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Stafford L, Sinclair M, Butow P, Hughes J, Park A, Gilham L, Rose A, Mann GB. Quality of Life Outcomes Associated With Optimization of Treatment by Omitting Radiotherapy in Early Breast Cancer. Clin Breast Cancer 2024; 24:447-456.e2. [PMID: 38548516 DOI: 10.1016/j.clbc.2024.03.002] [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: 12/08/2023] [Revised: 02/19/2024] [Accepted: 03/03/2024] [Indexed: 06/23/2024]
Abstract
PURPOSE Improved prognosis of early breast cancer (EBC) has created opportunities for treatment optimization but reducing morbidity should not inadvertently compromise quality of life (QoL). PROSPECT1 used pre-operative MRI and pathology findings to identify women suitable for radiotherapy (RT) omission following breast conserving surgery. We retrospectively explored the association between de-escalation by omission of RT and QoL in women with EBC. MATERIALS AND METHODS Three groups were recruited: PROSPECT participants who omitted RT following preoperative MRI (A); participants who received RT following preoperative MRI (B); and women who received usual care - No MRI, received RT (C). Measures included the EORTC QLQ-C30 and BR23, BCTOS, DASS-21 and a measure of decision regret. Between group differences were assessed using ANOVA or nonparametric equivalents. Semi-structured interviews were analyzed with qualitative description (n = 44). RESULTS Data from 400 women were analyzed (125A, 102B, 173C). Group A had fewer symptoms and better body image (breast symptoms: A-B P = .003, A-C P = <.001; arm symptoms: A-B P = .004, A-C P = .011; body image: A-C P = .041) and fewer differences between the treated and untreated breasts (cosmetic: A-B P < .001, A-C P < .001; functional: A-C P = .011; breast specific pain: A-B P < .001, A-C P < .001). Two qualitative themes were found: Treatment with the biggest impact on QoL, and Specific impact of RT on QoL. CONCLUSIONS Omission of RT was associated with better QoL and functional and cosmetic outcomes. It was highly acceptable to patients. Clinicians should consider the potential for preserved QoL associated with treatment optimization via omission of RT in treatment planning for patients with EBC.
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Affiliation(s)
- Lesley Stafford
- Familial Cancer Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia.
| | | | - Phyllis Butow
- School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - Janemary Hughes
- The Breast Service, The Royal Melbourne and Royal Women's Hospitals, Parkville, Victoria, Australia
| | - Allan Park
- The Breast Service, The Royal Melbourne and Royal Women's Hospitals, Parkville, Victoria, Australia
| | - Leslie Gilham
- Breast Cancer Trials, Newcastle, New South Wales, Australia
| | - Allison Rose
- The Breast Service, The Royal Melbourne and Royal Women's Hospitals, Parkville, Victoria, Australia; Northwestern Breast Screen, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
| | - G Bruce Mann
- Department of Surgery, University of Melbourne, Victoria, Australia; The Breast Service, The Royal Melbourne and Royal Women's Hospitals, Parkville, Victoria, Australia; Breast Cancer Trials, Newcastle, New South Wales, Australia
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Stafford L, Sinclair M, Butow P, Hughes J, Park A, Gilham L, Rose A, Mann GB. Is de-escalation of treatment by omission of radiotherapy associated with fear of cancer recurrence in women with early breast cancer? An exploratory study. Breast Cancer Res Treat 2023; 201:367-376. [PMID: 37480383 PMCID: PMC10460737 DOI: 10.1007/s10549-023-07039-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/05/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE Safe de-intensification of adjuvant radiotherapy (RT) for early breast cancer (BC) is currently under evaluation. Little is known about the patient experience of de-escalation or its association with fear of cancer recurrence (FCR), a key issue in survivorship. We conducted a cross-sectional study to explore this association. METHODS Psychometrically validated measures including the Fear of Cancer Recurrence Inventory-Short Form were completed by three groups of women with early BC: Women in the PROSPECT clinical trial who underwent pre-surgical MRI and omitted RT (A), women who underwent pre-surgical MRI and received RT (B); and women who received usual care (no MRI, received RT; C). Between group differences were analysed with non-parametric tests. A subset from each group participated in a semi-structured interview. These data (n = 44) were analysed with directed content analysis. RESULTS Questionnaires from 400 women were analysed. Significantly lower FCR was observed in Group A (n = 125) than in Group B (n = 102; p = .002) or Group C (n = 173; p = .001), and when participants were categorized by RT status (omitted RT vs received RT; p < .001). The proportion of women with normal FCR was significantly (p < .05) larger in Group A (62%) than in Group B (35%) or Group C (40%). Two qualitative themes emerged: 'What I had was best' and 'Coping with FCR'. CONCLUSIONS Omitting RT in the setting of the PROSPECT trial was not associated with higher FCR than receiving RT. Positive perceptions about tailored care, lower treatment burden, and trust in clinicians appear to be protective against FCR.
