|
1
|
Scaramuzzo L, Perna A, Velluto C, Borruto MI, Gorgoglione FL, Proietti L. Rethinking Strategies for Multi-Metastatic Patients: A Comprehensive Retrospective Analysis on Open Posterior Fusion Versus Percutaneous Osteosynthesis in the Treatment of Vertebral Metastases. J Clin Med 2024; 13:3343. [PMID: 38893054 PMCID: PMC11173164 DOI: 10.3390/jcm13113343] [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: 03/15/2024] [Revised: 05/16/2024] [Accepted: 06/04/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Managing vertebral metastases (VM) is still challenging in oncology, necessitating the use of effective surgical strategies to preserve patient quality of life (QoL). Traditional open posterior fusion (OPF) and percutaneous osteosynthesis (PO) are well-documented approaches, but their comparative efficacy remains debated. Methods: This retrospective study compared short-term outcomes (6-12 months) between OPF and PO in 78 cancer patients with spinal metastases. This comprehensive evaluation included functional, clinical, and radiographic parameters. Statistical analysis utilized PRISM software (version 10), with significance set at p < 0.05. Results: PO demonstrated advantages over OPF, including shorter surgical durations, reduced blood loss, and hospital stay, along with lower perioperative complication rates. Patient quality of life and functional outcomes favored PO, particularly at the 6-month mark. The mortality rates at one year were significantly lower in the PO group. Conclusions: Minimally invasive techniques offer promising benefits in VM management, optimizing patient outcomes and QoL. Despite limitations, this study advocates for the adoption of minimally invasive approaches to enhance the care of multi-metastatic patients with symptomatic VM.
Collapse
Affiliation(s)
- Laura Scaramuzzo
- Department of Aging, Orthopaedic and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (L.S.); (M.I.B.); (L.P.)
| | - Andrea Perna
- Department of Orthopaedics and Traumatology, Fondazione Casa Sollievo della Sofferenza IRCCS, 71013 San Giovanni Rotondo, Italy; (A.P.); (F.L.G.)
| | - Calogero Velluto
- Department of Aging, Orthopaedic and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (L.S.); (M.I.B.); (L.P.)
| | - Maria Ilaria Borruto
- Department of Aging, Orthopaedic and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (L.S.); (M.I.B.); (L.P.)
| | - Franco Lucio Gorgoglione
- Department of Orthopaedics and Traumatology, Fondazione Casa Sollievo della Sofferenza IRCCS, 71013 San Giovanni Rotondo, Italy; (A.P.); (F.L.G.)
| | - Luca Proietti
- Department of Aging, Orthopaedic and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy; (L.S.); (M.I.B.); (L.P.)
| |
Collapse
|
|
2
|
Purdy GM, Venner CP, Tandon P, McNeely ML. Feasibility of a tailored and virtually supported home exercise program for people with multiple myeloma using a novel eHealth application. Digit Health 2022; 8:20552076221129066. [PMID: 36249481 PMCID: PMC9554139 DOI: 10.1177/20552076221129066] [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] [Received: 03/23/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction eHealth exercise interventions have the unique ability to leverage the benefits of in-person programming (tailoring and supervision) with the benefits of home programming (flexibility). There may be a role for eHealth-delivered exercise for people with multiple myeloma (MM), as exercise tailoring and supervision are critical for successful outcomes due to the significant impacts/risks of myeloma-related side effects. The purpose of this study was to determine the safety, feasibility, and preliminary efficacy of a 12-week virtually supported eHealth exercise program. Methods Participants with MM completed a 12-week virtually supported home exercise program involving virtually supervised group workouts, independent workouts, and aerobic exercise. Tailoring was facilitated by the functionality of HEAL-Me, a novel eHealth app. Participants completed virtual fitness assessments and questionnaires at baseline and week 12. Results Twenty-nine participants consented, 26 completed all follow-up testing (90%). Exercise adherence was 90% (group), 83% (independent), and 90% (aerobic). No serious adverse events (grade ≥3) occurred. Significant improvements were found for quality of life and physical fitness. There was a high level of program/app satisfaction: 96% of participants agreed or strongly agreed that the exercise program was beneficial, 93% found it enjoyable, 89% were satisfied or very satisfied with delivery through the HEAL-Me app, and 48% felt that the eHealth program helped them manage cancer-related symptoms and side-effects. Conclusion An eHealth intervention that is individually tailored and includes virtual supervision and active support from the healthcare team is feasible and acceptable to people with MM. The findings from this study warrant investigation using a large-scale randomized controlled trial.
