European Journal of Cancer Care最新文献

Background. In this research, programmed cell death protein 1 (PD-1) inhibitors, including toripalimab, sintilimab, and camrelizumab, were evaluated for the treatment of non-small-cell lung cancer (NSCLC). Methods. This retrospective research was conducted on patients with locally advanced and advanced NSCLC receiving various PD-1 inhibitors including toripalimab, sintilimab, and camrelizumab, between April 2019 and March 2023. Results. In total, the ORR and DCR of 167 patients included in this research were 40.72% (68/167) and 92.81% (155/167), respectively, while the statistical median PFS was 13.90 months (95% CI, 10.657–17.143), and the median OS was 30.10 months (95% CI, 22.142–38.058). Multifactorial analysis showed that two factors, line of treatment and history of smoking, had a statistically significant benefit on the patients’ PFS benefit (P < 0.05), while the factor that had a statistically significant benefit on the patients’ OS benefit was the presence of serious adverse events (AEs) during treatment. 83.83% and 24.55% of patients experienced any grade AEs and grade 3–5 AEs, respectively. Conclusions. In our research, therapy lines and history of smoking had influence on the efficacy of immunotherapy, while serious AEs during treatment were prognostic factors that affected the OS benefit of immunotherapy. Patients we studied did not die from treatment-related causes, and PD-1 inhibitors did not cause additional toxicity in elderly patients. However, further investigations and multicenter studies are needed.

Background. Chemotherapy can cause a range of side effects including nausea, vomiting, diarrhea, and infection, which can have a significant impact on an individual’s quality of life. Survival outcomes can be impacted when side effects are poorly managed, leading to failure to complete the defined dose of treatment. Objective. This study presents clinicians’ experiences with a shared care model involving home-based community nurse (CN) support to improve side-effect management of individuals receiving chemotherapy as an outpatient. Methods. A qualitative study was conducted with CNs, cancer nurses, medical oncologists, and a general practitioner involved in the CN intervention delivered as part of a randomized controlled trial (RCT) aimed at reducing unplanned presentations to hospital of cancer patients receiving outpatient chemotherapy. Semistructured individual and focus group interviews were conducted. Key themes were identified using thematic analysis. Findings. Twenty-three healthcare professionals were interviewed. Three themes were identified: (1) being able to enhance patient-centered care and clinical practice during chemotherapy; (2) importance of effective communication and collaborative relationships between different care settings; and (3) ways to adapt the intervention for implementation in routine clinical practice. Participants reported that it was feasible for CNs to care for this patient group, and their home visits enabled preemptive symptom management. Suggestions to improve and modify the intervention to implement this care model within existing clinical care included a flexible approach, such as a blended delivery with face-to-face visits and telephone calls; a risk- or needs-based approach to prioritize patient groups more likely to benefit from the intervention; and sharing of electronic medical records for more effective collaboration and communication. Conclusions. A CN-delivered shared care model provided a feasible approach to the provision of individualized support for outpatients receiving chemotherapy. This study suggests ways to adapt this care model into existing clinical workflow and structures. This trial is registered with ACTRN12614001113640.

RUNX2, known as the core-binding factor subunit alpha-1 (Cbfa1), is a protein-coding gene recognized and responsible for its involvement in bone development and osteoblast differentiation. However, its dysregulation and aberrant expression have been linked to the pathogenesis of many diseases, such as oral squamous cell carcinoma (OSCC). This review highlights the significance of the RUNX2 gene in oral squamous cell carcinoma. Objectives. To review the contribution of the RUNX2 gene in oral squamous cell carcinoma and its implication on clinical diagnosis and treatments. Materials and Methods. A systematic scoping review was conducted to elucidate the role of RUNX2 in OSCC. A framework of five stages for scoping reviews outlined by Arksey and O’Malley (2005) was adopted for the current study. Results. The review showed that RUNX2 plays a role in the development and progression of OSCC, a common form of head and neck cancer. Conclusion. RUNX2 is an essential player in the molecular mechanisms underlying the development and progression of oral squamous cell carcinoma, and its dysregulation promotes tumor initiation, progression, and metastasis, making it a potential target therapy for future research aimed at developing novel therapies for oral squamous cell carcinoma. Clinical Relevance. Understanding the precise mechanisms by which RUNX2 contributes to OSCC pathogenesis can lead to target treatment for this challenging form of cancer.