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Affiliation(s)
- Lesley Stafford
- Familial Cancer Centre, Royal Melbourne Hospital, Melbourne, VIC Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia
| | | | - Phyllis Butow
- School of Psychology, University of Sydney, Sydney, NSW Australia
| | - Janemary Hughes
- The Breast Service, The Royal Melbourne and Royal Women’s Hospitals, Parkville, VIC Australia
| | - Allan Park
- The Breast Service, The Royal Melbourne and Royal Women’s Hospitals, Parkville, VIC Australia
| | | | - Allison Rose
- The Breast Service, The Royal Melbourne and Royal Women’s Hospitals, Parkville, VIC Australia
- Northwestern BreastScreen, The Royal Melbourne Hospital, Parkville, VIC Australia
| | - G. Bruce Mann
- Department of Surgery, University of Melbourne, Victoria, Australia
- The Breast Service, The Royal Melbourne and Royal Women’s Hospitals, Parkville, VIC Australia
- Breast Cancer Trials, Newcastle, NSW Australia
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Li S, Zhong L, Zhou D, Zhang X, Liu Y, Zheng B. Predictors of Psychological Distress among Patients with Colorectal Cancer-Related Enterostomy: A Cross-sectional Study. Adv Skin Wound Care 2023; 36:85-92. [PMID: 36662041 DOI: 10.1097/01.asw.0000911012.63191.4c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To identify variables that may predict psychological distress in patients with an enterostomy. METHODS Investigators recruited 77 patients with a stoma from a stoma clinic according to the inclusion criteria. Patients' psychological distress was assessed with the Distress Thermometer (DT) tool, and their personality type was determined by the Eysenck Personality Questionnaire. Researchers also collected demographic and disease-related data. Predictive values were estimated using multiple regression analyses. RESULTS The mean DT score of all patients was 5.94 (SD, 1.81), and approximately 85.7% consistently suffered from psychological distress. Being unmarried and having peristomal complications were associated with higher psychological distress, whereas having a monthly income 5,000 ¥ or more was associated with lower levels of distress. Moreover, patients with a melancholic personality type tended to have higher DT scores, which could act as a strong independent predictor for psychological distress. CONCLUSIONS The majority of patients with a stoma endured moderate to severe psychological distress during follow-up care. Exploring the related factors that predict the levels of psychological distress could enable clinicians to identify at-risk patients as early as possible and thus provide optimal care for improving patients' quality of life.
