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Challenge of Underrepresentation of Black and Hispanic Men in Advanced Prostate Cancer Trials-Progress? 黑人和西班牙裔男性在晚期前列腺癌试验中代表性不足的挑战-进展?
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-07 DOI: 10.1200/OP-25-01225
Donald L Trump
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引用次数: 0
Review of Familial Adenomatous Polyposis: Current Understanding and Clinical Management. 家族性腺瘤性息肉病:目前的认识和临床治疗。
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-06 DOI: 10.1200/OP-25-00553
Jared R Hendren, Elissa Dabaghi, Josh Sommovilla, David Liska

Familial adenomatous polyposis (FAP) is an autosomal dominant hereditary colorectal cancer (CRC) syndrome caused by germline pathogenic variants in the adenomatous polyposis coli (APC) gene. FAP is typically characterized by the development of hundreds to thousands of adenomatous polyps throughout the colon and rectum, with a nearly 100% chance of developing CRC if left untreated. Duodenal cancer is the second leading cause of cancer for patients with FAP; however, gastric cancer has become more prevalent in recent years with improved surveillance of the colon, rectum, and duodenum. Patients frequently develop other extracolonic manifestations including desmoid disease, which holds the highest extracolonic mortality risk, and thyroid nodules, which are more frequently associated with the cribriform morular variant of papillary thyroid cancer. Management of FAP is complex, and patients require frequent and lifelong surveillance. This review will discuss the current understanding and clinical management of FAP as well as innovations and challenges in clinical practice.

家族性腺瘤性息肉病(FAP)是一种常染色体显性遗传性结直肠癌(CRC)综合征,由大肠腺瘤性息肉病(APC)基因的种系致病变异引起。FAP的典型特征是在整个结肠和直肠中发展成百上千个腺瘤性息肉,如果不及时治疗,几乎100%的机会发展为结直肠癌。十二指肠癌是FAP患者的第二大癌症原因;然而,近年来随着结肠、直肠和十二指肠检查的改善,胃癌变得越来越普遍。患者经常出现其他结肠外表现,包括结肠外死亡风险最高的硬纤维瘤病和甲状腺结节,后者更常与乳头状甲状腺癌的筛状结节变异型相关。FAP的管理是复杂的,患者需要经常和终身监测。本文将讨论目前对FAP的理解和临床管理,以及临床实践中的创新和挑战。
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引用次数: 0
Identification of High-Performing Safety Net Hospitals for Radical Cystectomy: Implications for National Cancer Institute Cancer Center Partnership. 确定用于根治性膀胱切除术的高性能安全网医院:对国家癌症研究所癌症中心合作的意义。
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-06 DOI: 10.1200/OP-25-00330
Raj Bhanvadia, Emily Bochner, Changchuan Jiang, Arthur S Hong, Zine-Eddine Khene, Yair Lotan, Vitaly Margulis

Purpose: For patients with bladder cancer (BCa) undergoing radical cystectomy (RC), National Cancer Institute-designated (NCI-D) cancer centers are considered the gold standard treatment hospital. Underserved populations face disparities in access to NCI-D and receive care at safety net hospitals (SNHs). Variation in quality of care for the underserved at safety-nets remains understudied. We hypothesized that safety-nets with NCI-D partnerships (affiliated safety-nets) would have superior RC outcomes compared with unaffiliated safety-nets.

Methods: We compared outcomes for BCa undergoing RC between affiliated and unaffiliated safety-nets using the Texas Cancer Registry. Federal payments to hospitals for uncompensated care were used to identify safety-nets. Multivariate accelerated failure time modeled the primary outcome of overall (OS); secondary outcomes of pelvic lymph node dissection (PLND) and neoadjuvant chemotherapy (NAC) were modeled with logistic regression.

Results: From 2004 to 2019, there were 1,927 cases of RC. Overall survival was no different at affiliated safety-nets and NCI-D (hazard ratio [HR], 0.99; P = .96), and was worse at unaffiliated safety-nets compared with NCI-D (HR, 1.28; P = .03). Unaffiliated safety-nets had lower odds of NAC (odds ratio [OR], 0.61; P = .02) and PLND (OR, 0.48; P < .001) compared with NCI-D or affiliated safety-nets.

