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Tesio V, Benfante A, Franco P, Romeo A, Arcadipane F, Carlo Iorio G, Bartoncini S, Castelli L. The time course of health-related Quality of Life in rectal cancer patients undergoing combined modality treatment. Clin Transl Radiat Oncol 2024; 48:100824. [PMID: 39161735 PMCID: PMC11332791 DOI: 10.1016/j.ctro.2024.100824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/28/2024] [Accepted: 07/24/2024] [Indexed: 08/21/2024] Open
Abstract
Background and purpose This exploratory prospective observational study investigated the changes in Health-related Quality of Life (HRQoL) in rectal cancer patients (RCPs), from diagnosis to one-year-post-surgery follow-up and explored the role of physical symptoms and psychological determinants on HRQoL at the different time points. Materials and methods We assessed HRQoL, psychological distress, coping, affectivity, alexithymia and social support in 43 RCPs treated with preoperative (chemo)radiation and surgery, at three different assessment time points: diagnosis (T0), one month after the end of preoperative treatment (T1), one month after resection surgery (T2), and at follow-up (T3). Results The data showed that HRQoL decreased during active treatments, especially between T1 and T2 (p = 0.005), before increasing again at follow-up (p = 0.002).Baseline intestinal symptoms (p < 0.001) and negative affectivity trait (p = 0.03) significantly predicted HRQoL at T0. Baseline pain (p < 0.001), intestinal (p = 0.003) and urinary (p = 0.009) symptoms at T1 significantly predicted HRQoL at T1. A fatalistic coping style at T1 (p = 0.013), psychological distress (p = 0.003), mouth symptoms (p = 0.001) at T2 significantly predicted HRQoL at T2. Similarly, a fatalistic coping style at T1 (p = 0.006), psychological distress (p = 0.004), mouth (p = 0.002) and pain symptoms (p = 0.002) at T3 significantly predicted HRQoL at T3. Conclusion Several physical and psychological factors are involved in the changes occurring after diagnosis in RCPs' HRQoL. While cancer-related symptoms and treatment-related physical side effects are the main predictors of HRQoL at diagnosis and during active treatments, early psychological reactions have a higher predictive weight in post-treatment HRQoL.These data emphasise the importance of active screening, early diagnosis, and preventive psychological interventions immediately after diagnosis to improve HRQoL and psychological health outcomes.
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Affiliation(s)
- Valentina Tesio
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Agata Benfante
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | - Pierfrancesco Franco
- Department of Translational Medicine (DIMET), University of Eastern Piedmont, Via Solaroli 17, 28100, Novara, Italy
- Department of Radiation Oncology, "Maggiore della Carità" University Hospital, Corso Mazzini 18, 28100 Novara, Italy
| | - Annunziata Romeo
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
| | | | - Giuseppe Carlo Iorio
- Department of Oncology - Radiation Oncology, University of Turin, Via Genova 3, 10126 Turin, Italy
| | - Sara Bartoncini
- Department of Oncology - Radiation Oncology, University of Turin, Via Genova 3, 10126 Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Via Verdi 10, 10124, Turin, Italy
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Keane M, Weitkamp N, Madani I, Day J, Dal Bello R, Zamburlini M, Schiess A, Moreira A, Perryck S, Tomuschat K, Spencer M, Tanadini-Lang S, Guckenberger M, Brown M. Randomized self-controlled study comparing open-face vs. closed immobilization masks in fractionated cranial radiotherapy. Radiother Oncol 2024; 196:110314. [PMID: 38677329 DOI: 10.1016/j.radonc.2024.110314] [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: 11/05/2023] [Revised: 04/01/2024] [Accepted: 04/21/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE To compare patient discomfort and immobilisation performance of open-face and closed immobilization masks in cranial radiotherapy. MATERIAL AND METHODS This was a single-center randomized self-controlled clinical trial. At CT simulation, an open-face and closed mask was made for each patient and treatment plans with identical dose prescription were generated for each mask. Patients were randomised to start treatment with an open-face or closed mask. Masks were switched halfway through the treatment course; every patient was their own control. Patients self-reported discomfort, anxiety and pain using the visual analogue scale (VAS). Inter- and intrafraction set-up variability was measured with planar kV imaging and a surface guided radiotherapy (SGRT) system for the open-face masks. RESULTS 30 patients with primary or metastatic brain tumors were randomized - 29 completed radiotherapy to a median total dose of 54 Gy (range 30-60 Gy). Mean discomfort VAS score was significantly lower with open-face masks (0.5, standard deviation 1.0) vs. closed masks (3.3, standard deviation 2.9), P < 0.0001. Anxiety and pain VAS scores were significantly lower with open-face masks (P < 0.0001). Closed masks caused more discomfort in infraorbital (P < 0.001) and maxillary (P = 0.02) areas. Two patients and 27 patients preferred closed or open-face masks, respectively. Interfraction longitudinal shifts and roll and yaw rotations were significantly smaller and lateral shifts were significantly larger with closed masks in combination with the laser system (P < 0.05) compared to open masks in combination with a SGRT system. Intrafraction variability did not differ between the masks. CONCLUSIONS Open-face masks are associated with decreased patient discomfort without compromising patient positioning and immobilisation accuracy.
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Affiliation(s)
- Michèle Keane
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Nienke Weitkamp
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Indira Madani
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Jonathan Day
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Riccardo Dal Bello
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Mariangela Zamburlini
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Antonia Schiess
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Amanda Moreira
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Sophie Perryck
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Katja Tomuschat
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Marilyn Spencer
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Stephanie Tanadini-Lang
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Matthias Guckenberger
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
| | - Michelle Brown
- Department of Radiation Oncology, University Hospital Zürich and University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
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Jeong S, Pyo H, Park W, Han Y. The Prediction of Stress in Radiation Therapy: Integrating Artificial Intelligence with Biological Signals. Cancers (Basel) 2024; 16:1964. [PMID: 38893087 PMCID: PMC11171009 DOI: 10.3390/cancers16111964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
This study aimed to predict stress in patients using artificial intelligence (AI) from biological signals and verify the effect of stress on respiratory irregularity. We measured 123 cases in 41 patients and calculated stress scores with seven stress-related features derived from heart-rate variability. The distribution and trends of stress scores across the treatment period were analyzed. Before-treatment information was used to predict the stress features during treatment. AI models included both non-pretrained (decision tree, random forest, support vector machine, long short-term memory (LSTM), and transformer) and pretrained (ChatGPT) models. Performance was evaluated using 10-fold cross-validation, exact match ratio, accuracy, recall, precision, and F1 score. Respiratory irregularities were calculated in phase and amplitude and analyzed for correlation with stress score. Over 90% of the patients experienced stress during radiation therapy. LSTM and prompt engineering GPT4.0 had the highest accuracy (feature classification, LSTM: 0.703, GPT4.0: 0.659; stress classification, LSTM: 0.846, GPT4.0: 0.769). A 10% increase in stress score was associated with a 0.286 higher phase irregularity (p < 0.025). Our research pioneers the use of AI and biological signals for stress prediction in patients undergoing radiation therapy, potentially identifying those needing psychological support and suggesting methods to improve radiotherapy effectiveness through stress management.
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Affiliation(s)
- Sangwoon Jeong
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06355, Republic of Korea;
| | - Hongryull Pyo
- Department of Radiation Oncology, Samsung Medical Center, Seoul 06355, Republic of Korea; (H.P.); (W.P.)
- School of Medicine, Sungkyunkwan University, Seoul 06355, Republic of Korea
| | - Won Park
- Department of Radiation Oncology, Samsung Medical Center, Seoul 06355, Republic of Korea; (H.P.); (W.P.)
- School of Medicine, Sungkyunkwan University, Seoul 06355, Republic of Korea
| | - Youngyih Han
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06355, Republic of Korea;
- Department of Radiation Oncology, Samsung Medical Center, Seoul 06355, Republic of Korea; (H.P.); (W.P.)
- School of Medicine, Sungkyunkwan University, Seoul 06355, Republic of Korea
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Hassan MA, Mahmoud AEL, Kalash S, Kadi T, Bakhos N, Zeidane RA, Amhaz G, Bizri M, Assi HI. Prevalence of depression and anxiety among newly diagnosed cancer patients: a single centre experience in the Middle East. Ecancermedicalscience 2024; 18:1690. [PMID: 38774564 PMCID: PMC11108043 DOI: 10.3332/ecancer.2024.1690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Indexed: 05/24/2024] Open
Abstract
Failure to identify and treat depression and anxiety affecting 10% of patients with cancer, increases the disease burden. This study aimed to assess the psychological well-being of newly diagnosed patients in a tertiary healthcare centre in Lebanon. In this cross-sectional study, data were collected for 187 adult patients, from medical records and interviews using standardised questionnaires (Personal health questionnaire-9 (PHQ-9) and generalised anxiety disorder-7). Karnofsky performance status was also assessed, and incidence was calculated using descriptive statistics, chi-square, and T-tests. The rates of moderate or severe anxiety, minimal anxiety, mild depression, moderate or severe depression, and suicidality are 14.9%, 35.6%, 40.7% 22.7% and 6.2%, respectively. Participants with a past history of seeking help from mental health services (OR: 3.978, CI: (1.680-9.415), p = 0.002), those developing cancer-related complications (OR: 3.039, CI: (1.187-7.777), p = 0.020), and those who had an Eastern Cooperative Oncology Group of ≥2 (OR: 5.306, CI: (1.582-17.797), p = 0.007) were independently associated with depression (diagnosed with PHQ-9) in multivariate logistic regression analysis. Patients with cancer exhibit higher evidence of depression and anxiety and should have a thorough psychiatric history and additional psychiatric care.
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Affiliation(s)
- Mona Ali Hassan
- Department of Internal Medicine, Division of Hematology-Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ahmad EL Mahmoud
- Department of Internal Medicine, Division of Hematology-Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Suha Kalash
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Tamara Kadi
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nour Bakhos
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Reine Abou Zeidane
- Department of Internal Medicine, Division of Hematology-Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghid Amhaz
- Department of Internal Medicine, Division of Hematology-Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Bizri
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hazem I Assi
- Department of Internal Medicine, Division of Hematology-Oncology, Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
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Feighan L, MacDonald‐Wicks L, Callister R, Surjan Y. Practitioner perceptions on the use of exercise and nutritional interventions for patients with breast cancer receiving radiation therapy. J Med Radiat Sci 2023; 70:444-453. [PMID: 37559550 PMCID: PMC10715360 DOI: 10.1002/jmrs.713] [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: 09/06/2022] [Accepted: 07/26/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Radiation therapy treatment for breast cancer may negatively impact patients' health-related quality of life. Evidence suggests exercise and nutrition interventions may be beneficial to patients experiencing compromised health-related quality of life. This study investigates whether radiation oncology practitioners support the implementation of a tailored exercise and nutrition intervention for patients and explores their interest in participating in training for exercise and nutrition as interventions. METHODS Data were collected by an online survey, deployed to public and private radiation oncology departments, across three Australian states (Australian Capital Territory, New South Wales, Queensland). The survey was completed between June and August 2020. Radiation oncologists, radiation oncology registrars, radiation therapists and radiation oncology nurses completed the survey. The survey included demographics, patient assessment and questions regarding the radiation oncology practitioners' use of exercise and nutrition as interventions. RESULTS Of 192 practitioners targeted, 76 completed the survey, for a response rate of 40%. Of 76 respondents, 42% 'sometimes' recommended exercise and 41% 'sometimes' recommended nutrition as health-related quality of life interventions to their patients. The majority indicated they would benefit from more training in these subjects, with 58% for exercise and 55% for nutrition. 47 per cent of respondents thought patients would benefit from a tailored exercise and nutrition programme and 62% agreed they would refer patients to a programme if it were available. CONCLUSIONS Radiation oncology practitioners reported they need training in exercise and nutrition to better understand how this can benefit the health-related quality of life of breast cancer patients. Also, the findings indicate that if such an exercise and nutrition intervention were readily available, practitioners would refer patients who may benefit from this intervention.