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Affiliation(s)
- Siqing Li
- At the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China, Siqing Li, MD, is Enterostomal Therapist, Department of Gastrointestinal Surgery and Liping Zhong, MS, is Enterostomal Therapist, Radiology Department. Danyan Zhou, MS, is Nursing Student, Xinhua College of Sun Yat-sen University, Guangzhou, China. Also at the Fifth Affiliated Hospital of Sun Yat-sen University, Xiumin Zhang, MS, is Nurse, Intensive Care Unit; Yuxia Liu, MS, is Nurse, Department of Gastrointestinal Surgery; and Baojia Zheng, MD, is Health Manager, Health Management Center. Acknowledgment: Siqing Li and Liping Zhong contributed equally to this study, and Baojia Zheng and Yuxia Liu contributed equally to this study. The authors thank the Fifth Affiliated Hospital of Sun Yat-sen University for its free database use. This study was supported financially by the Young Talents of Sun Yat-sen University (N: N2020Y05). The authors have disclosed no other financial relationships related to this article. Submitted March 19, 2022; accepted in revised form May 2, 2022
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Adame H, Wettersten K, Schwinghamer A, Friesen-Janochoski A. Cancer-related fatigue as a mediator between self-efficacy and quality of life for adolescents and young adults impacted by cancer. J Psychosoc Oncol 2022; 41:502-517. [PMID: 36541375 DOI: 10.1080/07347332.2022.2147120] [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] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Adolescents and young adults are a unique subpopulation within oncology, with different and often unmet needs. The current study investigated the relationships between cancer-related self-efficacy, cancer-related fatigue, and quality of life, with the hypothesis that fatigue would mediate the negative relationship between self-efficacy and quality of life for adolescents and young adults impacted by cancer. METHODS Structural equation modeling was utilized to examine the pathways between these variables. RESULTS As predicted, results (n = 265, 92.8% female) demonstrated a strong positive relationship between self-efficacy and quality of life. Fatigue partially but significantly mediated the pathway between self-efficacy and quality of life. CONCLUSIONS It appears that cancer-related self-efficacy may work, at least in part, through the mediating variable of fatigue, to influence quality of life for adolescents and young adults.
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Wang H, Lai Q, Wang D, Pei J, Tian B, Gao Y, Gao Z, Xu X. Hedgehog signaling regulates the development and treatment of glioblastoma (Review). Oncol Lett 2022; 24:294. [PMID: 35949611 PMCID: PMC9353242 DOI: 10.3892/ol.2022.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/14/2022] [Indexed: 11/12/2022] Open
Abstract
Glioblastoma (GBM) is the most common and fatal malignant tumor type of the central nervous system. GBM affects public health and it is important to identify biomarkers to improve diagnosis, reduce drug resistance and improve prognosis (e.g., personalized targeted therapies). Hedgehog (HH) signaling has an important role in embryonic development, tissue regeneration and stem cell renewal. A large amount of evidence indicates that both normative and non-normative HH signals have an important role in GBM. The present study reviewed the role of the HH signaling pathway in the occurrence and progression of GBM. Furthermore, the effectiveness of drugs that target different components of the HH pathway was also examined. The HH pathway has an important role in reversing drug resistance after GBM conventional treatment. The present review highlighted the relevance of HH signaling in GBM and outlined that this pathway has a key role in the occurrence, development and treatment of GBM.
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Affiliation(s)
- Hongping Wang
- Department of Neurosurgery, Tangshan Gongren Hospital of Hebei Medical University, Tangshan, Hebei 063000, P.R. China
| | - Qun Lai
- Department of Hematology and Oncology, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Dayong Wang
- Department of Neurosurgery, Tangshan Gongren Hospital of Hebei Medical University, Tangshan, Hebei 063000, P.R. China
| | - Jian Pei
- Department of Neurosurgery, Tangshan Gongren Hospital of Hebei Medical University, Tangshan, Hebei 063000, P.R. China
| | - Baogang Tian
- Department of Neurosurgery, Tangshan Gongren Hospital of Hebei Medical University, Tangshan, Hebei 063000, P.R. China
| | - Yunhe Gao
- Department of Neurosurgery, Tangshan Gongren Hospital of Hebei Medical University, Tangshan, Hebei 063000, P.R. China
| | - Zhaoguo Gao
- Department of Neurosurgery, Tangshan Gongren Hospital of Hebei Medical University, Tangshan, Hebei 063000, P.R. China
