Asia-Pacific Journal of Oncology Nursing最新文献

Comparative predictive performance of three machine learning algorithms for acute radiation enteritis risk among patients with cervical cancer undergoing radiotherapy: A prospective cohort study 三种机器学习算法对宫颈癌放疗患者急性放射性肠炎风险的预测性能比较：一项前瞻性队列研究

IF 2.8 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2026-01-17 DOI: 10.1016/j.apjon.2026.100853

Zhao Wang , Huiying Liu , Xiaocen Chen , Fang Zhang , Yixuan Liu , Jiayun Sun , Lili Liu , Xiaotong Yang

Objective

To develop a machine learning-based risk prediction model for acute radiation enteritis (ARE) in patients with cervical cancer, providing a new method for early and accurate prediction of ARE during radiotherapy.

Methods

This prospective study enrolled patients with cervical cancer undergoing radiotherapy from March 2024 to March 2025. The patients were randomly divided into training and test sets at a 7:3 ratio. Prediction models were constructed using Logistic Regression (LR), Decision Tree (DT), and Random Forest (RF) algorithms. Model performance was evaluated based on the area under the receiver operating characteristic curve (AUC), accuracy, precision, sensitivity, specificity, and F1-score.

Results

The incidence of ARE was 52.85% (204/386). Among the three models, the Random Forest model demonstrated the best performance, with an AUC of 0.961, sensitivity of 0.934, and F1-score of 0.905. These performance metrics were consistently higher than those of the LR (AUC, 0.860; sensitivity, 0.739; F1-score, 0.736) and DT (AUC, 0.910; sensitivity, 0.887; F1-score, 0.873) models. The RF model showed good clinical utility in effectively identifying high-risk patients for early intervention. Feature importance ranking derived from the RF model identified the parametrial dose, radiotherapy time, clinical stage, rectal V40, age, Platelet-to-Lymphocyte Ratio (PLR), concurrent chemotherapy, and hypertension as the most influential predictors, in descending order of importance.

Conclusions

The RF-based risk prediction model exhibited excellent performance in assessing the risk of ARE among patients with cervical cancer undergoing radiotherapy, thereby enabling individualized risk assessment and facilitating early preventive strategies.

目的建立基于机器学习的宫颈癌患者急性放射性肠炎（acute radiation enteritis， ARE）风险预测模型，为放疗中早期准确预测ARE提供新方法。方法本前瞻性研究纳入2024年3月至2025年3月接受放疗的宫颈癌患者。患者按7:3的比例随机分为训练组和测试组。采用Logistic回归（LR）、决策树（DT）和随机森林（RF）算法构建预测模型。根据受试者工作特征曲线下面积（AUC）、准确度、精密度、灵敏度、特异性和f1评分来评估模型的性能。结果ARE的发生率为52.85%（204/386）。三种模型中，随机森林模型表现最好，AUC为0.961，灵敏度为0.934，f1得分为0.905。这些性能指标均高于LR （AUC, 0.860；灵敏度，0.739；f1评分，0.736）和DT （AUC, 0.910；灵敏度，0.887；f1评分，0.873）模型。射频模型在有效识别高危患者进行早期干预方面显示出良好的临床应用价值。根据RF模型得出的特征重要性排序，参数剂量、放疗时间、临床分期、直肠V40、年龄、血小板与淋巴细胞比（PLR）、同期化疗和高血压是影响最大的预测因素，其重要性由高到低依次排列。结论基于rf的风险预测模型在评估宫颈癌放疗患者ARE风险方面表现优异，可实现个体化风险评估，促进早期预防策略的制定。

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引用次数: 0

The burdens, coping strategies, and unmet needs of family caregivers of Chinese patients with lymphoma receiving commercial CAR-T-cell therapy: A qualitative study 中国淋巴瘤患者接受商业化car - t细胞治疗的家庭照顾者负担、应对策略和未满足需求：一项定性研究

IF 2.8 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2026-01-06 DOI: 10.1016/j.apjon.2025.100850

Xijun Lin , Jiali Liu , Jianwen Chen , Jiamin Tang, Zhicong Huang, Ye Wang, Simei Shi

Objective

This study aimed to describe the caregiving experiences, coping strategies, and unmet health care needs of family caregivers supporting Chinese patients with large B-cell lymphoma receiving commercial chimeric antigen receptor T-cell therapy.

