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A Study on the Intervention Model of Gastrointestinal Reactions Based on Self-efficacy Theory in Lung Cancer Patients During Chemotherapy
Liu Guixia,
Wu Caiyun,
Sun Shenghong,
Zhang Hui,
Meng Yun
Issue:
Volume 6, Issue 1, March 2021
Pages:
1-9
Received:
5 December 2020
Accepted:
19 December 2020
Published:
12 January 2021
Abstract: Background: Although there are many studies on clinical intervention of gastrointestinal reactions induced by chemotherapy, the methods and means of intervention are inconsistent and the results differ greatly. More importantly, there are fewer relatively uniform intervention models with theoretical support. Therefore, based on the self-efficacy theory and its framework, the aim of this study was to construct an intervention model of gastrointestinal reactions in patients with lung cancer undergoing chemotherapy and evaluate its effects of clinical application. Methods: Based on self-efficacy theory, a intervention model of gastrointestinal reactions was constructed and applied to 30 patients with lung cancer who had gastrointestinal reactions during chemotherapy for three consecutive chemotherapy cycles. Results: After three cycles of intervention, the analysis of repeated measurement data showed that there was decreased in the total score of gastrointestinal reactions induced by chemotherapy, as well as in yield and psychological distress, and at the same time, increased in the scores of self-efficacy, objective support, support utilization and internal control (P<0.05). Conclusion: The intervention model based on the self-efficacy theory is feasible to intervene in the gastrointestinal reactions of patients with lung cancer during chemotherapy. It can improve their self-efficacy and effectively reduce the gastrointestinal reactions.
Abstract: Background: Although there are many studies on clinical intervention of gastrointestinal reactions induced by chemotherapy, the methods and means of intervention are inconsistent and the results differ greatly. More importantly, there are fewer relatively uniform intervention models with theoretical support. Therefore, based on the self-efficacy th...
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Expression of Biomarkers (CD44, COX-2, TWIST, VEGF-C and LOX) in Esophageal Cancer: Implication for Prophylactic Radiation Field
Yasuhito Hagiwara,
Kenji Nemoto,
Ibuki Ota,
Masayoshi Yamada,
Osamu Hachiya,
Mitsunori Yamakawa
Issue:
Volume 6, Issue 1, March 2021
Pages:
10-16
Received:
29 December 2020
Accepted:
8 January 2021
Published:
22 January 2021
Abstract: Background and objective: If it becomes possible to reduce the prophylactic radiation field by using a personalized radiation field, radiation therapy of esophageal cancer may become safer. In this study, we examined the relationship between expression levels of biomarkers (CD44, COX-2, TWIST, VEGF-C and LOX) and lymph node metastasis and distant metastasis. Materials and methods: We performed retrospective analysis of 14 patients who underwent radical surgery for esophageal cancer between 2009 and 2011 in Yamagata University Hospital. Stain index was used for assessment of biomarker expression. The relationships of stain index with regional recurrence and distant metastasis were evaluated. Results: All patients had squamous cell carcinoma. The median follow-up duration was 38 months. Distant failure was significantly related to low COX-2 expression in the deep part of the tumor (stain index <2.8; p=0.0479). Pathological node-positive or regional recurrence was significantly related to low VEGF-C expression (stain index <0.3; p=0.0418). Patients with low CD44 expression in the surface of the tumor tended to have better reginal control (stain index <0.3; p=0.0902). Conclusions: COX-2, VEGF-C, and CD44 expression levels might have potential to enable omission of the prophylactic radiation field. Further analysis using biopsy samples is required for application to radical radiotherapy.
Abstract: Background and objective: If it becomes possible to reduce the prophylactic radiation field by using a personalized radiation field, radiation therapy of esophageal cancer may become safer. In this study, we examined the relationship between expression levels of biomarkers (CD44, COX-2, TWIST, VEGF-C and LOX) and lymph node metastasis and distant m...