Conclusion: NCI-D affiliated safety-nets may represent a subset of high preforming safety net hospitals for BCa patients undergoing RC. Survival differences are partly explained by greater odds of NAC and PLND at affiliated safety-nets. More work is needed to understand the drivers of higher-quality care at NCI-D affiliated safety net hospitals to improve BCa care across all safety net hospitals.

目的:对于接受根治性膀胱切除术(RC)的膀胱癌(BCa)患者,国家癌症研究所指定的(NCI-D)癌症中心被认为是金标准治疗医院。得不到充分服务的人口在获得NCI-D和在安全网医院接受护理方面存在差异。对安全网中服务不足人群的护理质量差异的研究仍然不足。我们假设与NCI-D伙伴关系的安全网(附属安全网)相比,非附属安全网具有更好的RC结果。方法:我们使用德克萨斯州癌症登记处比较了附属和非附属安全网中BCa接受RC的结果。联邦政府支付给医院的无偿医疗费用被用来确定安全网。多变量加速失效时间模拟总体(OS)的主要结局;盆腔淋巴结清扫(PLND)和新辅助化疗(NAC)的次要结局采用logistic回归模型。结果:2004 - 2019年,共发生RC 1927例。与NCI-D相比,附属安全网和NCI-D的总生存率没有差异(风险比[HR], 0.99; P = .96),而非附属安全网的总生存率较NCI-D差(风险比,1.28;P = .03)。与NCI-D或附属安全网相比,非附属安全网的NAC发生率(比值比[OR], 0.61; P = .02)和PLND发生率(比值比[OR], 0.48; P < .001)较低。结论:NCI-D附属安全网可能代表了BCa患者接受RC的高执行安全网医院的一部分。生存差异的部分原因是,在附属的安全网中,NAC和PLND的几率更高。需要做更多的工作来了解NCI-D附属安全网医院提供高质量护理的驱动因素,以改善所有安全网医院的BCa护理。
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引用次数: 0
Crisis of Cancer Drug Shortages: Understanding the Causes and Proposing Sustainable Solutions. 癌症药物短缺危机:了解原因并提出可持续解决方案。
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-07-01 DOI: 10.1200/OP-25-00381
Jason Westin, Shimere Sherwood, Karen Hagerty, Julie Gralow
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引用次数: 0
Timing and Outcomes of Palliative Care Integration Into Care of Adolescents and Young Adults With Advanced Cancer. 姑息治疗纳入晚期癌症青少年和青年护理的时机和结果。
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-05-13 DOI: 10.1200/OP-24-00907
Jeremiah Bonnet, Colin Cernik, Hajime Uno, Lanfang Xu, Cecile A Laurent, Lauren Fisher, Nancy Cannizzaro, Julie Munneke, Robert M Cooper, Joshua R Lakin, Corey M Schwartz, Mallory Casperson, Andrea Altschuler, Lawrence H Kushi, Chun R Chao, Lori Wiener, Jennifer W Mack

Purpose: Adolescent and young adult (AYA) patients with cancer frequently receive intensive measures at the end of life; many also express care goals that align with a palliative approach. We sought to understand the extent to which AYAs are referred to palliative care before death, the timing of referrals, and associations between referral timing and end-of-life care outcomes.

Methods: Review of electronic health data and medical records for 1,918 AYAs age 12-39 years who died after receiving care at one of the three sites between 2003 and 2019. Patients who received palliative care but lacked documentation of referral timing were excluded.

Results: Most included AYAs were White (61%); 12% were Asian, 8% Black, and 27% Hispanic. Nearly three quarters (73%) were referred to palliative care before death. Thirty-six percent of palliative care referrals took place before the last 90 days of life; 30% were in the last month of life. Palliative care referrals and their timing were associated with care received at the end of life, with earlier referrals associated with fewer intensive measures near death, including chemotherapy in the last 14 days of life (P = .001) as well as intensive care unit admissions, emergency room visits, and hospitalizations in the last month of life (P < .001 for all). Patients who were referred to palliative care were more likely to have symptoms assessed in the last 90 days of life, including pain, dyspnea, nausea, diarrhea, constipation, depression, and anxiety (P < .001 for all).

Conclusion: Although many AYAs receive intensive measures at the end of life, most are also referred to palliative care. Earlier referrals have potential to reduce care intensity and enhance attention to symptoms and quality of life near death.

