European Journal of Cancer Care最新文献

Background

Lung cancer is the leading cause of cancer mortality worldwide. The role of pulmonary rehabilitation (PR) in patients with inoperable advanced lung cancer remains less defined due to disease severity and poor prognosis. This scoping review aims to map the characteristics, implementation methods, outcome metrics, and effectiveness of PR in this specific population.

Methods

A systematic literature search was conducted across PubMed, Web of Science, CINAHL, Embase, Cochrane, and OpenGrey databases up to October 2025, following JBI guidelines and the PRISMA-ScR checklist. Randomized controlled trials and nonrandomized intervention studies focusing on PR for patients with advanced lung cancer were included. The literature was screened and selected according to the PICOS framework, after which data were extracted and organized from the included studies and finally integrated using a narrative synthesis approach.

Results

Thirty-two studies involving 1979 patients were included. Interventions were predominantly hospital-based, and core components included aerobic and resistance training. The intervention period ranged from 2 to 12 weeks, with the intensity primarily being moderate to high. Significant improvements were consistently reported in exercise capacity, muscle strength, and symptom burden. However, evidence regarding lung function and health-related quality of life remained heterogeneous. Completion rates varied from 44% to 100%, with disease progression being a primary barrier to adherence. None of the studies reported any serious adverse events.

Conclusions

PR is a safe and feasible intervention for patients with advanced lung cancer, offering clear benefits in terms of physical function and symptom management. However, maintaining high adherence remains a challenge. Future research should further explore home-based intervention models assisted by digital rehabilitation technologies and actively promote the integration of PR into multidisciplinary palliative care pathways.

Objective

This cross-sectional study was conducted to investigate the effect of social support on empowerment status and alopecia-related quality of life in breast cancer patients.

Methods

This study included 150 breast cancer patients who were admitted to the oncology outpatient clinic of a training and research hospital in Erzurum province, eastern Turkey, and met the inclusion criteria. Data were collected using the Descriptive Information Form, the Cancer Empowerment Scale, the Chemotherapy-Induced Alopecia Quality of Life Scale, and the Cancer Patient Social Support Scale. Structural equation modeling was used to examine the direct and indirect relationships among variables. This study was conducted in accordance with the STROBE guidelines.

Results

Social support was found to positively affect empowerment status (β = 0.960) and alopecia-related quality of life (β = 0.335). Empowerment status had a positive and significant effect on alopecia-related quality of life (β = 0.647). The indirect effect of social support on alopecia-related quality of life through empowerment status was positive and significant (β = 0.622), and the total effect of social support on alopecia-related quality of life was also positive and significant (β = 0.957). Social support explained 92% of the variance in empowerment status, and the overall model explained 94% of the variance in alopecia-related quality of life.

Conclusions

Social support positively influences both empowerment status and alopecia-related quality of life in breast cancer patients. In addition, social support improves alopecia-related quality of life indirectly by enhancing empowerment status. Strengthening social support mechanisms may therefore contribute to improved quality of life related to chemotherapy-induced alopecia in breast cancer patients.

Objective

To compare the effectiveness of Internet-based acceptance and commitment therapy (iACT) and bibliotherapy-based ACT (bACT) in reducing anxiety and depression among women with breast cancer.

Methods

In this three-arm randomized controlled trial, 99 participants were recruited from three oncology centers in Iran and randomly assigned to iACT, bACT, or a control group (n = 33 each). Interventions lasted 6 weeks with a 4-week follow-up. The Beck Anxiety Inventory and Beck Depression Inventory-Short Form were used to assess outcomes at baseline, post-intervention, and follow-up. Data were analyzed using generalized estimating equations (GEE).

Results

The iACT group showed significantly greater reduction in depression and anxiety than the control group at post-intervention and follow-up (all p < 0.001, except for post-intervention anxiety in iACT group was p = 0.001). The bACT group showed delayed but significant improvement in anxiety at follow-up (p > 0.001), but not in depression. Between-group comparisons revealed superior outcomes for iACT over bACT in both anxiety and depression post-intervention, though the difference in anxiety diminished by follow-up.

Conclusions

Internet-based ACT was more effective than bACT or standard care in reducing anxiety and depression in breast cancer patients. These results support the broader use of guided Internet-based ACT interventions in oncology settings.

