Supportive Care in Cancer最新文献

Background: Periodontitis is a known risk factor for oral squamous cell carcinoma (OSCC), but its impact on postoperative outcomes remains unclear.

Methods: This retrospective study included 552 OSCC patients who underwent radical surgery with free flap reconstruction. Patients were classified into three groups: no periodontitis (N = 169), mild periodontitis (N = 148), and severe periodontitis (N = 235), based on preoperative computed tomography evaluations of alveolar bone and tooth loss. Data on demographics, surgical details, laboratory results, and complications were collected. Generalized estimating equations and multivariable regression analysis were used to evaluate the association between periodontal status and short-term postoperative outcomes.

Results: Patients with mild or severe periodontitis had significantly higher risks of surgical site infection (SSI) (OR = 3.46, P = 0.012) and postoperative fever (OR = 10.93, P < 0.001). The average body temperature on the first three postoperative days (B = 0.22, P < 0.001), maximum temperature (B = 0.35, P < 0.001), and fever duration (B = 0.47, P < 0.001) were significantly higher in the periodontitis groups. Infection-related laboratory markers were consistently elevated within 1 week postoperatively in periodontitis patients (all P for trend < 0.05). Subgroup analysis revealed that the association between periodontitis and SSI was particularly pronounced in patients aged ≤ 60 years (OR = 4.12, P = 0.035), males (OR = 15.92, P = 0.010), those with longer operative durations (OR = 3.17, P = 0.019), smokers (OR = 27.93, P = 0.015), and patients without diabetes (OR = 3.85, P = 0.012).

Conclusion: The severity of periodontitis is significantly associated with postoperative infectious complications in OSCC patients. The management of periodontitis may be important in improving postoperative outcomes for OSCC surgery.

Purpose: Breaking bad news (BBN) in pediatric oncology is emotionally complex and often poorly supported by training or guidelines. The OKRA-Compass, developed through participatory research, provides practical recommendations aiming to enhance BBN quality in German pediatric oncology settings. This paper aims to track insights into the everyday BBN routine.

Methods: After 6 weeks implementing the OKRA-Compass in five pediatric oncology clinics, a focus group and written feedback captured user experiences. Using thematic analysis, researchers coded and analyzed data to assess perceived changes. The participatory approach included co-researchers, and findings were linked to the Compass's Delphi-based theses for deeper insight.

Results: Applying the OKRA-Compass revealed four key outcomes: (1) Considering BBN as a complex process, (2) addressing the multi-layered needs of BBN receivers, (3) encouraging new paths for shared decision-making, and (4) cultivating awareness of the needs of healthcare professionals. Interdisciplinary use enhanced preparation, communication, and emotional safety while highlighting the need for structured training and institutional anchoring of BBN practices.

Conclusion: The OKRA-Compass supports high-quality, individualized BBN by structuring communication, fostering emotional attunement, and promoting shared decision-making. It enhances interdisciplinary collaboration and self-reflection among healthcare providers. Findings highlight its practical relevance, though broader evaluation is needed. The tool offers a promising framework for improving communication culture in pediatric oncology. This process demands a readiness to adapt, allocate resources, and invest in enhancing team communication skills.

Objective: To explore the potential profiles of cancer-related fatigue (CRF) in colorectal cancer patients and their relationship with exercise adherence.

Methods: A cross-sectional study was conducted with 329 patients with colorectal cancer in Wuhan, Hubei Province China from March to September 2024. Data were collected using general information questionnaires, the Cancer Fatigue Scale, and the Exercise Adherence Scale. Latent profile analysis was applied to explore the latent profiles of CRF. Multivariate logistic regression was used to analyze the sociodemographic variables in each profile, and ANOVA was used to explore the relationships between CRF profiles and exercise adherence.

Results: CRF in colorectal cancer patients can be categorized into three profiles: low CRF cognitively clear group (n = 138, 41.9%), moderate CRF balanced group (n = 165, 50.2%), and high CRF severe physical group (n = 26, 7.9%). Multivariate logistic regression analysis showed that living arrangements, recurrence and/or metastasis, the number of chemotherapies, and BMI were influencing factors for the profiles of CRF in colorectal cancer patients. There were statistically significant differences in the scores of various dimensions and the total score of exercise adherence among colorectal cancer patients with different profiles of CRF (P < 0.05).

Conclusion: CRF in colorectal cancer patients can be divided into three profiles, and there are differences in exercise adherence among colorectal cancer patients with different profiles of CRF. It is recommended that healthcare professionals develop targeted interventions based on the different profiles of colorectal cancer patients to improve their exercise adherence and enhance their quality of life.