目的:青少年和年轻成人(AYA)癌症患者经常在生命结束时接受强化措施;许多人还表达了与姑息疗法相一致的护理目标。我们试图了解AYAs在死亡前被转介到姑息治疗的程度,转诊的时间,以及转诊时间与临终关怀结果之间的关系。方法:回顾2003年至2019年期间在三个地点之一接受治疗后死亡的1,918名年龄在12-39岁的青少年的电子健康数据和医疗记录。接受姑息治疗但缺乏转诊时间记录的患者被排除在外。结果:纳入的aya以白人居多(61%);12%是亚洲人,8%是黑人,27%是西班牙人。近四分之三(73%)的患者在死前接受了姑息治疗。36%的姑息治疗转诊发生在生命的最后90天之前;30%是在生命的最后一个月。姑息治疗转诊和转诊时间与临终时接受的护理有关,更早的转诊与更少的接近死亡的强化措施相关,包括生命最后14天的化疗(P = 0.001)以及生命最后一个月的重症监护病房入住、急诊室就诊和住院(所有P < 0.001)。接受姑息治疗的患者更有可能在生命的最后90天出现症状,包括疼痛、呼吸困难、恶心、腹泻、便秘、抑郁和焦虑(所有P < 0.001)。结论:尽管许多aya在生命结束时接受了强化措施,但大多数人也接受了姑息治疗。早期转诊有可能降低护理强度,加强对濒死症状和生活质量的关注。
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引用次数: 0
Long-Term Quality of Life, Cognitive Function, and Symptom Burden Among Chimeric Antigen Receptor T-Cell Recipients and Associated Cytokine Release Syndrome and Neurotoxicity. 嵌合抗原受体t细胞受体的长期生活质量、认知功能和症状负担及相关细胞因子释放综合征和神经毒性
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-05-13 DOI: 10.1200/OP-24-00823
Lucy Andersen, Ryan J Quinn, Heather Difilippo, Alfred L Garfall, David L Porter, Salimah H Meghani, Jie Deng

Purpose: Immediate side effects after chimeric antigen receptor (CAR) T-cell therapy are well documented and include cytokine release syndrome (CRS) and immune effector-cell-associated neurotoxicity (ICANS). However, long-term patient-reported outcomes are understudied. Using a social determinants of health (SDoH) framework, we described the long-term health-related quality of life (HRQoL), cognitive function, and symptom burden of patients in sustained remission after CAR T-cell therapy and examined the relationship between acute CRS and ICANS and long-term cognitive function and symptom burden.

Methods: This cross-sectional study included adults in remission after CAR T-cell therapy for multiple myeloma or B-cell lymphoma who were within 1-5 years post-treatment. We used bivariate analyses to measure associations between clinical and SDoH variables and long-term outcomes and linear regression to examine the relationship between ICANS and CRS toxicity and longer-term outcomes.

Results: Participants (n = 58) were a median of 67 years of age (22-88), 72% had lymphoma, 28% had multiple myeloma, and they were a median of 2 years (1-4.7) post-CAR T-cell infusion. Most of the participants reported good HRQoL. Over one third of participants reported mild-to-moderate impairment in physical function, social roles and activities, or pain domains. Higher income and employment were significantly associated with better physical HRQoL (P < .05). Participants reported low symptom burden, with fatigue most commonly reported. Neither CRS nor ICANS toxicity predicted long-term cognitive function or symptom burden.

Conclusion: Patients in long-term remission after CAR T-cell therapy have good HRQoL and cognitive function with minimal symptom burden. Importantly, there was no relationship between CRS and ICANS and long-term symptom burden or cognitive function. Results support the long-term clinical benefit of CAR T-cell therapy.

