1
|
Son KL, Shin JS, Lee SH, Lee S, Jung S, Kim WH, Jung D, Kim TY, Im SA, Lee KH, Hahm BJ, Yeom CW. Differences in severity of chemotherapy-induced nausea and vomiting between neoadjuvant and adjuvant chemotherapy in patients with breast cancer: analysis of data from two prospective observational studies. Support Care Cancer 2024; 32:511. [PMID: 39001910 DOI: 10.1007/s00520-024-08718-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 07/04/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE We assessed the differences in chemotherapy-induced nausea and vomiting (CINV) severity in patients with breast cancer, receiving neoadjuvant chemotherapy (NAC) and adjuvant chemotherapy (AC). METHODS CINV severity in patients on anthracycline-based NAC (n = 203) and AC (n = 79) was assessed at baseline (C0) and after the first and fourth chemotherapy using a 10-point Likert scale. Group-by-time interaction term was used to evaluate the effect of the group on changes in CIN (cCIN) and CIV (cCIV) from C0 to the follow-up periods (C1, C4). If insignificant, group effects were analyzed without the interaction term. Subgroup analysis was performed based on age 50. In statistical analyses, sociodemographic and clinical variables that differed between groups were adjusted for. RESULTS The effect of group by follow-up period was not significant in cCIN and cCIV. The AC group showed a significantly higher change in the severity of cCIN compared to the NAC group (estimated mean = 1.133, 95% CI = 0.104-2.161, p = 0.031), but there was no difference in cCIV. In those ≤ 50 years, significant differences in cCIN severity (estimated mean = 1.294, 95% CI = 0.103-2.484, p = 0.033) were observed, but not in cCIV. In those > 50 years, neither cCIN nor cCIV differed significantly between groups. CONCLUSIONS NAC in breast cancer patients showed less severe CIN than adjuvant chemotherapy AC, but not in those over 50. Clinicians should recognize that the severity of CIN may vary across different chemotherapy settings and adjust their management accordingly. TRIAL REGISTRATION The clinical trial registration ( www. CLINICALTRIALS gov ) numbers were NCT01887925 (the registration date is from June 20, 2013, to November 27, 2015) and NCT02011815 (the registration date is from December 10, 2013, to September 22, 2019).
Collapse
Affiliation(s)
- Kyung-Lak Son
- Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Joon Sung Shin
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun Hyung Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sungwon Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Saim Jung
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Dooyoung Jung
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
- Healthcare Center, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Chan-Woo Yeom
- Department of Psychiatry, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-Si, 11759, Republic of Korea.
| |
Collapse
|
2
|
Chen MY, Zheng WY, Liu YF, Li XH, Lam MI, Su Z, Cheung T, Ungvari GS, Tang L, Ng CH, Zhang Q, Xiang YT. Global prevalence of poor sleep quality in cancer patients: A systematic review and meta-analysis. Gen Hosp Psychiatry 2024; 87:92-102. [PMID: 38382421 DOI: 10.1016/j.genhosppsych.2023.12.004] [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: 08/02/2023] [Revised: 11/27/2023] [Accepted: 12/06/2023] [Indexed: 02/23/2024]
Abstract
OBJECTIVE Poor sleep quality is common in patients with cancer, but the prevalence rates varied widely across studies. This systematic review and meta-analysis examined the pooled prevalence of poor sleep quality among patients with cancer. METHODS Systematic literature searches were independently conducted in the major databases (Web of Science, PubMed, EMBASE and PsycINFO). Studies that reported the prevalence of poor sleep quality in patients with cancer were analyzed using a random effects model. Funnel plots and Egger's tests were used to assess publication bias. Statistical analyses were performed using R software. RESULTS A total of 59 epidemiological studies involving 16,223 patients were included. The pooled prevalence of poor sleep quality in patients with cancer was 57.4% [95% confidence interval (CI): 53.3% - 61.6%]. Additionally, three comparative studies with 372 patients and 412 healthy controls were included. Compared to healthy controls, patients with cancer had a significantly higher risk for poor sleep quality [odd ratio (OR) = 3.0; 95%CI: 1.2-7.2; P < 0.05]. Subgroup analyses of the studies revealed that studies from Middle East & North Africa region and low income countries, and on gynecological cancer as well as those with a lower cut-off value of sleep quality (all P < 0.01) reported a higher prevalence of poor sleep quality. Meta-regression analyses showed that higher prevalence of poor sleep quality was associated with higher prevalence of comorbid depression (P < 0.05) and anxiety (P < 0.01), but was associated with a lower education level (P < 0.05) and alcohol use ratio (P < 0.05). CONCLUSION Poor sleep quality is common among patients with cancer. Considering the overall high prevalence rate and negative impact of poor sleep quality, appropriate measures to identify and improve poor sleep quality are needed to enhance the clinical outcomes in this group.
Collapse
Affiliation(s)
- Meng-Yi Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Wan-Ying Zheng
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Yu-Fei Liu
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xiao-Hong Li
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Mei Ieng Lam
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- Psychiatry Section, University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Lili Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia.