Methods

A qualitative descriptive design was adopted. Semistructured interviews were conducted with 19 primary family caregivers at a university-affiliated cancer centre in southern China. Data were analysed using Braun and Clarke's thematic analysis framework.

Results

Three themes were identified: (1) overwhelming caregiving burden, including financial strain, emotional distress, and role conflict; (2) caregivers' patient-centred coping strategies, including familial financial sacrifice, emotional suppression to protect the patient, and reprioritizing work and personal life for care; and (3) unmet caregiver support needs, including navigating therapy costs without systemic support, gaps in caregiver education and care coordination, and caregivers' emotional support being overlooked in care systems.

Conclusions

Family caregivers of patients receiving this therapy in China experience significant challenges, which are often managed through culturally influenced coping strategies amid limited formal support. A caregiver-inclusive approach (including financial reforms, tailored caregiver education, increased care coordination, and psychosocial services) is essential to support the well-being of family caregivers and optimize treatment outcomes amid evolving oncology trends in China.

目的探讨中国大b细胞淋巴瘤患者接受商业嵌合抗原受体t细胞治疗的家庭照护者的护理经验、应对策略和未满足的医疗需求。方法采用定性描述设计。在中国南方的一所大学附属癌症中心，对19名主要家庭照顾者进行了半结构化访谈。数据分析采用Braun和Clarke的主题分析框架。结果发现了三个主题：(1)照顾负担过重，包括经济压力、情绪困扰和角色冲突；(2)护理人员以患者为中心的应对策略，包括家庭经济牺牲、情绪抑制以保护患者、工作和个人生活优先于护理；(3)未满足的照顾者支持需求，包括在没有系统支持的情况下导航治疗费用，照顾者教育和护理协调的差距，以及照顾者在护理系统中被忽视的情感支持。结论：在中国，接受这种治疗的患者的家庭照顾者面临着巨大的挑战，这些挑战通常是通过受文化影响的应对策略来应对的，而正式的支持有限。在中国不断发展的肿瘤学趋势中，照顾者包容性方法（包括金融改革、量身定制的照顾者教育、加强护理协调和社会心理服务）对于支持家庭照顾者的福祉和优化治疗结果至关重要。

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引用次数: 0

Determinants of patient delay and its association with quality of life among young women with breast cancer in China: A cross-sectional study 中国年轻女性乳腺癌患者延迟的决定因素及其与生活质量的关系：一项横断面研究

IF 2.8 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2026-01-06 DOI: 10.1016/j.apjon.2025.100846

Yueyang Peng , Jun Ma , Li Liu , Jinnan Xiao , Can Gu

Objective

The incidence of breast cancer in young women (< 40 years old) has been increasing in recent years. Patient delay is significant to disease prognosis, thus early diagnosis and prompt effective therapy represent the key elements in controlling breast cancer. This study aimed to identify determinants of patient delay and assess the association of patient delay with quality of life (QoL).

Methods

A cross-sectional study was conducted among 286 young patients with breast cancer from October, 2022 to March, 2023 at four tertiary hospitals in Hunan province, China with the guidance of Andersen Behavioral Model of Health Services Utilization. Determinants of patient delay were identified using binary logistic regression analysis. The association between patient delay and QoL was analyzed using linear regression.

Results

A total of 106 (37.06%) young patients with breast cancer had experienced patient delay, indicating that more than one in three women faced this critical barrier to timely care. Patients who lived in countryside (odd ratio [OR] 3.676, 95% confidence interval [CI] 1.468–9.206), had an initial outpatient consultation to other department (OR 3.910, 95% CI 1.439–10.624), waited > 7-day for initial outpatient consultation (OR 11.350, 95% CI 3.450–37.345) were more likely to experience patient delay. Detecting disease at routine physical examination (OR 0.208, 95% CI 0.045–0.967), having higher critical health literacy (OR 0.676, 95% CI 0.506–0.904), and having more friend support (OR 0.921, 95% CI 0.855–0.993), patients were less likely to experience patient delay. Patient delay was negatively correlated with QoL including overall FACT-B (t = −2.443, P = 0.015), physical well-being (t = −3.526, P < 0.001), functional well-being (t = −2.077, P = 0.039), and additional concerns (t = −1.974, P = 0.049).