Objective. To explore the impact of family function on quality of life (QoL) and investigate the mediating effects of fear of progression (FoP) and resilience in the pathway from family function to QoL among patients with cervical cancer (CC). Methods. A multicenter cross-sectional survey with convenience sampling was conducted from December 2021 to December 2022. A total of 252 patients with cervical cancer were recruited from five tertiary hospitals in Jiangsu Province, China. Patients completed the 5-item self-administered Family Adaptation, Partnership, Growth, Affection, Resolve (APGAR) scale, the Fear of Progress Questionnaire short-form, the 14-item Resilience Scale, and the 12-item Short-Form Health Survey. Structural equation modeling (SEM) was performed to explore the mediation effect of FoP and resilience between family function and QoL for CC patients. Bootstrapping procedures were used to verify the significance of the indirect effects of the mediating variables. Results. The mean score of family function was 7.97 ± 2.41 (scale range: 0–10), FoP was 29.58 ± 10.14 (scale range: 12–60), and resilience was 69.37 ± 14.36 (scale range: 14–98). The mean score for physical component summary (PCS) was 41.87 ± 10.00 (scale range: 0–100), and the mean score for mental component summary (MCS) was 46.68 ± 11.78 (scale range: 0–100). Family function positively predicted patients’ resilience and negatively predicted their FoP, while FoP negatively predicted CC patients’ resilience and QoL, and resilience positively predicted patients’ QoL. Patients’ family function was associated with their QoL directly and indirectly through the mediation of FoP and resilience, and the model explained 7% of the variation in FoP, 24% of the variation in resilience, and 42% of the variation in QoL. Conclusions. Chinese CC patients expressed poor QoL. FoP and resilience could mediate the association between patients’ family function and QoL. Healthcare professionals could improve QoL of patients with cervical cancer through reducing FoP and enhancing resilience.

Purpose. This study aimed to study the challenges and ways of coping with living with chronic lymphocytic leukemia (CLL) before the initiation of treatment. Methods. Semistructured interviews were carried out with 8 people living with CLL (4 males and 4 females) who had never received any treatment. Interpretative phenomenological analysis was utilized for the analysis of the data. Results. The following three themes were developed: (1) “Still waters run deep” highlights the contrast between living with minimal symptoms while experiencing high anxiety for the future, (2) “Surviving uncertainty” portrays participants’ supportive networks, communication challenges, and internal coping mechanisms to face the threatening overtones of CLL, and (3) “Turning over a new leaf” delineates participants’ realization of life’s finiteness and the way this acts as a nudge for psychological growth. Conclusion. Despite the limited physical discomfort, the CLL diagnosis and the watch-and-wait phase bring about psychological distress, which drives meaning-making efforts and an array of coping mechanisms, potentially leading to posttraumatic growth processes for people living with CLL.