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human rain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
| |
Collapse
|
3
|
Kong L, Wang J, Guan S, Chen X, Li M, Gao L, Zhong D, Zhang L. Nomogram for predicting opioid-induced nausea and vomiting for cancer pain patients. Support Care Cancer 2023; 31:663. [PMID: 37914831 PMCID: PMC10620250 DOI: 10.1007/s00520-023-08144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/24/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Opioid-induced nausea and vomiting are frequently observed as an adverse effect in the treatment of cancer-related pain. The factors that affect OINV in cancer patients remain unclear. In this study, we developed a nomogram for predicting the occurrence of OINV in this population using retrospective clinical data. METHODS We collected data from 416 cancer pain patients, 70% of whom used the training set to analyze demographic and clinical variables. We used multivariate logistic regression to identify significant factors associated with OINV. Then, we construct a prediction nomogram. The validation set comprises the remaining 30%. The reliability of the nomogram is evaluated by bootstrap resampling. RESULTS Using multivariate logistic regression, we identified five significant factors associated with OINV. The C-index was 0.835 (95% confidence interval [CI], 0.828-0.842) for the training set and 0.810 (95% CI, 0.793-0.826) for the validation set. The calibrated curves show a good agreement between the predicted and actual occurrence of OINV. CONCLUSION In a retrospective study based on five saliency-found variables, we developed and proved a reliable nomogram model to predict OINV in cancer pain patients. Future prospective studies should assess the model's reliability and usefulness in clinical practice.
Collapse
Affiliation(s)
- Lingping Kong
- Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Jing Wang
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Shasha Guan
- Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Xiaochen Chen
- Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Meiqing Li
- Department of Oncology, People's Hospital of Inner Mongolia Autonomous Region, Hohhot, 010017, Inner Mongolia, China
| | - Liming Gao
- Department of Oncology, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, Hebei, China
| | - Diansheng Zhong
- Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Linlin Zhang
- Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin, 300052, China.
| |
Collapse
|
4
|
Chan J, Ng DWL, Liao Q, Fielding R, Soong I, Chan KKL, Lee C, Ng AWY, Sze WK, Chan WL, Lee VHF, Lam WWT. Trajectories of sleep disturbance in cancer survivors during the first 2 years post-treatment. Sleep 2023; 46:zsad052. [PMID: 36861253 DOI: 10.1093/sleep/zsad052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/13/2023] [Indexed: 03/03/2023] Open
Abstract
STUDY OBJECTIVES To examine the trajectories of sleep disturbance in cancer survivors during the first 2 years post-treatment and to investigate whether psychological, cognitive, and physical factors differentiate trajectories. METHODS A total of 623 Chinese cancer survivors of diverse cancer types participated in a 2-year-long prospective study after the completion of cancer treatment. Sleep disturbance was measured using Pittsburgh Sleep Quality Index at 3 (T2), 6 (T3), 12 (T4), 18 (T5), and 24 (T6) months after baseline (within 6-months post-treatment; T1). Latent growth mixture modeling identified distinctive sleep disturbance trajectories and tested if these longitudinal patterns were predicted by baseline psychological distress, attentional control, attentional bias and physical symptom distress and T2 cancer-related distress. Fully adjusted multinomial logistic regression then identified whether these factors differentiated trajectories. RESULTS Two distinct sleep disturbance trajectories were identified, namely stable good sleepers (69.7%) and persistent high sleep disturbance (30.3%). Compared to those in the stable good sleep group, patients in the persistent high sleep disturbance group were less likely to report avoidant (OR=0.49, 95% CI = 0.26-0.90), while more likely to report intrusive thoughts (OR = 1.76, 95% CI = 1.06-2.92) and cancer-related hyperarousal (OR = 3.37, 95% CI = 1.78-6.38). Higher depression scores also predicted persistent high sleep disturbance group membership (OR = 1.13, 95% CI = 1.03-1.25). Attentional bias, attentional control, anxiety, and physical symptom distress did not predict sleep trajectory membership. CONCLUSIONS One in three cancer survivors experienced persistent high sleep disturbance. Screening and managing depressive symptoms and cancer-related distress in early cancer rehabilitation may reduce risk of persistent sleep disturbance among cancer survivors.