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Affiliation(s)
- Laura Feighan
- Global Centre for Research and Training in Radiation Oncology, School of Health Sciences, College of Health, Medicine, and WellbeingThe University of NewcastleCallaghanNew South WalesAustralia
| | - Lesley MacDonald‐Wicks
- School of Health Sciences, College of Health, Medicine, and WellbeingThe University of NewcastleCallaghanNew South WalesAustralia
| | - Robin Callister
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine, and WellbeingThe University of NewcastleCallaghanNew South WalesAustralia
| | - Yolanda Surjan
- Global Centre for Research and Training in Radiation Oncology, School of Health Sciences, College of Health, Medicine, and WellbeingThe University of NewcastleCallaghanNew South WalesAustralia
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Forbes E, Baker AL, Britton B, Clover K, Skelton E, Moore L, Handley T, Oultram S, Oldmeadow C, Gibberd A, McCarter K. A systematic review of nonpharmacological interventions to reduce procedural anxiety among patients undergoing radiation therapy for cancer. Cancer Med 2023; 12:20396-20422. [PMID: 37803922 PMCID: PMC10652309 DOI: 10.1002/cam4.6573] [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: 02/09/2023] [Revised: 08/30/2023] [Accepted: 09/12/2023] [Indexed: 10/08/2023] Open
Abstract
Procedural anxiety is a concern for a number of patients undergoing radiation therapy. While procedural anxiety is often treated pharmacologically, there is a clinical need for effective alternative strategies for patients who are contraindicated from medication use, and those who prefer not to take unnecessary medications. OBJECTIVES The primary objective was to assess the efficacy of nonpharmacological interventions delivered to adults with cancer, in the radiation oncology department, just prior to, or during radiation therapy, in reducing levels of self-reported procedural anxiety. The secondary objectives were to assess the efficacy of these interventions in reducing physiological symptoms of procedural anxiety and anxiety-related treatment disruptions. DESIGN Systematic review. DATA SOURCES Electronic databases (MEDLINE, CINAHL, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials) were searched from inception up until February 2022. INCLUSION CRITERIA Population: Adult patients with cancer undergoing external beam radiation therapy. INTERVENTION Nonpharmacological interventions delivered within the radiation therapy department. Comparison: standard care controls, or standard care plus an alternative intervention. OUTCOMES level of self-reported procedural anxiety (primary), physiological symptoms of anxiety (secondary) and measures of anxiety-related treatment disruptions (secondary). DATA EXTRACTION AND ANALYSIS Two reviewers independently extracted data. A meta-analysis was originally planned but deemed not feasible as the studies could not be confidently pooled for meta-analysis, due to the variability in the interventions, study designs and the generally low number of studies. Therefore, a narrative synthesis is presented. RESULTS Screening of 2363 records identified nine studies that met inclusion criteria: six studies of music interventions, two of video-based patient education and one of aromatherapy. Overall, three studies received a global rating of strong methodological quality and low risk of bias. Three studies reported a significant effect of the intervention on reducing the primary outcome of self-reported procedural anxiety: two music interventions (both strong methodological quality), and one video-based patient education (moderate methodological quality). One of the studies (a music intervention) also reported a significant reduction in the secondary outcome of physiological symptoms of procedural anxiety (systolic blood pressure). CONCLUSIONS The evidence for nonpharmacological interventions delivered to adults with cancer just prior to, or during radiation therapy, in reducing levels of self-reported procedural anxiety is limited, with very few well-designed studies. There is a need for interventions for procedural anxiety during radiation therapy to be evaluated through rigorous randomised controlled trials.
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Affiliation(s)
- Erin Forbes
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
| | - Amanda L. Baker
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
| | - Ben Britton
- Hunter New England Mental Health ServicesNewcastleAustralia
| | - Kerrie Clover
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
- Psycho‐Oncology Service, Department of Consultation Liaison PsychiatryCalvary Mater NewcastleWaratahAustralia
| | - Eliza Skelton
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
| | - Lyndell Moore
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders UniversityBedford ParkAustralia
| | - Tonelle Handley
- School of Medicine and Public Health, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanAustralia
| | - Sharon Oultram
- Department of Radiation OncologyCalvary Mater NewcastleWaratahAustralia
| | | | - Alison Gibberd
- Data Sciences, Hunter Medical Research InstituteNew LambtonAustralia
| | - Kristen McCarter
- School of Psychological Sciences, College of Engineering, Science and EnvironmentUniversity of NewcastleCallaghanAustralia
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Forbes E, Clover K, Baker AL, Britton B, Carlson M, McCarter K. 'Having the mask on didn't worry me until … they clamped my head down so I wouldn't move': A qualitative study exploring anxiety in patients with head and neck cancer during radiation therapy. J Med Radiat Sci 2023; 70:283-291. [PMID: 36724485 PMCID: PMC10500108 DOI: 10.1002/jmrs.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/11/2023] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION More than 20% of patients undergoing radiation therapy for head and neck cancer report anxiety specifically related to the immobilisation mask, a tight-fighting mask patients are required to wear for the duration of each treatment session. However, limited research has investigated this from the patient perspective. The aim of this study was to better understand patient experiences of mask anxiety during head and neck cancer radiation therapy and to explore patient attitudes toward potential strategies that may reduce mask anxiety during this treatment. METHODS Five patients with head and neck cancer, who had self-reported mask anxiety during radiation therapy, participated in semi-structured, qualitative interviews exploring their experiences of anxiety and suggestions for reducing anxiety. A codebook thematic analysis was conducted. RESULTS Six main themes were identified: (1) triggers of anxiety; (2) adjusting to radiation therapy; (3) education about the mask; (4) coping; (5) motivation and (6) improving the patient experience. CONCLUSION Findings from these interviews provide valuable insight into how and when healthcare providers may be able to assist patients to manage mask anxiety. Recommendations include increased communication from health care providers; delivery of visual information to improve patient preparedness; exposure/opportunities to interact with the masks prior to treatment commencing and increased control of music/soundtrack selection. However, a limitation of this study is the small sample size and further research is warranted.
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Affiliation(s)
- Erin Forbes
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Kerrie Clover
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- PsychoOncology Service, Department of Consultation Liaison PsychiatryCalvary Mater NewcastleCallaghanNew South WalesAustralia
| | - Amanda L. Baker
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Ben Britton
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Hunter New England Mental Health ServicesNewcastleNew South WalesAustralia
| | - Melissa Carlson
- School of Medicine and Public Health, College of Health Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Kristen McCarter
- School of Psychological Sciences, College of Science, Engineering and EnvironmentUniversity of NewcastleCallaghanNew South WalesAustralia
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Caliandro M, Carbonara R, Surgo A, Ciliberti MP, Di Guglielmo FC, Bonaparte I, Paulicelli E, Gregucci F, Turchiano A, Fiorentino A. The Role of Telemedicine for Psychological Support for Oncological Patients Who Have Received Radiotherapy. Curr Oncol 2023; 30:5158-5167. [PMID: 37232848 DOI: 10.3390/curroncol30050390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
AIM In our radiation departments, all patients received psycho-oncological support during RT and during follow-up. Based on the latter, the aim of this retrospective analysis was to evaluate the role of tele-visits and in-person psychological support for cancer patients after RT, and to report a descriptive analysis pointing out the needs of psychosocial intervention in a radiation department during radiation treatment. METHODS According to our institutional care management, all patients receiving RT were prospectively enrolled to receive charge-free assessment of their cognitive, emotional and physical states and psycho-oncological support during treatment. For the whole population who accepted the psychological support during RT, a descriptive analysis was reported. For all patients who agreed to be followed up by a psycho-oncologist, at the end of RT, a retrospective analysis was conducted to evaluate the differences between tele-consultations (video-call or telephone) and on-site psychological visits. Patients were followed up by on-site psychological visit (Group-OS) or tele-consult (Group-TC) visit. For each group, to evaluate anxiety, depression and distress, the Hospital Anxiety Depression Scale (HADS), Distress Thermometer and Brief COPE (BC) were used. RESULTS From July 2019 to June 2022, 1145 cases were evaluated during RT with structured psycho-oncological interviews for a median of 3 sessions (range 2-5). During their first psycho-oncological interview, all the 1145 patients experienced the assessment of anxiety, depression and distress levels with the following results: concerning the HADS-A scale, 50% of cases (574 patients) reported a pathological score ≥8; concerning the HADS-D scale, 30% of cases (340 patients) reported a pathological score ≥8, concerning the DT scale, 60% (687 patients) reported a pathological score ≥4. Eighty-two patients were evaluated after RT: 30 in the Group-OS and 52 in the Group-TC. During follow-up, a median of 8 meetings (range 4-28) were performed. Comparing psychological data at baseline (beginning of RT) and at the last follow-up, in the entire population, a significant improvement in terms of HADS-A, global HADS and BC was shown (p 0.04; p 0.05; and p 0.0008, respectively). Compared to baseline, statistically significant differences were observed between the two groups in terms of anxiety in favor of on-site visit: Group-OS reported a better anxiety score compared with Group-TC. In each group, a statistical improvement was observed in BC (p 0.01). CONCLUSION The study revealed optimal compliance to tele-visit psychological support, even if the anxiety could be better controlled when patients were followed up on-site. However, rigorous research on this topic is needed.
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Affiliation(s)
- Morena Caliandro
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Roberta Carbonara
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Alessia Surgo
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Maria Paola Ciliberti
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Fiorella Cristina Di Guglielmo
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Ilaria Bonaparte
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Eleonora Paulicelli
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Fabiana Gregucci
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Angela Turchiano
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Alba Fiorentino
- Radiation Oncology Department, General Regional Hospital F. Miulli, Strada Provinciale 127, Acquaviva delle Fonti, 70021 Bari, Italy
- Department of Medicine and Surgery, LUM University, Casamassima, 70010 Bari, Italy
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Esen CSB, Yazici G, Hurmuz P, Ozyigit G, Zorlu F. The Effect of Video-Based Education on Anxiety of Patients Receiving Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:426-430. [PMID: 35022988 DOI: 10.1007/s13187-022-02135-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 05/20/2023]
Abstract
Patients receiving stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) may have an anxiety due to unknown aspects of the treatment. We aimed to reduce patient anxiety by using video-based education. Forty patients were divided into 2 groups, with one-to-one information session (n = 20) and one-to-one information session plus video-based education (n = 20). The patients completed the State-Trait Anxiety Inventory (STAI) and visual facial anxiety scale before and after information sessions and after treatment. The setup time and disruptions during treatment sessions were recorded for patients receiving treatment with Novalis® and Cyberknife®, respectively. The patient characteristics and STAI scores before education were similar between groups. The anxiety level was significantly lower in group 1 after treatment (median 38, interquartile range (IQR) 27-45) compared to before (median 43, IQR 36-47) (p = 0.003) and after information sessions (median 42, IQR 36-47) (p = 0.004); however, any difference was not observed in anxiety levels between before and after information sessions (p = 0.317). The anxiety level was significantly lower in group 2 after video-based education (median 25, IQR 22-33) and after treatment (median 25, IQR 20-30) compared to before video-based education (median 35, IQR 31-42) (p < 0.001 for both), while there was no significant difference in anxiety levels between after video-based education and after the treatment (p = 0.407). The interruptions during treatment were observed in 9 (60%) patients in group 1 and 6 (40%) patients in group 2 (p = 0.038). Video-based educations significantly reduce patient anxiety before SRS/SBRT and increase their compliance with the treatment.
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Affiliation(s)
- Caglayan Selenge Beduk Esen
- Hacettepe University, Faculty of Medicine, Department of Radiation Oncology, Altındağ, Ankara, 06100, Turkey.
| | - Gozde Yazici
- Hacettepe University, Faculty of Medicine, Department of Radiation Oncology, Altındağ, Ankara, 06100, Turkey
| | - Pervin Hurmuz
- Hacettepe University, Faculty of Medicine, Department of Radiation Oncology, Altındağ, Ankara, 06100, Turkey
| | - Gokhan Ozyigit
- Hacettepe University, Faculty of Medicine, Department of Radiation Oncology, Altındağ, Ankara, 06100, Turkey
| | - Faruk Zorlu
- Hacettepe University, Faculty of Medicine, Department of Radiation Oncology, Altındağ, Ankara, 06100, Turkey
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Physical and nonphysical effects of weekly music therapy intervention on the condition of radiooncology patients. Strahlenther Onkol 2023; 199:268-277. [PMID: 36564569 DOI: 10.1007/s00066-022-02033-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/20/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE In oncology settings, music, especially music therapy (MT), is frequently used to improve patients' quality of life, pain situation, anxiety, depression, fatigue, and comfort. However, to date, there are no prospectively collected data correlating regular standardized MT sessions during radiotherapy (RT) to physical parameters such as heart rate, blood pressure, respiratory rate, and oxygen saturation and corresponding quality of life measures using quantitative descriptive scales in oncological patients. Thus, the aim of this study was to investigate the effect of MT on the condition of radiooncology patients using these parameters. MATERIALS AND METHODS During this study, patients participated weekly MT sessions guided by a board-certified music therapist. Data such as pain, physical comfort, and respiratory comfort based on the visual analogue scale (VAS) were collected before and after MT sessions. Furthermore, vital signs including heart rate, blood pressure, respiratory rate, and oxygen saturation as well as RT side effects were recorded. RESULTS A total of 57 patients (age 61 ± 11 years) were enrolled in the study. Median VAS score was significantly different before and after MT for pain: VAS 1 (interquartile range [IQR]: 0-3) vs. VAS 0 (IQR: 0-2; p < 0.001); physical comfort: VAS 7 (IQR: 6-7) vs. VAS 8 (IQR: 7-9; p < 0.001); and respiratory comfort only in the patients with pre-existing symptoms (VAS < 10 before therapy): VAS 8 (IQR: 6-8) vs. VAS 9 (IQR: 8-10; p = 0.002). Furthermore, vital signs were significantly reduced from pre-session to post-session (p > 0.001): heart rate 81 ± 14 min-1 to 76 ± 13 min-1 and respiratory rate from 12 ± 5 min-1 to 10 ± 4 min-1. RT-related side effects did not interfere with participation in MT sessions. CONCLUSION In our study cohort of radiooncology patients, weekly MT sessions improved defined physical parameters as well as pain, physical comfort, and respiratory comfort. Establishing MT in the routine clinical setting should be more readily considered to further improve patient outcomes.
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Amaadour L, Lahrch I, Siyouri O, Oualla K, Benbrahim Z, Arifi S, Aarab C, El Fakir S, Mellas N. SARS-CoV2 et cancer : quel impact psychologique ? PSYCHO-ONCOLOGIE 2023. [DOI: 10.3166/pson-2022-0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Introduction : La Covid-19 constitue une cause de plusieurs affections mentales, notamment chez les patients atteints de cancer qui sont déjà considérés comme une population vulnérable. Ainsi, l’objectif de la présente étude était d’évaluer les troubles psychologiques des patients suivis pour une maladie tumorale maligne, sous traitement médical systémique, ayant eu une infection au SARS-CoV2 ; ainsi que les conséquences que ces troubles psychologiques peuvent avoir sur l’adhésion aux soins oncologiques.