Conclusions

Waiting time for initial outpatient consultation > 7-day was the strongest determinant of patient delay among young women with breast cancer. Other significant factors included rural residence and initial consultation in non-specialist departments, while higher health literacy, friend support, and detection via physical examination were protective. Patient delay was significantly associated with poorer QoL, particularly in the domains of physical well-being, functional well-being, and additional concerns. These findings underscore the need for interventions targeting health care access to reduce patient delay and improve patient health outcomes.

目的近年来，年轻女性（40岁）乳腺癌的发病率呈上升趋势。患者延迟对疾病预后有重要影响，早期诊断和及时有效治疗是控制乳腺癌的关键因素。本研究旨在确定患者延迟的决定因素，并评估患者延迟与生活质量（QoL）的关系。方法以Andersen卫生服务利用行为模型为指导，对2022年10月至2023年3月湖南省四所三级医院286例年轻乳腺癌患者进行横断面研究。使用二元逻辑回归分析确定患者延误的决定因素。采用线性回归分析患者延迟与生活质量之间的关系。结果共有106例（37.06%）年轻乳腺癌患者经历过患者延误，表明超过三分之一的女性面临这一及时护理的关键障碍。居住在农村的患者（奇比[OR] 3.676, 95%可信区间[CI] 1.468 ~ 9.206），首次门诊到其他科室就诊（OR 3.910, 95% CI 1.439 ~ 10.624），首次门诊等待7天（OR 11.350, 95% CI 3.450 ~ 37.345）更容易出现患者延误。在常规体检中发现疾病（OR 0.208, 95% CI 0.045-0.967），具有较高的关键健康素养（OR 0.676, 95% CI 0.506-0.904），以及有更多的朋友支持（OR 0.921, 95% CI 0.855-0.993），患者不太可能经历患者延迟。患者延迟与生活质量呈负相关，包括总体FACT-B （t = - 2.443, P = 0.015）、身体健康（t = - 3.526, P = 0.001）、功能健康（t = - 2.077, P = 0.039）和其他问题（t = - 1.974, P = 0.049）。结论初诊等待时间（7天）是年轻女性乳腺癌患者延迟就诊的最大决定因素。其他重要因素包括农村居住和在非专科部门的初步咨询，而较高的健康素养、朋友支持和通过体检发现是保护因素。患者延迟与较差的生活质量显著相关，特别是在身体健康、功能健康和其他问题方面。这些发现强调需要针对卫生保健可及性采取干预措施，以减少患者延误并改善患者健康结果。

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引用次数: 0

Patient-reported outcomes with a personalized follow-up program after lung cancer resection: A single-center randomized controlled trial 肺癌切除术后患者报告的个性化随访结果：一项单中心随机对照试验

IF 2.8 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2026-01-02 DOI: 10.1016/j.apjon.2025.100844

Yiqing Luo , Yuna Cheng , Zuodong Song , Hui Chen , Yinping Bo , Haobo Shixing

Objective

This study aims to determine the impact of PROM with a personalized follow-up program on the evaluation of quality of life and self-management for patients after lung cancer resection.

Methods

Given a formal power calculation a total of 240 patients with lung cancer. Participants were randomly assigned to either the experimental or the control groups. Patients in the experimental group received a personalized follow-up program of patient-reported outcomes. The control group received only the telephone follow-up. Baseline data (T0) were collected before the intervention (on the day of discharge), and quality of life, self-efficacy, and compliance were measured at 2 weeks (T1), 4 weeks (T2), and 4 months (T3) post-discharge.

