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Breaking Barriers: Empowering Cervical Cancer Screening with HPV Self-Sampling for Sex Workers and Formerly Incarcerated Women in Toronto. 打破障碍:在多伦多性工作者和曾经被监禁的妇女中使用HPV自我抽样进行宫颈癌筛查。
IF 2.8 4区 医学 Q2 ONCOLOGY Pub Date : 2024-12-17 DOI: 10.3390/curroncol31120590
Mandana Vahabi, Jenna Hynes, Josephine Pui-Hing Wong, Natasha Kithulegoda, Masoomeh Moosapoor, Abdolreza Akbarian, Aisha Lofters

Background: Although cervical cancer (CC) is highly preventable through appropriate screening methods like the Papanicolaou (Pap) test, which enables early detection of malignant and precancerous lesions, access to such screening has not been equitable across social groups. Sex workers and people with records of incarceration are among the most under-screened populations in Ontario. Little is known about the acceptability and feasibility of HPV self-sampling (HPV-SS) as an alternative cervical cancer screening method for these groups. This online, community-based mixed-methods pilot study aimed to address this knowledge gap.

Methods: Eighty-four under- and never-screened sex workers and ex-prisoners aged 25-69 years and residing in the Greater Toronto Area, were recruited by community peer associates. Participants completed an online survey and viewed short videos about CC and screening with Pap and HPV-SS. Those who opted for HPV-SS conducted the test at one of two collaborating organizations.

Results: The median age of participants was 36.5 years. Most had limited knowledge about CC and screening. Approximately 13% identified as non-binary, and 5% as two-spirit or trans men, with the majority having completed secondary education. Of the participants, 88% chose HPV-SS, and one-third tested positive for high-risk HPV types. The ability to self-sample without judgment from healthcare providers was noted as a key advantage. However, there was a need for training on proper HPV-SS techniques.

Conclusions: To improve cervical cancer screening among sex workers, increasing awareness through participatory community co-creation of sexual health education is essential. Additionally, offering HPV-SS as a screening option is crucial, given its demonstrated acceptability and feasibility within this population, many of whom lack a primary care provider and face discriminatory attitudes in healthcare settings.

背景:虽然宫颈癌(CC)可以通过适当的筛查方法高度预防,如巴氏涂片(Pap)试验,它可以早期发现恶性和癌前病变,但在社会群体中获得这种筛查的机会并不公平。性工作者和有监禁记录的人是安大略省最缺乏筛查的人群。HPV自采样(HPV- ss)作为宫颈癌筛查方法的可接受性和可行性尚不清楚。这项以社区为基础的在线混合方法试点研究旨在解决这一知识差距。方法:84名年龄在25-69岁,居住在大多伦多地区的性工作者和刑满释放的性工作者。参与者完成了一项在线调查,并观看了有关CC和Pap和HPV-SS筛查的短视频。那些选择HPV-SS的人在两个合作组织中的一个进行了测试。结果:参与者的中位年龄为36.5岁。大多数人对CC和筛查的了解有限。大约13%的人是非二元性的,5%的人是双灵或变性人,其中大多数人完成了中学教育。在参与者中,88%的人选择了HPV- ss,三分之一的人对高危型HPV检测呈阳性。在没有医疗保健提供者判断的情况下进行自我抽样的能力被认为是一个关键优势。然而,有必要对正确的HPV-SS技术进行培训。结论:为了提高性工作者的宫颈癌筛查率,通过参与性社区共同创建性健康教育来提高认识是必不可少的。此外,提供HPV-SS作为筛查选择是至关重要的,因为它在这一人群中被证明是可接受的和可行的,其中许多人缺乏初级保健提供者,在医疗保健环境中面临歧视态度。
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引用次数: 0
The Impact of a Breast Cancer Diagnosis on the Social Interaction Patterns of Young Omani Women: A Qualitative Study Approach. 乳腺癌诊断对年轻阿曼妇女社会互动模式的影响:一项定性研究方法。
IF 2.8 4区 医学 Q2 ONCOLOGY Pub Date : 2024-12-16 DOI: 10.3390/curroncol31120589
Mohammed Al-Azri, Zayana Al-Kiyumi, Khalid Al-Bimani, Huda Al-Awaisi

Background and aim: Young women diagnosed with breast cancer (BC) face considerable psychological and emotional distress, impacting their interactions with themselves, their families, and the wider community. This study sought to explore the interaction patterns of young Omani BC survivors following their diagnosis and during treatment.