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Experience with Sorafenib in Patients with Advanced Hepatocellular Carcinoma Treated at the National Cancer Institute of Panama (Sorafen Study)
Ronald Jahir Dominguez-Molina,
Jose Pinto-Llerena
Issue:
Volume 6, Issue 1, March 2021
Pages:
17-21
Received:
5 January 2021
Accepted:
18 January 2021
Published:
25 January 2021
Abstract: Sorafenib is an oral multi-kinase inhibitor that increases survival and delays tumor progression in patients with advanced hepatocarcinoma (HCC). This study aimed to determine the progression-free survival (PFS) and overall survival (OS) and to analyze OS-related factors in this population between 2014 and 2019. We performed a retrospective review of patients with advanced HCC who were treated with sorafenib at the National Cancer Institute of Panama (Instituto Oncologico Nacional de Panama – IONP) from January 2014 to December 2019. The data were collected from electronic health records of the IONP. In total, 77 patients with a mean age of 65 years were analyzed. Sixty-three percent of the patients were men, and most of them had an Eastern Cooperative Oncology Group (ECOG) performance status of 1 and had not undergone any prior treatment. Forty-four percent patients had Child-Pugh Class A. The most frequent progression site was the liver (27%), followed by the lungs. Mean PFS was 1 month, and mean OS was 3 months. The clinical benefit was 39% and Overall response rate was 3,9%; for those with stable disease, it was 35,1%, and 3,9% showed a partial response. More encouraging results were obtained from patients with higher functional statuses (ECOG status 0-1) and who were in milder stages of liver disease (Child-Pugh Class A). The most common adverse events were fatigue, hand-foot syndrome, nausea and vomiting, and arterial hypertension. The survival results assessed in our institution for patients with advanced hepatocellular carcinoma treated with sorafenib are below of those published in the literature; however, after selecting the cases with ECOG 0-1 and Child A stage, our results were more in line with those of the international literature, being the most important prognostic factors in our patients. Fatigue and hand-foot syndrome were the most common adverse events. The key to the success of this therapy lies in an adequate selection of patients.
Abstract: Sorafenib is an oral multi-kinase inhibitor that increases survival and delays tumor progression in patients with advanced hepatocarcinoma (HCC). This study aimed to determine the progression-free survival (PFS) and overall survival (OS) and to analyze OS-related factors in this population between 2014 and 2019. We performed a retrospective review ...
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The Psychological Distress of Patients with Breast Cancer at University Teaching Hospital of Brazzaville
Judith Nsondé Malanda,
Freud Loukibou Ngouari,
Bab Salam Ngouaka,
Siméon Stéphane Moubié
Issue:
Volume 6, Issue 1, March 2021
Pages:
22-32
Received:
9 January 2021
Accepted:
16 January 2021
Published:
25 January 2021
Abstract: Introduction the breast cancer affects all aspects of the patient’s life. To assess the psychological of patients with breast cancer at University Teaching Hospital of Brazzaville. It is a transversal study carried out in the carcinology service of University Teaching Hospital of Brazzaville. The data collection took place in face-to-face mode into 2 stages; the first is a census of patients with breast cancer diagnosis showed to anatomy-pathology. The second is an individual interview on an epidemiological survey, clinical and therapeutic; then a survey on psychological distress on anxiety, depression and self-esteem. It took place from 1st January 2019 to 31st august 2019. One hundred and fifty (150) patients were quested. The Epi.info software and SPSS 25 allowed the data analysis. It was a cohort mostly formed with women (96%) The patients of middle age was 50.14 (utmost from 21 to 28 years old). The prevalence of psychological distress was 82%, depression and anxiety respectively; then 38% of patients showed a very week self-esteem. The associated factors with distress were: the developed stage of breast cancer (metastasis), side effects, aftermath related to the treatments, problems faced. It stands out that breast cancer has an aftereffect on psychological sphere of patients with breast cancer, showing an increase of psychological distress, anxiety, depression, together with the loss of self-esteem.
Abstract: Introduction the breast cancer affects all aspects of the patient’s life. To assess the psychological of patients with breast cancer at University Teaching Hospital of Brazzaville. It is a transversal study carried out in the carcinology service of University Teaching Hospital of Brazzaville. The data collection took place in face-to-face mode into...
