Supportive Care in Cancer最新文献

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.

Objective: To comprehensively map the available evidence on the application of Home Enteral Nutrition (HEN) in cancer patients, summarize its current application status, reported effects, and identified challenges, and to identify gaps in the literature to inform future research directions.

Methods: This scoping review was conducted following the Arksey and O'Malley framework. A computer-based search was conducted in eight databases (PubMed, Web of Science, Embase, Cochrane Library, CNKI, WanFang, VIP, and CBM) for relevant studies from their inception to April 16, 2025. The content from 19 included studies was extracted, summarized, and analyzed.

Results: A total of 19 studies were included, comprising 10 randomized controlled trials and 9 quasi-experimental studies. The most frequently studied cancer type was esophageal cancer (n = 11), followed by gastric cancer (n = 4); other cancer types (gastrointestinal, liver, nasopharyngeal, and colorectal) were also represented. The most frequently reported outcome domains were nutritional status (assessed in 18 studies), quality of life (7 studies), complications/adverse events (6 studies), and Chemotherapy-related conditions (5 studies), the included literature frequently reported improvements in these areas among patients receiving HEN.

Conclusion: The current literature suggests that HEN may play a beneficial role in the management of cancer patients, with studies reporting improvements in nutrition, quality of life, and chemotherapy tolerance. However, there are deficiencies in the quality and standardization of current research. Future research should focus on conducting high-quality studies, establishing unified standards, and strengthening personnel training and patient education to generate high-quality evidence and guide the rational application of HEN in cancer treatment.

Purpose: This cross-sectional study aimed to assess the Quality of Life of caregivers of patients with urologic cancer and identify key factors influencing their well-being.

Methods: The study involved caregivers of patients with urologic cancers, treated at Venizelio General Hospital of Heraklion. The CareGiver Oncology Quality of Life questionnaire was used to evaluate different QoL domains in relation with demographic and clinical data. Scores were calculated for each domain and transformed to a 0-100 scale.

Results: The sample included 106 caregivers; 86 of them were females (81.1%), with most aged between 56-75 years (44.4%). Care was offered by 65 spouses (61.3%), and 30 patients' children (28.3%). The overall QoL score was 59.7 (± 12.8), with the worst scores being in leisure, psychological well-being, and private life. Female caregivers had inferior psychological well-being (p = 0.035) and private life scores (p = 0.008) compared to males. Younger caregivers had the worst self-esteem scores (p = 0.031), while those with poorer education reported reduced leisure scores (p = 0.015). Financially disadvantaged caregivers scored worse in their relationship with healthcare (p = 0.001), administration and finances (p = 0.015), and self-esteem (p = 0.013). Spousal caregivers had the least private life (p = 0.001) and leisure scores (p = 0.032), and those living with the patient experienced poorer scores in both leisure (p = 0.002) and private life (p = 0.003).

Conclusion: In summary, caregivers of patients with urologic cancer experience substantial QoL challenges. Tailored interventions and policy support are essential to address their complex needs and enhance their overall well-being.

Purpose: Febrile neutropenia is a frequent complication of oncological treatment. Empirical antibiotic therapy should be started within the first hour after admission. Delays in its administration are associated with prolonged hospital stays and higher mortality rates. This study assessed the impact of Manchester Triage on time to antibiotic initiation in febrile neutropenia patients admitted to the Emergency Department (ED).

Methods: This retrospective single-center study included adult cancer patients admitted to the ED in 2022 diagnosed with febrile neutropenia.

Results: Among 38 patients, 34% were assigned an orange code and 11% a white code (referred from outpatient consultation); all in these two groups were directed to Internal Medicine (IM). A yellow triage code was assigned to 55% of patients, who were then directed either to IM or General Medicine (GM), without a defined criterion. Among patients triaged to IM (74%), the median time from admission to initiation of antibiotics was 4 h 27 min compared with 7 h 46 min for those triaged to GM (p = 0.03). There was no statistically significant correlation between time to antibiotic initiation and length of hospital stay or mortality.

Conclusion: Delays are significant and worsened when patients are assigned a yellow Manchester Triage code and are directed to GM. The study was underpowered to detect a statistically significant effect on mortality, but the observed mortality rate was double that reported in the literature. Proper triage of febrile oncological patients in the ED is crucial, and protocols with well-defined criteria should be implemented to ensure timely treatment.

Purpose: To assess the effect of patient education on quality of life, fatigue, and anxiety in patients diagnosed with lung cancer.

Methods: An electronic search was conducted across four databases (PubMed, Web of Science, CINAHL, and Scopus) using a combination of terms including lung neoplasms, health education, educat (truncated), quality of life, fatigue, and anxiety. The Cochrane RoB 2 tool and the TIDieR checklist were used to assess risk of bias and intervention replicability, respectively. The GRADE approach was applied to evaluate the certainty of the evidence. Study selection, data extraction, and all assessments were carried out independently by two reviewers. Where appropriate, data were pooled using meta-analysis (95% confidence interval [CI]).