Results

The difference in quality of life between the experimental and control groups was significant (Wald χ² = 5.204, P = 0.023), with the experimental group showing significantly better quality of life at T2 compared to the control group (t = 2.515, P = 0.013). Both groups showed improvements in quality of life at all post-test time points (Wald χ² = 574.167, P < 0.001), and the interaction between group and time was not statistically significant (Wald χ² = 2.354, P = 0.308). Regarding self-management efficacy, Generalized Estimating Equations results indicated a significant difference between the experimental and control groups (Wald χ² = 6.573, P = 0.010), with the experimental group showing significantly higher self-management efficacy at T2 and T3 compared to the control group (t = 3.024, P = 0.003; t = 2.214, P = 0.028). No significant differences were observed at T0 and T1. Both groups showed improvements in self-management efficacy at all post-test time points (Wald χ² = 301.390, P < 0.001), and the interaction between group and time was not statistically significant (Wald χ² = 3.971, P = 0.137).

Conclusions

For patients after lung cancer surgery, the program has optimized the evaluation of postoperative quality of life and self-management efficacy.

Trial registration

Chinese Clinical Trial Registry (NCT06483295).

目的本研究旨在通过个性化随访方案确定早膜PROM对肺癌切除术后患者生活质量评价和自我管理的影响。方法对240例肺癌患者进行正式功率计算。参与者被随机分配到实验组和对照组。实验组的患者接受了个性化的随访计划，根据患者报告的结果进行随访。对照组只接受电话随访。在干预前（出院当天）收集基线数据（T0），并在出院后2周（T1）、4周（T2）和4个月（T3）测量患者的生活质量、自我效能感和依从性。结果实验组与对照组患者生存质量比较差异有统计学意义（Wald χ2 = 5.204, P = 0.023），其中实验组患者T2期生存质量显著优于对照组（t = 2.515, P = 0.013）。两组患者在测试后各时间点的生活质量均有改善（Wald χ2 = 574.167, P < 0.001），组与时间的交互作用无统计学意义（Wald χ2 = 2.354, P = 0.308）。在自我管理效能方面，广义估计方程结果显示实验组与对照组之间存在显著差异（Wald χ2 = 6.573, P = 0.010），实验组在T2和T3时的自我管理效能显著高于对照组（t = 3.024, P = 0.003; t = 2.214, P = 0.028）。T0和T1无显著差异。两组患者在所有测试后时间点的自我管理效能均有改善（Wald χ2 = 301.390, P < 0.001），组与时间的交互作用无统计学意义（Wald χ2 = 3.971, P = 0.137）。结论该方案对肺癌术后患者的术后生活质量和自我管理效能进行了优化评价。中国临床试验注册中心（NCT06483295）。

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引用次数: 0

Latent profiles and influencing factors of sense of coherence in patients with advanced cancer: A cross-sectional study 晚期癌症患者连贯感的潜在特征及其影响因素：一项横断面研究

IF 2.8 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-12-30 DOI: 10.1016/j.apjon.2025.100848

Yongqi Huang , Huimin Xiong , Xia Tian , Jinjia Lai , Liqun Zhou , Lili Chen , Wenli Xiao

Objective

This study aims to identify the latent profiles of sense of coherence (SOC) in patients with advanced cancer and explore its influencing factors encompassing sociodemographic and clinical characteristics, and generalized resistance resources (GRRs).

Methods

A cross-sectional study of 262 patients with advanced cancer was conducted by convenience sampling in Guangzhou, China, from September 2023 to July 2024. Data were collected including sociodemographic and clinical characteristics, SOC-13, Revised Life Orientation Test (LOT-R), Rosenberg Self-Esteem Scale (RSES), Inner Peace State Scale (IPSS), Gratitude Questionnaire-6 (GQ-6), and Social Support Rating Scale (SSRS). Statistical analysis was performed using latent profile analysis (LPA) and multivariate logistic regression analysis.

Results

Three latent profiles of SOC were identified: low SOC and low comprehensibility group (29.01%), moderate SOC and high meaningfulness group (40.08%), and high SOC and high manageability group (30.91%). This study found that SOC was impacted by self-perceived severity of the disease and GRRs including optimism, self-esteem, and inner peace (P < 0.05).

