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Tang CC, Chang JC, Ho SJ, Liu WD, Pan MY, Chang SC, Wang WS, Yeh YC, Chen CH, Wu WW. Exploring the characteristics and antecedents of clinically significant long COVID: A longitudinal cohort study. Life Sci 2024; 357:123114. [PMID: 39369845 DOI: 10.1016/j.lfs.2024.123114] [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: 06/03/2024] [Revised: 09/24/2024] [Accepted: 10/03/2024] [Indexed: 10/08/2024]
Abstract
BACKGROUND A significant number of coronavirus disease 2019 (COVID-19) survivors are experiencing long COVID, with symptoms lasting beyond three months. While diverse long COVID symptoms are established, there are gaps in understanding its long-term trends, intensity, and risk factors, requiring further investigation. AIMS This study aimed to investigate the long COVID characteristics and associated factors by following COVID-19 survivors for one year post-infection and comparing them with healthy counterparts. MAIN METHODS In this longitudinal, correlational study, COVID-19 survivors diagnosed between November 2021 and February 2023 were monitored every three months for a year. Participants aged ≥18 years who had reported a positive COVID-19 test were recruited via social media and healthcare provider referrals. KEY FINDINGS Out of 182 survivors who initially agreed to participate, 176 completed the study. The mean age was 47.56 years (SD = 16.2), and 51.1 % were female. There was a clinically significant decline in cognitive function and health-related quality of life over time, with symptoms like shortness of breath, reduced physical fitness, and increased health concerns. Those with severe acute COVID-19 symptoms experienced greater cognitive and physical declines and more shortness of breath a year later. Lower financial status was linked to poorer health-related quality of life and increased health concerns. SIGNIFICANCE A year post-infection, COVID-19's impact on cognitive function and health-related quality of life remains significant, affecting individuals and communities. Survivors with severe initial symptoms and economic disadvantages need more attention. Future research should identify additional predictors of severe long COVID.
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Affiliation(s)
- Chia-Chun Tang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Jung Chen Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Jung Ho
- Division of Chest Medicine, Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan
| | - Wang-Da Liu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Mei-Yan Pan
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Shih-Chieh Chang
- Division of Chest Medicine, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
| | - Wei-Shin Wang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Chen Yeh
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Hsuan Chen
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Wen Wu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
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Takemura N, Cheung DST, Fong DYT, Hui D, Lee AWM, Lam TC, Ho JCM, Kam TY, Chik JYK, Lin CC. Tai Chi and Aerobic Exercise on Cancer-Related Dyspnea in Advanced Lung Cancer Patients: A Randomized Clinical Trial. J Pain Symptom Manage 2024; 68:171-179. [PMID: 38729532 DOI: 10.1016/j.jpainsymman.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024]
Abstract
CONTEXT Dyspnea, a prevalent and debilitating symptom in patients with advanced lung cancer, negatively affects symptom burden and prognosis. Physical activity has emerged as a promising non-pharmacological intervention for managing dyspnea. OBJECTIVES This study compared the effectiveness of two widely-recognized physical activity modalities, namely Tai Chi (TC) and aerobic exercise (AE) for treating dyspnea in patients with advanced lung cancer. METHODS Patients with advanced lung cancer (n=226) were randomized into TC, AE, or control groups. There was no baseline dyspnea requirement for patients. The AE group received two 60-minute supervised sessions and home-based exercises per month, the TC group received 60-minute sessions twice weekly, and the control group received exercise guidelines for 16 weeks. The primary outcome (sleep quality) of the study has been previously reported. In this secondary analysis, we focused on dyspnea outcomes, including overall and lung cancer-specific dyspnea. Assessments were conducted at baseline (T0), 16 weeks (T1), and one year (T2). RESULTS Compared to the control group, TC significantly improved overall dyspnea at T1 (between-group difference, -8.69; P=0.03) and T2 (between-group difference, -11.45; P=0.01), but not AE. Both AE (between-group difference, -11.04; P=0.01) and TC (between-group difference, -14.19; P<0.001) significantly alleviated lung cancer-specific dyspnea at T2 compared with the control group. CONCLUSION Both TC and AE alleviate dyspnea severity in patients with advanced lung cancer, and continuous exercise can yield substantial improvements. Due to its multi-component nature, Tai Chi has a greater effect on dyspnea.
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Affiliation(s)
- Naomi Takemura
- School of Nursing (N.T., D.S.T.C., D.Y.T.F., C.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing (N.T., D.S.T.C., D.Y.T.F., C.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing (N.T., D.S.T.C., D.Y.T.F., C.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine (D.H.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Anne Wing Mui Lee
- Department of Clinical Oncology (W.M.L., T.C.L.), The University of Hong Kong-Shenzhen Hospital, Guangdong, China; Department of Clinical Oncology (W.M.L., T.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tai-Chung Lam
- Department of Clinical Oncology (W.M.L., T.C.L.), The University of Hong Kong-Shenzhen Hospital, Guangdong, China; Department of Clinical Oncology (W.M.L., T.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - James Chung-Man Ho
- Department of Medicine (J.C.M.H.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tsz Yeung Kam
- Department of Clinical Oncology (T.Y.K.), Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - Jeannie Yin Kwan Chik
- Department of Clinical Oncology (J.Y.K.C.), Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Chia-Chin Lin
- School of Nursing (N.T., D.S.T.C., D.Y.T.F., C.C.L.), Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong; Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing (C.C.L.), Hong Kong.
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Yang X, Bai J, Zhang J, Wang Y, Zhao H, Zhu X. Symptom clusters and their impacts on the quality of life of patients with lung cancer receiving immunotherapy: A cross-sectional study. J Clin Nurs 2024. [PMID: 38886988 DOI: 10.1111/jocn.17321] [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: 01/19/2024] [Revised: 03/22/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024]
Abstract
AIM The objective of this study was to identify symptom clusters in lung cancer patients receiving immunotherapy and explore their impact on the quality of life of patients. BACKGROUND Immunotherapy is widely used in lung cancer; however, there is little understanding of symptom clusters and their impacts on the quality of life of this population. DESIGN Cross-sectional study. METHODS The survey contained the Memorial Symptom Assessment Scale (MSAS), Quality of Life Questionnaire-Lung Cancer 43 and a self-designed General Information Evaluation Form. Symptom clusters were identified using exploratory factor analysis (EFA) based on the symptom scores. Spearman correlation analysis was performed to evaluate the associations between each symptom cluster and the patients' quality of life. Multiple linear regression analysis was employed to examine the impact of the symptom clusters on quality of life. This study adhered to the STROBE guidelines. RESULTS In total, 240 participants completed the survey. Five symptom clusters were identified and named according to their characteristics: emotional-related symptom cluster, lung cancer-related symptom cluster, physical symptom cluster, skin symptom cluster and neural symptom cluster. All symptom clusters, except for the neural symptom cluster, had a significantly detrimental impact on patient quality of life. CONCLUSION Lung cancer patients undergoing immunotherapy experience a range of symptoms, which can be categorized into five clusters. These symptom clusters have a negative impact on patients' quality of life. Future research should focus on developing interventions for each symptom cluster and their influencing factors. PATIENT OR PUBLIC CONTRIBUTION In the data collection phase, lung cancer patients undergoing immunotherapy were recruited to participate in the survey.
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Affiliation(s)
- Xuying Yang
- Zhejiang Chinese Medical University, Hangzhou, China
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingcui Bai
- Department of Respiratory and Critical Care Medicine, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Jinhuang Zhang
- Shanxi Traditional Chinese Medical Hospital, Taiyuan, China
| | - Yanli Wang
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huanping Zhao
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuehua Zhu
- Zhejiang Chinese Medical University, Hangzhou, China
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Chen TC, Wang SH, Ho CM, Lin HC, Tung CL, Chang CC, Tsai CF, Chen TH, Fang YC, Lin WT, Lee YT, Chang YS, Lee MY. Effectiveness of early palliative care in patients with head and neck cancer in Taiwan. J Chin Med Assoc 2024; 87:643-652. [PMID: 38838200 DOI: 10.1097/jcma.0000000000001104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Early palliative care (EPC) benefits some cancers, but its clinical outcomes differ depending on patients' racial and ethnic disparities, and customs. To determine whether EPC improves symptoms, emotional distress, and quality of life among Taiwanese patients with early or advanced-stage head and neck cancer (HNC). METHODS Based on participants' pathological stages, they were categorized as having early and advanced-stage HNC. Those willing and unwilling to undergo EPC were assigned to the EPC and standard groups, respectively. Their daily cancer-related symptoms were assessed using the Distress Thermometer (DT) and MD Anderson Symptom Inventory (MDASI), whose scores' concurrent validity was evaluated using the European Organization for Research and Treatment of Core Quality of Life (EORTC-QLQ-C30) and Head and Neck 35 (EORTC-QLQ-H&N35) questionnaires. RESULTS Patients (n = 93) diagnosed with HNC at Taiwan's Chia-Yi Christian Hospital from November 2020 to October 2022 were recruited. The patients voluntarily split into two groups: EPC groups and standard groups (23 and 11 in early-stage; 46 and 13 in advanced-stage, respectively). DT assessment showed significant emotional distress improvements for all patients with HNC who received EPC. The EORTC-QLQ-C30 questionnaire indicated that, compared to standard interventions, EPC groups significantly improved the quality of life and some symptoms for both early and advanced-stage HNC patients. However, the EORTC-QLQ-H&N35 questionnaire found no significant difference between the two groups. Furthermore, advanced-stage patients' anticancer treatment completion rates with EPC and standard interventions were 95.35% and 75%, respectively. CONCLUSION EPC improves symptoms, emotional distress, quality of life, and treatment completion rates in Taiwanese patients with early or advanced-stage HNC. Nonetheless, further extensive clinical studies are required for validation.
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Affiliation(s)
- Tzu-Chun Chen
- Cancer Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
- Min-Hwei Junior College of Health Care Management, Tainan, Taiwan, ROC
| | - Shih-Hao Wang
- Department of Otolaryngology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
- Department of otolaryngology, St. Martin De Porres Hospital, Chiayi, Taiwan, ROC
| | - Cho-Ming Ho
- Department of Oral and Maxillofacial Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
| | - Hwan-Chung Lin
- Department of Oral and Maxillofacial Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
| | - Chun-Liang Tung
- Department of Oral and Maxillofacial Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
| | - Chih-Chia Chang
- Department of Radiation Therapy and Oncology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
| | - Ching-Fang Tsai
- Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
| | - Yi-Chun Fang
- Cancer Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
| | - Wei-Ting Lin
- Department of Oral and Maxillofacial Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
| | - Yu-Ting Lee
- Department of Internal Medicine, Division of Hemato-Oncology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
| | - Yu-Sung Chang
- Department of Otolaryngology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
| | - Ming-Yang Lee
- Min-Hwei Junior College of Health Care Management, Tainan, Taiwan, ROC
- Department of Internal Medicine, Division of Hemato-Oncology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan, ROC
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Takemura N, Jia S, Lin CC. Financial hardship experience in middle- and older-aged patients with advanced lung cancer. Support Care Cancer 2024; 32:372. [PMID: 38775918 PMCID: PMC11111556 DOI: 10.1007/s00520-024-08571-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Advancements in medical treatments have resulted in increased medical costs for cancer patients. More than half of the patients with advanced lung cancer reported unmet financial needs. The purpose of this study is to examine the differences in the prevalence and correlates of financial hardship between middle- and older-aged patients with advanced lung cancer, and its impact on multiple health-related outcomes. METHODS This study presents a cross-sectional analysis involving 226 patients with advanced lung cancer, who were enrolled in a randomized controlled trial conducted between 2018 and 2020. Data collection was performed through self-reported questionnaires and electronic medical records. Multivariable logistic and linear regression models were adopted for analysis. RESULTS 58.0% reported experiencing financial hardships. Middle-aged participants who were single and had a lower education level were more likely to experience financial difficulties. However, males and higher performance status were associated with a lower likelihood of experiencing financial difficulties among older-aged participants. Financial hardship was significantly associated with anxiety (p < 0.001), depression (p < 0.001), sleep disturbances (p < 0.001), quality of life, global health status (p = 0.002), functional scale score (p < 0.001), symptom scale score (p < 0.001), and lung cancer-specific scale score (p < 0.001). CONCLUSIONS More than half of the patients with advanced lung cancer experienced financial hardships caused by cancer or its treatment, with a higher prevalence reported in middle-aged patients. Different sociodemographic and clinical variables correlated with financial hardship in middle- and older-aged participants, respectively. More attention should be paid to middle-aged patients with advanced lung cancer, particularly during routine assessments.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, Academic Building, The University of Hong Kong, 5/F3 Sassoon Road, Pokfulam, Hong Kong
| | - Shumin Jia
- School of Nursing, Li Ka Shing Faculty of Medicine, Academic Building, The University of Hong Kong, 5/F3 Sassoon Road, Pokfulam, Hong Kong
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, Academic Building, The University of Hong Kong, 5/F3 Sassoon Road, Pokfulam, Hong Kong.
- Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Pokfulam, Hong Kong.