Méthode : Il s’agit d’une étude transversale sur une période de quatre mois (pic de la pandémie) menée au département d’oncologie médicale du centre hospitalier universitaire Hassan-II de Fès, Maroc. Les symptômes anxieux/dépressifs et le stress post-traumatique ont été évalués avec les échelles HADS, PCL-5. L’échelle mini-MAC était utilisée afin d’évaluer l’ajustement psychologique des patients atteints de cancer dans le contexte d’infection à la Covid-19.
Résultats : Au total, 53 patients ont été rencontrés : 45,2 % des patients présentaient des symptômes significatifs de stress post-traumatique et 20,7 % une symptomatologie dépressive. Une symptomatologie anxieuse importante était objectivée chez 69,8 % des patients. L’âge inférieur à 65 ans, le sexe féminin et la stratégie thérapeutique envisagée (curative versus palliative) étaient des facteurs prédictifs de survenue de troubles anxieux. Tous les patients sont revenus pour reprendre leurs soins oncologiques après l’épisode infectieux.
Conclusion : Les troubles anxieux et le stress posttraumatique sont très fréquents chez les patients atteints de cancer et positifs à la Covid-19 par rapport à la population générale. Nos résultats suggèrent la nécessité de mettre en place des soins de support psycho-oncologiques personnalisés durant le contexte pandémique.
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Hak A, Ali MS, Sankaranarayanan SA, Shinde VR, Rengan AK. Chlorin e6: A Promising Photosensitizer in Photo-Based Cancer Nanomedicine. ACS APPLIED BIO MATERIALS 2023; 6:349-364. [PMID: 36700563 DOI: 10.1021/acsabm.2c00891] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Conventional cancer treatment modalities are often associated with major therapeutic limitations and severe side effects. Photodynamic therapy is a localized noninvasive mode of treatment that has given a different direction to cancer research due to its effectivity against a wide range of cancers and minimal side effects. A photosensitizer is the key component of photodynamic therapy (PDT) that generates cytotoxic reactive oxygen species to eradicate cancer cells. As the therapeutic effectivity of PDT greatly depends upon the photosensitizer, great efforts have been made to search for an ideal photosensitizer. Chlorin e6 is a FDA approved second generation photosensitizer that meets the desired clinical properties for PDT. It is known for its high reactive oxygen species (ROS) generation ability and anticancer potency against many types of cancer. Hydrophobicity is a major drawback of Ce6 that leads to its poor biodistribution and rapid clearance from the circulatory system. To overcome this drawback, researchers have designed and fabricated several types of nanosystems, which can enhance Ce6 solubility and thereby enhance its bioavailability. These nanosystems also improve tumor accumulation of Ce6 by selectively targeting the cancer cells through passive and active targeting. In addition, Ce6 has been employed in many combination therapies like chemo-photodynamic therapy, photoimmunotherapy, and combined photodynamic-photothermal therapy. A combination therapy is more curative than a single therapy due to the synergistic effects of individual therapies. Ce6-based nanosystems for combination therapies have shown excellent results in various studies and provide a promising platform for cancer treatment.
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Affiliation(s)
- Arshadul Hak
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad, Kandi, Telangana 502285, India
| | - Mohammad Sadik Ali
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad, Kandi, Telangana 502285, India
| | | | - Vinod Ravasaheb Shinde
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad, Kandi, Telangana 502285, India
| | - Aravind Kumar Rengan
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad, Kandi, Telangana 502285, India
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Forbes E, Clover K, Baker AL, McCarter KL, Oultram S, Kumar M, Wratten C, Tieu MT, Nixon J, Britton B. Biofeedback Enabled CALM (BeCALM)-the feasibility of biofeedback on procedural anxiety during radiation therapy: study protocol for a pilot randomised controlled trial. BMJ Open 2022; 12:e062467. [PMID: 36600369 PMCID: PMC9730381 DOI: 10.1136/bmjopen-2022-062467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Patients undergoing treatment for cancer who require radiation therapy (RT) report anxiety specifically relating to the RT procedure. Procedural anxiety can be detrimental to treatment delivery, causing disruptions to treatment sessions, or treatment avoidance. Acute procedural anxiety is most commonly managed with anxiolytic medication. There is a need for effective, non-pharmacological interventions for patients not suitable for, or who prefer to avoid, anxiolytic medication. The primary objectives of this pilot trial are to evaluate the: (1) feasibility of conducting the Biofeedback Enabled CALM (BeCALM) intervention during RT treatment sessions; (2) acceptability of the BeCALM intervention among patients; and (3) acceptability of the BeCALM intervention among radiation therapists. The secondary objective of this pilot trial is to examine the potential effectiveness of the BeCALM intervention delivered by radiation therapists to reduce procedural anxiety during RT. METHODS AND ANALYSIS This is a pilot randomised controlled trial. A researcher will recruit adult patients with cancer (3-month recruitment period) scheduled to undergo RT and meeting eligibility criteria for procedural anxiety at the Calvary Mater Hospital, Newcastle (NSW), Australia. Participants will be randomly assigned to receive treatment as usual or the BeCALM intervention (biofeedback plus brief breathing techniques). The primary outcomes are feasibility (measured by recruitment, retention rates and percentage of treatment sessions in which the intervention was successfully delivered); radiation therapists perceived feasibility and acceptability (survey responses); and patient perceived acceptability (survey responses). Secondary outcome is potential effectiveness of the intervention (as measured by the State Trait Anxiety Inventory-State subscale; the Distress Thermometer; and an analysis of treatment duration). ETHICS AND DISSEMINATION The study protocol has received approval from Hunter New England Health Human Research Ethics Committee (2021/ETH11356). The results will be disseminated via peer-reviewed publications, as well as presentation at relevant conferences. TRIAL REGISTRATION NUMBER ACTRN12621001742864.
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Affiliation(s)
- Erin Forbes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Kerrie Clover
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- PsychoOncology Service, Department of Consultation Liaison Psychiatry, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Kristen Louise McCarter
- School of Psychological Sciences, College of Science, Engineering and Environment, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Sharon Oultram
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Mahesh Kumar
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Chris Wratten
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Minh Thi Tieu
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Jodie Nixon
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Ben Britton
- Mental Health Services, Hunter New England Health, New Lambton, New South Wales, Australia
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Szcześniak M, Madej D, Bielecka G. Relationship between World Assumptions and Post-Traumatic Growth among Polish Cancer Patients: Moderating Effect of Rumination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12444. [PMID: 36231744 PMCID: PMC9564848 DOI: 10.3390/ijerph191912444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Although post-traumatic growth is believed to be the result of complex interplays between various factors, cognitive variables appear to play a special role in these interactions. Yet, research on this topic is scant. Therefore, the first purpose of this study was to verify whether there is a direct relationship between world assumptions and post-traumatic growth among Polish cancer patients. As the effect of psychological change in post-traumatic growth may be affected by basic beliefs about the world and oneself, the second goal was to assess whether this association is moderated by rumination. METHODS The study included 215 Polish cancer patients. The Post-traumatic Growth and Depreciation Inventory-Expanded version-(intrusive and deliberate rumination), the World Assumption Scale, and the Event-related Rumination Inventory were applied. RESULTS Positive, albeit weak, correlations were found between the dimensions of world assumptions and post-traumatic growth. Post-traumatic growth correlated negatively with intrusive rumination and positively with deliberate rumination. The outcomes show that the level of post-traumatic growth resulting from world assumptions is significantly different at various levels of intrusive and deliberate rumination. CONCLUSION Lower/medium intrusive rumination seems to strengthen the relationship between benevolence of the world/worthiness of the self and post-traumatic growth, and higher deliberate rumination tends to reinforce the relationship between meaningfulness and post-traumatic growth.
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15
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Liu X, Yan G, Xu B, Yu H, An Y, Sun M. Evaluating the role of IDO1 macrophages in immunotherapy using scRNA-seq and bulk-seq in colorectal cancer. Front Immunol 2022; 13:1006501. [PMID: 36248886 PMCID: PMC9556727 DOI: 10.3389/fimmu.2022.1006501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/15/2022] [Indexed: 12/24/2022] Open
Abstract
Background Macrophage infiltration is crucial for colorectal cancer (CRC) immunotherapy. Detailed classification of macrophage subsets will facilitate the selection of patients suitable for immunotherapy. However, the classification of macrophages in CRC is not currently detailed. Methods In this study, we combined single-cell RNA sequencing (scRNA-seq) and bulk-seq to analyze patients with colorectal cancer. scRNA-seq data were used to study cell-cell communication and to differentiate immune-infiltrating cells and macrophage subsets. Bulk-seq data were used to further analyze immune infiltration, clinical features, tumor mutational burden, and expression of immune checkpoint molecules in patients with CRC having different macrophage subsets. Results Seven macrophage subpopulations were identified, among which indoleamine 2,3 dioxygenase 1 (IDO1) macrophages had the most significant difference in the degree of infiltration among normal, microsatellite-unstable, and microsatellite-stable populations. We then performed gene set variation analysis using 12 marker genes of IDO1 macrophages and divided the patients into two clusters: high-IDO1 macrophages (H-IDO1M) and low-IDO1 macrophages (L-IDO1M). H-IDO1M showed higher infiltration of immune cells, higher expression of immune checkpoints, and less advanced pathological stages than L-IDO1M (p < 0.05). Conclusions This study elucidated that IDO1-macrophage-based molecular subtypes can predict the response to immunotherapy in patients with CRC. The results provide new insights into tumor immunity and help in clinical decisions regarding designing effective immunotherapy for these patients.
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Affiliation(s)
- Xingwu Liu
- Department of Gastroenterology, The First Hospital of China Medical University, Shenyang, China
| | - Guanyu Yan
- Department of Gastroenterology, The First Hospital of China Medical University, Shenyang, China
| | - Boyang Xu
- Department of Gastroenterology, The First Hospital of China Medical University, Shenyang, China
| | - Han Yu
- School of Health Management, China Medical University, Shenyang, China
| | - Yue An
- Department of Endoscopy, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Mingjun Sun, ; Yue An,
| | - Mingjun Sun
- Department of Gastroenterology, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Mingjun Sun, ; Yue An,
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Ahmadsei M, Christ SM, Seiler A, Vlaskou Badra E, Willmann J, Hertler C, Guckenberger M. Quality-of-life and toxicity in cancer patients treated with multiple courses of radiation therapy. Clin Transl Radiat Oncol 2022; 34:23-29. [PMID: 35313618 PMCID: PMC8933336 DOI: 10.1016/j.ctro.2022.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022] Open
Abstract
Multiple repeat radiotherapy courses are used more frequently. Prediction of tolerability, quality of life and toxicity remains a challenge. Patients treated with a minimum of five radiotherapies show a stable quality of life. Yet, fatigue and low levels of hemoglobin and lymphocytes are long-term side effects.
Background Treatment of metastatic cancer patients with multiple repeat courses of radiotherapy has become more frequent due to their improved overall survival. However, very little is known about their long-term outcome. This analysis reports on the quality-of-life, hematologic toxicity, patient-reported experiences and satisfaction, and psychological distress of cancer patients treated with multiple repeat radiotherapy. Methods All patients treated with ≥5 courses of radiotherapy between 2011 and 2019 at the Department of Radiation Oncology, University Hospital Zurich (USZ) were screened for this study. A course of radiotherapy was defined as all treatment sessions to one anatomical site under one medical indication. All patients completed two questionnaires: EORTC QLQ-C30 questionnaire for quality-of-life and a questionnaire evaluating psychological distress and patient-reported experiences. Hematologic toxicities were assessed via a recent blood sample. Results Of n = 33 patients treated with ≥5 radiotherapy courses and being alive, 20 (60.6%) participated in this study. The most common primary tumor was non-small cell lung cancer (n = 14, 42.4%). The most common sites of irradiation were brain (n = 78, 37.1%) and bone metastases (n = 59, 28.1%). All participating patients reported that they had experienced a subjective benefit from multiple repeat radiotherapy and denied increased side effects in later radiotherapy courses. Yet, 45% (n = 9) of the patients reported an increase of psychological distress with increasing numbers of radiotherapy treatments. While global health status was stable, patients having received multiple repeat radiotherapy reported increased fatigue (p = <0.006). Blood analysis showed significantly reduced hemoglobin and lymphocyte levels compared to the healthy population (p = <0.03). Discussion and conclusion Patient-reported experiences and satisfaction of long-term cancer patients treated with multiple repeat radiotherapy are positive. However, increased levels of fatigue and significantly reduced hemoglobin and lymphocyte levels were observed. These data indicate the need to further investigate the effects of multiple courses of radiotherapy in chronic cancer patients.