Conclusions

SOC in patients with advanced cancer exhibited different characteristics. Enhancing positive disease perception and GRRs including optimism, self-esteem, and inner peace may be effective strategies for improving their SOC. Healthcare professionals can formulate strategies such as tailored health education, symptom management, and positive psychological interventions to enhance SOC in patients with advanced cancer.

目的了解晚期癌症患者的连贯性感（SOC）潜在特征，并探讨其影响因素，包括社会人口学特征、临床特征和广义耐药资源（GRRs）。方法对2023年9月至2024年7月在中国广州进行的262例晚期癌症患者进行方便抽样的横断面研究。收集的数据包括社会人口学和临床特征、SOC-13、修订生活取向测试（LOT-R）、Rosenberg自尊量表（RSES）、内心平静状态量表（IPSS）、感恩问卷-6 （GQ-6）和社会支持评定量表（SSRS）。统计学分析采用潜型分析（LPA）和多因素logistic回归分析。结果鉴定出低SOC和低可理解性组（29.01%）、中等SOC和高意义性组（40.08%）和高SOC和高可管理性组（30.91%）3种SOC潜在特征。本研究发现，SOC受自我感知疾病严重程度和grr（乐观、自尊、内心平静）的影响（P < 0.05）。结论晚期肿瘤患者的soc表现出不同的特点。提高积极的疾病认知和grr（包括乐观、自尊和内心平静）可能是改善患者SOC的有效策略。医护人员可以制定策略，例如针对性的健康教育、症状管理和积极的心理干预，以提高晚期癌症患者的SOC。

{"title":"Latent profiles and influencing factors of sense of coherence in patients with advanced cancer: A cross-sectional study","authors":"Yongqi Huang , Huimin Xiong , Xia Tian , Jinjia Lai , Liqun Zhou , Lili Chen , Wenli Xiao","doi":"10.1016/j.apjon.2025.100848","DOIUrl":"10.1016/j.apjon.2025.100848","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to identify the latent profiles of sense of coherence (SOC) in patients with advanced cancer and explore its influencing factors encompassing sociodemographic and clinical characteristics, and generalized resistance resources (GRRs).</div></div><div><h3>Methods</h3><div>A cross-sectional study of 262 patients with advanced cancer was conducted by convenience sampling in Guangzhou, China, from September 2023 to July 2024. Data were collected including sociodemographic and clinical characteristics, SOC-13, Revised Life Orientation Test (LOT-R), Rosenberg Self-Esteem Scale (RSES), Inner Peace State Scale (IPSS), Gratitude Questionnaire-6 (GQ-6), and Social Support Rating Scale (SSRS). Statistical analysis was performed using latent profile analysis (LPA) and multivariate logistic regression analysis.</div></div><div><h3>Results</h3><div>Three latent profiles of SOC were identified: low SOC and low comprehensibility group (29.01%), moderate SOC and high meaningfulness group (40.08%), and high SOC and high manageability group (30.91%). This study found that SOC was impacted by self-perceived severity of the disease and GRRs including optimism, self-esteem, and inner peace (<em>P</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>SOC in patients with advanced cancer exhibited different characteristics. Enhancing positive disease perception and GRRs including optimism, self-esteem, and inner peace may be effective strategies for improving their SOC. Healthcare professionals can formulate strategies such as tailored health education, symptom management, and positive psychological interventions to enhance SOC in patients with advanced cancer.</div></div>","PeriodicalId":8569,"journal":{"name":"Asia-Pacific Journal of Oncology Nursing","volume":"13 ","pages":"Article 100848"},"PeriodicalIF":2.8,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Merging artificial intelligence into cancer nursing care: Current applications, challenges, and opportunities 将人工智能融入癌症护理：当前的应用、挑战和机遇

IF 2.8 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-12-30 DOI: 10.1016/j.apjon.2025.100849

Mian Wang , Hammoda Abu-Odah , Yingchun Zeng

引用次数: 0

Dyadic relationship experience in Chinese patients with advanced cancer and their spouses: A longitudinal qualitative study 中国晚期癌症患者及其配偶的二元关系体验：一项纵向定性研究

IF 2.8 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-12-30 DOI: 10.1016/j.apjon.2025.100847

Haiyan Sun , Xi Chen , Xinyi Huang , Li Qin , Hui Zhu , Chintana Wacharasin , Pornpat Hengudomsub , Zhangyan Zhen , Yang Qin

Objective

To explore the process of dyadic relationship experiences among patients with advanced cancer and their spouses during anti-cancer treatment in China.