Purpose: This study aimed to explore the attitudes, challenges, and support needs related to pulmonary rehabilitation (PR) among patients with oral and maxillofacial cancers and their caregivers in China.

Methods: We conducted semi-structured, in-depth interviews with a purposive sample of patients, both pre- and post-surgery, and their caregivers at a tertiary hospital in Chengdu, China. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.

Results: A total of 14 participants (7 patients and 7 caregivers) were interviewed. Five key themes and thirteen sub-themes emerged: (1) perceptions and attitudes toward PR, (2) multifactorial influences on participation, (3) preferences for PR education formats, (4) challenges in engaging with PR, and (5) psychological burden and the need for information support.

Conclusion: This study offers critical insights into the barriers and facilitators of PR for oral and maxillofacial cancer patients in China. Findings underscore the need for culturally tailored, patient-centered PR programs that address both physical and psychological recovery. Improved PR initiatives could enhance pulmonary function, quality of life, and overall outcomes for this vulnerable population, offering valuable implications for healthcare stakeholders and policymakers in China and similar settings worldwide.

Purpose: The current study investigated the extent of knowledge and care regimen regarding the possible risks of cardiac dysfunction from Trastuzumab (Herceptin) treatment in women with either a diagnosis of primary or metastatic breast cancer who had undergone or were receiving Trastuzumab at the time of the study.

Method: In a qualitative interview, participants were asked questions regarding awareness of cardiac risks of Trastuzumab therapy and knowledge of cardiac damage symptoms, as well as questions concerning the regimen of heart function monitoring during and beyond their course of treatment. Thematic analysis was used to analyse the data.

Results: The emerging themes from the thematic analysis revealed inconsistencies in (a) knowledge and awareness of cardiac damage risk prior to taking Trastuzumab, (b) monitoring of cardiac function and risks of cardiac dysfunction during and beyond treatment, and (c) awareness of signs of possible cardiac damage of Trastuzumab during treatment.

Conclusions: Our results suggest that patients feel unsupported and ill-informed about the possible risks of cardiac damage from Trastuzumab. This has implications for the self-management of symptoms and mitigation of risks for cardiac damage and suggests the need for improvement in patient care.

Purpose: Oral mucositis (OM) is a common and debilitating adverse effect associated with chemoradiotherapy in nasopharyngeal carcinoma. This study aimed to investigate the association between Latexin (LXN) polymorphism and acute toxicity of oral mucositis.

Methods: A total of 238 nasopharyngeal carcinoma (NPC) patients were enrolled. LXN genotypes were analyzed by the Sequenom MassARRAY system. Multivariate logistic regression was performed to assess the association of LXN polymorphisms and chemoradiotherapy-induced toxicities. Multifactor and generalized multifactor dimensionality reduction methods were applied to calculate the SNP-SNP interaction.

Results: Our study showed that the frequency of the AG genotype of rs1492908 was significantly lower in the grade 3-4 oral mucositis group compared to the grade 0-2 group (14.1% vs. 27.1%, respectively). Patients carrying the LXN rs1492908 AG genotype exhibited a decreased risk of severe oral mucositis (OR = 0.452, 95% CI = 0.213-0.959, P = 0.039). Stratification analysis further revealed that the rs1492908 AG genotype conferred protective effects against oral mucositis in specific patient populations, including those aged ≥ 47 years (OR = 0.340, P = 0.041), body mass index (BMI) ≥ 24 (OR = 0.286, P = 0.035), WHO type Ⅲ histology (OR = 0.212, P = 0.007), and receiving a higher radiotherapy dose (planning gross tumor volume of nasopharynx (pGTVnx) ≥ 71 Gy) (OR = 0.158, P = 0.016). Additionally, SNP-SNP interaction analysis identified that the combination of rs1492908, rs9841, rs8455, rs2639655, and rs56321207 was the best multi-locus model for oral mucositis.

Conclusion: This study is the first to establish a link between NPC chemoradiotherapy-induced oral mucositis risk and LXN polymorphisms in the Chinese Han population.

Purpose: The objective of this research was to synthesize the evidence about the usage of pulsed electromagnetic field (PEMF) in women with breast cancer undergoing hypo-fractionated whole-breast irradiation (HFWBI) for the treatment of acute radiodermatitis.

Methods: The study included 50 patients (35-55 years) with unilateral breast cancer post-lumpectomy who received HFWBI. They were randomized into Group A (PEMF plus standard skin care) and Group B (standard skin care only). Skin reactions were assessed during PEMF therapy using sonographic skin thickness measurements and RTOG criterion.

