Supportive Care in Cancer最新文献

Background: Terminology used to describe cancer-related supportive services plays a critical role in shaping how both clinicians and patients perceive, access, and accept these interventions. In many low- and middle-income countries (LMICs), particularly in French-speaking contexts, terminological ambiguities may reinforce stigma and delay timely referral.

Methods: We conducted a nationwide, cross-sectional survey of 165 oncology professionals across Morocco to assess their preferences for three commonly used terms "soins de support" (supportive care), "soins de soutien" (support care), and "soins palliatifs" (palliative care). Participants rated the perceived emotional impact and referral likelihood associated with each term across four stages of the cancer trajectory. Quantitative analyses (multinomial regression, Wilcoxon tests) were complemented by thematic coding of free-text responses.

Results: "Supportive care" was the preferred term for 68% of respondents, while only 10% favored "palliative care." Referral to symptom management services was reported in only 21% of curative-phase cases but rose to 56% in advanced disease. "Supportive care" was consistently rated as more hopeful and acceptable to patients and families, while "palliative care" was strongly associated with increased distress. Medical specialty and practice setting significantly predicted terminology preference (p < 0.001). Referral likelihood also varied by terminology across stages: at initial diagnosis, 62% (supportive care) and 61% (support care) vs 26% (palliative care) (p < 0.001); in remission, 44% and 50% vs 19% (p < 0.001); in advanced disease, 94% and 87% vs 77% (p < 0.001). At end-of-life, rates converged (87%, 85%, 89%; NS). Free-text responses confirmed that terminology influenced clinicians' communication strategies and patient acceptance.

Conclusion: The choice of terminology is not merely semantic-it has measurable consequences on referral timing, patient engagement, and perceptions of care. Using labels such as "supportive care" encourages earlier referrals, while "palliative care" remains stigmatized and associated with terminal care. Standardizing terminology may facilitate earlier integration of these essential services and reduce inequities in cancer care.

Purpose: Enhanced Recovery After Surgery (ERAS) and immunonutrition (IMN) are established strategies for enhancing postoperative outcomes and modulating immune response. However, current research often overlooks the influence of patients' nutritional status and acceptability in the effectiveness of these combined therapies. The study was aimed at evaluating the effectiveness of perioperative IMN in gynaecological cancer (GC) patients.

Method: This was an open-label randomised controlled trial. The primary outcomes were postoperative hospitalisation, nutritional status, and functional status.

Results: A total of 110 participants were randomised into the perioperative IMN intervention (I-ERAS) or control (CO) group under an ERAS protocol. Mean age was 50.15 ± 13.07 years in I-ERAS and 49.27 ± 13.80 years in CO. Compared with CO, I-ERAS had a significantly shorter hospital stay (81.5 ± 40.9 h vs. 102.7 ± 58.7 h, p < 0.05) and faster gastrointestinal recovery, including earlier transition to a solid diet and return of bowel sounds. Importantly, none of the I-ERAS patients were readmitted within 30 days, compared with a 7.4% readmission rate in the CO group (p < 0.05). In addition, I-ERAS patients had improved wound healing (p < 0.05); better preservation of nutritional status (p < 0.05), a more favourable inflammatory profile (p < 0.01), and faster recovery of functional status (p < 0.05) and physical performance (p < 0.01).

Conclusion: Perioperative IMN within an ERAS protocol for GC surgery is a valuable intervention that reduces hospitalisation, enhances wound healing, improves inflammatory profiles, and lowers readmissions, making it suitable for routine ERAS practice.

Trial registration: NCT06039306, dated 14 September 2024 PROTOCOL VERSION: POIMNERAS2023, version 2, September 2023.

Purpose: Standardized quality metrics are critical to evaluate guideline adherence and outcomes, yet these are rarely tracked outside of time-limited research studies in resource-constrained settings. We describe the early implementation of the Global Fever Registry (FEVEREG), an electronic registry designed to collect local quality indicators and support implementation of a clinical guideline for fever with neutropenia in children with cancer.