Results: Seventeen studies were included in the qualitative synthesis, and thirteen in the quantitative analysis, comprising a total sample of 1799 participants. The meta-analysis demonstrated that, compared with controls, patient education interventions had a statistically significant and large effect on improving quality of life (SMD = 0.98; 95% CI [0.26, 1.69], p = 0.007, I² = 96%), anxiety (SMD = -1.75; 95% CI [-2.74, -0.77], p = 0.0005, I2 = 98%) and fatigue (SMD = -0.091; 95% CI [-1.61, -0.22], p = 0.01, I2 = 88%). In all cases, heterogeneity remained high. However, the educational content of the interventions was generally consistent, with most being delivered in a face-to-face format.

Conclusions: Patient education appears to be an effective approach for improving quality of life, fatigue, and anxiety in individuals with lung cancer. Nevertheless, these findings should be interpreted with caution, as the certainty of the evidence was rated as very low.

Purpose: Breast cancer is the most common malignancy among women in India, with patients often experiencing high symptom burden and compromised quality of life (QoL). Despite evidence supporting early supportive care integration, significant implementation gaps persist in low- and middle-income countries (LMICs). This study addresses the lack of feasible intervention models for resource-constrained settings and inadequate characterization of mechanisms through which early supportive care improves outcomes-particularly symptom-specific contributions and financial burden reduction.

Methods: This single-centre, randomised controlled trial at All India Institute of Medical Sciences, New Delhi, randomised 110 newly diagnosed adult female breast cancer patients (1:1) into intervention (early supportive care plus standard care) or control (standard care only) groups. Supportive care included symptom management, psychosocial counselling, and educational support. Outcomes were assessed at baseline and 3 months using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale (ESAS). Statistical analyses included t-tests, multivariate regression, and mediation modelling.

Results: Both groups showed significant QoL improvement, but greater symptom reduction occurred in the intervention group (mean ± SD ESAS reduction: 30.69 ± 15.51 vs. 22.9 ± 15.99; p = 0.014). Fatigue and pain were significantly lower in the supportive care group (Cohen's d = 0.55 [95% CI:0.17,0.94] and 0.38 [95% CI:0.00,0.75], respectively). Financial burden significantly reduced (p = 0.001), with higher patient and caregiver satisfaction (p = 0.032). Mediation analysis confirmed pain reduction as a key QoL predictor (p < 0.001).

Conclusions: Early supportive care integration significantly reduces symptom burden, enhances psychological well-being, and lowers financial stress, supporting its inclusion as standard adjunct cancer care in developing countries, providing actionable evidence for policymakers in LMICs.

Purpose: To explore the level of patient activation (PA) and its subgroups among postoperative breast cancer patients, and to analyze the differences and influencing factors across these subgroups.

Methods: A cross-sectional study was conducted from May to December 2024 using convenience sampling. A total of 230 postoperative breast cancer patients from a tertiary hospital in China completed questionnaires including general information, the Patient Activation Measure, the Posttraumatic Growth Inventory, the Social Impact Scale (for stigma), and the Perceived Social Support Scale. Latent profile analysis was used to identify PA subgroups. Differences among subgroups were analyzed using ANOVA, Kruskal-Wallis, or chi-square tests, followed by multinomial logistic regression to determine influencing factors.

Results: The average PA score was 51.0 ± 11.5, indicating that patients recognize their important role in disease management but lack the confidence and knowledge to take action. Three PA subgroups were identified: high PA-relatively proactive type (30.4%), moderate PA-knowledge deficient type (46.1%), and low PA-passive dependent type (23.5%). Protective factors for higher PA included urban residence, being employed, higher posttraumatic growth, and monthly family income ≥ 3000 yuan (all P < 0.05). Obstructive factors included not undergoing breast-conserving surgery and higher perceived stigma (both P < 0.05).

Conclusion: The PA score of postoperative breast cancer patients is classified at the second level, revealing three distinct categories with clear classification characteristics. Clinicians can identify patients exhibiting varying PA traits based on readily available demographic and disease-related data in clinical practice. This enables them to implement targeted interventions tailored to the specific characteristics and influencing factors of each group, ultimately enhancing PA levels.

Purpose: Cancer survivors with multiple chronic conditions (MCC) are a growing population with complex health needs, yet little is known about their care experiences and healthcare team trust.

Methods: This mixed methods study used a convenience sample of 441 adult cancer survivors recruited through online survey platforms. Participants completed surveys assessing care coordination, care access, healthcare team trust, and whether their care team included a social worker, navigator, or care coordinator during the 12 months after diagnosis. Twelve survivors also participated in semi-structured interviews. Relationships between care coordination and care access with healthcare team trust were examined using multivariable logistic regression followed by qualitative analysis of interviews.

Results: Overall 20.4% reported low trust in their healthcare team, 51.5% reported at least one care coordination problem, and 27.2% reported at least one care access issue. The adjusted prevalence odds ratios for low healthcare team trust were 14.5 times higher for cancer survivors who reported problems with care coordination (95% CI, 6.73, 31.29) and 6.3 times higher for care access problems (95% CI, 3.66, 10.69) compared with survivors reporting no problems. Having a social worker, coordinator, or navigator did not moderate these associations (p-values > 0.05). Participants described medical paternalism, transparency, honesty, established relationships, intergenerational trust, empathy and respect, and credibility as key experiences and attributes associated with trust.

Conclusion: Experiencing care problems was associated with reporting lower trust in one's healthcare team among cancer survivors with MCC, which represents potential modifiable points for intervention to improve trust, health outcomes, and quality of life.