Materials and methods: Semi-structured individual interviews were conducted with 11 Omani women diagnosed with BC, recruited from the Sultan Qaboos Comprehensive Cancer Care and Research Centre in Muscat, Oman. Participants were selected using purposive sampling to target Omani BC survivors aged under 45 years, with one to five years of survivorship post-diagnosis. Framework analysis was employed to analyse the qualitative data.

Results: Six key types of interactions with various groups were identified: self, children, spouses, family, friends, and society. While many BC survivors demonstrated resilience through their strong faith, viewing the illness as part of a divine plan, others experienced diminished confidence and social withdrawal due to body image issues. Interactions with children centred on maintaining normalcy, while spouses typically provided emotional support despite challenges with intimacy. Family and friends offered crucial support, although concerns regarding societal stigma led some women to conceal their diagnosis.

Conclusions: Participants in this study demonstrated a strong sense of acceptance of their cancer diagnosis as a result of their faith, viewing it as part of a divine plan. Their belief in divine guidance, paired with optimism about the available treatments, fostered resilience, allowing them to maintain a calm and hopeful outlook during their journey of treatment and recovery. However, some participants experienced a decline in self-confidence, particularly after treatment. This affected their willingness to socialise and interact with others, leading to introversion and a marked withdrawal from social interactions, often related to changed self-perception or fear of judgment following changes in appearance.

背景和目的:被诊断患有乳腺癌(BC)的年轻女性面临着相当大的心理和情绪困扰,影响了她们与自己、家人和更广泛的社区的互动。本研究旨在探讨年轻阿曼BC幸存者在诊断后和治疗期间的相互作用模式。材料和方法:从阿曼马斯喀特的苏丹卡布斯综合癌症护理和研究中心招募了11名诊断为BC的阿曼妇女,对她们进行了半结构化的个人访谈。参与者采用有目的的抽样选择,目标是45岁以下的阿曼BC幸存者,诊断后存活1至5年。采用框架分析法对定性数据进行分析。结果:确定了与不同群体的六种主要互动类型:自我、子女、配偶、家庭、朋友和社会。虽然许多不列颠哥伦比亚省的幸存者通过他们坚定的信仰表现出了韧性,将疾病视为神圣计划的一部分,但由于身体形象问题,其他人经历了信心下降和社交退缩。与孩子的互动以保持正常为中心,而配偶通常提供情感支持,尽管亲密关系面临挑战。家人和朋友提供了至关重要的支持,尽管对社会耻辱的担忧导致一些妇女隐瞒了自己的诊断。结论:这项研究的参与者表现出强烈的接受他们的癌症诊断的意识,因为他们的信仰,将其视为神圣计划的一部分。他们对神的指引的信仰,加上对现有治疗方法的乐观态度,培养了他们的韧性,使他们在治疗和康复的过程中保持冷静和充满希望的态度。然而,一些参与者经历了自信心的下降,尤其是在治疗后。这影响了他们社交和与他人互动的意愿,导致内向和明显的社交退缩,这通常与外表变化后自我认知的改变或对他人评价的恐惧有关。
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引用次数: 0
The Role of Stereotactic Body Radiotherapy in Oligometastatic Non-Small Cell Lung Cancer. 立体定向放疗在少转移性非小细胞肺癌中的作用。
IF 2.8 4区 医学 Q2 ONCOLOGY Pub Date : 2024-12-15 DOI: 10.3390/curroncol31120588
Benson Wan, Magali Lecavalier-Barsoum

Non-small cell lung cancer (NSCLC) is a major cause of mortality in Canada, with many patients presenting with metastatic disease. The oligometastatic state (OM-NSCLC) may be amenable to cure using aggressive local consolidative therapies. Stereotactic body radiotherapy (SBRT), which entails the utilization of a high dose of radiation in one or few fractions, has many benefits in this setting, including its applicability in varied patient populations to ablate lesions in varied anatomical locations. It has also been demonstrated to prolong the time to next-line systemic therapy, to reduce financial burden, to improve quality-adjusted life years, and reduce adverse events caused by these lesions. This review outlines the published phase II and III trials that have already demonstrated the utility of SBRT in OM-NSCLC, as well as the many ongoing trials aiming to further define its role, including the largest phase II/III trial to date, NRG-LU002. Overall, SBRT appears to improve outcomes when combined with a broad range of standard-of-care therapies and is generally well tolerated; however, careful patient selection is necessary to maximize benefits while minimizing harm. Ongoing trials will help define the optimal patients for SBRT and the best timing for this intervention.

