1
|
Zhu L, Li X, Zhou C, Tong Y, Liu Z, Huang C. Pelvic floor dysfunction after colorectal cancer treatment is related to physical and psychological health and body image: A cross-sectional study. Eur J Oncol Nurs 2023; 67:102425. [PMID: 37871415 DOI: 10.1016/j.ejon.2023.102425] [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: 07/31/2023] [Revised: 09/23/2023] [Accepted: 09/29/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE Pelvic floor dysfunction (PFD) often occurs in patients with colorectal cancer (CRC), which can affect their quality of life. However, the precise factors that related to PFD in CRC patients remain elusive. The main objective of this study was to identify the variables associated with PFD following CRC treatment and establish a foundation for the development of a tailored rehabilitation plan specific to this population. METHODS The classification of 149 patients with CRC was conducted according to the type of medical treatment they underwent. PFD was evaluated using the Urogenital Distress Inventory 6 (UDI-6) and Colorectal-Anal Distress Inventory 8 (CRADI-8) questionnaires. The study employed the Short form 36 health survey (SF-36) and Body Image Scale (BIS) to evaluate physical and psychological health as well as body image disorders. The connection between PFD and independent variables was determined through logistic regression analyses. RESULTS Of all patients, more than 50% reported experiencing dysfunction, with the highest proportion observed in the PRT (primary radiotherapy) group. The LRR/RR (robotic-assisted colorectal resection or laparoscopic colorectal resection) group revealed a significant association between high BMI (Body Mass Index) and alcohol consumption with PFD. Moreover, in the PRT group, PFD was correlated with poorer physical condition (OR = 0.94, 95% CI = [0.88-1.00]). CONCLUSIONS PFD is a commonly complained-about issue among patients with CRC. Early intervention targeted towards these factors may aid in the alleviation of associated distress and contribute towards the individualization of CRC rehabilitation programs, consequently improving the quality of life for patients.
Collapse
Affiliation(s)
- Liping Zhu
- Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xuhong Li
- Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chengyu Zhou
- Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yao Tong
- Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhaoxue Liu
- Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chenghui Huang
- Department of Oncology, The Third Xiangya Hospital, Central South University, Changsha, China.
| |
Collapse
|
2
|
Winters TA, Cassatt DR, Harrison-Peters JR, Hollingsworth BA, Rios CI, Satyamitra MM, Taliaferro LP, DiCarlo AL. Considerations of Medical Preparedness to Assess and Treat Various Populations During a Radiation Public Health Emergency. Radiat Res 2023; 199:301-318. [PMID: 36656560 PMCID: PMC10120400 DOI: 10.1667/rade-22-00148.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/21/2022] [Indexed: 01/20/2023]
Abstract
During a radiological or nuclear public health emergency, given the heterogeneity of civilian populations, it is incumbent on medical response planners to understand and prepare for a potentially high degree of interindividual variability in the biological effects of radiation exposure. A part of advanced planning should include a comprehensive approach, in which the range of possible human responses in relation to the type of radiation expected from an incident has been thoughtfully considered. Although there are several reports addressing the radiation response for special populations (as compared to the standard 18-45-year-old male), the current review surveys published literature to assess the level of consideration given to differences in acute radiation responses in certain sub-groups. The authors attempt to bring clarity to the complex nature of human biology in the context of radiation to facilitate a path forward for radiation medical countermeasure (MCM) development that may be appropriate and effective in special populations. Consequently, the focus is on the medical (as opposed to logistical) aspects of preparedness and response. Populations identified for consideration include obstetric, pediatric, geriatric, males, females, individuals of different race/ethnicity, and people with comorbidities. Relevant animal models, biomarkers of radiation injury, and MCMs are highlighted, in addition to underscoring gaps in knowledge and the need for consistent and early inclusion of these populations in research. The inclusion of special populations in preclinical and clinical studies is essential to address shortcomings and is an important consideration for radiation public health emergency response planning. Pursuing this goal will benefit the population at large by considering those at greatest risk of health consequences after a radiological or nuclear mass casualty incident.
