Supportive Care in Cancer最新文献

Background: The presence of cancer and its treatment will induce anxiety and various effects, not only on a physical level but also on a psychological level. Play therapy can be used by children to articulate their emotions and foster proficient communication with healthcare professionals and caregivers. Play therapy emerges as a highly effective method for the management of illness in children diagnosed with cancer.

Material and methods: A thorough search was conducted across multiple databases including PubMed, Web of Science, Scopus, Google Scholar, and Cochrane Library. Our review included only interventional studies published from inception to 1 March 2024 that investigated the impact of play therapy on depression and anxiety in hospitalized children with cancer. For each study, information was gathered regarding the study's objective, participant characteristics, conditions, intervention details, comparisons made, study duration, and outcome measures.

Results: Following the retrieval of 2158 records, 12 studies were found to meet the eligibility criteria and were thus selected to include in the synthesis. Play therapy has been explored in several studies using interventions like cognitive-behavioral-based play therapy, family-based play therapy, group-based play therapy, virtual reality-based play therapy, and play therapy combined with other therapeutic approaches. Specifically, six studies investigated the effects of play therapy on anxiety, two studies on depression, and four studies on anxiety and depression.

Conclusion: Play therapy is highly recommended due to its simplicity, minimal requirement of tools and materials, ease of implementation, affordability, and suitability for hospitalized preschool and school-age children with cancer.

Purpose: Physical performance is crucial for prognosis after allogeneic hematopoietic stem cell transplantation (allo-HCT). Cardiorespiratory fitness has already been shown to have prognostic value, and there is increasing evidence that muscle strength and associated parameters (e.g., sarcopenia) are also of clinical relevance. Therefore, there is a need for the quantification of muscle strength and defining risk factors for reduced performance values.

Methods: Maximal voluntary isokinetic (MVIC) and isometric (MIPT) muscle strength was assessed 2.4 ± 7.1 days prior admission for allo-HCT with a stationary isokinetic testing machine (IsoMed2000). We calculated percentiles for knee extension and hip flexion using healthy reference values. Regression models were used to identify predictors for reduced muscle strength including gender, age, body mass index (BMI), number of previous cardiotoxic therapies, number of previous transplantations, comorbidity index (HCT-CI), hemoglobin level, and physical activity.

Results: Data of 212 patients (male n = 143, female n = 69), with a mean age of 54.49 ± 11.4, revealed considerably deviations from healthy reference values. Patients were located in the following percentiles: MVIC_Knee 37.5 ± 30.3, MVIC_Hip 39.5 ± 31.3 and MIPT_Knee 22.9 ± 26.5; MIPT_Hip 22.6 ± 27.4. Sub-group analyses showed that patients with younger age and male gender possess the highest deviations. Muscle strength values were significantly (p < 0.05) influenced by age, female gender, lower BMI, and higher HCT-CI.

Conclusion: Muscle strength is considerably reduced immediately prior to allo-HCT. Identified patient characteristics for reduced muscle strength point to the population that should be primarily targeted with exercise respectively resistance training interventions prior to allo-HCT to contribute to a well prepared transplant candidate.

Trial registration: NCT01374399.

Purpose: Existing studies documenting cancer-related sexual concerns among hematological cancer patients tend to group all types of hematological cancer together, overlooking potentially unique concerns associated with multiple myeloma (MM). This study is the first to characterize sexuality in MM and to examine predictors of sexual satisfaction for MM, comparatively with participants with other hematological cancer types.

Methods: We conducted a cross-sectional self-report survey-based study. Adult participants were eligible to participate, provided they were sexually active (alone or with a partner) and had a diagnosis of hematological cancer.

Results: Men and women with MM (N = 44) and other hematological cancers (N = 37) participated. MM survivors exhibited poor sexual function but low sexual distress and endorsed mid-high scores on measures of sexual flexibility, sexual communication, and sexual satisfaction. No group differences were observed on sexuality variables. Results indicate that for MM and other hematological cancer survivors, lower sexual distress (b = -.72, p < .001) and higher sexual communication (b = .45, p < .001) were associated with higher sexual satisfaction, while sexual flexibility and sexual function were not significantly associated with sexual satisfaction.

Conclusion: Despite experiencing poor sexual function, many MM patients have low levels of sexual distress. Similar interventions to improve distress and communication may be appropriate for both groups of patients and may be valuable for efforts to improve sexual satisfaction.

Purpose: For cancer patients, prognostication by physicians constitutes a fundamental basis of decision-making to manage the cancer journey, especially with advanced stages of cancer. Various tools such as the palliative prognostic index (PPI) have been established to estimate patient survival. Such reliable and widely applied tools unfortunately provide unexpected results of prognosis predictions in some cases. To support disease-related decision-making, this study explores factors associated with prognosis prediction outliers in patients with advanced cancer in palliative care units (PCUs).

Methods: For this retrospective observational study conducted at a PCU, we surveyed medical records of patients with advanced cancer admitted to our facility during August 2018-June 2022. Specifically, we collected data for the PPI, laboratory data, physical status, and psychological symptoms on admission.

