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Rectal cancer management in elderly patients: experience of a single Portuguese institution
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Use of atropine-diphenoxylate compared with hyoscyamine to decrease rates of irinotecan-related cholinergic syndrome
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Impact of a telehealth intervention on quality of life and symptom distress in patients with head and neck cancer
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Beneficial effects of animal-assisted visits on quality of life during multimodal radiation-chemotherapy regimens
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Predictors of resolution in navigated patients with abnormal cancer screening tests
Objective To identify predictors of resolution of abnormal cancer screening tests in patients who received navigation.
Methods We examined data on patients with abnormal breast (n = 256) or cervical (n = 150) screening tests or symptoms who received navigation as part of the Ohio Patient Navigator Research Program during 2007-2010. We used multivariable Cox proportional hazards regression models to identify predictors of time to resolution (ie, when a patient’s clinical abnormality or abnormal screening test was determined to be a benign condition or a cancer diagnosis).
Results The median time to resolution was 183 days for navigated patients with breast abnormalities and 172 days for navigated patients with cervical abnormalities. In patients with breast abnormalities, those who reported at least 1 barrier to care during navigation (HR, 0.66; 95% CI, 0.51-0.86) or higher perceived stress (HR, 0.90; 95% CI, 0.82-0.98) had slower resolution. Among patients with cervical abnormalities, those who reported at least 1 barrier to care during navigation had slower resolution (HR, 0.62; 95% CI, 0.42-0.91). Patients with cervical abnormalities had faster resolution if they had private health insurance, but this effect was present only in younger women (interaction P = .003).
Limitations Unknown generalizability of results because patients were female and from clinics in central Ohio.
Conclusions Several variables predicted whether patient navigation led to faster resolution, and predictors differed somewhat by disease site. Results will be useful in improving current patient navigation programs and designing future programs.
Funding American Cancer Society and the National Institutes of Health
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Objective To identify predictors of resolution of abnormal cancer screening tests in patients who received navigation.
Methods We examined data on patients with abnormal breast (n = 256) or cervical (n = 150) screening tests or symptoms who received navigation as part of the Ohio Patient Navigator Research Program during 2007-2010. We used multivariable Cox proportional hazards regression models to identify predictors of time to resolution (ie, when a patient’s clinical abnormality or abnormal screening test was determined to be a benign condition or a cancer diagnosis).
Results The median time to resolution was 183 days for navigated patients with breast abnormalities and 172 days for navigated patients with cervical abnormalities. In patients with breast abnormalities, those who reported at least 1 barrier to care during navigation (HR, 0.66; 95% CI, 0.51-0.86) or higher perceived stress (HR, 0.90; 95% CI, 0.82-0.98) had slower resolution. Among patients with cervical abnormalities, those who reported at least 1 barrier to care during navigation had slower resolution (HR, 0.62; 95% CI, 0.42-0.91). Patients with cervical abnormalities had faster resolution if they had private health insurance, but this effect was present only in younger women (interaction P = .003).
Limitations Unknown generalizability of results because patients were female and from clinics in central Ohio.
Conclusions Several variables predicted whether patient navigation led to faster resolution, and predictors differed somewhat by disease site. Results will be useful in improving current patient navigation programs and designing future programs.
Funding American Cancer Society and the National Institutes of Health
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Objective To identify predictors of resolution of abnormal cancer screening tests in patients who received navigation.
Methods We examined data on patients with abnormal breast (n = 256) or cervical (n = 150) screening tests or symptoms who received navigation as part of the Ohio Patient Navigator Research Program during 2007-2010. We used multivariable Cox proportional hazards regression models to identify predictors of time to resolution (ie, when a patient’s clinical abnormality or abnormal screening test was determined to be a benign condition or a cancer diagnosis).
Results The median time to resolution was 183 days for navigated patients with breast abnormalities and 172 days for navigated patients with cervical abnormalities. In patients with breast abnormalities, those who reported at least 1 barrier to care during navigation (HR, 0.66; 95% CI, 0.51-0.86) or higher perceived stress (HR, 0.90; 95% CI, 0.82-0.98) had slower resolution. Among patients with cervical abnormalities, those who reported at least 1 barrier to care during navigation had slower resolution (HR, 0.62; 95% CI, 0.42-0.91). Patients with cervical abnormalities had faster resolution if they had private health insurance, but this effect was present only in younger women (interaction P = .003).
Limitations Unknown generalizability of results because patients were female and from clinics in central Ohio.
