Supportive Care in Cancer最新文献

Purpose: To explore the stress adaptation experiences of young and middle-aged couples with colorectal cancer (CRC), specifically examining the interaction between illness cognitions and dyadic coping.

Methods: Using purposive sampling, semi-structured interviews were conducted with eight pairs of young and middle-aged CRC couples, along with eight patients and five spouses, at a tertiary hospital in Guangzhou from October 2023 to February 2024. Data were analyzed following the six-stage process outlined in the interpretative phenomenological analysis research guidelines, with coding and organization supported by Nvivo 12.0 software to extract hierarchical themes reflecting the interaction process between illness cognitions and dyadic coping in CRC couples.

Results: Three themes emerged: (1) Intrapersonal dynamics: positive illness cognitions facilitated adaptive coping strategies, whereas negative cognitions triggered maladaptive coping behaviors. (2) Dyadic mechanisms: a cross-partner influence was observed where one partner's illness cognitions affected the other's coping through specific pathways, including negative resonance, reverse activation, and compensatory adaptive coping. (3) Key moderators: relationship intimacy, communication quality, family resilience, social support, family role identity, and division of labor significantly moderated these interactions.

Conclusions: The findings reveal complex bidirectional influences between CRC couples, including compensatory and reverse activation mechanisms. Relationship intimacy, communication quality, family role identity, resilience, and social support play crucial moderating roles in facilitating or hindering adaptive coping. These results underscore the necessity of psychosocial interventions adopting a family systems perspective, focusing on enhancing communication skills, clarifying role division, and strengthening support networks to improve psychological adjustment in cancer-affected families.

Purpose: The systematic review and meta-analysis aim to thoroughly assess the efficacy of manual interventions like massage therapy, reflexology, and acupressure techniques in relation to overall symptoms, pain, and quality of life (QOL) in patients suffering from CIPN.

Methods: A total of eight Chinese and English databases were searched, including PubMed, Embase, Cochrane Library, Web of Science, CINAHL, ProQuest, China National Knowledge Infrastructure, and Wan Fang Database. The searching lasted from the establishment of each database to July 2025. The study aims to include randomized controlled trials (RCTs) and quasi-experimental studies. The risk of bias was assessed using the Cochrane risk of bias tool. The primary outcome measures were symptoms of CIPN, pain, and QOL. Standard Deviation (SMD) and 95% CI were calculated in a random-effects model. This study was registered on the International Prospective Register of Systematic Reviews (PROSPERO, CRD420251112391).

Results: In total, 11 RCTs with a total of 646 patients were included. The meta-analysis showed that manual interventions may improve primary outcomes, including quality of life (SMD = 1.05; 95% CI = 0.60, 1.50; P < 0.00001), sensory (SMD = -0.62; 95% CI = -0.88, -0.35; P < 0.00001), and motor (SMD = -0.42; 95% CI = -0.72, -0.12; P = 0.006) symptoms, with low to moderate levels of heterogeneity. Although the aggregated data for overall CIPN symptoms (SMD = -1.67; 95% CI = -3.03, -0.30; P = 0.02) and pain (SMD = -0.77; 95% CI = -1.31, -0.24; P = 0.006) were statistically significant, they showed high heterogeneity (I² > 90%), which may be related to the limited number of existing studies and differences in intervention details.

Conclusions: Low- to very low-certainty evidence suggests that manual interventions may reduce core symptoms and pain associated with CIPN, and potentially improve sleep quality and quality of life. However, due to high heterogeneity and risk of bias, these findings should be interpreted with caution.

Background: Intravenous magnesium supplementation is increasingly adopted as a nephroprotective measure in patients receiving cisplatin-based chemotherapy, particularly in several Asian and European oncology centers. However, the dose-dependent nature of this effect remains poorly defined, and most studies have not addressed long-term renal outcomes.

Methods: In this multicenter retrospective study, 287 patients undergoing weekly cisplatin-based chemoradiotherapy for head and neck or cervical cancer were stratified based on prophylactic magnesium dose: 12 mEq or 24 mEq IV magnesium sulfate. Serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) were measured at baseline, during treatment, and up to 12 months post-treatment. The incidence of acute kidney injury (AKI) was defined using CTCAE v5.0 criteria. Comparative analysis was performed using standard statistical tests, and results were contextualized with recent large-scale cohort findings.

