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Nicolas Penel Sylvie Bonvalot Marie-Cécile Le Deley Antoine Italiano Camille Tlemsani Diane Pannier Clémence Leguillette Jean-Emmanuel Kurtz Maud Toulmonde Julien Thery Daniel Orbach Pascale Dubray-Longeras Benjamin Verret François Bertucci Cécile Guillemet Lucie Laroche Armelle Dufresne Jean-Yves Blay Axel Le Cesne 《International journal of cancer. Journal international du cancer》2023,153(2):407-416
The aim of this study is to evaluate the prevalence, determinants and prognostic value of pain at diagnosis in patients with desmoid-type fibromatosis (DF). We selected patients from the ALTITUDES cohort (NCT02867033), managed by surgery, active surveillance or systemic treatments, with pain assessment at diagnosis. Patients were invited to fill QLQ-C30 questionnaire and Hospital Anxiety Depression Scale. Determinants were identified using logistic models. Prognostic value on event-free survival (EFS) was evaluated using the Cox model. Overall, 382 patients were included in the current study (median age: 40.2 years; 117 men). The prevalence of pain was 36%, without significant difference according to first-line treatment (P = .18). In the multivariate analysis, pain was significantly associated with tumor size >50 mm (P = .013) and tumor site (P < .001); pain was more frequent in the neck and shoulder locations (odds ratio: 3.05 [1.27-7.29]). Pain at baseline was significantly associated with poor quality of life (P < .001), depression (P = .02), lower performance status (P = .03) and functional impairment (P = .001); we also observed a nonsignificant association with anxiety (P = .10). In the univariate analysis, baseline pain was associated with poor EFS; the 3-year EFS was 54% in patients with pain compared to 72% in those without pain. After adjustment for sex, age, size and line of treatment, pain was still associated with poor EFS (hazard ratio: 1.82 [1.23-2.68], P = .003). One third of recently diagnosed patients with DF experienced pain, especially those with larger tumors and neck/shoulder locations. Pain was associated with unfavorable EFS after adjustment for the confounders. 相似文献
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M.P. Pereira C. Zeidler T. Nau S. Bobko A.W.M. Evers S. Garcovich M. Gonalo J.A. Halvorsen J. Lambert F.J. Legat T. Leslie M. Metz L. Misery K. Nordlind A. Reich G. Schneider H. Stnder M. Streit J.C. Szepietowski J. Wallengren E. Weisshaar S. Stnder 《Journal of the European Academy of Dermatology and Venereology》2019,33(2):263-266
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Anne‐Grete Mrtson Anette Veringa Edwin R. van den Heuvel Martijn Bakker Daan J. Touw Tjip S. van der Werf Lambert F. R. Span Jan‐Willem C. Alffenaar 《Mycoses》2019,62(8):698-705
Posaconazole is indicated for prophylaxis and treatment of invasive aspergillosis. Therapeutic drug monitoring (TDM) of posaconazole is used to optimise drug exposure. The aim of this study was to analyse and describe the TDM practices and exposure of posaconazole tablets. Patients who received posaconazole for treatment or prophylaxis of fungal infections were included in the study. The following therapeutic window was defined: if concentration was low (<0.7 mg/L for prophylaxis or < 1.5 mg/L for treatment) or high (>3.75 mg/L), the hospital pharmacist provided the physician with dosage advice, which implementation to patient care was analysed. A longitudinal analysis was performed to analyse if different confounding variables had an effect on posaconazole concentrations. Forty‐seven patients were enrolled resulting in 217 posaconazole trough concentrations. A median of 3 (IQR 1‐7) samples was measured per patient. The median concentration was 1.7 mg/L (IQR 0.8‐2.7) for prophylaxis and 1.76 mg/L (IQR 1.3‐2.3) for treatment. Overall, 78 posaconazole concentrations were out of the therapeutic window. For 45 (54%) of these concentrations, a dosage change was recommended. In the longitudinal analysis, the laboratory markers and patient baseline variables did not have an effect on posaconazole concentrations. Adequate posaconazole exposure was shown in 64% (affected 28 patients) of the measured concentrations. TDM practice of posaconazole can be improved by increasing the implementation rate of dose recommendation by a multidisciplinary antifungal stewardship team. 相似文献