Conclusions Several variables predicted whether patient navigation led to faster resolution, and predictors differed somewhat by disease site. Results will be useful in improving current patient navigation programs and designing future programs.
Funding American Cancer Society and the National Institutes of Health
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Information and communication needs of Chinese American breast cancer patients: perspectives on survivorship care planning
Objective To examine the experiences of CABCS to better understand their information and communication needs and their preferences for survivorship care plans (SCPs).
Methods 16 CABCS, aged 37-72 years, were recruited through community-based organizations in the Northeast United States to participate in one-on-one telephone interviews about their breast cancer survivorship experience. The semistructured interviews were conducted in Mandarin, Cantonese, or English. Two investigators transcribed and translated the audio recordings into English and analyzed the interview transcripts using established methods of qualitative content analysis.
Results Three main themes were identified through analysis of interview transcripts: the need for evidence-based and culturally and linguistically appropriate health information; the role of language or communication barriers and culture in accessing care and communicating with providers; and preferences for SCP elements and format.
Limitations The sample may not be representative of the entire population of CABCS.
Conclusions The findings provide insight into the information and communication needs and SCP preferences of CABCS. Understanding the cultural nuances that underlie these needs and preferences is critical for improving CABCS’s quality of life after treatment for cancer. SCPs that incorporate Chinese-language resources and address the unique cultural needs of this population should be developed and they should include information about diet and nutrition as well as traditional Chinese medicine.
Funding This work was supported in part by the NIH-NCI’s Community Network Program Center, ACCHDC (U54CA153513, PI: Dr Grace Ma) and P30 CA06927.
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Objective To examine the experiences of CABCS to better understand their information and communication needs and their preferences for survivorship care plans (SCPs).
Methods 16 CABCS, aged 37-72 years, were recruited through community-based organizations in the Northeast United States to participate in one-on-one telephone interviews about their breast cancer survivorship experience. The semistructured interviews were conducted in Mandarin, Cantonese, or English. Two investigators transcribed and translated the audio recordings into English and analyzed the interview transcripts using established methods of qualitative content analysis.
Results Three main themes were identified through analysis of interview transcripts: the need for evidence-based and culturally and linguistically appropriate health information; the role of language or communication barriers and culture in accessing care and communicating with providers; and preferences for SCP elements and format.
Limitations The sample may not be representative of the entire population of CABCS.
Conclusions The findings provide insight into the information and communication needs and SCP preferences of CABCS. Understanding the cultural nuances that underlie these needs and preferences is critical for improving CABCS’s quality of life after treatment for cancer. SCPs that incorporate Chinese-language resources and address the unique cultural needs of this population should be developed and they should include information about diet and nutrition as well as traditional Chinese medicine.
Funding This work was supported in part by the NIH-NCI’s Community Network Program Center, ACCHDC (U54CA153513, PI: Dr Grace Ma) and P30 CA06927.
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Objective To examine the experiences of CABCS to better understand their information and communication needs and their preferences for survivorship care plans (SCPs).
Methods 16 CABCS, aged 37-72 years, were recruited through community-based organizations in the Northeast United States to participate in one-on-one telephone interviews about their breast cancer survivorship experience. The semistructured interviews were conducted in Mandarin, Cantonese, or English. Two investigators transcribed and translated the audio recordings into English and analyzed the interview transcripts using established methods of qualitative content analysis.
Results Three main themes were identified through analysis of interview transcripts: the need for evidence-based and culturally and linguistically appropriate health information; the role of language or communication barriers and culture in accessing care and communicating with providers; and preferences for SCP elements and format.
Limitations The sample may not be representative of the entire population of CABCS.
Conclusions The findings provide insight into the information and communication needs and SCP preferences of CABCS. Understanding the cultural nuances that underlie these needs and preferences is critical for improving CABCS’s quality of life after treatment for cancer. SCPs that incorporate Chinese-language resources and address the unique cultural needs of this population should be developed and they should include information about diet and nutrition as well as traditional Chinese medicine.
Funding This work was supported in part by the NIH-NCI’s Community Network Program Center, ACCHDC (U54CA153513, PI: Dr Grace Ma) and P30 CA06927.
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A feasibility study of dignity therapy in patients with stage IV colorectal cancer actively receiving second-line chemotherapy
Objectives To assess the feasibility of DT relatively early in the disease trajectory (primary endpoint) and the effect on death acceptance, distress, symptoms, quality of life, peacefulness, and advanced care planning (secondary outcome endpoint).