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Kwon JY, Russell L, Coles T, Klaassen RJ, Schick-Makaroff K, Sibley KM, Mitchell SA, Sawatzky R. Patient-Reported Outcomes Measurement in Radiation Oncology: Interpretation of Individual Scores and Change over Time in Clinical Practice. Curr Oncol 2022; 29:3093-3103. [PMID: 35621641 PMCID: PMC9139498 DOI: 10.3390/curroncol29050251] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 12/03/2022] Open
Abstract
Tools for measuring patients’ perceived health and quality of life, such as patient-reported outcome measures (PROMs), inform clinical decisions for patients requiring radiation therapy. However, there may be inconsistencies in how patients interpret and respond to PROMs due to cultural, environmental, personal, or experiential factors. Differential item functioning (DIF) and response shift (RS) refer to differences in the meaning of PROMs between patients or over time (respectively). DIF and RS can threaten the accurate interpretation and use of PROMs, potentially resulting in erroneous conclusions about effectiveness, and flawed individual-level clinical decision-making. Given the empirical evidence of DIF and RS, we aim to review clinical implications and solutions for addressing DIF and RS by providing vignettes from collaborative examinations with workshop participants, as well as the literature. By making these methodological concepts accessible and relevant, for practice, clinicians may feel more confident to ask clarifying questions of patients when PROM scores and the contextual patient information do not align. PROM scores need to be interpreted via dialogue with the patient to avoid misinterpretation due to DIF and RS, which could diminish patient–clinician communication and impede shared decision-making. This work is part of an interdisciplinary knowledge translation initiative focused on the interpretation of PROM scores by clinically-oriented audiences.
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Affiliation(s)
- Jae-Yung Kwon
- School of Nursing, University of Victoria, Victoria, BC V8P 5C2, Canada
- Institute on Aging and Lifelong Health, Victoria, BC V8N 5C2, Canada
- Correspondence:
| | - Lara Russell
- School of Nursing, Trinity Western University, Langley, BC V2Y 1Y1, Canada; (L.R.); (R.S.)
| | - Theresa Coles
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27701, USA;
| | - Robert J. Klaassen
- Division of Hematology/Oncology, Department of Pediatrics, Children’s Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | | | - Kathryn M. Sibley
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada;
- George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Sandra A. Mitchell
- Outcomes Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD 20850, USA;
| | - Richard Sawatzky
- School of Nursing, Trinity Western University, Langley, BC V2Y 1Y1, Canada; (L.R.); (R.S.)
- Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, BC V6Z 2K5, Canada
- Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
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Kaya C, Chan F, Bezyak J. Factors Impacting Functioning Level of Cancer Survivors in Turkey. REHABILITATION COUNSELING BULLETIN 2022. [DOI: 10.1177/00343552221087166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to investigate the relationships between demographic variables, personal factors, impairment-related variables, and functioning levels of cancer survivors in Turkey. Data for this study were collected from a major oncology institute and a nonprofit cancer organization in Turkey. Hierarchical regression analyses were conducted to investigate the sequential effect of demographic variables (i.e., age, gender, income, and education), personal factors (i.e., core self-evaluations, purpose in life, and religiosity), and impairment-related variables (i.e., pain, fatigue, perceived stress, and sleep disturbance) on the functioning level of Turkish cancer survivors (i.e., physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning). The results indicated that impairment-related variables explained a significant amount of variance in functioning scores above and beyond demographic and personal factors. Pain intensity and perceived stress were most prominent factors impacting functioning levels of Turkish cancer survivors. Pain and stress self-management training, psychotherapy and counseling, physical activity and exercise, and cognitive remediation training are recommended interventions to increase the functioning level and well-being of cancer survivors.
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Affiliation(s)
- Cahit Kaya
- University of Texas-Rio Grande Valley, USA
- Harran University, Sanliurfa, Turkey
| | - Fong Chan
- University of Wisconsin-Madison, USA
| | - Jill Bezyak
- University of Northern Colorado, Greeley, USA
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Burns M, Campbell R, French S, Dhillon HM, Butow PN, Pritchard A, Sundaresan P. Trajectory of anxiety related to radiation therapy mask immobilization and treatment delivery in head and neck cancer and radiation therapists’ ability to detect this anxiety. “Anxiety during radiation therapy with mask”. Adv Radiat Oncol 2022; 7:100967. [PMID: 36148368 PMCID: PMC9486416 DOI: 10.1016/j.adro.2022.100967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/28/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose Receiving radiation therapy treatment with an immobilization mask is a source of anxiety in people with head and neck cancer (HNC). This study aimed to document the trajectory of situational anxiety during HNC treatment delivery and explore radiation therapists’ (RTs’) ability to identify it. Methods and Materials Participants with HNC commencing radiation therapy completed the state-trait anxiety inventory at their mask-making session, and once each week immediately before and after their radiation treatment. Treating RTs independently rated their perception of participant's anxiety at the same time points. Participant- and RT-rated anxiety scores were calculated at each time point together with the proportion of participants reporting clinically significant anxiety (state-trait anxiety inventory ≥ 40). Intraclass correlations were calculated to assess concordance between participant- and RT-ratings. Results Sixty-five participants and 16 RTs took part in this study. Participants were classified into 1 of 5 trajectory groups: stable high (16%), increasing (19%), decreasing (27%), fluctuating (19%), and no anxiety (19%). Nearly half (43%) of participants reported clinically significant anxiety before their mask-making session, and between 30% and 43% across trajectories reported significant anxiety immediately before treatments. Intraclass correlation values indicated poor agreement between participant- and RT-ratings. Conclusions Situational anxiety is prevalent in people receiving HNC radiation therapy with mask immobilization. RTs did not reliably capture patients’ situational anxiety. There is no single best time point to provide intervention, suggesting people should be screened for anxiety regularly throughout their treatment. Resources and education should also be available to improve RT skills in providing psychosocial support.
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Anxiety and depression in patients with breast cancer undergoing radiotherapy: the role of intelligence, life history, and social support-preliminary results from a monocentric analysis. Strahlenther Onkol 2022; 198:388-396. [PMID: 35238982 PMCID: PMC8940795 DOI: 10.1007/s00066-022-01904-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/23/2022] [Indexed: 12/30/2022]
Abstract
Purpose It is known that the diagnosis of breast cancer often causes anxiety and depression. Radiotherapy of the breast as an obligatory part of a breast-conserving treatment concept can markedly increase these psychological symptoms in many, but not all patients. In this clinical observational study, we aimed at identifying cognitive, health-related and social factors that may either enhance or reduce the emergence of anxiety and depression. Methods Using a longitudinal study design with 25 women (mean age: 52.9 years; SD = 10.6; age range 29–70 years) with a first diagnosis of nonmetastatic breast cancer, measures of anxiety, depression, situational emotional states, intelligence, and aspects of social frameworks were assessed before, during, and after radiotherapy of the breast. At 4 time-points, standard and self-constructed questionnaires were used to assess the course of anxiety and depressive symptoms across the radiotherapy intervention. Results We found that anxiety is highest immediately before the start of radiation therapy, while the anxiety level was lowest on the day that therapy was completed. Anxiety and depression were enhanced in women with a lifetime history of chronic diseases at all time points of measurement. Moreover, women with high intelligence and low social support had stronger symptoms of depression than women with low intelligence and a stable family background at some time points of measurement. The degree of anxiety was neither related to intelligence nor to social support. Conclusion For the first time, we demonstrate empirical pilot data on cognitive and social modulators of anxiety and depression in women with breast cancer over the course of radiotherapy. Our results may help to optimize clinical procedures and thereby reduce symptoms of anxiety and depression in these patients. Supplementary Information The online version of this article (10.1007/s00066-022-01904-7) contains supplementary material, which is available to authorized users.
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21
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Adeberg S, Sauer C, Lambert L, Regnery S, Windisch P, Zaoui K, Freudlsperger C, Moratin J, Farnia B, Nikendei C, Krauss J, Ehrenthal JC, El Shafie R, Hörner-Rieber J, König L, Akbaba S, Lang K, Held T, Rieken S, Debus J, Friederich HC, Maatouk I. Screening and Psycho-Oncological Support for Patients With Head and Neck Cancer and Brain Malignancies Before Radiotherapy With Mask Fixation: Results of a Feasibility Study. Front Psychol 2021; 12:760024. [PMID: 34975651 PMCID: PMC8716729 DOI: 10.3389/fpsyg.2021.760024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
This single-center, single-arm trial investigates the feasibility of a psycho-oncological care program, which aims to reduce psychological distress and improve compliance with radiotherapy with mask fixation in patients with head and neck cancer or brain malignancies. The care program comprised (1) a screening/needs assessment and (2) the provision of a psycho-oncological intervention using imaginative stabilization techniques for distressed patients (distress due to anxiety ≥5) or in a case of subjective interest in the psycho-oncological intervention. Another allocation path to the intervention was directly through the radiation oncologist in charge who classified the patient as: in need of support to tolerate the immobilization device. Of a total of 1,020 screened patients, 257 (25.2%) patients indicated a distress ≥5 and 141 (13.8%) patients reported panic attacks. 25% of the patients reported a subjective interest in psycho-oncological support. A total of 35 patients received the psycho-oncological intervention, of which 74% were assigned by radiation oncologists. In this small patient cohort, no significant pre-post effects in terms of depression, anxiety, distress, and quality of life (mental and physical component scores) could be detected. Our results indicate a good feasibility (interdisciplinary workflow and cooperation, allocation by physicians in charge) of the psycho-oncological care program for this cohort of patients before radiotherapy with mask fixation. The screening results underline the high psychological distress and demand for psycho-oncological support. However, since the utilization of our intervention was low, future studies should reduce the barriers and improve compliance to psycho-oncological services by these patients.Clinical Trial Registration: https://www.drks.de/drks_web/setLocale_EN.do #DRKS00013493
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Affiliation(s)
- Sebastian Adeberg
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Christina Sauer
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
| | - Lena Lambert
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
| | - Sebastian Regnery
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Paul Windisch
- Department of Radiation Oncology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Karim Zaoui
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Freudlsperger
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Julius Moratin
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Benjamin Farnia
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, United States
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
| | - Juergen Krauss
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Rami El Shafie
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Juliane Hörner-Rieber
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Laila König
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Sati Akbaba
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Kristin Lang
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Thomas Held
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
| | - Stefan Rieken
- Department of Radiation Oncology, Goettingen University Hospital, Goettingen, Germany
| | - Juergen Debus
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
| | - Imad Maatouk
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg (UKHD), Heidelberg University, Heidelberg, Germany
- Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian University Würzburg, Würzburg, Germany
- *Correspondence: Imad Maatouk,
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22
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Park SH, Choi J. Analysis of Geometric and Dosimetric Effects of Bra Application to Support Large or Pendulous Breasts During Radiotherapy Planning: A Retrospective Single-Center Study. Technol Cancer Res Treat 2021; 20:15330338211027909. [PMID: 34180303 PMCID: PMC8243138 DOI: 10.1177/15330338211027909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: To evaluate geometric and dosimetric effects of bra application during
radiotherapy planning for breast cancer patients with large and pendulous
breasts. Materials and Methods: Twenty patients with chest sizes >38 inches between April 2019 and July
2019 underwent radiotherapy planning with and without a radiation bra
(Chabner XRT®). Geometric and dosimetric parameters included the
breast volume, superior-inferior (SI) distance, separation (S) as the
distance of the longest diameter of the clinical target volume (CTV),
conformity number (CN), and homogeneity index (HI) of CTV. The organs at
risk (OARs) were defined as the lungs, heart, and liver. Results: The use of the radiation bra provided mean changes of −0.51 cm for S, −1.45
cm for SI, and −61.18 cc for breast volume (all P <
0.05). Breast volume was correlated with bra-related changes in cross
diameter (r = 0.641, P = 0.002) and volume (r = 0.680,
P = 0.001). Significant dose reductions were observed
for the lungs (mean V10: 19.58 cc, V20: 17.13 cc,
Dmean: 86.24 cGy) and heart (Dmean: 170.23 cGy).
No significant differences were observed for CN (0.62-0.67) and HI
(0.19-0.20) of the CTV. Conclusion: The application of a radiation bra was associated with better geometric and
dosimetric planning parameters, with a smaller CTV and lower doses to the
OARs (lungs and heart) in the radiotherapy field. In addition, we expect
that bra use during radiotherapy would provide emotional benefits.
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Affiliation(s)
- So Hyun Park
- Department of Radiation Oncology, Jeju National University Hospital, Jeju University College of Medicine, Jeju, South Korea
| | - Jinhyun Choi
- Department of Radiation Oncology, Jeju National University Hospital, Jeju University College of Medicine, Jeju, South Korea
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Arnold BL, Halkett G, Dhillon H, Girgis A. Do radiation therapists feel able to routinely screen for symptoms and distress in people with cancer: barriers impacting practice. J Med Radiat Sci 2021; 68:149-156. [PMID: 33729701 PMCID: PMC8168062 DOI: 10.1002/jmrs.465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 02/26/2021] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION This study aimed to evaluate radiation therapists' (RTs) perceptions regarding the perceived barriers, knowledge, attitudes, confidence and role in administering an electronic screening tool to routinely screen for cancer patients' symptoms and distress. METHODS RTs at two radiation therapy departments completed a cross-sectional paper/pen survey to assess their demographic and workplace characteristics, perceptions of barriers, knowledge, attitudes, confidence and opinion of their role in symptom and distress screening. Responses were evaluated using simple frequencies and free-text responses using thematic analysis. RESULTS Of 39 RTs approached, 37 (95%) participated. The majority had not previously attended any emotional cues (77%) or psychosocial training (86%); 68% reported confidence discussing psychosocial concerns and recognising signs of anxiety and depression in patients, and 65% felt discussing patients' psychosocial concerns was part of their role. Administering the tool to patients was agreed to be the role of RTs by 38% of participants. Lack of education about psychosocial issues was the highest-ranked barrier to delivering the patient screening tool, with 74% of RTs responding 'it has made it difficult'. CONCLUSION Whilst RTs are willing to play a role in patients' psychosocial support, they do not feel able to fulfil this role adequately because they lacked knowledge and confidence to administer symptom and distress screening. This research has highlighted the need for RT education on psychosocial concerns and recognising and responding to emotional cues. Understanding the impact education may have on the knowledge, attitude, confidence and role of RTs performing routine symptom and distress screening is required.