Methods

A longitudinal, qualitative study using semi-structured interviews with cancer patients and their spouses was conducted within the first six months following cancer diagnosis. A total of 18 cancer patient-spouse dyads were recruited, with 16 dyads completing all follow-ups between March and December 2024. All interviews were audio-recorded, transcribed verbatim, and analyzed thematically.

Results

The study collected 96 individual interviews. The thematic framework was developed based on patient-spouse dyads, generating three key themes: relationship crisis at diagnosis, relationship reconfiguration during hospitalization, and relationship adaptation in home care. These were further elaborated through eight subthemes: mutual denial at the moment of diagnosis, communication avoidance by fear of burden, and collaborative struggles in dyadic coping (relationship crisis); collapse of traditional family roles and shared vulnerability as dyadic coping (relationship reconfiguration); and intra-dyadic reciprocal support in daily care, joint help-seeking as a unified front, and post-trauma mutual growth within familism (relationship adaptation).

Conclusions

The couple's relational experience evolves dynamically from diagnosis through hospitalisation to home care. These findings provide implications for health care providers to develop effective health guidance that supports a harmonious family atmosphere during transitional care. Culturally tailored, dyad-centred interventions addressing these phase-specific challenges may strengthen mutual support and improve the well-being of both patients and spouses.

目的探讨中国晚期癌症患者及其配偶在抗癌治疗过程中的二元关系体验过程。方法在癌症诊断后的前六个月内，对癌症患者及其配偶进行了半结构化访谈，进行了一项纵向定性研究。共招募了18名癌症患者-配偶对，其中16对在2024年3月至12月期间完成了所有随访。所有访谈都被录音，逐字抄写，并按主题进行分析。结果本研究收集了96个个人访谈。主题框架是基于患者-配偶二人组开发的，产生了三个关键主题：诊断时的关系危机，住院期间的关系重构以及家庭护理中的关系适应。这些通过八个子主题进一步阐述：诊断时的相互否认，因害怕负担而避免沟通，以及二元应对（关系危机）中的合作斗争；传统家庭角色的崩溃和作为二元应对的共同脆弱性（关系重构）以及日常护理中的双元内相互支持，作为统一战线的共同寻求帮助，以及创伤后家庭主义中的相互成长（关系适应）。结论从诊断到住院再到家庭护理，夫妻关系经历是动态发展的。这些发现为卫生保健提供者在过渡护理期间制定有效的健康指导以支持和谐的家庭氛围提供了启示。针对这些具体阶段的挑战，根据文化进行量身定制、以双方为中心的干预措施，可能会加强相互支持，改善患者和配偶的福祉。

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引用次数: 0

Emotional experiences across the cancer journey: A psycho-oncological perspective for patients, caregivers, and oncology nurses 癌症旅程中的情感体验：患者、护理人员和肿瘤护士的心理肿瘤学视角

IF 2.8 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-12-26 DOI: 10.1016/j.apjon.2025.100845

Nazmiye Yildirim

引用次数: 0

Development and preliminary validation of a PICC-related venous thrombosis risk prediction model for cancer patients: A systematic review and meta-analysis predominantly based on Chinese populations 癌症患者picc相关静脉血栓形成风险预测模型的建立和初步验证：主要基于中国人群的系统回顾和荟萃分析

IF 2.8 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-12-24 DOI: 10.1016/j.apjon.2025.100839

Jiwen Zhang , Caiyun Li , Huijuan Zhang , Wenbo Wu , Xiaoshuang Sun , Wei Zhang

Objective

To identify key risk factors for peripherally inserted central catheter -related deep venous thrombosis (PICC-RVT) in patients with cancer through a systematic review and meta-analysis, develop risk prediction model and validate its performance.

