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Bergerot CD, Bergerot PG, Razavi M, Philip EJ, Lakhdari S, França MVDS, Molina LNM, Freitas ANDS, Taveira MC, de Azeredo AC, Fuzita WH, Fernandes CM, Pio RB, de Araujo R, Couto MM, de Vasconcellos VF, Nonino MF, Lee D, de Matos Neto JN, Buso MM, Soto-Perez-de-Celis E, Dale W. Implementation and evaluation of a remote geriatric assessment and intervention program in Brazil. Cancer 2023; 129:2095-2102. [PMID: 36964938 DOI: 10.1002/cncr.34759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/31/2023] [Accepted: 02/21/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND This study sought to determine the feasibility and acceptability of a remote geriatric assessment (GA) and implementation (GAIN) program in Brazil. The authors also explored the effect of this program on health-related quality of life (HR-QOL) outcomes 3 months after initiating treatment. METHODS This is a longitudinal study enrolling older adults (65+ years), diagnosed with any type of solid tumor, scheduled to initiate chemotherapy in a networked Brazilian cancer center. The GA was performed through telehealth. We assessed the feasibility of the remote GA, acceptability to patients, and changes in patient-centered outcomes (HR-QOL, mood, function) from baseline to month 3. Linear mixed model analysis was done, adjusting for age, gender, race, income, and disease stage. RESULTS Fifty-six patients completed all intended assessments. Notably, the threshold of feasibility was 70% and there was 92% complete adherence. Average age was 76 years old (SD = 7.2). Most patients were female (57%), married (59%), and had a college degree (46%). The most common diagnoses were gastrointestinal (39%) and gynecological cancers (18%); most were diagnosed at an advance disease stage (77%). A total of 32 patients were referred to a remote appointment and 86% followed this recommendation(s). Significant improvement in Functional Assessment of Cancer Therapy - General FACT-G (mean difference, 6.04; p < .001), Geriatric Depression Scale (mean difference, -0.86; p = .008), and instrumental activities of daily living ratio (mean difference, 0.17; p < .001) were found. CONCLUSION Remote GAIN is feasible and acceptable to older adults with cancer receiving treatment in Brazil. The authors also found significant improvement in HR-QOL outcomes over time. Notably, this GAIN program could guide early detection of chemotherapy toxicity and improving patient-reported outcomes in low-resource environments.
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Affiliation(s)
- Cristiane Decat Bergerot
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Paulo Gustavo Bergerot
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Errol J Philip
- University of California San Francisco, San Francisco, California, USA
| | - Sabri Lakhdari
- Clínica Médica Cronos, Brasilia, Distrito Federal, Brazil
| | | | | | - Alici Natalia de Sousa Freitas
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Mariane Cunha Taveira
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | | | | | - Cristiano Menezes Fernandes
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Raquel Batista Pio
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Romildo de Araujo
- Centro Pernambucano de Oncologia, Grupo Oncoclinicas, Recife, Pernambuco, Brazil
| | - Milena Macedo Couto
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | | | - Maria Fernanda Nonino
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - David Lee
- University of New Mexico, Albuquerque, New Mexico, USA
| | - João Nunes de Matos Neto
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | - Marco Murilo Buso
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Grupo Oncoclinicas, Brasília, Distrito Federal, Brazil
| | | | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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Verduzco-Aguirre HC, Navarrete-Reyes AP, Negrete-Najar JP, Soto-Pérez-de-Celis E. [Cancer in older adults in Latin America: interdisciplinary cooperation between oncology and geriatrics]. Rev Salud Publica (Bogota) 2023; 22:337-345. [PMID: 36753161 DOI: 10.15446/rsap.v22n3.84617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 06/30/2020] [Indexed: 12/24/2022] Open
Abstract
Latin America, like the rest of the world, is currently facing the consequences of population aging. Among these consequences is a rise in incidence in malignant neoplasms among older adults, with an anticipated increase in oncologic health service requirements in this population. Geriatric oncology is a recently created discipline which integrates geriatric principles into oncology care to offer older adults with cancer individualized treatments. This multidisciplinary approach is now recommended as part of routine oncology care by international associations. Although several geriatric oncology clinical, educational and research initiatives exist in Latin America, the number and availability of specialized facilities and personnel is limited in comparison to those in high-income regions. In this manuscript, we review international recommendations for the implementation of geriatric oncology principles into routine clinical practice, describe resources available for geriatric oncology in Latin America, and provide recommendations to improve multidisciplinary care for older adults with cancer in the region.
