Current Issue : January - March Volume : 2021 Issue Number : 1 Articles : 6 Articles
Background: Currently, oral targeted therapies are known to be effective and are frequently used to treat\nmetastatic cancer patients, but fatigue is a frequently reported early side effect of these treatments. This fatigue\nmay impact the patientâ??s treatment adherence and result in a negative impact on quality of life. Physical exercise\nsignificantly improved the general well-being and quality of life of advanced cancer patients. However, there is no\nspecific physical activity program adapted for patients with advanced disease.\nMethods: QUALIOR is a two-part, randomized, open-label, and multicenter with two arms phase II/III trial. Patients\n(phase II: n = 120; phase III: n = 312) with metastatic cancer (breast cancer, kidney cancer, lung cancer, and other\ncancers [including but not limited to colon cancer, melanoma, sarcoma, or hepatocarcinoma]) treated with a firstor\nsecond-line oral targeted therapy without chemotherapy will be included. Patients will be randomized (2:1) to a\n3-month supervised home-based standardized physical activity program or to a recommended adapted physical\nactivity (via a booklet). The primary objective of the phase II is to evaluate the feasibility of the supervised program.\nThe primary objective of the phase III is the evaluation of the benefit of the supervised home-based program\ncompare to the recommended program in terms of fatigue and quality of life at 3 months. The secondary\nobjectives aim to evaluate the impact of the supervised program on fatigue over time, pain, physical capacities,\npsychosocial and cognitive functions, general quality of life, frequency of dose reduction and patientsâ?? adherence to\nthe targeted therapy, overall survival, and progression-free survival. This study will also evaluate the medicoeconomic\nimpact of supervised program..............................
Background: Adolescent and young adult (AYA) childhood cancer survivors (CCS) should be empowered to\ncontinue their survivor-focused care as they transition into adult medicine. However, the majority of AYA-aged\nsurvivors become lost to follow up around the age of typical transition to adulthood. The purpose of this study was\nto identify, from the patientâ??s perspective, key factors that facilitate successful transitions to adult-centered\nsurvivorship care.\nMethods: A qualitative study was conducted with AYA CCS (n = 29) from the survivorship clinic of a single\ninstitution as key informants. Data were collected through a series of structured phone interviews and subjected to\nthematic content analysis.\nResults: Four major themes with multiple subthemes were identified: (1) transition practices need to be flexible\nand individually tailored; (2) effective communication is critical to a successful transition; (3) continuity in providers\nis needed during the transition; and (4) comprehensive care means care that also addresses psycho-social wellbeing.\nConclusions: From the perspective of AYA CCS, the ideal model of transitional survivorship care could include a\npatient navigator who promotes provider flexibility, consistent communication, and pro-active comprehensive care\nthat encompasses both medical and psycho-social well-being. Models of care for CCS should be built to provide, or\nseamlessly facilitate, continuous survivor-focused care across the age continuum. A longitudinal relationship with a\nsurvivor-focused provider can help promote the values that CCSâ?? report as important in transitioning care from\npediatric- to adult-centered care....
Background: Brain metastasis represents a major complication with a significantly shorter overall survival of many\noncological diseases, in particular of lung cancer, breast cancer and malignant melanoma patients. However,\ndespite the poor prognosis, sometimes clinical decision-making, between on the one hand not to harm the patient\nand on the other hand not withholding a potential therapeutic option, is very challenging. Thus the aim of this\nretrospective study was to compare various scores, including scores for activities of daily living (ADL) before\nresection of brain metastases and to analyse their impact on survival.\nMethods: Our single institution retrospective patient cohort (N = 100) with a median age of 63.6 years, which had\nall undergone resection of one or more brain metastases, was categorized using the original patient files. The\ncohort includes 52 patients with lung cancer, 27 patients with breast cancer, 8 patients with colorectal carcinoma\nand 13 patients with kidney cancer. To categorize, we used different score systems which were capable to evaluate\nthe patient in relation to self-sufficiency, activity and self-determination as part of ADL. The retrospective analysis\nincludes the ECOG-Status, Karnofsky-Index, Barthel-Index, ASA-Classification and Katz-Index. Pre-processing and the\nanalysis of the data was implemented using KNIME, where we used the R-plugin nodes to perform the final\nstatistical tests with R.\nResults: Our analysis reveals that most of the ADL scores we tested are able to give a reliable prediction on overall\nsurvival after brain metastasis surgery. The survival rates decrease significantly with a lower score in all tested score\nsystems, with the exception............................
Introduction: The progressive ageing of the population from southern Sahara\nis leading to an increase in health needs among the elderly. The purpose of\nthis study was to output an overview about the reasons why the elderly come\nfor consultation in the internal medicine department of the HKM-NHUC in\nCotonou. Methodology: This was a retrospective, descriptive, and analytical\nstudy, which included all patients aged 65 years and over, who came for the\nfirst time for consultation in the Internal Medicine Department of the CNHUHKM\nbetween...........................
Background: Radiotherapy (RT) is the major part of the treatment strategy set by a multidisciplinary team (MDT) for\npatients diagnosed with esophageal cancer (EC). The effect of an MDT collaboration on patients with EC who\nunderwent RT is unclear.\nMethods: We retrospectively collected all patients diagnosed with EC in the radiation oncology department at our\ninstitution from January 2015 to May 2017. The patients were divided into groups based on if they had their cases\npresented or not presented at the MDT meeting (with MDT and non-MDT, respectively). Propensity score matching\n(PSM) was applied at a ratio of 1:1 and the nearest neighbor matching method to compare the two groups.\nResults: A total of 212 consecutive patients were analyzed, including 157 with MDT and 55 non-MDT. In the\nunmatched population, the patients with MDT were more likely to received chemotherapy than the non-MDT\npatients............................
Background: Growing evidence indicates that the systemic inflammatory response plays an important role in\ncancer development and progression. Several inflammatory markers have been reported to be associated with\nclinical outcomes in patients with various types of cancer. This study was designed to evaluate the prognostic value\nof inflammatory indexes in patients with ampullary cancer (AC) who underwent pancreaticoduodenectomy (PD).\nMethods: We retrospectively reviewed the data of 358 patients with AC who underwent PD between 2009 and\n2018. R software was used to compare the area under the time-dependent receiver operating characteristic (ROC)\ncurves (AUROCs) of the inflammation-based indexes, including the neutrophil-to-lymphocyte ratio (NLR), platelet-tolymphocyte\nratio (PLR), modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI) and\nprognostic index (PI), in terms of their predictive value for survival. The survival differences of these indexes were\ncompared by the Kaplan-Meier method and univariate and multivariate analyses were performed to determine the\nprognostic factors of disease-free survival (DFS) and overall survival (OS).\nResults: The estimated 1-, 2-, and 3-year OS and DFS rates were 83.9, 65.8, and 55.2% and 58.0, 42.8, and 37.8%,\nrespectively, for the entire cohort. The survival differences were significant in terms of OS and DFS when patients were\nstratified by these inflammation-based indexes. The comparisons of the AUROCs of these inflammation-based indexes\nillustrated that NLR and PI displayed the highest prognostic value, compared to the other indexes. When NLR and PI were\ncombined, NLR-PI showed even higher AUROC values and was identified as a significant prognostic factor for OS and DFS.\nConclusion: Specific inflammatory indexes, such as NLR, PLR and dNLR, were found to be able to predict the OS or\nDFS of patients. As a novel inflammatory index, the level of NLR-PI, which can be regarded as a more useful prognostic\nindex, exhibited strong predictive power for predicting the prognosis of patients with AC after the PD procedure....
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