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Takemura N, Cheung DST, Fong DYT, Lee AWM, Lam TC, Ho JCM, Kam TY, Chik JYK, Lin CC. Comparative effect of Tai Chi and aerobic exercise on cognitive function in advanced lung cancer survivors with perceived cognitive impairment: a three-arm randomized controlled trial with mediation analysis. J Cancer Surviv 2024:10.1007/s11764-024-01607-1. [PMID: 38691272 DOI: 10.1007/s11764-024-01607-1] [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: 12/15/2023] [Accepted: 04/17/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE Cancer-related cognitive impairment is prevalent in metastatic lung cancer survivors. This study aimed to compare the effectiveness of aerobic exercise and Tai Chi on perceived cognitive function and the mediating role of psychoneurological symptoms with perceived cognitive impairment. METHODS In a subgroup of a parent randomized clinical trial, participants who reported cognitive impairment underwent a 16-week aerobic exercise (n = 49), Tai Chi (n = 48), and control (n = 54) groups. Measures included perceived cognitive function and psychoneurological symptoms (sleep disturbance, fatigue, anxiety, and depression) assessed at baseline (T0), 16-week (T1), and 1 year (T2). RESULTS Participants in Tai Chi showed significant improvements compared to aerobic exercise and control groups in perceived cognitive function at T1 (AE: between-group difference, 6.52; P < 0.001; CG: 8.34; P < 0.001) and T2 (AE: between-group difference, 3.55; P = 0.05; CG: 5.94; P < 0.001). Sleep disturbance, fatigue, anxiety, and depression at month 12 explained 24%, 31%, 32%, and 24% of the effect of the intervention on cognitive function at month 12, respectively. Only anxiety at month 4 explained 23% of the intervention effect at month 12. CONCLUSIONS Tai Chi demonstrated beneficial effects on cognitive function in advanced lung cancer survivors with perceived cognitive impairment. Improvement in cognitive function was mediated by reducing sleep disturbance, fatigue, anxiety, and depression, highlighting the importance of addressing these symptoms in future interventions to improve cognitive function, with anxiety playing a significant role at an earlier stage. IMPLICATIONS FOR CANCER SURVIVORS Tai Chi is a potentially safe complementary therapeutic option for managing cognitive impairment in this vulnerable population. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04119778; retrospectively registered on 8 October 2019.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Anne Wing Mui Lee
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Guangdong, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tai-Chung Lam
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Guangdong, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - James Chung-Man Ho
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tsz Yeung Kam
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | | | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
- Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Pokfulam, Hong Kong.
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Takemura N, Cheung DST, Fong DYT, Lee AWM, Lam TC, Ho JCM, Kam TY, Chik JYK, Lin CC. Effectiveness of Aerobic Exercise and Tai Chi Interventions on Sleep Quality in Patients With Advanced Lung Cancer: A Randomized Clinical Trial. JAMA Oncol 2024; 10:176-184. [PMID: 38060250 PMCID: PMC10704344 DOI: 10.1001/jamaoncol.2023.5248] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/05/2023] [Indexed: 12/08/2023]
Abstract
Importance Sleep disturbances prevalent among patients with advanced lung cancer can aggravate physical and psychological symptoms, contributing to decreased quality of life and survival. Objective To compare the effectiveness of 2 physical activities of different modalities and intensities, namely aerobic exercise (AE) and tai chi (TC), on subjective sleep quality, physical and psychological outcomes, and survival in patients with advanced lung cancer. Design, Setting, and Participants This assessor-blinded, randomized clinical trial was conducted in 3 public hospitals in Hong Kong between December 19, 2018, and September 7, 2022. A total of 226 patients with advanced lung cancer were recruited and randomized 1:1:1 to AE, TC, or the control group. Interventions For 16 weeks, the AE group received two 60-minute supervised group exercise sessions and home-based exercises per month, and the TC group received 60-minute group sessions twice weekly. The control group received physical activity guidelines. Main Outcomes and Measures The primary outcome was subjective sleep quality. Secondary outcomes included objective sleep measures, anxiety, depression, fatigue, quality of life, physical function, circadian rhythm, and 1-year survival. Assessments were conducted at baseline, 16 weeks (T1), and 1 year (T2). Results The 226 participants had a mean (SD) age of 61.41 (8.73) years, and 122 (54.0%) were female. Compared with the control group, participants in the AE and TC groups showed statistically significant improvements in subjective sleep quality from baseline to T1 (AE: between-group difference, -2.72; 95% CI, -3.97 to -1.46; P < .001; TC: between-group difference, -4.21; 95% CI, -5.48 to -2.94; P < .001) and T2 (AE: between-group difference, -1.75; 95% CI, -3.24 to -0.26; P = .02; TC: between-group difference, -3.95; 95% CI, -5.41 to -2.49; P < .001), psychological distress, physical function, step count, and circadian rhythm. The TC group had a statistically significant greater improvement in sleep than the AE group at T1 (between-group difference, -1.49; 95% CI, -2.77 to -0.22; P = .02) and T2 (between-group difference, -2.20; 95% CI, -3.57 to -0.83; P < .001). Participants in the TC group showed statistically significant improvement in survival compared with the control group. Conclusions and Relevance In this randomized clinical trial, AE and TC improved sleep, psychological distress, physical function, and circadian rhythm, with TC demonstrating greater benefits on sleep and survival. Both exercises, but particularly TC, can be incorporated into lung cancer survivorship care. Trial Registration ClinicalTrials.gov Identifier: NCT04119778.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Anne Wing Mui Lee
- Department of Clinical Oncology, University of Hong Kong–Shenzhen Hospital, Guangdong, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Tai-Chung Lam
- Department of Clinical Oncology, University of Hong Kong–Shenzhen Hospital, Guangdong, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
- Rosemere Cancer Center, Royal Preston Hospital, Lancashire, England, United Kingdom
| | - James Chung-Man Ho
- Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Tsz Yeung Kam
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | | | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
- Alice Ho Miu Ling Nethersole Charity Foundation, Tai Po, Hong Kong
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Wu CX, Li CH, Shiao YH, Cheng HY, Wu TH, Lee CH, Chang ZY, Yeh YC. The effect of a helmet type, home-use low-level light therapy device for chemotherapy-induced alopecia: study protocol for a randomized controlled trial. Trials 2023; 24:789. [PMID: 38053197 DOI: 10.1186/s13063-023-07823-x] [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: 06/30/2022] [Accepted: 11/22/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Alopecia is one of the most common adverse effects of chemotherapy. It reduces the patient's self-esteem and quality of life and the effect of therapy. Scalp cooling is the only verified current method for prevention but success is not guaranteed, particularly after receiving anthracycline-based combinations. Low-level light therapy has been clinically proven to inhibit the progress of androgenic alopecia. A previous study using human subjects shows limited benefits for low-level light therapy for patients who suffer chemotherapy-induced alopecia but an increase in the number of probes and the optimization of light sources may improve the efficacy. This study determines the efficacy of low-level light therapy for the prevention of chemotherapy-induced hair loss for patients with breast cancer using a randomized controlled trial. METHODS One hundred six eligible breast cancer patients were randomly distributed into a low-level light therapy group and a control group, after receiving chemotherapy. Subjects in the low-level light therapy group received 12 courses of intervention within 4 weeks. Subjects in the control group received no intervention but were closely monitored. The primary outcome is measured as the difference in the hair count in a target area between the baseline and at the end of week 4, as measured using a phototrichogram (Sentra scalp analyzer). The secondary outcomes include the change in hair count at the end of week 1, week 2, and week 3 and hair width at the end of week 1, week 2, week 3, and week 4, as measured using a phototrichogram, and the change in distress, the quality of life, and self-esteem due to chemotherapy-induced alopecia, at the end of week 4, as measured using a questionnaire. DISCUSSION This study improves cancer patients' quality of life and provides clinical evidence. TRIAL REGISTRATION Registered at ClinicalTrials.gov- NCT05397457 on 1 June 2022.
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Affiliation(s)
- Cong-Xian Wu
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan
| | - Cheng-Hsin Li
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan
| | - Yi-Hsien Shiao
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan
- Graduate Institute of Natural Products, Chang Gung University, Taoyuan, 333323, Taiwan
| | - Huan-Yu Cheng
- The Institute of Health Policy and Management, National Taiwan University, Taipei, 106319, Taiwan
| | - Tsung-Han Wu
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, 20401, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, 33320, Taiwan
| | - Chun-Hui Lee
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan
| | - Zi-Yu Chang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan
- Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan
| | - Yuan-Chieh Yeh
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan.
- Program in Molecular Medicine, College of Life Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan.
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Yang YL, Chang YC, Cheng WF, Chen YL, Lai YH. Factors Predicting the Health Status of Women with Ovarian Cancer During Five Treatment Phases. Semin Oncol Nurs 2023; 39:151464. [PMID: 37400343 DOI: 10.1016/j.soncn.2023.151464] [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: 01/18/2023] [Revised: 04/07/2023] [Accepted: 05/24/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE The combined impact of disease status and treatment phase on the quality of life (QoL) of women with ovarian cancer has not been fully considered. Therefore, this clinical, epidemiologic study compared the QoL of patients with ovarian cancer between five different treatment phases and identified the factors predicting their QoL through multivariate modeling. DATA SOURCES This study had a cross-sectional survey design. The participants total of 183 were recruited from the inpatient and outpatient departments of the medical center in northern Taiwan. QoL was measured using the Quality of Life Scales QLQ-C30 and QLQ-OV28 and the Pittsburgh Sleep Quality Index. The patient's clinical characteristics data were obtained from the databank of the Taiwan Gynecologic Cancer Network, a registry of active patients being treated with gynecologic cancer. CONCLUSION Chemotherapeutic agents were the major predictors of poor global health status in patients with ovarian cancer. However, good sleep was beneficial to patients' QoL. The study results can be used as a reference to adjust oncological treatment regimens for more effective symptom management and to promote patient education to improve patients' QoL. IMPLICATIONS FOR NURSING PRACTICE The predicting factors can be considered by physicians and nurses to adjust treatment regimens and enhance patient education.
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Affiliation(s)
- Ya-Ling Yang
- Assistant Professor, School of Nursing, College of Medicine, National Taiwan University and Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
| | - Yun-Chen Chang
- Assistant Professor, School of Nursing and Graduate Institute of Nursing, China Medical University and Nursing Department, China Medical University Hospital, Taichung City, Beitun District, Taiwan
| | - Wen-Fang Cheng
- Professor, Department of Obstetrics and Gynecology, Graduate Institute of Oncology & College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Li Chen
- Assistant Professor, Department of Obstetrics and Gynecology, Graduate Institute of Oncology & College of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yeur-Hur Lai
- Professor, School of Nursing, College of Medicine, National Taiwan University and Department of Nursing, National Taiwan University Cancer Center Taipei, Taiwan
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Wang J, Li R, Chang J, Wang Y, Lai Y, Dong Y, Che G. Quality of life between home-based and outpatient pulmonary rehabilitation in patients after surgical resection for lung cancer: protocol for a prospective, single-blind, randomised controlled trial. BMJ Open 2023; 13:e067845. [PMID: 37156593 PMCID: PMC10174035 DOI: 10.1136/bmjopen-2022-067845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION Lung cancer remains a highly fatal disease. Surgical resection has been proven to be the most effective treatment for early-stage lung cancer. The conventional hospital-based pulmonary rehabilitation (PR) is shown to reduce symptoms, improve exercise capacity and impact the quality of life (QoL) for lung cancer patients. To date, scientific evidence on the effectiveness of home-based PR for patients with lung cancer following surgery is scarce. We aim to explore if home-based PR is non-inferior to outpatient PR for patients with lung cancer following surgical resection. METHODS AND ANALYSIS This study is a two-arm, parallel-group, assessor-blind, single-centre, randomised controlled trial. Participants will be recruited from West China Hospital, Sichuan University and randomly allocated to either an outpatient group or a home-based group at a ratio of 1:1. The PR programme involves self-management and exercises. The exercise includes warm-up (10 min), aerobic training (20 min), resistance training (15 min) and cool-down (10 min), lasting 4 weeks, with two sessions per week either at home or in the outpatient setting. The intensity will be adjusted according to the modified Borg rating of perceived exertion and heart rate before and after each exercise session. The primary outcome is QoL measured by EORTC QLQ-C30 & LC 13 after an intervention. Secondary outcomes include physical fitness measured by a 6 min walk test and stair-climbing test and symptom severity measured by patient-reported questionnaires and pulmonary function. The main hypothesis is that home-based PR is non-inferior to outpatient PR for patients with lung cancer following surgical resection. ETHICS AND DISSEMINATION The trial has been approved by the Ethical Committee of West China Hospital and is also registered with the Chinese Clinical Trial Registry. The results of this study will be disseminated through peer-reviewed publications and presentations at national and international conferences. TRIAL REGISTRATION NUMBER ChiCTR2100053714.
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Affiliation(s)
- Jiao Wang
- Department of Rehabilitation Medicine and Institute of Rehabilitation Medicine, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Ran Li
- Department of Rehabilitation Medicine and Institute of Rehabilitation Medicine, Sichuan University West China Hospital, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Junke Chang
- Department of Thoracic Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Yan Wang
- Department of Thoracic Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Yutian Lai
- Lung Cancer Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Yingxian Dong
- Department of Thoracic Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Guowei Che
- Department of Thoracic Surgery, Sichuan University West China Hospital, Chengdu, Sichuan, China
- Lung Cancer Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
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Liu Y, Luo X, Liu J, Ma Y, Tan J, Wang W, Hu J, Fu X, Xu L, Yu F, Xu S, Ma H, Yu X, You Q, Wang Z, Li L, Zhang X, Sun X. Shenlingcao oral liquid for patients with non-small cell lung cancer receiving adjuvant chemotherapy after radical resection: A multicenter randomized controlled trial. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2023; 113:154723. [PMID: 36871476 DOI: 10.1016/j.phymed.2023.154723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/20/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Low quality of life (QoL) in patients with non-small cell lung cancer (NSCLC) receiving adjuvant chemotherapy after radical resection is a major global health issue. High-quality evidence for the effectiveness of Shenlingcao oral liquid (SOL) as a complementary treatment in this patients is lacking at present. PURPOSE To determine whether complementary SOL treatment in NSCLC patients receiving adjuvant chemotherapy would yield greater improvements in QoL than chemotherapy alone. STUDY DESIGN We conducted a multicenter, randomized controlled trial of stages IIA-IIIA NSCLC patients undergoing adjuvant chemotherapy in seven hospitals. METHODS Using stratified blocks, participants were randomized in a 1:1 ratio to receive SOL combined with conventional chemotherapy or conventional chemotherapy alone. The primary outcome was the change in global QoL from baseline to the fourth chemotherapy cycle, and intention-to-treat analysis was applied with a mixed-effect model. Secondary outcomes were functional QoL, symptoms, and performance status scores at the 6-month follow-up. Missing data were handled with multiple imputation and a pattern-mixture model. RESULTS Among 516 randomized patients, 446 (86.43%) completed the study. After the fourth chemotherapy cycle, in comparison with the control group, patients receiving SOL showed a lower reduction in mean global QoL (-2.76 vs. -14.11; mean difference [MD], 11.34; 95% confidence interval [CI], 8.28 to 14.41), greater improvement in physical function (MD, 11.61; 95% CI, 8.57 to 14.65), role function (MD, 10.15; 95% CI, 5.75 to 14.54), and emotional function (MD, 4.71; 95% CI, 1.85 to 7.57), and greater improvements in lung cancer-related symptoms (e.g., fatigue, nausea/vomiting, and appetite loss) and performance status during the 6-month follow-up period (treatment main effect, p < 0.05). CONCLUSION SOL treatment for NSCLC patients receiving adjuvant chemotherapy can significantly improve QoL and performance status within 6 months after radical resection. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03712969.