| | - Xiang Xu
- Department of Neurosurgery, Tangshan Gongren Hospital of Hebei Medical University, Tangshan, Hebei 063000, P.R. China
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Risk factors for psychological morbidity and the protective role of coping self-efficacy in young women with breast cancer early in diagnosis: a national multicentre cohort study. Breast Cancer Res Treat 2022; 194:91-102. [DOI: 10.1007/s10549-022-06576-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/17/2022] [Indexed: 11/02/2022]
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Relationship of Circadian Rhythm and Psychological Health in Adolescents and Young Adults With Cancer. Cancer Nurs 2021; 44:E659-E669. [PMID: 34387235 DOI: 10.1097/ncc.0000000000000971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Evidence shows that adolescent and young adult (AYA) cancer patients have an increasing survival rate but experience psychological distress and circadian rhythm dysregulation. Little is known about the effect of circadian rhythm on psychological distress. OBJECTIVE To investigate the type of circadian rhythm in Chinese AYA cancer survivors and examine the associations among chronotype, demographic characteristics, psychological distress, anxiety and depression, character strengths, and medical coping in this group. METHODS This cross-sectional study enrolled 800 AYA cancer participants, 728 of whom completed the Chinese version of the Morningness-Eveningness Questionnaire, the Distress Thermometer, the Hospital Anxiety and Depression Scale, the Three-Dimensional Inventory of Character Strengths, and the Medical Coping Modes Questionnaire. RESULTS Evening- and morning-type participants accounted for 35.0% and 19.1%, respectively, among participants, which was significantly higher than those found in the general population. The prevalence of psychological distress was 84.9% among AYA cancer participants. Exercise, Distress Thermometer, and depression were important predictive factors for the circadian rhythm. CONCLUSIONS Circadian rhythm disorder and psychological distress were common among AYA cancer survivors. Evening-type participants performed worse on character strength, confrontation, and avoidance of medical coping. IMPLICATIONS FOR PRACTICE Healthcare professionals need to understand the circadian rhythm and psychological health of AYA cancer survivors. Psychological rehabilitation guidance, especially within the 6 months after diagnosis, may benefit AYA survivors according to their chronotype. Character strengths can also be used during rehabilitation to properly guide AYA survivors.
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AYA Considerations for Aggressive Lymphomas. Curr Hematol Malig Rep 2021; 16:61-71. [PMID: 33728589 DOI: 10.1007/s11899-021-00607-7] [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: 02/01/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW Lymphoma is the one of the most common cancer diagnoses among adolescents and young adults (AYAs) aged 15-39. Despite significant advances in outcomes observed in older adults and younger children, improvements in AYAs have lagged behind. The reasons for this are likely multifactorial including disparities in access to health insurance, low rates of enrollment to clinical trials, potential differences in disease biology, and unique psychosocial challenges. Here we will review Hodgkin lymphoma (HL) and primary mediastinal B cell lymphoma (PMBCL), two of the most common aggressive lymphomas that occur in AYAs. We will discuss the current knowledge about disease biology in AYAs, adult and pediatric treatment strategies, novel targeted therapies, and ongoing AYA clinical trials in these lymphoma subtypes. We also will review unique considerations for treatment-related toxicities in AYAs and psychosocial issues relevant to this population. RECENT FINDINGS Pediatric and adult trials in HL and PMBCL have demonstrated that treatment with dose-intense chemotherapeutic regimens with or without radiation results in high cure rates but can also be associated with long-term toxicity which must be considered in this young population. Novel targeted agents such as the antibody-drug conjugate brentuximab vedotin and/or antibodies targeted against PD-1/PD-L1 have demonstrated activity in the relapsed setting and are currently being evaluated in the upfront setting, which may reduce our reliance on therapies associated with long-term toxicity. AYA-focused clinical trials are currently underway to better elucidate the optimal therapy for lymphomas in this age group. There is an urgent need for clinical trials including AYAs in order to increase the knowledge of age-specific outcomes, toxicities, disease biology, and the need to develop comprehensive AYA care models that meet the unique and complex care needs of this patient population.