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Affiliation(s)
- Belinda L. Arnold
- Wollongong HospitalIllawarra Shoalhaven Local Health DistrictWollongongNew South WalesAustralia
- Centre for Oncology Education and Research Translation (CONCERT)Ingham Institute for Applied Medical ResearchUNSW SydneyLiverpoolNew South WalesAustralia
| | - Georgia Halkett
- Curtin School of Nursing, Faculty of Health SciencesCurtin UniversityBentleyWestern AustraliaAustralia
| | - Haryana Dhillon
- Centre for Medical Psychology & Evidence‐based Decision‐makingSchool of PsychologyFaculty of ScienceThe University of SydneyCamperdownNew South WalesAustralia
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT)Ingham Institute for Applied Medical ResearchUNSW SydneyLiverpoolNew South WalesAustralia
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24
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Anxiety during Radiation Therapy: A Prospective Randomized Controlled Trial Evaluating a Specific One-on-One Procedure Announcement Provided by a Radiation Therapist. Cancers (Basel) 2021; 13:cancers13112572. [PMID: 34073891 PMCID: PMC8197250 DOI: 10.3390/cancers13112572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary What is the influence of a one-on-one procedure announcement delivered by a radiation therapist before radiation therapy? In this trial randomizing 126 patients, no significant differences in mean trait or state anxiety scores measured before CT scan simulation, during the first and second sessions, or at the completion of radiotherapy were noted. Patients who benefited from the procedure announcement were significantly better informed of the treatment positioning and in vivo dosimetry. For patients, this specific procedure was not able to decrease their level of anxiety. Abstract Background: Anxiety impacts patient outcomes and quality of life in response to cancer diagnosis. A prospective phase 3 trial randomizing 126 patients was conducted to determine whether a specific one-on-one procedure announcement provided by a radiation therapist before CT scan simulation decreases anxiety for patients with breast cancer requiring radiotherapy. Material and Methods: Anxiety was measured using the STAI form, and the QLQ-C30 and BR-23 questionnaires were used to evaluate quality of life. Results: Mean trait or state anxiety scores before CT scan simulation, before the first and second sessions, and at the end of radiation treatment were not significantly different. We observed a decrease in the level of anxiety with time; however, no significant difference in mean state anxiety scores at any of the time intervals was detected. Factors, such as anxiety trait score, professional and marital status, age, and use of alternative therapy, did not significantly influence the evolution of anxiety status over time or the mean value. Anxiety was significantly influenced by the level of fatigue. Patients who benefited from the radiation therapists’ advice felt significantly better informed. Conclusions: The one-on-one program announcement occurring before CT scan simulation led to patients being more informed and greater satisfaction but did not decrease anxiety.
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25
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Grilo AM, Santos B, Baptista I, Monsanto F. Exploring the cancer patients' experiences during external radiotherapy: A systematic review and thematic synthesis of qualitative and quantitative evidence. Eur J Oncol Nurs 2021; 52:101965. [PMID: 34023669 DOI: 10.1016/j.ejon.2021.101965] [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: 11/22/2020] [Revised: 03/28/2021] [Accepted: 04/14/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the subjective experience of adult cancer patients undergoing external radiotherapy and provide evidence for better practices in radiotherapy services. METHODS A systematic review was performed according to the PRISMA Statement Guidelines. Qualitative and mixed studies were identified through five electronic databases (CINAHL, PsychINFO, Medline, Scopus and Web of Science), between March and April 2020, using defined criteria. Methodological quality assessment was conducted, and the data integrated into a thematic synthesis. RESULTS Of the 886 studies identified, 13 met our inclusion criteria. Patients experiences were described into four main themes: (1) Time, (2) Physical Environment, (3) Treatment Concerns and (4) Radiotherapy Team. Time refers to waiting time and treatment time; Physical Environment states temperature in the treatment room and equipment; Treatment Concerns included side effects, daily activities, positioning and immobilization and treatment preparation (e.g., bladder filling); radiotherapy team comprised patients support; response to patients needs and recognized team. The generating analytical phase of thematic analysis allowed us to recognize that the effectiveness of the radiotherapy team operates as a facilitator of the patients' experience. In contrast, time in the waiting room, the treatment preparation when is required, and the positioning and immobilization, specifically for the neck and head patients, act as barriers. CONCLUSION Four distinct themes were identified to be positively and negatively associated with patients' experience during external radiotherapy. The evidence provides valuable recommendations to improved radiotherapy services organization, as well as to the delivery of more patient-centred care adjusted to the concerns and needs of patients.
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Affiliation(s)
- Ana Monteiro Grilo
- H&TRC-Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal; CICPsi - Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Portugal.
| | - Bárbara Santos
- Medical Imaging and RT Degree, Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
| | - Inês Baptista
- Medical Imaging and RT Degree, Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
| | - Fátima Monsanto
- H&TRC-Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
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Nardone V, Reginelli A, Vinciguerra C, Correale P, Calvanese MG, Falivene S, Sangiovanni A, Grassi R, Di Biase A, Polifrone MA, Caraglia M, Cappabianca S, Guida C. Mood Disorder in Cancer Patients Undergoing Radiotherapy During the COVID-19 Outbreak. Front Psychol 2021; 12:568839. [PMID: 33815186 PMCID: PMC8017226 DOI: 10.3389/fpsyg.2021.568839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/25/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction: Novel coronavirus (COVID-19) is having a devastating psychological impact on patients, especially patients with cancer. This work aims to evaluate mood disorders of cancer patients undergoing radiation therapy during COVID-19 in comparison with cancer patients who underwent radiation therapy in 2019. Materials and Methods: We included all the patients undergoing radiation therapy at our department in two-time points (once a week for a month in May 2019) and during the COVID-19 outbreak (in April 2020). All the patients were asked to fulfill a validated questionnaire (STAI-Y1, State trait anxiety inventory scale), the Symptom Distress thermometer (SDT) (from 0 to 10 score), and the Beck Depression Inventory v.2 (BDI-2). We took into account the COVID-19 outbreak and also sex, age, week of radiation treatment, and disease. Results: We included 458 patients (220 males and 238 females), with a median age of 64 years. STAI-Y1 median score was 40 (mean 41,3, range 19-79), whereas the median score of SDT was five and BDI-2 median score was 11. STAI-Y1, SDT, and BDI-2 were significantly correlated with the COVID-19 outbreak (p < 0,001 for all the tests), sex (p: 0,016 for STAI-Y1, p < 0.001 for SDT, p:0.013 for BDI-2), week of treatment (p: 0.012 for STAI-Y1 and p: 0.031 for SDT), and disease (p:0.015 for STAI-Y1, p < 0.001 for SDT and p:0.020 for BDI-2). Conclusions: The prevalence of mood disorders in patients undergoing radiation therapy is higher than expected and even higher during the COVID-19 outbreak. These measurements could be useful as a baseline to start medical humanities programs to decrease these scores.
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Affiliation(s)
- Valerio Nardone
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | | | - Pierpaolo Correale
- Unit of Medical Oncology, Grand Metropolitan Hospital "Bianchi Melacrino Morelli," Reggio Calabria, Italy
| | | | - Sara Falivene
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Angelo Sangiovanni
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Angela Di Biase
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Maria Angela Polifrone
- Unit of Medical Oncology, Grand Metropolitan Hospital "Bianchi Melacrino Morelli," Reggio Calabria, Italy
| | - Michele Caraglia
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Cesare Guida
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
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He Y, Gao C, Pang Y, Chen J, Tang L. Psychosomatic symptoms affect radiotherapy setup errors in early breast cancer patients. Chin J Cancer Res 2021; 33:323-330. [PMID: 34321829 PMCID: PMC8286889 DOI: 10.21147/j.issn.1000-9604.2021.03.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/12/2021] [Indexed: 12/12/2022] Open
Abstract
Objective To examine the trajectory of psychosomatic symptoms and to explore the impact of psychosomatic symptoms on setup error in patients undergoing breast cancer radiotherapy. Methods A total of 102 patients with early breast cancer who received initial radiotherapy were consecutively recruited. The M.D. Anderson Symptom Inventory (MDASI) and three different anxiety scales, i.e., the Self-Rating Anxiety Scale (SAS), State-Trait Anxiety Inventory (STAI), and Anxiety Sensitivity Index (ASI), were used in this study. The radiotherapy setup errors were measured in millimetres by comparing the real-time isocratic verification film during radiotherapy with the digitally reconstructed radiograph (DRR). Patients completed the assessment at three time points: before the initial radiotherapy (T1), before the middle radiotherapy (T2), and before the last radiotherapy (T3). Results The SAS and STAI-State scores of breast cancer patients at T1 were significantly higher than those at T2 and T3 (F=24.44, P<0.001; F=30.25, P<0.001). The core symptoms of MDASI were positively correlated with anxiety severity. The setup errors of patients with high SAS scores were greater than those of patients with low anxiety levels at T1 (Z=-2.01, P=0.044). We also found that higher SAS scores were associated with a higher risk of radiotherapy setup errors at T1 (B=0.458, P<0.05). Conclusions This study seeks to identify treatment-related psychosomatic symptoms and mitigate their impact on patients and treatment. Patients with early breast cancer experienced the highest level of anxiety before the initial radiotherapy, and then, anxiety levels declined. Patients with high somatic symptoms of anxiety may have a higher risk of radiotherapy setup errors.
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Affiliation(s)
- Yi He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Chang Gao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Department of Outpatient, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Ying Pang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Jixiang Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Lili Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
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Miaskowski C, Paul SM, Snowberg K, Abbott M, Borno H, Chang S, Chen LM, Cohen B, Hammer MJ, Kenfield SA, Kober KM, Levine JD, Pozzar R, Rhoads KF, Van Blarigan EL, Van Loon K. Stress and Symptom Burden in Oncology Patients During the COVID-19 Pandemic. J Pain Symptom Manage 2020; 60:e25-e34. [PMID: 32889039 PMCID: PMC7462969 DOI: 10.1016/j.jpainsymman.2020.08.037] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/24/2020] [Accepted: 08/28/2020] [Indexed: 12/11/2022]
Abstract
CONTEXT No information is available on oncology patients' level of stress and symptom burden during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES To evaluate for differences in demographic and clinical characteristics, levels of social isolation and loneliness, and the occurrence and severity of common symptoms between oncology patients with low vs. high levels of COVID-19 and cancer-related stress. In addition, to determine which of these characteristics were associated with membership in the high-stressed group. METHODS Patients were 18 years and older; had a diagnosis of cancer; and were able to complete an online survey. RESULTS Of the 187 patients in this study, 31.6% were categorized in the stressed group (Impact of Event Scale-Revised [score of ≥24]). Stressed group's Impact of Event Scale-Revised score exceeds previous benchmarks in oncology patients and equates with probable post-traumatic stress disorder. In this stressed group, patients reported occurrence rates for depression (71.2%), anxiety (78.0%), sleep disturbance (78.0%), evening fatigue (55.9%), cognitive impairment (91.5%), and pain (75.9%). Symptom severity scores equate with clinically meaningful levels for each symptom. CONCLUSION We identified alarmingly high rates of stress and an extraordinarily high symptom burden among patients with cancer, exceeding those previously benchmarked in this population and on par with noncancer patients with post-traumatic stress disorder. Given that the COVID-19 pandemic will likely impact cancer care for an indefinite period, clinicians must exhibit increased vigilance in their assessments of patients' level of stress and symptom burden. Moreover, an increase in referrals to appropriate supportive care resources must be prioritized for high-risk patients.