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Affiliation(s)
- Yanmei Liu
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China; NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China; Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Xiaochao Luo
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China; NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China; Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Jiali Liu
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China; NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China; Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Yu Ma
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China; NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China; Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Jing Tan
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China; NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China; Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Wen Wang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China; NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China; Sichuan Center of Technology Innovation for Real World Data, Chengdu, China
| | - Jian Hu
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou 310003, China
| | - Xiangning Fu
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Lin Xu
- Department of Thoracic Surgery, Jiangsu Key Laboratory of Molecular and Translational Cancer Research, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210029, China
| | - Fenglei Yu
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Shidong Xu
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Haitao Ma
- Department of Thoracic Surgery, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu 215006, China
| | - Xiuyi Yu
- Department of Thoracic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - Qingjun You
- Department of Thoracic Surgery, The Affiliated Hospital of Jiangnan University, Wuxi 214062, China
| | - Zhiqiang Wang
- Department of Thoracic Surgery, The Affiliated Hospital of Jiangnan University, Wuxi 214062, China
| | - Ling Li
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China; NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China; Sichuan Center of Technology Innovation for Real World Data, Chengdu, China.
| | - Xun Zhang
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin 300051, China.
| | - Xin Sun
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China; NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, China; Sichuan Center of Technology Innovation for Real World Data, Chengdu, China.
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12
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Shen WC, Hou MM, Huang TL, Wang CH, Huang YM, Chen JS, Chen ML. Transdermal buprenorphine improves overall quality of life and symptom severity in cancer patients with pain. J Clin Nurs 2023; 32:539-547. [PMID: 35362192 DOI: 10.1111/jocn.16303] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/08/2022] [Accepted: 03/08/2022] [Indexed: 01/17/2023]
Abstract
AIM AND OBJECTIVES This study explored the effect of transdermal buprenorphine on quality of life and six symptoms in cancer patients with pain. BACKGROUND Transdermal opioids offer advantages over traditional routes of administration. The impact of transdermal buprenorphine on quality of life for patients with cancer in Asian populations is unknown. DESIGN This study employed a single-arm observational repeated measures design. Cancer patients with pain were evaluated prior to treatment (baseline). Over a 4-week treatment period, quality of life and symptoms were assessed at 2 and 4 weeks. This study adhered to the recommendations of STROBE guidelines. METHODS This multi-site study was conducted in six hospitals located across northern, middle and southern Taiwan. Adult cancer patients whose pain was previously stable with opioid analgesics and, based on clinical judgement, were able to convert to transdermal buprenorphine treatment were invited to participate. Quality of life was measured with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30). RESULTS Generalised estimating equations showed participants who completed at least one follow-up measurement (N = 80) over 4-weeks had a significant improvement in overall quality of life. Functional status only improved for social functioning. However, symptom severity decreased significantly for nausea/vomiting, pain, insomnia and constipation. CONCLUSIONS The study provides initial evidence supporting transdermal buprenorphine for providing beneficial effects of improving quality of life and reducing severity of symptoms in Asian patients with cancer. RELEVANCE TO CLINICAL PRACTICE The findings of this study can inform the clinical practice that the use of transdermal buprenorphine in cancer patients with pain may also reduce the severity of other symptoms and improve overall quality of life. TRIAL REGISTRATION DETAILS This study was registered in ClinicalTrials.gov. Identifier: NCT04315831.
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Affiliation(s)
- Wen-Chi Shen
- Division of Hematology-Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Chang Gung University, Taoyuan, Taiwan
| | - Ming-Mo Hou
- Division of Hematology-Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Chang Gung University, Taoyuan, Taiwan
| | - Tai-Lin Huang
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Cheng-Hsu Wang
- Chang Gung University, Taoyuan, Taiwan.,Division of Hematology-Oncology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yen-Min Huang
- Division of Hematology-Oncology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Jen-Shi Chen
- Division of Hematology-Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Chang Gung University, Taoyuan, Taiwan
| | - Mei-Ling Chen
- Division of Hematology-Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Chang Gung University, Taoyuan, Taiwan.,School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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13
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Chang CI, Yeh ML, Liao J. Chan-Chuang qigong with breathing meditation improves quality of life and interoceptive awareness in patients with breast cancer: a randomised controlled trial. Support Care Cancer 2023; 31:140. [PMID: 36707489 DOI: 10.1007/s00520-023-07578-w] [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: 06/28/2022] [Accepted: 01/05/2023] [Indexed: 01/29/2023]
Abstract
PURPOSE To evaluate the effect of Chan-Chuang qigong with breathing meditation on quality of life (QoL) and interoceptive awareness in patients with breast cancer during chemotherapy. METHODS This was a randomised controlled trial. Participants were randomly assigned to a qigong group (n = 30), which practised Chan-Chuang qigong with breathing meditation for 15 weeks, and a control group (n = 30), which received routine care. Outcomes were measured by using the European Organization for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ-C30) and Multidimensional Assessment of Interoceptive Awareness (MAIA-C). RESULTS The qigong group, when compared with the control group and baseline, exhibited significantly improved emotional function (p = 0.01) and decreased role function (p = 0.04) at week 15. The MAIA-C indicated a significant difference between groups in self-regulation at week 15 (p = 0.04). Within the qigong group, changes were found in attention regulation (p = 0.03), emotional awareness (p = 0.04), self-regulation (p = 0.01), and body listening (p = 0.002). CONCLUSIONS A 15-week programme of Chan-Chuang qigong with breathing meditation is a simple and safe intervention for patients with breast cancer to improve their emotional function and adjust to their role identity. Participants who practised qigong achieved increased awareness of their own bodies and were able to better regulate their emotion and attention. TRIAL REGISTER ClinicalTrials.gov Identifier: NCT05385146.
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Affiliation(s)
- Ching-I Chang
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Minte Road, Peitou District, Taipei City, 1112303, Taiwan.,Chang Gung University of Science and Technology, No.261, Wenhua 1st Rd., Guishan Dist, Taoyuan City, 333324, Taiwan
| | - Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Minte Road, Peitou District, Taipei City, 1112303, Taiwan.
| | - Justin Liao
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Minte Road, Peitou District, Taipei City, 1112303, Taiwan
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14
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Factors related to quality of life after video-assisted thoracoscopic surgery in patients with stage I adenocarcinoma lung cancer: A longitudinal study. Eur J Oncol Nurs 2022; 61:102225. [DOI: 10.1016/j.ejon.2022.102225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/09/2022] [Indexed: 11/22/2022]
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15
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Conceptualize Health Communication Impacts on Patient Outcomes in Oncology Outpatient Settings: A Mixed-Methods Study. Semin Oncol Nurs 2022:151355. [DOI: 10.1016/j.soncn.2022.151355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 11/15/2022]
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16
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Communication in Oncology Outpatient Clinic Settings: Congruence of Quality of Life Assessment between Patient-Physician and Patient-Caregiver Dyads. JOURNAL OF ONCOLOGY 2022; 2022:5463896. [PMID: 36059805 PMCID: PMC9436590 DOI: 10.1155/2022/5463896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/26/2022] [Accepted: 07/30/2022] [Indexed: 11/17/2022]
Abstract
Objectives The aims of this study were to investigate the congruence of HRQOL reports between patient-physician and patient-caregiver dyads and to determine the association of variables, if any, with the congruence between dyads. Methods This correlational study with a cross-sectional design first approached physicians who provided care for patients with advanced cancer at the participating institution. Then, participating physicians' patients and their caregivers were recruited. All participants were required to independently fill out an HRQOL questionnaire during their outpatient visits. Descriptive statistics, weighted kappa, Wilcoxon signed-rank test, and linear regression were employed for data analysis. Results A total of 52 patient-physician and 27 patient-caregiver dyads were examined. Patients suffered from considerable problems in all three HRQOL domains: symptom, functioning, and overall HRQOL. The patients' level of agreement was moderate with the caregivers and fair with the physicians. A significant relationship was found between several patient-related variables and disagreement. Conclusion These patients with advanced cancer experienced a compromised HRQOL, warranting immediate attention. When there are barriers to obtaining a patient's self-report, clinicians may consider caregivers as a reasonable source. Patients with special characteristics need additional attention because their problems may be at a greater risk of being overlooked.
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Chen Z, He G, Zhao Y, Han C, Xu L, Jian H, Chu Q, He Y. Symptom burden and emotional distress in advanced lung cancer: the moderating effects of physicians' communication skills and patients' disease understanding. Support Care Cancer 2022; 30:9497-9505. [PMID: 35971009 DOI: 10.1007/s00520-022-07323-9] [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: 04/03/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The elevated physical symptom burden in advanced lung cancer can disrupt patients' emotional well-being, and current literature suggests that physicians' good communication skills might be a buffer. However, little is known about for which group of patients this buffering effect is most effective. Based on a cross-sectional study in patients with advanced lung cancer, the present study examined whether the moderating effect of physicians' communication skills on the association between physical symptoms and emotional distress would further depend on patients' perceived disease understanding. METHODS Patients with advanced lung cancer (n = 199) completed a questionnaire including measures of physical symptoms related to lung cancer, anxiety, and depressive symptoms, perceptions of physicians' communication skills, and self-reported understanding of their disease. RESULTS Hierarchical regression analyses indicated a significant three-way interaction among physical symptoms, perceptions of physicians' communication skills, and perceived disease understanding on both anxiety and depression. Specifically, physicians' good communication skills exerted a buffering effect only for patients with lower levels of disease understanding. CONCLUSION Our findings indicate that improving physicians' communication skills may be especially beneficial for reducing the maladaptive emotional reactions to symptom burden for patients with limited disease understanding. When time and resources for communication are restricted, enhanced awareness and focused training may be directed at communicating with patients who possess limited knowledge about their disease.
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Affiliation(s)
- Zhonglin Chen
- Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Rd, Shanghai, 200030, China
| | - Gan He
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No. 227 South Chongqing Rd, Shanghai, 200025, China
| | - Yi Zhao
- Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Rd, Shanghai, 200030, China
| | - Chenyan Han
- Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Rd, Shanghai, 200030, China
| | - Lei Xu
- Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Rd, Shanghai, 200030, China
| | - Hong Jian
- Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Rd, Shanghai, 200030, China
| | - Qiao Chu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No. 227 South Chongqing Rd, Shanghai, 200025, China.
| | - Yaping He
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No. 227 South Chongqing Rd, Shanghai, 200025, China. .,Center for Health Technology Assessment, Shanghai Jiao Tong University China Hospital Development Institute, Shanghai Jiao Tong University, No. 227 South Chongqing Rd, Shanghai, 200025, China.
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Typology of Family Relationships, Psychological Distress, and Quality of Life in Chinese Patients With Advanced Lung Cancer. Cancer Nurs 2021; 45:E655-E662. [DOI: 10.1097/ncc.0000000000000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nonpanya N, Sanookpan K, Joyjamras K, Wichadakul D, Sritularak B, Chaotham C, Chanvorachote P. Norcycloartocarpin targets Akt and suppresses Akt-dependent survival and epithelial-mesenchymal transition in lung cancer cells. PLoS One 2021; 16:e0254929. [PMID: 34383763 PMCID: PMC8360371 DOI: 10.1371/journal.pone.0254929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/06/2021] [Indexed: 12/24/2022] Open
Abstract
In searching for novel targeted therapeutic agents for lung cancer treatment, norcycloartocarpin from Artocarpus gomezianus was reported in this study to promisingly interacted with Akt and exerted the apoptosis induction and epithelial-to-mesenchymal transition suppression. Selective cytotoxic profile of norcycloartocarpin was evidenced with approximately 2-fold higher IC50 in normal dermal papilla cells (DPCs) compared with human lung cancer A549, H460, H23, and H292 cells. We found that norcycloartocarpin suppressed anchorage-independent growth, cell migration, invasion, filopodia formation, and decreased EMT in a dose-dependent manner at 24 h, which were correlated with reduced protein levels of N-cadherin, Vimentin, Slug, p-FAK, p-Akt, as well as Cdc42. In addition, norcycloartocarpin activated apoptosis caspase cascade associating with restoration of p53, down-regulated Bcl-2 and augmented Bax in A549 and H460 cells. Interestingly, norcycloartocarpin showed potential inhibitory role on protein kinase B (Akt) the up-stream dominant molecule controlling EMT and apoptosis. Computational molecular docking analysis further confirmed that norcycloartocarpin has the best binding affinity of -12.52 kcal/mol with Akt protein at its critical active site. As Akt has recently recognized as an attractive molecular target for therapeutic approaches, these findings support its use as a plant-derived anticancer agent in cancer therapy.