Collapse
Affiliation(s)
- Graeme M. Purdy
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada,Margaret L. McNeely, Department of Physical Therapy, Faculty of Rehabilitation Medicine, Department of Oncology, Cross Cancer Institute, University of Alberta, 3-44L Corbett Hall, Edmonton, Alberta, Canada.
| | | | - Puneeta Tandon
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Margaret L. McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada,Cross Cancer Institute, Edmonton, Canada
| |
Collapse
|
|
3
|
Datzmann T, Kisel W, Kramer J, Dreimann M, Müller-Broich JD, Netzer C, Schaser KD, Schmitt J, Disch AC. eCross-cultural adaptation of the spine oncology-specific SOSGOQ2.0 questionnaire to German language and the assessment of its validity and reliability in the clinical setting. BMC Cancer 2021; 21:1044. [PMID: 34556063 PMCID: PMC8459467 DOI: 10.1186/s12885-021-08578-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 07/07/2021] [Indexed: 12/02/2022] Open
Abstract
Background The recently developed Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ2.0) was proven a valid and reliable instrument measuring health-related quality of life (HRQOL) for patients with spinal malignancies. A German version was not available. Objective A cross-cultural adaptation of the SOSGOQ2.0 to the German language and its multicenter evaluation. Methods In a multistep process, a cross-cultural adaptation of the SOSGOQ2.0 was conducted. Subsequently, a multicenter, prospective observational cohort study was initiated to assess the reliability and validity of the German adaptation. To assess external construct validity of the cross-cultural adapted questionnaire, a comparison to the established questionnaire QLQ-C30 from the European Organisation for Research and Treatment of Cancer was conducted. Mean-difference plots were used to measure the agreement between the questionnaires in total score and by domain (deviation from mean up to 10% allowed). Further reliability and validity tests were carried out. Change to baseline was analysed 3–16 weeks later after different interventions occurred. Clinically relevant thresholds in comparison to the EORTC QLQ-C30 questionnaire were evaluated by ROC curve analysis. Results We could enroll 113 patients from four different university hospitals (58 females, 55 males). Mean age was 64.11 years (sd 11.9). 80 patients had an ECOG performance status of 2 or higher at baseline. External construct validity in comparison to the EORTC QLQ-C30 questionnaire in total score and by domain was confirmed (range of deviation 4.4 to 9.0%). Good responsiveness for the domains Physical Functioning (P < .001) and Pain (P < .001) could be shown. The group mean values also displayed a difference in the domains of Social Functioning (P = .331) and Mental Health (P = .130), but not significant. The minimum clinically relevant threshold values for the questionnaire ranged from 4.0 to 7.5 points. Conclusions According to our results, the cross-cultural adapted questionnaire is a reliable and valid tool to measure HRQOL in German speaking patients with spinal malignancies. Especially the domains Physical Functioning and Pain showed overall good psychometric characteristics. In this way, a generic questionnaire, such as the EORTC QLQ-C30, can be usefully supplemented by spine-specific questions to increase the overall accuracy measuring HRQOL in patients with spinal malignancies. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08578-x.
Collapse
Affiliation(s)
- T Datzmann
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany. .,National Center for Tumor Diseases (NCT), Fetscherstraße 74, 01307, Dresden, Germany. .,German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany. .,Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany. .,Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Bautzner Landstraße 400, 01328, Dresden, Germany.