Objective. This study was to construct a ceRNA (lncRNA-miRNA-mRNA) regulatory network for prostate cancer (PCa) and to explore the prognostic correlation, key biological functions, and pathways of core RNAs. Methods. Three subgene expression matrices (miRNA, lncRNA, and mRNA expression matrix) were taken from the TCGA database and used in this investigation. Differential expression analysis and differential expression miRNAs were carried out. Next, the ceRNA (lncRNA-miRNA-mRNA) regulatory complex was used to visualize our data and show how they interacted. Ultimately, the primary molecular roles and biological pathways of PCa were identified using enrichment analysis by the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO). An effect of AC016773.1 on prostate cancer cell proliferation was investigated by knocking out AC016773.1 in an animal model. The interrelationship between AC016773.1 and hsa-mir-25 was validated using RNA immunoprecipitation technology. Results. The lncRNA, miRNA, and mRNA expression matrices obtained from the TCGA database contain 16901, 1881, and 19962 transcripts, respectively. Through differential expression analysis, we obtained 2010 de lncRNA comparative information, 75 lncRNA and miRNA interaction pairs, and 31 targeted de mRNAs. Through the differential expression analysis of RNA nodes in the ceRNA regulatory network, we found that compared with the NP group, in the PCa group, there were 14 lncRNAs upregulated and 25 lncRNAs downregulated, 1 miRNA upregulated and 3 miRNA downregulated, and 10 mRNA upregulated and 21 mRNA downregulated. In KEGG enrichment analysis, the pathways identified by targeted DE-mRNAs were mainly related to calcium signaling pathway, EGFR tyrosine kinase inhibitor resistance, melanoma, PI3K−Akt signaling pathway, and proteoglycans in cancer. In animal models, it was found that knocking down AC016773.1 significantly reduced tumor volume and weight, indicating that AC016773.1 may promote the proliferation of PCa cells. The use of RNA immunoprecipitation technology indicates a direct binding between AC016773.1 and hsa-mir-25. Conclusion. We elucidated the network regulatory relationship of lncRNA-miRNA-mRNA in PCa and further explored the key molecular functions, biological pathways, and prognostic value of targeted DE-mRNAs.

Postradiotherapy surveillance, which aims to detect and treat radiation injury, is important from the patient’s perspective, but also from the radiation oncologist’s perspective. Unfortunately, patient nonattendance increases over the course of five years. The aim of the study was to investigate the appropriateness and acceptability of reduced versus usual (conventional) postradiotherapy surveillance in breast cancer patients. A total of 192 consecutive patients with curatively irradiated breast cancer from two selected treatment years were included in our study, of whom 65 were offered six (after three months, 12 months, 24 months, 36 months, 48 months, and 60 months) and 127 were offered four follow-up appointments (after three months, 12 months, 36 months, and 60 months). Their patient-, tumour- and treatment-related characteristics were analysed, as well as follow-up events and attendance rates. The reduced four-meeting surveillance practice shows similar results to the traditional six-meeting practice in terms of appropriateness and acceptability, with significantly higher attendance rates at 36 and 60 months (p = 0.014 and 0.013, respectively) when the individual moments are compared on a one-to-one basis. The patient-, tumour-, and treatment-related variables examined did not show an effect on the attendance rate. There was also no significant difference between the two cohorts in the detection of follow-up events (such as recurrence) and late radiation effects. In conclusion, this retrospective study provides scientific support for the trend towards a risk-adjusted, reduced surveillance practice in radiation oncology. In particular, four postradiotherapy follow-up visits seem to be appropriate and accepted in breast cancer patients after curative postoperative breast irradiation. This reduced postradiotherapy surveillance practice has the advantage of saving time for the patient and resources for the healthcare system without compromising quality; it could also improve patient participation. We, therefore, recommend it as an appropriate standard for breast cancer patients.