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Affiliation(s)
- Haydeé C Verduzco-Aguirre
- HV: MD. Esp. Oncología Médica. Departamento de Hemato-Oncología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México.
| | - Ana P Navarrete-Reyes
- AN: MD. Esp. Geriatría. Servicio de Geriatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México.
| | - Juan P Negrete-Najar
- JN: MD. Esp. Geriatría. Servicio de Geriatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México.
| | - Enrique Soto-Pérez-de-Celis
- ES: Esp. Oncología Médica. Investigador en Ciencias Médicas "D". Maestro en Ciencias Médicas. Servicio de Geriatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México, México.
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Teixeira TOA, Moura VTD, Santos GPD, Carneiro IA, De Domenico EBL. Pandemia de Covid-19 y la atención especializada en oncología: relato de experiencia. REVISTA CUIDARTE 2021. [DOI: 10.15649/cuidarte.1377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: La pandemia de Covid-19 trajo muchos desafíos para la atención oncológica, generando nuevos diseños operativos en las esferas de gestión y atención. Objetivo: Describir las experiencias de implementación de procesos administrativos y de atención de instituciones proveedoras de atención oncológica durante la pandemia de Covid-19. Métodos: Reporte de caso, descriptivo, cualitativo. Las experiencias del reporte cubren el período del 5 de marzo al 31 de enero de 2021. Los informes provienen de diferentes instituciones en el municipio de São Paulo, São Paulo, Brasil. Resultados: Los 3 reportes describen acciones tales como: detección de pacientes para las estrategias de telemedicina y tele enfermería; preparación de entornos libres de Covid-19 para la seguridad de profesionales y pacientes; refuerzo de acciones educativas para generación de conocimiento y adopción de comportamientos seguros para profesionales y pacientes, entre otros. Discusión: Los reportes describen como eje común la implementación de acciones para la seguridad de los pacientes, los profesionales y el medio ambiente, así como la continuidad de la atención oncológica. La literatura científica, las recomendaciones de consejos, sociedades y organizaciones fueron subsidiarias de las medidas instituidas. Conclusión: La novedad del confinamiento social debido al riesgo de propagación de COVID-19 demostró ser un campo fructífero para la incorporación de nuevas estrategias de gestión y asistencia oncológica. Ciertamente, habrá pérdidas y daños en el proceso de atención oncológica durante esta pandemia. En este contexto, el mapeo de la caída del diagnóstico de cáncer, así como de las interrupciones del tratamiento, es esencial para mitigar sus consecuencias.
Como citar este artículo: Teixeira, Tamara Otsuru Augustinho; Moura, Veronica Torel de; Santos, Gislene Padilha dos; Carneiro, Ieda Aparecida; Domenico, Edvane Birelo Lopes De. Pandemia de Covid-19 e atendimento especializado em oncologia: relato de experiência. Revista Cuidarte. 2021;12(2):e1377. http://dx.doi.org/10.15649/cuidarte.1377
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Du C, Li S, Li Y, Galons H, Guo N, Teng Y, Zhang Y, Li M, Yu P. F7 and topotecan co-loaded thermosensitive liposome as a nano-drug delivery system for tumor hyperthermia. Drug Deliv 2021; 27:836-847. [PMID: 32508162 PMCID: PMC8216433 DOI: 10.1080/10717544.2020.1772409] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
In order to enhance the targeting efficiency and reduce anti-tumor drug’s side effects, topotecan (TPT) and F7 were co-loaded in thermosensitive liposomes (F7-TPT-TSL), which show enhanced permeability and retention in tumors, as well as local controlled release by heating in vitro. TPT is a water-soluble inhibitor of topoisomerase I that is converted to an inactive carboxylate structure under physiological conditions (pH 7.4). F7 is a novel drug significantly resistant to cyclin-dependent kinase but its use was restricted by its high toxicity. F7-TPT-TSL had excellent particle distribution (about 103 nm), high entrapment efficiency (>95%), obvious thermosensitive property, and good stability. Confocal microscopy demonstrated specific higher accumulation of TSL in tumor cells. MTT proved F7-TPT-TSL/H had strongest cell lethality compared with other formulations. Then therapeutic efficacy revealed synergism of TPT and F7 co-loaded in TSL, together with hyperthermia. Therefore, the F7-TPT-TSL may serve as a promising system for temperature triggered cancer treatment.