Collapse
Affiliation(s)
- Julia Chan
- School of Public Health, Centre for Psycho-Oncology Research and Training, University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Danielle Wing Lam Ng
- School of Public Health, Centre for Psycho-Oncology Research and Training, University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Qiuyan Liao
- School of Public Health, Centre for Psycho-Oncology Research and Training, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Fielding
- School of Public Health, Centre for Psycho-Oncology Research and Training, University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Inda Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China
| | - Karen Kar Loen Chan
- Department of Obstetrics and Gynaecology, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Conrad Lee
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong SAR, China
| | - Alice Wan Ying Ng
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, Hong Kong SAR, China
| | - Wing Kin Sze
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, Hong Kong SAR, China
| | - Wing Lok Chan
- Li Ka Shing Faculty of Medicine, Department of Clinical Oncology, University of Hong Kong, Hong Kong SAR, China
| | - Victor Ho Fun Lee
- Li Ka Shing Faculty of Medicine, Department of Clinical Oncology, University of Hong Kong, Hong Kong SAR, China
| | - Wendy Wing Tak Lam
- School of Public Health, Centre for Psycho-Oncology Research and Training, University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| |
Collapse
|
5
|
Abebe E, Giru BW, Boka A. Sleep Quality and Associated Factors Among Adult Cancer Patients on Treatments at Tikur Anbessa Specialized Hospital Oncology Unit, Addis Ababa, Ethiopia, 2021. Cancer Control 2023; 30:10732748231160129. [PMID: 36812068 PMCID: PMC9950603 DOI: 10.1177/10732748231160129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Patients with cancer frequently reported sleep problems during their treatments which can affect their sleep quality have an impact on patients' quality of life (QOL). OBJECTIVE to assess the prevalence of sleep quality and associated factors in adult cancer patients on treatment in the Oncology unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2021. METHODS institutional-based cross-sectional study design was used and data was collected by using face-to-face structured interview questionnaires from March 1 to April 1, 2021. Sleep Quality Index (PSQI) consisted of 19 items, the social support scale (OSS-3) consisted of 3 items, and the Hospital Anxiety and Depression Scale (HADS) consisted of 14 items were applied. Logistic regression including bivariate and multivariate analysis was done to examine the association between dependent and independent variables, and P< 0.05 was considered the level of significance for associations. RESULTS A total of 264 sampled adult cancer patients on treatments were included in this study, with a response rate of 93.61%. About 26.5% of the participants' age distribution was between 40 to 49 years, and 68.6% were female. 59.8% of the study participants were married. Concerning education, about 48.9% of participants attended primary and secondary school and 45% of participants were unemployed. Overall, 53.79% of individuals had poor sleep quality. Low income ((AOR=5.36 CI 95% (2.23, 12.90), fatigue (AOR=2.89 CI 95(1.32, 6.33), pain (AOR 3.82 C I95 % (1.84, 7.93), poor of social support (AOR =3.20 CI 95% (1.43, 6.74), anxiety (AOR=3.48 CI 95% (1.44, 8.38) and depression (AOR 2.87 CI 95 % (1.05-7.391) were all associated with poor sleep quality. CONCLUSION This study revealed a high prevalence of poor sleep quality, which was significantly associated with factors like low income, fatigue, pain, poor social support, anxiety, and depression among cancer patients on treatments.
Collapse
Affiliation(s)
- Eshetu Abebe
- Jimma University Medical
Center, Jimma, Ethiopia
| | - Berhanu Wordofa Giru
- School of Nursing and Midwifery
College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abdissa Boka
- School of Nursing and Midwifery
College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia,Abdissa Boka, School of Nursing and
Midwifery, College of Health Science, Addis Ababa University, Addis Ababa 1000,
Ethiopia.
| |
Collapse
|
6
|
Al Maqbali M, Al Sinani M, Alsayed A, Gleason AM. Prevalence of Sleep Disturbance in Patients With Cancer: A Systematic Review and Meta-Analysis. Clin Nurs Res 2022; 31:1107-1123. [PMID: 35484919 PMCID: PMC9266067 DOI: 10.1177/10547738221092146] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Sleep disturbance is one of the most common and troubling symptoms that harm the quality of life throughout all phases of treatment and stages of the illness among patients with cancer. The aim of this meta-analysis is to examine the present status of sleep disturbance prevalence in patients with cancer. The following databases were searched: PubMed, CINAHL, MEDLINE, EMBASE, PsycINFO, from inception to April 2021. Prevalence rates were pooled with meta-analysis using a random-effects model. A total of 160 studies (N = 46,279) published between 1998 and 2021 met the inclusion criteria. The overall prevalence of sleep disturbance was 60.7% (26,448/46,279 participants, 95% CI 58.1–63.3%) with significant heterogeneity between studies (p < .000, τ2 = .0000, I2 = 96.4%). This meta-analysis highlights the importance of developing optimal monitoring strategies to reduce sleep disturbance and improve the quality of life of cancer patients.