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The Impact of Special Access Programs (SAP) on Prescribing Patterns in Metastatic Castration Resistant Prostate Cancer (mCRPC)
Nimira Alimohamed,
Raya Leibowitz-Amit,
Arnoud Templeton,
Jo-An Seah,
Francisco Emilio Vera-Badillo,
Anthony Michael Joshua,
Sarah Elizabeth Wong,
Jennifer Jane Knox,
Ian Frederick Tannock,
Srikala Sujata Sridhar
Issue:
Volume 6, Issue 1, March 2021
Pages:
33-37
Received:
26 January 2021
Accepted:
13 February 2021
Published:
27 February 2021
Abstract: Background: Special access programs provide physicians in Canada access to new drugs before they are publicly funded, but little is known about how they impact prescribing practices. For men with metastatic castration-resistant prostate cancer post-docetaxel chemotherapy, a special access program for enzalutamide was open from June-December 2013. To better understand how this impacted prescribing practices, we surveyed medical oncologists at our institution. Methods: All four genitourinary medical oncologists at the Princess Margaret Cancer Centre completed an anonymous paper or electronic survey for each patient enrolled. The survey consisted of seven multiple-choice questions (with free text option) asking about disease characteristics, prior treatments, and reasons for prescribing enzalutamide. Results: Surveys were completed on all 155 patients; 92% (142/155) had metastatic disease, with 20% (28/142) having visceral disease; 8% (13/155) had non-metastatic disease; and the majority (92%) had progressive disease. All patients were on androgen deprivation therapy, 60% had prior prednisone, 30% had prior abiraterone, and 34% had prior docetaxel. Most (50%) used enzalutamide because it was supported by available data; 35% reported free drug was the motivating factor; 10% indicated their patients were unfit for chemotherapy; and in 5%, all other options were exhausted. Over half reported feeling enzalutamide was the appropriate treatment option for their patient at that time. Conclusions: During the special access program, most patients received enzalutamide in settings supported by available evidence. A minority did, however, received enzalutamide outside of the formally studied setting, suggesting that funding and accessibility can impact prescribing practices.
Abstract: Background: Special access programs provide physicians in Canada access to new drugs before they are publicly funded, but little is known about how they impact prescribing practices. For men with metastatic castration-resistant prostate cancer post-docetaxel chemotherapy, a special access program for enzalutamide was open from June-December 2013. T...
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“Bridge” Neoadjuvant Endocrine Therapy for Early Stage Breast Cancer Patients During COVID-19 at an Academic Hospital in NYC: Lessons Learned and Future Directions
Joshua Feinberg,
Cindy Cen,
Freya Schnabel,
Sylvia Adams,
Magdalena Plasilova,
Janet Yeh,
Marleen Meyers,
James Speyer,
Elliot Belenkov,
Maryann Kwa,
Yelena Novik,
Elena Katz,
Amber Azniv Guth
Issue:
Volume 6, Issue 1, March 2021
Pages:
38-41
Received:
24 January 2021
Accepted:
23 February 2021
Published:
4 March 2021
Abstract: Background: The COVID-19 pandemic presented a unique challenge to our healthcare system and rapidly changed the delivery of cancer care. During the height of the pandemic in New York State, non-emergent surgery, including cancer surgery, was postponed. For patients with hormone receptor positive breast cancer, “bridge” neoadjuvant hormonal therapy was initiated until surgery could be safely performed. Objective: We present our institutional experience with this approach and lessons learned, including oncologic outcomes and factors which may lead to increased medication compliance. Method: This is a single institution, retrospective, observational chart review. Using data from the NYU Perlmutter Cancer Center, we created a database of patients who were diagnosed with ER+ stage 0, I, or II breast cancer and were offered preoperative endocrine therapy (tamoxifen or aromatase inhibitors) between March 12, 2020 and June 1, 2020. Variables collected included demographics, tumor characteristics, as well as the rates of medication uptake and compliance. Patients eligible for review were adult (age>18) males and females who had initial visits at our two cancer centers between March 12, 2020 and June 1, 2020, during the height of the COVID-19 pandemic in New York. Results: Of 192 newly diagnosed breast cancer patients seen at the NYU Perlmutter Cancer Center during the study time period, 136 (71%) patients had early stage ER positive breast cancer. Forty-five patients (23%) had not yet undergone surgery, and were recommended to receive presurgical hormonal therapy as a bridge. Average age: 60.5 +/- 13.8 years old (range 31-89). Thirty-four patients (75.6%) had invasive cancer, 8 had DCIS (17.8%), 3 had DCIS with microinvasion (6.7%). There were 9 patients (20%) who did not take the medication. Thirty-six patients (80%) took medication for an average of 43.6 +/- 27.3 days (range 9-101 days) prior to surgery. Twenty-eight patients (77.8%) took an aromatase inhibitor, and 8 (22.2%) took tamoxifen. Forty-two patients have now undergone surgery (93.3%) – the remaining patients include one who is refusing all treatment, one patient who relocated out of state, and another patient who has not yet scheduled surgery, but is still taking an aromatase inhibitor. Conclusion: Despite traditionally low uptake and adherence to endocrine therapy, acceptance of neo-adjuvant bridge therapy during the COVID-19 pandemic was high (80%). We plan to investigate our patient population further, especially psychosocial and behavioral factors that influence willingness to take endocrine therapy – and apply these lessons to management of early-stage ER positive breast cancer.
