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Nieder C, Imingen KS. Palliative Radiotherapy for Non-metastatic Non-small-cell Lung Cancer: Impact of Blood Test Results on Survival. In Vivo 2023; 37:771-776. [PMID: 36881095 PMCID: PMC10026628 DOI: 10.21873/invivo.13140] [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: 12/30/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND/AIM Non-small-cell lung cancer (NSCLC) not amenable to curative treatment can be managed with palliative thoracic radiation or chemoradiation, however, with variable success. This study evaluated the prognostic impact of the LabBM score [serum lactate dehydrogenase (LDH), C-reactive protein, albumin, hemoglobin, platelets] in 56 patients who were scheduled to receive at least 10 fractions of 3 Gy. PATIENTS AND METHODS Uni- and multivariate analyses of prognostic factors for overall survival were employed in a retrospective single-institution study of stage II and III NSCLC. RESULTS The first multivariate analysis showed that hospitalization in the month before radiotherapy (p<0.001), concomitant chemoradiotherapy (p=0.03), and LabBM point sum (p=0.09) were the leading predictors of survival. A second model with individual blood tests rather than the sum score suggested that concomitant chemoradiotherapy (p=0.002), hemoglobin (p=0.01), LDH (p=0.04), and hospitalization before radiotherapy (p=0.08) played important roles. Surprisingly long survival was seen in patients without prior hospitalization who received concomitant chemoradiotherapy and had favorable LabBM score (0-1 points): median 24 months, 5-year rate 46%. CONCLUSION Blood biomarkers provide relevant prognostic information. The LabBM score has 1) previously been validated in patients with brain metastases and 2) demonstrated encouraging results in a cohort irradiated for different palliative non-brain indications, e.g., bone metastases. It might be helpful in predicting survival in patients with non-metastatic cancer, e.g., NSCLC stage II and III.
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Affiliation(s)
- Carsten Nieder
- Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway;
- Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Kristian S Imingen
- Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway
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Lynch C, Reguilon I, Langer DL, Lane D, De P, Wong WL, Mckiddie F, Ross A, Shack L, Win T, Marshall C, Revheim ME, Danckert B, Butler J, Dizdarevic S, Louzado C, Mcgivern C, Hazlett A, Chew C, O'connell M, Harrison S. A comparative analysis: international variation in PET-CT service provision in oncology-an International Cancer Benchmarking Partnership study. Int J Qual Health Care 2021; 33:6030987. [PMID: 33306102 PMCID: PMC7896108 DOI: 10.1093/intqhc/mzaa166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/10/2020] [Accepted: 12/11/2020] [Indexed: 12/17/2022] Open
Abstract
Objective To explore differences in position emission tomography-computed tomography (PET-CT) service provision internationally to further understand the impact variation may have upon cancer services. To identify areas of further exploration for researchers and policymakers to optimize PET-CT services and improve the quality of cancer services. Design Comparative analysis using data based on pre-defined PET-CT service metrics from PET-CT stakeholders across seven countries. This was further informed via document analysis of clinical indication guidance and expert consensus through round-table discussions of relevant PET-CT stakeholders. Descriptive comparative analyses were produced on use, capacity and indication guidance for PET-CT services between jurisdictions. Setting PET-CT services across 21 jurisdictions in seven countries (Australia, Denmark, Canada, Ireland, New Zealand, Norway and the UK). Participants None. Intervention(s) None. Main Outcome Measure(s) None. Results PET-CT service provision has grown over the period 2006–2017, but scale of increase in capacity and demand is variable. Clinical indication guidance varied across countries, particularly for small-cell lung cancer staging and the specific acknowledgement of gastric cancer within oesophagogastric cancers. There is limited and inconsistent data capture, coding, accessibility and availability of PET-CT activity across countries studied. Conclusions Variation in PET-CT scanner quantity, acquisition over time and guidance upon use exists internationally. There is a lack of routinely captured and accessible PET-CT data across the International Cancer Benchmarking Partnership countries due to inconsistent data definitions, data linkage issues, uncertain coverage of data and lack of specific coding. This is a barrier in improving the quality of PET-CT services globally. There needs to be greater, richer data capture of diagnostic and staging tools to facilitate learning of best practice and optimize cancer services.