Methods Stage IV colorectal cancer patients who progressed on first-line chemotherapy were enrolled. Patients received DT over 2 visits and had outcome measures assessed pre-DT, immediately post-DT and 1 month post-DT.
Results 15 of 17 patients (88%) who were approached enrolled in the study. Most of the patients who completed DT reported being satisfied and felt it was helpful, that it increased their sense of meaning, that it would be helpful to their family, and that it increased their sense of dignity, their sense of purpose, and their will to live.
Limitations This is a small study that lacks power for statistical significance of findings. There is no control group for comparison.
Conclusions DT is a highly feasible, satisfying, and meaningful intervention for advanced colorectal cancer patients who are receiving chemotherapy earlier in the course of their and may result in an understanding of disease and goals of care at the end of life. Larger feasibility and exploratory studies are warranted in advanced cancer patients.
Funding American Cancer Society (ACS-IRG 93-037-15)
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Objectives To assess the feasibility of DT relatively early in the disease trajectory (primary endpoint) and the effect on death acceptance, distress, symptoms, quality of life, peacefulness, and advanced care planning (secondary outcome endpoint).
Methods Stage IV colorectal cancer patients who progressed on first-line chemotherapy were enrolled. Patients received DT over 2 visits and had outcome measures assessed pre-DT, immediately post-DT and 1 month post-DT.
Results 15 of 17 patients (88%) who were approached enrolled in the study. Most of the patients who completed DT reported being satisfied and felt it was helpful, that it increased their sense of meaning, that it would be helpful to their family, and that it increased their sense of dignity, their sense of purpose, and their will to live.
Limitations This is a small study that lacks power for statistical significance of findings. There is no control group for comparison.
Conclusions DT is a highly feasible, satisfying, and meaningful intervention for advanced colorectal cancer patients who are receiving chemotherapy earlier in the course of their and may result in an understanding of disease and goals of care at the end of life. Larger feasibility and exploratory studies are warranted in advanced cancer patients.
Funding American Cancer Society (ACS-IRG 93-037-15)
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Objectives To assess the feasibility of DT relatively early in the disease trajectory (primary endpoint) and the effect on death acceptance, distress, symptoms, quality of life, peacefulness, and advanced care planning (secondary outcome endpoint).
Methods Stage IV colorectal cancer patients who progressed on first-line chemotherapy were enrolled. Patients received DT over 2 visits and had outcome measures assessed pre-DT, immediately post-DT and 1 month post-DT.
Results 15 of 17 patients (88%) who were approached enrolled in the study. Most of the patients who completed DT reported being satisfied and felt it was helpful, that it increased their sense of meaning, that it would be helpful to their family, and that it increased their sense of dignity, their sense of purpose, and their will to live.
Limitations This is a small study that lacks power for statistical significance of findings. There is no control group for comparison.
Conclusions DT is a highly feasible, satisfying, and meaningful intervention for advanced colorectal cancer patients who are receiving chemotherapy earlier in the course of their and may result in an understanding of disease and goals of care at the end of life. Larger feasibility and exploratory studies are warranted in advanced cancer patients.
Funding American Cancer Society (ACS-IRG 93-037-15)
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Quality of life and symptoms after stereotactic body radiotherapy in early-stage lung cancer patients
Objective To describe QoL and symptoms in a small, prospective cohort of early-stage NSCLC patients treated with SBRT.
Methods 19 NSCLC patients who were medically unfit for surgery or chose not to undergo surgery were included in the study. All of the patients were treated with SBRT between 2009 and 2013 at a single comprehensive cancer center. Patients completed a baseline assessment of functional and cognitive status, symptoms, psychological distress, and overall QoL. Questionnaires were repeated at 6 and 12 weeks after accrual.
Results There were no significant differences in all outcomes across the 3 evaluation time points. Overall QoL scores were moderate, and the lowest score was observed for the functional well-being domain. The most severe symptoms at baseline were pain, lack of energy, cough, nervousness, difficulty sleeping, shortness of breath, and worry. Severity scores for pain, lack of energy, and cough increased, whereas nervousness, difficulty sleeping, and worry decreased at the 12 week evaluation.
Limitations Small sample size and lack of sufficient diversity in the cohort. Conclusions QoL scores remained relatively stable across time. Anxiety improved after SBRT, whereas symptoms such as generalized pain, lack of energy, and cough worsened. The findings suggest that SBRT is overall a well-tolerated treatment with no significant decrement in patient-centered outcomes.