目的:嵌合抗原受体(CAR) t细胞治疗后的直接副作用有充分的文献记载,包括细胞因子释放综合征(CRS)和免疫效应细胞相关神经毒性(ICANS)。然而,患者报告的长期结果尚未得到充分研究。使用健康的社会决定因素(SDoH)框架,我们描述了CAR -t细胞治疗后持续缓解患者的长期健康相关生活质量(HRQoL)、认知功能和症状负担,并检查了急性CRS和ICANS与长期认知功能和症状负担之间的关系。方法:这项横断面研究纳入了CAR -t细胞治疗多发性骨髓瘤或b细胞淋巴瘤后1-5年内缓解的成年人。我们使用双变量分析来测量临床和SDoH变量与长期结果之间的关联,并使用线性回归来检查ICANS和CRS毒性与长期结果之间的关系。结果:参与者(n = 58)的中位年龄为67岁(22-88岁),72%患有淋巴瘤,28%患有多发性骨髓瘤,car - t细胞输注后的中位时间为2年(1-4.7年)。大多数参与者报告了良好的HRQoL。超过三分之一的参与者报告了身体功能、社会角色和活动或疼痛领域的轻度至中度损伤。较高的收入和就业与较好的身体HRQoL显著相关(P < 0.05)。参与者报告症状负担低,最常见的是疲劳。CRS和ICANS毒性均不能预测长期认知功能或症状负担。结论:CAR -t细胞治疗后长期缓解的患者HRQoL和认知功能良好,症状负担轻。重要的是,CRS和ICANS与长期症状负担或认知功能没有关系。结果支持CAR -t细胞疗法的长期临床益处。
{"title":"Long-Term Quality of Life, Cognitive Function, and Symptom Burden Among Chimeric Antigen Receptor T-Cell Recipients and Associated Cytokine Release Syndrome and Neurotoxicity.","authors":"Lucy Andersen, Ryan J Quinn, Heather Difilippo, Alfred L Garfall, David L Porter, Salimah H Meghani, Jie Deng","doi":"10.1200/OP-24-00823","DOIUrl":"10.1200/OP-24-00823","url":null,"abstract":"<p><strong>Purpose: </strong>Immediate side effects after chimeric antigen receptor (CAR) T-cell therapy are well documented and include cytokine release syndrome (CRS) and immune effector-cell-associated neurotoxicity (ICANS). However, long-term patient-reported outcomes are understudied. Using a social determinants of health (SDoH) framework, we described the long-term health-related quality of life (HRQoL), cognitive function, and symptom burden of patients in sustained remission after CAR T-cell therapy and examined the relationship between acute CRS and ICANS and long-term cognitive function and symptom burden.</p><p><strong>Methods: </strong>This cross-sectional study included adults in remission after CAR T-cell therapy for multiple myeloma or B-cell lymphoma who were within 1-5 years post-treatment. We used bivariate analyses to measure associations between clinical and SDoH variables and long-term outcomes and linear regression to examine the relationship between ICANS and CRS toxicity and longer-term outcomes.</p><p><strong>Results: </strong>Participants (n = 58) were a median of 67 years of age (22-88), 72% had lymphoma, 28% had multiple myeloma, and they were a median of 2 years (1-4.7) post-CAR T-cell infusion. Most of the participants reported good HRQoL. Over one third of participants reported mild-to-moderate impairment in physical function, social roles and activities, or pain domains. Higher income and employment were significantly associated with better physical HRQoL (<i>P</i> < .05). Participants reported low symptom burden, with fatigue most commonly reported. Neither CRS nor ICANS toxicity predicted long-term cognitive function or symptom burden.</p><p><strong>Conclusion: </strong>Patients in long-term remission after CAR T-cell therapy have good HRQoL and cognitive function with minimal symptom burden. Importantly, there was no relationship between CRS and ICANS and long-term symptom burden or cognitive function. Results support the long-term clinical benefit of CAR T-cell therapy.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"131-140"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Receipt of Alcohol Screening, Brief Intervention, and Treatment Among US Adults With and Without a History of Cancer. 接受酒精筛查、短暂干预和治疗在美国有和没有癌症史的成年人中
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-05-09 DOI: 10.1200/OP-24-01030
Devon K Check, Zhen Li, Sahar Shibeika, Caroline E Sloan, Andrea Sitlinger, Leah L Zullig, Solomon A Graf, Dan V Blalock

Purpose: Many cancer survivors consume alcohol above recommended limits, increasing their risk of recurrence, second cancers, and cancer-related mortality. Alcohol screening, brief intervention, and referral to treatment (SBIRT) is a guideline-recommended strategy for reducing unhealthy alcohol consumption among adult primary care patients. To our knowledge, no prior studies have evaluated SBIRT's reach among cancer survivors.

Methods: We conducted a cross-sectional study of adults who completed the National Survey on Drug Use and Health from 2015 to 2022. We examined past-year receipt of alcohol screening and-among respondents who endorsed unhealthy alcohol use-brief intervention and treatment. All outcomes were examined among cancer survivors and those with no cancer history. We used modified Poisson regression to assess the associations of cancer history with each outcome, adjusting for sociodemographic characteristics.

