bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dermocosmetics in management of cancer-related skin toxicities: International expert consensus.
Authors: Dreno Brigitte , Khosrotehrani Kiarash , De Barros Silva Giselle , Ryan-Wolf Julie , Kerob Delphine , Trombetta Mark G. , Atenguena Okobalemba Etienne , Dielenseger Pascale , Pan Meng , Lacouture Mario E. 
Published: June 2023

e24115 Background: Skin toxicities – one of the most frequent adverse events associated with cancer therapies – can occur with all types of cancer therapeutic interventions. New side effects emerge as new oncology drugs are approved (eg, targeted therapies, immunotherapies), which are associated with a negative impact on quality of life, oncologic treatment dose reductions and/or treatment discontinuation. From a pathophysiologic point of view, skin toxicities during cancer treatment result mostly from alterations in skin barrier function, inflammation, altered immune responses, and phototoxicity. Minimizing alterations in skin barrier function and photoprotection facilitate prevention and management of adverse events to optimize treatment outcomes. Methods: In partnership with the Association Francophone des Soins Oncologiques de Support (AFSOS) and Multinational Association of Supportive Care in Cancer (MASCC), a group of international experts (dermatologists, oncologist, radiation oncologist, oncology nurse) involved in management of cancer patients performed a literature review and a consensus meeting to discuss the role of dermocosmetics to prevent or manage skin adverse events induced by oncology treatments. Dermocosmetics, or cosmeceuticals, include a range of products that can have both therapeutic and cosmetic value. These products help support and maintain the epidermal skin barrier and cutaneous microbiome. Some have been formulated for skin that is fragile, pathological, and sensitive. Results: General recommendations: 1) skin care should be implemented at initiation of therapy for drugs associated with skin toxicities, since prevention is a crucial aspect of management. 2) Skin hydration relieves symptoms and reduces exacerbations of xerosis. 3) Cleansers should have a pH close to 5, while basic and neutral pH cleansers should be avoided. 4) Urea, particularly in the case of some oncology treatments leading to hand foot syndrome, is important due to its exfoliating and hydrating actions. Urea should be avoided with irritated skin. The group also developed recommendations for the management of specific skin toxicities. Conclusions: Emerging evidence is providing support for the beneficial impact of dermocosmetics in management of treatment-related skin toxicities.
Symptom burden and end of life care in patients with acute myeloid leukemia undergoing intensive induction chemotherapy in a rural setting.
Authors: O'Neil Sean , Frankki Susan M , Rosenstein Lori J. 
Published: June 2023

e24117 Background: Patients with acute myeloid leukemia (AML) who receive intensive induction chemotherapy (IC) face a prolonged hospitalization and a life-threatening illness. As a result, patients experience a high physical, psychological, and emotional symptom burden which can significantly affect their quality of life (QOL).1 There is also a high mortality rate associated with IC, with one study showing 12.3% chance of in-hospital death and 3.7% discharge to hospice.2 Early integration of palliative care (IPC) has shown improvements in QOL, decrease in psychological stress and improved end-of-life care.3 The aim of this study was to examine the historic use of IPC during IC and assess the symptom burden in a rural healthcare setting and to provide a rationale for early incorporation of palliative care into IC. Methods: We performed an IRB approved retrospective study of all patients with AML who were admitted to Gundersen Health System for IC from January 2013 to September 2021. Data collection included basic demographics, disease and treatment specific variables, and admission variables. Symptom burden was also assessed by reviewing daily progress notes. Statistical analysis included descriptive statistics, Wilcoxon signed-rank test, and Fisher’s exact test and was performed in SAS version 9.4 at a significance level of 0.05. Results: Our study included 33 patients with an average age of 62 years. Our sample was 100% white, 58% male, 82% married and 58% former smokers. Average length of stay was 29 days and 5 (15%) patients died during this time. Individuals experienced an average of 9.8 (range 4-17) of the 20 recorded symptoms, most commonly pain (97%), fevers (88%), edema (73%), anorexia (67%), rash (61%), and diarrhea (61%). Only 6 patients (18%) received a palliative care consultation during IC. For patients without a palliative care consultation during IC, advanced care planning (ACP) documents were found in only 37% during or before IC. However, when palliative care was consulted, ACP documentation increased to 83% demonstrating a trend towards significance (p = 0.07). There was a significant difference between the number of symptoms observed in those who received a palliative care consultation (median = 13 symptoms) and those who did not (median = 9 symptoms, p = 0.007). Conclusions: Despite our patients experiencing a high symptom burden and a significant chance of death, there was a low rate of early integration of palliative care. This retrospective study was unable to determine if IPC improved symptom burden, but we did find that IPC increased the rate of ACP documentation from 37% to 83%. The presence of ACP documentation has been shown to significantly reduce ICU utilization and improve the quality of care at the end of life.4 Given these findings; we plan to move forward with routine integration of palliative care into the management of patients undergoing IC for AML.
Pilot randomized trial of a telehealth intervention for women with advanced ovarian cancer and PARP inhibitor-related fatigue.
Authors: Wright Alexi A. , Poort Hanneke , Tavormina Anna , Schmiege Sarah , Matulonis Ursula A. , Campos Susana M , Liu Joyce F. , Slivjak Elizabeth , Gilmour Anna , Salinger Julia , Haggerty Ashley Ford , Arch Joanna J 
Published: June 2023