Trial Registration: Iranian Registry of Clinical Trials: IRCT20231209060301N1

Background

Breast and cervical cancers are the most prevalent cancers among women in Namibia, with a prevalence of 28.9% and 18.3%, respectively, in 2020. However, the knowledge and attitudes of Namibian women toward breast and cervical cancers are not documented, as this is essential for early detection and improved treatment outcomes.

Aim

This study explored the knowledge and attitudes regarding these cancers among women aged 18 and above in Windhoek, Khomas Region.

Methods

A mixed-methods cross-sectional random sampling study was conducted from November 2024 to March 2025 across all eight constituencies of Windhoek. A questionnaire was used to document demographic information, knowledge, and awareness of breast and cervical cancer, cancer screening habits, and barriers to screening. Multivariable logistic regression was used for data analysis.

Results

A total of 232 females participated in the study, of which 93.5% and 95.3% reported having heard of breast and cervical cancer, respectively. Among those who were aware, 35.3% underwent breast cancer screening, while 34.5% had been screened for cervical cancer. Knowledge regarding the causes, symptoms, and prevention of both cancers was moderate to high. Education level was a significant predictor of awareness and screening behavior. Women with tertiary education (73.7%) were four times more likely to have heard of breast cancer (OR = 4.0; 95% CI: 2.8–5.7; p < 0.001) and twice as likely to have heard of cervical cancer (OR = 2.0; 95% CI: 1.5–2.7; p < 0.001).

Conclusion

Public awareness campaigns regarding early screening are crucial to improve awareness and knowledge regarding breast and cervical cancers among Namibian women.

Background

A common side effect of breast cancer treatment is breast cancer–related lymphedema (BCRL), which is associated with many symptoms, such as swelling, heaviness, tightness, pain, discomfort and poor quality of life. The breast cancer and lymphedema symptom experience index (BCLE-SEI) captures the presence of BCRL-related symptoms and distress. However, the BCLE-SEI is not available in Marathi, one of the most commonly spoken Indian languages. The purpose of this study was to translate and validate the BCLE-SEI in Marathi.

Methodology

The BCLE-SEI was forward- and backward-translated, and the consolidated back translation was checked for equivalence following established guidelines. The BCLE-SEI-Marathi was then validated among 169 Marathi-speaking women with or at risk of developing BCRL. Content validity, structural validity, internal consistency, test–retest reliability, construct validity (through hypothesis testing) and known group validity were tested. Three different thresholds were used when testing known group validity.

Results

Content validity of the BCLE-SEI-Marathi was confirmed by 98% of the participants. Exploratory factor analysis identified two factors in the symptom occurrence subscale and three factors in the symptom distress subscale, which explained 49% and 53.8% of the total sample variance, respectively. Internal consistency of dimensions (factors) ranged from α = 0.82 to 0.94. Construct validity was established through hypothesis testing. The test–retest reliability was strong (Spearman’s rho of 0.88 (p < 0.01, 95% CI: 0.8–0.9)). The BCLE-SEI total score was able to distinguish the participants with BCRL from those at risk for BCRL.

Conclusion

This study demonstrated that the BCLE-SEI-Marathi questionnaire is a valid and reliable tool to assess the occurrence and distress of symptoms in Marathi-speaking women with or at risk of BCRL.

Trail Registration: Clinical Trials Registry India: CTRI/2017/11/010326

Objective

This review aims to identify and evaluate the management options for the extranodal NK/T-cell lymphoma, nasal type of head and neck in the pediatric population.

Methods

The study was conducted based on a comprehensive literature review from 2009 to 2025. The following keywords were used: extranodal NK/T cell lymphoma and children and head and neck.

Results

The clinical data, including sex, age, symptoms, localization at presentation, correlation with EBV infection, treatment, and its outcome, were analyzed. A total of 64 patients were evaluated. Among these cases, the nasal site was the most involved region. Positive results for EBV infection were present in 100% of patients. The mortality rate in this study was 25%.

Conclusions

This systematic review highlights a clear male predominance, a pronounced geographic concentration of cases in East Asia, and underscores the diagnostic importance of EBV positivity in the diagnosis of ENKTL. In the case of the chronic course of destructive processes in aerodigestive organs with no improvement after standard treatment, NK-cell lymphomas should be considered in the differential diagnosis. Multimodal treatment strategies, particularly asparaginase-based chemotherapy with or without radiotherapy, are associated with improved outcomes, although disease-related mortality remains substantial. Given the limited number of pediatric cases and the heterogeneity of available data, further prospective, multicenter studies with standardized diagnostic and therapeutic approaches are essential to optimize management and improve long-term survival.