非小细胞肺癌(NSCLC)是加拿大死亡的主要原因,许多患者表现为转移性疾病。寡转移状态(OM-NSCLC)可能可以通过积极的局部巩固治疗来治愈。立体定向体放疗(SBRT)需要在一个或几个部分中使用高剂量的辐射,在这种情况下有许多好处,包括它适用于不同的患者群体,可以消融不同解剖位置的病变。它也被证明可以延长到下一步全身治疗的时间,减轻经济负担,提高质量调整生命年,并减少这些病变引起的不良事件。本综述概述了已经发表的II期和III期试验,这些试验已经证明了SBRT在OM-NSCLC中的应用,以及许多正在进行的旨在进一步确定其作用的试验,包括迄今为止最大的II/III期试验NRG-LU002。总的来说,SBRT在与广泛的标准治疗相结合时似乎改善了结果,并且通常耐受性良好;然而,谨慎的患者选择是必要的,以最大限度地提高效益,同时减少危害。正在进行的试验将有助于确定SBRT的最佳患者和这种干预的最佳时机。
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引用次数: 0
The Influence of Nordic Walking Training on the Serum Levels of Sirtuins, FOXO3a, and Vitamin D Metabolites in Patients with Multiple Myeloma. 北欧步行训练对多发性骨髓瘤患者血清Sirtuins、FOXO3a和维生素D代谢物水平的影响
IF 2.8 4区 医学 Q2 ONCOLOGY Pub Date : 2024-12-14 DOI: 10.3390/curroncol31120587
Olga Czerwińska-Ledwig, Małgorzata Żychowska, Artur Jurczyszyn, Joanna Kryst, Adrianna Dzidek, Roxana Zuziak, Anna Jurczyszyn, Anna Piotrowska

Background: Multiple myeloma, a malignancy of plasma cells, often involves the disruption of vitamin D metabolism. Vitamin D, acting through its receptor (VDR), affects transcription factors like FOXO and sirtuins, which regulate cellular processes. The impact of physical activity on these markers in multiple myeloma patients is unclear. Therefore, the objective of this study was to evaluate the effects of a 6-week training program on these parameters.

Material and methods: The study was completed by 30 patients, including 16 in the Nordic walking training group (TG) and 14 in the control group (non-exercising, CG). All participants underwent a thorough medical interview before starting the project. Venous blood samples were collected from all participants four times-at baseline, after 3 weeks, after 6 weeks, and after 9 weeks (follow-up). The serum concentrations of sirtuin 1, sirtuin 3, Foxo3a, vitamin D receptor (VDR), 25(OH)D3, and 1,25(OH)2D were determined. Body composition, physical fitness, and physical activity level were assessed at baseline and after 6 weeks.

Results: No statistically significant changes were observed in the serum levels of sirtuins, the FOXO3a protein, and 1,25(OH)2D. A statistically significant difference was observed in the levels of VDR for both time and group factors, but this was not confirmed in the post hoc test. Vitamin 25(OH)D3 level increased significantly in the study group with time.

Conclusions: The applied 6-week Nordic walking training cycle positively affected the level of vitamin 25(OH)D3 but did not influence the rest of the biochemical parameters studied. The obtained results also indicate that the applied intervention is safe for patients and does not interfere with body composition.