Collapse
Affiliation(s)
| | - Mohammed Al Sinani
- Imperial College London, London, UK.,Ministry of Health, Al Buraimi, Oman
| | | | | |
Collapse
|
7
|
Shim EJ, Jeong D, Jung D, Kim TY, Lee KH, Im SA, Hahm BJ. Do posttraumatic stress symptoms predict trajectories of sleep disturbance and fatigue in patients with breast cancer? A parallel-process latent growth model. Psychooncology 2022; 31:1286-1293. [PMID: 35301799 DOI: 10.1002/pon.5923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/28/2022] [Accepted: 03/13/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Using a parallel-process latent growth model (LGM), this study examined whether posttraumatic stress symptoms (PTSS) are associated with the trajectory of sleep disturbance (SD) and fatigue and whether the SD trajectory mediates the PTSS-fatigue relationship. METHODS Data were from 215 patients with breast cancer recruited from a tertiary hospital in South Korea. A self-report survey was administered at four time points during the course of adjuvant chemotherapy. RESULTS The mean age of the participants was 46.69 (SD = 9.08) and the majority was at stage I and the average months since diagnosis was 1.33 (SD=1.43). Unconditional parallel-process LGM indicated that SD and fatigue were positively associated with each other, both in terms of initial status and growth rate. Then, the conditional parallel-process LGM with baseline PTSS (i.e., avoidance, intrusion, and hyperarousal) as predictors were examined and anxiety, depressive symptoms and chronotype were entered as covariates in the model. Results indicated that a higher initial status and faster growth of SD were associated with a faster increase in fatigue. Greater baseline hyperarousal was directly related to a higher initial status and a slower increase in SD, and higher initial fatigue. Furthermore, a higher hyperarousal was associated with a greater initial SD, which was related to a faster increase in fatigue. Additionally, the late chronotype was related to a faster increase in fatigue through its impact on the initial SD. CONCLUSIONS The detrimental impact of hyperarousal on the SD trajectory and fatigue suggests the need to intervene in PTSS and SD early and throughout the course of cancer treatments to prevent fatigue. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Donghee Jeong
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Dooyoung Jung
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea.,Healthcare Center, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bong-Jin Hahm
- Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| |
Collapse
|
8
|
Son KL, Jung D, Lee KM, Yeom CW, Oh GH, Kim TY, Im SA, Lee KH, Spiegel D, Hahm BJ. Morning Chronotype Decreases the Risk of Chemotherapy-Induced Peripheral Neuropathy in Women With Breast Cancer. J Korean Med Sci 2022; 37:e34. [PMID: 35132840 PMCID: PMC8822114 DOI: 10.3346/jkms.2022.37.e34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/08/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The purpose of this longitudinal prospective cohort study was to investigate the role of chronotype in the incidence of chemotherapy-induced peripheral neuropathy (CIPN) among women with breast cancer. METHODS We recruited women with breast cancer awaiting adjuvant chemotherapy, including four cycles of docetaxel. Participants reported peripheral neuropathy symptoms of numbness/tingling at the baseline, and at 4weeks after completion of chemotherapy. Candidate psychiatric factors associated with CIPN were assessed at the baseline, using the Composite Scale of Morningness, the Pittsburgh Sleep Quality Index, and the Hospital Anxiety and Depression Scale. To examine the association between chronotype and CIPN, we built logistic regression models, adjusting for demographic, clinical, and other psychiatric variables. RESULTS Among 48 participants, 29 participants developed CIPN. The morning chronotype was inversely associated with CIPN (odds ratio, 0.06; confidence interval, 0.01-0.74; P = 0.028) after adjusting for age, BMI, education, type of operation, alcohol use, smoking, sleep quality, depression, and anxiety. CONCLUSION Our results suggest that the morning chronotype is a protective factor against the development of CIPN in patients with breast cancer who were treated with docetaxel. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01887925.
Collapse
Affiliation(s)
- Kyung-Lak Son
- Department of Neuropsychiatry, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Dooyoung Jung
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Korea
| | | | - Chan-Woo Yeom
- Department of Psychiatry, Uijeongbu Eulji Medical Center, Uijeongbu, Korea
| | - Gyu Han Oh
- Public Health Medical Service, Seoul National University Hospital, Seoul, Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - David Spiegel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
| |
Collapse
|
9
|
Factors associated with sleep disturbances in women undergoing treatment for early-stage breast cancer. Support Care Cancer 2021; 30:157-166. [PMID: 34244851 PMCID: PMC8270775 DOI: 10.1007/s00520-021-06373-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/19/2021] [Indexed: 10/26/2022]
Abstract
PURPOSE The purpose of this study was to examine factors associated with sleep disturbance in women receiving adjuvant therapy for breast cancer. METHODS This study employed a cross-sectional design using data collected at 3 months post-surgery from an ongoing longitudinal parent study. Participant data were divided into adjuvant treatment groups (chemotherapy, radiation, and aromatase inhibitors) and no adjuvant treatment groups. Symptoms were measured using patient self-report measures. Analysis of variance was used to assess between adjuvant treatment group differences in sleep disturbance. Regression analysis was performed to assess the relationship between sleep disturbance and other symptoms within adjuvant treatment groups. RESULTS The sample included 156 women diagnosed with early-stage breast cancer. There were significant differences in levels of reported sleep disturbance between treatment groups (p = 0.049), with significantly higher levels of sleep disturbances in those receiving radiation compared to those receiving no adjuvant treatment (p = 0.038) and in those receiving chemotherapy and those receiving no adjuvant treatment (p = 0.027). Increased sleep disturbance was found to be a significant predictor for increased pain severity, nausea severity, anxiety, depressive symptoms, fatigue, decreased physical function, and decreased ability to participate in social roles and activities. Co-occurring symptoms with sleep disturbance differed between adjuvant treatment groups. Sleep disturbance was also associated with younger age (p = 0.008). CONCLUSIONS Patients undergoing chemotherapy or radiation for breast cancer report higher levels of sleep disturbance than those not receiving adjuvant therapy. Sleep disturbance is associated with other symptoms experienced by patients with cancer and thus requires continual assessment and future research into effective interventions.
