would infect them.” Financial necessity (45%) and a return to normalcy (33%) were the main motivators to return to work, and 14% did not wish to continue working at the time of the survey. Conclusions: After their initial treatment, the majority of patients in this study underwent changes in employment status or stop working altogether. A considerable portion of the participants did not feel supported by their workplace and some even faced discrimination due to their disease. Future studies need to be conducted to understand the physical and psychological aspects, and the employer and societal factors that limit cancer survivors’ successful return to work in Mexico. Advocacy and reform must be undertaken to decrease workplace discrimination and balance work-life and breast cancer care. [Table: see text]
Interpersonal concerns of young adult surgical oncology patients with advanced cancer diagnoses: A mixed methods study.
Authors: Sun Beatrice J. , Pang Emily , Lee Byrne 
Published: June 2023

e24225 Background: Incidence of cancer in young adults (YA) is increasing. YA patients with advanced cancer are more likely than elderly counterparts to undergo elective or palliative surgeries. A diagnosis of advanced malignancy poses unique social and emotional burdens on YA. This study aims to understand the experiences of YA cancer patients in managing interpersonal relationships and social expectations. Methods: This mixed-methods study consisted of cross-sectional patient quality of life (QOL) surveys (Functional Assessment of Cancer Therapy: General [FACT-G]), caregiver QOL surveys (Caregiver QOL – Cancer [CQOLC]), and semi-structured qualitative interviews with patients. Participants were YA ages 18-45 years with advanced-stage cancers, recruited from surgical oncology clinic at a tertiary academic institution. Interviews were transcribed and analyzed by two independent reviewers to describe themes (italicized) on social and interpersonal impacts of patients’ cancer diagnosis. Results: Interviews and patient surveys were conducted with 18 YA patients. Median time since cancer diagnosis was 15 months, 44% of patients had metastatic disease at diagnosis, and 89% of patients had previously undergone both chemotherapy and surgery for cancer treatment. 56% of patients identified their spouse or significant other as the person they were closest to, and 28% were closest to a parent or sibling. 56% of patients had children of their own who lived in the household. Median FACT-G scores were 23/28 for social/family well-being (IQR: 18-25) and 13/28 for emotional well-being (IQR: 8-17). Caregiver surveys were completed for 12 of 18 patients, revealing that most developed a closer relationship with their loved one (67%) and felt informed about their disease (92%). Qualitative interview analysis revealed themes of: information-sharing about cancer, where patients shared concerns of withholding prognostic information to give loved ones hope; impacted relationships with friends and colleagues, as patients struggled with who to disclose their cancer diagnosis to; social/physical perceptions by others, as patients worried about changes in their physical appearance (e.g. weight loss) as a result of cancer; financial concerns as a result of treatment and its future impact on the patient’s loved ones. Conclusions: This mixed methods study highlights the interpersonal concerns of YA with advanced cancers. At a phase where identity formation, social perceptions, and personal relationships may be threatened by cancer, unique psychosocial and emotional challenges arise. Programmatic changes are needed to provide appropriate support, resources, and empathetic care to this distinct population of cancer patients.
Characterization of pre-malignant lesions in patients with pediatric neurofibromatosis type 1 using a novel whole-body magnetic resonance imaging technique.
Authors: Baca Nicole M. , Majlessipour Fataneh (Fae) , Xie Yibin , Posadas Edwin Melencio 
Published: June 2023