| | - W Kisel
- University Comprehensive Spine Center (UCSC), University Center for Orthopedics, Traumatology and Plastic Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - J Kramer
- University Comprehensive Spine Center (UCSC), University Center for Orthopedics, Traumatology and Plastic Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - M Dreimann
- Department of Trauma and Orthopedic Surgery, Center for Surgical Medicine, University Hospital Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - J D Müller-Broich
- Orthopedic University Hospital Friedrichsheim, Marienburgstraße 2, 60528, Frankfurt (Main), Germany
| | - C Netzer
- Spine Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - K D Schaser
- University Comprehensive Spine Center (UCSC), University Center for Orthopedics, Traumatology and Plastic Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - J Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.,National Center for Tumor Diseases (NCT), Fetscherstraße 74, 01307, Dresden, Germany
| | - A C Disch
- University Comprehensive Spine Center (UCSC), University Center for Orthopedics, Traumatology and Plastic Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | | |
Collapse
|
|
4
|
Nusca SM, Parisi A, Mercantini P, Gasparrini M, Pitasi FA, Lacopo A, Colonna V, Stella G, Cerulli C, Grazioli E, Tranchita E, Santoboni F, Latini E, Trischitta D, Vetrano M, Visco V, Pavan A, Vulpiani MC. Evaluation of a Post-Operative Rehabilitation Program in Patients Undergoing Laparoscopic Colorectal Cancer Surgery: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115632. [PMID: 34070340 PMCID: PMC8197504 DOI: 10.3390/ijerph18115632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/21/2021] [Accepted: 05/21/2021] [Indexed: 01/07/2023]
Abstract
This pilot study explores the effects of a post-operative physical exercise program on the quality of life (QoL) and functional and nutritional parameters of patients that underwent laparoscopic colorectal cancer surgery, compared to usual care alone. The intervention group (IG) attended a 2-month-long supervised and combined exercise–training program during the post-operative period. Both IG and control group (CG) participated in the QoL, functional, and nutritional assessments before exercise training (T0), 2 months after the beginning of the exercise (end of treatment) (T1), and 2 (T2) and 4 (T3) months from the end of treatment. Eleven patients with colorectal cancer that underwent laparoscopic surgery were enrolled (six intervention; five control). The IG showed significant improvements compared to the CG in “Physical functioning” (PF2) (p = 0.030), “Cognitive functioning” (CF) (p = 0.018), and “Fatigue” (FA) (p = 0.017) of the European Organization for Research and Treatment of Cancer Quality of Life-C30 Questionnaire (EORTC QLQ-C30) at T1; in SMWT (p = 0.022) at T1; in PF2 (p = 0.018) and FA (p = 0.045) of EORTC QLQ-C30 at T2, in phase angle (PhA) of bioelectrical impedance analysis (p = 0.022) at T3. This pilot study shows that a post-operative, combined, and supervised physical exercise program may have positive effects in improving the QoL, functional capacity, and nutritional status in patients that undergo laparoscopic colorectal cancer surgery.
Collapse
Affiliation(s)
- Sveva Maria Nusca
- PhD Course in “Translational Medicine and Oncology”, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy
- Correspondence:
| | - Attilio Parisi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.P.); (C.C.); (E.G.); (E.T.)
| | - Paolo Mercantini
- Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy;
| | - Marcello Gasparrini
- Department of General Surgery, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy;
| | - Francesco Antonio Pitasi
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Alessandra Lacopo
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Vincenzo Colonna
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Giulia Stella
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Claudia Cerulli
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.P.); (C.C.); (E.G.); (E.T.)
| | - Elisa Grazioli
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.P.); (C.C.); (E.G.); (E.T.)
| | - Eliana Tranchita
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.P.); (C.C.); (E.G.); (E.T.)
| | - Flavia Santoboni
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Eleonora Latini
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Donatella Trischitta
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Mario Vetrano
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| | - Vincenzo Visco
- Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (V.V.); (A.P.)
| | - Antonio Pavan
- Department of Clinical and Molecular Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (V.V.); (A.P.)
| | - Maria Chiara Vulpiani
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea University Hospital, “Sapienza” University of Rome, 00189 Rome, Italy; (F.A.P.); (A.L.); (V.C.); (G.S.); (F.S.); (E.L.); (D.T.); (M.V.); (M.C.V.)
| |
Collapse
|
|
5
|
Downie S, Stillie A, Moran M, Sudlow C, Simpson H. Patient-reported assessment of outcome after surgery for bone metastases. Orthop Rev (Pavia) 2021; 13:9062. [PMID: 33953891 PMCID: PMC8077288 DOI: 10.4081/or.2021.9062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/20/2021] [Indexed: 12/14/2022] Open
Abstract
Regardless of prognosis, surgery is often considered in metastatic bone disease (MBD) as a palliative procedure to improve function and quality of life. Traditional focus on objective outcomes such as mortality is inappropriate in this group, and there is a drive to assess outcomes via patient-reported outcome measures (PROMs). This is an overview of current understanding of MBD outcomes and how this should influence future decision-making and research. The objectives of this review were to identify difficulties in measuring PROMs in the MBD patient population and explore alternatives to patientreported outcomes. We also provide an overview of current understanding of outcomes in MBD and how this should influence decision-making and direct research.