Methods: Between 2021 and 2023, the registry was introduced at six referral hospitals in Central America and the Caribbean. We assessed the feasibility of a cohort-based implementation model through descriptive analysis of the duration of key implementation steps, delays in data entry, completion of required data fields, and center participation.

Results: Over 2 years, 619 febrile episodes from 472 children were recorded. The all-site median delay from episode onset to database entry was over 30 days, but two centers had median delays of > 4 months; one subsequently discontinued registry use. Audits at 14 and 24 months after registry activation demonstrated 89% completion of required fields at both time points.

Conclusion: A heterogeneous group of centers successfully implemented a common registry and achieved high data completeness. However, workforce shortages and competing clinical demands contributed to intermittent registry use and delayed entry, highlighting the need for institutional investment in data management. Registry data have already informed local quality improvement projects; future work should identify factors that sustain long-term use.

Purpose: Women with breast cancer face many psychosocial problems. This study aims to determine the spiritual experiences of women diagnosed with breast cancer and the effect of these experiences on their psychosocial well-being.

Methods: The study was conducted with thematic analysis approach, and the sample consisted of women diagnosed with breast cancer (n = 15). The findings were obtained through individual semi-structured interviews, guided by the interview form presented in the Supplementary Materials. The thematic approach was employed to analyze data.

Results: The main themes identified in this study were 'spiritual empowerment and coping strategies during the breast cancer process', 'the impact of spirituality on social bonding and emotional support', 'empowerment and identity building through spirituality', and 'integration of spirituality into holistic cancer care'.

Conclusion: Findings of the present study revealed that spirituality contributes to strengthening the emotional and social support mechanisms of patients, helping them develop coping strategies, and improving their psychosocial well-being. Raising the sensitivity of healthcare professionals to spiritual care and integrating it into patient care can help address the psychosocial needs of patients more comprehensively. Furthermore, promoting spiritual counselling services may improve the psychosocial well-being of patients.

Background: Pancreatic cancer remains one of the most lethal malignancies worldwide, particularly among older adults with multimorbidity and frailty. Palliative care (PC) is essential for optimizing quality of life and reducing nonbeneficial interventions. This study examined national patterns, trends, and outcomes of inpatient PC use among older adults hospitalized with pancreatic cancer in Thailand.

Methods: A retrospective study using the National Health Security Office database from 2017 to 2024, including patients aged ≥ 60 years hospitalized with a primary diagnosis of pancreatic cancer (ICD-10 codes C25.0-C25.7). Inpatient PC utilization was identified using the ICD-10 code Z51.5, recorded at any time during hospitalization. We assessed demographics, hospital type, interventions, costs, and discharge outcomes. Univariate and multivariate logistic regression analyses were performed to examine associations between PC utilization and clinical outcomes, including medical interventions, healthcare costs, and mortality.

Results: Among 8566 hospital visits, 1045 (12.2%) involved PC. PC recipients were slightly younger, more frequently female, and more likely to be treated at non-Ministry of Public Health hospitals. Across study years, inpatient PC utilization declined in all age groups, most markedly in patients aged 60-69 years. Compared with non-PC patients, those receiving PC had lower rates of chemotherapy (AOR 0.10, 95% CI 0.07-0.13), Whipple surgery (AOR 0.05, 95% CI 0.02-0.12), pancreatectomy (AOR 0.10, 95% CI 0.02-0.40), and biliary interventions (AOR 0.33, 95% CI 0.24-0.44). PC patients had higher odds of blood transfusion (AOR 1.28, 95% CI 1.09-1.49), parenteral nutrition (AOR 1.71, 95% CI 1.09-2.68), prolonged hospital stay (AOR 1.01, 95% CI 1.001-1.02), and in-hospital mortality (AOR 2.89, 95% CI 2.41-3.45). Median hospitalization costs were slightly lower in the PC group (USD 550 vs. 597).

Conclusion: Among older Thai inpatients with pancreatic cancer, PC was utilized in only 12.2% of admissions, with declining trends over time. PC was associated with less aggressive treatment, lower costs, and lower in-hospital mortality, reflecting its potential to reduce nonbeneficial interventions.