e24122 Background: Poly(ADP-ribose) polymerase inhibitors (PARPi) have dramatically changed the treatment of advanced ovarian cancer and are increasingly used in other cancers. However, PARPi cause significant fatigue in nearly half of patients. Psychosocial interventions have shown promise for treating cancer-related fatigue, but there is limited evidence for use in patients with advanced cancers. Moreover, most fatigue interventions have been delivered in person over many sessions, limiting their accessibility and scalability. Methods: We conducted a pilot randomized trial of REVITALIZE, a 6-session telehealth intervention developed and refined by our group, compared with enhanced usual care among 35 fatigued patients with advanced or recurrent ovarian cancer on PARPi at two sites, Dana-Farber Cancer Institute and University of Pennsylvania. REVITALIZE was based on acceptance and commitment-based behavioral therapy and addressed modifiable contributors to PARPi-related fatigue. The trial tested the feasibility, acceptability, and preliminary efficacy of REVITALIZE through 3-month follow-up. Exit interviews were conducted with all REVITALIZE patients. Results: Among 35 participants (mean age=62.5 years, 83% stage III/IV disease, 46% first-line maintenance therapy), the trial met or exceeded its acceptability and feasibility goals. Exit interviews further indicated high acceptability. Relative to enhanced usual care, REVITALIZE significantly reduced fatigue interference at 12-week follow-up (Cohen’s d=.94, p=.008) and fatigue severity (d=.54, p=.049), while improving current fatigue levels (d=.62, p=0.04). REVITALIZE participants also reported improved fatigue self-efficacy, fatigue catastrophizing, depression, anxiety, and quality of life (ds=.60-.86). REVITALIZE participants were also numerically less likely to experience PARPi dose reductions compared with enhanced usual care (7% vs. 17%), and less likely to have dose delays (7% vs. 22%). Conclusions: Among fatigued adults with advanced ovarian cancer on PARPi, a brief telehealth intervention based on acceptance and commitment therapy showed strong feasibility, acceptability, and preliminary efficacy with improvements in fatigue, anxiety, depression, and quality of life outcomes. REVITALIZE is a novel, scalable telehealth intervention worthy of further investigation in patients with advanced cancers with PARPi-related fatigue. The study is supported by the National Comprehensive Cancer Network (NCCN) through a grant provided by AstraZeneca. Neither NCCN or AstraZeneca are the sponsors of this study. Clinical trial information: NCT04525183 .
Evaluating response to interventions for vasomotor symptoms in patients with breast cancer: A patient-centered approach.
Authors: Cole Katherine , McGee Sharon , Clemons Mark J. , Liu Michelle , MacDonald Fiona , Vandermeer Lisa , Ng Terry L. , Pond Gregory Russell , El Emam Khaled 
Published: June 2023

