Supportive Care in Cancer最新文献

Psychiatric symptoms are frequently found in patients with cancer and often require specific pharmacological treatment. Depression seems to be the most common psychiatric disorder followed by adjustment disorders, anxiety, and delirium. Psychiatric comorbidities are responsible for worse quality of life and low adherence to anticancer treatment. Many different psychiatric drugs are beneficial, but there are increasing risks of drug-drug interactions (DDIs) with anticancer drugs. We conducted a PRISMA-compliant systematic review (PROSPERO registered) on drug-drug interactions between psychiatric and anticancer medications, using predefined search terms in electronic databases and specialized interaction software. Only six studies met the predefined inclusion criteria, confirming a significant lack of evidence on this topic. The available studies were often limited by small sample sizes, inadequate controls, or insufficient assessment of drug interactions. Our expanded search in drug interaction software allowed us to cross-reference results and identify clinically relevant interactions. The aim of this paper is to collect and summarize in a user-friendly format the most significant DDIs and to show unfavorable and potentially dangerous combination of drugs.

Purpose: Breast cancer is the most commonly diagnosed cancer among women, and breast cancer survivors face ongoing challenges related to physical, psychological, and social well-being. Social media-based interventions have emerged as potential tools for knowledge dissemination, emotional support, and health management, yet their effectiveness remains under-researched. This review identifies gaps in the current literature and offers recommendations to guide future research and improve social media use in survivorship care.

Methods: A comprehensive literature search was conducted using PubMed, MEDLINE, Embase, CINAHL, Web of Science, and Google Scholar to identify studies published from database inception through March 2025 that examined the use of social media interventions. Studies were categorized into key themes: knowledge acquisition, social support, psychological health, and physical health outcomes.

Results: Breast cancer survivors may use social media interventions for knowledge acquisition, allowing them to exchange information, engage in peer support, and access expert resources. While these platforms improve understanding of treatment-related concerns, challenges such as misinformation and information overload remain. Social media interventions offer emotional support, fostering peer connections and reducing isolation, often through hashtags that allow individuals to connect, share experiences, and seek emotional support, and allow for anonymous self-expression. However, the emotional amplification of shared suffering may heighten distress. For psychological health, mixed findings suggest that social media has no effect or, in some cases, a negative impact on anxiety and depression experienced by breast cancer survivors. Social media interventions promoting physical activity promise to improve exercise adherence and health outcomes, though long-term effects remain unclear.

Conclusion: Social media interventions have the potential to improve knowledge acquisition and support for breast cancer survivors. Future research should focus on randomized controlled trials to better understand the impact of social media interventions on social support and well-being.

Purpose: Sexual health-related side effects during breast cancer treatment are common and distressing but not always expected by patients. We created an online sexual health educational video series to increase patients' awareness of these issues. In this exploratory study, we aimed to evaluate the acceptability, appropriateness, and feasibility of the video series among newly diagnosed breast cancer patients.

Methods: This was a repeat-measure, single-arm preliminary study where eligible and interested patients completed a baseline questionnaire within one month of diagnosis or surgical evaluation. Enrolled participants accessed the online sexual health video series. A follow-up questionnaire evaluating acceptability, appropriateness, and feasibility was administered after 6 months. Descriptive statistics, paired t-tests, and thematic analysis were utilized.

Results: Twenty-eight participants (January-June 2024) with mean age of 48 years (± 8 years) comprised the present analysis with 86%White, 4% Hispanic, 89% straight/heterosexual, 86% married/partnered, and 68% Stage I at diagnosis. Eleven participants (39%) completed the 6-month survey. Of the nine participants who reported watching the online videos, mean acceptability, appropriateness, and feasibility on a 5-point Likert scale was 4.1 (± 1.0), 4.3 (± 0.7), and 4.4 (± 0.7), respectively. Qualitative feedback showed strong endorsement for the video series and offered suggested improvements.

Conclusion: Breast cancer patients lack access to adequate sexual health resources during treatment, but an online educational video series has the potential to be acceptable, appropriate, and feasible as an educational resource. This video series fills a unique gap in patient care and has the potential to significantly advance the sexual health resources available to breast cancer patients and survivors.

Trial registration: ClinicalTrials.gov, Registration No. NCT06121258, Registration Date: 11/7/2023.