Results: AKI incidence was 17.7% in the 12 mEq group and 13.2% in the 24 mEq group (p = 0.32). However, longitudinal renal follow-up revealed a significant divergence in sCr and eGFR trajectories: the 24 mEq cohort maintained near-baseline renal function, whereas the 12 mEq group exhibited progressive deterioration at 6 and 12 months. These findings contrast with prior binary exposure studies and indicate a sustained, dose-dependent protective effect.

Conclusions: Magnesium's renoprotective benefit in cisplatin-based therapy is not only determined by its presence, but also by its dose. Our results support the incorporation of standardized magnesium dosing, specifically a minimum of 24 mEq, into clinical protocols. Dose precision, not merely inclusion, should guide prophylactic strategies to ensure effective renal protection.

Objective: This study aims to analyze the annual trends in postoperative ¹³¹I treatment frequency among differentiated thyroid cancer (DTC) patients and systematically evaluate the changes in psychological status and quality of life across different treatment stages, thereby providing an evidence-based foundation for developing precise patient support strategies.

Methods: We conducted a retrospective analysis of 1651 patients with nondistant metastatic DTC treated between 2018 and 2023 to examine trends in ¹³¹I therapy. In addition, an observational analysis of routinely collected questionnaire data from 2024 was performed, including a psychological stress scale, the Hospital Anxiety and Depression Scale (HADS), and the Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), to assess patients' psychological status and quality of life as part of standard clinical follow-up across different treatment stages.

Results: The adoption of single-dose ¹³¹I therapy for nonmetastatic DTC rose markedly from 5.99% (2018) to 98.34% (2023) (χ² = 87.407, p < 0.05), surpassing 92% after 2020. This shift was accompanied by a 38.9% reduction in treatment-cycle psychological distress (p < 0.001), though acceptance decreased by 6.6% at the 6-12-month assessment stage (p = 0.028). Willingness for multiple therapies declined 28.1% (p < 0.05), with variations by sex, education, and physician. HADS scores improved at subsequent assessment stages, and baseline anxiety was significantly associated with increased psychological risk at later stages (r = 0.534). Quality of life initially declined but showed subsequent improvement across treatment stages (p < 0.01).

Conclusion: Under the trend of single-session ¹³¹I therapy, a phase-specific health education system for high-risk groups is suggested. It may help strengthen pre-treatment cognitive intervention and post-treatment psychological support and provide a theoretical reference for improving adherence and long-term quality of life.

Background: To explore the current situation and influencing factors of resilience in patients with lung cancer undergoing chemotherapy, and to provide a basis for constructing a comprehensive and effective resilience enhancement program for patients with lung cancer undergoing chemotherapy.

Methods: Using descriptive qualitative research and purposive sampling method, 20 patients with lung cancer undergoing chemotherapy from October to December 2024 in the oncology department of a tertiary general hospital in Wuxi City, Jiangsu Province, China were interviewed semi-structured. The data were organized and coded with the help of Nvivo 14.0 software, and themes were distilled using the traditional content analysis method.

Results: A total of three themes and eight sub-themes were derived. The resilience status of patients with lung cancer undergoing chemotherapy was reflected in cognitive deficiency and a casual attitude. The protective factors for resilience among patients with lung cancer undergoing chemotherapy included intrinsic positive traits, multiple support networks, and professional medical support. The risk factors for resilience among patients with lung cancer undergoing chemotherapy included the damage of disease treatment, heavy economic burden, and lack of disease knowledge.

Conclusions: The study found that resilience among patients with lung cancer undergoing chemotherapy is multifaceted, shaped by a complex interplay of factors. Medical care, family, and society should jointly provide help to promote the protective factors of resilience and overcome the risk factors of resilience through collaborative efforts aimed at bolstering resilience, ultimately enhancing the quality of life for patients with lung cancer during chemotherapy.

Purpose: This study aimed to investigate the impact of a functional training prehabilitation program supported by the Prehab® App on the functional capacity, physical activity level, and symptoms of anxiety and depression in cancer patients undergoing major surgery.