e24126 Background: Vasomotor symptoms (VMS), such as hot flashes, are a common reason for early discontinuation of endocrine therapy for patients (pts) with breast cancer (BC). The optimal intervention for VMS remains unknown. Using a novel symptom change analysis and regression trees, we examined whether clinically important change in VMS severity depends on baseline symptomatology. Methods: In this prospective study, pts with BC experiencing VMS chose either a lifestyle (LS), or non-LS (i.e. complementary and alternative therapies [CAM], prescription medications [PM], or endocrine therapy modification [ETM]) intervention. The primary outcome was change in symptom severity using the 10-point Hot Flush Rating Scale (HFRS). Patients declining interventions were included as controls. At the end of the 6-week intervention, participants rated the effectiveness of their chosen intervention on a five-point Likert scale. A logistic sigmoid function and Bayesian optimization were used to weight the change in VMS score based on baseline VMS severity. A regression tree was trained to predict which intervention resulted in the greatest improvement in VMS at 6 weeks. Results: 100 baseline and follow-up questionnaires from 85 pts were included in an intention to treat analysis. The median baseline HFRS was 5.0 (IQR 3.33 ,7.00). Selected interventions included LS (27%), CAM (25%), PM (11%) and ETM (8%), with 29% declining interventions. After removal of missing data, 59 individuals provided responses for both the HFRS score and the effectiveness score. Higher baseline HFRS scores had greater impact on symptom change scores. The largest difference in VMS improvement was noted between the non-LS (median symptom change –0.82, IQR –2.00, –0.01) and LS/control groups (median symptom change – 0.38, IQR –1.46, 0.00) (Table 1). Of non-LS interventions, CAM had the greatest improvement in VMS severity. Pre-menopausal individuals who pursued LS interventions had the least improvement in VMS severity. Conclusions: Interventions for VMS were most impactful among pts with greater baseline symptoms. While LS interventions were the most commonly selected intervention, the resulting improvement in symptoms at 6 weeks was negligible, and alternative strategies should be encouraged. Future studies integrating pt preferences and accounting for baseline symptom severity are needed. [Table: see text]
The effect of touch on pain, anxiety, and the patient experience during bone marrow biopsies.
Authors: Dhawan Natasha , Schaal Anna , Pushee Jacob R. , Broglio Kathleen 
Published: June 2023

e24131 Background: Many patients report severe pain and anxiety during bone marrow biopsies (BMBx), but there is no formal consensus on the best approach to managing these symptoms during the procedure. The aims of this study were to evaluate the effect of simple foot touch on pain and anxiety during BMBx, and to describe the patients’ experience during the procedure. Methods: A single-center randomized control trial using permuted block randomization was conducted at a rural academic cancer center. Nursing assistants without specialized massage training performed simple foot touch on patients in the intervention arm, while the BMBx was performed by advanced practice registered nurses. The patients in the control arm received usual care. Patients rated pain and anxiety levels before and after BMBx using the Visual Analog Scale (VAS) and Spielberger State-Trait Anxiety Inventory (STAI) scales, respectively. All participants completed a post-intervention survey about their experience. Results: 46 patients were enrolled in the study; 21 in the intervention arm (median age 64.1 years) and 25 in the control arm (median age 64.4 years). There was no difference in the use of anxiolytics (p = 0.51) or opioids (p = 0.48) during the procedure between the two arms. There were no statistically significant differences on the VAS (p = 0.37) or STAI (p = 0.40) between the intervention and control arms. Participants in the intervention arm reported more positive feedback and had fewer suggestions for improving the patient experience compared to the control arm (table 1). Conclusions: This is the first study to use an interprofessional team approach to evaluate the impact of touch on pain, anxiety, and the patient experience during BMBx. While the intervention did not impact pain or anxiety scores, it may be a feasible, minimal-risk, and no-cost intervention to improve patients’ overall experience during BMBx. Clinical trial information: NCT04935775 . [Table: see text]
Opiate use after total hip arthroplasty for metastatic bone disease.
Authors: Vijayakumar Gayathri , Vance Dylan , Colman Matthew W. , Gitelis Steven , Sweeney Kyle , Blank Alan T. 
Published: June 2023

e24132 Background: Metastatic bone disease (MBD) commonly affects the hip and surgical intervention including total hip arthroplasty (THA) may be indicated for pain relief or to improve function. Following THA, patients are often prescribed short courses of opioids for postoperative pain relief. This study investigated postoperative opioid use following THA in MBD patients. Methods: This was a retrospective review of patients using opioids preoperatively who underwent THA for MBD at two institutions between 2009 and 2022. Preoperative and postoperative opioid usage at 6 weeks and 90 days were quantified through calculating daily morphine milligram equivalents (MME) and compared using the sign test. Results: Nineteen primary THA and 11 THA with complex acetabular reconstruction were included. At six weeks, 26 (86.7%) patients were utilizing opiates and at ninety days 23 (76.7%) patients were utilizing opiates. There was a statistically significant difference between median daily preoperative MME compared to daily MME at ninety days (p < 0.001). The only statistically significant association with opioid use at 90 days was opioid use at 6 weeks. Conclusions: To our knowledge, this is the first paper evaluating postoperative opioid use following primary THA in MBD patients. After THA in the setting of MBD, patients exhibit decreased postoperative opioid use.[Table: see text]
Effect of multimodal intervention care on cachexia in patients with advanced cancer compared to conventional management (MIRACLE): An open-label, parallel, randomized, phase 2 trial.
Authors: Kim Bo-Hyung , Maeng Chi Hoon , Chon Jinmann , Kang Won Sub , Kang Kyounglan , Woo Mihye , Hong Il Ki , Lee Junhee , Lee Kil Yeon 
Published: June 2023