Collapse
Affiliation(s)
- Thomas A Winters
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - David R Cassatt
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Jenna R Harrison-Peters
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Brynn A Hollingsworth
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Carmen I Rios
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Merriline M Satyamitra
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Lanyn P Taliaferro
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| | - Andrea L DiCarlo
- Radiation and Nuclear Countermeasures Program (RNCP), Division of Allergy, Immunology and Transplantation (DAIT), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland
| |
Collapse
|
3
|
White KL, Henson CC, Hann M, Eden M, Burden ST, Lal S, Davidson SE, McLaughlin JT. Randomised clinical trial of a gastrointestinal care bundle to reduce symptoms in patients with pelvic cancer undergoing chemoradiotherapy. BMJ Open Gastroenterol 2021; 7:bmjgast-2020-000432. [PMID: 32771983 PMCID: PMC7418694 DOI: 10.1136/bmjgast-2020-000432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/03/2020] [Accepted: 06/07/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Pelvic radiotherapy is used to treat 17 000 people in the UK each year. Eight in 10 develop difficult bowel problems during pelvic treatment, especially diarrhoea, urgency and incontinence. Some cannot complete treatment, reducing the chance of cancer cure. Undertaking gastroenterologist-led investigation and management during pelvic radiotherapy has never been evaluated. In this study, we aimed to assess whether patients could successfully receive a novel gastrointestinal (GI) care bundle during chemoradiotherapy (feasibility aim) and would experience reduced symptom severity (clinical impact aim). DESIGN This randomised controlled trial recruited patients with cervical and bladder cancers undergoing radical chemoradiotherapy. Participants were randomised to intervention or control groups. Questionnaire and anthropometric data were collected. All intervention group patients received individualised dietary counselling weekly throughout treatment, and if bowel symptoms developed they were offered rapid-access investigation and treatment for any identified pathology: lactose intolerance, bacterial overgrowth or bile acid malabsorption. RESULTS Feasibility: 50 participants were recruited, 24 were randomised to the intervention group and 26 to the control group. All completed 20 fractions of external beam pelvic radiotherapy. It was possible to perform 57/72 (79%) of proposed intervention tests with no disruption of oncological management. CLINICAL IMPACT All participants developed GI symptoms during radiotherapy. The median symptom score for each group increased from baseline at 6 weeks. This was from 0.156 (0.000-0.333) to 0.600 (0.250-1.286) in the control group, and from 0.00 (0.000-0.300) to 0.402 (0.000-0.667) in the intervention group. CONCLUSION It was feasible to recruit to and deliver a randomised controlled trial of interventions in patients undergoing pelvic chemoradiotherapy. Lower median bowel scores were reported in the intervention group at 6 weeks, with fewer patients experiencing symptoms overall. TRIAL REGISTRATION NUMBER ISRCTN783488.
Collapse
Affiliation(s)
- Katherine L White
- Gastroenterology, Manchester Foundation Trust, Wythenshawe Hospital, Manchester, UK.,Manchester Academic Health Sciences Centre, Health Innovation Manchester, Manchester, UK
| | - Caroline C Henson
- Gastroenterology, Manchester Foundation Trust, Wythenshawe Hospital, Manchester, UK.,Manchester Academic Health Sciences Centre, Health Innovation Manchester, Manchester, UK
| | - Mark Hann
- Manchester Academic Health Sciences Centre, Health Innovation Manchester, Manchester, UK.,Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Martin Eden
- Manchester Academic Health Sciences Centre, Health Innovation Manchester, Manchester, UK.,Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Sorrel T Burden
- Manchester Academic Health Sciences Centre, Health Innovation Manchester, Manchester, UK.,Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Salford Royal Foundation Trust, Salford, UK
| | - Simon Lal
- Manchester Academic Health Sciences Centre, Health Innovation Manchester, Manchester, UK.,Salford Royal Foundation Trust, Salford, UK
| | - Susan E Davidson
- Manchester Academic Health Sciences Centre, Health Innovation Manchester, Manchester, UK.,Christie NHS Foundation Trust, Manchester, UK
| | - John T McLaughlin
- Manchester Academic Health Sciences Centre, Health Innovation Manchester, Manchester, UK .,Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Salford Royal Foundation Trust, Salford, UK
| |
Collapse
|
4
|