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Bult MK, van Bindsbergen KLA, Schepers SA, de Ridder-Sluiter HG, Verhaak CM, van Litsenburg RRL, Merks JHM, van Noesel MM, Grootenhuis MA. Health-Related Quality of Life of Adolescents with Cancer During the First Year of Treatment. J Adolesc Young Adult Oncol 2019; 8:616-622. [PMID: 31268387 DOI: 10.1089/jayao.2019.0017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Purpose: Adolescents with cancer (aged 12-18 years) are at risk for impaired health-related quality of life (HRQoL). Little is known about this population during treatment. This study aimed to (1) determine the HRQoL of adolescents with cancer during the first year of treatment and compare them with age-matched peers and (2) obtain insight into cancer-specific HRQoL of adolescents during the first year of treatment. Methods: Participants were part of a larger study focused on routine monitoring of electronic reported outcomes in standard pediatric oncology care. Adolescents completed the pediatric quality of life inventory (PedsQL) 4.0 and the PedsQL Cancer Module 3.0. Mean generic HRQoL scale scores were compared between the groups using multivariate analysis of covariance. Cancer-specific item scores were dichotomized and percentages were calculated to determine the proportion of adolescents reporting presence or absence of problems. Results: A total of 73 (mean [M]age = 14.71, standard deviation [SD] = 1.85) adolescents with cancer (Mage = 14.71, SD = 1.85, Mtimesincediagnosis = 3.51 months, SD = 2.8) and 268 healthy peers (Mage = 14.23, SD = 1.51) participated. Adolescents with cancer reported significantly lower generic HRQoL scores on all domains than their peers (p's <0.05, η2 = 0.01-0.42). Most frequently reported cancer-specific HRQoL problems were pain (hurt joint/muscle, 42.9%), nausea (during medical treatments [47.1%]; food not tasting good [54.3%]; food and smells [61.4%]), worry (about relapse [45.7%]; about side effects [52.9%]), cognitive problems (paying attention [47.1%]), and physical appearance (not good looking [47.1%]). Conclusions: Adolescents with cancer showed impaired HRQoL during treatment on both physical and psychosocial domains. Close monitoring of physical and psychosocial symptoms during treatment is, therefore, important.
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Affiliation(s)
- Maureen K Bult
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Sasja A Schepers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
| | | | - Chris M Verhaak
- Amalia Children's Hospital/Radboud University Medical Center, Nijmegen, The Netherlands
| | - Raphaële R L van Litsenburg
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Johannes H M Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Max M van Noesel
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Distinct demographic profile and molecular markers of primary CNS tumor in 1873 adolescent and young adult patient population. Childs Nerv Syst 2018; 34:1489-1495. [PMID: 29730791 DOI: 10.1007/s00381-018-3785-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 03/22/2018] [Indexed: 01/02/2023]
Abstract
INTRODUCTION We present detailed demographic profile, tumor types, and their molecular markers in adolescent and young adult (AYA) patients of age group between 15 and 39 years with primary central nervous system (PCNS) tumors, and compare with pediatric and adult patient populations. METHODOLOGY Demographic- and disease-related information of 1873 PCNS tumor patients of age 15-39 years registered between 1 January 2011 and 31 December 2015 at our institution was analyzed with respect to their demographics and tumor subtypes. Various molecular markers for glial tumors and subgroup classification of medulloblastoma were evaluated for AYA, pediatric, and older adult patient populations. RESULTS AYA constituted 27% of all PCNS. Median age was 29 years. Glial tumors (62.36%) comprised the largest tumor type with astrocytoma (38.55%) being the most common histology. Glioblastoma (51.52%) was the commonest astrocytic tumor with 74.67% of them being isocitrate dehydrogenase 1 (IDH1) negative and 41.38% with O (6)-methylguanine DNA methyltransferase (MGMT) promoter methylated. Diffuse astrocytoma and glioblastoma showed significantly higher IDH1 positivity and loss of alpha-thalassemia/mental retardation syndrome X-linked (ATRX) for AYAs as compared to pediatric and adult patient populations (p < 0.0001). Medulloblastoma (73.8%) was the most commonly diagnosed embryonal tumor, with sonic hedgehog (SHH) being the commonest molecular subtype (48%). Younger patients among AYA population presents with pediatric type of tumor spectrum, while older ones present with more aggressive tumor subtypes. CONCLUSION This is among the few studies reporting spectrum of PCNS tumor in AYA population with distinct tumor subtypes and molecular profiles. AYA patient populations may need special attention with appropriately designed clinical trials.