Collapse
|
10
|
Daniel LC, Meltzer LJ, Gross JY, Flannery JL, Forrest CB, Barakat LP. Sleep practices in pediatric cancer patients: Indirect effects on sleep disturbances and symptom burden. Psychooncology 2021; 30:910-918. [PMID: 33686678 DOI: 10.1002/pon.5669] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/15/2021] [Accepted: 02/18/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Sleep hygiene recommendations are commonly given to address patient-reported concerns about sleep, yet few studies have examined the relationship between sleep hygiene and sleep disturbances in the context of pediatric oncology. Because poor sleep may affect the patient's experience of cancer-related symptoms, understanding whether sleep hygiene practices influence sleep disturbances and symptoms may be important to improving symptom burden. METHODS One hundred and two caregivers of children ages 5-17 and 59 patients ages 8-17 receiving treatment for cancer completed parallel measures of child sleep, sleep hygiene, pain, fatigue, and nausea. Sleep hygiene practices were described, correlates between measures were examined, and the indirect relationship of sleep hygiene on symptom burden through sleep disturbances was tested using PROCESS. RESULTS Patients received adequate sleep for age but sleep timing was later than recommended for more than half of the sample and consistency in sleep times was poor. Sleep disturbances were moderately related to all symptoms, with the exception of patient-reported fatigue. Consistent sleep habits were indirectly related to fewer cancer-related symptoms of pain, fatigue, and nausea through sleep disturbances by caregiver report but not patient report. CONCLUSION Sleep disturbances are closely related to pain, fatigue, and nausea in pediatric cancer. Consistency in sleep/wake routines and schedules may be important to experiencing fewer sleep disturbances and lower symptom burden. Providing recommendations supporting consistent sleep habits broadly across pediatric oncology may be more effective than only presenting sleep hygiene recommendations to patients experiencing poor sleep.
Collapse
Affiliation(s)
- Lauren C Daniel
- Department of Psychology, Rutgers University-Camden, Camden, New Jersey, USA
| | - Lisa J Meltzer
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
| | - J Yael Gross
- Department of Psychology, Rutgers University-Camden, Camden, New Jersey, USA
| | - Jamie L Flannery
- Department of Psychology, Rutgers University-Camden, Camden, New Jersey, USA
| | - Christopher B Forrest
- Department of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lamia P Barakat
- Department of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
11
|
Vaid AK, Gupta S, Doval DC, Agarwal S, Nag S, Patil P, Goswami C, Ostwal V, Bhagat S, Patil S, Barkate H. Expert Consensus on Effective Management of Chemotherapy-Induced Nausea and Vomiting: An Indian Perspective. Front Oncol 2020; 10:400. [PMID: 32292721 PMCID: PMC7120415 DOI: 10.3389/fonc.2020.00400] [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: 09/30/2019] [Accepted: 03/05/2020] [Indexed: 11/25/2022] Open
Abstract
Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and feared side effects in cancer patients undergoing chemotherapy. Scientific evidence proves its detrimental impact on a patient's quality of life (QoL), treatment compliance, and overall healthcare cost. Despite the CINV-management landscape witnessing a radical shift with the introduction of novel, receptor-targeting antiemetic agents, this side effect remains a chink in the armor of a treating oncologist. Though global guidelines acknowledge patient-specific risk factors and chemotherapeutic agent emetogenic potential in CINV control, a “one-fit-for-all” approach cannot be followed across all geographies. Hence, in a pioneering attempt, India-based oncologists conveyed easily implementable, region-specific, consensus-based statements on CINV prevention and management. These statements resulted from integrating the analysis of scientific evidence and guidelines on CINV by the experts, with their clinical experience. The statements will strengthen decision-making abilities of Indian oncologists/clinicians and help in achieving consistency in CINV prevention and management in the country. Furthermore, this document shall lay the foundation for developing robust Indian guidelines for CINV prevention and control.
Collapse
Affiliation(s)
- Ashok K Vaid
- Medical Oncology and Hematology, Medanta - The Medicity, Gurugram, India
| | | | - Dinesh C Doval
- Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Shyam Agarwal
- Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - Shona Nag
- Medical Oncology, Sahyadri Hospital, Pune, India
| | - Poonam Patil
- Medical Oncologist, Manipal Hospital, Bangalore, India
| | - Chanchal Goswami
- Oncology Services, MEDICA Super Speciality Hospital, Kolkata, India
| | - Vikas Ostwal
- Medical Oncology, TATA Memorial Hospital, Mumbai, India
| | - Sagar Bhagat
- Medical Services, HO IF, Glenmark Pharmaceuticals Ltd., Mumbai, India
| | - Saiprasad Patil
- Medical Services, IF, Glenmark Pharmaceuticals Ltd., Mumbai, India
| | - Hanmant Barkate
- Medical Services, IF & MEA, Glenmark Pharmaceuticals Ltd., Mumbai, India
| |
Collapse
|
12
|
Perez-Pozuelo I, Zhai B, Palotti J, Mall R, Aupetit M, Garcia-Gomez JM, Taheri S, Guan Y, Fernandez-Luque L. The future of sleep health: a data-driven revolution in sleep science and medicine. NPJ Digit Med 2020; 3:42. [PMID: 32219183 PMCID: PMC7089984 DOI: 10.1038/s41746-020-0244-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/18/2020] [Indexed: 01/04/2023] Open
Abstract
In recent years, there has been a significant expansion in the development and use of multi-modal sensors and technologies to monitor physical activity, sleep and circadian rhythms. These developments make accurate sleep monitoring at scale a possibility for the first time. Vast amounts of multi-sensor data are being generated with potential applications ranging from large-scale epidemiological research linking sleep patterns to disease, to wellness applications, including the sleep coaching of individuals with chronic conditions. However, in order to realise the full potential of these technologies for individuals, medicine and research, several significant challenges must be overcome. There are important outstanding questions regarding performance evaluation, as well as data storage, curation, processing, integration, modelling and interpretation. Here, we leverage expertise across neuroscience, clinical medicine, bioengineering, electrical engineering, epidemiology, computer science, mHealth and human-computer interaction to discuss the digitisation of sleep from a inter-disciplinary perspective. We introduce the state-of-the-art in sleep-monitoring technologies, and discuss the opportunities and challenges from data acquisition to the eventual application of insights in clinical and consumer settings. Further, we explore the strengths and limitations of current and emerging sensing methods with a particular focus on novel data-driven technologies, such as Artificial Intelligence.
