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Bolgeo T, Di Matteo R, Crivellari S, Gatti D, Cassinari A, Riccio C, De Angelis A, Delfanti S, Ferrero E, Gnani C, Riili G, Maconi A. Quality of life in patients with PICC diagnosed with mesothelioma: Results of a multicenter epidemiological survey (LifePICC). J Vasc Access 2025; 26:217-227. [PMID: 37873988 DOI: 10.1177/11297298231202046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Pleural mesothelioma (PM) is a rare and aggressive cancer. PICC devices are widely used in cancer patients. The aim of the study is to evaluate the quality of life of patients with PICC diagnosed with PM treated at the Hospital of Casale Monferrato and Alessandria (Italy), an area with a high incidence of asbestos-related diseases. STUDY DESIGN AND METHODS Longitudinal prospective observational study with data collection at PICC insertion (T0), after 3 months (T1), 6 months (T2), and 9 months (T3). Participants were aged >18 years, diagnosed with PM, eligible for PICC insertion. Questionnaires used: EORTC QLQ-C30, EORTC QLQ-LC13, and HADS rating scale. RESULTS Twenty-eight patients were enrolled. The mean age was 68.93 years (SD 9.13), mostly male (57.1%). The most frequent cancer stage at diagnosis was III (39.3%), then I (32.1%), and IV (21.4%). 85.7% were treated with chemotherapy, 14.3% also with immunotherapy. 96.4% of patients reported no complications during PICC implantation. The perception of health status and quality of life, measured on a scale of 1-7, was in line with an average score of 5 during the evaluation period. The total anxiety and depression score remained normal for most patients (0-7). CONCLUSIONS The PICC management involved a multidisciplinary team with different skills: study findings revealed the key role that dedicated nurses play in PICC placement and ensuring patient problems are promptly addressed. From our study results, PICC placement does not seem to negatively impact the patient's quality of life.
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Affiliation(s)
- Tatiana Bolgeo
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera "SS. Antonio e Biagio e Cesare Arrigo," Alessandria, Italy
| | - Roberta Di Matteo
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera "SS. Antonio e Biagio e Cesare Arrigo," Alessandria, Italy
| | - Stefania Crivellari
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera "SS. Antonio e Biagio e Cesare Arrigo," Alessandria, Italy
- SS Progetti, Ricerca e Innovazione, Ospedale Michele and Pietro Ferrero, ASL CN2, Verduno (CN), Italy
| | - Denise Gatti
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera "SS. Antonio e Biagio e Cesare Arrigo," Alessandria, Italy
| | - Antonella Cassinari
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera "SS. Antonio e Biagio e Cesare Arrigo," Alessandria, Italy
| | - Carmela Riccio
- Oncology Unit, Azienda Ospedaliera "SS. Antonio e Biagio e Cesare Arrigo," Alessandria, Italy
| | - Antonina De Angelis
- Mesothelioma and Rare Tumors Unit, Azienda Ospedaliera "SS. Antonio e Biagio e Cesare Arrigo," Alessandria, Italy
| | - Sara Delfanti
- Mesothelioma and Rare Tumors Unit, Azienda Ospedaliera "SS. Antonio e Biagio e Cesare Arrigo," Alessandria, Italy
| | - Elisabetta Ferrero
- Oncology and Hematology Day Hospital, Azienda Ospedaliera "SS. Antonio e Biagio e Cesare Arrigo," Alessandria, Italy
| | - Claudia Gnani
- SC General Medicine, Ospedale S. Spirito, ASL AL, Casale Monferrato, Italy
| | - Giuseppe Riili
- SC Oncology, Ospedale S. Spirito, ASL AL, Casale Monferrato, Italy
| | - Antonio Maconi
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), Azienda Ospedaliera "SS. Antonio e Biagio e Cesare Arrigo," Alessandria, Italy
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Franzoi IG, Sauta MD, Bonafede M, Francioso G, De Luca A, Barbagli F, Granieri A. Psychological Distress in Patients With Asbestos-Related Diseases and Their Families: A Systematic Literature Review. Psychooncology 2025; 34:e70051. [PMID: 39776006 PMCID: PMC11707407 DOI: 10.1002/pon.70051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 11/08/2024] [Accepted: 12/09/2024] [Indexed: 01/11/2025]
Abstract
BACKGROUND Exposure to asbestos in the workplace is currently recognized as one of the leading causes of work-related deaths, with more than half of deaths attributable to cancer. AIMS The aim of this systematic literature review was to investigate the mental health and psychological distress of patients affected by asbestos-related diseases and their caregivers. METHODS The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The studies were identified in October 2023 by searching four electronic databases: Scopus, Web of Science, PubMed and PsycInfo/PsycArtcicles. Risk of bias was assessed using the JBI checklist. RESULTS Fourteen articles were identified. The studies focused exclusively on the psychological distress of patients with malignant mesothelioma (MM) and their caregivers. MM appears to have traumatic effects on both patients and caregivers, who may experience anxiety and depression, an impoverished emotional life, somatization, social withdrawal, and a deterioration in their quality of life. In addition, a need for information about MM, its progression and associated care tasks was identified, and patients and caregivers reported frequently seeking information from online sources. CONCLUSIONS Our review has shown that there are still few studies addressing psychological distress in MM patients and their caregivers, and none addressing distress in the context of other asbestos-related diseases. The somatopsychic consequences of MM in patients and caregivers should encourage institutions and health professionals to develop assessment and intervention models that are tailored to the specific suffering and needs of MM patients and their caregivers and promote their residual vitality.
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Affiliation(s)
| | | | - Michela Bonafede
- Epidemiology and Hygiene DepartmentOccupational and Environmental MedicineItalian Workers' Compensation Authority (INAIL)RomeItaly
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Lond B, Apps L, Quincey K, Williamson I. The psychological impact of living with peritoneal mesothelioma: An interpretative phenomenological analysis. J Health Psychol 2024:13591053241298932. [PMID: 39584559 DOI: 10.1177/13591053241298932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2024] Open
Abstract
Peritoneal mesothelioma is a rare life-limiting cancer that is likely to have an extremely negative impact on mental health; however, no studies to date have explored the impact and needs of those living with the condition. Ten individuals diagnosed with peritoneal mesothelioma (eight women, two men) participated in interviews and could share and discuss photographs to convey their illness experiences. Data analysis was informed by 'Interpretative Phenomenological Analysis'. Two themes are presented: 'Experiences of Care' and 'Psychological Distress'. Individuals experienced a lengthy diagnostic journey with little follow-up support. Women also reported negative impacts on body image due to abdominal swelling and scaring, diminished sexual ability and loss of fertility. Individuals recalled vivid feelings of anxiety and post-traumatic stress, and tried to cope by compartmentalising their fears and modifying diets. These findings demonstrate the need to further signpost services, help individuals manage gendered issues, and alleviate feelings of anxiety.
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Plummer R, Greystoke A, Naylor G, Sarker D, Anam ANMK, Prenen H, Teuwen LA, Van Cutsem E, Dekervel J, Haugk B, Ness T, Bhoi S, Jensen M, Morris T, Baumann P, Sjögren N, Tunblad K, Wallberg H, Öberg F, Evans TRJ. A Phase 1a/1b Study of Fostroxacitabine Bralpamide (Fostrox) Monotherapy in Hepatocellular Carcinoma and Solid Tumor Liver Metastases. J Hepatocell Carcinoma 2024; 11:2033-2047. [PMID: 39469286 PMCID: PMC11514655 DOI: 10.2147/jhc.s481410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 10/11/2024] [Indexed: 10/30/2024] Open
Abstract
Purpose To evaluate safety, preliminary efficacy, pharmacokinetics, and pharmacodynamics, of fostroxacitabine bralpamide (fostrox, MIV-818), a novel oral troxacitabine nucleotide prodrug designed to direct exposure to the liver, while minimizing systemic toxicity. Patients and Methods Fostrox monotherapy was administered in an open-label, single-arm, first-in-human, phase 1a/1b study, in patients with hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma, or solid tumor liver metastases. The first part (1a) consisted of intra/inter-patient escalating doses (3 mg to 70 mg) QD for up to 5 days, and the second part (1b), doses of 40 mg QD for 5 days, in 21-day cycles. Safety and tolerability were evaluated by the Safety Review Committee, and efficacy was assessed every 6 weeks with CT or MRI using RECIST 1.1 and mRECIST. Results Nineteen patients were treated with fostrox. Most common adverse events (AEs) were hematological and increased AST. Grade 3 treatment related AEs (TRAE) were seen in 53% of the patients, with transient neutropenia and thrombocytopenia as the most common. No grade 5 AE was observed. Recommended Phase 2 dose of fostrox was 40 mg QD for 5 days in 21-day cycles. Preliminary efficacy showed a clinical benefit rate in the liver of 53% and stable disease (SD) as best response in 10 patients. Liver targeting with fostrox was confirmed with higher exposure of troxacitabine and its metabolites in liver compared to plasma. Systemic exposure of fostrox was generally low with troxacitabine as main analyte. Biopsies demonstrated tumor-selective, drug-induced DNA damage. Conclusion The phase 1a/1b monotherapy study of fostrox, in patients with liver tumors, showed a tumor selective effect in the liver and that 40 mg QD for 5 days in 21-day cycles is safe and tolerable. Safety and preliminary efficacy in patients with advanced HCC supports clinical development of fostrox in combination with other modes of action in HCC.
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Affiliation(s)
- Ruth Plummer
- Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Alastair Greystoke
- Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Gregory Naylor
- Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow, UK
| | - Debashis Sarker
- School of Cancer and Pharmaceutical Sciences, King’s College London, London, UK
- Department of Medical Oncology, Guy’s Hospital, London, UK
| | | | - Hans Prenen
- Department of Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Laure-Anne Teuwen
- Department of Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Eric Van Cutsem
- Department of Oncology, University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium
| | - Jeroen Dekervel
- Department of Oncology, University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium
| | - Beate Haugk
- Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Thomas Ness
- Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
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Adhikary G, Shrestha S, Naselsky W, Newland JJ, Chen X, Xu W, Emadi A, Friedberg JS, Eckert RL. Mesothelioma cancer cells are glutamine addicted and glutamine restriction reduces YAP1 signaling to attenuate tumor formation. Mol Carcinog 2023; 62:438-449. [PMID: 36562471 PMCID: PMC10071591 DOI: 10.1002/mc.23497] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/18/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022]
Abstract
Glutamine addiction is an important phenotype displayed in some types of cancer. In these cells, glutamine depletion results in a marked reduction in the aggressive cancer phenotype. Mesothelioma is an extremely aggressive disease that lacks effective therapy. In this study, we show that mesothelioma tumors are glutamine addicted suggesting that glutamine depletion may be a potential therapeutic strategy. We show that glutamine restriction, by removing glutamine from the medium or treatment with inhibitors that attenuate glutamine uptake (V-9302) or conversion to glutamate (CB-839), markedly reduces mesothelioma cell proliferation, spheroid formation, invasion, and migration. Inhibition of the SLC1A5 glutamine importer, by knockout or treatment with V-9302, an SLC1A5 inhibitor, also markedly reduces mesothelioma cell tumor growth. A relationship between glutamine utilization and YAP1/TEAD signaling has been demonstrated in other tumor types, and the YAP1/TEAD signaling cascade is active in mesothelioma cells and drives cell survival and proliferation. We therefore assessed the impact of glutamine depletion on YAP1/TEAD signaling. We show that glutamine restriction, SLC1A5 knockdown/knockout, or treatment with V-9302 or CB-839, reduces YAP1 level, YAP1/TEAD-dependent transcription, and YAP1/TEAD target protein (e.g., CTGF, cyclin D1, COL1A2, COL3A1, etc.) levels. These changes are observed in both cells and tumors. These findings indicate that mesothelioma is a glutamine addicted cancer, show that glutamine depletion attenuates YAP1/TEAD signaling and tumor growth, and suggest that glutamine restriction may be useful as a mesothelioma treatment strategy.