Methods

A systematic literature search was performed in Pubmed, EMBASE, Web of Science (core collection), Scopus, CINAHL and Ovid databases from the time of their inception to June 2025. Study quality was assessed using the Newcastle-Ottawa Scale (NOS) checklist. Meta-analysis was performed using RevMan 5.4 statistical software to identify independent risk factors for PICC-RVT in adult patients with cancer, then the effect of each independent risk factor was determined using β - formation conversion for developing the risk predictive model. Finally, we collected the clinical datal of 338 adult patients with cancer who underwent PICC catheterization from June 2024 to May 2025 to evaluate the predictive performance of the risk predictive model by drawing the receiver of curve (ROC).

Results

A total of 32 cohort studies involving 28,813 individuals (28 from China, 2 from UK, 1 each from US and Canada) were included. Twenty-one independent risk factors were identified through meta-analysis. The risk prediction model was developed using β - coefficient transformation: pooled odds ratios (ORs) from meta-analysis were converted to β coefficients through natural logarithmic transformation (β = ln[OR]), then each β - coefficient was multiplied by 10 and rounded to one decimal place to create a point-based scoring system. The total risk score was calculated by summing individual factor scores. Preliminary external validation was conducted in 338 patients with cancer (15 thrombosis events, 4.4% incidence) from a single Chinese center, yielding an area under curve (AUC) of 0.792 (95% [confidence interval (CI)] 0.653–0.931). The model showed acceptable calibration (Hosmer–Lemeshow P = 0.082) but validation was underpowered (15 events vs. recommended 100+ events for precise performance estimation).

Conclusions

This study developed a PICC-RVT risk prediction model based primarily on Chinese patients with cancer. The model demonstrated moderate discrimination in preliminary single-center validation, but requires multi-center validation with adequate event numbers before clinical implementation. The model provides a framework for PICC-RVT risk stratification in Chinese and similar healthcare settings.

Systematic review registration

PROSPERO (CRD420250651190).

目的通过系统回顾和荟萃分析，找出癌症患者外周血管植入相关深静脉血栓形成（PICC-RVT）的关键危险因素，建立风险预测模型并验证其性能。方法系统检索Pubmed、EMBASE、Web of Science（核心馆藏）、Scopus、CINAHL、Ovid等数据库自建库至2025年6月的文献。使用纽卡斯尔-渥太华量表（NOS）检查表评估研究质量。采用RevMan 5.4统计软件进行meta分析，确定成年癌症患者PICC-RVT的独立危险因素，并利用β -形成转换确定各独立危险因素的影响，建立风险预测模型。最后，我们收集了2024年6月至2025年5月338例接受PICC置管的成年癌症患者的临床资料，通过绘制受试者曲线（receiver of curve， ROC）来评估风险预测模型的预测性能。结果共纳入32项队列研究，涉及28,813例个体（中国28例，英国2例，美国和加拿大各1例）。通过meta分析确定了21个独立的危险因素。采用β系数变换建立风险预测模型：将meta分析的合并优势比（OR）通过自然对数变换（β = ln[OR]）转换为β系数，然后将每个β系数乘以10并四舍五入到小数点后1位，形成基于积分的评分系统。总风险评分通过将个体因素得分相加来计算。对来自中国单一中心的338例癌症患者（15例血栓形成，发生率4.4%）进行了初步的外部验证，曲线下面积（AUC）为0.792（95%[置信区间（CI）] 0.653-0.931）。该模型显示出可接受的校准（Hosmer-Lemeshow P = 0.082），但验证能力不足（15个事件，而推荐的100多个事件用于精确的性能估计）。结论本研究建立了基于中国癌症患者的PICC-RVT风险预测模型。该模型在初步的单中心验证中表现出中度的歧视，但在临床实施之前需要多中心验证并获得足够的事件数。该模型为中国和类似医疗机构的PICC-RVT风险分层提供了一个框架。系统评价注册号prospero （CRD420250651190）。