Collapse
Affiliation(s)
- Ignacio Perez-Pozuelo
- Department of Medicine, University of Cambridge, Cambridge, UK
- The Alan Turing Institute, London, UK
| | - Bing Zhai
- Open Lab, University of Newcastle, Newcastle, UK
| | - Joao Palotti
- Qatar Computing Research Institute, HBKU, Doha, Qatar
- CSAIL, Massachusetts Institute of Technology, Cambridge, MA USA
| | | | | | - Juan M. Garcia-Gomez
- BDSLab, Instituto Universitario de Tecnologias de la Informacion y Comunicaciones-ITACA, Universitat Politecnica de Valencia, Valencia, Spain
| | - Shahrad Taheri
- Department of Medicine and Clinical Research Core, Weill Cornell Medicine - Qatar, Qatar Foundation, Doha, Qatar
| | - Yu Guan
- Open Lab, University of Newcastle, Newcastle, UK
| | | |
Collapse
|
13
|
Singh K, Paul SM, Kober KM, Conley YP, Wright F, Levine JD, Joseph PV, Miaskowski C. Neuropsychological Symptoms and Intrusive Thoughts Are Associated With Worse Trajectories of Chemotherapy-Induced Nausea. J Pain Symptom Manage 2020; 59:668-678. [PMID: 31689477 PMCID: PMC7024637 DOI: 10.1016/j.jpainsymman.2019.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/20/2019] [Accepted: 10/23/2019] [Indexed: 12/12/2022]
Abstract
CONTEXT Although chemotherapy-induced vomiting is well controlled with evidence-based antiemetic regimens, chemotherapy-induced nausea (CIN) remains a significant clinical problem. OBJECTIVES Study purposes, in a sample of outpatients with breast, gastrointestinal, gynecological, or lung cancer who received two cycles of chemotherapy (CTX, n = 1251), were to evaluate for interindividual differences in the severity of CIN and to determine which demographic, clinical, symptom, and stress characteristics are associated with higher initial levels as well as with the trajectories of CIN. METHODS Patients were recruited during their first or second cycle of CTX. Patients completed self-report questionnaires a total of six times over two cycles of CTX. Hierarchical linear modeling was used to evaluate for interindividual differences in and characteristics associated with the severity of CIN. RESULTS Across the two cycles of CTX, higher levels of sleep disturbance, depression, and morning fatigue, as well as higher levels of intrusive thoughts, were associated with higher initial levels of CIN. In addition, lower functional status scores and shorter cycle lengths were associated with higher initial levels of CIN, and younger age and higher emetogenicity of the CTX regimen were associated with both higher initial levels as well as worse trajectories of CIN severity. CONCLUSION These findings suggest that common symptoms associated with cancer and its treatment are associated with increased severity of CIN. Targeted interventions for these symptoms may reduce the burden of unrelieved CIN.
Collapse
Affiliation(s)
- Komal Singh
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Fay Wright
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA
| | - Paule V Joseph
- Sensory Science & Metabolism Unit, Biobehavioral Branch, Division of Intramural Research, Department of Health and Human Services, National Institutes of Health, Bethesda, Maryland, USA
| | | |
Collapse
|
14
|
Wang JP, Lu SF, Guo LN, Ren CG, Zhang ZW. Poor preoperative sleep quality is a risk factor for severe postoperative pain after breast cancer surgery: A prospective cohort study. Medicine (Baltimore) 2019; 98:e17708. [PMID: 31689803 PMCID: PMC6946447 DOI: 10.1097/md.0000000000017708] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to assess the effect of preoperative sleep quality on acute postoperative pain in breast cancer patients.The Pittsburgh Sleep Quality Index questionnaire (PSQI) was used to assess the overall sleep status of women scheduled for unilateral modified radical mastectomy in the past month. Based on the responses, patients were allocated to good sleep group or poor sleep group. Postoperatively, acute pain was assessed using the numerical rating score in the first 24 hours; in addition, the requirement of analgesics and the incidence of postoperative complications were recorded.A total of 108 breast surgery patients were enrolled. Based on the PSQI results, 55 (51%) patients were allocated to poor sleep group and 53 (49%) to good sleep group. Pain scores were similar in the 2 groups at the end of surgery (P = .589); however, poor sleep group reported higher postoperative pain scores than the good sleep group at 2 (P = .002), 6 (P < .001), 12 (P < .001), and 24 (P = .002) hours after surgery. The incidence of severe pain in the poor sleep group was higher than that in the good sleep group (27% vs 8%, P = .018), and the ratio of participants who required rescued analgesics was greater in the poor sleep group (52% vs 22%, P = .002). In addition, patients with poor sleep quality had more postoperative complications and longer hospital stay.In this study, breast cancer patients with poor preoperative sleep quality reported more severe postoperative pain, required more analgesics, experienced more complications, and had longer hospital stay.