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Affiliation(s)
- Gautam Adhikary
- Department of Biochemistry and Molecular Biology University of Maryland School of Medicine
| | - Suruchi Shrestha
- Department of Biochemistry and Molecular Biology University of Maryland School of Medicine
| | - Warren Naselsky
- Department of Surgery University of Maryland School of Medicine
| | - John J. Newland
- Department of Surgery University of Maryland School of Medicine
| | - Xi Chen
- Department of Biochemistry and Molecular Biology University of Maryland School of Medicine
| | - Wen Xu
- Department of Biochemistry and Molecular Biology University of Maryland School of Medicine
| | - Ashkan Emadi
- Department of Medicine University of Maryland School of Medicine
- The Marlene and Stewart Greenebaum Comprehensive Cancer Center University of Maryland School of Medicine
| | - Joseph S. Friedberg
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University
| | - Richard L. Eckert
- Department of Biochemistry and Molecular Biology University of Maryland School of Medicine
- Department of Dermatology University of Maryland School of Medicine
- The Marlene and Stewart Greenebaum Comprehensive Cancer Center University of Maryland School of Medicine
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Multifactorial Evaluation following Cytoreductive Surgery for Malignant Pleural Mesothelioma in Patients with High Symptom-Burden. J Clin Med 2022; 11:jcm11216418. [DOI: 10.3390/jcm11216418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022] Open
Abstract
Mesothelioma has a scant prognosis and a great impact on symptoms and the quality of life. Pleurectomy/decortication and extrapleural pneumonectomy are the two cytoreductive surgical strategies, with different invasiveness, but achieving similar oncological results. Hereafter, the two surgical procedures effects on symptoms and the quality of life are compared in a high symptom-burden population. Between 2003 and 2017, 55 consecutive patients underwent pleurectomy/decortication (n = 26) or extrapleural pneumonectomy (n = 29), both followed by adjuvant chemo-radiotherapy. Cardio-pulmonary function, symptoms and the quality of life (Short-Form-36 and St.George’s questionnaires) were evaluated pre- and 3-, 6-, 12- and 24-months postoperatively. Extrapleural pneumonectomy demonstrated lower pain at 12 months but a higher decrement of forced vital capacity at 24 months than pleurectomy/decortication. Both procedures revealed a 3-months improvement of many symptoms and the quality of life determinants. Improvement in physical, social and pain-related measured parameters lasted for a longer time-spawn in the extrapleural pneumonectomy group. No differences were found in chemotherapy compliance and survival between groups. Age-at-presentation (p = 0.02) and non-epitheliod histology (p = 0.10) were the only significant prognosticators. Surgery, despite poor survival results, improved symptoms and the quality of life in patients with mesothelioma with high symptom-burden at diagnosis. Therefore, extrapleural pneumonectomy demonstrated the most durable effects.
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Breen LJ, Huseini T, Same A, Peddle-McIntyre CJ, Lee YCG. Living with mesothelioma: A systematic review of patient and caregiver psychosocial support needs. PATIENT EDUCATION AND COUNSELING 2022; 105:1904-1916. [PMID: 35260259 DOI: 10.1016/j.pec.2022.02.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Practice guidelines emphasize the importance of investigating psychosocial distress in mesothelioma patients and family caregivers. We aimed to synthesize research on the psychosocial support needs of mesothelioma patients and their family caregivers. METHODS We conducted a systematic review with a narrative synthesis and quality assessment. The review process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS MEDLINE, EMBASE, Scopus, PsychArticles, and PsycINFO were searched until December 2020 and 37 studies in English met inclusion criteria. Most (n = 24) included mesothelioma patients as a very small proportion of their cancer samples. A narrative synthesis was conducted on the 13 studies including only mesothelioma patients (n = 297) and/or caregivers (n = 82). Patients and caregivers want improvements in the diagnosis delivery and access to palliative care. Patients want emotional support, patient-centered treatment, improved information about illness progression and death, and to meet others with mesothelioma. Caregivers want one-on-one practical and emotional support. Study quality varied. CONCLUSIONS Few studies focus on the psychosocial support needs relevant to mesothelioma. Mesothelioma patients and family caregivers highlight targeted psychosocial care as an unmet need. PRACTICE IMPLICATIONS Efforts are required to design and test psychosocial interventions for this vulnerable and overlooked group. PROTOCOL REGISTRATION PROSPERO (registration number CRD42020167852).
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Affiliation(s)
- Lauren J Breen
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Taha Huseini
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Anne Same
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Carolyn J Peddle-McIntyre
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Y C Gary Lee
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; Centre for Respiratory Health, University of Western Australia, Perth, Western Australia, Australia
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Strøm L, Danielsen JT, Amidi A, Cardenas Egusquiza AL, Wu LM, Zachariae R. Sleep During Oncological Treatment - A Systematic Review and Meta-Analysis of Associations With Treatment Response, Time to Progression and Survival. Front Neurosci 2022; 16:817837. [PMID: 35516799 PMCID: PMC9063131 DOI: 10.3389/fnins.2022.817837] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/02/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction Disrupted sleep and sleep-wake activity are frequently observed in cancer patients undergoing oncological treatment. These disruptions are often associated with aggravated symptom burden and diminished health-related quality of life that in turn may compromise treatment adherence and, thus, effectiveness. In addition, disrupted sleep has been linked to carcinogenic processes, which ultimately could result in worse prognostic outcomes. Aims Our aim was to systematically review and conduct a meta-analysis of studies examining the associations between sleep and sleep-wake activity and prognostic outcomes in cancer patients undergoing oncological treatment. Methods A comprehensive systematic search of English language papers was undertaken in June 2020 using PubMed, The Cochrane Library, and CINAHL. Two reviewers independently screened 4,879 abstracts. A total of 26 papers were included in the narrative review. Thirteen papers reporting hazard ratios reflecting associations between a dichotomized predictor variable (sleep) and prognostic outcomes were subjected to meta-analysis. Results Nineteen of the 26 eligible studies on a total of 7,092 cancer patients reported associations between poorer sleep and poorer response to treatment, shorter time to progression, and/or reduced overall survival, but were highly heterogeneous with respect to the sleep and outcome parameters investigated. Meta-analysis revealed statistically significant associations between poor self-reported sleep and reduced overall survival (HR = 1.33 [95% CI 1.09-1.62], k = 11), and shorter time to progression (HR = 1.40 [95% CI 1.23-1.59], k = 3) and between poor objectively assessed sleep and reduced overall survival (HR = 1.74 [95% CI 1.05-2.88], k = 4). Conclusion The current findings indicate that disturbed sleep during treatment may be a relevant behavioral marker of poor cancer prognosis. The limited number of studies, the common use of single item sleep measures, and potential publication bias highlight the need for further high quality and longitudinal studies.
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Affiliation(s)
- Louise Strøm
- Unit for Psycho-Oncology and Health Psychology, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Josefine T. Danielsen
- Unit for Psycho-Oncology and Health Psychology, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Ali Amidi
- Unit for Psycho-Oncology and Health Psychology, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Ana Lucia Cardenas Egusquiza
- Department of Psychology and Behavioral Sciences, Center for Autobiographical Memory Research, Aarhus University, Aarhus, Denmark
| | - Lisa Maria Wu
- Unit for Psycho-Oncology and Health Psychology, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - Robert Zachariae
- Unit for Psycho-Oncology and Health Psychology, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
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9
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Koller M, Musoro JZ, Tomaszewski K, Coens C, King MT, Sprangers MA, Groenvold M, Cocks K, Velikova G, Flechtner HH, Bottomley A. Minimally important differences of EORTC QLQ-C30 scales in patients with lung cancer or malignant pleural mesothelioma – Interpretation guidance derived from two randomized EORTC trials. Lung Cancer 2022; 167:65-72. [DOI: 10.1016/j.lungcan.2022.03.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 12/09/2022]
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Hoon SN, Fyfe K, Peddle-McIntyre CJ, Bowyer S, Hawkins F, Jeffery E, Chih HJ, Creaney J, Nowak A, Brims F. Randomised placebo-controlled cross-over study examining the role of anamorelin in mesothelioma (The ANTHEM study): rationale and protocol. BMJ Open Respir Res 2021; 7:7/1/e000551. [PMID: 32213537 PMCID: PMC7173983 DOI: 10.1136/bmjresp-2019-000551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/31/2020] [Accepted: 02/09/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Cachexia is common in malignant mesothelioma (MM); half of patients have malnutrition and low skeletal muscle mass. Malnourished patients have worse quality of life (QoL). Weight loss is strongly associated with poor survival. Anamorelin is an oral ghrelin receptor agonist that improves appetite, body weight and QoL in advanced cancer. The aim of this study is to examine the efficacy of anamorelin in improving appendicular skeletal muscle mass (ASM) and patient-reported outcomes in patients with MM with cachexia. METHODS AND ANALYSIS A single-centre, phase II, randomised, placebo-controlled cross-over pilot study with 28-day treatment periods and 3-day washout. Forty patients will be randomised. Primary outcome is change in ASM relative to height measured by dual energy X-ray absorptiometry at end of period 1. Secondary outcomes include cancer-specific and cachexia-related QoL, objective physical activity, dietary intake and adverse events. Eligible patients will have confirmed MM, Eastern Cooperative Oncology Group 0-2, expected survival >3 months and cachexia (defined as >5% weight loss in 6 months or body mass index <20 kg/m2 with weight loss >2%). ETHICS AND DISSEMINATION Ethical approval has been granted. Results will be reported in peer-reviewed publications. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (U1111-1240-6828).
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Affiliation(s)
- Siao Nge Hoon
- Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Curtin Medical School, Curtin University, Perth, Western Australia, Australia
| | - Katrina Fyfe
- Curtin Medical School, Curtin University, Perth, Western Australia, Australia.,Institute of Respiratory Health, Nedlands, Western Australia, Australia
| | - Carolyn J Peddle-McIntyre
- Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Institute of Respiratory Health, Nedlands, Western Australia, Australia.,Exercise Medicine Research Institute, Edith Cowan University-Joondalup Campus, Joondalup, Western Australia, Australia
| | - Samantha Bowyer
- Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Felicity Hawkins
- Palliative Care, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Emily Jeffery
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Hui Jun Chih
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Jenette Creaney
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Anna Nowak
- Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Fraser Brims
- Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia .,Curtin Medical School, Curtin University, Perth, Western Australia, Australia.,Institute of Respiratory Health, Nedlands, Western Australia, Australia
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Switch-maintenance gemcitabine after first-line chemotherapy in patients with malignant mesothelioma (NVALT19): an investigator-initiated, randomised, open-label, phase 2 trial. THE LANCET RESPIRATORY MEDICINE 2021; 9:585-592. [PMID: 33515500 DOI: 10.1016/s2213-2600(20)30362-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/09/2020] [Accepted: 07/17/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Almost all patients with malignant mesothelioma eventually have disease progression after first-line therapy. Previous studies have investigated maintenance therapy, but none has shown a great effect. We aimed to assess the efficacy and safety of switch-maintenance gemcitabine in patients with malignant mesothelioma without disease progression after first-line chemotherapy. METHODS We did a randomised, open-label, phase 2 trial in 18 hospitals in the Netherlands (NVALT19). We recruited patients aged older than 18 years with unresectable malignant mesothelioma with no evidence of disease progression after at least four cycles of first-line chemotherapy (with platinum and pemetrexed), who had a WHO performance status of 0-2, adequate organ function, and measurable or evaluable disease. Exclusion criteria were active uncontrolled infection or severe cardiac dysfunction, serious disabling conditions, symptomatic CNS metastases, radiotherapy within 2 weeks before enrolment, and concomitant use of any other drugs under investigation. Patients were randomly assigned (1:1), using the minimisation method, to maintenance intravenous gemcitabine (1250 mg/m2 on days 1 and 8, in cycles of 21 days) plus supportive care, or to best supportive care alone, until disease progression, unacceptable toxicity, serious intercurrent illness, patient request for discontinuation, or need for any other anticancer agent, except for palliative radiotherapy. A CT scan of the thorax or abdomen (or both) and pulmonary function tests were done at baseline and repeated every 6 weeks. The primary outcome was progression-free survival in the intention-to-treat population. Safety was analysed in all participants who received one or more doses of the study drug or had at least one visit for supportive care. Recruitment is now closed; treatment and follow-up are ongoing. This study is registered with the Netherlands Trial Registry, NTR4132/NL3847. FINDINGS Between March 20, 2014, and Feb 27, 2019, 130 patients were enrolled and randomly assigned to gemcitabine plus supportive care (65 patients [50%]) or supportive care alone (65 patients [50%]). No patients were lost to follow-up; median follow-up was 36·5 months (95% CI 34·2 to not reached), and one patient in the supportive care group withdrew consent. Progression-free survival was significantly longer in the gemcitabine group (median 6·2 months [95% CI 4·6-8·7]) than in the supportive care group (3·2 months [2·8-4·1]; hazard ratio [HR] 0·48 [95% CI 0·33-0·71]; p=0·0002). The benefit was confirmed by masked independent central review (HR 0·49 [0·33-0·72]; p=0·0002). Grade 3-4 adverse events occurred in 33 (52%) of 64 patients in the gemcitabine group and in ten (16%) of 62 patients in the supportive care group. The most frequent adverse events were anaemia, neutropenia, fatigue or asthenia, pain, and infection in the gemcitabine group, and pain, infection, and cough or dyspnoea in the supportive care group. One patient (2%) in the gemcitabine group died, due to a treatment-related infection. INTERPRETATION Switch-maintenance gemcitabine, after first-line chemotherapy, significantly prolonged progression-free survival compared with best supportive care alone, among patients with malignant mesothelioma. This study confirms the activity of gemcitabine in treating malignant mesothelioma. FUNDING Dutch Cancer Society (Koningin Wilhelmina Fonds voor de Nederlandse Kankerbestrijding) and Stichting NVALT studies.