Results: The cohort included 86,410 respondents with no history of cancer and 9,963 cancer survivors. The percentages of respondents endorsing past-year receipt of alcohol screening (approximately 40%), brief intervention (approximately 8%), and treatment (approximately 2%) were similarly low in both groups. After adjustment, there was a small but statistically significant difference in alcohol screening, with cancer survivors more likely than people without a history of cancer to receive alcohol screening (adjusted risk ratio [aRR], 1.07; 95% CI, 1.02 to 1.13). Among those with unhealthy alcohol use, cancer survivors were no more or less likely than people without a history of cancer to receive brief alcohol intervention (aRR, 1.00; 95% CI, 0.93 to 1.07) or alcohol treatment (aRR, 0.92; 95% CI, 0.47 to 1.69).

Conclusion: Results reveal an important opportunity to improve SBIRT uptake across the board and especially for cancer survivors, who are at increased risk of alcohol-related adverse health effects and, potentially, more motivated to change cancer-related health behaviors.

目的:许多癌症幸存者的饮酒量超过推荐限度,增加了他们的复发、二次癌症和癌症相关死亡率的风险。酒精筛查、短暂干预和转诊治疗(SBIRT)是指南推荐的减少成人初级保健患者不健康饮酒的策略。据我们所知,之前没有研究评估过SBIRT在癌症幸存者中的作用。方法:对2015 - 2022年完成全国药物使用与健康调查的成年人进行横断面研究。我们检查了过去一年酒精筛查的收据,并在支持不健康饮酒的受访者中进行了简短的干预和治疗。所有结果都在癌症幸存者和没有癌症病史的人中进行了检查。我们使用修正泊松回归来评估癌症病史与每个结果的关联,并根据社会人口统计学特征进行调整。结果:该队列包括86410名无癌症病史的受访者和9963名癌症幸存者。在两组中,赞同过去一年接受酒精筛查(约40%)、短暂干预(约8%)和治疗(约2%)的受访者百分比同样较低。调整后,酒精筛查的差异虽小但有统计学意义,癌症幸存者比无癌症史的人更有可能接受酒精筛查(调整风险比[aRR], 1.07;95% CI, 1.02 ~ 1.13)。在不健康饮酒的人群中,癌症幸存者接受短暂酒精干预的可能性并不比没有癌症史的人多或少(aRR, 1.00;95% CI, 0.93 ~ 1.07)或酒精治疗(aRR, 0.92;95% CI, 0.47 ~ 1.69)。结论:研究结果揭示了一个重要的机会,可以全面提高SBIRT的吸收,特别是对于癌症幸存者来说,他们面临着酒精相关不良健康影响的风险增加,并且可能更有动力改变与癌症相关的健康行为。
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引用次数: 0
Fertility Preservation Services for Adolescents and Young Adults: 2022 National Cancer Institute Community Oncology Research Program Landscape Assessment. 青少年和年轻人的生育能力保存服务:2022年国家癌症研究所社区肿瘤研究项目景观评估。
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-06-04 DOI: 10.1200/OP-24-01017
Erin M Mobley, Julie Anna Wolfson, Jennifer Levine, Lingyun Ji, Subhash Ramakrishnan, Chandylen L Nightingale, Emily V Dressler, Carol Kittel, David R Freyer, Aaron J Sugalski, Pinki Kumari Prasad, Jessica Sheth Bhutada, Karly Murphy, Wade Kyono, Michael E Roth, Susan K Parsons, Melissa P Beauchemin

Purpose: Given the impact of cancer treatment on fertility among adolescents and young adults (AYAs: 15-39 years), it is important to ensure AYAs access to fertility preservation (FP). However, the availability of FP services for AYAs treated in community settings is unknown. We examined FP access at National Cancer Institute Community Oncology Research Program (NCORP) practice groups.

Methods: The 2022 NCORP Landscape Assessment survey captured available resources and cancer care services including FP services at practice groups. We described FP services as accessible (on-site or off-site) versus not accessible by AYA-treating status (as previously defined). Univariable and multivariable analyses were used to evaluate associations between FP services and practice characteristics (NCORP classification [minority/underserved or community] and proportion of Medicaid or uninsured above/below the national average).