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Ritt-Olson A, Miller K, Baezconde-Garbanati L, Freyer D, Ramirez C, Hamilton A, Milam J. Depressive Symptoms and Quality of Life Among Adolescent and Young Adult Cancer Survivors: Impact of Gender and Latino Culture. J Adolesc Young Adult Oncol 2018; 7:384-388. [PMID: 29768076 DOI: 10.1089/jayao.2017.0078] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Ethnic and sex variations in depressive symptoms and quality of life (QOL) among adolescent and young adult (AYA) childhood cancer survivors were explored among a sample of Latino and non-Latino childhood cancer survivors (CCSs) (n = 194) treated at hospitals in Los Angeles County. Latinos scored higher in depressive symptoms and lower in QOL when compared with non-Latinos. Males had higher depressive symptoms. Among Latinos, higher levels of acculturation were associated with depression and a poorer QOL, and we found that more acculturated Latino males were more likely to have meaningful levels of depression than less acculturated males or females. Interventions addressing depressive symptoms may be most needed for Hispanic male CCSs.
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Affiliation(s)
- Anamara Ritt-Olson
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
| | - Kimberly Miller
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
| | - Lourdes Baezconde-Garbanati
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
| | - David Freyer
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California.,2 Department of Pediatrics, Keck School of Medicine of the University of Southern California , Los Angeles, California.,3 Department of Medicine, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles , Los Angeles, California.,4 Department of Medicine, USC Norris Comprehensive Cancer Center , Los Angeles, California
| | - Cynthia Ramirez
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
| | - Ann Hamilton
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
| | - Joel Milam
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
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Chan A, Poon E, Goh WL, Gan Y, Tan CJ, Yeo K, Chua A, Chee M, Law YC, Somasundaram N, Kanesvaran R, Ng QS, Tham CK, Toh CK, Lim ST, Tao M, Tang T, Quek R, Farid M. Assessment of psychological distress among Asian adolescents and young adults (AYA) cancer patients using the distress thermometer: a prospective, longitudinal study. Support Care Cancer 2018; 26:3257-3266. [DOI: 10.1007/s00520-018-4189-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/28/2018] [Indexed: 11/30/2022]
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Pereira-Morales AJ, Adan A, Lopez-Leon S, Forero DA. Personality traits and health-related quality of life: the mediator role of coping strategies and psychological distress. Ann Gen Psychiatry 2018; 17:25. [PMID: 29930692 PMCID: PMC5991445 DOI: 10.1186/s12991-018-0196-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 05/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study of health-related quality of life (HRQOL) is an important topic in mental health around the globe. However, there is the need for more evidence about the cumulative influence of psychological variables on HRQOL. The main aim of the study was to evaluate how specific personality traits might explain scores in HRQOL and to explore how this relationship might be mediated by coping styles and psychological distress. METHODS Young Colombian subjects (N = 274) were included (mean age: 21.3; SD = 3.8). The Short-Form Health Survey was used to measure HRQOL. For assessment of psychological variables, the Hospital Anxiety and Depression Scale, the Zung Self-Rating Anxiety Scale, The Coping Inventory for Stressful Situations and the short version of Big Five Inventory were used. RESULTS The personality trait that was the best predictor of HRQOL was openness to experience, forming an explanatory model for HRQOL, along with emotional coping style and depressive and anxious symptoms. Emotional coping style and psychological distress were significant mediators of the relationship between openness and HRQOL. CONCLUSIONS Our findings provide additional data about the cumulative influence of specific psychological variables on HRQOL, in a mostly young female Latin American sample.