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12
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Hoon SN, Lawrie I, Qi C, Rahman N, Maskell N, Forbes K, Gerry S, Monterosso L, Chauhan A, Brims FJH. Symptom Burden and Unmet Needs in Malignant Pleural Mesothelioma: Exploratory Analyses From the RESPECT-Meso Study. J Palliat Care 2020; 36:113-120. [PMID: 32791881 DOI: 10.1177/0825859720948975] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Malignant Pleural Mesothelioma (MPM) has a poor prognosis and high symptom burden. RESPECT-Meso was a multicenter randomized study examining the role of early specialist palliative care (SPC) on quality of life (QoL) with MPM. This is a post-hoc exploratory analysis of the symptom burden and unmet needs identified from RESPECT-Meso participants. METHODS Exploratory analysis from 174 participants using the General Health Status (GHS) measure (from the EORTC QLQ-C30 QoL questionnaire) and 87 participants using validated assessment questionnaires in those randomized to SPC. Eligibility for the study included confirmed MPM with diagnosis <6 weeks prior, performance score (PS) 0 or 1, no significant physical or psychological comorbidity. Cox proportional hazards models were derived to examine for relationships with survival. Free text was assessed using content analysis, looking for common themes and words. RESULTS Participants were predominantly male (79.9%), mean age 72.8 years, PS was 0 in 38%, 78% of MPM was epithelioid. At least 3 symptoms were reported in 69.8% of participants, including fatigue (81%), dyspnea (73.3%), pain (61.2%), weight loss (59.3%). Anxiety was reported by 54.7% of participants, 52.3% low mood and 48.8% anhedonia symptoms. After multivariable adjustment, only pain remained statistically significant with a hazard ratio (HR) 2.9 (95% CI 1.3-6.7; p = 0.01). For each 1 unit increase in GHS score, the HR for death was 0.987 (0.978-0.996; p = 0.006), indicating a worse reported QoL is related to shorter survival. Unmet needs were common: 25.9% wanted more information about their condition, 24.7% about their care and 21.2% about their treatment. 79.1% were concerned about the effect of their illness on family. CONCLUSION There is a high symptom burden in mesothelioma despite good baseline performance status. A worse QoL is associated with a worse survival. Unmet needs are common, perhaps highlighting a need for improved communication and information sharing.
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Affiliation(s)
- Siao Nge Hoon
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Curtin Medical School, 1649Curtin University, Perth, Western Australia, Australia
| | - Iain Lawrie
- Department of Palliative Medicine, North Manchester General Hospital, Manchester, United Kingdom.,Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Cathy Qi
- Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - Najib Rahman
- Oxford Respiratory Trials Unit, University of Oxford, Oxford, United Kingdom.,National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Nick Maskell
- Department of Respiratory Medicine, University of Bristol, Bristol, United Kingdom
| | - Karen Forbes
- Department of Palliative Medicine, University of Bristol, Bristol, United Kingdom
| | - Stephen Gerry
- Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - Leanne Monterosso
- School of Nursing and Midwifery, University of Notre Dame, Fremantle, Australia.,School of Nursing and Midwifery, Edith Cowan University.,St John of God Murdoch Hospital, Murdoch, Australia
| | - Anoop Chauhan
- Department of Respiratory Medicine, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom.,Research & Innovation Department, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom.,School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, United Kingdom
| | - Fraser J H Brims
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Curtin Medical School, 1649Curtin University, Perth, Western Australia, Australia
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13
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Sim JA, Kim YA, Kim JH, Lee JM, Kim MS, Shim YM, Zo JI, Yun YH. The major effects of health-related quality of life on 5-year survival prediction among lung cancer survivors: applications of machine learning. Sci Rep 2020; 10:10693. [PMID: 32612283 PMCID: PMC7329866 DOI: 10.1038/s41598-020-67604-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 06/01/2020] [Indexed: 01/11/2023] Open
Abstract
The primary goal of this study was to evaluate the major roles of health-related quality of life (HRQOL) in a 5-year lung cancer survival prediction model using machine learning techniques (MLTs). The predictive performances of the models were compared with data from 809 survivors who underwent lung cancer surgery. Each of the modeling technique was applied to two feature sets: feature set 1 included clinical and sociodemographic variables, and feature set 2 added HRQOL factors to the variables from feature set 1. One of each developed prediction model was trained with the decision tree (DT), logistic regression (LR), bagging, random forest (RF), and adaptive boosting (AdaBoost) methods, and then, the best algorithm for modeling was determined. The models' performances were compared using fivefold cross-validation. For feature set 1, there were no significant differences in model accuracies (ranging from 0.647 to 0.713). Among the models in feature set 2, the AdaBoost and RF models outperformed the other prognostic models [area under the curve (AUC) = 0.850, 0.898, 0.981, 0.966, and 0.949 for the DT, LR, bagging, RF and AdaBoost models, respectively] in the test set. Overall, 5-year disease-free lung cancer survival prediction models with MLTs that included HRQOL as well as clinical variables improved predictive performance.
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Affiliation(s)
- Jin-Ah Sim
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea
| | - Young Ae Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Ju Han Kim
- Department of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Mog Lee
- Center for Lung Cancer, National Cancer Center, Goyang, Korea
| | - Moon Soo Kim
- Center for Lung Cancer, National Cancer Center, Goyang, Korea
| | - Young Mog Shim
- Lung and Esophageal Cancer Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Seoul, Korea
| | - Jae Ill Zo
- Lung and Esophageal Cancer Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Seoul, Korea
| | - Young Ho Yun
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea.
- Department of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea.
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea.
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14
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Kawata AK, Lenderking WR, Eseyin OR, Kerstein D, Huang J, Huang H, Zhang P, Lin HM. Converting EORTC QLQ-C30 scores to utility scores in the brigatinib ALTA study. J Med Econ 2019; 22:924-935. [PMID: 31125274 DOI: 10.1080/13696998.2019.1624080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Aims: Health utilities summarize a patient's overall health status. This study estimated utilities based on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (QLQ-C30), a widely used measure of health-related quality-of-life (HRQoL) in oncology, using published mapping algorithms. Materials and methods: Data were from the Anaplastic Lymphoma Kinase (ALK) in Lung Cancer Trial of brigatinib (ALTA; NCT02094573), an open-label, international, phase 2 study. ALTA evaluated the efficacy and safety of two randomized dosing regimens of brigatinib in patients with locally advanced or metastatic ALK + non-small cell lung cancer (NSCLC) that had progressed on prior therapy with crizotinib. QLQ-C30 scores were mapped to European Quality-of-Life-5 Dimensions (EQ-5D) utility scores using two published algorithms (Khan et al. for EQ-5D-5L; Longworth et al. for EQ-5D-3L). The impact of brigatinib treatment on health utilities over time was assessed. Results: The analysis included 208 subjects. Mean baseline utility scores for both algorithms ranged between 0.60 - 0.71 and increased to 0.78 by cycle 5. Utility improvements were sustained during most of the treatment, before disease progression. Minor variations were observed between utility scores; Khan et al. estimates were approximately 0.01 or 0.02 points lower than Longworth et al. estimates. Limitations: Algorithms considered were limited to those available in the published literature at the time of the study. This utility analysis was exploratory, and the ALTA trial did not include an internal control group (i.e. standard of care) and was not powered to detect differences in QoL/utility outcomes between treatment arms. Conclusions: Converting QLQ-C30 scores into utilities in trials using established mapping algorithms can improve evaluation of medicines from the patient perspective. Both algorithms suggested that brigatinib improved health utility in crizotinib-refractory ALK + NSCLC patients, and improvements were maintained during most of the treatment. Clinicaltrials.gov identifier: NCT02094573.
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Affiliation(s)
| | | | | | - David Kerstein
- b Millennium Pharmaceuticals, Inc , Cambridge , MA , USA , a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Joice Huang
- b Millennium Pharmaceuticals, Inc , Cambridge , MA , USA , a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Hui Huang
- b Millennium Pharmaceuticals, Inc , Cambridge , MA , USA , a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Pingkuan Zhang
- b Millennium Pharmaceuticals, Inc , Cambridge , MA , USA , a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
| | - Huamao M Lin
- b Millennium Pharmaceuticals, Inc , Cambridge , MA , USA , a wholly owned subsidiary of Takeda Pharmaceutical Company Limited
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15
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Lenderking WR, Lin H, Speck RM, Zhu Y, Huang H, Huang J, Kerstein D, Langer CJ. Patient-reported outcomes and quality of life in advanced ALK+ non-small-cell lung cancer trial of brigatinib (ALTA). Future Oncol 2019; 15:2841-2855. [DOI: 10.2217/fon-2019-0185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Aim: Patient-reported outcomes (PRO) can support clinically relevant primary end points. Materials & methods: The ALTA trial, an open-label, Phase II, randomized dose-comparison study, evaluated the safety and efficacy of brigatinib in ALK+ non-small-cell lung cancer. PRO data collection included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (QLQ-C30). A linear mixed model for repeated measures was used to analyze change from baseline in the Global Health Status/Quality of Life subscale (GHS/QOL), with a change of greater than or equal to ten points deemed meaningful. Results: Improvement in mean GHS/QOL scores was statistically significant in the majority of treatment cycles; <10% of patients experienced a meaningful worsening of their GHS/QOL and symptom scores. Conclusion: PRO-measured benefits are consistent with objective response benefits associated with brigatinib.
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Affiliation(s)
| | - Huamao Lin
- Global Outcomes Research Oncology, Millennium Pharmaceuticals, Inc., Cambridge, MA, 02139, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
| | - Rebecca M Speck
- Division of Patient-Centered Research, Evidera, Bethesda, MD 20814, USA
| | - Yanyan Zhu
- Global Outcomes Research Oncology, Millennium Pharmaceuticals, Inc., Cambridge, MA, 02139, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
| | - Hui Huang
- Global Outcomes Research Oncology, Millennium Pharmaceuticals, Inc., Cambridge, MA, 02139, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
| | - Joice Huang
- Global Outcomes Research Oncology, Millennium Pharmaceuticals, Inc., Cambridge, MA, 02139, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
| | - David Kerstein
- Global Outcomes Research Oncology, Millennium Pharmaceuticals, Inc., Cambridge, MA, 02139, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
| | - Corey J Langer
- Global Outcomes Research Oncology, Millennium Pharmaceuticals, Inc., Cambridge, MA, 02139, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
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16
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Mendoza TR, Williams LA, Keating KN, Siegel J, Elbi C, Nowak AK, Hassan R, Cuffel B, Cleeland CS. Evaluation of the psychometric properties and minimally important difference of the MD Anderson Symptom Inventory for malignant pleural mesothelioma (MDASI-MPM). J Patient Rep Outcomes 2019; 3:34. [PMID: 31209661 PMCID: PMC6579804 DOI: 10.1186/s41687-019-0122-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/05/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Symptom assessment requires psychometrically validated questionnaires that are easy to use, relevant to the disease, and quick to administer. The MD Anderson Symptom Inventory for malignant pleural mesothelioma (MDASI-MPM) was adapted from the general (core) MDASI to assess the severity of cancer-related and treatment-related symptoms specific to patients with this condition. The MDASI-MPM includes the 13 core MDASI symptoms, which are experienced by most cancer patients, and 6 MPM-specific items developed via qualitative interviewing, a method favored by the US Food and Drug Administration for instrument item generation and development. Qualitative interviewing that summarizes the item generation and development for the MDASI-MPM is detailed in a separate report. The psychometric study reported here was the next step in developing the validation dossier for the MDASI-MPM. RESULTS In this secondary analysis of data from a Phase II trial, 248 patients provided MDASI-MPM data at multiple timepoints during therapy. Over time, fatigue, pain, shortness of breath, feeling of malaise, and muscle weakness were consistently the worst symptoms reported; symptoms interfered most with work and general activity and least with relations with others. Cronbach coefficient alpha values for all MDASI-MPM subscales were at least 0.88 at baseline and 0.91 during treatment, indicating good internal consistency reliability. Intraclass correlations of at least 0.86 for all MDASI-MPM subscales administered a cycle apart (n = 82) were indicative of good test-retest reliability. Correlations between MDASI-MPM subscales and LCSS-Meso scores were at least 0.70 (P < 0.001 for all comparisons). Patients with good performance status had significantly lower scores than did patients with poor performance status (all P < 0.05), supporting evidence for known-group validity and sensitivity. Effect-size differences were 0.69 and higher, indicating medium-to-large effects. The minimally important difference in the MDASI-MPM subscales ranged from 1.0 to 1.5 points on a 0-10 scale. CONCLUSIONS Symptoms specific to a particular cancer, treatment method, or treatment site can be added to the core MDASI to create a tailored, "fit for purpose" instrument. We found the MDASI-MPM to be a valid, reliable, and responsive (sensitive) instrument for assessing the severity of symptoms of patients with MPM and their interference in patients' daily functioning.