e24135 Background: Cancer Cachexia (CC) is a multi-factorial process characterized by progressive weight loss, muscle mass and fat tissue wasting, and adversely affecting their quality of life and survival in patients with advanced stage of cancer. We investigated the efficacy and safety of a multi-modal intervention including anti-inflammation, omega-3-fatty acids, nutritional supplement with counselling, physical exercise, psychiatric intervention as well as Bojungikki-tang which mediates immune-modulation and reverse chronic inflammation and wasting condition as a complementary and alternative medicine compared to patients receiving best supportive care. Methods: Eligible criteria included patients with advanced stage of gastrointestinal (gastric, colorectal and pancreaticobiliary) as well as lung cancer undergoing active palliative chemotherapy. Patients are randomized into experimental arm (Multi-modal intervention care: MIC) versus control arm (Conventional Palliative Care, CPC). MIC are comprised of daily oral medications; ibuprofen 400 mg three times a day, omega-3-fatty acid 1 g twice a day, Bojungikki-tang 3.75g twice a day, oral nutritional supplement (HAMONILAN SOLN) 200 ml twice a day, and weekly physical exercise (60 minutes per visit), psychiatric assessment on every other week, and nutritional counselling total four times during the study period. CPC included basic nutritional counselling for two times provided by National Health Insurance Service, and megestrol acetate as needed (ie, anorexia≥grade 2). All interventions were provided during 12 weeks per subject. Co-primary outcomes are total lean body mass changes and handgrip strength change from the baseline. Secondary outcomes included change of fat mass and total body mass, lean body mass, and quality of life assessment (KCT0004967, NCT 04907864). Results: A total of 112 patients was planned to be assigned to the two arms (56 in each group), however, the study was terminated due to low accrual rate and the expiration of the study approval period of the national research fund, after enrolling up to 56 subjects (28 in each group). Demographic findings were even distributed between arms. The difference of median changes of total lean body mass in MIC group after 12 weeks of intervention, was numerically increased without statistical significance compared to CPC group (MIC vs CPC, 91 vs. -295 g, p= 0.3863). There was no difference of median changes of handgrip strength between MIC and CPC groups (MIC vs CPC, 0.4 vs. 0.9, p= 0.2319). Other secondary outcomes showed no differences, either. Conclusions: Multimodal intervention in this study did not show clinical meaningful improvement. We have to further investigate another method to improve cachexia. Clinical trial information: NCT04907864 .
Mobile-based multimodal rehabilitation including exercise, nutritional, and psychological interventions in patients with abdominal cancer receiving concurrent chemoradiotherapy: Prospective, multicenter, randomized trial.
Authors: Yang Lei , Wen-bo Wang , Xiong Yudi , Cao Dedong , Dai Jing , Xu Hui , Wu Han , Peng Jin , Wang You , Su Jing , Chen Xin , Wang Qing-Yun , Jiang Huangang , Xia Ling , Chen Weidong , Xu Ximing , Zhou Fuxiang 
Published: June 2023