背景:多发性骨髓瘤是一种浆细胞恶性肿瘤,常伴有维生素D代谢紊乱。维生素D通过其受体(VDR)作用,影响转录因子,如FOXO和sirtuins,它们调节细胞过程。在多发性骨髓瘤患者中,体育活动对这些标志物的影响尚不清楚。因此,本研究的目的是评估为期6周的训练计划对这些参数的影响。材料和方法:30例患者完成研究,其中北欧步行训练组(TG) 16例,对照组(非运动组,CG) 14例。在项目开始前,所有参与者都接受了彻底的医疗采访。在基线、3周后、6周后和9周后(随访)四次采集所有参与者的静脉血样本。测定血清中sirtuin 1、sirtuin 3、Foxo3a、维生素D受体(VDR)、25(OH)D3、125 (OH)2D的浓度。在基线和6周后评估身体组成、身体健康和身体活动水平。结果:血清sirtuins、FOXO3a蛋白、1,25(OH)2D水平变化无统计学意义。在时间和组因素中观察到VDR水平的统计学显著差异,但这在事后测试中未得到证实。研究组维生素25(OH)D3水平随时间显著升高。结论:6周的北欧步行训练周期对维生素25(OH)D3水平有积极影响,但对研究的其他生化参数没有影响。所获得的结果还表明,所应用的干预措施对患者是安全的,并且不会干扰身体成分。
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引用次数: 0
Education and Training Needs of Health Care Professionals in the Philippines Encountering Patients with Lung Oligometastatic Cancers. 菲律宾卫生保健专业人员遇到肺少转移癌患者的教育和培训需求。
IF 2.8 4区 医学 Q2 ONCOLOGY Pub Date : 2024-12-13 DOI: 10.3390/curroncol31120586
Daphne J Valmonte, Naa Kwarley Quartey, Fatima Gutierrez, Janel Mendoza, Janet Papadakos, Meredith Giuliani

This study aimed to examine the education and training needs of health care practitioners (HCPs) in the Philippines who encounter lung oligometastatic cancer patients. Lung oligometastatic disease is among the most common sites for cancer spread and has the most established practices for treating oligometastases. A modified version of the Hennessy-Hicks Training Needs Assessment Questionnaire was administered online to HCPs working in private and public centers in the Philippines. HCPs were recruited via purposive sampling. Twenty-seven HCPs completed the questionnaire (47% response rate). Respondents were mostly female (59%) and between the ages of 30 and 39 years (70%). Three-quarters (74%) were consultants, and most respondents were radiation oncologists (44%) or medical oncologists (30%). Medical oncologists rated Management/Supervisory Tasks (mean = 1.42) as their highest area of training need while radiation oncologists rated Clinical Tasks (mean = 1.30) as their highest training need. Pulmonologists (mean = 0.60) and other specialists (mean = 1.00) rated Administration tasks as their top area of training need. The clinical task-related category was rated the highest need among the continuing medical education topics. This study provides valuable insights for the implementation and advancement of a comprehensive curriculum in clinical oncology, specifically designed to enhance the administrative, clinical, and research capacities of oncologists who encounter oligometastatic lung disease in the Philippines.

本研究旨在探讨菲律宾卫生保健从业者(HCPs)遇到肺少转移癌患者的教育和培训需求。肺低转移性疾病是癌症最常见的扩散部位之一,也是治疗低转移性疾病最成熟的方法。一份修改版的轩尼诗-希克斯培训需求评估问卷被在线发放给在菲律宾私人和公共中心工作的医护人员。通过有目的的抽样来招募医务人员。27名医护人员完成了问卷调查(47%的应答率)。受访者大多是女性(59%),年龄在30至39岁之间(70%)。四分之三(74%)的受访者是顾问,大多数受访者是放射肿瘤学家(44%)或内科肿瘤学家(30%)。医学肿瘤学家认为管理/监督任务(平均= 1.42)是他们最高的培训需求领域,而放射肿瘤学家认为临床任务(平均= 1.30)是他们最高的培训需求领域。肺科医生(平均= 0.60)和其他专家(平均= 1.00)认为管理任务是他们最需要培训的领域。在继续医学教育主题中,与临床任务相关的类别被评为最需要的。本研究为临床肿瘤学综合课程的实施和推进提供了有价值的见解,特别设计用于提高菲律宾遇到少转移性肺病的肿瘤学家的管理,临床和研究能力。
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引用次数: 0
The Clinical Characteristics of a Stage II Colorectal Cancer T4 Tumor: A Ten-Year Single-Center Research Report. 结直肠癌II期T4肿瘤的临床特征:10年单中心研究报告
IF 2.8 4区 医学 Q2 ONCOLOGY Pub Date : 2024-12-12 DOI: 10.3390/curroncol31120584
Bo-Zhi Lin, Chang-Lin Lin, Feng-Fan Chiang, Chou-Chen Chen, Ming-Cheng Chen, Chun-Yu Lin, Shang-Chih Huang