Abstract: Background: The COVID-19 pandemic presented a unique challenge to our healthcare system and rapidly changed the delivery of cancer care. During the height of the pandemic in New York State, non-emergent surgery, including cancer surgery, was postponed. For patients with hormone receptor positive breast cancer, “bridge” neoadjuvant hormonal therapy ...
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Comparison of Hernia Recurrence and Seroma Formation in Cancer Patients Undergoing Incisional Hernia Repair with Transfascial Sutures vs. Fibrin Glue for Mesh Fixation
Celia Ledet,
David Santos,
Xuemei Wang,
Heather Gibson,
Angela Limmer,
Brian Badgwell
Issue:
Volume 6, Issue 1, March 2021
Pages:
42-48
Received:
15 February 2021
Accepted:
25 February 2021
Published:
4 March 2021
Abstract: Background: Open ventral incisional hernia repairs with mesh reduce hernia recurrence rates to less than 10%. The Rives-Stoppa retrorectus hernia repair technique is becoming the standard of care for mesh repair of complex incisional hernias. In these hernia repairs, mesh has traditionally been fixated with transfascial sutures, but fibrin glue has been used as an alternative to reduce pain and may also reduce operative time and the risk of seroma formation. The primary objective of this study was to compare the rates of hernia recurrence and seroma formation in cancer patients who underwent Rives-Stoppa incisional hernia repair using transfascial sutures vs. fibrin glue for mesh fixation. Methods: We conducted a retrospective review of a prospectively maintained database of cancer patients at our free-standing cancer institution who underwent Rives-Stoppa ventral incisional hernia repair performed at our institution. Fisher’s exact test was used to assess differences in hernia recurrence and seroma formation rates between patients who underwent mesh fixation with transfascial sutures vs. fibrin glue. Using a neutral prior probability distribution, a Bayesian analysis was performed to evaluate the posterior probability of seroma formation requiring intervention and hernia recurrence after retrorectus repair with fibrin glue fixation. Log-rank test was used to assess the difference in overall survival between the two groups. Results: Forty-one patients (22 in the transfascial suture group and 19 in the fibrin glue group) were included in the analysis. The patient demographics were similar in both groups. There was no statistically significant difference in seroma formation requiring drainage by interventional radiology (IR) between the fibrin glue and the transfascial suture groups (5.3% vs. 9.1%; P=1.00). The odds of having a hernia recurrence was 4 times higher in the transfascial suture group than in the fibrin glue fixation group, but this was not statistically significant (18.2% vs 5.3%, p=0.35). The Bayesian analysis showed a 90% probability that the hernia recurrence rate would be higher in the transfascial suture than in the fibrin glue fixation group. Conclusion: Using fibrin glue instead of transfascial sutures may reduce hernia recurrences and seroma formation in cancer patients undergoing ventral incisional hernia repairs with retro rectus mesh. The high probability of reducing the odds of hernia recurrence with fibrin glue fixation warrants a prospective randomized, multi-institutional clinical trial.
Abstract: Background: Open ventral incisional hernia repairs with mesh reduce hernia recurrence rates to less than 10%. The Rives-Stoppa retrorectus hernia repair technique is becoming the standard of care for mesh repair of complex incisional hernias. In these hernia repairs, mesh has traditionally been fixated with transfascial sutures, but fibrin glue has...
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