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Affiliation(s)
- Tito R Mendoza
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA.
| | - Loretta A Williams
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA
| | - Karen N Keating
- Bayer HealthCare Pharmaceuticals, 100 Bayer Boulevard, Whippany, NJ, 07981, USA
| | - Jonathan Siegel
- Bayer HealthCare Pharmaceuticals, 100 Bayer Boulevard, Whippany, NJ, 07981, USA
| | - Cem Elbi
- Bayer HealthCare Pharmaceuticals, 100 Bayer Boulevard, Whippany, NJ, 07981, USA
| | - Anna K Nowak
- Faculty of Health and Medical Sciences, UWA Medical School, The University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia
| | - Raffit Hassan
- Thoracic and Gastrointestinal Malignancies Branch, NCI/CCR, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Brian Cuffel
- Bayer HealthCare Pharmaceuticals, 100 Bayer Boulevard, Whippany, NJ, 07981, USA
| | - Charles S Cleeland
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA
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17
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Eberst G, Anota A, Scherpereel A, Mazieres J, Margery J, Greillier L, Audigier-Valette C, Moro-Sibilot D, Molinier O, Léna H, Rivière F, Monnet I, Gounant V, Janicot H, Gervais R, Locher C, Charton E, Morin F, Zalcman G, Westeel V. Health-Related Quality of Life Impact from Adding Bevacizumab to Cisplatin-Pemetrexed in Malignant Pleural Mesothelioma in the MAPS IFCT-GFPC-0701 Phase III Trial. Clin Cancer Res 2019; 25:5759-5765. [DOI: 10.1158/1078-0432.ccr-18-2860] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/18/2019] [Accepted: 06/04/2019] [Indexed: 11/16/2022]
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18
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Warby A, Dhillon HM, Kao S, Vardy JL. A survey of patient and caregiver experience with malignant pleural mesothelioma. Support Care Cancer 2019; 27:4675-4686. [PMID: 30944991 DOI: 10.1007/s00520-019-04760-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 03/19/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) is a rare cancer with poor prognosis. As there is little information on the lived experience of MPM, our aim was to document the experience of MPM patients and their caregivers. METHODS Surveys for MPM patients and caregivers were developed from previous interviews with patients, caregivers, and health professionals, about treatments and decision-making. Participants were recruited from two hospitals, government compensation body, and support groups. RESULTS Survey responses were received from 78 MPM patients and 106 caregivers from January to September 2014. PATIENTS 85% male, median age 69 years, median time since diagnosis 15 months. Caregivers: median age 68, 91% female, 90% spouse of MPM patient, 95% bereaved. Most participants felt informed about treatment options but only 69% thought all treatment options were discussed. Chemotherapy was discussed most frequently (92-95%); ~80% had sufficient information for decision-making. Decision regarding chemotherapy was made by patient considering doctor's opinion (24%), doctor and patient equally (18%), and doctor (17%). Participants 'agreed'/'strongly agreed' that they made the right decision about chemotherapy (patients 81%, caregivers 60%), but 5% and 16%, respectively, regretted the decision. Most participants received 'sufficient' support (71%). A quarter reported seeing cancer nurse specialists. Palliative care referral: 31% patients, 85% caregivers. Caregivers would have liked to talk to someone by themselves (41%), more time with doctors (30%), psychological support (29%), and clearer information (31%). Bereaved caregivers requested grief counselling (39%) and post-death consultation with specialists (23-25%). CONCLUSIONS Satisfaction with treatment was high, but participants identified need for improved communication and quality information, discussion about all treatments, end-of-life assistance, and caregiver support after the patient's death.
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Affiliation(s)
- Anne Warby
- Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, Sydney, NSW, 2006, Australia.,Asbestos Diseases Research Institute, Bernie Banton Centre, Gate 3, Hospital Rd., Concord, NSW, 2139, Australia
| | - Haryana M Dhillon
- Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Steven Kao
- Asbestos Diseases Research Institute, Bernie Banton Centre, Gate 3, Hospital Rd., Concord, NSW, 2139, Australia.,Chris O'Brien Lifehouse, 119-143 Missenden Rd, Camperdown, NSW, 2050, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Janette L Vardy
- Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, Sydney, NSW, 2006, Australia. .,Asbestos Diseases Research Institute, Bernie Banton Centre, Gate 3, Hospital Rd., Concord, NSW, 2139, Australia. .,Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia. .,Concord Cancer Centre, Concord Repatriation General Hospital, Hospital Rd., Concord, NSW, 2139, Australia.
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19
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Warby A, Dhillon HM, Kao S, Vardy JL. Managing malignant pleural mesothelioma: experience and perceptions of health care professionals caring for people with mesothelioma. Support Care Cancer 2019; 27:3509-3519. [PMID: 30684047 DOI: 10.1007/s00520-019-4648-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/14/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) has a poor prognosis and heavy symptom burden. Here, we investigate health professionals' attitudes to management and decision-making in people with MPM. METHODS Survey questions were based on previous interviews with health professionals, MPM patients, and caregivers. Surveys were sent to specialist doctors and nurses who treat MPM. RESULTS Surveys were completed by 107 doctors and 19 nurses from January-September 2014. Most doctors were respiratory physicians (50%) or medical oncologists (35%). Overall, 90% of doctors estimated > 10% of eligible MPM patients did not receive chemotherapy; 43% estimated the rate was > 20%. Doctors believed clinical barriers to chemotherapy were clinician nihilism (70%); non-referral to medical oncology (49%); and lack of specialists in rural/regional areas (44%). Nurses perceived barriers as follows: delayed diagnosis (74%); non-referral to medical oncology (63%); lack of clinician knowledge (58%). Patient-related barriers were negative perception of chemotherapy (83%) and belief survival benefit not worthwhile (63%). Doctors' preference in decision-making was for the patient to make the decision while strongly considering the doctor's opinion (33%); equally with the doctor (29%); and using knowledge gained (23%). Nurses described their roles as providing patient support (100%); information (95%); intermediary (74%); and link to palliative care (74%). Overall, 95% believed they enabled better resource allocation and provided patients with holistic care (95%); clearer communication (89%); more time (89%); additional information (89%); timely referrals (89%). CONCLUSIONS Caring for patients with MPM is challenging and complex. Health care professionals believe under-utilisation of chemotherapy is occurring, primarily due to clinician nihilism and lack of medical oncology referral.
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Affiliation(s)
- Anne Warby
- Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, Sydney, NSW, 2006, Australia
- Asbestos Diseases Research Institute, Bernie Banton Centre, Gate 3, Hospital Rd., Concord, NSW, 2139, Australia
| | - Haryana M Dhillon
- Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Steven Kao
- Asbestos Diseases Research Institute, Bernie Banton Centre, Gate 3, Hospital Rd., Concord, NSW, 2139, Australia
- Chris O'Brien Lifehouse, 119-143 Missenden Rd., Camperdown, NSW, 2050, Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Janette L Vardy
- Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, Sydney, NSW, 2006, Australia.
- Asbestos Diseases Research Institute, Bernie Banton Centre, Gate 3, Hospital Rd., Concord, NSW, 2139, Australia.
- Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia.
- Concord Cancer Centre, Concord Repatriation General Hospital, Hospital Rd, Concord, NSW, 2139, Australia.
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Brims F, Gunatilake S, Lawrie I, Marshall L, Fogg C, Qi C, Creech L, Holtom N, Killick S, Yung B, Cooper D, Stadon L, Cook P, Fuller E, Walther J, Plunkett C, Bates A, Mackinlay C, Tandon A, Maskell NA, Forbes K, Rahman NM, Gerry S, Chauhan AJ. Early specialist palliative care on quality of life for malignant pleural mesothelioma: a randomised controlled trial. Thorax 2019; 74:354-361. [DOI: 10.1136/thoraxjnl-2018-212380] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 11/29/2018] [Accepted: 12/10/2018] [Indexed: 12/25/2022]
Abstract
PurposeMalignant pleural mesothelioma (MPM) has a high symptom burden and poor survival. Evidence from other cancer types suggests some benefit in health-related quality of life (HRQoL) with early specialist palliative care (SPC) integrated with oncological services, but the certainty of evidence is low.MethodsWe performed a multicentre, randomised, parallel group controlled trial comparing early referral to SPC versus standard care across 19 hospital sites in the UK and one large site in Western Australia. Participants had newly diagnosed MPM; main carers were additionally recruited. Intervention: review by SPC within 3 weeks of allocation and every 4 weeks throughout the study. HRQoL was assessed at baseline and every 4 weeks with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30. Primary outcome: change in EORTC C30 Global Health Status 12 weeks after randomisation.ResultsBetween April 2014 and October 2016, 174 participants were randomised. There was no significant between group difference in HRQoL score at 12 weeks (mean difference 1.8 (95% CI −4.9 to 8.5; p=0.59)). HRQoL did not differ at 24 weeks (mean difference −2.0 (95% CI −8.6 to 4.6; p=0.54)). There was no difference in depression/anxiety scores at 12 weeks or 24 weeks. In carers, there was no difference in HRQoL or mood at 12 weeks or 24 weeks, although there was a consistent preference for care, favouring the intervention arm.ConclusionThere is no role for routine referral to SPC soon after diagnosis of MPM for patients who are cared for in centres with good access to SPC when required.Trial registration numberISRCTN18955704.
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21
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Ben Bouazza Y, Van Meerbeeck JP. The use of patient-reported outcome measures (PROMs) in the management of malignant pleural mesothelioma: a descriptive literature survey. Transl Lung Cancer Res 2018; 7:507-515. [PMID: 30450288 DOI: 10.21037/tlcr.2018.07.08] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background Malignant pleural mesothelioma (MPM) remains a highly symptomatic and aggressive malignancy. The treatment options are for most patients limited to palliative chemotherapy and best supportive care. Therefore, the use of patient-reported outcome measures (PROMs) is recommended for the improvement of the quality of care. The aim of this literature survey is to provide an up to date review of the use of PROMs in mesothelioma. A concise comparison is made of the identified instruments. Methods We searched PubMed, Web of Science and Google Scholar for the use of PROMs in MPM. Quality of the study and risk of bias were assessed using the appraisal tools recommended by the Dutch Cochrane Center. Results A total of 31 articles on PROMs in MPM were identified that met the inclusion criteria and a total of 14 instruments. The instruments are categorized in generic (n=2), cancer-specific (n=4), lung cancer-specific (n=3), mesothelioma-specific (n=2) and symptom-specific (n=3). They were mostly used in clinical trials. Conclusions PROMs have the potential to improve the management of MPM. No particular instrument is specifically recommended, although there is a preference for patient-reported disease-specific instruments encompassing the concept of health-related quality of life (hrQoL) and relevant symptoms. Such instruments are the EORTC QLQ-LC13, LCSS-Meso and FACT-L, which measure the impact of malignant mesothelioma and its treatment on patients. Assessments should be made on baseline and post-treatment. The frequency of assessments should be further evaluated in this population.