Aim: The tumor staging of colorectal cancer (CRC) plays a significant role in both treatment and prognosis, impacting surgical planning and adjuvant therapy decisions. Currently, the staging of CRC is based on the TNM system developed by the American Joint Committee on Cancer. Prior studies have suggested that survival rates and recurrent rates of T4a tumors appear to be worse than that of T4b tumors, although there is currently no consensus. Therefore, we collected patient data from Taichung Veterans General Hospital over the past decade in order to conduct further research.

Method: Between 2010 and 2018, a total of 5760 newly diagnosed CRC patients were seen at the hospital. To eliminate the influence of any local lymph node involvement or distant organ metastasis on the research results, we focused on patients with pathologic Stage IIc disease (T4a-bN0M0). Patients with rectal cancer who had received neoadjuvant concurrent chemoradiotherapy were excluded. Ultimately, 132 patients were included in this study. A multivariate Cox regression analysis was conducted to identify independent risk factors for both 10-year cancer-specific survival (CSS) and overall survival (OS).

Results: A total of 132 patients were included in the study, with 90 classified as T4a and 42 as T4b. The 10-year CSS for pT4a and pT4b was 72.5% and 56.5%, respectively, with a p-value of 0.011. The 10-year OS for pT4a and pT4b was 48.4% and 42.5%, respectively, with a p-value of 0.086. There was no significant difference in the site of first recurrence between the pT4a and pT4b groups (p-value = 0.936). Overall, patients who received adjuvant chemotherapy therapy had a significantly better prognosis (p-value < 0.05). However, there was no significant difference in prognosis between oral 5-FU and FOLFOX.

Conclusion: Based on our data, patients diagnosed with pathologic T4aN0M0 CRC appeared to experience a trend toward better 10-year OS when compared to those with T4bN0M0 disease, but this trend lacks statistical significance. Patients with locally advanced Stage II colon cancer clearly benefited from adjuvant chemotherapy therapy; therefore, FOLFOX may not necessarily be required.

目的:结直肠癌(CRC)的肿瘤分期对治疗和预后均有重要影响,影响手术计划和辅助治疗决策。目前,CRC的分期是基于美国癌症联合委员会(American Joint Committee on Cancer)制定的TNM系统。先前的研究表明,T4a肿瘤的生存率和复发率似乎比T4b肿瘤差,尽管目前尚无共识。因此,我们收集台中退伍军人总医院近十年的病患资料,以作进一步研究。方法:2010年至2018年,本院共收治新诊断的结直肠癌患者5760例。为了消除任何局部淋巴结累及或远处器官转移对研究结果的影响,我们重点研究了病理性IIc期疾病(T4a-bN0M0)患者。同时接受新辅助放化疗的直肠癌患者被排除在外。最终,132名患者被纳入本研究。采用多变量Cox回归分析确定影响10年癌症特异性生存(CSS)和总生存(OS)的独立危险因素。结果:共纳入132例患者,其中T4a级90例,T4b级42例。pT4a和pT4b的10年CSS分别为72.5%和56.5%,p值为0.011。pT4a和pT4b的10年OS分别为48.4%和42.5%,p值为0.086。pT4a组与pT4b组首次复发部位比较差异无统计学意义(p值= 0.936)。总体而言,接受辅助化疗的患者预后明显较好(p值< 0.05)。然而,口服5-FU与FOLFOX的预后无显著差异。结论:根据我们的数据,与T4bN0M0疾病相比,病理性T4aN0M0 CRC患者的10年OS似乎有更好的趋势,但这种趋势缺乏统计学意义。局部晚期II期结肠癌患者明显受益于辅助化疗;因此,FOLFOX可能不一定是必需的。
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引用次数: 0
STIL Overexpression Is Associated with Chromosomal Numerical Abnormalities in Non-Small-Cell Lung Carcinoma Through Centrosome Amplification. 通过中心体扩增发现非小细胞肺癌中STIL过表达与染色体数量异常相关。
IF 2.8 4区 医学 Q2 ONCOLOGY Pub Date : 2024-12-12 DOI: 10.3390/curroncol31120585
Shunsuke Ohtsuka, Hisami Kato, Rei Ishikawa, Hirofumi Watanabe, Ryosuke Miyazaki, Shin-Ya Katsuragi, Katsuhiro Yoshimura, Hidetaka Yamada, Yasuhiro Sakai, Yusuke Inoue, Yusuke Takanashi, Keigo Sekihara, Kazuhito Funai, Haruhiko Sugimura, Kazuya Shinmura