e24138 Background: Concurrent chemoradiotherapy (CCRT) has several adverse toxicities such as fatigue, bone marrow suppression and malnutrition. We aimed to examine whether the mobile-based multimodal rehabilitation including exercise, nutritional and psychological interventions have an impact on clinical outcomes in abdominal cancer patients receiving concurrent chemoradiotherapy. Methods: A total of 90 eligible abdominal cancer patients were randomly assigned (1:1) to either the study (n = 47) or control (n = 43) group from February 2022 to November 2022. Multimodal rehabilitation was provided by a team of oncologists, rehabilitation physicians, nurses, clinical nutritionists and psychologists, while patients in the control group received only standard oncologic care. The study group received a wearable device and mobile app that provided an exercise program (at least 90 to 150 minutes of aerobic and resistance exercise per week for 5 weeks, depending on the patient's health status). Primary endpoints were changes in grip strength and body weight, with secondary endpoints including nutrition-related haematological indicators, toxicity and treatment completion rate. Results: Our study found that the body weight and grip strength of patients in the control group decreased significantly after CCRT, while those in the study group remained stable. The average weight loss (-0.19 ± 1.51 kg vs 1.28±1.90 kg, P = 0.016) and average grip strength loss (-0.95 ± 2.24 vs 1.26 ± 2.38 kg, P = 0.008) in the study group and control group after CCRT were significantly different. Meanwhile, patients in the study group showed less decline in haemoglobin levels (-1.96 ± 10.24 vs 12.05 ± 8.45 g/L, P = 0.000), serum albumin levels (0.65 ± 4.40 g/L vs 3.42 ± 2.87 g/L, P = 0.030) and lymphocyte count (0.74 ± 0.30 vs 1.16 ± 0.62 g/L, P = 0.010) contrast with control group. Conclusions: Multimodal rehabilitation based on mobile health could effectively maintain the body weight and nutritional status of patients undergoing concurrent chemoradiotherapy, which may be beneficial to improve the treatment tolerance of patients. Keywords: Abdominal cancer; Concurrent chemoradiotherapy; Multimodal rehabilitation; Mobile health; Grip strength. Clinical trial information: NCT05325554 .
Effectiveness of NEPA, an oral fixed-dose combination of netupitant and palonosetron in the prevention of chemotherapy induce nausea (CIN): A post-hoc analysis.
Authors: Pednekar Amullya , Gupta Sudeep , Biswas Ghanashyam , MV Chandrakanth , Dattatreya Palanki Satya , Thomas Boben , Gupta Sumant , Bhagat Sagar B , Patil Saiprasad , Barkate Hanmant V. 
Published: June 2023

e24140 Background: Despite widespread use of antiemetics, chemotherapy-induced nausea is still reported by upto 70% of adult patients receiving moderately emetogenic chemotherapy(MEC) or highly emetogenic chemotherapy (HEC) agents. Control of nausea remains an important, unmet need among cancer patients. The current evidence suggests that, overall, no significant nausea is reported by upto 75% of the patients with the aprepitant based regimens. Here, we present a post-hoc analysis of an observational study on NEPA (NEtupitant 300mg and PAlonosetron 0.50 mg) in preventing nausea in patients receiving HEC/MEC in a real-world setting in India. Methods: An open-label, single-arm, prospective study among chemonaive patients was conducted across six centers from April 2019 to December 2021 after approval from each institutional ethics committee (CTRI/2020/02/023586). A post-hoc analysis was carried out to assess the effectiveness of NEPA in preventing CIN in patients. The parameters assessed included severity of nausea using a visual analogue scale (VAS) [No significant nausea (includes no/mild nausea) < 2.5cm on VAS scale, moderate nausea 2.5cm to 7.5cm, Severe nausea 7.5cm to 10cm], complete control (no nausea and complete response) and safety. Results: Of the 354 patients, 289 (81.64%) received the HEC regimen, and the remaining 65 (18.36%) received the MEC regimen. Anthracycline-Cyclophosphamide (36.16%) and FOLFOX (6.21%) were the most common HEC and MEC regimens, respectively. In the overall, acute, and delayed phases, no significant nausea was reported in 89.83%., 93.22% and 92.65% of the patients, respectively. Moderate and severe nausea was reported in 5.65%, and 1.13% of patients in the acute phase, 5.65%, and 1.69% in the delayed phase, and 8.19%, and 1.98% in the overall phase respectively. Among, those on HEC and MEC regimen, no significant nausea was reported in 93.42 % and 89.23 % respectively during the overall phase (Table 1). Complete control was achieved in 77.40% of patients in the overall phase, 82.77% in the acute phase, and 85.03% in the delayed phase. Adverse events were reported in 10 (3.4%) patients, with leg pain being the most common 3(0.8%). Conclusions: NEPA was found to be effective and well tolerated in preventing nausea in patients receiving HEC/MEC regimens, with almost 90% of patients reporting no significant nausea in real world Indian setting. Clinical trial information: CTRI/2020/02/023586 .[Table: see text]