Purpose: Days at home (DAH) is a global measure that measures time spent outside of healthcare institutions. There is currently no consensus regarding use, terms, or definitions. We conducted a scoping review to map the literature on DAH in cancer research, highlight its use, and perform an analysis to guide future use.

Methods: The objectives and methods were published a priori and designed using the JBI Manual for Evidence Synthesis and Arksey and O'Malley's expanded framework. The final search was run for Medline, Embase, and Scopus in February 2024 and captured adult cancer research where DAH, or equivalent, was measured. DAH was defined as a composite outcome, recording the time a patient spends alive and outside of healthcare institutions.

Results: Of 1022 studies screened, 53 were included. The number of publications increased annually across study designs, with 16 studies published in 2023. DAH was assessed across multiple cancer populations, most commonly evaluating a heterogeneous cohort of cancer patients (14 studies, 26.4%). Sixteen unique terms were used to capture DAH, with days at home being most common (17 studies, 32%). There was variability in terms used, definitions applied, handling of death, and statistical methods when examining DAH. Several patient, cancer, treatment, and system level factors were associated with DAH across multiple cancer populations.

Conclusion: DAH may bridge the gap between methodologic rigor, data accessibility, and patient-centeredness in cancer research. There is considerable variability in terms, definitions, and reporting. With a view to coordinating the growing body of literature, we have shared considerations guided by this review to improve future use.

Purpose: To examine how frailty influences chemotherapy-induced peripheral neuropathy (CIPN) and psychological distress (anxiety and depression) in chemotherapy patients, exploring the mediating role of fatigue and the moderating (protective) role of mindfulness.

Methods: A cross-sectional survey enrolled 445 chemotherapy patients from three tertiary hospitals in China during April 2024-February 2025. Participants completed validated measures including the Treatment-Induced Neuropathy Assessment Scale (TNAS), Tilburg Frailty Indicator (TFI), Cancer Fatigue Scale (CFS), Freiburg Mindfulness Inventory (FMI), and Hospital Anxiety and Depression Scale (HADS). Moderated mediation analyses were conducted using structural equation modeling (SEM) with bootstrap techniques.

Results: Frailty significantly predicted higher CIPN symptoms (β = 0.179, 95% CI [0.101, 0.032]) and anxiety/depression (β = 0.216, 95% CI [0.140, 0.289]). Fatigue significantly mediated these relationships, with indirect effects of frailty on CIPN symptoms (β = 0.125, 95% CI [0.081, 0.179], accounting for 41.1% of total effect) and on anxiety/depression (β = 0.116, 95% CI [0.076, 0.163], accounting for 34.9% of total effect). Mindfulness moderated the association between frailty and fatigue (β = -0.106, 95% CI [-0.260, 0.006]) and between frailty and anxiety/depression (β = -0.083, 95% CI [-0.187, -0.005]); however, mindfulness did not significantly moderate fatigue-CIPN pathways (β = 0.022, 95% CI [-0.048, 0.089]).

Conclusion: Fatigue is a critical mediator linking frailty to CIPN and psychological distress. Mindfulness effectively buffers the negative impacts of frailty on fatigue and psychological distress. Integrating frailty assessment, targeted fatigue management, and mindfulness interventions into clinical practice may enhance symptom management and psychological well-being among chemotherapy patients.

Purpose: Palliative care (PC) is active continuous care for patients with life-limiting illnesses. It can be implemented early in association with life-prolonging treatments to preserve the patient's quality of life. However, both patients and oncologists are reluctant to discuss PC as the term is strongly connotated with poor prognoses and death. This study aimed to observe how oncologists introduce the concept of early PC referral integrated with a Phase I trial and what patients understand about it.

Methods: Consultations during which oncologists introduced referral to early PC to patients at the time of enrollment in a Phase I study were recorded. One-on-one interviews with the same patients were conducted and recorded. A thematic content analysis was then performed using NVIVO® software.

Results: The following themes emerged from the consultations with the oncologists: the contribution of early PC in terms of symptomatic and psychological support, its integration and entry into a Phase I trial at the same time, the anticipation of the benefits of PC support, and the perceived ambivalence between a Phase I trial and PC. Other themes emerged from the interviews conducted by the researchers after the consultations, including (mis)understanding the early PC referral integrated with a Phase I trial, information overload, the lack of knowledge about the role of PC, and the perceived ambivalence between a Phase I trial and PC.