STIL is a regulatory protein essential for centriole biogenesis, and its dysregulation has been implicated in various diseases, including malignancies. However, its role in non-small-cell lung carcinoma (NSCLC) remains unclear. In this study, we examined STIL expression and its potential association with chromosomal numerical abnormalities (CNAs) in NSCLC using The Cancer Genome Atlas (TCGA) dataset, immunohistochemical analysis, and in vitro experiments with NSCLC cell lines designed to overexpress STIL. TCGA data revealed upregulated STIL mRNA expression in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC), the two major subtypes of NSCLC. Immunohistochemical analysis of cases from our hospital (LUAD, n = 268; LUSC, n = 98) revealed STIL protein overexpression. To elucidate the functional role of STIL, an inducible STIL-overexpressing H1299 NSCLC cell line was generated. Overexpression of STIL in these cells promoted centrosome amplification, leading to chromosomal instability. Finally, analysis of arm-level chromosomal copy number alterations from the TCGA dataset revealed that elevated STIL mRNA expression was associated with CNAs in both LUAD and LUSC. These findings suggest that STIL overexpression is associated with CNAs in NSCLC, likely through centrosome amplification, which is linked to chromosomal instability and might represent a potential therapeutic target for NSCLC treatment.

STIL是中心粒生物发生所必需的调节蛋白,其失调与包括恶性肿瘤在内的多种疾病有关。然而,其在非小细胞肺癌(NSCLC)中的作用尚不清楚。在这项研究中,我们利用癌症基因组图谱(TCGA)数据集、免疫组织化学分析和设计过表达STIL的非小细胞肺癌细胞系的体外实验,研究了STIL表达及其与染色体数值异常(CNAs)的潜在关联。TCGA数据显示,STIL mRNA在肺腺癌(LUAD)和肺鳞状细胞癌(LUSC)这两种非小细胞肺癌的主要亚型中表达上调。本院病例免疫组化分析(LUAD, n = 268;LUSC, n = 98)显示STIL蛋白过表达。为了阐明STIL的功能作用,我们构建了一个可诱导的过表达STIL的H1299 NSCLC细胞系。这些细胞中STIL的过度表达促进中心体扩增,导致染色体不稳定。最后,来自TCGA数据集的臂水平染色体拷贝数改变分析显示,LUAD和LUSC中升高的STIL mRNA表达与CNAs相关。这些发现表明,STIL过表达可能通过中心体扩增与非小细胞肺癌中的CNAs相关,这与染色体不稳定性有关,可能是非小细胞肺癌治疗的潜在治疗靶点。
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引用次数: 0
Longitudinal Follow-Up of the Psychological Well-Being of Patients with Colorectal Cancer: Final Analysis of PICO-SM. 结直肠癌患者心理健康的纵向随访:PICO-SM的最终分析。
IF 2.8 4区 医学 Q2 ONCOLOGY Pub Date : 2024-12-11 DOI: 10.3390/curroncol31120582
Konstantinos Kamposioras, Panagiotis Ntellas, Katerina Dadouli, Eleftherios Christodoulis, Marios Adamou, Daniel Anderson, Anup Shanthappa, Jacqueline Connell, Joseph Williams, Lilly Simpson, Theodora Germetaki, Michael Braun, Jorge Barriuso, Jurjees Hasan, Saifee Mullamitha, Kalena Marti, Mark Saunders, Kok Haw Jonathan Lim