Collapse
Affiliation(s)
- Samantha Downie
- Orthopaedics and Trauma Department, The University of Edinburgh, Edinburgh
| | | | | | - Cathie Sudlow
- Division of Clinical Neurosciences, The University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - Hamish Simpson
- Orthopaedics and Trauma Department, The University of Edinburgh, Edinburgh
| |
Collapse
|
|
6
|
Ribi K, Thürlimann B, Schär C, Dietrich D, Cathomas R, Zürrer-Härdi U, von Briel T, Anchisi S, Bohanes P, Blum V, von Burg P, Mannhart M, Caspar CB, von Moos R, Mark M. Quality of life and pain in patients with metastatic bone disease from solid tumors treated with bone-targeted agents- a real-world cross-sectional study from Switzerland (SAKK 95/16). BMC Cancer 2021; 21:182. [PMID: 33607966 PMCID: PMC7893880 DOI: 10.1186/s12885-021-07903-8] [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] [Received: 10/09/2020] [Accepted: 02/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background Bone-targeted agents (BTAs) are widely used in the management of patients with bone metastases from solid tumors. Knowledge of the impact of their routine care use on patient-reported pain and bone pain-related quality of life (QoL) is limited. Methods This real world, cross-sectional study enrolled patients over a 3-month period through oncologists across Switzerland. Patients were ≥ 18 years, had solid tumors and at least one bone metastasis, and received routine care for bone metastases. Physicians provided data on BTA-related practices, risk of bone complications and BTA regimen. Patients completed questionnaires about pain (BPI-SF), general and bone pain-related QoL (FACT-G, FACT-BP) and treatment satisfaction (FACIT-TS-G). Results Eighteen sites recruited 417 patients. Based on the FACT-BP, 42% of the patients indicated not having bone pain. According to the BPI-SF, 28% reported no, 43% mild, 14% moderate, and 15% severe pain, respectively. Patients not treated with a BTA had better overall QoL (FACT-G: p = 0.031) and bone pain-related QoL (FACT-BP, p = 0.007) than those treated with a BTA. All pain and other QoL scales did not differ between groups. Patients perceived at ‘low risk of bone complications’ by their physician not receiving a BTA reported less pain and better QoL than those considered at ‘low risk’ but receiving BTA treatment or those considered at ‘high risk’ regardless of BTA treatment. Overall satisfaction with the treatment was good; almost 50% of patients reporting that they were completely satisfied. Conclusions Overall, pain and QoL did not differ according to BTA treatment or physicians’ risk perception. Patient with low risks not receiving BTA treatment reported least pain and highest QoL scores. These results may suggest that treating physicians assess bone complication risk appropriately and treat patients accordingly, but they need to be confirmed by objective determination of longitudinal skeletal complication risk. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-07903-8.
Collapse
Affiliation(s)
- Karin Ribi
- International Breast Cancer Study Group (IBCSG), Bern, Switzerland.
| | | | - Corinne Schär
- Swiss Group for Clinical Cancer Research (SAKK) Coordinating Center, Bern, Switzerland
| | - Daniel Dietrich
- Swiss Group for Clinical Cancer Research (SAKK) Coordinating Center, Bern, Switzerland
| | | | | | | | | | - Pierre Bohanes
- Centre de Chimiothérapie Anti-Cancéreuse, Lausanne, Switzerland
| | | | | | | | | | | | | |
Collapse
|
|
7
|
Downie S, Stillie A, Moran M, Sudlow C, Simpson AHRW. A prospective longitudinal study investigating outcomes including patient-reported outcome measures after surgery for metastatic bone disease. Bone Jt Open 2021; 2:79-85. [PMID: 33573398 PMCID: PMC7925207 DOI: 10.1302/2633-1462.22.bjo-2020-0173.r1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aims Surgery is often indicated in patients with metastatic bone disease (MBD) to improve pain and maximize function. Few studies are available which report on clinically meaningful outcomes such as quality of life, function, and pain relief after surgery for MBD. This is the published protocol for the Bone Metastasis Audit — Patient Reported Outcomes (BoMA-PRO) multicentre MBD study. The primary objective is to ascertain patient-reported quality of life at three to 24 months post-surgery for MBD. Methods This will be a prospective, longitudinal study across six UK orthopaedic centres powered to identify the influence of ten patient variables on quality of life at three months after surgery for MBD. Adult patients managed for bone metastases will be screened by their treating consultant and posted out participant materials. If they opt in to participate, they will receive questionnaire packs at regular intervals from three to 24 months post-surgery and their electronic records will be screened until death or five years from recruitment. The primary outcome is quality of life as measured by the European Organisation for Research and the Treatment of Cancer Quality of Life questionnaire (EORTC-QLQ) C30 questionnaire. The protocol has been approved by the Newcastle & North Tyneside 2 Research Ethics Committee (REC ref 19/NE/0303) and the study is funded by the Royal College of Physicians and Surgeons of Glasgow (RCPSG) and the Association for Cancer Surgery (BASO-ACS). Discussion This will be the first powered study internationally to investigate patient-reported outcomes after orthopaedic treatment for bone metastases. We will assess quality of life, function, and pain relief at three to 24 months post-surgery and identify which patient variables are significantly associated with a good outcome after MBD treatment. Cite this article: Bone Jt Open 2021;2(2):79–85.