Results: Our survey of data of 675 patients revealed that the presence and absence of severely reduced oral intake were significantly associated, respectively, with shorter (p < 0.001) and longer (p < 0.001) than estimated survival. Moreover, symptoms other than pain and female sex were associated, respectively, with shorter-than-expected and longer-than-expected survival.

Conclusion: The oral intake status of patients with advanced cancer in a PCU plays an important role in prognosis estimation. During prognosis, effects of symptoms other than pain and sex difference must also be considered. Although PPI-based prediction can provide a foundation for care management, cancer patients in more advanced stages of disease particularly require more detailed consideration.

Purpose: Patients with metastatic colorectal cancer (mCRC) undergoing systemic treatment often experience toxicities. Although exercise may improve physical fitness and quality of life and counteract treatment toxicity, knowledge in patients with mCRC is limited. The ongoing randomized controlled AMICO trial evaluates the effects of supervised exercise on clinical outcomes. The present qualitative study was a pre-planned part of this trial aiming to capture adherence, satisfaction, and perceived effects of exercise among patients with mCRC.

Methods: Patients with mCRC receiving first-line systemic treatment were randomized (1:1:1) to a control group or one of two supervised exercise arms including continuous aerobic exercise with either resistance exercises or high-intensity interval training. Semi-structured interviews with patients in the exercise arms were transcribed verbatim and thematically analyzed. Descriptive data on adherence (exercise logs) and satisfaction (questionnaire) was collected to complement and contextualize the qualitative findings.

Results: Twenty-one patients were interviewed. Median exercise attendance was 67% [IQR 35-91], and the median satisfaction score was 8 [IQR 8-9] out of 10. Patients valued the guidance and knowledge of the physical therapist and expressed interindividual preferences regarding training content. Patients experienced that exercise improved their physical and mental wellbeing and helped them to endure treatment. Perceived exercise barriers were treatment toxicity, physical problems, and hospital appointments. Perceived exercise facilitators included adequate tailoring and internal or external motivation.

Conclusion: Patients with mCRC appreciated exercise during systemic treatment and perceived several beneficial effects, both physically and mentally. Exercise attendance varied and barriers were mainly treatment- and disease-related.

Trial registration: Clinical trial.

Gov id: NCT04754672. Date of registration: 04-12-2020.

Purpose: Cancer survivors in a state with no legal access to cannabis may be hesitant to discuss their cannabis use with providers, particularly in light of legal consequences which disproportionately affect certain racial groups. This study examined potential racial disparities in the relationship of cannabis use status with patient-provider discussions of and attitudes toward cannabis in a state where there is no legal cannabis marketplace.

Methods: Survivors of cancer (N = 1003, M_age = 62.36; 13% Black/African-American; 41% male) completed a cross-sectional survey. Weight-adjusted regressions examined racial differences in the relationship between cannabis use status with (a) comfort and discussion of cannabis with providers, and (b) beliefs about impact of legalization on patients' and providers' comfort discussing cannabis.

Results: No racial differences were observed in rates of cannabis use or discussion, and patients who used cannabis were more comfortable discussing cannabis. Black patients who had used cannabis reported the greatest comfort discussing cannabis with providers, but also the greatest perceived improvement in comfort in the event of legalization.

Conclusions: Results highlight comfort and willingness to discuss cannabis with cancer care providers, particularly among Black patients who already use cannabis, which was not the hypothesized direction of findings. Further work is needed to inform recommendations for provider-led communication about cannabis.

Purpose: Peripheral neuropathy is one of the most devastating symptoms experienced by the patients. Supportive and holistic care interventions are crucial to help these patients. The aim of this study is to determine the effects of hand and foot exercises on chemotherapy-induced peripheral neuropathy and quality of life in women with breast cancer.

Methods: The sample of this randomized controlled trial study consisted of 79 women with breast cancer who underwent taxane-group chemotherapy in a hospital. The women diagnosed with grade 1 or higher peripheral neuropathy were included in the study. Women were divided into three groups as exercises with a massage ball, exercises with a stress ball, and control group. Hand and foot exercises last for 8 weeks. Data were collected using the Information Form, the Common Terminology Criteria for Adverse Events, and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire.

Results: The severity of neuropathy decreased significantly in both massage ball and stress ball exercise groups compared to the control group (p < 0.05). The group and time interaction was statistically significant in fatigue, pain, and motor symptoms (p < 0.05).

Conclusion: Women with breast cancer who undergo neurotoxic chemotherapy are thought to alleviate neuropathy symptoms and enhance their quality of life through simple home-based exercises. Nonpharmacological, applicable interventions, such as hand-foot exercises, can be integrated into patient education and care practices during the chemotherapy process.

Trial registration: ClinicalTrails.gov (Registration number: NCT06055088. registered on 01 June 2023).