PICO-SM was a prospective longitudinal study investigating the psychological impact of the COVID-19 pandemic on patients with colorectal cancer treated in a large UK tertiary cancer centre. Here, we present the impact of the third wave of the pandemic (December 2021 to February 2022), when the Omicron variant became prevalent in the UK, and the complete longitudinal comparison across the entire duration of this study. Patients were invited to complete a questionnaire, including screening psychometric tools. In total, n = 312 patients were included in the final analysis. Specifically, in this Omicron-predominant wave, n = 96 patients were studied in detail: the mean age was 64 years, 64% were male, 33% reported poor well-being, 27% anxiety, 11% depressive symptoms, and 3% trauma-related symptoms. The participants who had investigations cancelled (OR 9.22, 95% CI 1.09-77.85; p = 0.041) or felt that the pandemic would affect their mental health (OR 3.82, 95% CI 1.96-7.44; p < 0.001) had an increased risk of anxiety according to a multivariate analysis. Similarly, independent predictors of poor well-being included concern that the pandemic would affect their cancer treatment (OR 4.59, 95% CI 1.03-20.56; p = 0.046) or mental health (OR 3.90, 95% CI 1.38-11.03; p = 0.010). The psychological distress experienced by patients, particularly anxiety, remained high during the third wave of the COVID-19 pandemic. These results align with our previously reported findings, emphasising the importance of continuing cancer treatment amidst an ongoing humanitarian emergency.

PICO-SM是一项前瞻性纵向研究,旨在调查COVID-19大流行对英国一家大型三级癌症中心治疗的结直肠癌患者的心理影响。在这里,我们介绍了第三波大流行(2021年12月至2022年2月)的影响,当时欧米克隆变异在英国流行,并在整个研究期间进行了完整的纵向比较。患者被邀请完成一份问卷,包括筛选心理测量工具。最终分析共纳入n = 312例患者。具体来说,在这个以omicron为主的波中,详细研究了n = 96例患者:平均年龄为64岁,64%为男性,33%报告幸福感差,27%焦虑,11%抑郁症状,3%创伤相关症状。取消调查的参与者(OR 9.22, 95% CI 1.09-77.85;p = 0.041)或认为大流行会影响他们的心理健康(or 3.82, 95% CI 1.96-7.44;多变量分析显示,P < 0.001)焦虑风险增加。同样,健康状况不佳的独立预测因素包括担心大流行会影响他们的癌症治疗(OR 4.59, 95% CI 1.03-20.56;p = 0.046)或心理健康(or 3.90, 95% CI 1.38-11.03;P = 0.010)。在第三波COVID-19大流行期间,患者经历的心理困扰,特别是焦虑,仍然很高。这些结果与我们之前报告的结果一致,强调了在持续的人道主义紧急情况下继续进行癌症治疗的重要性。
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引用次数: 0
Real-World Oncological Outcomes of Nivolumab Plus Ipilimumab in Advanced or Metastatic Renal Cell Carcinoma: A Multicenter, Retrospective Cohort Study in Japan. Nivolumab联合Ipilimumab治疗晚期或转移性肾细胞癌的真实肿瘤预后:日本的一项多中心、回顾性队列研究
IF 2.8 4区 医学 Q2 ONCOLOGY Pub Date : 2024-12-11 DOI: 10.3390/curroncol31120583
Tomoki Taniguchi, Koji Iinuma, Kei Kawada, Takashi Ishida, Kimiaki Takagi, Masayuki Tomioka, Makoto Kawase, Kota Kawase, Keita Nakane, Yuki Tobisawa, Takuya Koie

A combination of nivolumab and ipilimumab (NIVO + IPI) is the only approved combination of two immune checkpoint inhibitors for metastatic or advanced renal cell carcinoma (mRCC). Inadequate evidence of treatment with NIVO + IPI has been reported in Japanese cohorts. We evaluated the clinical efficacy of NIVO + IPI treatment. Patients with mRCC who received NIVO + IPI at nine Japanese facilities between August 2018 and March 2023 were enrolled in this study. The primary endpoint in this study was the assessment of oncological outcomes in patients with mRCC who received NIVO + IPI. Eighty-four patients with mRCC were enrolled. The median follow-up period was 18.3 months, and median progression-free and overall survival were 13.3 and 50.9 months, respectively. The objective response rate was 47.6%, and the disease control rate was 78.6%. To our knowledge, this is the largest study that evaluates Japanese patients with mRCC receiving NIVO + IPI treatment. In this study, the real-world oncological outcomes after NIVO + IPI treatment were comparable to those in the CheckMate 214 study.