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Affiliation(s)
| | - Jan P Van Meerbeeck
- Faculty of Medicine and Health Care, Antwerp University, Antwerpen, Belgium.,Department of Pulmonology, Department of Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium.,Multidisciplinary Oncological Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium
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22
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Williams LA, Whisenant MS, Mendoza TR, Haq S, Keating KN, Cuffel B, Cleeland CS. Modification of existing patient-reported outcome measures: qualitative development of the MD Anderson Symptom Inventory for malignant pleural mesothelioma (MDASI-MPM). Qual Life Res 2018; 27:3229-3241. [PMID: 30187393 DOI: 10.1007/s11136-018-1982-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2018] [Indexed: 11/12/2022]
Abstract
PURPOSE Malignant pleural mesothelioma (MPM) is an aggressive cancer of the lung pleura. The MD Anderson Symptom Inventory (MDASI) is a patient-reported outcome (PRO) measure of symptom burden, the combined impact of disease-related and treatment-related symptoms on functioning. Validated PRO measures may require modification for use in specific study populations. We sought to modify the MDASI for patients with MPM and create a fit-for-purpose symptom-burden measure for use in a clinical trial, according to US Food and Drug Administration guidance on PRO utilization to support labeling claims. METHODS A literature review for MPM symptoms was conducted. Patients with MPM were qualitatively interviewed about experiences of disease and treatment. Descriptive analysis identified symptoms and interference with functioning to define MPM-related symptom burden. An expert panel rated the relevance of identified symptoms to patients with MPM. Patients who received the investigational drug in a previous Phase I study were interviewed for drug-specific symptoms. RESULTS Literature review and interviews of 20 patients identified 31 MPM-related symptoms. A conceptual model of MPM-related symptom burden was developed. After expert-panel relevance review, five MPM-specific items and the 13 core MDASI symptoms met criteria for inclusion in a provisional MDASI-MPM for psychometric testing. Interviews with six patients identified six drug-specific symptoms; three were mentioned by multiple patients. Of these three, one was not in the core MDASI. CONCLUSIONS The MDASI-MPM has established content validity and, with the addition of one symptom item, is ready for psychometric testing as fit-for-purpose for a clinical trial of an investigational agent.
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Affiliation(s)
- Loretta A Williams
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA.
| | - Meagan S Whisenant
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA
| | - Tito R Mendoza
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA
| | - Shireen Haq
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA
| | - Karen N Keating
- Bayer HealthCare Pharmaceuticals, 100 Bayer Boulevard, Whippany, NJ, 07981, USA
| | - Brian Cuffel
- Bayer HealthCare Pharmaceuticals, 100 Bayer Boulevard, Whippany, NJ, 07981, USA
| | - Charles S Cleeland
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1450, Houston, TX, 77030, USA
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23
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Bonafede M, Ghelli M, Corfiati M, Rosa V, Guglielmucci F, Granieri A, Branchi C, Iavicoli S, Marinaccio A. The psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects: A systematic review of published studies. Am J Ind Med 2018; 61:400-412. [PMID: 29575036 DOI: 10.1002/ajim.22831] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND The purpose of this study is to present the results of a systematic review of published research that focuses on psychological aspects of malignant mesothelioma patients and asbestos-exposed people. METHODS Our research includes primary studies published between 1980 and 2016, using information from the Cochrane Library, the Psychology Behavioral Sciences Collection, PsychINFO, PubMed, PubGet, PubPsych, and Scopus, in compliance with PRISMA guidelines. RESULTS We identified 12 papers that investigated the psychological distress and care needs of mesothelioma patients, and nine papers for asbestos-exposed subjects. CONCLUSIONS This paper highlights the paucity of studies on the psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects. It confirms that malignant mesothelioma is associated with the physical, emotional, and social functioning of patients, while also suggesting that the risk of developing asbestos-related diseases among asbestos-exposed subjects is associated with high levels of psychological distress, despair, and mental health difficulties.
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Affiliation(s)
- Michela Bonafede
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | - Monica Ghelli
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | - Marisa Corfiati
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | - Valentina Rosa
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | | | | | - Claudia Branchi
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | - Sergio Iavicoli
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
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24
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Nagamatsu Y, Oze I, Aoe K, Hotta K, Kato K, Nakagawa J, Hara K, Kishimoto T, Fujimoto N. Quality of life of survivors of malignant pleural mesothelioma in Japan: a cross sectional study. BMC Cancer 2018; 18:350. [PMID: 29587685 PMCID: PMC5872515 DOI: 10.1186/s12885-018-4293-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/22/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Previous studies have indicated that people with malignant pleural mesothelioma (MPM) have a poor quality of life (QOL); however, information about the QOL of people with MPM in Japan is anecdotal. The aims of this study were to investigate the QOL of survivors of MPM in Japan and to determine the factors that correlate with their QOL. METHODS This was a cross sectional study. The included patients were those diagnosed with MPM in Japan. We created a self-administered questionnaire consisting of 64 questions. The questionnaires were sent to hospitals and patient advocacy groups, distributed to the patients, completed, and sent back to the researchers by postal mail. QOL was assessed with the European Organization for Research and Treatment of Cancer 16 questionnaire (QLQ) and the short version of the core domains of the Comprehensive Quality of Life Outcome questionnaire (CoQoLo). RESULTS In total, 133 questionnaires were collected. The QLQ assessments demonstrated that the survivors of MPM most frequently complained of fatigue, pain, sleep disturbances, and dyspnea. The symptom scales were acceptable, but the functional scales were significantly poorer for the patients with poor performance statuses (PSs). The short CoQoLo assessment was very unfavorable for 'Being free from physical pain.' Being a long-term survivor and a survivor with a poor PS were significantly correlated with poor global health status. CONCLUSIONS Survivors of MPM have impaired function, a variety of symptoms, and lower QOL. Survivors of MPM, even those in good physical condition, need broad support.
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Affiliation(s)
- Yasuko Nagamatsu
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashicho, Chuo-ku, Tokyo, 1040044, Japan
| | - Isao Oze
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chigusa-ku, Nagoya, 4648681, Japan
| | - Keisuke Aoe
- National Hospital Organization Yamaguchi-Ube Medical Center, Department of Medical Oncology, 685 Higashikiwa, Ube, 7550241, Japan
| | - Katsuyuki Hotta
- Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikatacho, Okayama, 7008558, Japan
| | - Katsuya Kato
- Department of Radiology, Kawasaki General Medical Center, 2-6-1 Nakasange, Okayama, 7008505, Japan
| | - Junko Nakagawa
- Department of Nursing, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Okayama, 7028055, Japan
| | - Keiko Hara
- Department of Nursing, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Okayama, 7028055, Japan
| | - Takumi Kishimoto
- Department of Medicine, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Okayama, 7028055, Japan
| | - Nobukazu Fujimoto
- Department of Medical Oncology, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Okayama, 7028055, Japan.
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25
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Hung HY, Wu LM, Chen KP. Determinants of Quality of Life in Lung Cancer Patients. J Nurs Scholarsh 2018; 50:257-264. [DOI: 10.1111/jnu.12376] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Hsiu-Yu Hung
- Registered Nurse, Division of Chest Department; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
| | - Li-Min Wu
- Associate Professor, School of Nursing, Kaohsiung Medical University, and Department of Medical Research; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
| | - Kang-Pan Chen
- Supervisor of Nursing Department; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
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26
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Guglielmucci F, Franzoi IG, Bonafede M, Borgogno FV, Grosso F, Granieri A. "The Less I Think About It, the Better I Feel": A Thematic Analysis of the Subjective Experience of Malignant Mesothelioma Patients and Their Caregivers. Front Psychol 2018; 9:205. [PMID: 29515509 PMCID: PMC5826294 DOI: 10.3389/fpsyg.2018.00205] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 02/07/2018] [Indexed: 12/13/2022] Open
Abstract
Aim: A cancer diagnosis-and in particular a Malignant Mesothelioma (MM) one-breaks the somatopsychic balance of the individual, compromising the quality of residual life and giving rise to many negative emotions difficult to integrate and to elaborate (such as depression, fears, anxieties, hopelessness, guilt, shame, and rage). Several national and international guidelines acknowledged the importance of evaluating psychological and socio-relational features in MM patients and their caregiver. However, only few studies have investigated the subjective experience of MM patients and even less research has focused on the caregivers' experience. Thus, the aim of the present study is to investigate the lived experience of both MM patients and their caregivers, providing an in-depth comprehension of the psychological sequelae of the disease. Materials and Methods: Within a psychoanalytically-informed conceptual framework, open-ended interviews were conducted with 10 MM patients and 9 caregivers. Thematic analysis was employed: interviews were audio-recorded, transcribed verbatim, and coded in order to identify the main recurring themes across the narratives. Results: We detected four different themes: (1) bodily symptoms and embodied emotions; (2) living in or near a National Priority Contaminated Site (NCPS); (3) "nothing is like it was" (that is, the impact of the diagnosis on everyday life, the changes it causes in the family relationships, the things that are still possible to do, the mourning process); (4) "what will become of us?" (that is, worries about the impact of the diagnosis on the beloved ones, death and legacy). Discussion: MM patients and caregivers seem to be stuck in a concrete mental functioning focused on symptoms and they find it difficult to openly think and talk about the affective and emotional consequences of the diagnosis. Alongside this, they express the need to find new and less conflictual ways to stay together and talk to each other during the period of active treatments for the illness (i.e., chemotherapy, radiotherapy, etc) and the end-of-life. The results of this study have important implications for the clinical management of MM and can help develop multi-professional specialist interventions addressed to both patients and caregivers.
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Affiliation(s)
| | | | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | | | - Federica Grosso
- Interdepartmental Functional Unit for Malignant Mesothelioma, SC Oncology, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
- S Spirito Hospital, Casale Monferrato, Italy
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27
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Nagaya M, Ito S, Fukui T, Inoue T, Kawaguchi K, Nakamura S, Nishida Y, Hasegawa Y, Yokoi K. Preoperative evaluation of six-minute walk test in patients with malignant pleural mesothelioma. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2017.1421007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Motoki Nagaya
- Department of Rehabilitation, Nagoya University Hospital, Nagoya 466-8550, Japan
| | - Satoru Ito
- Department of Rehabilitation, Nagoya University Hospital, Nagoya 466-8550, Japan
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
- Department of Respiratory Medicine and Allergology, Aichi Medical University, Nagakute 480-1195, Japan
| | - Takayuki Fukui
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Takayuki Inoue
- Department of Rehabilitation, Nagoya University Hospital, Nagoya 466-8550, Japan
| | - Koji Kawaguchi
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Shota Nakamura
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Yoshihiro Nishida
- Department of Rehabilitation, Nagoya University Hospital, Nagoya 466-8550, Japan
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Yoshinori Hasegawa
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Kohei Yokoi
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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28
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Brosseau S, Assoun S, Naltet C, Steinmetz C, Gounant V, Zalcman G. A review of bevacizumab in the treatment of malignant pleural mesothelioma. Future Oncol 2017; 13:2537-2546. [PMID: 29086616 DOI: 10.2217/fon-2017-0307] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive cancer with poor prognosis. Systemic chemotherapy is the primary treatment modality for the majority of patients. VEGF plays a key mitogen for MPM cells physiopathology. Bevacizumab, a monoclonal anti-VEGF antibody, was a rational approach to be tested in MPM. Based on the results of the Phase III IFCT-0701 mesothelioma avastin cisplatin pemetrexed study, cisplatin-pemetrexed-bevacizumab is now the accepted standard in France. The National Comprehensive Cancer Network guidelines have also included this combination as an option for standard front-line therapy. This review summarized the efficacy and safety data of bevacizumab in the treatment of patients with MPM.
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Affiliation(s)
- Solenn Brosseau
- Department of Thoracic Oncology & CIC 1425/CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France.,University Paris-Diderot, Paris, France
| | - Sandra Assoun
- Department of Thoracic Oncology & CIC 1425/CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - Charles Naltet
- Department of Thoracic Oncology & CIC 1425/CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - Christelle Steinmetz
- Pharmacy Department, Bichat-Claude Bernard Hospital, APHP, Paris, 46, rue Henri Huchard, 75877 Paris Cedex 18, France
| | - Valérie Gounant
- Department of Thoracic Oncology & CIC 1425/CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - Gérard Zalcman
- Department of Thoracic Oncology & CIC 1425/CLIP2 Paris-Nord, Bichat-Claude Bernard Hospital, APHP, Paris, France.,University Paris-Diderot, Paris, France
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29
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Zylla D, Steele G, Gupta P. A systematic review of the impact of pain on overall survival in patients with cancer. Support Care Cancer 2017; 25:1687-1698. [PMID: 28190159 DOI: 10.1007/s00520-017-3614-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 02/06/2017] [Indexed: 01/13/2023]
Abstract
PURPOSE Pain commonly occurs in cancer patients, and has been associated with shorter survival. However, the importance of pain is less clear when analyzed with other known prognostic variables. This systematic review was performed to better understand how pain impacts overall survival (OS) in common cancers when key clinical variables are included in multivariate analysis. METHODS A Medline search was completed to find studies examining the relationship between pain, clinical variables, and OS in patients with breast, colorectal, lung, or prostate cancer. Multivariate analysis included known prognostic variables including age, performance status, disease burden, and laboratory parameters. RESULTS Fifty studies met inclusion criteria. In patients with breast, colorectal, and lung cancer, pain was not a significant prognostic factor for OS on multivariate analysis in most studies. In contrast, several studies suggest that pain is an independent prognostic factor for OS in advanced prostate cancer, even when relevant clinical prognostic variables are included. However, analgesic use was often used as a surrogate for prostate cancer pain, making it difficult to determine whether pain or opioid exposure was more important in influencing survival. CONCLUSIONS Pain may be associated with shorter survival in patients with cancer, but the mechanism for this relationship is unknown. The available evidence is insufficient to definitively determine if pain independently influences survival in patients with breast, colorectal, or lung cancer. The majority of studies in prostate cancer show pain to be an independent prognostic factor for OS, and often also incorporate opioid analgesic use in multivariate analysis. Prospective studies are needed to better understand how opioid utilization and pain may affect cancer progression and survival in diverse malignancies.