Pisani R, Bezzina P, Couto JG. Effect of patient thickness on acute gastrointestinal toxicities following radiotherapy for prostate cancer. ACTA ACUST UNITED AC 2021; 26:352-359. [PMID: 34277088 PMCID: PMC8281905 DOI: 10.5603/rpor.a2021.0053] [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: 09/19/2020] [Accepted: 02/23/2021] [Indexed: 11/25/2022]
Abstract
Background There is conflicting literature regarding the effect of patient size on radiotherapy toxicities. This study aimed to determine whether there is any association between patient thickness and severity and incidence of acute GI toxicities of prostate cancer patients receiving VMAT radiotherapy. The impact of confounding factors was also examined: rectal dose, age and lymph node irradiation. Materials and methods This study used a non-experimental, retrospective, descriptive and cross-sectional design. All patients who complied with the inclusion criteria (n = 96) were included. GI toxicity scores (baseline and last week of radiotherapy), rectal dose, lymph nodes irradiation and patient age at diagnosis were collected from the treatment file. Patient separations were measured from the CT-Simulator images. Statistical tests were performed to analyse the influence of these factors on acute GI toxicities. Results Patient thickness was shown to have no statistically significant effect on the incidence (p = 0.947 for antero-posterior and p = 0.839 for lateral thicknesses), and severity (p = 0.986 and 0.905, respectively) of acute GI toxicities. Severity of GI toxicities increased following radiotherapy: the Expanded Prostate Cancer Index Composite (EPIC) score increased by 2.64 from baseline (p < 0.001). The confounding factors had no statistically significant effect on toxicities (p > 0.05). Conclusion As expected, most patients experienced an increase in GI toxicity following radiotherapy. No relationship was established between patient thickness and the severity or incidence of acute GI toxicities, adding to the existing body of knowledge. Therefore, all patients should receive adequate follow up, irrespective of size. Side-effect recording tools should be implemented systematically for continuous assessment of this relationship.
Collapse
Affiliation(s)
- Robert Pisani
- Department of Radiography, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Paul Bezzina
- Department of Radiography, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Jose Guilherme Couto
- Department of Radiography, Faculty of Health Sciences, University of Malta, Msida, Malta
| |
Collapse
|
5
|
Morita M, Fukagai T, Hirayama K, Yamatoya J, Noguchi T, Ogawa Y, Igarashi A, Niiya A, Kato M, Morota M, Oshinomi K, Ogawa Y, Lederer JL. Placement of SpaceOAR hydrogel spacer for prostate cancer patients treated with iodine-125 low-dose-rate brachytherapy. Int J Urol 2019; 27:60-66. [PMID: 31587417 DOI: 10.1111/iju.14123] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/06/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The aim of the present study was to report on our early experience with hydrogel spacer (SpaceOAR) placement in combination with iodine-125 low-dose-rate brachytherapy for prostate cancer. METHODS From April 2018, SpaceOAR hydrogel spacer was placed in 100 consecutive patients undergoing iodine-125 low-dose-rate brachytherapy. Complications and the status of the placement were evaluated. Deformation of the prostate by the spacer was examined measuring prostate diameters and evaluating the change from preoperative status. The position of the prostate was similarly examined by evaluating the change in distance between the pubic symphysis and the prostate. Post-plan dosimetric data were compared with 200 patients treated without a spacer. RESULTS No complications were found during either the intraoperative or perioperative periods. The mean displacement distance of 11.64 mm was created, the mean value before spacer placement was 0.28 mm (P < 0.0001). The change of the prostate diameters showed a positive increase in all directions, with no significant negative change in any one direction. Regarding the change in distance between pubic symphysis and the prostate, no significant shortening trend was observed between the two groups (P = 0.14). Whereas the dosimetric parameters showed means of 0.001 and 0.026 cc for RV150 and RV100 in the spacer group, they were 0.025 and 0.318 cc, respectively, in the non-spacer group, showing a significant decrease in both parameters (P < 0.001). CONCLUSIONS Prostate deformation secondary to hydrogel placement might adversely affect dosimetric parameters in patients undergoing low-dose-rate brachytherapy. However, a significant reduction in the rectal dose can be adopted without adversely affecting the other parameters related to treatment outcome.