Collapse
Affiliation(s)
- Samantha Downie
- Orthopaedics and Trauma Department, The University of Edinburgh, Edinburgh, UK
| | - Alison Stillie
- Department of Clinical Oncology, Western General Hospital, Edinburgh, UK
| | - Matthew Moran
- Orthopaedics and Trauma Department, The University of Edinburgh, Edinburgh, UK
| | - Catherine Sudlow
- Division of Clinical Neurosciences, The University of Edinburgh, Western General Hospital, Edinburgh, UK
| | | |
Collapse
|
|
8
|
|
|
9
|
Püsküllüoğlu M, Zygulska AL, Tomaszewska IM, Ochenduszko S, Konopka K, Tomaszewski KA. Evaluation of health-related quality of life and its main influencing factors in a Polish population of patients with bone metastases. Curr Probl Cancer 2016; 40:183-197. [PMID: 27855962 DOI: 10.1016/j.currproblcancer.2016.09.008] [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: 05/09/2016] [Revised: 08/23/2016] [Accepted: 09/21/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE Regardless of cancer type, the skeleton is one of the most common sites for cancer spread. Health-related Quality of Life (HRQoL) can be considered a primary endpoint in clinical trials concerning cancer patients with palliative disease. The proper measurement of this endpoint requires valid and reliable instruments. The aim of this study was to evaluate HRQoL and its main influencing factors using validated EORTC tools - the QLQ-C30 and the QLQ-BM22 in Polish population of patients with skeletal metastases. METHODS Patients with bone metastases and histologically confirmed malignancy were qualified for the study. They filled out a personal questionnaire, the Polish version of the EORTC QLQ-C30 and its supplementary module QLQ-BM22. The influence of numerous socio-clinical factors such as age, gender, working status, level of education, performance status, primary location, and previous treatment received was assessed. RESULTS One hundred and ten patients (65 women) were enrolled into this study (mean age ±SD; 57.8±13.8). The most significant HRQoL issues were fatigue (59.29/100); pain (56.97/100) and insomnia (56.36/100). Men coped worse with pain (p=0.013), fatigue (p=0.050), nausea and vomiting (p=0.024) and financial difficulties (p=0.016) than women. CONCLUSIONS The main factors influencing HRQoL in Polish patients with bone metastases are fatigue, pain and insomnia, and as such should be a primary focus of patient-centered care in this group.
Collapse
Affiliation(s)
- Mirosława Püsküllüoğlu
- Department of Clinical Oncology, University Hospital in Krakow, Poland; Department of Oncology, Jagiellonian University Medical College, Krakow, Poland.