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Affiliation(s)
- Dylan Zylla
- Division of Hematology/Oncology/Transplantation, Department of Medicine, University of Minnesota, 3931 Louisiana Ave S, Minneapolis, MN, 55426, USA. .,Park Nicollet Oncology Research and HealthPartners Institute, St. Louis Park, MN, USA.
| | - Grant Steele
- Park Nicollet Oncology Research and HealthPartners Institute, St. Louis Park, MN, USA
| | - Pankaj Gupta
- Division of Hematology/Oncology/Transplantation, Department of Medicine, University of Minnesota, 3931 Louisiana Ave S, Minneapolis, MN, 55426, USA.,Hematology/Oncology Section, Department of Medicine, Minneapolis VA Health Care System, Minneapolis, USA
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30
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Bibby AC, Tsim S, Kanellakis N, Ball H, Talbot DC, Blyth KG, Maskell NA, Psallidas I. Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment. Eur Respir Rev 2016; 25:472-486. [PMID: 27903668 PMCID: PMC9487555 DOI: 10.1183/16000617.0063-2016] [Citation(s) in RCA: 208] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 10/12/2016] [Indexed: 02/06/2023] Open
Abstract
Malignant pleural mesothelioma is an aggressive malignancy of the pleural surface, predominantly caused by prior asbestos exposure. There is a global epidemic of malignant pleural mesothelioma underway, and incidence rates are predicted to peak in the next few years.This article summarises the epidemiology and pathogenesis of malignant pleural mesothelioma, before describing some key factors in the patient experience and outlining common symptoms. Diagnostic approaches are reviewed, including imaging techniques and the role of various biomarkers. Treatment options are summarised, including the importance of palliative care and methods of controlling pleural effusions. The evidence for chemotherapy, radiotherapy and surgery is reviewed, both in the palliative setting and in the context of trimodality treatment. An algorithm for managing malignant pleural effusion in malignant pleural mesothelioma patients is presented. Finally new treatment developments and novel therapeutic approaches are summarised.
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Affiliation(s)
- Anna C Bibby
- Academic Respiratory Unit, University of Bristol, Bristol ,UK
- North Bristol NHS Trust, Bristol, UK
| | - Selina Tsim
- Queen Elizabeth University Hospital, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Nikolaos Kanellakis
- Respiratory Trials Unit, University of Oxford, Churchill Hospital, Oxford, UK
- Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, UK
| | - Hannah Ball
- Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, UK
- Dept of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Denis C Talbot
- Dept of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Kevin G Blyth
- Queen Elizabeth University Hospital, Glasgow, UK
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Nick A Maskell
- Academic Respiratory Unit, University of Bristol, Bristol ,UK
- North Bristol NHS Trust, Bristol, UK
| | - Ioannis Psallidas
- Respiratory Trials Unit, University of Oxford, Churchill Hospital, Oxford, UK
- Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, UK
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31
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Özyürek BA, Özmen Ö, Özdemirel TŞ, Erdoğan Y, Kaplan B, Kaplan T. Relation between neutrophil/lymphocyte ratio and primary tumor metabolic activity in patients with malign pleural mesothelioma. CLINICAL RESPIRATORY JOURNAL 2016; 12:646-651. [PMID: 27768834 DOI: 10.1111/crj.12574] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 10/04/2016] [Accepted: 10/16/2016] [Indexed: 11/26/2022]
Abstract
The aim of this study was to evaluate the relationship of the pre-treatment blood neutrophil/lymphocyte count ratio (NLR) with the maximum standard uptake value (SUVmax) of primary masses on positron emission tomography/computed tomography (PET/CT) taken before treatment in patients diagnosed with malignant pleural mesothelioma (MPM) and to evaluate the contribution to prognosis. A retrospective evaluation was made of 73 patients diagnosed with MPM in our hospital between January 2006 and January 2014. The SUVmax value of the primary mass on pre-treatment PET/CT, the haemogram parameters (Hb, Hct, NLR, MPV, PLT) at the time of diagnosis, the progression history, the date of the final visit, and the date of death of exitus patients was recorded from patient files PET/CT. The study group comprised 37 males (50.7%) with a mean age of 56.1 ± 11.4 years. The median survival time of these patients was 13 months. The survival time of the patient group aged <55 years was significantly longer (P = .006). Although the survival time of patients with NLR < 3 and SUVmax < 5 was longer, the difference was not statistically significant (P = .63, P = 0.08). A statistically significant difference was determined between the mean (or median) SUVmax values of the patient groups with NLR < 3 and NLR ≥3 (P = .019) with the SUVmax value of the NLR < 3 group found to be low. In conclusion, in patients with MPM, NLR ≥3 and high SUVmax values at the time of diagnosis can be considered an indicator of poor prognosis but are not a guide in the prediction of progression.
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Affiliation(s)
- Berna Akıncı Özyürek
- Chest Diseases Clinic, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Özlem Özmen
- Nuclear Medicine Clinic, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Tuğçe Şahin Özdemirel
- Chest Diseases Clinic, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Yurdanur Erdoğan
- Chest Diseases Clinic, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
| | - Bekir Kaplan
- TC Ministry of Health, General Directorate of Health Research, Ankara, Turkey
| | - Tuğba Kaplan
- Chest Diseases, Ulus State Hospital, Ankara, Turkey
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Eser S, Göksel T, Erbaycu AE, Baydur H, Başarık B, Yanık AÖ, Gürsul KK, Çelik P, Ediz EÇ, Hatipoğlu O, Yayla BA, Başer S, Eser E. Comparison of generic and lung cancer-specific quality of life instruments for predictive ability of survival in patients with advanced lung cancer. SPRINGERPLUS 2016; 5:1833. [PMID: 27818871 PMCID: PMC5074985 DOI: 10.1186/s40064-016-3492-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 10/07/2016] [Indexed: 01/22/2023]
Abstract
Background Our purpose is to examine the relationship of Health related quality of life measured by EORTC QLQc30, QLQ-LC13; FACT-L, LCSS, Eq5D) with survival in advanced lung cancer patients. A total of 299 Lung Cancer (LC) patients were, included in this national multicenter Project entitled of “the LC Quality of Life Project (AKAYAK). Baseline scores were analyzed by using Cox’s proportional hazard regression to identify factors that influenced survival. Univariate and multivariate models were run for each of the scales included in the study. Results Mean and median survival were 12.5 and 8.0 months respectively. Clinical stage (as TNM), comorbidity; symptom scales of fatigue, insomnia, appetit loss and constipation were associated with survival after adjustment for age and sex. Global, physical and role functioning scales of QLQc30; physical and functional scales of LCS and TOI of the FACT-L was also associated with survival. Mobility and Usual activities dimensions of the Eq5D; Physical functioning and the constipation symptom scale of the QLQ-c30; and LCS and TOI scores of the FACT-L remained statistically significant after adjustment. LC13 and LCSS scales were not predictors of survival. Conclusions HRQOL serves as an additional predictive factor for survival that supplements traditional clinical factors. Besides the strong predictive ability of ECOG on survival, FACT-L and the Eq5D are the most promising HRQOL instruments for this purpose.
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Affiliation(s)
- Sultan Eser
- Institute of Public Health, Hacettepe University, Ankara, Turkey
| | - Tuncay Göksel
- Department of Chest Diseases, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Ahmet Emin Erbaycu
- Dr. Suat Seren Chest Diseases and Thoracic Surgery Education and Research Hospital, İzmir, Turkey
| | - Hakan Baydur
- Department of Social Work, Faculty of Health Sciences, Celal Bayar University, Manisa, Turkey
| | - Burcu Başarık
- Department of Chest Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ayşen Öz Yanık
- Department of Chest Diseases, Nevsehir State Hospital, Nevsehir, Turkey
| | - Kader Kıyar Gürsul
- Dr. Suat Seren Chest Diseases and Thoracic Surgery Education and Research Hospital, İzmir, Turkey
| | - Pınar Çelik
- Department of Chest Diseases, School of Medicine, Ege University, İzmir, Turkey
| | - Ebru Çakır Ediz
- Department of Chest Diseases, School of Medicine, Trakya University, Edirne, Turkey
| | - Osman Hatipoğlu
- Department of Chest Diseases, School of Medicine, Trakya University, Edirne, Turkey
| | - Bedriye Atay Yayla
- Department of Chest Diseases, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Sevin Başer
- Department of Chest Diseases, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Erhan Eser
- Department of Public Health (Halk Sağlığı AD), School of Medicine (Tıp Fak), Celal Bayar University, 45040 Manisa, Turkey
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Tanrikulu AC, Abakay A, Komek H, Abakay O. Prognostic value of the lymphocyte-to-monocyte ratio and other inflammatory markers in malignant pleural mesothelioma. Environ Health Prev Med 2016; 21:304-311. [PMID: 27068290 PMCID: PMC5305982 DOI: 10.1007/s12199-016-0530-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 03/29/2016] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Inflammation plays a role in malignant pleural mesothelioma (MPM) prognosis and symptoms. We investigated the roles of the new and old inflammatory indexes and markers in MPM prognosis. METHODS Two hundred and ninety-two MPM patients (167 male and 125 female) were included in this retrospective study. Demographic parameters were collected from the patients' files. Kaplan-Meier curves and multivariate Cox regression analyses were used for the analysis of prognosis. RESULTS The mean age of the patients was 58.4 years. The mean survival time was 14.6 ± 13.0 months. Twenty-four potential prognostic factors associated with a poor outcome were calculated in the univariate analysis, and 16 potential prognostic factors were associated with a poor prognosis. These 16 potential prognostic factors were also analyzed in multivariate analysis. Multivariate analysis showed that increased age, stage 3-4 disease, the non-epithelial type, a low Karnofsky performance score, a high white blood cell count, and a low lymphocyte-to-monocyte ratio (LMR) were associated with a poor prognosis. The results of the multivariate analysis showed that a decreased LMR was associated with poor survival. Patients with LMR ≤2.6 had poor survival compared with those with LMR >2.6 (mean 9.6 vs. 17.0 months, respectively; p = 0.004). CONCLUSIONS LMR is an independent marker of prognosis in patients with MPM and is superior to the other inflammation-based markers. The inexpensive nature and easy reproducibility of the hemogram should encourage the use of the LMR in clinical practice.
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Affiliation(s)
| | - Abdurrahman Abakay
- Department of Chest Diseases, Medical School of Dicle University, Diyarbakir, Turkey.
| | - Halil Komek
- Department of Nuclear Medicine, Diyarbakir Education and Training Hospital, Diyarbakir, Turkey
| | - Ozlem Abakay
- Department of Chest Diseases, Medical School of Dicle University, Diyarbakir, Turkey
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Bates GE, Hashmi AK, Bressler T, Zajac J, Hesdorffer M, Taub RN. Approach to offering remote support to mesothelioma patients: the mesothelioma survivor project. Transl Lung Cancer Res 2016; 5:216-8. [PMID: 27413697 DOI: 10.21037/tlcr.2016.05.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND From the moment of diagnosis, malignant mesothelioma (MM) decreases health-related quality of life (QOL) in patients and their caregivers. In addition to symptoms of disease, aggressive treatments such as surgery, radiation, and chemotherapy can cause extreme side effects-chemotherapy specifically is associated with chronic fatigue, unremitting nausea, vomiting, and systemic pain. These side effects of treatments can be burdensome enough to lead to noncompliance or outright refusal of continuation of care. METHODS The platform for the support group was remote, consisting of online and telephone domains. Participants would utilize both online and phone systems during sessions held once a week for a total of six weeks. Sessions were guided and kept closed, available only to those affected by mesothelioma. Follow-up information and session summaries were provided online after support meetings. RESULTS Using a 0-5 Likert Scale, consistent attendees reported support groups as very helpful. Irregular attendees had mixed feelings ranging from extremely helpful to neutral. Eighty per cent of attendees participated in support groups prior to this project. CONCLUSIONS Active participation in a guided and closed support group allowed participants to share their experiences and concerns about their diagnoses comfortably, supporting transition beyond active-treatment. Online space gave participants a place to provide more reflective responses outside the main dialogue of support sessions.