Objective. To characterise cancer diagnosis in Scottish primary care in 2018/19 and draw comparisons with diagnostic activity in 2014. Methods. A national audit of cancer diagnosis undertaken in Scottish general practices. Participating GPs collected diagnostic pathway data on patients diagnosed with cancer in 2018/19 from medical records. These data were supplemented by linkage to the Scottish Cancer Registry and previous audit data from 2014. Analyses explored and compared patient demographics, presentation, diagnostic routes, and intervals. Results. Seventy-three practices submitted data on 2,014 cases in 2014 and 90 practices submitted data on 2,318 cases in 2018/2019. Individual demographics and types of cancer were similar. There was a higher proportion of USC (urgent suspected cancer) referrals in 2019 than 2014 (42.9% vs 38.1%, p = 0.008) but a similar proportion of emergency presentations (19.2% vs 20.4%). Primary care (median 4 (IQR 0–22) vs 5 (0–23)) and diagnostic intervals (27 (10–59) vs 30 (13–68)) were similar in both periods. Significantly fewer (24.5% vs 28.3, p = 0.015) had a diagnostic interval >60 days in 2019 than 2014. Harder to diagnose cancers were more likely to present as emergencies and be subject to prolonged delays in both cohorts. Conclusions. The 2014 and 2018/19 cohorts were broadly similar. There is limited evidence that USC use had increased between 2014 and 2018/19. Harder to diagnose cancers are still most likely to present as emergencies and be subject to delays. Overall, it seems there were small improvements in cancer diagnosis prepandemic and a further audit could examine evidence for a postpandemic recovery.

Background. There are many different haematological malignancy subtypes. Most follow chronic pathways that are uncertain and unpredictable, which may lead to feelings of anxiety and distress. The provision of information can ameliorate such difficulties, but patients are known to have unmet needs in this regard. The aim of this study is to explore experiences of information sharing among patients with chronic blood cancers and the factors impacting this process. Methods. The study is set within a UK cohort of blood cancer patients, where care is provided across 14 hospitals according to national clinical guidelines. Purposive sampling was used to identify expert participants (based on experience), and in-depth qualitative interviews were conducted with 35 patients, 10 with a relative present. The study was intended to inform practice and utilised qualitative description, with thematic content analysis and systematic data coding. Results. Experiences of information sharing varied. Most patients described this positively, but not all. Several barriers and facilitators were identified, which are discussed within five themes: (1) shock affects ability to process information, (2) the importance of time to facilitate information exchange, (3) personal relationships have an impact on meeting information needs, (4) HCP interpersonal skills are central to good information sharing, and (5) communication skills and terminology. Conclusions. Patients with chronic blood cancers prefer to engage in information sharing when they are not in a state of shock, and when they have adequate time to process material that is effectively and sensitively delivered, by HCPs they know and trust.

Objective. Perceived control refers to an individual’s subjective perception, affective experience, or cognitive beliefs regarding their level of control. The objective of this study was to examine the relationship between perceived control and quality of life (QoL) among breast cancer (BC) patients using a structural equation model. Method. Participants (N = 80) completed questionnaire surveys on perceived control and QoL using the Cancer Experience and Efficacy Scale (CEES) and the Quality of Life Questionnaire Core 30 (EORTC QLQ-C30 V3.0), respectively. Structural equation modeling was employed to examine the associations between perceived control factors, including cancer experience and control efficacy, and QoL. Results. The QoL in BC patients was found to be significantly negatively correlated with physical symptoms, accounting for 51.6%. This indicates that the QoL of patients decreased by 51.6% with each unit increase in physical symptoms. In terms of perceived control among BC patients, socioeconomic strain exerted the greatest influence on cancer experience, accounting for 44.3%, followed by emotional strain and personal strain at 40.08% and 34.6%, respectively. Group efficacy had the highest impact on control efficacy at 43.0%, followed by individual efficacy and medical efficacy at 41.8% and 29.7%, respectively. QoL in BC patients decreased by 4.2% with every unit increase in cancer experience but improved by 3.5% with every unit increase in control efficacy. Conclusion. The structural equation model facilitates a comprehensive understanding of the interrelationships among various variables in perceived control and QoL among BC patients. The cancer experience in perceived control is negatively correlated with the QoL, whereas control efficiency demonstrates a positive correlation with QoL. Consequently, healthcare professionals should implement appropriate interventions to alleviate physical symptoms and enhance control efficiency, thereby improving both perceived control and QoL levels among BC patients. This trial is registered with ChiCTR2300069476.