nivolumab和ipilimumab的联合(NIVO + IPI)是唯一被批准用于转移性或晚期肾细胞癌(mRCC)的两种免疫检查点抑制剂的联合。在日本队列中报道了NIVO + IPI治疗的证据不足。我们评估NIVO + IPI治疗的临床疗效。2018年8月至2023年3月期间在日本9家医院接受NIVO + IPI治疗的mRCC患者纳入了本研究。本研究的主要终点是评估接受NIVO + IPI治疗的mRCC患者的肿瘤预后。84例mRCC患者入组。中位随访期为18.3个月,中位无进展生存期和总生存期分别为13.3个月和50.9个月。客观有效率为47.6%,疾病控制率为78.6%。据我们所知,这是评估日本mRCC患者接受NIVO + IPI治疗的最大研究。在这项研究中,NIVO + IPI治疗后的真实肿瘤学结果与CheckMate 214研究中的结果相当。
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引用次数: 0
First-Line (1L) Treatment Decision Patterns and Survival of Hormone Receptor (HR)-Positive/HER2-Negative Advanced Breast Cancer (ABC) Patients in a Latin American (LATAM) Public Institution. 拉丁美洲(LATAM)公共机构中激素受体(HR)阳性/ her2阴性晚期乳腺癌(ABC)患者的一线(1L)治疗决策模式和生存率
IF 2.8 4区 医学 Q2 ONCOLOGY Pub Date : 2024-12-09 DOI: 10.3390/curroncol31120581
Guillermo Valencia, Patricia Rioja, Miguel Chirito, Olenka Peralta, Jorge Sánchez, Connie Rabanal, Raúl Mantilla, Zaida Morante, Hugo Fuentes, Carlos Castaneda, Tatiana Vidaurre, Cristian Pacheco, Silvia Neciosup, Henry L Gomez

Advanced breast cancer is an incurable disease, with a median overall survival of 3 years, including in countries without access problems. Although chemotherapy is reserved in some cases, it is still used in many countries as a first-line therapy. The aim of our study is to evaluate the first-line treatment choices and the factors that influence therapeutic decisions. A retrospective analysis was conducted of hormone receptor (+)/HER2 (-) advanced breast cancer patients classified into three groups according to the first-line and second-line treatment received: endocrine therapy-chemotherapy, endocrine therapy-endocrine therapy and chemotherapy-endocrine therapy. Additionally, we explored the overall survival of sequencing therapy groups. First-line chemotherapy was chosen in 34% of patients. Also, around 60% of our patients met the "aggressive disease" criteria from the RIGHT Choice trial, justifying the use of chemotherapy in a population with poor prognosis. Furthermore, de novo and progressive disease were prognostic factors that influenced the use of chemotherapy as a first-line treatment. Regarding overall survival, the sequencing treatment groups in this trial saw an increase in survival compared with patients of the MONALEESA trials (endocrine therapy alone arms). No significant differences in progression-free survival or overall survival were found in the treatment sequencing groups. There was a higher use of chemotherapy as a first-line therapy, with de novo and "aggressive disease" criteria being the main factors to influence the decision.

晚期乳腺癌是一种无法治愈的疾病,中位总生存期为3年,包括在没有获取问题的国家。虽然在某些情况下保留化疗,但在许多国家仍将其作为一线治疗方法。本研究的目的是评估一线治疗选择和影响治疗决策的因素。回顾性分析激素受体(+)/HER2(-)晚期乳腺癌患者根据接受一线和二线治疗分为三组:内分泌治疗-化疗、内分泌治疗-内分泌治疗和化疗-内分泌治疗。此外,我们探讨了测序治疗组的总生存率。34%的患者选择一线化疗。此外,大约60%的患者符合RIGHT Choice试验的“侵袭性疾病”标准,这证明在预后不良的人群中使用化疗是合理的。此外,新生和疾病进展是影响化疗作为一线治疗的预后因素。关于总生存期,与MONALEESA试验(单独内分泌治疗组)的患者相比,该试验中测序治疗组的患者生存期增加。在治疗顺序组中,无进展生存期或总生存期未发现显著差异。化疗作为一线治疗的使用率较高,新发和“侵袭性疾病”标准是影响决定的主要因素。
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引用次数: 0
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Current oncology
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