Results: Among 271 practice groups responding to the survey, 100 were categorized as AYA-treating, of which 32% had neither male nor female FP services available. Sperm banking was available at 59 AYA-treating practices, among which 43 (73%) referred for sperm banking off-site. Although approximately half of AYA-treating practices reported accessible female FP services (embryo = 54%, oocyte = 55%, ovarian tissue = 40%), most of them referred patients off-site (embryo = 72%, oocyte = 80%, ovarian tissue = 83%). The odds of access to male FP were lower at minority/underserved practices (odds ratio, 0.34 [95% CI, 0.13 to 0.88]; P = .026; ref = community); however, this same relationship was not seen for females.

Conclusion: Despite guidelines surrounding FP discussions before cancer therapy, and strong consensus regarding the importance of FP access, many AYA-treating practices in community settings lack access to FP services. Understanding how to leverage available services and broadly expand access is urgently needed to facilitate guideline-concordant, high-quality cancer care for AYAs.

目的:考虑到癌症治疗对青少年和年轻成人(年龄:15-39岁)生育能力的影响,确保青少年获得生育保护(FP)非常重要。然而,目前尚不清楚在社区环境中接受治疗的未成年人能否获得计划生育服务。我们检查了国家癌症研究所社区肿瘤研究计划(NCORP)实践小组的FP获取情况。方法:2022年NCORP景观评估调查收集了现有资源和实践小组的癌症护理服务,包括计划生育服务。我们将FP服务描述为可访问(现场或非现场),而不是按aya处理状态(如前所定义)不可访问。单变量和多变量分析用于评估计划生育服务与实践特征之间的关系(NCORP分类[少数/服务不足或社区]和医疗补助或未保险比例高于/低于全国平均水平)。结果:在271个回应调查的实践组中,100个被归类为aya治疗,其中32%既没有男性也没有女性计划生育服务。59家aya治疗诊所提供精子库,其中43家(73%)转诊到非现场精子库。虽然大约一半的人工授精治疗实践报告可获得女性计划生育服务(胚胎= 54%,卵母细胞= 55%,卵巢组织= 40%),但其中大多数将患者转到非现场(胚胎= 72%,卵母细胞= 80%,卵巢组织= 83%)。少数民族/服务不足的诊所获得男性计划生育的几率较低(优势比,0.34 [95% CI, 0.13至0.88];P = 0.026;Ref = community;然而,在女性身上却没有发现同样的关系。结论:尽管在癌症治疗前有关于计划生育讨论的指导方针,并且对计划生育获取的重要性有强烈的共识,但许多社区环境中的aya治疗实践缺乏计划生育服务。迫切需要了解如何利用现有服务并广泛扩大可及性,以促进符合指南的高质量aya癌症护理。
{"title":"Fertility Preservation Services for Adolescents and Young Adults: 2022 National Cancer Institute Community Oncology Research Program Landscape Assessment.","authors":"Erin M Mobley, Julie Anna Wolfson, Jennifer Levine, Lingyun Ji, Subhash Ramakrishnan, Chandylen L Nightingale, Emily V Dressler, Carol Kittel, David R Freyer, Aaron J Sugalski, Pinki Kumari Prasad, Jessica Sheth Bhutada, Karly Murphy, Wade Kyono, Michael E Roth, Susan K Parsons, Melissa P Beauchemin","doi":"10.1200/OP-24-01017","DOIUrl":"10.1200/OP-24-01017","url":null,"abstract":"<p><strong>Purpose: </strong>Given the impact of cancer treatment on fertility among adolescents and young adults (AYAs: 15-39 years), it is important to ensure AYAs access to fertility preservation (FP). However, the availability of FP services for AYAs treated in community settings is unknown. We examined FP access at National Cancer Institute Community Oncology Research Program (NCORP) practice groups.</p><p><strong>Methods: </strong>The 2022 NCORP Landscape Assessment survey captured available resources and cancer care services including FP services at practice groups. We described FP services as accessible (on-site or off-site) versus not accessible by AYA-treating status (as previously defined). Univariable and multivariable analyses were used to evaluate associations between FP services and practice characteristics (NCORP classification [minority/underserved or community] and proportion of Medicaid or uninsured above/below the national average).</p><p><strong>Results: </strong>Among 271 practice groups responding to the survey, 100 were categorized as AYA-treating, of which 32% had neither male nor female FP services available. Sperm banking was available at 59 AYA-treating practices, among which 43 (73%) referred for sperm banking off-site. Although approximately half of AYA-treating practices reported accessible female FP services (embryo = 54%, oocyte = 55%, ovarian tissue = 40%), most of them referred patients off-site (embryo = 72%, oocyte = 80%, ovarian tissue = 83%). The odds of access to male FP were lower at minority/underserved practices (odds ratio, 0.34 [95% CI, 0.13 to 0.88]; <i>P</i> = .026; ref = community); however, this same relationship was not seen for females.</p><p><strong>Conclusion: </strong>Despite guidelines surrounding FP discussions before cancer therapy, and strong consensus regarding the importance of FP access, many AYA-treating practices in community settings lack access to FP services. Understanding how to leverage available services and broadly expand access is urgently needed to facilitate guideline-concordant, high-quality cancer care for AYAs.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"112-121"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Therapy for Diffuse Astrocytic and Oligodendroglial Tumors in Adults: ASCO-SNO Guideline Rapid Recommendation Update Clinical Insights. 成人弥漫性星形细胞和少突胶质细胞肿瘤的治疗:ASCO-SNO指南快速推荐更新临床见解
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-04-29 DOI: 10.1200/OP-25-00185
Nimish A Mohile, Andrew B Lassman, David Schiff, Jaishri Blakeley
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引用次数: 0
Low-Intensity Vibration to Reduce Symptoms and Improve Physical Functioning in Cancer Survivors With Chemotherapy-Induced Peripheral Neuropathy: A Pilot Randomized Trial. 低强度振动减轻化疗诱导周围神经病变癌症幸存者的症状和改善身体功能:一项试点随机试验
IF 4.6 3区 医学 Q1 ONCOLOGY Pub Date : 2026-01-01 Epub Date: 2025-05-15 DOI: 10.1200/OP-24-00961
Stephanie M Krasnow, Clinton T Rubin, Eric J Roeland, Fay B Horak, Sydnee A Stoyles, Nathan F Dieckmann, Kendra N Braun, Kerri M Winters-Stone