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Affiliation(s)
- Nongyao Nonpanya
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Kittipong Sanookpan
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Keerati Joyjamras
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Graduate Program of Pharmaceutical Sciences and Technology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Duangdao Wichadakul
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Boonchoo Sritularak
- Departments of Pharmacognosy and Pharmaceutical Botany, Chulalongkorn University, Bangkok, Thailand
| | - Chatchai Chaotham
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Pithi Chanvorachote
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
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Kuo HJ, Chang NT, Tien YW, Chou YJ, Shun SC. Determinants of Quality of Life in Individuals With a Dual Diagnosis of Resectable Pancreatic Cancer and Diabetes Mellitus. Oncol Nurs Forum 2021; 48:390-402. [PMID: 34142999 DOI: 10.1188/21.onf.390-402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To explore the associations among clinical characteristics, fatigue, diabetes mellitus (DM) self-care activities, and quality of life (QOL) in individuals with resectable pancreatic cancer and DM. SAMPLE & SETTING 57 individuals with resectable pancreatic cancer and DM from an outpatient pancreatic surgical department in Taiwan were included in the final analysis. METHODS & VARIABLES A cross-sectional, correlational design was used. QOL, fatigue, and DM self-care were measured by the European Organisation for Research and Treatment of Cancer QOL Questionnaire-Core 30, the Fatigue Symptom Inventory, and the Summary of Diabetes Self-Care Activities. RESULTS Participants who had a shorter duration of DM and higher levels of fatigue (including intensity, duration, and interference) reported lower QOL scores. Participants who performed more DM self-care activities and physical activity per week had higher QOL scores. Fatigue, DM self-care activities, and DM duration were significant factors related to QOL. IMPLICATIONS FOR NURSING Shorter DM duration, increased fatigue, and fewer DM self-care activities were determinants of worse QOL in individuals with resectable pancreatic cancer and DM.
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Rashid HU, Rashid M, Khan N, Ansari SS, Bibi N. Taking a step down on the reconstruction ladder for head and neck reconstruction during the COVID-19 pandemic. BMC Surg 2021; 21:120. [PMID: 33685447 PMCID: PMC7938274 DOI: 10.1186/s12893-021-01134-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/01/2021] [Indexed: 01/08/2023] Open
Abstract
Background Most of the head and neck cancers are time-critical and need urgent surgical treatment. Our unit is one of the departments in the region, at the forefront in treating head and neck cancers in Pakistan. We have continued treating these patients in the COVID-19 pandemic with certain modified protocols. The objective of this study is to share our experience and approach towards head and neck reconstruction during the COVID-19 pandemic. Results There were a total of 31 patients, 20 (64.5%) were males and 11 (35.4%) patients were females. The mean age of patients was 52 years. Patients presented with different pathologies, i.e. Squamous cell carcinoma n = 26 (83.8%), mucoepidermoid carcinoma n = 2 (6.4%), adenoid cystic carcinoma n = 2 (6.4%) and mucormycosis n = 1 (3%). The reconstruction was done with loco-regional flaps like temporalis muscle flap n = 12 (38.7%), Pectoralis major myocutaneous flap n = 8 (25.8%), supraclavicular artery flap n = 10 (32.2%) and combination of fore-head, temporalis major and cheek rotation flaps n = 1 (3%). Defects involved different regions like maxilla n = 11 (35.4%), buccal mucosa n = 6 (19.3%), tongue with floor of mouth n = 6 (19.3%), mandible n = 4 (12.9%), parotid gland, mastoid n = 3 (9.6%) and combination of defects n = 1 (3%). Metal reconstruction plate was used in 3 (9.6%) patients with mandibular defects. All flaps survived, with the maximum follow-up of 8 months and minimum follow-up of 6 months. Conclusion Pedicled flaps are proving as the workhorse for head and neck reconstruction in unique global health crisis. Vigilant use of proper PPE and adherence to the ethical principles proves to be the only shield that will benefit patients, HCW and health system.
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Affiliation(s)
- Haroon Ur Rashid
- Plastic Surgery Department, Shifa International Hospital, Pitras Bukhari Road H-8, Islamabad, Pakistan.
| | - Mamoon Rashid
- Plastic Surgery Department, Shifa International Hospital, Pitras Bukhari Road H-8, Islamabad, Pakistan
| | - Nasir Khan
- Plastic Surgery Department, Shifa International Hospital, Pitras Bukhari Road H-8, Islamabad, Pakistan
| | | | - Noshi Bibi
- Plastic Surgery Department, Shifa International Hospital, Pitras Bukhari Road H-8, Islamabad, Pakistan
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22
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Cheung DST, Takemura N, Lam TC, Ho JCM, Deng W, Smith R, Yan Y, Lee AWM, Lin CC. Feasibility of Aerobic Exercise and Tai-Chi Interventions in Advanced Lung Cancer Patients: A Randomized Controlled Trial. Integr Cancer Ther 2021; 20:15347354211033352. [PMID: 34549648 PMCID: PMC8461121 DOI: 10.1177/15347354211033352] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/04/2021] [Accepted: 06/30/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND A majority of lung cancer patients are diagnosed at advanced stages. Although there is considerable evidence of the benefits of aerobic exercise and tai-chi for lung cancer patients, little is known about the comparative effectiveness of the 2 exercise modes in advanced lung cancer patients. OBJECTIVES To explore the feasibility and preliminary effects of aerobic exercise and tai-chi interventions on survival and well-being among advanced lung cancer patients. METHODS In an assessor-blinded, exploratory randomized controlled trial, 30 advanced lung cancer patients were randomized to an aerobic exercise group, a tai-chi group (both attending 12-week, twice-weekly supervised sessions), or a self-management control group (receiving written exercise guidelines). The primary outcomes focused on feasibility including intervention completion, exercise adherence, and adverse events, while the secondary outcomes addressed preliminary effects and included 1-year survival, cancer symptoms (Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Score, Brief Fatigue Inventory), quality of life (EORTC QLQ-C30, QLQ-LC13), physical performance (6-minute walk test, up-and-go, sit-to-stand, 1-leg standing), activity levels (actigraph), and circadian rhythms (salivary cortisol). RESULTS Intervention feasibility was established with a satisfactory completion rate at post-intervention for the aerobic exercise group (80%) and the tai-chi group (78%). The tai-chi group attained higher adherence than the exercise group in terms of attendance in supervised sessions (89% vs 75% of scheduled classes) and self-practice (225% vs 87% of the prescribed amount). Higher adherence to self-practice in the tai-chi group remained at the 6-month follow-up (81% vs 38% of the prescribed amount). No adverse event as a result of the intervention was reported. Effect-related outcomes did not show statistically significant changes in any group, except an improvement post-intervention in the up-and-go (-2.26, 95% CI: -4.04, -0.48) and sit-to-stand tests (4.52, 95% CI: 2.19, 6.85) in the aerobic exercise group. CONCLUSIONS The findings support the feasibility of aerobic exercise and tai-chi interventions in advanced lung cancer patients. A future study with a larger sample from multiple sites is recommended to confirm the comparative effects of the 2 exercise interventions relative to the self-management group and to enhance the generalizability of the findings.
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Affiliation(s)
| | | | - Tai Chung Lam
- The University of Hong Kong, Hong Kong,
China
- The University of Hong Kong-Shenzhen
Hospital, Shenzhen, China
| | | | - Wen Deng
- The University of Hong Kong, Hong Kong,
China
| | | | - Yinxia Yan
- The University of Hong Kong, Hong Kong,
China
| | - Anne Wing Mui Lee
- The University of Hong Kong, Hong Kong,
China
- The University of Hong Kong-Shenzhen
Hospital, Shenzhen, China
| | - Chia Chin Lin
- The University of Hong Kong, Hong Kong,
China
- Taipei Medical University, Taipei
- Alice Ho Miu Ling Nethersole Charity
Foundation Professorship in Nursing, Hong Kong, China
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23
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Tsai JM, Hsu CY, Tsai LY, Tsay SL. Translation and validation of Taiwan Chinese version of the self-regulation questionnaire for gynecologic cancer survivors. Taiwan J Obstet Gynecol 2020; 58:614-620. [PMID: 31542081 DOI: 10.1016/j.tjog.2019.05.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To culturally adapt the self-regulation questionnaire to the Taiwan Chinese version (TC-SRQ) and to evaluate its psychometric properties for gynecologic cancer survivors. MATERIALS AND METHODS A cross-sectional study was employed with a purposive sample of 287 gynecologic cancer survivors. The TC-SRQ was adapted from a Germany version through back-translation to ensure its quality. For construct validity, confirmatory factor analysis (CFA) was used to assess the TC-SRQ measurement model with fit indexes including the χ2 test, the root mean square error of approximation (RMSEA), and the normed fit index (NFI), the comparative fit index (CFI), and non-normed fit indices (NNFI). For concurrent validity, the Taiwanese version of the European Organization for Research and Treatment of Cancer's 30-item core quality of life (EORTC QLQ-C30) questionnaire was used as a criterion measure for quality of life (QOL). Reliability was evaluated by internal consistency and test-retest reliability. RESULTS For a modified measurement model of TC-SRQ, the model fit (χ2 = 311.23, P = .0; RMSEA = .088; NFI = .97, CFI = .98, NNFI = .97) was acceptable. The evidence of construct validity of TC-SRQ scale was confirmed by the model estimates. TC-SRQ correlated positively with the global QOL, physical, cognitive, emotional, and social functioning domains, and negatively with fatigue and pain domains of EORTC QLQ-C30. For known groups validity, TC-SRQ was correlated with groups attributed by age, family support, health status, and sleep quality. A Cronbach's α of .91 indicated good internal consistency; the test-retest reliability was .82. CONCLUSIONS TC-SRQ is a valid and reliable instrument for assessing self-regulation in gynecologic cancer survivors.
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Affiliation(s)
- Jung-Mei Tsai
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan; Mackay Memorial Hospital, Taipei City, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan; Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
| | - Chen-Yuan Hsu
- Department of Nursing, Dayeh University, Changhua, Taiwan
| | - Li-Yun Tsai
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan.
| | - Shiow-Luan Tsay
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan.
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24
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Arunmanee W, Ecoy GAU, Khine HEE, Duangkaew M, Prompetchara E, Chanvorachote P, Chaotham C. Colicin N Mediates Apoptosis and Suppresses Integrin-Modulated Survival in Human Lung Cancer Cells. Molecules 2020; 25:E816. [PMID: 32069989 PMCID: PMC7070259 DOI: 10.3390/molecules25040816] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/06/2020] [Accepted: 02/12/2020] [Indexed: 01/26/2023] Open
Abstract
The inherent limitations, including serious side-effects and drug resistance, of current chemotherapies necessitate the search for alternative treatments especially for lung cancer. Herein, the anticancer activity of colicin N, bacteria-produced antibiotic peptide, was investigated in various human lung cancer cells. After 24 h of treatment, colicin N at 5-15 µM selectively caused cytotoxicity detected by MTT assay in human lung cancer H460, H292 and H23 cells with no noticeable cell death in human dermal papilla DPCs cells. Flow cytometry analysis of annexin V-FITC/propidium iodide indicated that colicin N primarily induced apoptosis in human lung cancer cells. The activation of extrinsic apoptosis evidenced with the reduction of c-FLIP and caspase-8, as well as the modulation of intrinsic apoptosis signaling proteins including Bax and Mcl-1 were observed via Western blot analysis in lung cancer cells cultured with colicin N (10-15 µM) for 12 h. Moreover, 5-15 µM of colicin N down-regulated the expression of activated Akt (p-Akt) and its upstream survival molecules, integrin β1 and αV in human lung cancer cells. Taken together, colicin N exhibits selective anticancer activity associated with suppression of integrin-modulated survival which potentiate the development of a novel therapy with high safety profile for treatment of human lung cancer.
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Affiliation(s)
- Wanatchaporn Arunmanee
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand; (W.A.); (G.A.U.E.); (H.E.E.K.); (M.D.)
- Vaccines and Therapeutic Proteins Research Group, the Special Task Force for Activating Research (STAR), Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Gea Abigail U. Ecoy
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand; (W.A.); (G.A.U.E.); (H.E.E.K.); (M.D.)
- Department of Pharmacy, School of Health Care Professions, University of San Carlos, Cebu 6000, Philippines
| | - Hnin Ei Ei Khine
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand; (W.A.); (G.A.U.E.); (H.E.E.K.); (M.D.)
| | - Methawee Duangkaew
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand; (W.A.); (G.A.U.E.); (H.E.E.K.); (M.D.)
- Vaccines and Therapeutic Proteins Research Group, the Special Task Force for Activating Research (STAR), Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Eakachai Prompetchara
- Vaccines and Therapeutic Proteins Research Group, the Special Task Force for Activating Research (STAR), Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand;
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Center of Excellence in Vaccine Research and Development (Chula Vaccine Research Center-Chula VRC), Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Pithi Chanvorachote
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand
- Cell-based Drug and Health Products Development Research Unit, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand
| | - Chatchai Chaotham
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand; (W.A.); (G.A.U.E.); (H.E.E.K.); (M.D.)