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Affiliation(s)
- Chunyang Du
- College of Biotechnology, China International Science and Technology, Cooperation Base of Food Nutrition/Safety and Medicinal Chemistry, Tianjin International Cooperation Research Centre of Food Nutrition/Safety and Medicinal Chemistry, Tianjin University of Science & Technology/Tianjin Enterprise Key Laboratory for Application Research of Hyaluronic Acid, Tianjin, China
| | - Shuangshuang Li
- College of Biotechnology, China International Science and Technology, Cooperation Base of Food Nutrition/Safety and Medicinal Chemistry, Tianjin International Cooperation Research Centre of Food Nutrition/Safety and Medicinal Chemistry, Tianjin University of Science & Technology/Tianjin Enterprise Key Laboratory for Application Research of Hyaluronic Acid, Tianjin, China
| | - Yuan Li
- College of Biotechnology, China International Science and Technology, Cooperation Base of Food Nutrition/Safety and Medicinal Chemistry, Tianjin International Cooperation Research Centre of Food Nutrition/Safety and Medicinal Chemistry, Tianjin University of Science & Technology/Tianjin Enterprise Key Laboratory for Application Research of Hyaluronic Acid, Tianjin, China
| | - Hervé Galons
- College of Biotechnology, China International Science and Technology, Cooperation Base of Food Nutrition/Safety and Medicinal Chemistry, Tianjin International Cooperation Research Centre of Food Nutrition/Safety and Medicinal Chemistry, Tianjin University of Science & Technology/Tianjin Enterprise Key Laboratory for Application Research of Hyaluronic Acid, Tianjin, China.,Institut Parisien de Chimie Moléculaire, UMR CNRS 8232, Paris, France
| | - Na Guo
- College of Biotechnology, China International Science and Technology, Cooperation Base of Food Nutrition/Safety and Medicinal Chemistry, Tianjin International Cooperation Research Centre of Food Nutrition/Safety and Medicinal Chemistry, Tianjin University of Science & Technology/Tianjin Enterprise Key Laboratory for Application Research of Hyaluronic Acid, Tianjin, China
| | - Yuou Teng
- College of Biotechnology, China International Science and Technology, Cooperation Base of Food Nutrition/Safety and Medicinal Chemistry, Tianjin International Cooperation Research Centre of Food Nutrition/Safety and Medicinal Chemistry, Tianjin University of Science & Technology/Tianjin Enterprise Key Laboratory for Application Research of Hyaluronic Acid, Tianjin, China
| | - Yongmin Zhang
- College of Biotechnology, China International Science and Technology, Cooperation Base of Food Nutrition/Safety and Medicinal Chemistry, Tianjin International Cooperation Research Centre of Food Nutrition/Safety and Medicinal Chemistry, Tianjin University of Science & Technology/Tianjin Enterprise Key Laboratory for Application Research of Hyaluronic Acid, Tianjin, China.,Institut Parisien de Chimie Moléculaire, UMR CNRS 8232, Paris, France
| | - Mingyuan Li
- College of Biotechnology, China International Science and Technology, Cooperation Base of Food Nutrition/Safety and Medicinal Chemistry, Tianjin International Cooperation Research Centre of Food Nutrition/Safety and Medicinal Chemistry, Tianjin University of Science & Technology/Tianjin Enterprise Key Laboratory for Application Research of Hyaluronic Acid, Tianjin, China
| | - Peng Yu
- College of Biotechnology, China International Science and Technology, Cooperation Base of Food Nutrition/Safety and Medicinal Chemistry, Tianjin International Cooperation Research Centre of Food Nutrition/Safety and Medicinal Chemistry, Tianjin University of Science & Technology/Tianjin Enterprise Key Laboratory for Application Research of Hyaluronic Acid, Tianjin, China
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