TPS10637 Background: Neurofibromatosis Type 1 (NF-1) patients can develop benign tumors, plexiform neuromas (PN), that may transform into malignant peripheral nerve sheath tumors (MPNST)(Tucker, et al. 2009). MPNST are rare; but in NF1, the lifetime incidence is 8-13% and MPSTs present at younger ages(Miettinen, et al. 2017). MPNST are aggressive tumors requiring full resection for best outcomes (Mautner, et al. 2008). Emerging data suggests whole-body MRI (WB-MRI) can identify NF patients with higher PN tumor burden and maybe at risk of developing MPNST. We have created a rapid, motion-robust quantitative WB-MRI technique that is likely suitable for pediatric patients. High-resolution multiparametric tissue mapping, including T1, T2, and ADC (apparent diffusion coefficient), are acquired concurrently in a single scan, as shown in prior studies (Christodoulou, et al. 2018, Ma, et al. 2020, Nguyen, et al. 2016, Wang, et al. 2020). This project will evaluate the feasibility and reproducibility of novel WB-MRI for the characterization of pre-malignant lesions in NF-1 patients. Methods: Trial Design: Pilot study of novel WB-MRI technique in pediatric NF-1 patients with a goal of 15 patients between the ages of 5-17 years. Trial MRI scans are performed at baseline, 1 month, and then 12 months (+/-3 months). A clinical 3T MR scanner (Siemens MAGNETOM Vida) performs a head-to-knee WB-MRI in 70 minutes. Signal-to-noise ratio (SNR) and imaging quality scores will be evaluated. The lesion volume and mean T1/T2/ADC are measured for each lesion on the corresponding quantitative maps based on manual ROI’s (regions of interest). To assess scan-rescan reproducibility, image quality metrics (SNR and quality score), lesion identification, and lesion characteristics (T1, T2, and ADC) will be compared between the baseline and the 1-month scan using a Bland-Altman analysis and Schuirman’s equivalence. The coefficient of variation (CV = 100 [SD/mean] %) values for each of the quantitative values will be calculated. To evaluate for lesion characterization, changes in the mean in each MRI quantitative metrics (T1, T2, and ADC) will be measured for each lesion on the baseline and 12-month visit. Spaghetti plots will be used to visualize the change over time, and the difference in mean will be tested using an appropriate parametric or nonparametric test depending on the results of tests on normality and homoscedasticity. Intervention: WB-MRI at baseline, 1 month, and 12 months (+/-3 months) Eligibility: 5 to 17 years old not requiring sedation; Clinically or molecularly diagnosed NF-1 including mosaic/segmental subjects; Not Eligible: allergy to animal dander, animal-instigated asthma, pregnant, breastfeeding, or have intrauterine device; Current Enrollment (February 2023): 5 subjects (One unable to finish a non-sedated MRI). Clinical trial information: NCT04763109 .
UCLA B-13: A phase 1b trial evaluating the safety of ribociclib, tucatinib, and trastuzumab in patients with metastatic, HER2+ breast cancer and a multicenter, randomized, open-label, phase 2 study of preoperative treatment with ribociclib, trastuzumab, tucatinib, with or without fulvestrant versus docetaxel, carboplatin, trastuzumab, and pertuzumab in HR+/HR-, HER2+ breast cancer.
Authors: McAndrew Nicholas Patrick , Hurvitz Sara A. , Tetef Merry L. , Kivork Christine , Ikenouye Larissa , Slamon Dennis J. 
Published: June 2023

TPS1116 Background: Overexpression of the HER2 protein is an important prognostic and predictive biomarker in about 20% of breast cancers, and while trastuzumab-based regimens are still considered standard of care in the early and metastatic settings, these regimens require chemotherapy co-administration. Pre-clinical mouse models suggest that a tucatinib/CDK 4/6 inhibitor combination regimen may be equally effective as standard regimens. Thus, finding more effective/tolerable therapies for this disease remains an area of unmet need. This randomized, open label, phase II clinical trial will explore the safety and efficacy of two novel, chemotherapy free combination drug regimens, given neoadjuvantly, in patients with anatomic stage I-III, HER2+ breast cancer. Methods: Phase 1b dose escalation trial: To establish the safety profile of the combination of ribociclib and tucatinib, an initial dose-finding phase 1b trial will be performed in patients with metastatic HER2+ breast cancer before moving into the larger phase 2 trial. 3-6 patients will be assigned sequentially to groups of increasing doses of ribociclib (200mg-600 mg) with fixed doses of tucatinib (300mg) and trastuzumab (SOC dosing) for a total of four 28-day cycles. The recommended phase 2 dose will be established when 6 patients have been treated at the highest dose level cohort. As of January 2023, 1 participant has been enrolled in dose level 1. Phase 2 neoadjuvant trial: Following MTD determination and approval from regulatory boards and funding partners, a total of 100 patients will be enrolled in the phase 2 portion of the study. Enrollment will be stratified by hormone receptor status. Patients will be randomized 1:1 (25 in each group) to receive six cycles of one of the following regimens: ribociclib/trastuzumab/tucatinib/+/- fulvestrant (28 day cycles) or docetaxel/carboplatin/trastuzumab/pertuzumab (SOC, 21 day cycles), preceded by one run-in cycle of trastuzumab/pertuzumab. To assess for changes in predictive molecular biomarkers, biopsies pre-and-post cycle 1 will be planned in all arms. Early imaging response assessments in the experimental arms will be planned after 2 cycles. Other endpoints include safety, changes in Ki67 expression, RCBi, biomarker analysis, and health-related quality of life. Clinical trial information: NCT05319873 .