- Cell-based Drug and Health Products Development Research Unit, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand
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25
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Huang ZP, Cheng HL, Loh SY, Cheng KKF. Functional Status, Supportive Care Needs, and Health-Related Quality of Life in Advanced Lung Cancer Patients Aged 50 and Older. Asia Pac J Oncol Nurs 2020; 7:151-160. [PMID: 32478132 PMCID: PMC7233568 DOI: 10.4103/apjon.apjon_50_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/06/2019] [Indexed: 01/10/2023] Open
Abstract
Objective: This study aimed to examine the levels of functional status, supportive care needs, and health-related quality of life (HRQOL), and their relationships reported by advanced lung cancer patients aged 50 and older. Methods: A cross-sectional descriptive correlational study was conducted with 103 participants recruited from a cancer center in Singapore. Functional status, supportive care needs, and HRQOL were measured using validated instruments. Descriptive statistics were used to describe the sample profiles. Univariate and multivariate regression analyses were adopted to determine factors that were associated with HRQOL. Results: About 70.9% of participants were dependent in at least one instrumental activities of daily living (IADL). The mean number of unmet needs rated by participants was 9 (range = 0–28). The top three ranked items with moderate-to-severe unmet needs were “not being able to do things you used to do” (28.2%), “fear about cancer spreading” (25.3%), and “lack of energy/tiredness” (25.2%). Higher IADL scores were significantly associated with better HRQOL, whereas higher levels of supportive care needs, particularly in psychological domain significantly predicted poorer HRQOL in most domains. Conclusions: This study found that poor functional status and unmet supportive care needs are common in advanced lung cancer patients. Psychological needs and functional status are associated with patients' HRQOL. Future interventions incorporating functional assistance and psychological support may increase HRQOL in this population.
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Affiliation(s)
- Zhe-Peng Huang
- National Cancer Centre, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hui-Lin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Soon Yue Loh
- National Cancer Centre, The Hong Kong Polytechnic University, Hong Kong, China
| | - Karis Kin Fong Cheng
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
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26
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Wang Z, Li S, Wu L, Qi Q, Liu H, Jin X, Tian J, Zhang M, Ma X, Sun D, Xu S, Wu H. Effect of acupuncture on lung cancer-related fatigue: study protocol for a multi-center randomized controlled trial. Trials 2019; 20:625. [PMID: 31706345 PMCID: PMC6842537 DOI: 10.1186/s13063-019-3701-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/04/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Fatigue is one of the primary symptoms in lung cancer, with a prevalence of 88.0% in survivors of cancer, and an even higher prevalence post resection surgery. Effective fatigue control after lung cancer surgery is important for patient recovery and quality of life. Some studies have shown that acupuncture might be effective in treating cancer-related fatigue; however, randomized controlled trials (RCTs) of suitable sample size are limited. METHOD/DESIGN This is a multi-center, patient-blinded RCT. A total of 320 eligible patients will be recruited in four centers and randomly assigned to either the acupuncture group or the sham acupuncture group in a 1:1 ratio. Treatment will be given twice per week for 12 sessions. Treatment will be given at acupoints GV20, GV29, CV12, CV6, CV4, and bilateral LI4, LR3, SP6, ST36. The primary outcome will be assessed using the Chinese version of The Brief Fatigue Inventory. The secondary outcomes will be measured using The European Organization for Research and The Treatment of Cancer Quality of Life Questionnaire, and the Hamilton Rating Scale for Depression. The primary outcome will be assessed at all main points (baseline, the 3rd week, the 6th week, and at follow up time points) and the secondary outcomes will be assessed at baseline and the 6th week. Intention-to-treat analysis will be used in this RCT. DISCUSSION This trial protocol provides an example of the clinical application acupuncture treatment in the management of lung cancer-related fatigue. If the acupuncture treatment protocol confirms that acupuncture is an effective and safe option for lung cancer-related fatigue, it can be adopted as a standardized treatment. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1900022831. Registered on 27 April 2019. URL: http://www.chictr.org.cn/showproj.aspx?proj=37823.
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Affiliation(s)
- Zhaoqin Wang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
| | - Shanshan Li
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071 China
| | - Luyi Wu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
| | - Qin Qi
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437 China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
| | - Huirong Liu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
| | - Xiaoming Jin
- Stark Neurosciences Research Institute & Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN 46202 USA
| | - Jianhui Tian
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Ming Zhang
- Shanghai Chest Hospital, Shanghai, 200030 China
| | - Xiaopeng Ma
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
| | - Deli Sun
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032 China
| | - Shifen Xu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071 China
| | - Huangan Wu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, 200030 China
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27
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Lee YH, Hu CC, Humphris G, Huang IC, You KL, Jhang SY, Chen JS, Lai YH. Screening for fear of cancer recurrence: Instrument validation and current status in early stage lung cancer patients. J Formos Med Assoc 2019; 119:1101-1108. [PMID: 31677865 DOI: 10.1016/j.jfma.2019.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/27/2019] [Accepted: 10/07/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is one of the most distressing concerns for cancer patients. A psychometrically validated brief scale is urgently needed for use in busy clinical oncology settings. This study aimed to (1) develop and validate the 7-item fear of cancer recurrence scale Chinese version (FCR7-C), and (2) explore the severity of FCR in post-operative early-stage lung cancer patients in Taiwan. METHODS Early-stage lung cancer patients were recruited from a medical center in Taiwan. The FCR7-C was evaluated for content and construct validity and internal consistency reliability. Construct validity of FCR7-C was determined by the empirically supported correlation and confirmatory factor analysis (CFA). RESULTS A total of 160 subjects were recruited. The FCR7-C was shown to have satisfactory content validity and internal consistency reliability (Cronbach's α = 0.9). The uni-dimensional structure was confirmed by CFA that showed a good fit for the model. The FCR7-C score correlates positively with the degree of most of the physical symptoms, anxiety, and depression, but correlates negatively with patient age, performance status, and quality of life. We found that 81.9% of patients reported at least some FCR, with a mean FCR severity of 15.18 (SD = 7.78). CONCLUSION FCR7-C is a brief screening tool with good psychometrics. Patients with early-stage lung cancer still revealed mild to moderate level of FCR. Applying the FCR7-C for to screen cancer patients' distress and further develop personalized psychological interventions would be strongly suggested.
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Affiliation(s)
- Yun-Hsiang Lee
- School of Nursing, National Taiwan University, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chan-Chuan Hu
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Gerry Humphris
- Health Psychology, Bute Medical School, University of St Andrews, St Andrews, UK
| | - I-Chin Huang
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kai-Lin You
- School of Nursing, National Taiwan University, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sin-Yuan Jhang
- Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Jin-Shing Chen
- Department of Thoracic Surgery, National Taiwan University Hospital, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yeur-Hur Lai
- School of Nursing, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan.
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28
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Kuo HJ, Tien YW, Chang NT, Chou YJ, Shun SC. Comparison of Fatigue and Quality of Life in Individuals With Pancreatogenic Diabetes After Total or Partial Pancreatectomy. Oncol Nurs Forum 2019; 46:E159-E170. [DOI: 10.1188/19.onf.e159-e170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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29
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Liao LJ, Hsu WL, Lo WC, Cheng PW, Shueng PW, Hsieh CH. Health-related quality of life and utility in head and neck cancer survivors. BMC Cancer 2019; 19:425. [PMID: 31064331 PMCID: PMC6505071 DOI: 10.1186/s12885-019-5614-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 04/15/2019] [Indexed: 11/25/2022] Open
Abstract
Background This study seeks to assess quality of life (QOL) and utility scores of head and neck cancer survivors. Methods We compared QOL as indicated by EORTC QLQ-C30, QLQ-H&N35, utility scores by time trade off (TTO) with previous published reference values and tested series characteristics related to global QOL and utility. Results A total of 127 patients were recruited. Of the patients, 102 (80%) completed the utility assessment. Cancer survivors had lower scores compared with norm values. Patients without a spouse had a lower utility than those with a spouse. Patients with a low annual family income also had lower global QOL and utility scores (p < 0.05). Other factors were not significantly related to QOL and utility scores. Conclusion Disease and treatment of head and neck cancer lead to disability and poor health-related QOL and utility. Economic status may contribute to health-related QOL and utility, while marital status is related to utility for head and neck cancer patients.
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Affiliation(s)
- Li-Jen Liao
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan
| | - Wan-Lun Hsu
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology, Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chen-Hsi Hsieh
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan. .,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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30
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Li L, Chan SL, Mo F, Hui EP, Koh J, Chan AK, Tang NL, Chu CM, Hui J, Lee KF, Yu S, Yeo W. Status of inflammation in relation to health related quality of life in hepatocellular carcinoma patients. Qual Life Res 2019; 28:2597-2607. [PMID: 31037590 DOI: 10.1007/s11136-019-02190-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE Both Inflammation and health-related quality of life (HRQoL) are independent prognosticators in HCC patients. We hypothesized that inflammation can cause impairment in HRQoL and investigated the correlation between inflammatory status and HRQoL in HCC patients. METHODS Clinical, laboratory and HRQoL (using EORTC QLQ-C30, QLQ-HCC18, C30 and HCC18 index-scores) data were prospectively collected from HCC patients at diagnosis. Correlation analyses were performed between HRQoL and inflammation-based markers including C-reactive protein (CRP), CRP/albumin ratio (CRP/alb), Glasgow Prognostic Score (GPS), Inflammation-Based Index (IBI) and Prognostic Index (PI). RESULTS Among 445 HCC patients, higher inflammatory states were significantly correlated with worse HRQoL. For CRP and CRP/alb ratio, the HRQoL factors with higher correlations included C30 and HCC18 index-scores, certain QLQ-C30 domains and items ('physical functioning', 'role functioning', 'fatigue', 'pain', 'appetite loss') and QLQ-HCC18 items ('fatigue', 'body image', 'nutrition' and 'abdominal swelling'), where the Pearson's correlation coefficients were up to 0.416. Multivariate analyses indicated that worse HRQoL factors were significantly correlated with worse scores in GPS, IBI and PI. CONCLUSION In HCC patients, inflammatory status correlates with HRQoL at presentation. In particular, relatively stronger correlations with CRP-based markers have been observed in HRQoL scales that assess constitutional symptoms (QLQ-C30 'physical functioning', 'role functioning', 'fatigue', 'appetite loss' and QLQ-HCC18 'fatigue' and 'nutrition') and tumor burden (QLQ-C30 'pain' and QLQ-HCC18 'abdominal swelling' and 'body image'). Future studies are warranted to evaluate whether intervention that reduces inflammation could improve HRQoL in HCC patients.
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Affiliation(s)
- Leung Li
- State Key Laboratory of Translational Oncology, Department of Clinical Oncology, Faculty of Medicine, Prince of Wales Hospital, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, Hong Kong
| | - Stephen L Chan
- State Key Laboratory of Translational Oncology, Department of Clinical Oncology, Faculty of Medicine, Prince of Wales Hospital, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, Hong Kong
| | - Frankie Mo
- State Key Laboratory of Translational Oncology, Department of Clinical Oncology, Faculty of Medicine, Prince of Wales Hospital, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, Hong Kong
| | - Edwin P Hui
- State Key Laboratory of Translational Oncology, Department of Clinical Oncology, Faculty of Medicine, Prince of Wales Hospital, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, Hong Kong
| | - Jane Koh
- State Key Laboratory of Translational Oncology, Department of Clinical Oncology, Faculty of Medicine, Prince of Wales Hospital, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, Hong Kong
| | - Allen Kc Chan
- Department of Chemical Pathology, Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Nelson Ls Tang
- Department of Chemical Pathology, Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Cheuk M Chu
- Department of Imaging and Interventional Radiology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Joyce Hui
- Department of Imaging and Interventional Radiology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Kit F Lee
- Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, Hong Kong
| | - Simon Yu
- Department of Imaging and Interventional Radiology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Winnie Yeo
- State Key Laboratory of Translational Oncology, Department of Clinical Oncology, Faculty of Medicine, Prince of Wales Hospital, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, Hong Kong.
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Chinese Version of the Assessment of Survivor Concerns Scale for Gynecological Cancer Survivors: A Psychometric Study in Taiwan. J Nurs Res 2019; 27:e41. [PMID: 30908430 PMCID: PMC6752688 DOI: 10.1097/jnr.0000000000000323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Most gynecological cancer survivors outlive the acute stage, and many reach permanent survival. However, the fear of cancer recurrence (FCR) is stressful and affects quality of life. Purpose: This study was designed to validate a Chinese version of the Assessment of Survivor Concerns (ASC) questionnaire in terms of its ability to assess FCR in gynecological cancer survivors. Methods: A two-stage study procedure was employed. The first stage involved the translation of the ASC questionnaire from English into Chinese using the methods proposed by Guillemin, which include translation, back-translation, consensus meetings, and a trial of potential users. In the second stage, a pilot study was completed with 37 gynecological cancer survivors followed by a psychometric property study with 287 gynecological cancer survivors. Construct validity was determined using confirmatory factor analysis (CFA) with structural equation modeling. Convergent validity was determined using composite reliability and the average variance extracted values of the ASC model. Discriminant validity was determined by comparing the model fitness of the ASC model against the model fitness of a one-construct model. Concurrent criterion validity was assessed using the European Organization for Research and Treatment of Cancer's Quality-of-Life Questionnaire Core 30 as the auxiliary instrument. Reliability was determined by measuring the internal consistency reliability using Cronbach's α in addition to the 3-week test–retest reliability with a 95% confidence interval of the intraclass correlation coefficient. Results: The process of translation and back-translation was performed to ensure the conceptual equivalence of the Chinese version with the original ASC questionnaire. For CFA, the fit indices of the ASC model (χ2 = 9.87, p > .05; root mean square error of approximation = .03. comparative fit index = 1, nonnormed fit index = 1) indicated appropriate model fitness. For convergent validity, the composite reliability and average variance extracted values of the ASC model were satisfactory. For discriminant validity, the model fitness of the ASC model was significantly improved over the one-construct model. For concurrent criterion validity, the ASC scores correlated negatively with the scores of the global quality of life and the five functions (physical, role, cognition, emotions, and social) of the European Organization for Research and Treatment of Cancer's Quality-of-Life Questionnaire Core 30, as hypothesized. For reliability, the Cronbach's α and the 95% confidence interval of intraclass correlation coefficient for the ASC model were .91 and [.18, .68], respectively. Conclusions/Implications for Practice: The Chinese version of the ASC questionnaire is a valid and reliable instrument that is suitable for assessing FCR in gynecological cancer survivors in clinical and research settings.