| | - Aneta L Zygulska
- Department of Clinical Oncology, University Hospital in Krakow, Poland
| | - Iwona M Tomaszewska
- Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland
| | - Sebastian Ochenduszko
- Department of Clinical Oncology, University Hospital in Krakow, Poland; Department of Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Kamil Konopka
- Department of Clinical Oncology, University Hospital in Krakow, Poland
| | | |
Collapse
|
|
10
|
Wong E, Zhang L, Rowbottom L, Chiu N, Chiu L, McDonald R, Tsao M, Barnes E, Danjoux C, Chow E. Symptoms and quality of life in patients with brain metastases receiving whole-brain radiation therapy. Support Care Cancer 2016; 24:4747-59. [PMID: 27358169 DOI: 10.1007/s00520-016-3326-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 06/20/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE Patients with multiple brain metastases may be treated with whole-brain radiation therapy (WBRT). For these patients, symptom palliation and improvement of quality of life (QOL) and performance status is of the upmost importance. The objective of the present study was to determine the symptom experience and overall QOL in patients with brain metastases before and after WBRT. METHODS A total of 14 symptom scores and overall QOL were collected prospectively in 217 patients for up to 3 months. Wilcoxon signed rank test was applied to determine significant symptoms and QOL changes. Spearman's correlations were applied to determine the relationship between symptom scores and QOL. RESULTS Appetite loss, weakness, and nausea significantly increased from baseline, while balance, headache, and anxiety significantly decreased from baseline. At baseline, all symptoms other than coordination were significantly correlated with QOL. At 1-month follow-up (FU), changes in concentration, weakness, coordination, and balance were significantly associated with QOL changes. At 2-month FU, changes in pain, insomnia, concentration, balance, and depression were significantly associated with QOL changes. At 3-month FU, only change in nausea was significantly associated with QOL changes. CONCLUSIONS Following WBRT, certain symptoms may influence overall QOL to a greater extent than others, which may fluctuate with time.
Collapse
Affiliation(s)
- Erin Wong
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Liying Zhang
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Leigha Rowbottom
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Nicholas Chiu
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Leonard Chiu
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Rachel McDonald
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - May Tsao
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Barnes
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Cyril Danjoux
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Edward Chow
- Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
|
11
|
Ganesh V, Agarwal A, Popovic M, Cella D, McDonald R, Vuong S, Lam H, Rowbottom L, Chan S, Barakat T, DeAngelis C, Borean M, Chow E, Bottomley A. Comparison of the FACT-C, EORTC QLQ-CR38, and QLQ-CR29 quality of life questionnaires for patients with colorectal cancer: a literature review. Support Care Cancer 2016; 24:3661-8. [DOI: 10.1007/s00520-016-3270-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/05/2016] [Indexed: 11/24/2022]
|
|
12
|
Validation of the Chinese version of EORTC QLQ-BM22 in patients with bone metastases. Support Care Cancer 2015; 24:1019-24. [PMID: 26245496 DOI: 10.1007/s00520-015-2870-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 07/27/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Our aim is to test the validity, reliability, and acceptability of the Chinese version of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Bone Metastases 22 (EORTC QLQ-BM22) module to assess health-related quality of life (HRQOL) in patients with bone metastases in China. METHODS Patients with histological confirmation of malignancy and bone metastases from Tianjin Cancer Institution and Hospital from June 2013 to April 2014 were enrolled in this study. All patients self-administered the EORTC QLQ-BM22 and the EORTC QLQ-C30. The Karnofsky Performance Scale (KPS) was performed to evaluate scores. The reliability and validity tests of the questionnaires were based on Cronbach's α coefficients, Pearson correlation test, and Wilcoxon rank sum nonparametric test. RESULTS Internal consistency reliabilities of all the four scales were acceptable. Scales measuring similar HRQOL aspects were found to correlate with one another between EORTC QLQ-BM22 and EORTC QLQ-C30, but differences still existed. Significant differences were demonstrated in the scores of all four subscales of the QLQ-BM22 between the two KPS subgroups (KPS ≤ 80; KPS > 80). Meanwhile, the compliance for item completion of the QLQ-BM22 was satisfactory. CONCLUSIONS The Chinese version of EORTC QLQ-BM22 is a reliable and valid instrument, which is appropriate for measuring the HRQOL of patients with bone metastases in China.