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) can have deleterious effects on mobility and quality of life in people with cancer. Vibration therapy shows promise as a CIPN intervention but is understudied. We investigated the feasibility and preliminary efficacy of low-intensity vibration (LIV) in cancer survivors with CIPN.

Methods: We conducted a pilot randomized controlled trial in adult cancer survivors with persistent CIPN symptoms. Participants were randomly assigned to twice-daily LIV sessions (10 min/session; 30 Hz, 0.4 g) for 12 weeks or usual care (UC). We assessed feasibility by accrual, retention, adherence, and adverse event (AE) reporting. We evaluated preliminary efficacy by changes in patient-reported CIPN symptoms (Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity), pain (Brief Pain Inventory), fatigue (Patient-Reported Outcome Measurement Information System Fatigue), and physical functioning (Late-Life Function and Disability Instrument) and objectively measured physical functioning (chair stand time, gait speed), stability (postural sway), and mobility (Timed-Up-and-Go). Linear regression models were used to generate effect size estimates (Cohen's d).

Results: We accrued 95% of our target sample (n = 38, mean age: 62.6 ± 9.9 years, 89% female, median time since chemotherapy completion: 18 [6-39] months), with 20 participants randomly assigned to LIV and 18 to UC. Trial retention was 97% and mean adherence to LIV was 77% ± 18%. There were no serious AEs. Compared with UC, LIV participants reported greater improvements in sensory neuropathy symptoms (LIV, +1.4 ± 3.3 points; UC, +0.2 ± 2.8 points; Cohen's d = 0.45) and basic lower extremity function (LIV, +5.3 ± 8.5 points; UC, -0.7 ± 9.2 points; Cohen's d = 0.80), with moderate-to-large effect sizes for changes in stability, mobility, and gait (Cohen's d = 0.60-0.66).

Conclusion: LIV is safe, feasible, and shows preliminary efficacy for CIPN symptom relief and improving physical functioning in cancer survivors with CIPN.