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Affiliation(s)
- Gleneara E Bates
- 1 Division of Medical Oncology Hematology, Department of Medicine, Columbia University Medical Center, New York, NY, USA ; 2 Mesothelioma Applied Research Foundation, Alexandria, VA, USA ; 3 Maimonides Medical Center, Brooklyn, NY, USA
| | - Anisah K Hashmi
- 1 Division of Medical Oncology Hematology, Department of Medicine, Columbia University Medical Center, New York, NY, USA ; 2 Mesothelioma Applied Research Foundation, Alexandria, VA, USA ; 3 Maimonides Medical Center, Brooklyn, NY, USA
| | - Toby Bressler
- 1 Division of Medical Oncology Hematology, Department of Medicine, Columbia University Medical Center, New York, NY, USA ; 2 Mesothelioma Applied Research Foundation, Alexandria, VA, USA ; 3 Maimonides Medical Center, Brooklyn, NY, USA
| | - Jill Zajac
- 1 Division of Medical Oncology Hematology, Department of Medicine, Columbia University Medical Center, New York, NY, USA ; 2 Mesothelioma Applied Research Foundation, Alexandria, VA, USA ; 3 Maimonides Medical Center, Brooklyn, NY, USA
| | - Mary Hesdorffer
- 1 Division of Medical Oncology Hematology, Department of Medicine, Columbia University Medical Center, New York, NY, USA ; 2 Mesothelioma Applied Research Foundation, Alexandria, VA, USA ; 3 Maimonides Medical Center, Brooklyn, NY, USA
| | - Robert N Taub
- 1 Division of Medical Oncology Hematology, Department of Medicine, Columbia University Medical Center, New York, NY, USA ; 2 Mesothelioma Applied Research Foundation, Alexandria, VA, USA ; 3 Maimonides Medical Center, Brooklyn, NY, USA
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Nutrition, exercise, and complementary medicine: potential role in mesothelioma? CURRENT PULMONOLOGY REPORTS 2016. [DOI: 10.1007/s13665-016-0133-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Avelino CUR, Cardoso RM, Aguiar SSD, Silva MJSD. Assessment of quality of life in patients with advanced non-small cell lung carcinoma treated with a combination of carboplatin and paclitaxel. J Bras Pneumol 2015; 41:133-42. [PMID: 25972967 PMCID: PMC4428850 DOI: 10.1590/s1806-37132015000004367] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 12/12/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE: Non-small cell lung carcinoma (NSCLC) is the most common type of lung cancer. Most patients are diagnosed at an advanced stage, palliative chemotherapy therefore being the only treatment option. This study was aimed at evaluating the health-related quality of life (HRQoL) of advanced-stage NSCLC patients receiving palliative chemotherapy with carboplatin and paclitaxel. METHODS: This was a multiple case study of advanced-stage NSCLC outpatients receiving chemotherapy at a public hospital in Rio de Janeiro, Brazil. The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire was used in conjunction with its supplemental lung cancer-specific module in order to assess HRQoL. RESULTS: Physical and cognitive functioning scale scores differed significantly among chemotherapy cycles, indicating improved and worsened HRQoL, respectively. The differences regarding the scores for pain, loss of appetite, chest pain, and arm/shoulder pain indicated improved HRQoL. CONCLUSIONS: Chemotherapy was found to improve certain aspects of HRQoL in patients with advanced-stage NSCLC.
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Affiliation(s)
- Camila Uanne Resende Avelino
- José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil. Multiprofessional Residence Program in Oncology, José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil
| | - Rafael Marques Cardoso
- José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil. Chemotherapy Center, Cancer Hospital I, José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil
| | - Suzana Sales de Aguiar
- José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil. Department of Clinical Epidemiology, José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil
| | - Mário Jorge Sobreira da Silva
- José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil. José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil
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Koller M, Warncke S, Hjermstad MJ, Arraras J, Pompili C, Harle A, Johnson CD, Chie WC, Schulz C, Zeman F, van Meerbeeck JP, Kuliś D, Bottomley A. Use of the lung cancer-specific Quality of Life Questionnaire EORTC QLQ-LC13 in clinical trials: A systematic review of the literature 20 years after its development. Cancer 2015; 121:4300-23. [PMID: 26451520 DOI: 10.1002/cncr.29682] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/24/2015] [Accepted: 07/02/2015] [Indexed: 12/19/2022]
Abstract
The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) covers 13 typical symptoms of lung cancer patients and was the first module developed in conjunction with the EORTC core quality-of-life (QL) questionnaire. This review investigates how the module has been used and reported in cancer clinical trials in the 20 years since its publication. Thirty-six databases were searched with a prespecified algorithm. This search plus an additional hand search generated 770 hits, 240 of which were clinical studies. Two raters extracted data using a coding scheme. Analyses focused on the randomized controlled trials (RCTs). Of the 240 clinical studies that were identified using the LC13, 109 (45%) were RCTs. More than half of the RCTs were phase 3 trials (n = 58). Twenty RCTs considered QL as the primary endpoint, and 68 considered it as a secondary endpoint. QL results were addressed in the results section of the article (n = 89) or in the abstract (n = 92); and, in half of the articles, QL results were presented in the form of tables (n = 53) or figures (n = 43). Furthermore, QL results had an impact on the evaluation of the therapy that could be clearly demonstrated in the 47 RCTs that yielded QL differences between treatment and control groups. The EORTC QLQ-LC13 fulfilled its mission to be used as a standard instrument in lung cancer clinical trials. An update of the LC13 is underway to keep up with new therapeutic trends and to ensure optimized and relevant QL assessment in future trials.
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Affiliation(s)
- Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Sophie Warncke
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Marianne J Hjermstad
- Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital and European Palliative Care Research Centre, Department of Cancer and Molecular Medicine, Norwegian University of Science and Technology, Norway
| | - Juan Arraras
- Oncology Departments, Navarra Hospital Complex, Pamplona, Spain
| | - Cecilia Pompili
- Division of Thoracic Surgery, St. James's University Hospital, Leeds, United Kingdom
| | - Amelie Harle
- The Christie National Health Service Foundation Trust, Manchester, United Kingdom
| | - Colin D Johnson
- University Surgical Unit, University Hospital Southampton, Hampshire, United Kingdom
| | - Wei-Chu Chie
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Christian Schulz
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Florian Zeman
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
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Arnold DT, Hooper CE, Morley A, White P, Lyburn ID, Searle J, Darby M, Hall T, Hall D, Rahman NM, De Winton E, Clive A, Masani V, Dangoor A, Guglani S, Jankowska P, Lowndes SA, Harvey JE, Braybrooke JP, Maskell NA. The effect of chemotherapy on health-related quality of life in mesothelioma: results from the SWAMP trial. Br J Cancer 2015; 112:1183-9. [PMID: 25756395 PMCID: PMC4385962 DOI: 10.1038/bjc.2015.77] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 01/25/2015] [Accepted: 02/01/2015] [Indexed: 12/19/2022] Open
Abstract
Background: The effect of chemotherapy on health-related quality of life (HRQoL) in malignant pleural mesothelioma (MPM) is poorly understood. Patient-individualised prognostication and prediction of treatment response from chemotherapy is useful but little evidence exists to guide practice. Method: Consecutive patients with MPM who were fit for first-line chemotherapy with pemetrexed and cisplatin\carboplatin were recruited and followed up for a minimum of 12 months. This study focussed on the HRQoL outcomes of these patients using the EQ-5D, EORTC QLQ-C30 and LC13. Results: Seventy-three patients were recruited of which 58 received chemotherapy and 15 opted for best supportive care (BSC). Compliance with HRQoL questionnaires was 98% at baseline. The chemotherapy group maintained HRQoL compared with the BSC group whose overall HRQoL fell (P=0.006) with worsening dyspnoea and pain. The impact of chemotherapy was irrespective of histological subtype although those with non-epithelioid disease had worse HRQoL at later time points (P=0.012). Additionally, those with a falling mesothelin or improvement on modified-RECIST CT at early follow-up had a better HRQoL at 16 weeks. Conclusions: HRQoL was maintained following chemotherapy compared with a self-selected BSC group. Once chemotherapy is initiated, a falling mesothelin or improved RECIST CT findings infer a quality-of-life advantage.
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Affiliation(s)
- D T Arnold
- Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Bristol BS10 5NB, UK
| | - C E Hooper
- 1] Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Bristol BS10 5NB, UK [2] North Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK
| | - A Morley
- North Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK
| | - P White
- Applied Statistics Group, University of West of England (UWE), Bristol BS16 1QY, UK
| | - I D Lyburn
- Cobalt Health, Thirlestaine Road, Cheltenham GL53 7AS, UK
| | - J Searle
- Cobalt Health, Thirlestaine Road, Cheltenham GL53 7AS, UK
| | - M Darby
- Department of Radiology, Southmead Hopsital, North Bristol NHS Trust, Bristol BS10 5NB, UK
| | - T Hall
- Department of Radiology, Royal United Hospital Bath, Bath BA1 3NG, UK
| | - D Hall
- Cobalt Health, Thirlestaine Road, Cheltenham GL53 7AS, UK
| | - N M Rahman
- Oxford Respiratory Clinical Trial Unit (Funded by the NIHR Biomedical Research Centre), Churchill Hospital, Oxford OX3 7LJ, UK
| | - E De Winton
- Department of Oncology, Royal United Hospital Bath, Bath BA1 3NG, UK
| | - A Clive
- Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Bristol BS10 5NB, UK
| | - V Masani
- Department of Respiratory Medicine, Royal United Hospital Bath, Bath BA1 3NG, UK
| | - A Dangoor
- Bristol Haematology and Oncology Centre, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8ED, UK
| | - S Guglani
- Department of Oncology, Cheltenham General Hospital, Cheltenham GL53 7AN, UK
| | - P Jankowska
- Department of Oncology, Musgrove Park Hospital, Taunton, Severn TA1 5DA, UK
| | - S A Lowndes
- Department of Oncology, Great Western Hospital, Swindon SN3 6BB, UK
| | - J E Harvey
- North Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK
| | - J P Braybrooke
- Bristol Haematology and Oncology Centre, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8ED, UK
| | - N A Maskell
- 1] Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Bristol BS10 5NB, UK [2] North Bristol Lung Centre, Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK
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Gunatilake S, Brims FJH, Fogg C, Lawrie I, Maskell N, Forbes K, Rahman N, Morris S, Ogollah R, Gerry S, Peake M, Darlison L, Chauhan AJ. A multicentre non-blinded randomised controlled trial to assess the impact of regular early specialist symptom control treatment on quality of life in malignant mesothelioma (RESPECT-MESO): study protocol for a randomised controlled trial. Trials 2014; 15:367. [PMID: 25238873 PMCID: PMC4180732 DOI: 10.1186/1745-6215-15-367] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 09/09/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Malignant pleural mesothelioma is an incurable cancer caused by exposure to asbestos. The United Kingdom has the highest death rate from mesothelioma in the world and this figure is increasing. Median survival is 8 to 12 months, and most patients have symptoms at diagnosis. The fittest patients may be offered chemotherapy with palliative intent. For patients not fit for systemic anticancer treatment, best supportive care remains the mainstay of management. A study from the United States examining advanced lung cancer showed that early specialist palliative care input improved patient health related quality of life and depression symptoms 12 weeks after diagnosis. While mesothelioma and advanced lung cancer share many symptoms and have a poor prognosis, oncology and palliative care services in the United Kingdom, and many other countries, vary considerably compared to the United States. The aim of this trial is to assess whether regular early symptom control treatment provided by palliative care specialists can improve health related quality of life in patients newly diagnosed with mesothelioma. METHODS This multicentre study is an non-blinded, randomised controlled, parallel group trial. A total of 174 patients with a new diagnosis of malignant pleural mesothelioma will be minimised with a random element in a 1:1 ratio to receive either 4 weekly regular early specialist symptom control care, or standard care. The primary outcome is health related quality of life for patients at 12 weeks. Secondary outcomes include health related quality of life for patients at 24 weeks, carer health related quality of life at 12 and 24 weeks, patient and carer mood at 12 and 24 weeks, overall survival and analysis of healthcare utilisation and cost. DISCUSSION Current practice in the United Kingdom is to involve specialist palliative care towards the final weeks or months of a life-limiting illness. This study aims to investigate whether early, regular specialist care input can result in significant health related quality of life gains for patients with mesothelioma and if this change in treatment model is cost-effective. The results will be widely applicable to many institutions and patients both in the United Kingdom and internationally. TRIAL REGISTRATION Current controlled trials ISRCTN18955704. Date ISRCTN assigned: 31 January 2014.