Background: Chemotherapy-induced peripheral neuropathy (CIPN) significantly impacts patients' quality of life and treatment adherence. Despite the growing research on CIPN, bibliometric analyses remain scarce, limiting understanding of the field.

Materials and methods: A bibliometric analysis of CIPN-related publications was conducted using records retrieved from the Web of Science Core Collection. Publications from 1992 to 2024 were included. CiteSpace, VOSviewer, and Bibliometrix were applied to analyze publication outputs, citation patterns, co-citation networks, keyword co-occurrence and clustering, collaboration networks among countries, institutions, and authors, and thematic evolution.

Result: The bibliometric analysis identified approximately 3398 studies published since 1992, involving 87 countries, 4126 institutions, and 15,611 authors. The USA leads in both publication output and collaborations. Keyword analysis identified terms such as "neuropathic pain," "breast cancer," and "quality of life," and thematic maps highlighted motor themes.

Conclusions: CIPN research has grown steadily, shifting its focus from neurotoxicity to supportive care. Future research will likely focus on biological mechanisms and improved rehabilitation.

Purpose: This review aimed to scrutinise and critically appraise the evidence on the effects of psychosocial interventions in alleviating CRF for colorectal cancer patients.

Methods: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL Ultimate, APA PsycInfo, CNKI, and WANFANG Database were electronically searched from inception to 31st August 2025 for randomised controlled trials examining psychosocial interventions for CRF in colorectal cancer patients. Meta-analyses were performed for short-term (immediately post-intervention to 1 month), medium-term (> 1 to 3 months), and long-term (> 3 months) follow-up periods. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The Review Manager Software (Version 5.4.1) was used for data analysis.

Results: Nine studies with 1426 participants were included. Interventions were categorised as psychotherapies, psycho-behavioural interventions, and yoga. Meta-analyses indicated that compared to controls, psychosocial interventions significantly reduced CRF at short-term (standardised mean difference (SMD) = -0.53, 95% confidence interval (CI) = -0.82 to -0.23), medium-term (SMD = -0.51, 95%CI = -0.73 to -0.29), and long-term (SMD = -0.24, 95%CI = -0.46 to -0.01) follow-up. Subgroup analyses indicated that psycho-behavioural interventions were effective (SMD = -0.39, 95% CI = -0.76 to -0.01), while psychotherapy and yoga showed no significant effects. The certainty of evidence ranged from very low to moderate.

Conclusions: Psychosocial interventions, particularly psycho-behavioural approaches, appear effective in reducing CRF among patients with colorectal cancer; however, effects were consistent at medium-term and long-term follow-up, while short-term findings showed substantial heterogeneity. More rigorous, adequately powered trials are needed to strengthen and extend the current evidence base.

Purpose: Chemotherapy-induced nausea and vomiting (CINV) is a common adverse effect that clearly benefits from prophylactic management. Awareness of CINV and adherence to CINV management guidelines was assessed under a continuing medical education program involving a personal practice assessment (PPA)-THRIVE (Training to Help Reduce CINV ratEs).

Methods: Forty-six medical oncologists from Canada (n = 21), Brazil (n = 20), and Argentina (n = 5) answered an anonymous survey of their practices during patient consultations. The questionnaire was developed by a group of medical oncologist experts.

Results: The survey included data on 446 patients with multiple cancer types undergoing treatment with highly emetogenic chemotherapy (HEC; 60%) and moderately emetogenic chemotherapy (MEC; 40%). Although 65% of respondents reported using more than one guideline to establish CINV management protocols, discrepancies between respondents' classifications and major guidelines were observed, particularly for newer agents and carboplatin dosing. In addition, 11% of respondents did not discuss personal additional risk factors for CINV with patients. Regarding CINV prophylactic protocol for MEC, 39% of respondents did not include neurokinin 1 receptor antagonist (NK-1 RA) in the regimen for patients with additional risk factors on MEC. The survey also revealed significant variability in the time points adopted for assessing CINV, with 35% of physicians relying solely on spontaneous reports by patients of delayed CINV.

Conclusion: There is a pressing need to explore and support initiatives for effective implementation of guidelines and identifying the causes of nonadherence.