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Yang P. Maximizing quality of life remains an ultimate goal in the era of precision medicine: exemplified by lung cancer. PRECISION CLINICAL MEDICINE 2019; 2:8-12. [PMID: 35694702 PMCID: PMC8985777 DOI: 10.1093/pcmedi/pbz001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 11/23/2022] Open
Abstract
An ultimate goal of precision medicine in lung cancer treatment is to restore patient health with maximized quality of life (QOL). Results from Mayo Clinic studies show that a significant improvement in fatigue, dyspnea, and pain scales could lead to better overall QOL. Although treatments and guidelines for clinical implementation to alleviate these key symptoms are available, few cancer patients receive adequate therapy, mostly because of limitations in current care delivery systems and unclear clinicians’ roles. For optimal care of lung cancer survivors in different subpopulations, three barriers must be overcome: physicians’ lack of knowledge, unwarranted practice variation, and uncertainty regarding care provider roles. Appropriate culturally adapted, tested and validated tools for QOL measures must be developed, rather than directly translating existing tools between different languages and across cultures or diverse subpopulations. Finally, lack of sensitive, adequate, and relevant tools in measuring health-related QOL (HRQOL) has long been an issue for effective data collection, demanding a global consensus on a set of core components that reflect the needs of all critical parties for the best cure and care, supporting patients to achieve optimal HRQOL.
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Affiliation(s)
- Ping Yang
- Mayo Clinic College of Medicine and Science, Mayo Clinic Arizona, 13400 E. Shea Boulevard, Scottsdale, AZ, USA
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Huang CC, Kuo HP, Lin YE, Chen SC. Effects of a Web-based Health Education Program on Quality of Life and Symptom Distress of Initially Diagnosed Advanced Non-Small Cell Lung Cancer Patients: A Randomized Controlled Trial. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:41-49. [PMID: 28780685 DOI: 10.1007/s13187-017-1263-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Advanced non-small cell lung cancer (NSCLC) patients treated with chemotherapy experience functional decline and decreased quality of life. The purpose of this study was to evaluate the effects of a web-based health education program on global quality of life, quality of life-related functional dimensions, and symptom distress of initially diagnosed advanced non-small cell lung cancer patients. This study used a randomized, pre- and post-repeated measures design. A total of 55 participants were randomly assigned to an experimental group (n = 27) and a control group (n = 28). The experimental group participated in a web-based health education program, and the control group received usual care. Patients were assessed at 4 time points: baseline assessment (T0), and then 1, 2, and 3 months (T1, T2, and T3) after participating in the web-based health education program or receiving usual care. Patients in the experimental group had significantly greater global quality of life and emotional function, and significantly less top ten significant symptom distresses compared to those in the control group. There were no differences between the groups and within groups with respect to physical function, role function, cognitive function, and social function. The web-based health education can improve global quality of life, emotional function, and top ten significant symptom distresses in patients receiving chemotherapy during the first 3 months after initial diagnosis of advanced NSCLC. Web-based health education can improve quality of life and lessen distress of initially diagnosed NSCLC patients treated with chemotherapy.
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Affiliation(s)
- Chi-Chin Huang
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Han-Pin Kuo
- Department of Chest Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yueh-E Lin
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Road, Kweishan, Taoyuan, 333, Taiwan
| | - Shu-Ching Chen
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Road, Kweishan, Taoyuan, 333, Taiwan.
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Proton and Radiation Therapy Center, Taoyuan, Taiwan.
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Shen MH, Chen LP, Ho TF, Shih YY, Huang CS, Chie WC, Huang CC. Validation of the Taiwan Chinese version of the EORTC QLQ-CR29 to assess quality of life in colorectal cancer patients. BMC Cancer 2018; 18:353. [PMID: 29606101 PMCID: PMC5880067 DOI: 10.1186/s12885-018-4312-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 03/26/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The increasing incidence of colorectal cancer in Taiwan has generated a need for a disease-specific quality-of-life measuring instrument. We aimed to validate the Taiwan Chinese version of the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR29. METHODS A total of 108 patients were interviewed. Convergent and discriminant validity, Cronbach's alpha coefficient, test-retest reliability, and known-groups comparisons were used to examine the reliability and validity. RESULTS We found good internal consistency reliability for multi-item scales of the QLQ-C30 and QLQ-CR29, except for the cognitive function and pain scale of the QLQ-C30. Patients in the active treatment group reported compromised functional scale scores (global health status/quality of life, QLQ-C30) and worse symptoms (blood and mucus in stool, QLQ-CR29) than those in the follow-up group. Similar results were found in comparisons based on Eastern Cooperative Oncology Group (ECOG) Performance Status and Bristol Stool Scale: higher physical function/sexual interest, less fatigue/urine frequency symptoms for patients with the lowest ECOG Performance Status (Grade 0), and borderline worse stool frequency scores from Types 5 and 6 patients on the Bristol Stool Scale. CONCLUSION The study validated the Taiwan Chinese version of the EORTC QLQ-C30 and QLQ-CR29. The clinical applicability warrants further studies with greater number of participants.
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Affiliation(s)
- Ming-Hung Shen
- Division of Colorectal Surgery, Department of Surgery, Cathay General Hospital, No.280, Jen-I Rd. Sec.4, Daan Dist., Taipei City, 106, Taiwan.,Division of General Surgery, Department of Surgery, Fu-Jen Catholic University Hospital, No.69; Gui-Zi Rd., Taishan Dist., New Taipei City, 243, Taiwan
| | - Ling-Ping Chen
- Division of Hematology and Oncology, Department of Medicine, Cathay General Hospital, No.280, Jen-I Rd. Sec.4, Daan Dist., Taipei City, 106, Taiwan
| | - Thien-Fiew Ho
- Department of Surgery, Cathay General Hospital Sijhih, No.2, Lane 59, Jian-Cheng Rd., Sijhih Dist., New Taipei City, 221, Taiwan
| | - Ying-Yih Shih
- Department of Medicine, Cathay General Hospital Sijhih, No.2, Lane 59, Jian-Cheng Rd., Sijhih Dist., New Taipei City, 221, Taiwan
| | - Ching-Shui Huang
- Division of General Surgery, Department of Surgery, Cathay General Hospital, No.280, Jen-I Rd. Sec.4, Daan Dist., Taipei City, 106, Taiwan.,School of Medicine, College of Medicine, Taipei Medical University, No.250, Wu-Xing St., Xinyi Dist., Taipei City, 110, Taiwan
| | - Wei-Chu Chie
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No.17, Xu-Zhou Rd., Zhongzheng Dist., Taipei City, 100, Taiwan
| | - Chi-Cheng Huang
- Division of General Surgery, Department of Surgery, Fu-Jen Catholic University Hospital, No.69; Gui-Zi Rd., Taishan Dist., New Taipei City, 243, Taiwan. .,Division of General Surgery, Department of Surgery, Cathay General Hospital, No.280, Jen-I Rd. Sec.4, Daan Dist., Taipei City, 106, Taiwan. .,School of Medicine, College of Medicine, Taipei Medical University, No.250, Wu-Xing St., Xinyi Dist., Taipei City, 110, Taiwan. .,School of Medicine, College of Medicine, Fu-Jen Catholic University, No.510, Zhong-Zheng Rd., Xinzhuang Dist., New Taipei City, 242, Taiwan.
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35
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Lee YH, Liao YC, Shun SC, Lin KC, Liao WY, Chang PH, Jhang SY, Yu CJ, Yang PC, Hsieh PY, Lai YH. Trajectories of caregiver burden and related factors in family caregivers of patients with lung cancer. Psychooncology 2018; 27:1493-1500. [PMID: 29476636 DOI: 10.1002/pon.4678] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 02/05/2018] [Accepted: 02/08/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study aimed to (1) identify the changes of 5 domains of family caregiver (FC) burden, overall burden, and its subtrajectories when caring for newly diagnosed advanced lung cancer patients during the first 6 months following cancer diagnosis; and (2) identify the FC-related and patient-related factors most associated with the overall FC burden and each of its subtrajectories. METHODS A total of 150 newly diagnosed advanced lung cancer patient-FC dyads were recruited from a Taiwanese medical center. The overall FC burden was evaluated 4 times: before treatment, and 1, 3, and 6 months after treatment. The potential subtrajectory of the caregiver burden was investigated by latent class growth analysis. The FC-related and patient-related factors having the greatest effect on the overall FC burden and its subtrajectories over time were identified by generalized estimating equations. RESULTS The highest level of burden domain was "Impact on daily schedule" over time. Generally, most of the FC reported a moderate level of overall burden over the investigation period. Three subtrajectories of the overall FC burden over time (% caregivers) were identified: high burden (34.7%), moderate burden (56.0%), and low burden (9.3%), respectively. The self-efficacy of FC was the strongest factor related to the changes of the FC's burden and burden in each subtrajectory. CONCLUSION The results support the existing and different types of subtrajectories of the FC's burden. Health care professionals should provide care based on those differences. Further research to test interventions which integrate those important factors related to FC's burden, particularly FC's self-efficacy, is strongly suggested.
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Affiliation(s)
- Yun-Hsiang Lee
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Chien Liao
- Department of Nursing, Yuanpei University, Hsinchu City, Taiwan
| | - Shiow-Ching Shun
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Yu Liao
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Pi-Hua Chang
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Sin-Yuan Jhang
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Chong-Jen Yu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Pan-Chyr Yang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Yin Hsieh
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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36
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Hlosrichok A, Sumkhemthong S, Sritularak B, Chanvorachote P, Chaotham C. A bibenzyl from Dendrobium ellipsophyllum induces apoptosis in human lung cancer cells. J Nat Med 2018; 72:615-625. [PMID: 29488156 DOI: 10.1007/s11418-018-1186-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 01/31/2018] [Indexed: 12/22/2022]
Abstract
Failure of current chemotherapeutic drugs leads to the recurrence of tumor pathology and mortality in lung cancer patients. This study aimed to evaluate the anticancer activity and related mechanisms of 4,5,4'-trihydroxy-3,3'-dimethoxybibenzyl (TDB), a bibenzyl extracted from Dendrobium ellipsophyllum Tang and Wang, in human lung cancer cells. Cytotoxicity of TDB (0-300 µM) in different types of human lung cancer cells (H460, H292 and H23) and human dermal papilla cells (DPCs) was evaluated via MTT viability assay. Selective anticancer activity of TDB against human lung cancer cells was demonstrated with a high IC50 (approximately > 300 µM) in DPCs, while IC50 in human lung cancer H460, H292 and H23 cells was approximately 100 ± 5.18, 100 ± 8.73 and 188.89 ± 8.30 µM, respectively. After treatment with 50 µM of TDB for 24 h, flow cytometry analysis revealed the significant increase of early and late apoptosis with absence of necrosis cell death in human lung cancer cells. The up-regulation of p53, a tumor-suppressor protein, was elucidated in human lung cancer cells treated with 10-50 µM of TDB. Alteration to down-stream signaling of p53 including activation of pro-apoptosis protein (Bcl-2-associated X protein; Bax), reduction of anti-apoptosis (B cell lymphoma 2; Bcl-2 and myeloid cell leukemia 1; Mcl-1) and suppression on protein kinase B (Akt) survival pathway were notified in TDB-treated lung cancer cells. The information obtained from this study strengthens the potential development of TDB as an anticancer compound with a favorable human safety profile and high efficacy.
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Affiliation(s)
- Anirut Hlosrichok
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Somruethai Sumkhemthong
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Boonchoo Sritularak
- Departments of Pharmacognosy and Pharmaceutical Botany, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Pithi Chanvorachote
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.,Cell-based Drug and Health Products Development Research Unit, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chatchai Chaotham
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand. .,Cell-based Drug and Health Products Development Research Unit, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
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37
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Lau BHP, Chow AYM, Wong DFK, Chan JSM, Chan CHY, Ho RTH, So TH, Lam TC, Lee VHF, Lee AWM, Chow SF, Chan CLW. Study protocol of a randomized controlled trial comparing integrative body-mind-spirit intervention and cognitive behavioral therapy in fostering quality of life of patients with lung cancer and their family caregivers. ACTA ACUST UNITED AC 2018; 15:258-276. [PMID: 29400621 DOI: 10.1080/23761407.2018.1435325] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Compared to cancers at other sites, lung cancer often results in greater psychosocial distress to both the patients and their caregivers, due to the poor prognosis and survival rate, as well as the heavy symptom burden. In recent years, making protocols of proposed or on-going studies publicly available via clinical trial registries and/or peer-reviewed journals has benefited health sciences with timely communication of the latest research trends and improved transparency in reporting. However, such practice is yet to be a common sight in evidence-informed social work. Hence, this paper discusses the value of publishing protocols in social work research and presents the protocol of a randomized controlled trial that compares the effectiveness of integrative body-mind-spirit intervention with cognitive behavioral therapy for enhancing quality of life of patients with lung cancer and their family caregivers. The data collection process was still on-going at the time of manuscript submission.