目的:化疗诱导的周围神经病变(CIPN)可对癌症患者的活动能力和生活质量产生有害影响。振动疗法作为CIPN干预有希望,但尚未得到充分研究。我们研究了低强度振动(LIV)在CIPN癌症幸存者中的可行性和初步疗效。方法:我们在有持续CIPN症状的成年癌症幸存者中进行了一项随机对照试验。参与者被随机分配到每天两次的LIV疗程(10分钟/次;30 Hz, 0.4 g), 12周或常规护理(UC)。我们通过累积、保留、依从性和不良事件(AE)报告来评估可行性。我们通过患者报告的CIPN症状(癌症治疗功能评估/妇科肿瘤组神经毒性)、疼痛(简短疼痛量表)、疲劳(患者报告的结果测量信息系统疲劳)和身体功能(晚期功能和残疾仪器)的变化来评估初步疗效,并客观地测量身体功能(椅子站立时间、步态速度)、稳定性(姿势摇摆)和机动性(time - up -and- go)。线性回归模型用于产生效应大小估计(Cohen’s d)。结果:我们收集了95%的目标样本(n = 38,平均年龄:62.6±9.9岁,89%为女性,化疗完成后的中位时间:18[6-39]个月),其中20名参与者随机分配到LIV和18名UC。试验保留率为97%,平均依从性为77%±18%。没有严重的ae。与UC相比,LIV参与者报告感觉神经病变症状的改善更大(LIV, +1.4±3.3分;UC, +0.2±2.8分;Cohen’s d = 0.45)和下肢基本功能(LIV, +5.3±8.5分;UC, -0.7±9.2分;Cohen’s d = 0.80),对稳定性、活动性和步态的变化有中等到较大的影响(Cohen’s d = 0.60-0.66)。结论:LIV是安全可行的,对CIPN癌症幸存者CIPN症状缓解和身体功能改善有初步疗效。
{"title":"Low-Intensity Vibration to Reduce Symptoms and Improve Physical Functioning in Cancer Survivors With Chemotherapy-Induced Peripheral Neuropathy: A Pilot Randomized Trial.","authors":"Stephanie M Krasnow, Clinton T Rubin, Eric J Roeland, Fay B Horak, Sydnee A Stoyles, Nathan F Dieckmann, Kendra N Braun, Kerri M Winters-Stone","doi":"10.1200/OP-24-00961","DOIUrl":"10.1200/OP-24-00961","url":null,"abstract":"<p><strong>Purpose: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) can have deleterious effects on mobility and quality of life in people with cancer. Vibration therapy shows promise as a CIPN intervention but is understudied. We investigated the feasibility and preliminary efficacy of low-intensity vibration (LIV) in cancer survivors with CIPN.</p><p><strong>Methods: </strong>We conducted a pilot randomized controlled trial in adult cancer survivors with persistent CIPN symptoms. Participants were randomly assigned to twice-daily LIV sessions (10 min/session; 30 Hz, 0.4 g) for 12 weeks or usual care (UC). We assessed feasibility by accrual, retention, adherence, and adverse event (AE) reporting. We evaluated preliminary efficacy by changes in patient-reported CIPN symptoms (Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity), pain (Brief Pain Inventory), fatigue (Patient-Reported Outcome Measurement Information System Fatigue), and physical functioning (Late-Life Function and Disability Instrument) and objectively measured physical functioning (chair stand time, gait speed), stability (postural sway), and mobility (Timed-Up-and-Go). Linear regression models were used to generate effect size estimates (Cohen's d).</p><p><strong>Results: </strong>We accrued 95% of our target sample (n = 38, mean age: 62.6 ± 9.9 years, 89% female, median time since chemotherapy completion: 18 [6-39] months), with 20 participants randomly assigned to LIV and 18 to UC. Trial retention was 97% and mean adherence to LIV was 77% ± 18%. There were no serious AEs. Compared with UC, LIV participants reported greater improvements in sensory neuropathy symptoms (LIV, +1.4 ± 3.3 points; UC, +0.2 ± 2.8 points; Cohen's d = 0.45) and basic lower extremity function (LIV, +5.3 ± 8.5 points; UC, -0.7 ± 9.2 points; Cohen's d = 0.80), with moderate-to-large effect sizes for changes in stability, mobility, and gait (Cohen's d = 0.60-0.66).</p><p><strong>Conclusion: </strong>LIV is safe, feasible, and shows preliminary efficacy for CIPN symptom relief and improving physical functioning in cancer survivors with CIPN.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"100-111"},"PeriodicalIF":4.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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JCO oncology practice
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