Supportive Care in Cancer最新文献

Purpose: Venous thromboembolism (VTE) represents a significant complication in pancreatic cancer patients, impacting both mortality and quality of life. Understanding research trends and developments in this field is crucial for advancing clinical care and identifying knowledge gaps. This study aims to examine the trends in research related to VTE and pancreatic cancer through a bibliometric analysis.

Methods: A comprehensive bibliometric analysis was performed using the Web of Science Core Collection database, covering publications from 1928 to 2024. Publications were analyzed using VOSviewer, CiteSpace, and R-bibliometrix.

Results: A total of 494 publications from 219 source journals were identified, involving 3321 authors. The USA led research output with 167 articles and 12,282 citations, followed by China and Japan. The Medical University of Vienna emerged as the most productive institution with 67 publications. Leading journals included Thrombosis Research and Journal of Thrombosis and Haemostasis. Key research themes encompassed molecular weight heparin, risk assessment, prophylaxis, and ambulatory patient care, with recent emphasis on personalized treatment approaches.

Conclusion: This bibliometric analysis highlights the significant growth in research on VTE associated with pancreatic cancer, characterized by substantial international collaboration and evolving research priorities. Recent trends indicate an increasing emphasis on precision medicine and outpatient care, suggesting promising directions for future research.

Purpose: Febrile neutropenia (FN) is a common side effect of chemotherapy. It may be prevented by granulocyte colony-stimulating factors (G-CSF), requiring customization based on patients' risk factors, the type of cancer and chemotherapy, and the formulation used. This observational study investigated all-day use of a pegfilgrastim formulation, also available for self-administration.

Methods: In outpatient clinics across Germany, doctors recorded data of adult patients suffering from a malignant disease routinely treated with chemotherapy and pegfilgrastim.

Results: Overall, 1636 patients received pegfilgrastim, predominantly women suffering from yet untreated breast cancer, 62% being at moderate and 38% at high risk of FN. In total, 2.5% of patients experienced FN despite treatment with pegfilgrastim, with 52.5% requiring hospitalization; in 40%, subsequent chemotherapy had to be postponed or reduced in dose. FN incidence and hospitalization rates were slightly lower when pegfilgrastim was given for primary versus secondary prophylaxis whereas there was no difference when given on day 1 or any later day following chemotherapy. FN incidence was much higher in patients with hematological as compared to solid tumors, particularly when treated with BEACOPP regimens. By contrast, related hospitalization depended less on cancer type and chemotherapy. Pegfilgrastim counterbalanced patients' risk factors, but a previous FN episode and male sex still increased the risk of hospitalization. Overall, 13.4% of patients experienced infections. The most common side effect of pegfilgrastim was bone-related pain. The syringe and self-injector formulations showed comparable effectiveness and safety.

Conclusions: Pegfilgrastim (Pelgraz®) treatment appeared to be effective and safe in all-day practice.

Purpose: Aboriginal and Torres Strait Islander people (hereafter respectfully referred to as First Nations) experience poorer cancer outcomes and higher mortality rates compared to non-Indigenous Australians. Barriers in accessing and engaging with cancer care services contribute significantly to these disparities. The First Nations Cancer Coordinator (FNCC) role offers a model that combines cultural and coordination support to improve the navigation of cancer services for First Nations people. This project sought to understand perceptions and impact of a pilot FNCC intervention on the care of First Nations patients, from the perspective of cancer care teams.

Methods: An exploratory, qualitative study was undertaken. The study was co-designed with a First Nations Community Advisory Group. Semi-structured interviews were undertaken with ten non-Indigenous cancer staff who had worked alongside the FNCC to support First Nations patients with cancer and their families.

Results: Analysis revealed three overarching themes relating to the scope and impact of the FNCC role: 1) Integrating cultural wisdom in cancer care delivery; 2) Relationship building through dedicated time and presence; 3) Bridging cultures by facilitating two-way communication and trust between patients and healthcare providers.

Conclusion: The findings highlight the critical importance of FNCC roles in advocating for and enhancing cultural safety in cancer care, essential for addressing disparities and improving cancer outcomes for First Nations Australians.