Discussion-conclusion: Although oncologists tend to adapt their discourse to their patients, they often base it on evidence. However, patients have difficulty processing information about early PC. This study highlights the potential difficulties faced by oncologists and patients and suggests solutions, such as supporting patients in dealing with their emotions, analyzing practice, and training health professionals. The questions of "timing", "time", and "who" to refer patients to PC when setting up a Phase I trial remain paramount.

Purpose: Venous thromboembolism (VTE) represents a significant complication in pancreatic cancer patients, impacting both mortality and quality of life. Understanding research trends and developments in this field is crucial for advancing clinical care and identifying knowledge gaps. This study aims to examine the trends in research related to VTE and pancreatic cancer through a bibliometric analysis.

Methods: A comprehensive bibliometric analysis was performed using the Web of Science Core Collection database, covering publications from 1928 to 2024. Publications were analyzed using VOSviewer, CiteSpace, and R-bibliometrix.

Results: A total of 494 publications from 219 source journals were identified, involving 3321 authors. The USA led research output with 167 articles and 12,282 citations, followed by China and Japan. The Medical University of Vienna emerged as the most productive institution with 67 publications. Leading journals included Thrombosis Research and Journal of Thrombosis and Haemostasis. Key research themes encompassed molecular weight heparin, risk assessment, prophylaxis, and ambulatory patient care, with recent emphasis on personalized treatment approaches.

Conclusion: This bibliometric analysis highlights the significant growth in research on VTE associated with pancreatic cancer, characterized by substantial international collaboration and evolving research priorities. Recent trends indicate an increasing emphasis on precision medicine and outpatient care, suggesting promising directions for future research.

Purpose: Febrile neutropenia (FN) is a common side effect of chemotherapy. It may be prevented by granulocyte colony-stimulating factors (G-CSF), requiring customization based on patients' risk factors, the type of cancer and chemotherapy, and the formulation used. This observational study investigated all-day use of a pegfilgrastim formulation, also available for self-administration.

Methods: In outpatient clinics across Germany, doctors recorded data of adult patients suffering from a malignant disease routinely treated with chemotherapy and pegfilgrastim.

Results: Overall, 1636 patients received pegfilgrastim, predominantly women suffering from yet untreated breast cancer, 62% being at moderate and 38% at high risk of FN. In total, 2.5% of patients experienced FN despite treatment with pegfilgrastim, with 52.5% requiring hospitalization; in 40%, subsequent chemotherapy had to be postponed or reduced in dose. FN incidence and hospitalization rates were slightly lower when pegfilgrastim was given for primary versus secondary prophylaxis whereas there was no difference when given on day 1 or any later day following chemotherapy. FN incidence was much higher in patients with hematological as compared to solid tumors, particularly when treated with BEACOPP regimens. By contrast, related hospitalization depended less on cancer type and chemotherapy. Pegfilgrastim counterbalanced patients' risk factors, but a previous FN episode and male sex still increased the risk of hospitalization. Overall, 13.4% of patients experienced infections. The most common side effect of pegfilgrastim was bone-related pain. The syringe and self-injector formulations showed comparable effectiveness and safety.

Conclusions: Pegfilgrastim (Pelgraz®) treatment appeared to be effective and safe in all-day practice.

Purpose: Aboriginal and Torres Strait Islander people (hereafter respectfully referred to as First Nations) experience poorer cancer outcomes and higher mortality rates compared to non-Indigenous Australians. Barriers in accessing and engaging with cancer care services contribute significantly to these disparities. The First Nations Cancer Coordinator (FNCC) role offers a model that combines cultural and coordination support to improve the navigation of cancer services for First Nations people. This project sought to understand perceptions and impact of a pilot FNCC intervention on the care of First Nations patients, from the perspective of cancer care teams.

Methods: An exploratory, qualitative study was undertaken. The study was co-designed with a First Nations Community Advisory Group. Semi-structured interviews were undertaken with ten non-Indigenous cancer staff who had worked alongside the FNCC to support First Nations patients with cancer and their families.

Results: Analysis revealed three overarching themes relating to the scope and impact of the FNCC role: 1) Integrating cultural wisdom in cancer care delivery; 2) Relationship building through dedicated time and presence; 3) Bridging cultures by facilitating two-way communication and trust between patients and healthcare providers.

Conclusion: The findings highlight the critical importance of FNCC roles in advocating for and enhancing cultural safety in cancer care, essential for addressing disparities and improving cancer outcomes for First Nations Australians.