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Affiliation(s)
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Karin Snowberg
- School of Nursing, University of California, San Francisco, California, USA
| | - Maura Abbott
- Columbia University Medical Center, New York, New York, USA
| | - Hala Borno
- School of Medicine, University of California, San Francisco, California, USA
| | - Susan Chang
- School of Medicine, University of California, San Francisco, California, USA
| | - Lee M Chen
- School of Medicine, University of California, San Francisco, California, USA
| | - Bevin Cohen
- Mount Sinai Medical Center, New York, New York, USA
| | | | - Stacey A Kenfield
- School of Medicine, University of California, San Francisco, California, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA
| | - Rachel Pozzar
- Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Kim F Rhoads
- School of Medicine, University of California, San Francisco, California, USA
| | - Erin L Van Blarigan
- School of Medicine, University of California, San Francisco, California, USA
| | - Katherine Van Loon
- School of Medicine, University of California, San Francisco, California, USA
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Forbes E, Baker AL, Britton B, Clover K, Skelton E, Oultram S, Oldmeadow C, McCarter K. Non-pharmacological approaches to procedural anxiety reduction for patients undergoing radiotherapy for cancer: systematic review protocol. BMJ Open 2020; 10:e035155. [PMID: 33039983 PMCID: PMC7549444 DOI: 10.1136/bmjopen-2019-035155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Procedural anxiety relates to an affective state of anxiety or fear in relation to a medical procedure. Various treatment-related factors may elicit anxiety among oncology patients, including fear of diagnostic imaging (such as MRI scans) and impending treatment and medical procedures (such as chemotherapy and radiotherapy). It is common in oncology settings to manage acute anxiety relating to medical procedures with anxiolytic medication. However, pharmacological approaches are not suitable for many patients. Despite this, non-pharmacological interventions are infrequently used. The aim of this systematic review is to determine whether non-pharmacological interventions delivered prior to, or during, radiotherapy are effective in reducing procedural anxiety. METHODS AND ANALYSIS Data sources will include the bibliographic databases CINAHL, MEDLINE, EMBASE, PsycINFO and Cochrane Central Register of Controlled trials (CENTRAL) (from inception onward). Eligible studies will include adult patients with cancer undergoing radiotherapy treatment. Included studies will be those which employ a non-pharmacological intervention, delivered within existing radiotherapy appointments, with the aim of reducing procedural anxiety related to radiotherapy. All research designs with a control or other comparison group will be included. The primary outcome will be change in levels of self-reported procedural anxiety. Secondary outcomes will be changes in scores on physiological measures of anxiety and/or changes in treatment completion and/or changes in treatment duration and/or changes in psychological distress. Two investigators will independently complete title and abstract screening, full-text screening, data extraction and assessment of methodological quality. If appropriate, a meta-analyses will be performed. Any important amendments to this protocol will be updated in the PROSPERO registration and documented in the resulting review publication. ETHICS AND DISSEMINATION No ethical issues are anticipated from this review. The findings will be disseminated through peer-reviewed publication and at conferences by presentation. SYSTEMATIC REVIEW REGISTRATION CRD42019112941.
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Affiliation(s)
- Erin Forbes
- School of Medicine and Public Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
| | - Ben Britton
- Department of Consultation Liaison Psychiatry, John Hunter Hospital, New Lambton, New South Wales, Australia
| | - Kerrie Clover
- School of Medicine and Public Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
- Psycho-Oncology, Calvary Mater Newcastle, Hunter Region Mail Centre, New South Wales, Australia
| | - Eliza Skelton
- School of Medicine and Public Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
| | - Sharon Oultram
- Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Christopher Oldmeadow
- CREDITSS-Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Kristen McCarter
- School of Medicine and Public Health, The University of Newcastle Faculty of Health and Medicine, Callaghan, New South Wales, Australia
- Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
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Nardone V, Vinciguerra C, Correale P, Guida C, Tini P, Reginelli A, Cappabianca S. Music therapy and radiation oncology: State of art and future directions. Complement Ther Clin Pract 2020; 39:101124. [DOI: 10.1016/j.ctcp.2020.101124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/11/2020] [Accepted: 02/22/2020] [Indexed: 10/24/2022]
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Dilalla V, Chaput G, Williams T, Sultanem K. Radiotherapy side effects: integrating a survivorship clinical lens to better serve patients. Curr Oncol 2020; 27:107-112. [PMID: 32489253 PMCID: PMC7253739 DOI: 10.3747/co.27.6233] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The Canadian Cancer Society estimated that 220,400 new cases of cancer would be diagnosed in 2019. Of the affected patients, more than 60% will survive for 5 years or longer after their cancer diagnosis. Furthermore, nearly 40% will receive at least 1 course of radiotherapy (rt). Radiotherapy is used with both curative and palliative intent: to treat early-stage or locally advanced tumours (curative) and for symptom management in advanced disease (palliative). It can be delivered systemically (external-beam rt) or internally (brachytherapy). Although technique improvements have drastically reduced the occurrence of rt-related toxicity, most patients still experience burdensome rt side effects (seffs). Radiotherapy seffs are local or locoregional, and manifest in tissues or organs that were irradiated. Side effects manifesting within weeks after rt completion are termed "early seffs," and those occurring months or years after treatment are termed "late seffs." In addition to radiation oncologists, general practitioners in oncology and primary care providers are involved in survivorship care and management of rt seffs. Here, we present an overview of common seffs and their respective management: anxiety, depression, fatigue, and effects related to the head-and-neck, thoracic, and pelvic treatment sites.
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Affiliation(s)
- V Dilalla
- Division of Radiation Oncology, McGill University, Montreal, QC
| | - G Chaput
- Department of Family Medicine (Secondary Care), Division of Supportive and Palliative Medicine, McGill University Health Centre, and McGill University, Montreal, QC
| | - T Williams
- Cancer Care Mission Patients' Committee, McGill University Health Centre, Montreal, QC
| | - K Sultanem
- Department of Oncology, Division of Radiation Oncology, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC
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Almigbal TH, Almutairi KM, Fu JB, Vinluan JM, Alhelih E, Alonazi WB, Batais MA, Alodhayani AA, Mubaraki MA. Assessment of psychological distress among cancer patients undergoing radiotherapy in Saudi Arabia. Psychol Res Behav Manag 2019; 12:691-700. [PMID: 31693712 PMCID: PMC6708396 DOI: 10.2147/prbm.s209896] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/13/2019] [Indexed: 01/09/2023] Open
Abstract
Background Cancer patients under psychological distress have reduced compliance with treatment and prolonged hospitalizations. Identifying cancer patients who may be more likely to suffer from psychological distress over the disease trajectory is essential to targeting the proper interventions and providing the best care. In this descriptive cross-sectional study, we aim to assess the levels of emotional and physical distress, depressive symptoms, and social concerns of cancer patients undergoing radiotherapy treatment in Saudi Arabia. Methods A total of 148 cancer patients undergoing radiotherapy from five different public tertiary-level hospitals in Saudi Arabia participated in this study. The survey was conducted by a trained researcher from November 2015 through April 2016. The Psycho-Oncology Screening Tool was used to identify levels of distress of cancer patients undergoing radiotherapy. Emotional and physical distress, depressive symptoms, and social concerns in receiving psychosocial services were assessed. Results The findings show above average levels of physical and emotional distress was (342.07±78.9) and social concerns was (7.27±1.68). Age was a significant predictor of psychological distress and in social concerns (P<0.05). Marital status and employment status emerged as significant predictors of depressive symptoms and social concerns (<0.05), (P<0.001), respectively. The patients’ type of cancer was significantly associated with the level of physical distress, emotional distress, and depressive symptoms (P<0.05). Conclusion Cancer patients undergoing radiotherapy displayed above-average levels of distress. This may have significant implications on their adherence for treatment and patient outcomes. Routine screening and support services or psychosocial care for patients are warranted among cancer patients undergoing radiotherapy.
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Affiliation(s)
| | - Khalid M Almutairi
- Department of Community Health Science, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia
| | - Jack B Fu
- Department of Palliative, Rehabilitation, and Integrative Medicine, University of Texas Md Anderson Cancer Center, Houston, TX, USA
| | - Jason M Vinluan
- Department of Community Health Science, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia
| | - Eyad Alhelih
- College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Wadi B Alonazi
- College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Murad A Mubaraki
- Clinical Laboratory Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Grilo AM, Gomes AI, Monsanto F, Albino D, Augusto C, Pragana C. First day of radiotherapy for women with breast cancer: predictors of anxiety. Support Care Cancer 2019; 28:1241-1248. [PMID: 31227988 DOI: 10.1007/s00520-019-04902-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Radiotherapy treatment may generate anxiety, especially on the first day of treatment. This study aimed to identify potential predictors of radiotherapy-related anxiety in women with breast cancer before treatment initiation, in terms of treatment concerns and trait anxiety. METHODS This transversal study included 94 patients from one Radiation Oncology Department, who had been diagnosed with primary breast cancer and who had been prescribed external radiotherapy for the first time. Patients completed a Treatment Concerns Questionnaire and the State-Trait Anxiety Inventory (STAI) before the first treatment session. RESULTS Women identified radiation involved in the procedure and treatment efficacy as major concerns surrounding radiotherapy. No significant differences were found between patients with higher and lower state anxiety scores, or by age, level of education, cancer treatment protocol used, prior information given about treatment, or report of doubts before treatment initiation. In the final model, the combination of trait anxiety (49.1% of the total variance) with two treatment-related concerns, regarding radiation and the duration of treatment (plus 10.8% of the total variance), significantly predicted treatment-related anxiety experienced on the first day of treatment. CONCLUSION Our findings highlight the need to identify women with moderate or higher levels of trait anxiety before radiotherapy initiation and to provide them with a more approach to personalized care, adjusted to their specific concerns and susceptibility to anxious reactions. Effective education sessions involving the discussion of specific treatment concerns, and anxiety coping strategies training should be developed and applied in initial interactions with breast cancer patients.
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Affiliation(s)
- Ana M Grilo
- ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal. .,CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013, Lisbon, Portugal.
| | - Ana I Gomes
- ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal.,CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013, Lisbon, Portugal
| | - Fátima Monsanto
- H&TRC- Centro de Investigação em Saúde e Tecnologia, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal
| | - Daniel Albino
- ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal
| | - Cláudio Augusto
- ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal
| | - Catarina Pragana
- Unidade de Radioterapia, Hospital CUF Descobertas, R. Mário Botas, Parque das Nações, 1998-018, Lisbon, Portugal
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Karadag E, Uğur Ö, Çetinayak O. The effect of music listening intervention applied during radiation therapy on the anxiety and comfort level in women with early-stage breast cancer: A randomized controlled trial. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Yang Y, Cameron J, Bedi C, Humphris G. Fear of cancer recurrence trajectory during radiation treatment and follow-up into survivorship of patients with breast cancer. BMC Cancer 2018; 18:1002. [PMID: 30342495 PMCID: PMC6195993 DOI: 10.1186/s12885-018-4908-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) has been shown to be higher in patients treated with external beam radiotherapy (RT) compared to those untreated. However, little is known about the dynamics of patient's FCR during and after RT. The aim of this study was to examine FCR levels in a longitudinal panel design with breast cancer patients receiving RT. METHODS Consecutive newly-diagnosed breast cancer patients (n = 94) attending a single cancer centre were invited to complete a 7-item FCR scale (FCR7) that was collected weekly by paper instrument and at a follow-up phone call 6-8 weeks after completion of RT. Descriptive statistics, and Latent Growth Curve Modelling (LGCM) were utilised to analyse the data. RESULTS Women who were younger, single/separated, had chemotherapy, had extra boost radiation treatment, taking Herceptin and treated by 4-field technique reported higher recurrence fear at baseline. There was strong evidence of substantial variation in the trajectory of FCR (z = - 3.54, p < .0001). The average trajectory of FCR over RT was negative (unstandardized estimate = - 0.59) and associated with FCR follow-up level (standardised estimate = 0.36, z = 3.05, p < .002), independent of baseline recurrence fears. CONCLUSION Patients vary in their trajectory of recurrence fears over RT which predicts FCR approximately 2 months following treatment. Review appointments by therapy radiographers presents an opportunity to intervene in FCR trajectories. TRIAL REGISTRATION ClinicalTrials.gov: NCT02599506 . Prospectively registered on 11th March 2015.
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Affiliation(s)
- Y. Yang
- Department of Psychiatry and Psychology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong China
| | - J. Cameron
- Edinburgh Cancer Centre, Western General Hospital, Crewe Road, Edinburgh, UK
| | - C. Bedi
- Edinburgh Cancer Centre, Western General Hospital, Crewe Road, Edinburgh, UK
| | - G. Humphris
- Division of Population and Behavioural Sciences, School of Medicine, University of St Andrews, North Haugh, St Andrews, Fife UK
- Edinburgh Cancer Centre, Western General Hospital, Crewe Road, Edinburgh, UK
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Nathoo D, Willis S, Tran WT. Distress Among Locally Advanced Breast Cancer Patients from Diagnosis to Follow-Up: A Critical Review of Literature. J Med Imaging Radiat Sci 2018; 49:325-336. [PMID: 32074060 DOI: 10.1016/j.jmir.2018.04.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/18/2018] [Accepted: 04/24/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE This critical review used a systematic approach to explore the prevalence of distress among locally advanced breast cancer (LABC) patients along their treatment journey. This review explored the domains of distress (psychosocial, physical and/or practical) that are significant to this patient population and determined indications for psychosocial support throughout the patients' treatment. METHODS Electronic databases including CINAHL, EmBase, Medline PsycInfo, and gray literature were searched from the year 2000 to 2016, to produce relevant literature. A critical review was conducted on 73 articles meeting the inclusion and exclusion criteria. A narrative synopsis was used to summarize the findings under key themes. RESULTS The results indicate that 16/73 studies assessed for distress in all three domains of distress throughout the treatment course. A meta-analysis was not possible due to the methodological heterogeneity of the articles, the variation of assessment tools used, timing in which the assessments were done, and the different treatment modalities. Distress was prevalent from the time of diagnosis, through treatment, and into survivorship. Sexuality, body image, age, financial difficulty, family/social support, and informational needs were common themes that emerged among the LABC population in these studies. CONCLUSIONS Comprehensive assessments incorporating all three domains of distress with the appropriate tools will assist health care professionals throughout the complicated treatment trajectory of LABC patients in taking a more proactive approach in assisting patients' concerns and preventing undue or increase in psychological distress during or after active treatment. This will encourage effective patient-centered communication and supportive care referrals for a better patient experience.