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Affiliation(s)
- Bobo Hi-Po Lau
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Amy Y M Chow
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Daniel F K Wong
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Jessie S M Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Celia H Y Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Rainbow T H Ho
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Tsz-Him So
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Tai-Chung Lam
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Victor Ho-Fun Lee
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Anne W M Lee
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | | | - Cecilia L W Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
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Chan A, Lew C, Wang XJ, Ng T, Chae JW, Yeo HL, Shwe M, Gan YX. Psychometric properties and measurement equivalence of the Multidimensional Fatigue Syndrome Inventory- Short Form (MFSI-SF) amongst breast cancer and lymphoma patients in Singapore. Health Qual Life Outcomes 2018; 16:20. [PMID: 29351803 PMCID: PMC5775581 DOI: 10.1186/s12955-018-0846-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 01/10/2018] [Indexed: 11/18/2022] Open
Abstract
Background Currently, several fatigue measurement instruments are available to evaluate and measure cancer-related fatigue. Amongst them, Multidimensional Fatigue Syndrome Inventory-Short Form (MFSI-SF) is a self-reported instrument and a multidimensional scale that aims to capture the global, somatic, affective, cognitive and behavioural symptoms of fatigue. This study examines the psychometric properties and measurement equivalence of the English and Chinese versions of MFSI-SF in breast cancer and lymphoma patients in Singapore. Methods Patients were recruited from National Cancer Centre Singapore. Validity, reliability and responsiveness of MFSI-SF were evaluated in this study. Convergent validity was evaluated by correlating total and subscales of MFSI-SF to known related constructs in EORTC QLQ-C30. Known group validity was assessed based on patients’ cancer stage, pain, insomnia and depression symptoms. Reliability was evaluated by Cronbach’s α. Responsiveness analyses were performed with patients who have undergone at least one cycle of chemotherapy. Multiple regression was used to compare the total and subscale scores of MSFI-SF between the two language versions. Results Data from 246 (160 English and 86 Chinese version) breast cancer and lymphoma patients were included in the study. Moderate to high correlations were observed between correlated MFSI-SF subscales and EORTC QLQ-C30 domains (|r| = 0.524 to 0.774) except for a poor correlation (r = 0.394) observed between MFSI-SF vigour subscale and EORTC QLQ-C30 role functioning subscale. Total MFSI-SF scores could differentiate between patients with higher depression, pain and insomnia status. Internal consistency of MFSI-SF was also high (α = 0.749 to 0.944). Moderate correlation was observed between change in total MFSI-SF score and change in fatigue symptom scale score and global QoL score on EORTC QLQ-C30 (|r| = 0.478 and 0.404 respectively). Poor correlations were observed between change in scores of hypothesised subscales (|r| = 0.202 to 0.361) except for a moderate correlation between change in MFSI-SF emotional fatigue score and change in EORTC QLQ-C30 emotional functioning domain score. Measurement equivalence was established for all subscales and total MFSI-SF score except for the emotional and vigour subscales. Conclusions This study supports the use of MFSI-SF as a reasonably valid scale with good internal consistency for measuring fatigue levels in the Singapore cancer population. Electronic supplementary material The online version of this article (10.1186/s12955-018-0846-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexandre Chan
- Department of Pharmacy, National University of Singapore, Blk S4A Level 3, 18 Science Drive 4, Singapore, 117543, Singapore. .,Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore. .,Duke-NUS Graduate Medical School Singapore, Singapore, Singapore.
| | - Claire Lew
- Department of Pharmacy, National University of Singapore, Blk S4A Level 3, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Xiao Jun Wang
- Department of Pharmacy, National University of Singapore, Blk S4A Level 3, 18 Science Drive 4, Singapore, 117543, Singapore.,Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore
| | - Terence Ng
- Department of Pharmacy, National University of Singapore, Blk S4A Level 3, 18 Science Drive 4, Singapore, 117543, Singapore.,Department of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Jung-Woo Chae
- Department of Pharmacy, National University of Singapore, Blk S4A Level 3, 18 Science Drive 4, Singapore, 117543, Singapore.,Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore.,College of Pharmacy, Chungnam National University, Daejeon, South Korea
| | - Hui Ling Yeo
- Department of Pharmacy, National University of Singapore, Blk S4A Level 3, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Maung Shwe
- Department of Pharmacy, National University of Singapore, Blk S4A Level 3, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Yan Xiang Gan
- Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore
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Prateep A, Sumkhemthong S, Suksomtip M, Chanvorachote P, Chaotham C. Peptides extracted from edible mushroom: Lentinus squarrosulus induces apoptosis in human lung cancer cells. PHARMACEUTICAL BIOLOGY 2017; 55:1792-1799. [PMID: 28532227 PMCID: PMC6130440 DOI: 10.1080/13880209.2017.1325913] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
CONTEXT Lentinus squarrosulus Mont. (Polyporaceae) is an interesting source of diverse bioactive compounds. OBJECTIVE This is the first study of the anticancer activity and underlying mechanism of peptides extracted from Lentinus squarrosuls. MATERIALS AND METHODS Peptides were isolated from the aqueous extract of L. squarrosulus by employing solid ammonium sulphate precipitation. They were further purified by ion-exchange chromatography on diethylaminoethanol (DEAE)-cellulose and gel filtration chromatography on Sephadex G25. Anticancer activity was investigated in human lung cancer H460, H292 and H23 cells cultured with 0-40 μg/mL of peptide extracts for 24 h. Cell viability and mode of cell death were evaluated by MTT and nuclear staining assay, respectively. Western blotting was used to investigate the alteration of apoptosis-regulating proteins in lung cancer cells treated with peptide extracts (0-20 μg/mL) for 24 h. RESULTS The cytotoxicity of partially-purified peptide extracts from L. squarrosulus was indicated with IC50 of ∼26.84 ± 2.84, 2.80 ± 2.14 and 18.84 ± 0.30 μg/mL in lung cancer H460, H292 and H23 cells, respectively. The extracts at 20 μg/mL induced apoptosis through the reduction of anti-apoptotic Bcl-2 protein (∼0.5-fold reduction) and up-regulation of BAX (∼4.5-fold induction), a pro-apoptotic protein. Furthermore, L. squarrosulus peptide extracts (20 μg/mL) also decreased the cellular level of death receptor inhibitor c-FLIP (∼0.6-fold reduction). CONCLUSIONS AND DISCUSSION This study provides the novel anticancer activity and mechanism of L. squarrosulus peptide extracts, which encourage further investigation and development of the extracts for anticancer use.
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Affiliation(s)
- Arisara Prateep
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Somruethai Sumkhemthong
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Maneewan Suksomtip
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Pithi Chanvorachote
- Department of Pharmacology and Physiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Cell-based Drug and Health Products Development Research Unit, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Chatchai Chaotham
- Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- Cell-based Drug and Health Products Development Research Unit, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
- CONTACT Chatchai Chaotham Department of Biochemistry and Microbiology, Faculty of Pharmaceutical Sciences, Chulalongkorn University, 10330Bangkok, Thailand
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40
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Quality of life among survivors of early-stage cervical cancer in Taiwan: an exploration of treatment modality differences. Qual Life Res 2017; 26:2773-2782. [PMID: 28608151 DOI: 10.1007/s11136-017-1619-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2017] [Indexed: 11/12/2022]
Abstract
PURPOSE Women with early-stage cervical cancer may experience changes in their quality of life (QoL) due to treatment or to the effects of the cancer. In this study, we examined differences in QoL by treatment modality between women who underwent surgery only and those treated with concurrent chemoradiation (CCRT). METHODS The sample of 290 women had been diagnosed with stage I-II cervical cancer. Data were collected on these women's demographic and disease characteristics, general QoL, and cancer-specific QoL using an author-designed demographic-disease survey, the European Organization for Research and Treatment of Cancer QoL questionnaire, and the Taiwanese-version Cervical Cancer Module 24 questionnaire, respectively. Data were analyzed by descriptive statistics and analysis of covariance. RESULTS Women with cervical cancer who underwent surgery only had significantly worse constipation and body image than those treated with CCRT. Women who underwent CCRT had worse physical and role functioning than those who underwent surgery only. Women who had CCRT also reported worse symptoms, such as fatigue, appetite loss, diarrhea, financial difficulties, sexual enjoyment, and sexual/vaginal functioning, than those who had only surgery. CONCLUSIONS Our results add knowledge about QoL in women with early-stage cervical cancer who receive different treatment modalities. When suggesting treatment modalities for women with cervical cancer, health professionals should also consider changes in women's QoL after cancer treatment. To improve women's QoL after treatment, professionals should also offer timely and individualized interventions based on women's cervical cancer treatment.
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Li L, Xue J, Li ZZ, Chen LZ. Development and Testing of a Reliable and Valid Patient-Needs Questionnaire for Breast Cancer Inpatients in China. J Clin Diagn Res 2016; 10:XC06-XC10. [PMID: 27891441 DOI: 10.7860/jcdr/2016/17907.8668] [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: 11/20/2015] [Accepted: 07/08/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Breast cancer patients are demanding more active roles in their care, especially in the initial diagnosis and treatment stages. At present, there is no suitable patient questionnaire that appropriately incorporates Chinese language, habits, and cultural differences. AIM To develop and validate a patient-needs questionnaire for female breast cancer inpatients in China. MATERIALS AND METHODS The questionnaire structure was based on Maslow's model and a modern medical model. In the first step, a focus group was used to design 125 questions, of which 64 constituted the initial questionnaire for item screening with a group of 115 hospitalized patients with breast cancer. Items were included or excluded based on the evaluation of eight statistical analysis. Ultimately, 38 items were selected and validated. The reliability and validity of the 38-item questionnaire were determined in a cohort of 323 patients. RESULTS The scale was set up with the 38 selected items. The four primary areas were disease knowledge, medical environment, psychosocial parameters and sexual attitudes. Cronbach's coefficient was 0.959. The split-half reliability value was 0.935. Principal component factor analysis extracted four common factors. CONCLUSION Our new questionnaire, designed to assess the care needs of Chinese inpatients with breast cancer is reliable, sensitive, effective, independent and representative. It can be used in medical practice as a tool for a more complete assessment of patients' needs.
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Affiliation(s)
- Ling Li
- Associate Senior Technician, Records Office, Guangzhou First People's Hospital, Guangzhou Medical College , Guangzhou, Guangdong, China
| | - Jing Xue
- Attending Doctor, Department of Epidemiology and Biostatistics, School of Public Health, Central South University , 78 Xiangya Road, Changsha, Hunan, China
| | - Zhan-Zhan Li
- Attending Doctor, Department of Epidemiology and Biostatistics, School of Public Health, Central South University , 78 Xiangya Road, Changsha, Hunan, China
| | - Li-Zhang Chen
- Professor, Department of Epidemiology and Biostatistics, School of Public Health, Central South University , 78 Xiangya Road, Changsha, Hunan, China
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Zhang JK, Fang LL, Zhang DW, Jin Q, Wu XM, Liu JC, Zhang CD, Dai DQ. Type D Personality in Gastric Cancer Survivors: Association With Poor Quality of Life, Overall Survival, and Mental Health. J Pain Symptom Manage 2016; 52:81-91. [PMID: 27112312 DOI: 10.1016/j.jpainsymman.2015.12.342] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 12/10/2015] [Accepted: 12/23/2015] [Indexed: 12/17/2022]
Abstract
CONTEXT The associations between Type D personality and poor quality of life, overall survival, and mental health in gastric cancer survivors. OBJECTIVES The aim of this research was to explore quality of life (QoL), mental health status, Type D personality, symptom duration, and emergency admissions of Chinese gastric cancer patients, as well as the relationship between these factors. METHODS Eight hundred thirty eligible Chinese patients newly diagnosed with gastric cancer between July 2009 and July 2011 were enrolled in this prospective study. Type D personality was measured with the 14-item Type D Personality Scale (DS14). Mental health status was measured with the Hospital Anxiety and Depression Scale. The QoL outcomes were assessed longitudinally using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 and Quality of Life Questionnaire-STO22 at baseline and six months after diagnosis. RESULTS The proportion of patients with symptom duration of more than one month and who were diagnosed after emergency admissions in the Type D group was significantly higher than that in the non-Type D personality group. At both of the time points, Type D patients reported statistically significant lower scores on role, emotional, cognitive, and social functioning (all Ps < 0.001) functional scales, global health status/QoL scales (P < 0.001), and worse symptom scores compared to patients without a Type D personality. During the six-month time frame, a higher percentage of patients in the Type D group demonstrated a considerable QoL deterioration. Clinically elevated levels of anxiety and depression were more prevalent in Type D than in non-Type D survivors (both Ps < 0.001). There was a statistically significant difference in three-year overall survival between the patients in the Type D group and the non-Type D personality group. CONCLUSION Type D personality is associated with poor QoL, three-year overall survival and mental health status among survivors of gastric cancer, even after adjustment of confounding background variables. The Type D personality group experienced increased levels of pain and fatigue compared to non-Type D patients. Type D personality might be a general vulnerability factor to screen for subgroups at risk of longer symptom duration and emergency admissions in clinical practice.
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Affiliation(s)
- Jia-Kui Zhang
- Department of Gastroenterological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Li-Li Fang
- Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - De-Wei Zhang
- Department of Gastroenterological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Qiu Jin
- Department of Psychiatry, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiao-Mei Wu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Ji-Chao Liu
- Department of Gastroenterological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Chun-Dong Zhang
- Department of Gastroenterological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Dong-Qiu Dai
- Department of Gastroenterological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China.
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Zhang JK, Fang LL, Zhang DW, Jin Q, Wu XM, Liu JC, Zhang CD, Dai DQ. Type D personality is associated with delaying patients to medical assessment and poor quality of life among rectal cancer survivors. Int J Colorectal Dis 2016; 31:75-85. [PMID: 26243469 DOI: 10.1007/s00384-015-2333-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2015] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this research was to explore quality of life (QoL), mental health status, type D personality, symptom duration, and emergency admissions of Chinese rectal cancer patients as well as the relationship between these factors. METHODS Type D personality was measured with the 14-item Type D Personality Scale (DS14). Mental health status was measured with the Hospital Anxiety and Depression Scale (HADS). The QoL outcomes were assessed longitudinally using the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR38 questionnaires at the baseline and 6 months after diagnosis. RESULTS Of the 852 survivors who responded (94 %), 187 (22 %) had a type D personality. The proportion of patients with duration of symptoms >1 month and being diagnosed after emergency admissions in type D group is significantly higher than that in non-type D group. At both of the time points, type D patients reported statistically significant lower scores on most of the functional scales, global health status/QoL scales, and worse symptom scores compared to patients without a type D personality. At the 6-month time point, a higher percentage of patients in the type D group demonstrated QoL deterioration. Clinically elevated levels of anxiety and depression were more prevalent in type D than in non-type D survivors. CONCLUSIONS Type D personality was associated with poor QoL and mental health status among survivors of rectal cancer, even after adjustment for confounding background variables. Type D personality might be a general vulnerability factor to screen for subgroups at risk for longer symptom duration and emergency admissions in clinical practice.