Funding/sponsorship This research was supported by grant 5 P01 CA136396-02 (PI: Ferrell) from the National Cancer Institute.
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Objective To describe QoL and symptoms in a small, prospective cohort of early-stage NSCLC patients treated with SBRT.
Methods 19 NSCLC patients who were medically unfit for surgery or chose not to undergo surgery were included in the study. All of the patients were treated with SBRT between 2009 and 2013 at a single comprehensive cancer center. Patients completed a baseline assessment of functional and cognitive status, symptoms, psychological distress, and overall QoL. Questionnaires were repeated at 6 and 12 weeks after accrual.
Results There were no significant differences in all outcomes across the 3 evaluation time points. Overall QoL scores were moderate, and the lowest score was observed for the functional well-being domain. The most severe symptoms at baseline were pain, lack of energy, cough, nervousness, difficulty sleeping, shortness of breath, and worry. Severity scores for pain, lack of energy, and cough increased, whereas nervousness, difficulty sleeping, and worry decreased at the 12 week evaluation.
Limitations Small sample size and lack of sufficient diversity in the cohort. Conclusions QoL scores remained relatively stable across time. Anxiety improved after SBRT, whereas symptoms such as generalized pain, lack of energy, and cough worsened. The findings suggest that SBRT is overall a well-tolerated treatment with no significant decrement in patient-centered outcomes.
Funding/sponsorship This research was supported by grant 5 P01 CA136396-02 (PI: Ferrell) from the National Cancer Institute.
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Objective To describe QoL and symptoms in a small, prospective cohort of early-stage NSCLC patients treated with SBRT.
Methods 19 NSCLC patients who were medically unfit for surgery or chose not to undergo surgery were included in the study. All of the patients were treated with SBRT between 2009 and 2013 at a single comprehensive cancer center. Patients completed a baseline assessment of functional and cognitive status, symptoms, psychological distress, and overall QoL. Questionnaires were repeated at 6 and 12 weeks after accrual.
Results There were no significant differences in all outcomes across the 3 evaluation time points. Overall QoL scores were moderate, and the lowest score was observed for the functional well-being domain. The most severe symptoms at baseline were pain, lack of energy, cough, nervousness, difficulty sleeping, shortness of breath, and worry. Severity scores for pain, lack of energy, and cough increased, whereas nervousness, difficulty sleeping, and worry decreased at the 12 week evaluation.
Limitations Small sample size and lack of sufficient diversity in the cohort. Conclusions QoL scores remained relatively stable across time. Anxiety improved after SBRT, whereas symptoms such as generalized pain, lack of energy, and cough worsened. The findings suggest that SBRT is overall a well-tolerated treatment with no significant decrement in patient-centered outcomes.
Funding/sponsorship This research was supported by grant 5 P01 CA136396-02 (PI: Ferrell) from the National Cancer Institute.
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Chemotherapy-induced peripheral neuropathy and impact on quality of life 6 months after treatment with chemotherapy
Background Chemotherapy-induced peripheral neuropathy (CIPN) is a major dose-limiting toxicity of cytostatics. With improved survival among cancer patients, CIPN may have a major impact on quality of life (QoL) of cancer survivors.
Objective To determine the occurrence of CIPN induced by oxaliplatin and taxanes and its impact on QoL median 6 months after chemotherapy.
Methods All patients who received their last treatment with oxaliplatin or taxanes in 2 consecutive years in the Máxima Medical Centre, the Netherlands, were eligible for the study. Neurotoxicity and its effect on QoL was assessed with the recently developed Chemotherapy Induced Neurotoxicity Questionnaire (CINQ) and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) median 6 months after cessation of therapy.
Results Of the 58 eligible patients, 43 (74.1%) completed the questionnaire. After a median follow-up of 6.5 months after cessation of therapy, most of the patients experienced neurotoxicity in the upper and lower extremities (78.8% and 89.7%, respectively). Overall, the most-reported complaints included numbness and tingling in hands as well as feet, suffering from cold feet, and trouble distinguishing objects in the hands. Housekeeping difficulties were reported in 12.8% of patients, and 20.5% of patients became more dependent on others because of the neurotoxicity. Overall, QoL was negatively affected by the impact of CIPN in 48.6% of patients.
Limitations Due to the small sample size selection bias cannot be ruled out and no data about CIPN during treatment were available. Conclusions After a median follow-up of 6.5 months after cessation of therapy with oxaliplatin or taxanes, CIPN is common and leads to impairment in patient QoL. More research is needed to assess the impact of neurotoxicity on QoL.