Results: After radiation, skin thickness increased in both groups, peaking at 4 weeks (PEMF 2.82 mm; control 2.74 mm, p = 0.030). By 6 weeks, thickness declined in the PEMF group but remained high in controls (p < 0.001), and by 8 weeks PEMF returned near baseline (2.01 mm) while controls stayed thickened (p < 0.001). Skin reactions worsened in both groups by week 4, with more severe cases in controls (36% vs. 12%, p = 0.150). By week 6, PEMF patients mostly had mild reactions (72% Grade 0-1) compared to predominantly severe reactions in controls (84% Grade 2-3, p = 0.001). At 8 weeks, recovery was greater with PEMF, as 52% returned to Grade 0 versus only 8% in controls (p = 0.001).

Conclusion: Results such as these indicate that PEMF therapy accelerates recovery from radiotherapy and diminishes the intensity of acute radiodermatitis.

Trial registration: Trial registration number: NCT06003764. Date of registration: 12 August 2023. Prospectively registered for prospectively registered trials.

Background: In diseases requiring long-term treatment, such as cancer, the importance of holistic nursing support is increasing. Both foot massage and bed baths are holistic care methods that address patients' physical, emotional, and psychological needs, and research indicates they can effectively reduce symptoms like fatigue and sleep disturbances.

Objective: This study aims to evaluate and compare the effects of foot massage and bed baths on fatigue and sleep quality in hospitalized cancer patients.

Method: The research was conducted with hospitalized patients in the oncology clinic of a university hospital between April and November 2024, employing a three-group randomized controlled experimental design. The study included 39 cancer patients who were randomly assigned to three groups: Foot Massage (FM) (n = 12), Bed Bath (BB) (n = 12), and Control (n = 15). The treatments were administered for four consecutive days, two hours before bedtime, with each session lasting 30 min. The control group received routine care without additional interventions. Data was collected using the Patient Information Form, the Brief Fatigue Inventory (BFI), and the Richard Campbell Sleep Questionnaire (RCSQ), through five repeated measurements.

Results: Before the interventions began, there were no significant differences between the groups in terms of fatigue or sleep quality. Regarding the BFI scores, on days three (p < .05) and four (p < .001) the FM group demonstrated lower mean scores compared with both the BB group and the control group. On day five, the BFI scores of the FM group and the BB group remained lower than those of the control group, and this difference reached statistical significance (p < .001). Regarding the RCSQ scores, starting from day three, the FM group exhibited significantly higher mean scores than the control group (p < .05 and p < .001). From day four onward, the BB group also demonstrated significantly higher RCSQ scores compared with the control group (p < .001). No significant differences were observed between the FM and BB groups regarding the RCSQ (p > .05).

Conclusion: These findings suggest that foot massage and bed baths serve as effective supplementary nursing interventions for reducing fatigue and improving sleep quality in hospitalized cancer patients.

Clinical trial number: NCT06373614.

Trial registration: ClinicalTrials. gov Registry (NCT06373614) in April 2024.

Artificial intelligence (AI) is increasingly being used in oncology to support early diagnosis and develop personalized treatment plans. However, its successful use in cancer care depends not only on the technology itself, but also on whether people trust it, understand it, and are open to accepting it. This study explored how digitally engaged adults living in Abu Dhabi, UAE, perceive AI-assisted cancer treatment, focusing on how factors like demographics, AI familiarity, and personal cancer experience influence acceptance and concern. A cross-sectional survey was completed by 413 adults using a structured, bilingual (Arabic-English) questionnaire. Participants were asked about their awareness of AI in healthcare, their willingness to accept AI-assisted cancer treatment, and their concerns about issues such as safety, accuracy, cost, and data privacy. Chi-square tests were used to analyze the relationships between these factors. Familiarity with AI had a significant impact on acceptance (p = 0.0006), with those who were very familiar with AI more likely to accept its use in cancer treatment. In contrast, education level (p = 0.664) and personal experience with cancer (p = 0.3562) were not significantly associated with acceptance. Participants who were less familiar with AI expressed more concerns about its accuracy, safety, cost, and the privacy of their data (p = 0.0073), pointing to awareness as a key factor in shaping trust. These findings suggest that trust in AI-assisted cancer care is driven more by how familiar people are with the technology than by their educational background or cancer experience. To build public trust and encourage responsible use of AI in oncology, it is essential to keep healthcare professionals actively involved and to communicate clearly and transparently with patients.