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Affiliation(s)
- Jia-kui Zhang
- Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China
| | - Li-li Fang
- Department of Anesthesiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, 310009, People's Republic of China
| | - De-wei Zhang
- Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China
| | - Qiu Jin
- Department of Psychiatry, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, People's Republic of China
| | - Xiao-mei Wu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Ji-chao Liu
- Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China
| | - Chun-dong Zhang
- Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China
| | - Dong-qiu Dai
- Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China.
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Koller M, Warncke S, Hjermstad MJ, Arraras J, Pompili C, Harle A, Johnson CD, Chie WC, Schulz C, Zeman F, van Meerbeeck JP, Kuliś D, Bottomley A. Use of the lung cancer-specific Quality of Life Questionnaire EORTC QLQ-LC13 in clinical trials: A systematic review of the literature 20 years after its development. Cancer 2015; 121:4300-23. [PMID: 26451520 DOI: 10.1002/cncr.29682] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/24/2015] [Accepted: 07/02/2015] [Indexed: 12/19/2022]
Abstract
The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) covers 13 typical symptoms of lung cancer patients and was the first module developed in conjunction with the EORTC core quality-of-life (QL) questionnaire. This review investigates how the module has been used and reported in cancer clinical trials in the 20 years since its publication. Thirty-six databases were searched with a prespecified algorithm. This search plus an additional hand search generated 770 hits, 240 of which were clinical studies. Two raters extracted data using a coding scheme. Analyses focused on the randomized controlled trials (RCTs). Of the 240 clinical studies that were identified using the LC13, 109 (45%) were RCTs. More than half of the RCTs were phase 3 trials (n = 58). Twenty RCTs considered QL as the primary endpoint, and 68 considered it as a secondary endpoint. QL results were addressed in the results section of the article (n = 89) or in the abstract (n = 92); and, in half of the articles, QL results were presented in the form of tables (n = 53) or figures (n = 43). Furthermore, QL results had an impact on the evaluation of the therapy that could be clearly demonstrated in the 47 RCTs that yielded QL differences between treatment and control groups. The EORTC QLQ-LC13 fulfilled its mission to be used as a standard instrument in lung cancer clinical trials. An update of the LC13 is underway to keep up with new therapeutic trends and to ensure optimized and relevant QL assessment in future trials.
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Affiliation(s)
- Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Sophie Warncke
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Marianne J Hjermstad
- Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital and European Palliative Care Research Centre, Department of Cancer and Molecular Medicine, Norwegian University of Science and Technology, Norway
| | - Juan Arraras
- Oncology Departments, Navarra Hospital Complex, Pamplona, Spain
| | - Cecilia Pompili
- Division of Thoracic Surgery, St. James's University Hospital, Leeds, United Kingdom
| | - Amelie Harle
- The Christie National Health Service Foundation Trust, Manchester, United Kingdom
| | - Colin D Johnson
- University Surgical Unit, University Hospital Southampton, Hampshire, United Kingdom
| | - Wei-Chu Chie
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Christian Schulz
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Florian Zeman
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
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Hyde MK, Chambers SK, Shum D, Ip D, Dunn J. Psycho-oncology assessment in Chinese populations: a systematic review of quality of life and psychosocial measures. Eur J Cancer Care (Engl) 2015; 25:691-718. [PMID: 26292029 DOI: 10.1111/ecc.12367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2015] [Indexed: 11/26/2022]
Abstract
This systematic review describes psychosocial and quality of life (QOL) measures used in psycho-oncology research with cancer patients and caregivers in China. Medline and PsycINFO databases were searched (1980-2014). Studies reviewed met the following criteria: English language; peer-reviewed; sampled Chinese cancer patients/caregivers; developed, validated or assessed psychometric properties of psychosocial or QOL outcome measures; and reported validation data. The review examined characteristics of measures and participants, translation and cultural adaptation processes and psychometric properties of the measures. Ninety five studies met review criteria. Common characteristics of studies reviewed were they: assessed primarily QOL measures, sampled patients with breast, colorectal, or head and neck cancer, and validated existing measures (>80%) originating in North America or Europe. Few studies reported difficulties translating measures. Regarding psychometric properties of the measures >50% of studies reported subscale reliabilities <α = 0.70, <50% reported test-retest reliability, and <30% reported divergent validity. Few reported sensitivity, specificity or responsiveness. Improved accuracy and transparency of reporting for translation, cultural adaptation and psychometric testing of psychosocial measures is needed. Developing support structures for translating and validating psychosocial measures would enable this and ensure Chinese psycho-oncology clinical practice and research keeps pace with international focus on patient reported outcome measures and data management.
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Affiliation(s)
- M K Hyde
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia
| | - S K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia.,Health and Wellness Institute, Edith Cowan University, Perth, WA, Australia.,Centre for Clinical Research, The University of Queensland, Herston, Qld, Australia.,Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia
| | - D Shum
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| | - D Ip
- The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - J Dunn
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Spring Hill, Qld, Australia.,School of Social Science, The University of Queensland, St Lucia, Qld, Australia
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Wang L, Wang ZH, Chen XQ, Wang KF, Huang HQ, Xia ZJ. First-line combination of GELOX followed by radiation therapy for patients with stage IE/IIE ENKTL: An updated analysis with long-term follow-up. Oncol Lett 2015; 10:1036-1040. [PMID: 26622621 DOI: 10.3892/ol.2015.3327] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 05/12/2015] [Indexed: 11/05/2022] Open
Abstract
In recent years, asparaginase-based chemotherapy regimens have produced excellent short-term efficacy in patients with extranodal natural killer/T-cell lymphoma (ENKTL). However, few long-term outcomes have been reported to date. A phase II clinical trial evaluating the efficacy and safety of a combination of gemcitabine, oxaliplatin and asparaginase (GELOX), followed by radiotherapy (RT) in the treatment of localized ENKTL, was reported by this group in 2012. By the time of the present analysis, detailed information had been collected for all 27 patients in the phase II trial, over an extended follow-up period. The median follow-up time was 63.15 months. The 5-year overall survival and progression-free survival were 85.0 and 74.0%, respectively. Recurrence within the RT field was observed in three patients, and the planning target-volume control rate at 5 years was 88.9%. One patient with confirmed lung invasion who did not respond to autologus stem cell transplantation (ASCT) was successfully treated by salvage therapy with lenalidomide monotherapy, and the EBV DNA load in this individual reflected disease progression and treatment response. No clinically significant late toxicities were identified during follow-up visits. In conclusion, this updated analysis confirmed the long-term benefit of the GELOX regimen followed by RT, and demonstrated a good safety profile for this treatment. This strategy may be one of the most suitable options for the treatment of early stage ENKTL.
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Affiliation(s)
- Liang Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China ; Department of Hematological Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China
| | - Zhi-Hui Wang
- Department of Medical Oncology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong, P.R. China
| | - Xiao-Qin Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China ; Department of Hematological Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China
| | - Ke-Feng Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China ; Department of Hematological Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China
| | - Hui-Qiang Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China ; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China
| | - Zhong-Jun Xia
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China ; Department of Hematological Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China
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Lin JK, Tan ECH, Yang MC. Comparing the effectiveness of capecitabine versus 5-fluorouracil/leucovorin therapy for elderly Taiwanese stage III colorectal cancer patients based on quality-of-life measures (QLQ-C30 and QLQ-CR38) and a new cost assessment tool. Health Qual Life Outcomes 2015; 13:61. [PMID: 25986478 PMCID: PMC4448214 DOI: 10.1186/s12955-015-0261-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 05/09/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is a leading cause of cancer-related deaths in developed countries and its incidence increases with age. Intravenous administration of bolus 5-fluorouracil (5-FU) and leucovorin (LV) has been a standard treatment regime for stage III CRC. However, patients generally prefer oral therapy such as Capecitabine. Studies showed that combination of oxaliplatin and capecitabine demonstrated efficacy and safety on par with treatment involving various 5-FU/LV-based regimens in elderly patients as they are in younger ones. However, little is known regarding the cost of adjuvant therapy or the effect of therapy on HRQoL. Thus the aims of this study were to evaluate the influence of different adjuvant care for stage III CRC on the HRQoL of elderly patients and to compare the economic costs associated with capecitabine-based and 5-FU/LV-based adjuvant treatments from a societal perspective in Taiwan. METHODS A prospective, open-label, observational, multicenter study involving 123 patients aged 70 and over from 11 different centers was conducted between July 2008 and July 2011 in Taiwan. The adjusted monthly costs per patient and HRQoL were evaluated from individual-level data. The HRQoL of patients was assessed before and after adjuvant treatment. Direct and indirect costs of adjuvant treatment were estimated from a number of sources, and QoL scores were compared between groups. RESULTS After correcting for baseline characteristics of patients, no significant differences were observed in the global HRQoL scores between treatment groups during the study period. According to QLQ-CR38 results, capecitabine-based therapy appeared to alleviate problems related to defecation (4.54 vs. 8.5; P = 0.011); however, micturition problems increased (9.27 vs. 7.51; P = 0.04), compared with 5-FU/LV-based treatment. The adjusted monthly treatment cost per patient was NT$27,300 for capecitabine-based treatment and NT$53,671 for 5-FU/LV-based treatment. The total cost of 5-FU/LV-based treatment was 59 % greater than that of capecitabine-based treatment. CONCLUSIONS Analyzing from the societal perspective in Taiwan, capecitabine-based therapy incurred lower treatment costs than 5-FU/LV-based therapy and did not jeopardize HRQoL. Therefore, capecitabine, with or without oxaliplatin, could be considered as an alternative treatment option for elderly patients with stage III CRC.
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Affiliation(s)
- Jen-Kou Lin
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
- Section of Colon and Rectal Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Elise Chia-Hui Tan
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Ming-Chin Yang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
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Xie BG, Lu WY, Huang YH, Zhu WJ. Quality of life in cervical cancer treated with systematic nerve-sparing and modified radical hysterectomies. J OBSTET GYNAECOL 2015; 35:839-43. [DOI: 10.3109/01443615.2015.1017556] [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]
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Kim I, Lee H. [Effects of a progressive walking program on physical activity, exercise tolerance, recovery, and post-operative complications in patients with a lung resection]. J Korean Acad Nurs 2015; 44:381-90. [PMID: 25231803 DOI: 10.4040/jkan.2014.44.4.381] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to identify the effects of a Progressive Walking program (PW) on physical activity, exercise tolerance, recovery, and post-operative complications for patients with a lung resection. METHODS A nonequivalent control group non-synchronized design was utilized and 37 participants with a lung resection (22 for control group, 15 for experimental group) were recruited at A university hospital from December 2012 to August 2013. The PW consisted of preoperative education, goal setting, and feedback, provided to the experimental group, and usual care to the control group. Data were analyzed using the SPSS WIN 18.0. RESULTS A higher proportion of patients in the experimental group showed adequate levels of physical activity (p=.001), shorter period of chest tube retention (≤ 7 days; p=.011), and shorter stay in the hospital (≤ 10 days; p=.036) than patients in the control group. Patients in the experimental group reported longer 6-minute walking distance (p=.032) and lower levels of dyspnea (p=.049) than patients in the control group. The PW did not influence the occurrence of pulmonary complications. CONCLUSION The findings of this study suggest that the PW could be a useful strategy for improving patients' post-operative health and reducing cost after lung resection.
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Affiliation(s)
- Inah Kim
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Haejung Lee
- College of Nursing, Pusan National University, Yangsan, Korea.
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Li CC, Chen ML, Chang TC, Chou HH, Chen MY. Social support buffers the effect of self-esteem on quality of life of early-stage cervical cancer survivors in Taiwan. Eur J Oncol Nurs 2015; 19:486-94. [PMID: 25782718 DOI: 10.1016/j.ejon.2015.02.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 02/02/2015] [Accepted: 02/15/2015] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to examine the effects of self-esteem and social support on quality of life (QoL) in stage I and II cervical cancer survivors. METHOD The sample consisted of 110 participants who had been diagnosed with stage I-II cervical cancer and had completed their treatment 5 years or more before data collection. Each participant completed four structured questionnaires: a demographic-disease survey, the Rosenberg Self-Esteem Scale, Medical Outcomes Study Social Support Survey, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30. Data were analyzed using descriptive statistics, independent sample t-test, one-way ANOVA, and hierarchical multiple linear regression analyses. RESULTS The participants' mean age was 60.74 ± 10.69 years. Better QoL was significantly associated with younger age, higher self-esteem, and stronger social support; in addition, social support buffered the effect of self-esteem on global QoL. Together, five variables (age, time since treatment, self-esteem, social support, and the interaction term of self-esteem and social support) explained 36% of the variance in global QoL, with self-esteem being the strongest predictor. CONCLUSIONS The results of this study advance current knowledge of QoL in cervical cancer survivors by demonstrating that survivors with low self-esteem and social support tend to have lower QoL than those with low self-esteem but high social support. Health professionals should help survivors seek support and provide appropriate strategies to expand their social networks and enhance their self-esteem to improve their global QoL after cervical cancer.
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Affiliation(s)
- Chia-Chun Li
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
| | - Mei-Ling Chen
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Ting-Chang Chang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Hung-Hsueh Chou
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Min-Yue Chen
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
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