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Affiliation(s)
- Dilshad Nathoo
- Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario.
| | | | - William T Tran
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario
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Stamm B, Girardon-Perlini NMO, Pasqualoto AS, Beuter M, Magnago TSBDS. Intervenção telefônica para manejo da ansiedade de pacientes oncológicos: ensaio clínico randomizado. ACTA PAUL ENFERM 2018. [DOI: 10.1590/1982-0194201800021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Avaliar a eficácia da intervenção telefônica realizada por enfermeira na diminuição dos escores de ansiedade de pacientes em tratamento radioterápico. Métodos Ensaio clínico randomizado realizado em ambulatório de radioterapia com seguimento de 15 dias. A amostra foi composta por 39 pacientes em tratamento radioterápico (20 no Grupo Intervenção e 19 no Grupo Controle). As intervenções foram realizadas por meio de dois contatos telefônicos. Para coleta de dados, utilizaram-se questionário com questões sociodemográficas e clínicas, e Inventário de Ansiedade Traço-Estado. Os dados foram analisados pelo pacote estatístico Statistical Package for Social Sciences. O teste t de Student para amostras pareadas foi utilizado para comparar os momentos pré e pós-intervenção. Resultados Houve redução significativa dos escores de ansiedade após as ligações telefônicas (p<0,027) para os pacientes do Grupo Intervenção. Conclusão O uso do telefone durante seguimento de 15 dias mostrou-se estratégia eficaz para a diminuição dos escores de ansiedade de pacientes em tratamento radioterápico. Registro Brasileiro de Ensaios Clínicos – REBEC: RBR-8wn8ck
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Haefner MF, Giesel FL, Mattke M, Rath D, Wade M, Kuypers J, Preuss A, Kauczor HU, Schenk JP, Debus J, Sterzing F, Unterhinninghofen R. 3D-Printed masks as a new approach for immobilization in radiotherapy - a study of positioning accuracy. Oncotarget 2018; 9:6490-6498. [PMID: 29464087 PMCID: PMC5814227 DOI: 10.18632/oncotarget.24032] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 01/02/2018] [Indexed: 11/25/2022] Open
Abstract
We developed a new approach to produce individual immobilization devices for the head based on MRI data and 3D printing technologies. The purpose of this study was to determine positioning accuracy with healthy volunteers. 3D MRI data of the head were acquired for 8 volunteers. In-house developed software processed the image data to generate a surface mesh model of the immobilization mask. After adding an interface for the couch, the fixation setup was materialized using a 3D printer with acrylonitrile butadiene styrene (ABS). Repeated MRI datasets (n=10) were acquired for all volunteers wearing their masks thus simulating a setup for multiple fractions. Using automatic image-to-image registration, displacements of the head were calculated relative to the first dataset (6 degrees of freedom). The production process has been described in detail. The absolute lateral (x), vertical (y) and longitudinal (z) translations ranged between −0.7 and 0.5 mm, −1.8 and 1.4 mm, and −1.6 and 2.4 mm, respectively. The absolute rotations for pitch (x), yaw (y) and roll (z) ranged between −0.9 and 0.8°, −0.5 and 1.1°, and −0.6 and 0.8°, respectively. The mean 3D displacement was 0.9 mm with a standard deviation (SD) of the systematic and random error of 0.2 mm and 0.5 mm, respectively. In conclusion, an almost entirely automated production process of 3D printed immobilization masks for the head derived from MRI data was established. A high level of setup accuracy was demonstrated in a volunteer cohort. Future research will have to focus on workflow optimization and clinical evaluation.
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Affiliation(s)
- Matthias Felix Haefner
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), 69120 Heidelberg, Germany
| | - Frederik Lars Giesel
- Department of Nuclear Medicine, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Matthias Mattke
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), 69120 Heidelberg, Germany
| | - Daniel Rath
- Department of Nuclear Medicine, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Moritz Wade
- Department of Nuclear Medicine, Heidelberg University Hospital, 69120 Heidelberg, Germany.,Institute of Antropomatics and Robotics, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany
| | - Jacob Kuypers
- Department of Nuclear Medicine, Heidelberg University Hospital, 69120 Heidelberg, Germany.,Institute of Antropomatics and Robotics, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany
| | - Alan Preuss
- Department of Nuclear Medicine, Heidelberg University Hospital, 69120 Heidelberg, Germany.,Institute of Antropomatics and Robotics, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Jens-Peter Schenk
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Juergen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), 69120 Heidelberg, Germany
| | - Florian Sterzing
- National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), 69120 Heidelberg, Germany.,Department of Radiation Oncology Kempten, 87439 Kempten, Germany
| | - Roland Unterhinninghofen
- Institute of Antropomatics and Robotics, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany.,Institute of Robotics and Mechatronics, German Aerospace Center, 82234 Oberpfaffenhofen-Weßling, Germany
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Habibullah G, Gul R, Cassum S, Elahi R. Experiences of the Breast Cancer Patients Undergoing Radiotherapy at a Public Hospital Peshawar Pakistan. Asia Pac J Oncol Nurs 2018; 5:184-194. [PMID: 29607379 PMCID: PMC5863428 DOI: 10.4103/apjon.apjon_70_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective This study aimed to explore the experiences of female breast cancer patients undergoing radiotherapy (RT) in a public hospital in Peshawar, Pakistan. Methods This study employed a descriptive exploratory method. A purposive sample of 14 breast cancer women undergoing RT was selected for this study. Data were collected over the period of 5 months, using a semi-structured interview guide and conducting in-depth face-to-face interviews. These interviews were audio taped and transcribed by a bilingual transcriber. The translated version of the interview was coded, and the analysis was done manually. Results Four main categories emerged from data analysis, which were: feelings and perceptions of the patients, their challenges, coping strategies, and teaching and informational needs. Conclusions Women undergoing RT in this culture experience more intense psychological effects, as compared to the physical effects. Keeping in mind, the magnitude of the emotional stress experienced by the participants, recommendations for policy reforms, and training for female RT staff are suggested based on findings of this research.
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Affiliation(s)
| | - Raisa Gul
- Shifa College of Nursing, Tameer-e-Millat University, Islamabad, Pakistan
| | - Shanaz Cassum
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Rehana Elahi
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
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Lemanska A, Byford RC, Correa A, Cruickshank C, Dearnaley DP, Griffin C, Hall E, de Lusignan S, Faithfull S. Linking CHHiP prostate cancer RCT with GP records: A study proposal to investigate the effect of co-morbidities and medications on long-term symptoms and radiotherapy-related toxicity. Tech Innov Patient Support Radiat Oncol 2017; 2:5-12. [PMID: 32095558 PMCID: PMC7033766 DOI: 10.1016/j.tipsro.2017.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 05/17/2017] [Accepted: 06/07/2017] [Indexed: 12/25/2022] Open
Abstract
Background Patients receiving cancer treatment often have one or more co-morbid conditions that are treated pharmacologically. Co-morbidities are recorded in clinical trials usually only at baseline. However, co-morbidities evolve and new ones emerge during cancer treatment. The interaction between multi-morbidity and cancer recovery is significant but poorly understood. Purpose To investigate the effect of co-morbidities (e.g. cardiovascular and diabetes) and medications (e.g. statins, antihypertensives, metformin) on radiotherapy-related toxicity and long-term symptoms in order to identify potential risk factors. The possible protective effect of medications such as statins or antihypertensives in reducing radiotherapy-related toxicity will also be explored. Methods Two datasets will be linked. (1) CHHiP (Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy for Prostate Cancer) randomised control trial. CHHiP contains pelvic symptoms and radiation-related toxicity reported by patients and clinicians. (2) GP (General Practice) data from RCGP RSC (Royal College of General Practitioners Research and Surveillance Centre). The GP records of CHHiP patients will be extracted, including cardiovascular co-morbidities, diabetes and prescription medications. Statistical analysis of the combined dataset will be performed in order to investigate the effect. Conclusions Linking two sources of healthcare data is an exciting area of big healthcare data research. With limited data in clinical trials (not all clinical trials collect information on co-morbidities or medications) and limited lengths of follow-up, linking different sources of information is increasingly needed to investigate long-term outcomes. With increasing pressures to collect detailed information in clinical trials (e.g. co-morbidities, medications), linkage to routinely collected data offers the potential to support efficient conduct of clinical trials.
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Key Words
- ANOVA, analysis of variance
- BNF, British National Formulary
- Big data
- CHHiP
- CHHiP, Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy for Prostate Cancer
- Data linkage
- EPIC, Expanded Prostate Cancer Index Composite
- FACT-P, Functional Assessment of Cancer Therapy-Prostate
- GEE, Generalized Estimating Equations
- GP, General Practitioner
- ICD10, International Classification of Disease version 10
- ICR, Institute of Cancer Research
- IMRT, Intensity Modulated Radiotherapy
- LENT/SOMA, Late Effects Normal Tissue Toxicity; subjective, objective, management, and analytic
- Late-effects
- PCa, Prostate cancer
- PROs, Patient Reported Outcomes
- QOL, Quality of life
- RCGP RSC
- RCGP, Royal College of General Practitioners
- RCT, Randomised Control Trial
- REC, Research Ethics Committee
- RSC, Research & Surveillance Centre
- RTOG, Radiation Therapy Oncology Group
- Radiotherapy-related side-effects
- SHA2-512, Secure Hash Algorithm 2 with 512 bit hash values
- UCLA-PCI, University of California, Los Angeles Prostate Cancer Index
- UK, United Kingdom
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Affiliation(s)
- Agnieszka Lemanska
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Rachel C Byford
- Department of Health Care Management and Policy, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Ana Correa
- Department of Health Care Management and Policy, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Clare Cruickshank
- The Institute of Cancer Research - Clinical Trials and Statistics Unit, London, UK
| | - David P Dearnaley
- The Institute of Cancer Research and Royal Marsden NHS Trust, London, UK
| | - Clare Griffin
- The Institute of Cancer Research - Clinical Trials and Statistics Unit, London, UK
| | - Emma Hall
- The Institute of Cancer Research - Clinical Trials and Statistics Unit, London, UK
| | - Simon de Lusignan
- Department of Health Care Management and Policy, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Sara Faithfull
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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41
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Rossetti A, Chadha M, Torres BN, Lee JK, Hylton D, Loewy JV, Harrison LB. The Impact of Music Therapy on Anxiety in Cancer Patients Undergoing Simulation for Radiation Therapy. Int J Radiat Oncol Biol Phys 2017; 99:103-110. [PMID: 28816136 PMCID: PMC7864375 DOI: 10.1016/j.ijrobp.2017.05.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 04/28/2017] [Accepted: 05/01/2017] [Indexed: 01/10/2023]
Abstract
PURPOSE Radiation therapy (RT) is associated with high stress levels. The role of music therapy (MT) for patients receiving RT is not well described. This study evaluates the impact of MT on anxiety and distress during simulation in patients with newly diagnosed head and neck or breast cancer. METHODS AND MATERIALS This institutional review board-approved randomized trial of MT versus no MT at the time of simulation included the pre-State-Trait Anxiety Inventory (STAI-S Anxiety) questionnaire and Symptom Distress Thermometer (SDT). Patients randomized to MT received a consultation with a music therapist, during which music of the patients' choice to be played during simulation was selected. The no-MT patients did not receive the MT consultation, nor did they hear prerecorded music during simulation. Subsequent to the simulation, all patients repeated the STAI-S Anxiety questionnaire and the SDT. RESULTS Of the 78 patients enrolled (39 in MT group and 39 in no-MT group), 38 had breast cancer and 40 had head and neck cancer. The male-female ratio was 27:51. The overall mean pre- and post-simulation STAI-S scores were 38.7 (range, 20-60) and 35.2 (range, 20-72), respectively. The overall mean pre- and post-simulation SDT scores were 3.2 (range, 0-10) and 2.5 (range, 0-10), respectively. The MT group had mean pre- and post-simulation STAI-S scores of 39.1 and 31.0, respectively (P<.0001), and the mean SDT scores before and after simulation were 3.2 and 1.7, respectively (P<.0001). The no-MT group's mean pre- and post-simulation STAI-S scores were 38.3 and 39.5, respectively (P=.46), and the mean SDT scores were 3 and 3.2, respectively (P=.51). CONCLUSIONS MT significantly lowered patient anxiety and distress during the simulation procedure on the basis of the STAI-S questionnaire and SDT. Incorporating culturally centered individualized MT may be an effective intervention to reduce stressors. Continued research defining the role of MT intervention in improving the patient experience by reducing anxiety is warranted.