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Affiliation(s)
- Angela J Pereira-Morales
- 1Laboratory of Neuropsychiatric Genetics, Biomedical Sciences Research Group, School of Medicine, Universidad Antonio Nariño, Bogotá, 110231 Colombia
| | - Ana Adan
- 2Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain.,3Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Sandra Lopez-Leon
- 4Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ 07936-1080 USA
| | - Diego A Forero
- 1Laboratory of Neuropsychiatric Genetics, Biomedical Sciences Research Group, School of Medicine, Universidad Antonio Nariño, Bogotá, 110231 Colombia
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Bigenwald C, Galimard JE, Quero L, Cabannes-Hamy A, Thieblemont C, Boissel N, Brice P. Hodgkin lymphoma in adolescent and young adults: insights from an adult tertiary single-center cohort of 349 patients. Oncotarget 2017; 8:80073-80082. [PMID: 29108389 PMCID: PMC5668122 DOI: 10.18632/oncotarget.20684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/11/2017] [Indexed: 11/25/2022] Open
Abstract
Background Adolescent and young adults (AYA) represent one third of patients affected by Hodgkin lymphoma (HL). These patients are frequently treated either with pediatric or adult protocol depending on their physician background. This population has been understudied so far, in terms of HL characteristics and treatment-associated outcomes. Aim We aimed to extensively describe HL features in the AYA population including HL characteristics, progression-free (PFS) and overall survival (OS). Methods From 1979 to 2013, consecutive patients with HL aged between 15 to 25 years and followed at Saint-Louis Hospital were prospectively enrolled. Survivals were estimated using the Kaplan-Meier method. Results 349 patients were included and studied, with a median follow-up of 7 years. The majority of patients were treated with adult protocols (mainly ABVD and BEACOPP). They presented adverse clinical characteristics with a high proportion of stage III and IV according to Ann Arbor classification (45 %), a high rate of B symptoms (46 %) and extra-nodal involvement (36 %). Despite these pejorative clinical features, the prognosis remains good with a 10-year PFS and OS estimated at 81.0 % (95%CI [76.7-85.5]) and 90.7% (95%CI [87.2-94.4]), respectively. In multivariate analysis, stages III and IV according to Ann Arbor classification, mixed cellularity histology, elevated neutrophils and LDH above range were independently associated with a worse PFS. We identified a subgroup of 11 primary refractory patients with a particularly poor prognosis. The toxicity rate was low (7.4 %). Conclusion Despite their baseline pejorative features, AYA with HL have a good prognosis. Progresses are still needed in order to reduce toxicities. Primary refractory patients with a particularly poor prognosis should be detected early in order to quickly introduce new targeted therapies.
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Affiliation(s)
- Camille Bigenwald
- Department of Onco-Hematology, Hôpital Saint Louis, Assistance Publique des Hôpitaux de Paris (AP-HP), Université Paris, Paris, France
| | - Jacques-Emmanuel Galimard
- Department of Biostatistics and Medical Information (ECSTRA Team), Center of Research in Epidemiology and Statistics Sorbonne, Inserm UMR 1153, Université Paris Diderot, Paris, France
| | - Laurent Quero
- Department of Radiation Oncology, Hôpital Saint Louis, AP-HP, Université Paris, Paris, France
| | - Aurélie Cabannes-Hamy
- Hematology Adolescents and Young Adults Unit, Hôpital Saint-Louis, AP-HP, Université Paris, Paris, France
| | - Catherine Thieblemont
- Department of Onco-Hematology, Hôpital Saint Louis, Assistance Publique des Hôpitaux de Paris (AP-HP), Université Paris, Paris, France
| | - Nicolas Boissel
- Hematology Adolescents and Young Adults Unit, Hôpital Saint-Louis, AP-HP, Université Paris, Paris, France
| | - Pauline Brice
- Department of Onco-Hematology, Hôpital Saint Louis, Assistance Publique des Hôpitaux de Paris (AP-HP), Université Paris, Paris, France
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