Collapse
Affiliation(s)
- Jin-ping Wang
- School of Medicine, Shandong University, Jinan City
- Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng City, Shandong Province, P.R. China
| | - Su-fen Lu
- Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng City, Shandong Province, P.R. China
| | - Li-na Guo
- Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng City, Shandong Province, P.R. China
| | - Chun-guang Ren
- Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng City, Shandong Province, P.R. China
| | - Zong-wang Zhang
- School of Medicine, Shandong University, Jinan City
- Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng City, Shandong Province, P.R. China
| |
Collapse
|
15
|
Son KL, Jung D, Lee KM, Hwang H, Lee J, Kim TY, Im SA, Lee KH, Spiegel D, Hahm BJ. Morning chronotype is a protective factor against chemotherapy-induced hot flashes in premenopausal women with breast cancer. Support Care Cancer 2019; 28:1351-1358. [PMID: 31264189 DOI: 10.1007/s00520-019-04949-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/18/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE Adjuvant chemotherapy in patients with breast cancer often causes hot flashes, impairing quality of life. However, the chronobiological or psychiatric factors associated with the development of chemotherapy-induced hot flashes (CIHFs) remain undetermined. The purpose of this study was to investigate whether chronotype was associated with the incidence of CIHFs. METHODS A total of 119 premenopausal women with non-metastatic breast cancer awaiting adjuvant chemotherapy after surgery without hot flashes were included. The presence of CIHF was defined as having moderate to severe hot flashes, as measured by the subscale of hot flashes in the Menopause Rating Scale, at 4 weeks after the completion of chemotherapy. Chronotype (Morning/Intermediate/Evening) was assessed with the Composite Scale of Morningness before adjuvant chemotherapy. To examine the association between chronotype and CIHF, we built logistic regression models, adjusting for age, body mass index, sleep quality, and radiation therapy. RESULTS CIHF occurred in 50.4% of participants. Morning type was inversely associated with CIHF (reference: Intermediate type, odds ratio [OR], 0.37; 95% confidence interval [CI], 0.16-0.94; p = 0.040) in the univariate model, and the association remained significant (OR, 0.37; CI, 0.13-0.96; p = 0.045) after adjusting for age, body mass index, sleep quality, and radiation therapy. CONCLUSIONS Morning chronotype is a protective factor against the development of CIHF in patients with breast cancer. Chronotypes should be assessed and considered in the prediction and management of CIHF.
Collapse
Affiliation(s)
- Kyung-Lak Son
- Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Dooyoung Jung
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Kwang-Min Lee
- Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, South Korea.,Department of Public Health Medical Service, Seoul National University Hospital, Seoul, South Korea.,Department of Psychiatry, Chungcheongnam-do Seosan Medical Center, Seosan, South Korea
| | - Heesung Hwang
- Department of Psychiatry, Bucheon Korea Hospital, Bucheon, South Korea
| | - JooYoung Lee
- Department of Psychiatry, University of Maryland Medical Center, Baltimore, MD, USA
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.,Cancer Research Institute, Seoul National University, Seoul, South Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.,Cancer Research Institute, Seoul National University, Seoul, South Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.,Cancer Research Institute, Seoul National University, Seoul, South Korea
| | - David Spiegel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Bong-Jin Hahm
- Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, South Korea. .,Department of Psychiatry, Seoul National University Hospital, Seoul, South Korea.
| |
Collapse
|
16
|
Liu L, Petrich S, McLaren B, Kelly L, Baxter GD. An integrative Tai Chi program for patients with breast cancer undergoing cancer therapy: study protocol for a randomized controlled feasibility study. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018. [PMID: 29526243 DOI: 10.1016/j.joim.2017.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Breast cancer patients experience various side effects during cancer therapy, often resulting in reduced quality of life and poor adherence to treatment. A limited range of proven interventions has been developed to target such side effects. While Tai Chi offers benefits for the health and well-being of breast cancer survivors, the effectiveness of Tai Chi across the treatment continuum has not been evaluated. Improved patient education and support has been suggested as a priority for breast cancer care. This pilot study assesses the feasibility of a randomized controlled trial (RCT) to evaluate the effectiveness of "an integrative Tai Chi" (ANITA) program for breast cancer patients undergoing cancer therapy. METHODS/DESIGN This is a single-centre, two-arm feasibility RCT. Twenty-four patients with breast cancer who have undergone surgical treatment will be recruited from the Dunedin Hospital (New Zealand) over a 12-month period (from August 2017 to July 2018). Subject to informed consent, patients will be randomized to receive standard cancer treatment alone or standard cancer treatment plus the ANITA program, consisting of peer support, health education, and Tai Chi Ruler exercise. The program runs alongside the patient's adjuvant cancer therapy, which may include chemotherapy, radiation therapy, antibody treatment, and/or antihormonal therapy. Analysis in this study will focus on process evaluation of participant recruitment, retention, treatment fidelity, acceptability of the program, and occurrence of adverse events. Clinical outcomes (i.e., fatigue, sleep quality, anxiety and depression and quality of life) will be assessed at baseline, and at 12 weeks and 24 weeks post-randomization. DISCUSSION Outcomes from this study will inform the feasibility and methodology for a future fully-powered RCT. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry with the identifier ACTRN12617000975392.