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Affiliation(s)
- Charlotte Lynch
- International Cancer Benchmarking Partnership (ICBP), Policy & Information, Cancer Research UK, 2 2 Redman Place, London, E20 1JQ, UK
| | - Irene Reguilon
- International Cancer Benchmarking Partnership (ICBP), Policy & Information, Cancer Research UK, 2 2 Redman Place, London, E20 1JQ, UK.,Brand & Strategy, eConsult Health Ltd, 46-48 East Street, Surrey, KT17 1HQ, UK
| | - Deanna L Langer
- Cancer Imaging, Ontario Health (Cancer Care Ontario), 620 University Avenue, Toronto, ON M5G 2L7, Canada
| | - Damon Lane
- Radiology, Pacific Radiology, 123 Victoria Street, Christchurch Central, Christchurch 8013, New Zealand
| | - Prithwish De
- Surveillance and Cancer Registry, Ontario Health (Cancer Care Ontario), 620 University Avenue, Toronto, ON M5G 2L7, Canada
| | - Wai-Lup Wong
- Nuclear Medicine, Mount Vernon Hospital, East and North Hertfordshire NHS Trust, Rickmansworth Road, Northwood, HA6 2RN, UK
| | - Fergus Mckiddie
- Nuclear Medicine and PET Department, NHS Grampian, 2 Eday Road, Aberdeen AB15 6RE, UK
| | - Andrew Ross
- Dalhousie Medical School, Dalhousie University, 6299 South Street, Halifax, Nova Scotia, NS B3H 4R2, Canada
| | - Lorraine Shack
- Surveillance and Reporting, Alberta Health Services (Cancer Control Alberta), 10030-107 Street NW, Edmonton, Alberta, T5J 3E4, Canada
| | - Thida Win
- General and Respiratory Medicine, Lister Hospital, East and North Hertfordshire NHS Trust, Coreys Mill Lane, Stevenage, SG1 4AB, UK
| | - Christopher Marshall
- Wales Research and Diagnostic PET Imaging Centre, Cardiff University, Cardiff University School of Medicine Health Park, Cardiff, CF14, 4XN, UK
| | - Mona-Eliszabeth Revheim
- Division of Radiology and Nuclear Medicine, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Pb 4950 Nydalen, Oslo, 0424, Norway
| | - Bolette Danckert
- Research Centre, Danish Cancer Society, Strandboulevarden 49, 2100 Kobenhavn, Denmark
| | - John Butler
- International Cancer Benchmarking Partnership (ICBP), Policy & Information, Cancer Research UK, 2 2 Redman Place, London, E20 1JQ, UK.,Gynaecology Department, Royal Marsden NHS Foundation Trust, 203 Fulham Road, London, SW3 6JJ, UK
| | - Sabina Dizdarevic
- Imaging and Nuclear Medicine, Brighton and Sussex University Hospital Trust, Kemptown, Brighton, BN2 1ES, United Kingdom and Brighton and Sussex Medical School, University of Sussex and Brighton, London Road, Brighton, BN1 4GE, UK
| | - Cheryl Louzado
- Strategy Implementation Planning & Partner Relations, Canadian Partnership Against Cancer, 145 King St, Toronto, ON M5H 1J8, Canada
| | - Canice Mcgivern
- Department of Regional Medical Physics, Belfast Health and Social Care Trust, 83 Shankill Road, Belfast, BT13 1FD, UK
| | - Anne Hazlett
- Department of Regional Medical Physics, Belfast Health and Social Care Trust, 83 Shankill Road, Belfast, BT13 1FD, UK
| | - Cindy Chew
- School of Medicine, Dentistry and Nursing, University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK
| | - Martin O'connell
- Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin, DO7 R2WY, Ireland
| | - Samantha Harrison
- International Cancer Benchmarking Partnership (ICBP), Policy & Information, Cancer Research UK, 2 2 Redman Place, London, E20 1JQ, UK
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Huot S, Ho H, Ko A, Lam S, Tactay P, MacLachlan J, Raanaas RK. Identifying barriers to healthcare delivery and access in the Circumpolar North: important insights for health professionals. Int J Circumpolar Health 2020; 78:1571385. [PMID: 30696379 PMCID: PMC6352934 DOI: 10.1080/22423982.2019.1571385] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Lack of access to healthcare services for people living in the Circumpolar North may have important consequences for their health and well-being, both in terms of the actual treatment and other possible health-related consequences intertwined with their life situation. The aim of the present study was to identify the specific challenges to healthcare service delivery and access for populations in the Circumpolar North that are addressed in contemporary literature. A scoping review of literature published between 2005 and 2016 was conducted and 43 articles were selected for inclusion into the review. The review findings address 4 main themes identified in the literature: (1) the influence of physical geography, (2) healthcare provider-related barriers, (3) the importance of culture and language and (4) the impact of systemic factors. The review of the literature enabled us to identify existing gaps in both health service access and issues discussed in the available literature, particularly for informing healthcare services in the Circumpolar North, as well as point towards opportunities for future research. The thematic findings drawn from interdisciplinary and international literature inform understandings of the impact of health system barriers on healthcare services and the opportunities for Northern residents to support their own health.
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Affiliation(s)
- S Huot
- a Department of Occupational Science and Occupational Therapy , University of British Columbia , Vancouver , Canada
| | - H Ho
- b School of Occupational Therapy , University of Western Ontario , London , Canada
| | - A Ko
- b School of Occupational Therapy , University of Western Ontario , London , Canada
| | - S Lam
- b School of Occupational Therapy , University of Western Ontario , London , Canada
| | - P Tactay
- b School of Occupational Therapy , University of Western Ontario , London , Canada
| | - J MacLachlan
- c Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
| | - R K Raanaas
- d Department of Public Health Science , Norwegian University of Life Sciences , Ås , Norway
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