Purpose: Diffuse large B-cell lymphoma (DLBCL) is one of the most common and aggressive forms of non-Hodgkin's lymphoma. This study aimed to evaluate the performance of the abbreviated Comprehensive Geriatric Assessment (aCGA) in assessing frailty and predicting clinical outcomes in elderly patients with DLBCL.

Methods: A total of 91 patients aged ≥ 65 years with newly diagnosed DLBCL and who received immunochemotherapy at a single medical center in Taiwan between August 2019 and December 2022 were prospectively enrolled. Frailty was assessed in all participating patients within seven days of the first cycle of immunochemotherapy. The primary objective was to compare aCGA's accuracy in assessing frailty with that of the full CGA. Secondary objectives included assessing correlations between frailty and severe adverse events (sAEs), early mortality, and overall survival (OS).

Results: In the cohort, 50 (55%) and 38 (42%) patients were categorized as frail based on CGA and aCGA, respectively. A high number of aCGA domains impairment were positively associated with a high number of CGA domains impairment. The receiver operating characteristic for aCGA for detecting frailty was 0.846 (95% confidence interval [CI], 0.756-0.926). A cut-off point of ≥ 2 aCGA domain impairments indicated frailty, with a sensitivity of 70.0% and specificity of 92.7%. Based on aCGA, the early mortality rate was 7.5% and 26.3% (p = 0.019) for fit and frail patients, respectively. The 1-year and 2-year OS rates were 77.7% and 67.4% for fit patients, and 57.1% and 45.4% for frail patients, respectively. The adjusted hazard ratio for OS was 2.42 (95% CI, 1.06-5.49, p = 0.035) for frail patients compared to fit patients.

Conclusions: This finding suggested that aCGA could be used as an efficient alternative to the full CGA, potentially improving the clinical management and treatment decision-making for elderly patients with DLBCL.

Purpose: To evaluate cancer patients' willingness to pay for exercise services and oncology health professionals' perception of patients' willingness to pay.

Methods: A mixed-methods design was used. Online questionnaires and semi-structured interviews were administered to people with any type of cancer and oncology health professionals delivering clinical care. Questionnaires assessed patients' willingness to pay for one consultation with a cancer-trained exercise specialist (i.e. exercise physiologist/physiotherapist) and regular group exercise sessions supervised by cancer-trained exercise specialists. Interviews probed factors associated with the out-of-pocket cost of adopting exercise guidelines. Data were analysed using standard descriptive statistics and an interpretive descriptive approach to qualitative analysis.

Results: Participants included 450 cancer patients and 300 oncology health professionals. A randomly selected sub-set of 30 patients and 31 health professionals completed interviews. The majority of patients surveyed would pay for an exercise consultation (94%) and regular group exercise sessions (58.4% extremely likely; 24.7% moderately likely; standard 7-point Likert scale response options). A greater proportion of patients who were employed (97.2% p = 0.030), below average general health (97.0% p = 0.031), were female (96.1% p = 0.013), and insufficiently active (95.3% p = 0.048) were willing to pay for exercise services. Oncology health professionals perceived fewer patients would be willing to pay for exercise services (p < 0.001; consultation = 7.0% extremely likely, 32.7% moderately likely; regular supervised sessions = 5.3% extremely likely; 32.0% moderately likely).

Conclusions: When briefly informed of the benefits and costs of exercise, the majority of patients in this study would pay for cancer-specific exercise services. There is an opportunity to align perceptions of willingness to pay among patients and health professionals involved in their care to help facilitate the uptake of exercise guidelines.

Purpose: The aim of this study is to evaluate how aromatherapy with the inhalation of lavender oil affects fatigue and sleep quality in patients with hematological malignancies undergoing chemotherapy.

Methods: This randomized, parallel-group study was carried out in the Adult Bone Marrow Transplant unit and Hematology-Oncology clinics between January 2022 and April 2023. A total of 120 patients were assigned to experimental and control groups by randomization. The study was completed with 100 patients including 50 in the experimental group and 50 in the control group. Lavender essential oil was applied to the experimental group for 20 min prior to going to bed every night for 5 consecutive days. Physiological saline solution was applied to the control group in the same way. A Participant Information Form, the Richards-Campbell Sleep Questionnaire, and the Piper Fatigue Scale were used as data collection tools.

Results: The experimental group showed a significantly higher sleep quality (p = 0.001) and had a significantly lower PFS scores (p = 0.001) compared to the control group. Also, the mean scores of the experimental group on the Behavioral, Sensory, and Cognitive subscales were statistically significantly lower than the scores of the control group (p < 0.05). Variables of lavender aromatherapy and total sleep quality accounted for 17.1% of the variance in fatigue levels (R² = 0.171).

Conclusions: Consequently, it was determined that aromatherapy with lavender essential oil significantly alleviated fatigue and lowered PFS total and subscale scores in patients with hematological malignancies undergoing chemotherapy. Also, sleep quality significantly enhanced in the overall PFS and its subscales.

Trial registration: NCT05808296. Date of Registration: 30 March 2023.