Collapse
Affiliation(s)
- Lizhou Liu
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand.
| | - Simone Petrich
- Department of Surgical Sciences, Southern District Health Board, Dunedin 9016, New Zealand
| | - Blair McLaren
- Oncology Department, Southern District Health Board, Dunedin 9016, New Zealand
| | - Lyndell Kelly
- Oncology Department, Southern District Health Board, Dunedin 9016, New Zealand
| | - G David Baxter
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand
| |
Collapse
|
17
|
Lee KM, Jung DY, Hwang H, Kim WH, Lee JY, Kim TY, Im SA, Lee KH, Spiegel D, Hahm BJ. Late chronotypes are associated with neoadjuvant chemotherapy-induced nausea and vomiting in women with breast cancer. Chronobiol Int 2017; 34:480-491. [PMID: 28362229 DOI: 10.1080/07420528.2017.1295978] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Neoadjuvant chemotherapy, that is, the administration of chemotherapy before surgery, has been commonly used for locally advanced breast cancer to improve the surgical outcomes and increase the opportunity for breast-conserving therapy. Women with breast cancer often receive an anthracycline-based regimen as the neoadjuvant chemotherapy, which is associated with a high risk of emesis. Despite the development of novel antiemetics, chemotherapy-induced nausea and vomiting (CINV) has been commonly reported as a major adverse effect, affecting the quality of life of the patients. However, the factors predicting CINV in women with breast cancer undergoing neoadjuvant chemotherapy remain unclear. In this single-institution, prospective, observational study conducted at an outpatient cancer centre in the Republic of Korea from November 2013 to March 2016, we analysed women with breast cancer who planned to be treated with neoadjuvant chemotherapy before surgery. Candidate factors associated with CINV were assessed before neoadjuvant chemotherapy using the Munich Chronotype Questionnaire, Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale. CINV was assessed after chemotherapy by using the Multinational Association of Supportive Care in Cancer Antiemesis Tool. Of a total of 143 participants, 7 patients were lost to follow-up and 2 patients were excluded due to changes in their treatment plan; thus, 134 patients were finally included in the analyses. Overall, 48.5% of the participants experienced CINV, with delayed CINV prevalence (42.5%) being more common than acute (39.6%). In the univariate analyses, overall CINV was significantly associated with late chronotypes (odds ratio [OR], 3.49; 95% confidence interval [CI], 1.37-8.87; p = 0.009), a history of nausea/vomiting (OR, 2.19; 95% CI, 1.10-4.37; p = 0.026) and anxiety (OR, 2.25; 95% CI, 1.05-4.81; p = 0.036). In the multivariate analyses, late chronotypes (OR, 3.53; 95% CI, 1.27-9.79; p = 0.015) and a history of nausea/vomiting (OR, 2.83; 95% CI, 1.31-6.13; p = 0.008) remained significantly associated with CINV. In conclusion, in women with breast cancer undergoing neoadjuvant chemotherapy before surgery, late chronotypes were found to have an increased risk of CINV; these data suggest that clinicians need to assess and consider the chronotype in the management of CINV.
Collapse
Affiliation(s)
- Kwang-Min Lee
- a Department of Psychiatry and Behavioral Sciences , Seoul National University College of Medicine , Seoul , Korea.,b Public Health Medical Service, Seoul National University Hospital , Seoul , Korea.,c Department of Psychiatry , Gyeonggi Provincial Medical Center Uijeongbu Hospital , Uijeongbu , Korea
| | - Doo-Young Jung
- d Department of Human Factors Engineering , Ulsan National Institute of Science and Technology , Ulsan , Korea
| | - Heesung Hwang
- e Department of Neuropsychiatry , Seoul National University Hospital , Seoul , Korea
| | - Won-Hyoung Kim
- f Department of Psychiatry , Inha University Hospital , Incheon , Korea
| | - Joo-Young Lee
- g Department of Health Management , Armed Forces Medical Command , Seongnam , Korea
| | - Tae-Yong Kim
- h Department of Internal Medicine , Seoul National University Hospital , Seoul , Korea.,i Cancer Research Institute, Seoul National University , Seoul , Korea
| | - Seock-Ah Im
- h Department of Internal Medicine , Seoul National University Hospital , Seoul , Korea.,i Cancer Research Institute, Seoul National University , Seoul , Korea.,j Department of Internal Medicine , Seoul National University College of Medicine , Seoul , Korea
| | - Kyung-Hun Lee
- h Department of Internal Medicine , Seoul National University Hospital , Seoul , Korea.,i Cancer Research Institute, Seoul National University , Seoul , Korea
| | - David Spiegel
- k Department of Psychiatry and Behavioral Sciences , Stanford University , Stanford , CA , USA
| | - Bong-Jin Hahm
- a Department of Psychiatry and Behavioral Sciences , Seoul National University College of Medicine , Seoul , Korea.,e Department of Neuropsychiatry , Seoul National University Hospital , Seoul , Korea
| |
Collapse
|