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Affiliation(s)
- Andrew Rossetti
- Louis Armstrong Center for Music & Medicine, Department of Music Therapy, Mount Sinai Beth Israel Medical Center, New York, New York.
| | - Manjeet Chadha
- Department of Radiation Oncology, Mount Sinai Downtown Union Square, Mount Sinai Health System, New York, New York
| | - B Nelson Torres
- Moffitt Cancer Center, Biostatistics Shared Resources Core, Tampa, Florida
| | - Jae K Lee
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
| | - Donald Hylton
- Department of Radiation Oncology, Mount Sinai Downtown Union Square, Mount Sinai Health System, New York, New York
| | - Joanne V Loewy
- Louis Armstrong Center for Music & Medicine, Department of Music Therapy, Mount Sinai Beth Israel Medical Center, New York, New York
| | - Louis B Harrison
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
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42
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Kreitschmann-Andermahr I, Buchfelder M, Kleist B, Kohlmann J, Menzel C, Buslei R, Kołtowska-Häggsträm M, Strasburger C, Siegel S. PREDICTORS OF QUALITY OF LIFE IN 165 PATIENTS WITH ACROMEGALY: RESULTS FROM A SINGLE-CENTER STUDY. Endocr Pract 2016; 23:79-88. [PMID: 27749131 DOI: 10.4158/ep161373.or] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Even if treated, acromegaly has a considerable impact on patient quality of life (QoL); despite this, the exact clinical determinants of QoL in acromegaly are unknown. This study retrospectively examines a cohort of treated patients with acromegaly, with the aim of identifying these determinants. METHODS Retrospective survey analysis, with 165 patients included in the study. All patients completed a survey, which included demographic data and the clinical details of their disease, the Short Form-36 Health Survey (SF-36), the revised Beck Depression Inventory (BDI-II), and the Bern Embitterment Inventory (BEI). Stepwise regression was used to identify predictors of QoL. RESULTS The strongest predictors of the physical component score of the SF-36 were (in order of declining strength of association): Delay between first presentation of the disease and diagnosis, body mass index (BMI), number of doctors visited before the diagnosis of acromegaly, and age at diagnosis. For the mental component score, the strongest predictors were: number of doctors visited, previous radiotherapy, and age at study entry; and, for the BDI-II score: number of doctors visited, previous radiotherapy, age at study entry, and employment status at the time of diagnosis. The following were predictors of the BEI score: number of doctors visited, and age at study entry. CONCLUSION Diagnostic delay and lack of diagnostic acumen in medical care provision are strong predictors of poor QoL in patients with acromegaly. Other identified parameters are radiotherapy, age, BMI, and employment status. An efficient acromegaly service should address these aspects when devising disease management plans. ABBREVIATIONS BDI-II = Beck Depression Inventory II BEI = Bern Embitterment Inventory BMI = body mass index IGF-1 = insulin-like growth factor 1 MCS = mental component summary (score) PCS = physical component summary (score) QoL = quality of life SDS = standard deviation score SF-36 = Short Form-36 Health Survey.
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43
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Yang Y, Cameron J, Humphris G. The relationship between cancer patient's fear of recurrence and radiotherapy: a systematic review and meta-analysis. Psychooncology 2016; 26:738-746. [DOI: 10.1002/pon.4224] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 07/05/2016] [Accepted: 07/12/2016] [Indexed: 01/25/2023]
Affiliation(s)
- Yuan Yang
- School of Medicine; University of St Andrews; St Andrews UK
| | - Josie Cameron
- Edinburgh Cancer Centre; Western General Hospital; Edinburgh UK
| | - Gerry Humphris
- School of Medicine; University of St Andrews; St Andrews UK
- Edinburgh Cancer Centre; Western General Hospital; Edinburgh UK
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44
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Hernández Blázquez M, Cruzado JA. A longitudinal study on anxiety, depressive and adjustment disorder, suicide ideation and symptoms of emotional distress in patients with cancer undergoing radiotherapy. J Psychosom Res 2016; 87:14-21. [PMID: 27411747 DOI: 10.1016/j.jpsychores.2016.05.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 05/10/2016] [Accepted: 05/29/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of this study is to evaluate the presence of anxiety, depressive and adjustment disorders, suicide ideation, and symptoms of anxiety and depression in patients with cancer before (T1), and after radiotherapy (T2) and at the 1-month follow-up (T3). METHODS A longitudinal study on 103 patients with cancer treated as outpatients undergoing radiotherapy was carried out, evaluating them three times (T1-T2-T3) according to DSM-IV criteria with the Mini-International Neuropsychiatric Interview and the Hospital Anxiety and Depression Scale. RESULTS Prevalence of the depressive disorders was: T1=6.8%, T2=3.9% and T3=3.9%; for anxiety disorders: T1=16.5%, T2=18.4% and T3=16.5%; for adjustment disorder: 10.7%, 5.8% and 7.8%; and for suicide ideation: T1=11.7%, T2=7.8% and T3=7.8%. In all, the presence of disorders was: T1=35%, T2=26.2%0.4% and T3=29.1%. At least one mental disorder was diagnosed in 46.6% of patients in one of the three times of the study. In relation to the symptoms, the prevalence of the possible cases of clinical anxiety was: T1=35.9%, T2=18.4% and T3=22.3%; the prevalence of possible cases of clinical depression was 19.4%, 16.5% and 10.7%, respectively; and the prevalence of emotional distress was 27.2%, 17.5% and 18.4%, respectively. All symptoms decreased significantly from T1 to T2 and from T1 to T3, with moderate effect sizes. No changes were observed between the end of the radiotherapy and the follow-up period. CONCLUSIONS High prevalence of mental disorders and symptoms of anxiety, depression and distress were observed in the patients with cancer before finishing radiotherapy treatment and during the follow-up. FUNDING Basurto University Hospital and Basque Foundation for Innovation and Research in Health-BIOEF.
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Affiliation(s)
| | - Juan Antonio Cruzado
- Faculty of Psychology, Complutense University of Madrid, , 28223 - Madrid, Spain.
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45
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Butlin H, Salter KL, Williams A, Garcia C. PracticeCALM: Coaching Anxiety Lessening Methods for Radiation Therapists: A Pilot Study of a Skills-Based Training Program in Radiation Oncology. J Med Imaging Radiat Sci 2016; 47:147-154.e2. [PMID: 31047178 DOI: 10.1016/j.jmir.2015.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 12/03/2015] [Accepted: 12/07/2015] [Indexed: 11/29/2022]
Abstract
PracticeCALM is an 8-week on-the-job training program to teach radiation therapists (RTs) techniques for assisting patients who are experiencing treatment-related anxiety. Twelve clinical RTs in a regional oncology program were recruited on a volunteer basis to participate in the training. A mixed-method approach was undertaken to evaluate perceived benefits to clinical practice. The quantitative findings from the Perceived Stress Scale (PSS) showed there were no changes before and after training. Qualitative findings showed significant benefits to RTs, including (1) ability to empathically attune more effectively and earlier to signs of anxiety in patients; (2) improved confidence and self-efficacy for effectively intervening in difficult treatment situations; and (3) enhanced creative problem solving in partnership with patients to assist the acutely anxious patient. The PSS results suggest that intrinsic and extrinsic stressors are a variable but consistent part of the everyday reality of RT practice. A training program focusing on the therapeutic presence dimension of RT practice has a direct impact on effectiveness in assisting anxious patients undergoing RT. When embedded in the clinical life of a radiation therapy department, such a training program has the potential to capture the lived practice wisdom and creative skills of RTs, and effectively mediate these skills across a team through group discussions and documentation on patient charts.
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Affiliation(s)
- Helen Butlin
- Graduate Program, Health and Rehabilitation Sciences, University of Western Ontario, London, ON, Canada; Department of Radiation Oncology and Supportive Care, London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada.
| | - Katherine L Salter
- Graduate Program, Health and Rehabilitation Sciences, University of Western Ontario, London, ON, Canada
| | - Amanda Williams
- Department of Radiation Oncology and Supportive Care, London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada
| | - Carla Garcia
- Department of Radiation Oncology and Supportive Care, London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada; Department of Psychiatry, Faculty of Medicine, Psychiatry, University of Western Ontario, London, ON, Canada
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46
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Liénard A, Delevallez F, Razavi D, Gibon AS, Libert Y, Delvaux N, Marchal S, Etienne AM, Bragard I, Reynaert C, Slachmuylder JL, Durieux JF, Farvacques C, Scalliet P, Van Houtte P, Coucke P, Merckaert I. Is it possible to improve communication around radiotherapy delivery: A randomized study to assess the efficacy of team training? Radiother Oncol 2016; 119:361-7. [PMID: 27072941 DOI: 10.1016/j.radonc.2016.03.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/15/2016] [Accepted: 03/20/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND PURPOSE The aim of this study was to assess the efficacy of a 38-h communication skills training program designed for multidisciplinary radiotherapy teams. MATERIALS AND METHODS Four radiotherapy teams were randomly assigned to a training program or to a waiting list. Assessments were scheduled at baseline (T1) and then after the training was completed or four months later (T2), respectively. Communication around radiotherapy delivery was assessed based on audio recordings of the first and last radiotherapy sessions in order to assess team members' communication skills and the expression of concerns by breast cancer patients (analyzed with content analysis software LaComm). RESULTS 198 radiotherapy sessions were recorded. During the first radiotherapy sessions, members of the trained teams exhibited more assessment skills (p=0.048), provided more setting information (p<0.001), and used more social words (p=0.019) compared to the members of the untrained teams. During the last radiotherapy session, members of the trained teams used more assessment skills (p=0.004) and patients interacting with members of the trained teams expressed more sadness words (p=0.023). CONCLUSION Training of multidisciplinary teams has the potential to transfer skills that affect the short exchanges that take place around radiotherapy delivery.
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Affiliation(s)
- Aurore Liénard
- Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Éducation, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Belgium
| | - France Delevallez
- Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Éducation, Belgium
| | - Darius Razavi
- Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Éducation, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Belgium
| | - Anne-Sophie Gibon
- Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Éducation, Belgium
| | - Yves Libert
- Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Éducation, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Belgium
| | - Nicole Delvaux
- Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Éducation, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Belgium; Hôpital Universitaire Erasme, Service de Psychologie, Brussels, Belgium
| | - Serge Marchal
- Institut Jules Bordet, Université Libre de Bruxelles, Belgium; Hôpital Universitaire Erasme, Service de Psychologie, Brussels, Belgium; C.P.O. (Centre de Psycho-Oncologie), Brussels, Belgium
| | - Anne-Marie Etienne
- Université de Liège, Faculté des Sciences Psychologiques et de l'Éducation, Belgium
| | - Isabelle Bragard
- Université de Liège, Faculté des Sciences Psychologiques et de l'Éducation, Belgium
| | - Christine Reynaert
- Université Catholique de Louvain, Faculté de Psychologie et des Sciences de l'Éducation, Louvain-la-Neuve, Belgium; Université Catholique de Louvain, Faculté de Médecine, Louvain-la-Neuve, Belgium
| | | | | | | | - Pierre Scalliet
- Université Catholique de Louvain, Faculté de Médecine, Louvain-la-Neuve, Belgium
| | - Paul Van Houtte
- Institut Jules Bordet, Université Libre de Bruxelles, Belgium; Université Libre de Bruxelles, Faculté de Médecine, Belgium
| | | | - Isabelle Merckaert
- Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Éducation, Belgium; Institut Jules Bordet, Université Libre de Bruxelles, Belgium.
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47
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López E, de la Torre-Luque A, Lazo A, Álvarez J, Buela-Casal G. Assessment of sleep disturbances in patients with cancer: Cross-sectional study in a radiotherapy department. Eur J Oncol Nurs 2016; 20:71-6. [DOI: 10.1016/j.ejon.2014.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 12/27/2014] [Accepted: 12/31/2014] [Indexed: 11/17/2022]
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48
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Mullaney T, Olausson K, Sharp L, Zackrisson B, Edvardsson D, Nyholm T. The influence of a department's psychosocial climate and treatment environment on cancer patients' anxiety during radiotherapy. Eur J Oncol Nurs 2016; 20:113-8. [DOI: 10.1016/j.ejon.2015.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 05/05/2015] [Accepted: 06/19/2015] [Indexed: 11/27/2022]
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49
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Seok SH, Jun SE. Factors Affecting Sleep Quality in Women with Cancer Undergoing Radiotherapy. ASIAN ONCOLOGY NURSING 2016. [DOI: 10.5388/aon.2016.16.1.30] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sung-Hee Seok
- Department of Nursing, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Sang-Eun Jun
- College of Nursing, Keimyung University, Daegu, Korea
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50
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Aouizerat BE, Dhruva A, Paul SM, Cooper BA, Kober KM, Miaskowski C. Phenotypic and Molecular Evidence Suggests That Decrements in Morning and Evening Energy Are Distinct but Related Symptoms. J Pain Symptom Manage 2015; 50:599-614.e3. [PMID: 26031709 PMCID: PMC4624028 DOI: 10.1016/j.jpainsymman.2015.05.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 05/11/2015] [Accepted: 05/19/2015] [Indexed: 10/25/2022]
Abstract
CONTEXT Little is known about energy levels in oncology patients and their family caregivers. OBJECTIVES This study sought to identify latent classes of participants, based on self-reported energy levels and evaluate for differences in phenotypic and genotypic characteristics between these classes. METHODS Energy subscale scores from the Lee Fatigue Scale were used to determine latent class membership. Morning and evening energy scores were obtained just before, during, and for four months after the completion of radiation therapy. Genetic associations were evaluated for 15 proinflammatory and anti-inflammatory cytokine genes. RESULTS Two latent classes with distinct morning energy trajectories were identified. Participants who were younger, female, not married/partnered, black, and had more comorbidities, and a lower functional status were more likely to be in the low morning energy class. Two polymorphisms (IL2 rs1479923 and NFKB1 rs4648110) were associated with morning energy latent class membership. Two latent classes with distinct evening energy trajectories were identified. Participants who were younger and male and who had more comorbidities, decreased body weight, and a lower functional status were more likely to be in the moderate evening energy class. Five different polymorphisms (IL1R2 rs4141134, IL6 rs4719714, IL17A rs8193036, NFKB2 rs1056890, and TNFA rs1800683) were associated with evening energy latent class membership. CONCLUSION This study provides preliminary evidence that decrements in morning and evening energy are associated with different phenotypic risk factors and cytokine gene variations.
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Affiliation(s)
- Bradley E Aouizerat
- School of Nursing, University of California, San Francisco, California, USA; Institute for Human Genetics, University of California, San Francisco, California, USA
| | - Anand Dhruva
- School of Medicine, University of California, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California, USA
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