Conclusions After a median follow-up of 6.5 months after cessation of therapy with oxaliplatin or taxanes, CIPN is common and leads to impairment in patient QoL. More research is needed to assess the impact of neurotoxicity on QoL.
Funding Floortje Mols was supported by a VENI grant (#451-10-041) from the Netherlands Organization for Scientific Research, The Hague, The Netherlands.
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Background Chemotherapy-induced peripheral neuropathy (CIPN) is a major dose-limiting toxicity of cytostatics. With improved survival among cancer patients, CIPN may have a major impact on quality of life (QoL) of cancer survivors.
Objective To determine the occurrence of CIPN induced by oxaliplatin and taxanes and its impact on QoL median 6 months after chemotherapy.
Methods All patients who received their last treatment with oxaliplatin or taxanes in 2 consecutive years in the Máxima Medical Centre, the Netherlands, were eligible for the study. Neurotoxicity and its effect on QoL was assessed with the recently developed Chemotherapy Induced Neurotoxicity Questionnaire (CINQ) and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) median 6 months after cessation of therapy.
Results Of the 58 eligible patients, 43 (74.1%) completed the questionnaire. After a median follow-up of 6.5 months after cessation of therapy, most of the patients experienced neurotoxicity in the upper and lower extremities (78.8% and 89.7%, respectively). Overall, the most-reported complaints included numbness and tingling in hands as well as feet, suffering from cold feet, and trouble distinguishing objects in the hands. Housekeeping difficulties were reported in 12.8% of patients, and 20.5% of patients became more dependent on others because of the neurotoxicity. Overall, QoL was negatively affected by the impact of CIPN in 48.6% of patients.
Limitations Due to the small sample size selection bias cannot be ruled out and no data about CIPN during treatment were available. Conclusions After a median follow-up of 6.5 months after cessation of therapy with oxaliplatin or taxanes, CIPN is common and leads to impairment in patient QoL. More research is needed to assess the impact of neurotoxicity on QoL.
Conclusions After a median follow-up of 6.5 months after cessation of therapy with oxaliplatin or taxanes, CIPN is common and leads to impairment in patient QoL. More research is needed to assess the impact of neurotoxicity on QoL.
Funding Floortje Mols was supported by a VENI grant (#451-10-041) from the Netherlands Organization for Scientific Research, The Hague, The Netherlands.
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Background Chemotherapy-induced peripheral neuropathy (CIPN) is a major dose-limiting toxicity of cytostatics. With improved survival among cancer patients, CIPN may have a major impact on quality of life (QoL) of cancer survivors.
Objective To determine the occurrence of CIPN induced by oxaliplatin and taxanes and its impact on QoL median 6 months after chemotherapy.
Methods All patients who received their last treatment with oxaliplatin or taxanes in 2 consecutive years in the Máxima Medical Centre, the Netherlands, were eligible for the study. Neurotoxicity and its effect on QoL was assessed with the recently developed Chemotherapy Induced Neurotoxicity Questionnaire (CINQ) and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) median 6 months after cessation of therapy.
Results Of the 58 eligible patients, 43 (74.1%) completed the questionnaire. After a median follow-up of 6.5 months after cessation of therapy, most of the patients experienced neurotoxicity in the upper and lower extremities (78.8% and 89.7%, respectively). Overall, the most-reported complaints included numbness and tingling in hands as well as feet, suffering from cold feet, and trouble distinguishing objects in the hands. Housekeeping difficulties were reported in 12.8% of patients, and 20.5% of patients became more dependent on others because of the neurotoxicity. Overall, QoL was negatively affected by the impact of CIPN in 48.6% of patients.
Limitations Due to the small sample size selection bias cannot be ruled out and no data about CIPN during treatment were available. Conclusions After a median follow-up of 6.5 months after cessation of therapy with oxaliplatin or taxanes, CIPN is common and leads to impairment in patient QoL. More research is needed to assess the impact of neurotoxicity on QoL.
Conclusions After a median follow-up of 6.5 months after cessation of therapy with oxaliplatin or taxanes, CIPN is common and leads to impairment in patient QoL. More research is needed to assess the impact of neurotoxicity on QoL.
Funding Floortje Mols was supported by a VENI grant (#451-10-041) from the Netherlands Organization for Scientific Research, The Hague, The Netherlands.