Cancer survivors face cancer and treatment-related health challenges and are at increased risk of developing other chronic diseases, often leading to multimorbidity. Lifestyle medicine can reduce the risk and severity of up to 80% of these chronic diseases and are an important component of survivorship care. Healthy lifestyle habits - such as a plant-forward diet, regular exercise, and maintaining healthy weight - improve life expectancy in a general population with compelling evidence supporting the same benefits among cancer survivors. A new resource from the American College of Lifestyle Medicine (ACLM), the Lifestyle Medicine Cancer Risk Reduction and Survivorship Toolkit (LMCT), aims to overcome barriers by providing accessible, evidence-based lifestyle medicine resources for use at the point of care. To support oncology healthcare professionals and cancer survivors, MASCC has endorsed the ACLM Cancer Risk Reduction and Survivorship Toolkit. This editorial describes the LMCT and how it can be a resource for cancer supportive care.

Purpose: This qualitative phenomenological study explored the lived experiences of breast cancer patients and caregivers in navigating cancer-related information.

Methods: Semi-structured interviews were conducted with 16 participants (13 patients, 3 caregivers), most of whom were female (n = 13), highly educated, and reported strong digital and health literacy. Participants' ages ranged from 36 to 71 (M = 52). The majority were navigating invasive breast cancer, with a smaller number diagnosed with ductal carcinoma in situ. Interviews focused on participants' experiences with information access, evaluation, and use across the cancer journey. Data were analyzed thematically.

Results: Despite high education levels, participants described feeling unprepared and overwhelmed by the amount and complexity of cancer information at diagnosis. Three themes emerged: (1) Tension Between Physician Guidance and Patient Autonomy, highlighting mixed feelings about clinicians' discouragement of independent research; (2) Information Overload and the Need for Timely, Personalized Communication, with a preference for specific guidance over large volumes of information; and (3) Unmet Needs for Tailored, Inclusive, and Accessible Support, as participants, especially male and racialized individuals, struggled to find information and peer support reflecting their identities and experiences.

Conclusion: Findings reveal persistent information gaps underscoring the emotional and cognitive burdens of breast cancer information seeking.

Objectives: Positive psychological changes in cancer patients have been shown to positively influence disease progression and enhance quality of life. Based on this, the present study explores the psychological dynamics facilitating post-traumatic growth (PTG) in cervical cancer patients, specifically examining the roles of self-disclosure and marital intimacy in this process.

Methods: This was a descriptive qualitative study.Twelve patients with cervical cancer were recruited from Nantong, China to participate in this study. Data were collected between October 2022 and August 2023 and analyzed using Colaizzi's seven-step analysis.

Results: In this study, six thematic keywords were extracted: "Traumatic reactions", "Psychological breakdown", "Need for self-disclosure", "Enhanced marital intimacy", "Cognitive restructuring and life changes", and "Current needs and future expectations".

Conclusions: Both self-disclosure and marital intimacy played pivotal roles in facilitating PTG among cervical cancer patients. Nurses should focus on fostering positive psychological changes in cervical cancer patients-specifically, self-disclosure and marital intimacy play significant roles in facilitating post-traumatic growth. This suggests that fostering self-disclosure and marital intimacy could be important therapeutic goals to enhance psychosocial well-being and quality of life in cervical cancer patients.

Background: Breast cancer-related lymphedema (BCRL) is relatively common in postoperative breast cancer patients, requiring early, lifelong prevention. However, these patients often have low preventive behavioral intention, with unclear influencing factors, and their internal links urgently need a systematic analysis of these interrelationships.

Methods: A cross-sectional survey was conducted on 672 breast cancer survivors at different postoperative stages to collect sociodemographic data and psychological variables related to lymphedema preventive intention. After univariate analysis of sociodemographic data, binary logistic regression identified significant predictors of intention, and path analysis elucidated the directional relationships between psychological variables and preventive intention.

Results: Multidimensional interventions that strengthen lymphedema prevention knowledge and enhance self-efficacy, risk perception, and positive expectations are likely to increase the preventive behavioral intentions of breast cancer survivors and promote active self-management after hospital discharge.

Conclusions: Multidimensional interventions that reinforce lymphedema prevention knowledge and enhance self-efficacy, risk perception, and positive expectation are likely to increase the preventive behavioral intention of breast cancer survivors and encourage active self-management after hospital discharge.

Purpose: This study aimed to evaluate the effects of a 12-week multicomponent intervention combining fixed-seat rowing (falucho) with targeted strength and flexibility exercises on physical and psychosocial outcomes in women with and without a history of breast cancer.