Collapse
|
|
13
|
Chow R, Lao N, Popovic M, Chow E, Cella D, Beaumont J, Lam H, Pulenzas N, Bedard G, Wong E, DeAngelis C, Bottomley A. Comparison of the EORTC QLQ-BN20 and the FACT-Br quality of life questionnaires for patients with primary brain cancers: a literature review. Support Care Cancer 2015; 22:2593-8. [PMID: 25015058 DOI: 10.1007/s00520-014-2352-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 07/01/2014] [Indexed: 11/12/2022]
Abstract
PURPOSE This review compares and contrasts the development, validity, and characteristics of two quality of life (QOL) assessment tools used in patients with primary brain cancers: the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Brain Cancer Module (EORTC QLQ-BN20) and the Functional Assessment of Cancer Therapy-Brain (FACT-Br). METHODS A literature search was conducted using the Cochrane Central Register of Controlled Trials (June 2013), Ovid EMBASE (1947 to 2013, week 27), and Ovid MEDLINE (1946 to July 2013, week 1) to identify studies that discussed the development, characteristics, validity, and reliability of the EORTC QLQ-BN20 or the FACT-Br. RESULTS The EORTC QLQ-BN20 consists of 20 items that assess future uncertainty, visual disorder, motor dysfunction, and communication deficit. Items are presented as questions on a scale ranging from 1 = “not at all” to 4 = “very much.” Reliability and validity testing of the QLQ-BN20 revealed a Cronbach’s alpha coefficient that ranged from 0.71 to 0.90. The FACT-Br consists of 23 items that assess general well-being and brain cancer-specific concerns that include concentration, memory, seizures, eyesight, hearing, speech, personality, expression of thoughts, weakness, coordination, and headaches. These items are presented as statements on a scale ranging from 0 = “not applicable” to 4 = “extremely relevant.” The FACT-Br underwent validity as well as test-retest reliability testing with 101 and 46 patients, respectively. Validity testing found low to moderate correlation with the FACT-G questionnaire, while reliability testing for the brain subscale revealed an acceptable correlation coefficient (r = 0.66; p < 0.001). CONCLUSIONS The QLQ-BN20 and the FACT-Br are both valid and reliable tools that have been used extensively in the primary brain cancer population. Choice between the two tools should consider each instrument’s individual strengths and weaknesses.
Collapse
|
|
14
|
Does a regional comprehensive palliative care program improve pain in outpatient cancer patients? Support Care Cancer 2014; 22:2445-55. [PMID: 24705857 DOI: 10.1007/s00520-014-2232-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
Abstract
CONTEXT Pain is still a major problem for cancer patients, and the effect of a population-based approach on patients' experience of pain is not fully understood. AIMS The primary aim of this study was to clarify the changes in pain intensity in outpatients before and after a regional palliative care program. The secondary aim was to clarify the prevalence of patients who had unmet needs for pain treatment and to clarify the reasons for not wanting pain treatment. SUBJECTS AND METHODS A regional palliative care program was implemented in four regions of Japan. A region-representative sample of metastatic/locally advanced cancer patients in outpatient settings took part in questionnaire surveys before and after the regional intervention. Responses were obtained from 859 from 1,880 and 857 from 2,123 in the preintervention and postintervention surveys, respectively. RESULTS After a regional palliative care program, neither worst, average, nor least pain levels in outpatients changed significantly. A total of 134 patients (16 %) reported that they needed more pain treatment. There were various reasons for not wanting pain treatment, namely, minimum interference with daily life, general nonpreference for medicines, longstanding symptoms before the diagnosis of cancer, concerns about tolerance and addiction, and experienced neuropsychiatric symptoms under current medications. CONCLUSION The regional palliative care program failed to demonstrate improvement of the pain intensity of cancer outpatients. One possible interpretation is that they are less likely to be regarded as target populations and that the study population experienced generally well-controlled pain. Future study including patients with more severe pain is needed, but to improve pain levels of cancer outpatients, intensive, patient-directed intervention seems to be more promising than region-based intervention.
Collapse
|
|
15
|
Functional benefits are sustained after a program of supervised resistance exercise in cancer patients with bone metastases: longitudinal results of a pilot study. Support Care Cancer 2014; 22:1537-48. [DOI: 10.1007/s00520-013-2103-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 12/12/2013] [Indexed: 02/04/2023]
|
|
16
|
Yekaninejad MS, Ahmadzadeh A, Mosavi SH, Saffari M, Pakpour AH, Tolooei F, Chow E, Bottomley A. The reliability and validity of the Iranian version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for patients with Bone Metastases: the EORTC QLQ-BM22. Expert Rev Pharmacoecon Outcomes Res 2013; 14:147-56. [PMID: 24328844 DOI: 10.1586/14737167.2014.864559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of the present study was to evaluate the psychometric properties of the measure among a sample of Iranian patients with bone metastases. One hundred and seventy-seven patients with bone metastases undergoing various treatments were recruited from Imam Khomeini Hospital in Tehran to participate in the study. The coefficient alpha affirmed internal consistency reliability of the Quality of Life Questionnaire for patients with Bone Metastases (QLQ-BM22). This measure discriminated well between subgroups of the patients based on performance status and responding to treatment. Confirmatory factor analysis confirmed the factorial validity of the four hypothesized QLQ-BM22 scales. Patients in this study had a similar interpretation of the items on the QLQ-BM22 regardless of gender. All scales of the QLQ-BM22 were sensitive to change after treatment over a month's follow-up, with the exception of psychosocial aspects. The Persian version of the EORTC QLQ-BM22 was highly reliable and is valid for use among patients with bone metastases who are undergoing various treatment regimes.