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Impact of aprepitant on emesis control, dose intensity, and recurrence-free survival in a population-based cohort of head and neck cancer patients receiving high-dose cisplatin chemotherapy
Objective To evaluate the impact of aprepitant on emesis control, DI, and RFS.
Methods HNC patients treated at the British Columbia Cancer Agency were analyzed. Kaplan-Meier method and adjusted Cox proportional hazard models were used to evaluate RFS in aprepitant users. To control for selection bias, a propensity score analysis was conducted.
Results A total of 192 HNC patients were included: 141 received aprepitant prophylaxis. The aprepitant-treated and untreated groups were comparable in mean age (56.3 vs 58.1 years), male gender (82.3% vs 86.3%), tumor location, and number of metastatic sites. However, more patients in the aprepitant group than in the untreated group had surgically resectable disease (31.2% vs 15.7%, respectively) and better performance status (ECOG 0/1, 87.9% vs 76.4%). Less emesis was reported in the aprepitant group (21.3% vs 28.0%). Patients in the treated group were also more likely to complete 3 cycles of high-dose cisplatin (OR, 2.3; P = .03). The propensity score adjusted Cox regression analysis suggested a reduced risk of disease recurrence in patients who received aprepitant (HR, 0.47; 95% CI, 0.17- 1.28).
Limitations Potential confounders such as other diseases or treatments that may have influenced the presence of nausea/emesis symptoms.
Conclusion Aprepitant contributed to improved emesis control, enhanced DI, and better adherence to cisplatin chemotherapy.
Funding/sponsorship The British Columbia Cancer Foundation and Canadian Cancer Society Research Institute.
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Objective To evaluate the impact of aprepitant on emesis control, DI, and RFS.
Methods HNC patients treated at the British Columbia Cancer Agency were analyzed. Kaplan-Meier method and adjusted Cox proportional hazard models were used to evaluate RFS in aprepitant users. To control for selection bias, a propensity score analysis was conducted.
Results A total of 192 HNC patients were included: 141 received aprepitant prophylaxis. The aprepitant-treated and untreated groups were comparable in mean age (56.3 vs 58.1 years), male gender (82.3% vs 86.3%), tumor location, and number of metastatic sites. However, more patients in the aprepitant group than in the untreated group had surgically resectable disease (31.2% vs 15.7%, respectively) and better performance status (ECOG 0/1, 87.9% vs 76.4%). Less emesis was reported in the aprepitant group (21.3% vs 28.0%). Patients in the treated group were also more likely to complete 3 cycles of high-dose cisplatin (OR, 2.3; P = .03). The propensity score adjusted Cox regression analysis suggested a reduced risk of disease recurrence in patients who received aprepitant (HR, 0.47; 95% CI, 0.17- 1.28).
Limitations Potential confounders such as other diseases or treatments that may have influenced the presence of nausea/emesis symptoms.
Conclusion Aprepitant contributed to improved emesis control, enhanced DI, and better adherence to cisplatin chemotherapy.
Funding/sponsorship The British Columbia Cancer Foundation and Canadian Cancer Society Research Institute.
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Objective To evaluate the impact of aprepitant on emesis control, DI, and RFS.
Methods HNC patients treated at the British Columbia Cancer Agency were analyzed. Kaplan-Meier method and adjusted Cox proportional hazard models were used to evaluate RFS in aprepitant users. To control for selection bias, a propensity score analysis was conducted.
Results A total of 192 HNC patients were included: 141 received aprepitant prophylaxis. The aprepitant-treated and untreated groups were comparable in mean age (56.3 vs 58.1 years), male gender (82.3% vs 86.3%), tumor location, and number of metastatic sites. However, more patients in the aprepitant group than in the untreated group had surgically resectable disease (31.2% vs 15.7%, respectively) and better performance status (ECOG 0/1, 87.9% vs 76.4%). Less emesis was reported in the aprepitant group (21.3% vs 28.0%). Patients in the treated group were also more likely to complete 3 cycles of high-dose cisplatin (OR, 2.3; P = .03). The propensity score adjusted Cox regression analysis suggested a reduced risk of disease recurrence in patients who received aprepitant (HR, 0.47; 95% CI, 0.17- 1.28).
Limitations Potential confounders such as other diseases or treatments that may have influenced the presence of nausea/emesis symptoms.
Conclusion Aprepitant contributed to improved emesis control, enhanced DI, and better adherence to cisplatin chemotherapy.
Funding/sponsorship The British Columbia Cancer Foundation and Canadian Cancer Society Research Institute.
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