Background

Decision-making in recurrent or metastatic head and neck cancer (HNC) is challenging, often involving high uncertainty and psychological distress.

Objective

To identify factors contributing to decisional conflict in patients with recurrent or metastatic HNC.

Methods

This cross-sectional study used convenience sampling to recruit participants from the outpatient department of a cancer center in northern Taiwan between August 2021 and July 2024. The Decisional Conflict Scale (DCS) and the University of Washington Quality of Life Scale (UW-QOL) were used to assess decisional conflict, physical function, and social-emotional function.

Results

A total of 140 patients were recruited. Among them, 78.6% experienced decisional conflict. The main areas of concern were lack of support, ineffective decision-making, unclear values, insufficient information, and uncertainty. Patients with lower education, living alone, with lower family income, with private insurance, or with lower physical and social-emotional functioning were more likely to experience decisional conflict.

Conclusions

Lower education, living alone, lower family income, private insurance, or lower physical or social-emotional function contribute significantly to decisional conflict in patients with recurrent or metastatic HNC. Healthcare providers should incorporate targeted interventions addressing these factors into the shared decision-making processes to reduce decisional conflict and enhance patient-centered care.

Objective

To map existing research on community-based multidimensional cancer rehabilitation, specifically relating to characteristics of studies, participants, intervention formats, outcomes, and outcome measures.

Data Sources

Searches were performed in MEDLINE, Embase, CINAHL, and Web of Science databases in May 2022 and updated in February/March 2024.

Review Methods

The review followed the methodological guidance for scoping reviews developed by the Joanna Briggs Institute. We considered evidence from primary research, knowledge syntheses, and research protocols, and imposed no limits on study design. All authors screened independently for eligibility, using a standardized template for data extraction. We used descriptive statistics and presented the results in tables and narrative summaries.

Results

The search retrieved 6424 records, of which 104 were selected for full-text screening. Twelve publications were included in the review, representing nine unique rehabilitation interventions. The included studies comprised 594 participants with a mean age of 59.6 years. The cancer types were mixed with an overrepresentation of breast and prostate cancer. Seven of the publications were feasibility, pilot, protocol, or intervention development studies, and only two were randomized controlled trials. Physical activity/exercise was the most common component within physical functioning, and social support/peer support was most common within psychosocial functioning. Sixty-five tools were used to measure a range of outcomes, the most frequent being health-related quality of life.

Conclusion

The findings demonstrate that this field of research is in its infancy in Europe. Improving homogeneity in outcomes and outcome measures would enhance comparisons and pooling of results in future research.

Objective

This multicenter randomized controlled trial compared the changes in the degree of quality of life (QOL) and its components between mindfulness-based stress reduction (MBSR) and treatment-as-usual (TAU) groups over 3 points of time (T₀ = preintervention baseline assessment; T₁ = postintervention, which was right after the intervention completed or 6 weeks after the intervention began; and T₂ = follow-up, which was 12 weeks after the intervention ended) in head and neck cancer (HNC) survivors.

Methods

A total of 120 HNC patients were randomized into MBSR (n = 60) and TAU (n = 60) groups and administered the demographic and clinical data questionnaire and the Malay version of the Functional Assessment for Cancer Therapy-General and Head and Neck module (FACT-General and FACT-HN; to assess the QOL) across the three time points (T_0, T_1, and T₂).

Results

In the MBSR group, the main effect of the interaction between group and time for total FACT-General [F(2, 232) = 24.7, p < 0.001], social relationship [F(2, 227) = 21.7, p < 0.001], and emotion-related QOL [F(2, 230) = 35.1, p < 0.001] was significant after adjusting for confounding factors (such as age of participants, marital status, types of HNC, and stage of cancer). The total FACT-General and social relationship-related QOL scores of participants significantly increased from T₀ to T₁ and from T₁ to T₂, while the emotion-related QOL score significantly increased from T₁ to T₂. However, MBSR exhibited only a small effect on the physical health, functional, and the HN-related QOL scores in the MBSR group across the three time points.

Conclusion

MBSR enhances the overall QOL by enhancing the social and emotional components of QOL across time when compared with TAU. Hence, MBSR may be considered as part of the treatment regime for HNC, but its effect on QOL among HNC patients should be confirmed in the future study with longer follow-up assessments.

Trial Registration:ClinicalTrials.gov identifier: NCT04800419