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Affiliation(s)
- Samal Gunatilake
- RESPECT Meso trial co-ordinator, Portsmouth Hospitals NHS Trust, Portsmouth, England.
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Kozlowski D, Provost SC, Tucker J, van der Zwan R. Dusted community: piloting a virtual peer-to-peer support community for people with an asbestos-related diagnosis and their families. J Psychosoc Oncol 2014; 32:463-75. [PMID: 24794734 DOI: 10.1080/07347332.2014.917142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Individuals with an asbestos-related diagnosis and their carers face burdens including debilitating and life-limiting physical symptoms and medico-legal stressors. Feelings of social isolation are common. Increasing social connectedness can lead to increased feelings of personal empowerment and may inhibit chronic stress responses. The authors report on the development, via a process of participatory action research, of an online peer-to-peer support group, and the first 30-day test phase of this virtual community. Initial indications are that individuals with an asbestos-related diagnosis and their carers can benefit, in psychosocial terms, from membership of an on-line support group comprised of experientially similar others.
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Affiliation(s)
- Desirée Kozlowski
- a Discipline of Psychology , Southern Cross University , Coffs Harbour , NSW , Australia
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Abakay O, Tanrikulu AC, Palanci Y, Abakay A. The value of inflammatory parameters in the prognosis of malignant mesothelioma. J Int Med Res 2014; 42:554-65. [DOI: 10.1177/0300060513504163] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Objective This study investigated the relationship between potential prognostic parameters that may be associated with increased inflammation and survival in patients with malignant mesothelioma (MM). Methods This retrospective study assessed potential prognostic parameters measured at the time of MM diagnosis. Data on asbestos exposure, histopathological subtype of MM and laboratory parameters were collected. Results In 155 patients with MM (90 male), mean survival time was 13.9 months. In univariate analysis, age ≥60 years and neutrophil-to-lymphocyte ratio (NLR) ≥3 were associated with significantly shortened median survival times. In multivariate analysis, nonepithelial subtype, red cell distribution width (RDW) ≥20% and NLR ≥3 were associated with significantly shortened median survival times. Mortality rate was increased 2.77-, 1.67- and 1.52-fold in patients with RDW ≥20%, NLR ≥3 and nonepithelial subtype, respectively. Nonepithelial subtype, white blood cell count ≥11 200 µl and platelet-to-lymphocyte ratio ≥300 at baseline were associated with a heightened NLR value. Conclusions The NLR and RDW were significant predictive factors for MM prognosis.
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Affiliation(s)
- Ozlem Abakay
- Department of Chest Diseases, Dicle University, Diyarbakir, Turkey
| | | | - Yilmaz Palanci
- Department of Public Health, Dicle University, Diyarbakir, Turkey
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Kao SCH, Clarke S, Vardy J, Corte P, Clarke C, van Zandwijk N. Patterns of care for malignant pleural mesothelioma patients compensated by the Dust Diseases Board in New South Wales, Australia. Intern Med J 2014; 43:402-10. [PMID: 22909129 DOI: 10.1111/j.1445-5994.2012.02925.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Accepted: 08/05/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND The silent epidemic of mesothelioma in Australia is steadily increasing, and 30% of cases occur in New South Wales (NSW). AIM To describe the patterns of care and outcomes of patients with malignant pleural mesothelioma (MPM) in NSW. METHODS MPM patients in NSW applying for compensation at the NSW Dust Diseases Board from 2007 to 2009 were included. Survival from time of diagnosis was determined by the Kaplan-Meier method. The Chi-squared test was used to determine if there was an association between utilisation of treatment and geographical location. RESULTS A total of 138 patients was included: median age was 72.5; 91.3% male; 60.1% epithelial subtype; and 65.2% lived in major cities. All patients had at least one chest X-ray and computed tomography scan, and 21% had a positron emission tomography scan; 93.5% and 4.3% had histological or cytological confirmation respectively. Thoracoscopy (59.4%) was the most commonly used diagnostic procedure. Treatment utilisation: 53.6% chemotherapy; 35.5% radiotherapy; 9.4% extrapleural pneumonectomy (EPP); and 72.5% had palliative care involvement. There were no major differences in treatment utilisation between patients living in major cities and those in regional NSW (chemotherapy P = 0.42; radiotherapy P = 0.13 and palliative care P = 0.60), except for a higher rate of EPP in regional patients (16.7% vs 5.6%; P = 0.03). Median survival was 9.7 versus 12.3 months for city and regional patients respectively (P = 0.22). CONCLUSION Survival and treatment utilisation was not significantly different between MPM patients living in major cities and regional NSW, except for a higher rate of EPP in patients in regional NSW.
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Affiliation(s)
- S C-H Kao
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia
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Mauer ME, Bottomley A, Coens C, Gotay C. Prognostic factor analysis of health-related quality of life data in cancer: a statistical methodological evaluation. Expert Rev Pharmacoecon Outcomes Res 2014; 8:179-96. [DOI: 10.1586/14737167.8.2.179] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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van Zandwijk N, Clarke C, Henderson D, Musk AW, Fong K, Nowak A, Loneragan R, McCaughan B, Boyer M, Feigen M, Currow D, Schofield P, Nick Pavlakis BI, McLean J, Marshall H, Leong S, Keena V, Penman A. Guidelines for the diagnosis and treatment of malignant pleural mesothelioma. J Thorac Dis 2013; 5:E254-307. [PMID: 24416529 PMCID: PMC3886874 DOI: 10.3978/j.issn.2072-1439.2013.11.28] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 11/25/2013] [Indexed: 12/24/2022]
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Linton A, van Zandwijk N, Reid G, Clarke S, Cao C, Kao S. Inflammation in malignant mesothelioma - friend or foe? Ann Cardiothorac Surg 2013; 1:516-22. [PMID: 23977546 DOI: 10.3978/j.issn.2225-319x.2012.10.02] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 10/17/2012] [Indexed: 12/29/2022]
Affiliation(s)
- Anthony Linton
- Asbestos Diseases Research Institute, Sydney, Australia; ; University of Sydney, Sydney, Australia; ; Department of Medical Oncology, Sydney Cancer Centre, Sydney, Australia
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Kao SC, Vardy J, Chatfield M, Corte P, Pavlakis N, Clarke C, van Zandwijk N, Clarke S. Validation of Prognostic Factors in Malignant Pleural Mesothelioma: A Retrospective Analysis of Data from Patients Seeking Compensation from the New South Wales Dust Diseases Board. Clin Lung Cancer 2013; 14:70-7. [DOI: 10.1016/j.cllc.2012.03.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 03/05/2012] [Accepted: 03/13/2012] [Indexed: 11/24/2022]
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Granieri A, Tamburello S, Tamburello A, Casale S, Cont C, Guglielmucci F, Innamorati M. Quality of life and personality traits in patients with malignant pleural mesothelioma and their first-degree caregivers. Neuropsychiatr Dis Treat 2013; 9:1193-202. [PMID: 23983468 PMCID: PMC3748052 DOI: 10.2147/ndt.s48965] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Asbestos exposure causes significant pleural diseases, including malignant pleural mesothelioma (MPM). Taking into account the impact of MPM on emotional functioning and wellbeing, this study aimed to evaluate the quality of life and personality traits in patients with MPM and their first-degree caregivers through the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF). The sample was composed of 27 MPM patients, 55 first-degree relatives enrolled in Casale Monferrato and Monfalcone (Italy), and 40 healthy controls (HC). Patients and relatives reported poorer physical health than the HC. Patients had a higher overall sense of physical debilitation and poorer health than relatives and the HC, more numerous complaints of memory problems and difficulties in concentrating, and a greater belief that goals cannot be reached or problems solved, while often claiming that they were more indecisive and inefficacious than the HC. First-degree relatives reported lower opinions of others, a greater belief that goals cannot be reached or problems solved, support for the notion that they are indecisive and inefficacious, and were more likely to suffer from fear that significantly inhibited normal activities than were HC. In multinomial regression analyses, partial models indicated that sex, physical comorbidities, and the True Response Inconsistency (TRIN-r), Malaise (MLS), and Behavior-Restricting Fears (BRF) dimensions of the MMPI-2-RF had significant effects on group differences. In conclusion, health care providers should assess the ongoing adjustment and emotional wellbeing of people with MPM and their relatives, and provide support to reduce emotional distress.
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Mollberg NM, Vigneswaran Y, Kindler HL, Warnes C, Salgia R, Husain AN, Vigneswaran WT. Quality of Life After Radical Pleurectomy Decortication for Malignant Pleural Mesothelioma. Ann Thorac Surg 2012; 94:1086-92. [DOI: 10.1016/j.athoracsur.2012.05.102] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 05/16/2012] [Accepted: 05/25/2012] [Indexed: 01/23/2023]
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Health-related quality of life and inflammatory markers in malignant pleural mesothelioma. Support Care Cancer 2012; 21:697-705. [PMID: 22936495 DOI: 10.1007/s00520-012-1569-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 08/13/2012] [Indexed: 12/29/2022]
Abstract
PURPOSE Malignant pleural mesothelioma (MPM) is a highly aggressive and symptomatic disease. We examined the relationship between health-related quality of life (HRQoL) and inflammatory markers, and the prognostic role of HRQoL in MPM patients. METHODS MPM patients from two parallel phase II studies (thalidomide alone or thalidomide with chemotherapy) were included. HRQoL was assessed at baseline using the modified Lung Cancer Symptom Scale (LCSS). Baseline inflammatory markers and cytokines were measured. Spearman correlation was used to examine the relationship between inflammatory markers and HRQoL measures. The prognostic value of the HRQoL domains was examined using Cox proportional hazard model. RESULTS Sixty-three patients were included: median age 61 years (range 44-79); 82% male; 77% Eastern Cooperative Oncology Group (ECOG) performance status 0-1; 44% epithelial histology subtype. Baseline systemic symptoms of anorexia and fatigue, the summation symptoms of overall symptomatic distress, interference with normal activity and global QoL and the aggregate score of total LCSS score were all associated with elevated neutrophil-to-lymphocyte ratio, C-reactive protein and vascular endothelial growth factor levels at baseline (rho ≥ 0.25; p < 0.05). Baseline anorexia, fatigue, cough, dyspnoea, pain, overall symptomatic distress, interference with normal activity, global QoL and total LCSS score were all significantly related to survival (p < 0.05) after adjusting for established prognostic factors (age, gender, histological subtype and performance status) and treatment effect. CONCLUSIONS In conclusion, HRQoL seems to relate to a patient's systemic inflammatory status and is associated with survival in MPM patients.
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Trajkovic-Vidakovic M, de Graeff A, Voest EE, Teunissen SCCM. Symptoms tell it all: a systematic review of the value of symptom assessment to predict survival in advanced cancer patients. Crit Rev Oncol Hematol 2012; 84:130-48. [PMID: 22465016 DOI: 10.1016/j.critrevonc.2012.02.011] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 02/14/2012] [Accepted: 02/29/2012] [Indexed: 12/31/2022] Open
Abstract
PURPOSE To determine the prognostic meaning of symptoms in patients with advanced cancer. DESIGN Medline, Embase, Cochrane and Cinahl databases were systematically explored. The predicting symptoms were also evaluated in the three stages of palliative care: disease-directed palliation, symptom-oriented palliation and palliation in the terminal stage. RESULTS Out of 3167 papers, forty-four papers satisfied all criteria. Confusion, anorexia, fatigue, cachexia, weight loss, cognitive impairment, drowsiness, dyspnea, dysphagia, dry mouth and depressed mood were associated with survival in ≥ 50% of the studies evaluating these symptoms. Multivariate analysis showed confusion, anorexia, fatigue, cachexia, weight loss, dyspnea and dysphagia as independent prognostic factors in 30-56% of the studies. In the stage of disease-directed palliation anorexia, cachexia, weight loss, dysphagia and pain and in the stage of symptom-oriented palliation confusion, fatigue, cachexia, weight loss, dyspnea, dysphagia and nausea were shown to be independent predictors of survival in >30% of the studies. CONCLUSION Symptoms with independent predictive value are confusion, anorexia, fatigue, cachexia, weight loss, dyspnea and dysphagia. New insights are added by the variance between the three palliative stages.
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Affiliation(s)
- Marija Trajkovic-Vidakovic
- Department of Medical Oncology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
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