Collapse
Affiliation(s)
- Masashi Morita
- Department of Urology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Takashi Fukagai
- Department of Urology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Kidai Hirayama
- Department of Urology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Jin Yamatoya
- Department of Urology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Tetsuo Noguchi
- Department of Urology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Yu Ogawa
- Department of Urology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Atsushi Igarashi
- Department of Urology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Akifumi Niiya
- Department of Radiation Oncology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Masako Kato
- Division of Radiation Oncology, Department of Radiology, Showa University School of Medicine, Tokyo, Japan
| | - Madoka Morota
- Department of Radiation Oncology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Kazuhiko Oshinomi
- Department of Urology, Showa University School of Medicine, Tokyo, Japan
| | - Yoshio Ogawa
- Department of Urology, Showa University School of Medicine, Tokyo, Japan
| | - John L Lederer
- Department of Surgery, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, Hawaii, USA
| |
Collapse
|
6
|
Doi H, Kuribayashi K, Kijima T. Utility of polaprezinc in reducing toxicities during radiotherapy: a literature review. Future Oncol 2018; 14:1977-1988. [DOI: 10.2217/fon-2018-0021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Chemoradiotherapy is important for treating malignancies. However, radiation-induced toxicities develop as chemoradiotherapy-related complications. Various agents reduce or prevent toxicities, but there are no standard treatments. Polaprezinc (PZ), a chelating compound used for gastric ulcers, has antioxidant and free radical scavenging effects. Although few studies have evaluated PZ and radiation-induced normal tissue damage, several clinical studies have shown the efficacy of PZ for oral mucositis, esophagitis, proctitis and taste alterations during and after radiotherapy. Moreover, preclinical data support the clinical data, indicating good potential of testing PZ in future trials. However, as there are only few well-documented review articles on PZ use in cancer treatment, we conducted this literature review. PZ reduced several radiation-induced toxicities and improved the quality of life.
Collapse
Affiliation(s)
- Hiroshi Doi
- Department of Radiation Oncology, Meiwa Cancer Clinic, Nishinomiya, Hyogo, Japan
- Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Kozo Kuribayashi
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Takashi Kijima
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| |
Collapse
|
7
|
Medical hospitalizations in prostate cancer survivors. Med Oncol 2016; 33:81. [PMID: 27324503 DOI: 10.1007/s12032-016-0796-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/14/2016] [Indexed: 10/21/2022]
Abstract
The objectives of the study were to explore the context and reasons for medical hospitalizations among prostate cancer survivors and to study their relationship with obesity and the type of prostate cancer treatment. A retrospective review of medical records was performed at an academic institution for male patients aged 40 years and older who were diagnosed and/or treated for prostate cancer 2 years prior to the study's observation period from January 2008 to December 2010. Unpaired t test, ANOVA, and Chi-square tests were used to compare patients' characteristics, admission types, and medical comorbidities by body mass index (BMI) and prostate cancer treatment. Mean age for the study population was 76 years (SD = 9.2). Two hundred and forty-five prostate cancer survivors were stratified into two groups: non-obese (BMI < 30 kg/m(2)) and obese (BMI ≥ 30 kg/m(2)). The study population's characteristics analyzed by BMI were similar including Gleason score, presence of metastatic disease and genitourinary-related side effects. Only 13 % of admissions were for complaints related to their genitourinary system. Neither the specific treatment that the patients had received for their prostate cancer, nor obesity was associated with the reasons for their medical admission. Survivorship after having a diagnosis of prostate cancer is often lengthy, and these men are at risk of being hospitalized, as they get older. From this inquiry, it has become clear that neither body mass index nor prior therapy is associated with specific admission characteristics, and only a minority of such admissions was directly related to prostate cancer or the genitourinary tract.
Collapse
|