Collapse
Affiliation(s)
- Mir S Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | | | | |
Collapse
|
|
17
|
Klein E, Altshuler D, Hallock A, Szerlip N. Quality of life research in neuro-oncology: a quantitative comparison. J Neurooncol 2013; 116:333-40. [DOI: 10.1007/s11060-013-1299-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 10/27/2013] [Indexed: 11/25/2022]
|
|
18
|
Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis 2013; 16:328-35. [PMID: 23917308 DOI: 10.1038/pcan.2013.22] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 05/30/2013] [Accepted: 06/26/2013] [Indexed: 01/10/2023]
Abstract
BACKGROUND Due to concerns of fragility fracture, exercise is a perceived contraindication for prostate cancer patients with bone metastases. These patients experience significant functional impairment and muscle atrophy, which may lead to an increased likelihood of skeletal complicaTIOns (i.e., pathological fracture, bone pain) and/or falls. Safe resistance exercise prescription may counteract this effect. The aim of this feasibility trial was to determine the safety and efficacy of resistance exercise by prostate cancer survivors with bone metastatic disease. METHODS Twenty men with established bone metastases secondary to prostate cancer were randomly assigned to a 12-week resistance exercise program in which exercise prescription was based on the location of bone lesions (n=10) or usual care (n=10). Outcomes included safety and tolerance of the exercise program, physical function, physical activity level, body composition, fatigue, quality of life and psychological distress. Outcomes were compared between groups using analysis of covariance adjusted for baseline values. RESULTS Participants had significant disease load with 65% of participants presenting with two or more regions affected by bone metastases and an average Gleason score of 8.2±0.9. Five participants (exercise=2; usual care=3) did not complete the intervention, three of which were due to advancing disease (exercise=2; usual care=1). No adverse events or skeletal complications occurred during the supervised exercise sessions. The exercise program was well tolerated as evidenced by high attendance (83%) and compliance rates (93%), and the ability of the participants to exercise at an intensity within the target range for cancer survivors (rating of perceived exertion =13.8±1.5). The change in physical function (muscle strength ∼11%; submaximal aerobic exercise capacity ∼5% and ambulation ∼12%), physical activity level (∼24%) and lean mass (∼3%) differed significantly between groups following the intervention, with favorable changes in the exercise group compared with the usual care group. No significant between-group differences were observed for fatigue, quality of life or psychological distress. CONCLUSIONS This initial evidence involving a small sample size suggests that appropriately designed and supervised resistance exercise may be safe and well tolerated by prostate cancer patients with bone metastatic disease and can lead to improvements in physical function, physical activity levels and lean mass. Future trials involving larger sample sizes are required to expand these preliminary findings.
Collapse
|
|
19
|
Validation of the Polish version of the EORTC QLQ-BM22 module for the assessment of health-related quality of life in patients with bone metastases. Qual Life Res 2013; 23:527-32. [PMID: 23912854 DOI: 10.1007/s11136-013-0486-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of our study was to undertake a prospective validation study of the Polish version of the European Organization for Research and Treatment of Cancer (EORTC) bone metastases (QLQ-BM22) module used alongside the EORTC core measure. METHODS The translated module was pilot-tested according to the established EORTC guidelines. Patients with histological confirmation of malignancy and bone metastases, diagnosed by imaging studies, were eligible for the study. All patients filled out the Polish version of the QLQ-BM22 module in addition to QLQ-C30 and a demographic questionnaire. Standard validity and reliability analyses were performed. RESULTS One hundred and fifty-five patients were enrolled into the study, including 94 women (60.7 %) and 61 men (mean age ± SD; 59.1 ± 12.1). Cronbach's alpha coefficients, range 0.68-0.93, showed positive internal consistency. Re-test was undertaken with fifty patients (32.3 %). Interclass correlations for the EORTC QLQ-BM22 ranged from 0.91 to 0.93 and proved sufficient test-retest reliability. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen. CONCLUSIONS Our study provides new and robust evidence which shows that the Polish version of the QLQ-BM22 module is a valid and reliable instrument for measuring health-related quality of life in patients with bone metastases. It is suitable for use in clinical trials and in research.
Collapse
|