Methods: This before-and-after experimental study was conducted with 38 patients who had a limited ability to attend a fully supervised prehabilitation program, scheduled for tumour resection at Hospital Clinic-Barcelona. Outcome measures included: Functional capacity assessed by the 30″ sit-to-stand test (30″ STS), Physical activity (PA) measured by the self-reported PA questionnaire: Yale Physical Activity Score (YPAS) and weekly step count via activity trackers; and the psychological status measured by the Hospital Anxiety and Depression Scale (HADS). All the variables were recorded at the beginning of the prehabilitation program (baseline) and the end of the program (before surgery). The statistical analysis was conducted using the paired-samples t-test.

Results: Most patients underwent upper gastrointestinal surgery, and the prehabilitation program had a mean duration of 6.5 weeks. Participants showed notable improvements in functional capacity assessed by 30″ STS, physical activity assessed by YPAS and in the psychological status after the intervention.

Conclusion: A functional training prehabilitation program supported by the Prehab® App appears to be effective in improving functional capacity, physical activity and psychological status in cancer patients undergoing major surgery.

Objectives: To determine the prevalence and factors associated with malnutrition in older adults with cancer upon admission for outpatient treatment.

Methods: This cross-sectional study was conducted with older adults with cancer admitted to an oncogeriatrics outpatient clinic from 2015 to 2020 in the Northeast of Brazil. Sociodemographic data, lifestyle, and clinical variables were collected. Nutritional status was assessed using the Mini Nutritional Assessment short-form (MNA-SF) and classified as normal nutritional status (12 to 14 points), at risk of malnutrition (8 to 11 points), or malnourished (0 to 7 points). The multivariate Poisson regression was used to verify the association between the independent variables and malnutrition.

Results: A total of 1954 patients were included. Of these, 14.9% were at risk of malnutrition, and 31.5% were malnourished. The risk factors for malnutrition were female gender (prevalence ratio [PR] = 1.28; 95% confidence interval [CI] = 1.03-1.59), upper gastrointestinal tumor (PR = 2.39; 95%CI = 1.66-3.45), colon, rectum, anus, and anal canal tumors (PR = 2.54; 95%CI = 1.77-3.64), lung tumor (PR = 2.35; 95%CI = 1.37-4.02), metastasis (PR = 1.37; 95%CI = 1.11-1.70), history of falls (PR = 1.27; 95%CI = 1.01-1.61), sedentary lifestyle (PR = 1.46; 95%CI = 1.11-1.93), and risk of depression (PR = 1.42; 95%CI = 1.16-1.73).

Conclusion: The prevalence of nutritional risk and malnutrition was relatively high in older adults with cancer at the beginning of outpatient treatment. These findings underscore the need for routine malnutrition screening at admission in oncology outpatient settings to ensure early identification and management. The associated factors were easily identifiable within standard clinical evaluations, supporting the feasibility of systematic screening.

Purpose: Adenocarcinoma of the pancreas (PANC) is an aggressive and often incurable cancer, associated with disease-related symptoms and poor outcomes. A comprehensive approach to care, including a focus on symptom management and quality of life, is essential. Introducing a palliative care approach early in the cancer journey improves survival and quality of life and decreases healthcare costs. However, barriers exist to providing early palliative care. This study is aimed at assessing the acceptability and impact of a novel clinical nurse specialist (CNS)-led early palliative care initiative on quality of care for patients with PANC.

Methods: Patients with PANC in the pre- and post-CNS eras were identified using the Manitoba Cancer Registry and CNS clinical database. Acceptability of the CNS initiative was measured by capturing those who agreed to CNS consultation. Quality measures included the proportion enrolled in a community-based palliative care program early (within 8 weeks of diagnosis) and late (within 2 weeks of death). Descriptive statistics were used. Chi-square tests were used to test for significance between the two eras.

Results: The CNS model was acceptable, with 93.3% of patients accepting consultation. There were fewer late referrals to community palliative care programs with the involvement of a CNS (p = 0.02) and a trend towards more early referrals (p = 0.07), suggesting an improvement in quality of care. After CNS consultation, 33% of patients declined either a diagnostic biopsy, medical oncology consultation, or both, facilitating decisions in line with patient goals of care.

Conclusions: The CNS-led model for PANC was acceptable to patients and associated with timely referral to community-based palliative care. This model provides an opportunity to address patient goals of care early and decrease unwanted procedures and consultations.