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引用次数: 0

Frailty profiles and symptomatic radiation pneumonitis in patients with lung cancer undergoing radiotherapy: A latent class analysis 接受放射治疗的肺癌患者的虚弱特征和症状性放射性肺炎：一项潜在分类分析

IF 2.8 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing

Pub Date : 2025-12-23 DOI: 10.1016/j.apjon.2025.100840

Jiang Zhang , Xijuan Zhao , Song Li , Jiawei Liao , Lu Xu , Yanyan Fei , Jiang Wu , Qiongyao Guan

Objective

This study aimed to identify distinct frailty subtypes and their influencing factors, and to further explore the relationship between these frailty characteristics and the occurrence of symptomatic radiation pneumonitis (SRP) in patients with lung cancer undergoing radiotherapy.

Methods

The Observational study was conducted among 204 patients with lung cancer undergoing radical radiotherapy. Frailty was assessed via the Fried Frailty Phenotype, and nutritional risk was evaluated by the Nutrition Risk Screening 2002 (NRS-2002). Radiation pneumonitis (RP) was graded by the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 in conjunction with chest CT results. Radiotherapy parameters, including total radiation dose, treatment technique, bilateral lung mean dose (Dmean, Gy), and bilateral lung V20 (%), were collected. Latent class analysis (LCA) was performed to identify potential frailty subgroups. Multinomial logistic regression was conducted to determine factors associated with frailty classes, and binary logistic regression was subsequently used to assess the relationship between frailty class and the incidence of SRP in patients with lung cancer.

Results

LCA identified three distinct frailty subgroups: prefrailty (C1, 37.3%), frail physical activity decline (C2, 31.9%), and severe-frail core-strength decline (C3, 30.9%) group. Radiotherapy sessions, nutritional risk, and age were the main factors influencing frailty classification. The incidence of SRP in group C3 (68.3%) was significantly higher than that in group C2 (47.7%) and group C1 (19.7%) (P < 0.001). The risk of SRP was 3.71 times higher in C2 and 8.84 times higher in C3 as compared to C1.

Conclusions

Frailty among patients with lung cancer undergoing radiotherapy exhibit marked frailty heterogeneity. Those with severe frailty, particularly characterized by core strength and physical function decline, strongly associated with increased SRP risk. These findings indicating the importance of individualized nursing assessments and early, targeted interventions to prevent and mitigate frailty progression and SRP occurrence.

Trial registration

National Clinical Trial Registry (ChiCTR2400081213).

目的鉴别肺癌放疗患者不同的衰弱亚型及其影响因素，并进一步探讨这些衰弱特征与症状性放射性肺炎（SRP）发生的关系。方法对204例接受根治性放疗的肺癌患者进行观察性研究。脆弱性通过油炸脆弱表型进行评估，营养风险通过营养风险筛查2002 （NRS-2002）进行评估。放射性肺炎（RP）按照不良事件通用术语标准（CTCAE） 5.0版结合胸部CT结果进行分级。收集放疗参数，包括总放射剂量、治疗方法、双侧肺平均剂量（Dmean, Gy）、双侧肺V20（%）。进行潜在分类分析（LCA）以确定潜在的脆弱亚组。采用多项logistic回归确定与衰弱等级相关的因素，随后采用二元logistic回归评估肺癌患者衰弱等级与SRP发生率之间的关系。结果slca鉴定出三个不同的虚弱亚组：虚弱（C1, 37.3%）、虚弱体力活动下降（C2, 31.9%）和严重虚弱核心力量下降（C3, 30.9%）组。放疗时间、营养风险和年龄是影响衰弱分型的主要因素。C3组SRP发生率（68.3%）明显高于C2组（47.7%）和C1组（19.7%）（P < 0.001）。与C1相比，C2和C3发生SRP的风险分别高出3.71倍和8.84倍。结论肺癌放疗患者虚弱表现出明显的异质性。那些严重虚弱的人，尤其是核心力量和身体功能下降的人，与SRP风险增加密切相关。这些发现表明个性化护理评估和早期有针对性的干预措施对于预防和减轻虚弱进展和SRP发生的重要性。国家临床试验注册中心（ChiCTR2400081213）。

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