Methods: A quasi-experimental, parallel-group design was employed. Nineteen breast cancer survivors and nineteen healthy women participated in a structured program consisting of twice-weekly open-water rowing sessions and gym-based conditioning exercises. Functional, psychological, and quality of life variables were assessed at baseline and post-intervention using validated tools (Hand Grip Strength, 30-Seconds Sit to Stand Test, QuickDASH, Piper Fatigue Scale, and WHOQOL-BREF). A multivariate repeated measures model and bootstrapping methods were used for statistical analysis.

Results: Significant improvements over time were observed in all functional variables across both groups. Notably, breast cancer survivors showed greater reductions in upper limb disability (QuickDASH, p = 0.011) and cancer-related fatigue (Piper score, p < 0.001). Positive effects on quality of life were also found, particularly in the physical dimension. Group-based rowing in an outdoor maritime setting may have contributed to improved emotional well-being and social engagement, although psychological, social, and environmental domains showed only time-related effects. Attendance exceeded 80% of planned sessions, with no adverse events reported.

Conclusion: This intervention appears to be a feasible and beneficial strategy to enhance physical function, reduce fatigue, and support psychosocial recovery in breast cancer survivors. The findings suggest that traditional rowing, especially when combined with complementary exercises, may be a valuable addition to oncology rehabilitation programs.

Purpose: Cognitive and psychological symptoms in neuropsychiatric disorders have been linked to blood cell parameters, including neutrophil-to-lymphocyte ratios (NLRs), systemic immune-inflammation indices (SIIs), and platelet-to-lymphocyte ratios (PLRs). It remains unclear whether cognitive impairments in haematological cancers are associated with biological vulnerabilities reflected in these parameters. We examined whether cognitive and psychological morbidity correlated with blood cell parameters before, during, and after chemotherapy in individuals with aggressive lymphoma.

Methods: Neuropsychological testing and self-reported questionnaires were administered at diagnosis, mid-chemotherapy, and 6-8 weeks post-treatment (n = 30). Regression models assessed associations between cognition and blood cell parameters. Bootstrapped Pearson correlations examined relationships between NLRs, SIIs, PLRs, and psychological symptoms. To test specificity, similar analyses were conducted in healthy controls (n = 72).

Results: In individuals with aggressive lymphoma, NLRs, SIIs, and PLRs correlated with impairments in inhibitory control, cognitive flexibility, delayed recall, and working memory across time points (p < 0.05). A disconnect emerged between these parameters and subjective self-reports. At diagnosis, lower NLRs, SIIs, and PLRs were associated with worse objective cognitive performance but better perceived cognition. Mid-chemotherapy, higher NLRs correlated with worse delayed recall but fewer reported depression and anxiety symptoms (p < 0.05). No significant associations were observed in healthy controls.

Conclusion: Cognitive impairment was associated with blood cell parameters in individuals with aggressive lymphoma, indicating distinct biological patterns of dysfunction before, during, and after chemotherapy. The disconnect between objective neuropsychological performance and subjective self-reports reinforces the value of incorporating biomarkers into cognitive assessments in this population.

Objective: This study aimed to evaluate the effectiveness of whole-course high-quality nursing care combined with individualized nutritional intervention in patients undergoing spinal surgery during the perioperative period.

Methods: In this single-center, single-blind randomized controlled trial, patients were assigned to receive either routine perioperative care or whole-course high-quality nursing care combined with individualized nutritional intervention. Outcomes included pain level (visual analog scale, VAS), functional recovery (Berg balance scale, BBS), 6-min walking distance (6MWD), nutritional status (albumin, total protein), activities of daily living (ADL), quality of life, incidence of complications, and nursing satisfaction.

Results: Compared with the control group, the intervention group had significantly lower VAS scores, higher BBS scores, longer 6MWD, and improved albumin and total protein levels (all P < 0.05). ADL and quality-of-life scores were higher in the intervention group, accompanied by greater nursing satisfaction and a lower incidence of postoperative complications (P < 0.05).

Conclusion: Whole-course high-quality nursing management combined with nutritional intervention effectively improves pain control, functional recovery, nutritional status, daily living ability, and quality of life while reducing postoperative complications and improving nursing satisfaction in patients undergoing spinal surgery.